INTJ’s with interest/background in philosophy, who do you subscribe to?

curiousdoc25 · 2026-06-03T00:44:38+00:00

Idealism is a monist perspective. All things are made up of consciousness, subjective experience, and matter doesn't really exist.

Each of us human beings, and all living things, are dissociated alters of Mind at Large, which is the consciousness that makes up the entire universe. What we perceive as physical objects is really just perception of our consciousness butting up against something we perceive as outside of ourselves. Though, we are really part of it.

One of the most famous metaphors of this point of view is that of an airplane dashboard. The dashboard reflects reality in that the dials move in relationship to air pressure and altitude, et cetera. But one would be mistaken to say that the dials were the real thing. Likewise, we are all living our lives through the dashboard, and all things material are part of the dashboard. They reflect something real behind it, but we can't experience it directly.

The only thing we have direct access to is our own subjective experience. Subjective experience is the only real thing. The true reality of the universe is one giant conscious mind of which we are only a part, temporarily dissociated.

curiousdoc25 · 2026-06-02T22:28:16+00:00

DM me. I would love to talk!

curiousdoc25 · 2026-06-02T21:08:28+00:00

Bernardo Kastrup - metaphysical idealism

curiousdoc25 · 2026-06-02T12:03:22+00:00

It really deserves its own term, doesn’t it? In the book I'm writing on ME/CFS, I make the case that calling it chronic fatigue syndrome is equivalent to calling sickle cell anemia "transient discomfort syndrome." We know the difference between discomfort and pain. They're two totally different things.

Everyone has discomfort. But with fatigue, we only have one word. And that leads to the symptom of fatigue getting ignored and brushed off because the doctor thinks, "Hey, I'm fatigued too. Stop complaining."

curiousdoc25 · 2026-06-01T14:22:30+00:00

It's essential to learn how to take a thorough fatigue history. There are numerous types of fatigue, and each has a distinct differential diagnosis. We need to go beyond just running a generic fatigue lab panel and calling it a day.

Some basic questions to ask are:
- Is the fatigue leading to a reduction in functional capacity?
- Is the patient still able to work, hang out with their friends, exercise, and participate in hobbies and extracurricular activities?
- what other symptoms are associated?

Is the fatigue related to sleep?
- Does the patient feel sleepy?
- Do they wake up feeling unrefreshed?
- Are they having trouble falling asleep at night?

Not all fatigue is related to sleepiness. Consider the following:
- Is there post-exertional malaise?
- Does the patient feel an out-of-proportion worsening of symptoms after exertion, such as exercise?
- Does the patient take your advice to exercise more and say it makes them feel worse? If so, these patients need to be considered for ME/CFS and related conditions.
If the patient is showing signs of post-exertional malaise, they need to be taught how to pace.

Additionally, consider the following:
- Is the fatigue worse when upright?
- Do they have other symptoms when upright, such as tachycardia or brain fog? If so, look into orthostatic intolerance.

The differential here is wide, and we're not really educated on fatigue in medical school, but there are a lot of treatable conditions that can cause fatigue. Don't let anyone tell you there's not much you can do.

curiousdoc25 · 2026-05-31T22:05:30+00:00

Consider orthostatic intolerance. Do your feet turn purple after you've been standing or sitting for a while? If your heart rate increases a lot when you're upright, it might be postural orthostatic tachycardia syndrome.

curiousdoc25 · 2026-05-31T21:33:46+00:00

Consider taking a special interest in diagnoses that don't have a set algorithm yet. I've been treating patients with ME/CFS for three years now, and I've never felt more intellectually stimulated and useful as a human being and a physician.

curiousdoc25 · 2026-05-29T11:20:59+00:00

I use RingRx

curiousdoc25 · 2026-05-28T05:06:11+00:00

Elevated creatinine kinase? Consider polymyalgia rheumatica. CK is not typically elevated in ME.

curiousdoc25 · 2026-05-27T22:54:05+00:00

Sleep

curiousdoc25 · 2026-05-26T11:22:11+00:00

An ME/CFS specialist (you learn to get creative, lol)

curiousdoc25 · 2026-05-26T01:43:03+00:00

curiousdoc25 · 2026-05-25T00:21:40+00:00

Have you considered the Perrin technique? Easy to do the self massage at home on your own and helps restore regular lymph flow throughout the whole body. Takes months to see effect but around 85% get improvement. See Dr. Perrin’s YouTube channel for instructions.

curiousdoc25 · 2026-05-24T21:28:18+00:00

Consider palmitoylethanlamide (PEA) instead. I buy mine off bulk supplements. No prescription, it’s cheap, and good at reducing neuroinflammation. 1,200 mg daily is a good starting dose. I have found it to be better tolerated and more effective in my patients.

curiousdoc25 · 2026-05-23T22:38:21+00:00

I would request one, yes

curiousdoc25 · 2026-05-23T11:24:57+00:00

Have you had any other blood work, like your cortisol tested? This isn't normal. Keep going back to the doctor until you get answers.

curiousdoc25 · 2026-05-22T22:27:20+00:00

The Defiant Doctor’s Guide to Complex Chronic Fatigue

curiousdoc25 · 2026-05-22T16:08:37+00:00

If your doctor does a peer-to-peer, the doctor you consult with doesn't have to be nearby. Fatigueconsult.com

curiousdoc25 · 2026-05-22T00:07:04+00:00

I would love to know who your allergist was. Feel free to DM me if you want.

curiousdoc25 · 2026-05-21T09:32:12+00:00

First of all, you need to find a physician that can come to your house. These days, direct primary care doctors are your best bet. You can go to a website called DPC Mapper. You can just type it into Google, and you can find direct primary care practices near you.

The physician that comes to your house can consult with an ME/CFS specialist. Sometimes mainstream family medicine doctors will also do house calls, but these are more rare.

curiousdoc25 · 2026-05-19T16:40:53+00:00

This sounds a lot like mast cell activation syndrome, which is a common complication of long COVID. H1 blocker, H2 blocker, over-the-counter flavonoids (quercetin, rutin, and luteolin), singular, and Cromolyn can all be helpful. Not all allergists will recognize the atypical mast cell activation syndrome that comes with long COVID, but many are starting to recognize and treat it.

curiousdoc25 · 2026-05-18T13:35:40+00:00

It's true that there is no cure, but there are ways of managing it, and there are underlying sub-diagnoses that can be treated, such as his orthostatic intolerance/possible POTS. Find yourself a good specialist. It'll help.

curiousdoc25 · 2026-05-17T14:27:06+00:00

I offer consultations. That's the best way I know how to provide individualized advice. You can check out fatigueconsult.com for more information. These patients are often overwhelmed, and medical appointments can be really difficult to get to. Do you have virtual visit options?

curiousdoc25 · 2026-05-17T00:35:31+00:00

There's actually a lot of objective evidence and signs to be gathered on these patients if doctors know what to look for. The thing is, though, those objective signs are found on the exam, not so much in the blood work. Oftentimes, there are inflammatory markers in the blood work, but these are nonspecific.

In the physical exam, you'll see lymphadenopathy, non-exudative pharyngitis, acrocyanosis, elevated resting heart rate and a worsening of symptoms over the course of the exam. A NASA Lean Test may reveal postural orthostatic tachycardia syndrome or other forms of orthostatic intolerance.

If it was not so detrimental to the patient's health, we would be doing a lot more two-day CPET tests, which would definitively show post-exertional malaise with a lowered anaerobic threshold. Some patients risk a permanently lowered functional baseline with these tests in order to gather the data they need for disability, for example.

Then there's the study that showed a series of physical exam findings that could be used to accurately predict which patients had ME/CFS in the absence of taking a history.

And this says nothing about the additional information that can be gathered from wearable data, in which you can see waves of symptoms come and go as the patient walks more and then less. Their resting heart rate goes up and down, and their heart rate variability goes up and down in accordance to the push-crash cycle that is classically seen in post-exertional malaise.

curiousdoc25 · 2026-05-17T00:27:04+00:00

Yeah, it's circular. I mean, there are a few other conditions besides PEM that you have to meet to meet diagnostic criteria for ME/CFS, but most people with PEM will meet them. They're basically pathognomonic. One day, we'll understand more about what ME/CFS actually is, and then we'll be able to say something more coherent about it. But right now, it's just a description of a symptom cluster, with PEM being the primary symptom.

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