Would you intentionally cause a crash or PEM prior to a medical assessment?

  • Some of us might need to see an independent medical expert or get a functional assessment at some point. My huge fear is that if I’m on a day where I’m feeling slightly better, I would not look like the totally incapacitated person that I am, because I can still walk a short distance and sit upright for a period of time - especially in the mornings before my energy is totally gone. I suppose even though I know I can not do much and not even live independently, I fear that won’t be enough for NdIS etc.

    So my question seems totally unethical for sure - but it’s something that occurred to me and probably naturally so after the horrible time I’ve had going through medical practitioners as we can all imagine .

    FYI I would in no way actually endorse anyone else causing their own crash 😞

  • I found (it is a while since I have had assessments) that there is no point. The assessor read my reports, listened to my symptoms and answers to questions and assessed me on them.
    Even on a good day I need to clarify my needs eg not standing, and on a bad day I can be slightly feverish and have good colour and bright eyes.
    In fact I'd say try and be at your best, so you can listen to questions better and answer them more sensibly. For me this means resting before hand, making sure I am hydrated, trying to get the timing right so I am not waiting too long. (I always fail so I end up crashing anyway).

  • I have actually done this. Not for the purposes of an NDIS assessment, but in order for certain abnormalities to show up on tests (arrhythmias for a Holter monitor). I've recently started seriously considering doing the 2-day CPET so that I have incontrevertible proof of my illness; I am running out of patience and energy explaining to people that exercise is dangerous for me. I also have a burning curiosity about what my results would be. And based on current research, the CPET results would be able to prove that I have ME/CFS and not any other disease, as the CPET results for people with ME/CFS are unique.

    I obviously do not condone anyone else doing this. It is self-harm, really.

    I tend to agree with Dot that if you need to socially interact it is actually better to be functioning at your best cognitively.

  • Years ago, I actually had a Dr recommend to me to not be 'too well' for an assessment i had.

    They weren't encouraging me to be dishonest. They simply understood the nature of my condition more than I did, and what they HAD meant was that the assessor had to be able to see me, if not at my worst, then really they had to see the impairment.

    some days i really do 'pass' as normal. it really can be an 'invisible' illness. for the person outside, looking in, that is.

    for me, i personally wouldn't trigger a full blown flare because that is just way too extreme and scary for me, and do what i can in my power to avoid/prevent that. i wouldn't be able to make it to an assessment of any sort, let alone be able to communicate and think clearly. and the PEM/recovery would be brutal. (I cling to whatever independence i do have)

    i would be discerning with how you go about this, if you choose to. Like river said, it is self harm, really. only you know your limits. but it can be very frustrating going to a dr and then it happens to be that day your symptoms are not showing up.

    I hope you find your best way moving forward

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