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Karina Hansen news (updated: her guardian is discharged)* + a battle with NICE (the UK’s National Institute for Health and Care Excellence)

September 28, 2018

[NOTE: a brief personal update

Last year I went to live abroad. I wrote about this change in my February 2017 post PAUSE-REVIEW-REFLECT: towards a bigger picture? [revised version . As of September 2018, I am now UK-based again. While I was away, I continued my work assisting and advising members of the international myalgic encephalomyelitis (ME) community, in addition to the general research work which I have been doing for many years, some of which is reflected in this blog. My work goes on although it remains severely limited by health problems (I have lived with ME since 1981).]


* KARINA HANSEN NEWS – updated 10 October

On 26 September 2018, a further court hearing took place in the case of Karina Hansen. Karina is a young Danish woman with severe ME who was forcibly removed from her family home by the state authorities and confined to an institution as a de facto psychiatric patient for three and a half years. She was eventually allowed to return home in October 2016. However, the local court had appointed a guardian in her case, because of misplaced concerns regarding her capacity to make decisions about her own health and finances.

The 26 September hearing was to determine whether or not the guardian should continue in his role or be discharged by the court. As often happens at court, the matter was adjourned until 10 October.

On 10 October, the court finally discharged the guardian from his duties in relation to Karina.

Karina has now finally regained control of her own health and financial affairs

For full details and the background to her story, see my previous post at Karina Hansen 8 (updated): the aftermath continues The full list of articles about Karina can be found in the Karina Hansen category in the sidebar of this blog.



(This is quite long, at slightly over 4500 words, but it falls naturally into shorter subsections so I hope that the brain-fogged among us – of which I am one – will be able to read it in stages. That is how I had to write it).

NICE is the UK body which “provides national guidance and advice to improve health OtVmgpckQr25e6Xxl%PU8Aand social care.” It was first created in 1999. NICE issues guidelines on the diagnosis, treatment and management of a range of illnesses. The last set of guidelines for ME (or “Myalgic encephalomyelitis (or encephalopathy)/chronic fatigue syndrome” as it is currently calling the condition) was issued in 2007. This was a problematic time for the ME community, not least because of the failure of a judicial review (JR) of the CFS/ME [sic] guidelines review process. The JR was launched by two community activists and concluded unhappily in 2009.

The 2007 guidelines were due for update in 2017 but, initially, that review was postponed. Following pressure from the ME community, this decision was reversed and an update is now ongoing with the new guidelines expected in October 2020.

Some background observations

Earlier this year, I had an email discussion about the NICE process with another member of the ME community. In order to put a context around my subsequent exchanges with NICE (below), I’m copying some extracts from that discussion (my emails only, slightly edited for clarity):

February 2018  (in response to some questions)

The current incarnation of NICE was created by statute, the Health and Social Care Act 2012 (HSCA). It is governed by its own process as set out in the manual. There is very little flexibility about what it can do and how it can do it. NICE is not governed by any one specific area of law but by general public and administrative law practice and procedure, as are all public bodies. Likewise, the status of stakeholder has no legal basis as such. Any attempt to try a novel legal approach [on the process] would be risky in terms of costs and outcome.

Professor Mark Baker [the then outgoing Director of the Centre for Guidelines at NICE] will not be able to make any undertakings or commitments. That would be beyond his discretion and outside the scope of the NICE process. Even if he could, he could not bind any successor. It’s necessary to understand that, even if anyone at NICE did want to “help” the ME community more, they do not (officially) have the power to do so ie. even if they did, they would not be able to say so publicly.

I am the first to argue that ME patients merit special treatment, given the way we have been treated over many decades. However, the NICE process isn’t going to fix that. Without the benefit of a comprehensive, proactive/reactive media strategy aimed at radically changing the perception of both patients and illness (which would take a while) this will be a slow process [emphasis added].

Whether or not it’s worth engaging in the NICE process is an impossible question. I have argued that we needed an expedited review to prevent further harm [by continuing the current treatment recommendations] but the amount it can achieve is limited, as is the role of stakeholders. Trying to get NICE to accommodate the demands of the community won’t work. However, even if a mass walkout of patient groups could be organised, that just leaves the review in the hands of unhelpful others. On balance, I think it’s better to be part of it but to keep expectations realistic.

That said, there is always room for appropriate direct action by patient groups, so that voices are heard and concerns raised. Unfortunately, our reputation precedes us (crazy/hostile/angry/dangerous/unreasonable etc. etc.) and that isn’t a good starting point.

As I said in [a recent] blog post – “The exhortation to “speak truth to power” has become a commonly used slogan. The actual use of this concept to achieve real results is a complicated and nuanced process, especially if those doing the speaking are themselves without power.” Until we can change that [see reference to “media strategy” above], progress will continue to be painfully slow.

And later:

March 2018

The NICE manual on developing guidelines is here The relevant part of the HSCA on NICE (section 232 onwards) is here It creates the power for NICE to carry out its statutory functions and sets out the usual duties/standards etc.

NICE has very broad statutory powers and is a self-regulating public body. This means that it would have to act very “irrationally” (in the legal sense) for any of its actions to be susceptible to challenge. This is quite normal for bodies of this nature and is to allow them a broad discretion in which to operate.

In a nutshell, NICE writes its own rules and marks its own homework. That said, I wouldn’t necessarily dismiss everyone connected with it out of hand. Obviously, I remain sceptical – but not everyone is a bad guy. However, as I said before, those who work for NICE have very little discretion in what they can do as they are bound by the process.

The main purpose of section 232 was to bring social care under NICE along with health. Presumably this was for political expediency – more commonly known as other ways in which we can cut costs and screw patients/those needing social care.

[apologies for the language but sometimes it’s necessary to call a spade a spade…]

The battle begins

NICE appears to encourage community engagement by inviting interested organisations to register as stakeholders in the guidelines update process. Because of the particular work which I have done over the many years, I applied to become a stakeholder for the “ME/CFS” review process under the “Organisations that fund or carry out research” category. This was in May 2018. (My application was much later than I had intended as a result of other life events intervening).

My application was duly accepted. In July, I checked the newly-updated list of stakeholders but could not find my organisation, Law and Health (the sub-heading of this blog since 2012) listed. I queried this with NICE and received the somewhat alarming reply below (note that there are some redactions in this correspondence because of data protection requirements). I apologise for the chaotic formatting which, despite my best efforts, falls apart from this point on:

NICE to me – 25 July 2018

We currently have you registered on our stakeholder list under the Queen Mary University of London name. This is because this organisation meets our criteria to be a registered stakeholder as we accept universities as stakeholders on our guidelines.
If you wish to be registered under the Law and Health organisation title instead, we would need you to re-register through our website as a stakeholder under this organisation name. Please be advised however that we would require proof with your registration that this organisation has a national remit and meets our criteria outlined on our website.  
If you are happy to stay registered under the Queen Mary University of London name, we are happy to accept any consultation comments from you and formally respond to each of these comments. However, please be advised that should your Law and Health organisation be judged to not meet our criteria, we will now not be able to formally respond to any comments you submit. We can only respond to comments from registered stakeholders which you currently are.
I was rather stunned by this news (many readers will recall that QMUL was the public authority responsible for withholding information about the controversial PACE trial of treatments for Chronic Fatigue Syndrome [sic]). Initially, I decided to take the line of least resistance and leave things as they were. However, within a few days, I had become extremely troubled by what NICE had done so I replied as follows:

My reply to NICE – 1 August

I have given some further thought to our recent email exchange and would like to raise the following points:
  1. I applied to register as a stakeholder under the banner of my organisation “Law and Health”. The notification that my application had been successful did not explain that this had been changed and I was now registered as a QMUL stakeholder. This was a unilateral change made without consultation or agreement and the notification was therefore misleading.
  2. Law and Health is a small organisation but, to the best of my knowledge, no other UK organisation covers this area. Its remit is to research due process as it relates to medical issues, particularly “ME/CFS”. Some of its work is reflected on the website (link below) but there is also ongoing work providing advice and assistance to other groups and individuals. This work is not publicly visible. To continue the work, I need access to as much information as possible regarding governmental, quasi- and non-governmental bodies. This is why I applied to register as a stakeholder under the Law and Health banner.
  3. I have no mandate to speak for QMUL regarding the NICE guidelines review. QMUL is aware of my work on “ME/CFS” and I use my academic address because it gives me greater access to research materials. However, I would be unable to comment on behalf of QMUL on NICE issues as my academic status there does not relate to this area
  4. I realise that the current round of comments on the current review has just closed. However, I would like the option of commenting later on in the process and to continue to receive the relevant documentation as a legitimate stakeholder.
I would be grateful if you would clarify how this situation came about, that I was registered under a different organisation from the one under which I applied and then not told of the change or given the chance to make further representations.
I would not expect to have to submit a further application as my first one should stand on its own merits in conjunction with the additional information I have provided here.
NICE to me – 10 August
Sorry for the delayed response. I have spoken with my colleagues in the Public Involvement Programme and we would unfortunately not be able to accept your Law and Health organisation as a valid stakeholder. Within our criteria we unfortunately cannot accept individuals, blogs or local/regional organisations as stakeholders. Our stakeholders must be a national organisation with a national remit and we believe that we currently have a few large national organisations registered on our stakeholder list that cover the same remit as yourselves.
We would recommend that you check our stakeholder list for this ME/CFS topic for an organisation that can represent your interests. Once you have found an organisation that shares the same remit as yourself, we would advise approaching this organisation to ask if you can submit any comments to them during our next consultation period. We would then be able to formally respond to your comments once they are submitted through this registered stakeholder.
You will also be able to submit any comments you have during our next consultation period if you choose to remain as a non-registered organisation. We will review these, however we will just not publish our responses to these comments on our website.
In terms of why you were initially aligned with the QMUL organisation, I believe this was because you registered through your QMUL email address and we were not able to find any information about your Law and Health organisation when searching online. We also didn’t receive a web link for your Law and Health organisation with your initial application. Therefore, we believed that this Law and Health organisation name was a sub-department of QMUL. We do not accept sub-departments of universities as registered stakeholders, so we registered you under the over-arching university name. However, we apologise for the confusion this has caused you.
As you have stated that you cannot be registered under the QMUL name, I will remove you from the stakeholder list now for this university. I would recommend that you please check our stakeholder list for any organisations that represent your interests.
My reply to NICE – 10 August
Thank you for your reply. Unfortunately, it contains a number of inaccuracies and incorrect assumptions so it fails to address adequately the issues which I raised in my previous email.
I have again checked the list of stakeholders and again cannot find any organisation which covers the same remit. We are therefore not in a position to approach any other stakeholder to “represent our interests”. One of our main purposes is research, for which we need direct access to stakeholder information.
I would be grateful if you could advise me of the appeal process against this decision.
NICE to me – 13 August
I have been passed your e-mail regarding registration as a stakeholder organisation for the ME/CFS guideline update. We very much welcome your interest in the guideline but, as set out in X’s original reply, based on the information provided your organisation does not appear to meet the criteria for registration. We’re unable to find any detail regarding Law and Health as an organisation, and the views and commentary on your personal website look to be broadly similar in nature to those from other registered organisations.
You stated that you require access to stakeholder information for research that you undertake. I’d like to reassure you that the minutes from the committee meetings throughout the guideline’s development, and the consultation versions of the guideline documents, are all made publically available on NICE’s website and access is not limited to stakeholders.
As X noted, at the point of consultation you will be still able to comment on all of the documents as a non-registered stakeholder, and those comments will be reviewed and considered by the guideline committee – it’s just that your comments will not receive a formal response and will not be published.
You note that your organisation provides advice and assistance to other groups and individuals and so we would encourage you to liaise with one of the national organisations which does similar work if you wish to submit comments through a registered organisation.
My reply to NICE – 15 August
Thank you for your email. As it mostly repeats the earlier points made by X, it does not take matters any further.
I am completely baffled as to why NICE should be using so much time (and therefore also public funding) trying to prevent me from becoming a legitimate stakeholder in the guidelines review process under the “organisations which fund and carry out research” criteria.
The evidence for this research (which we also fund) is clear and is contained within the Law and Health blog. It is also clear that it is not a “personal” blog, as you state (other than the category marked “Personal” in the sidebar). The title Law and Health appears at the top left of the screen, under the main picture, as it has done since I created the site in 2012.
Law and Health is neither “local” nor “regional”. The fact I provide assistance to other national stakeholder organisations indicates that its work is NOT covered by any other UK organisation.
NICE’s policy in dealing with this stakeholder application is proving to be opaque, inequitable and random in its application of the criteria. The effect of this approach is that I am apparently required to make representations retrospectively and in the absence of formal notice of the reasons for the refusal of the application.
As a statutory body and an executive branch of a governmental department, NICE is required to be fair, transparent and accountable. This stakeholder selection process is failing to meet those standards.
I would be grateful if you would advise me of the appeal process from this point.
NICE to me – 16 August
Thank you for your e-mail.
As noted in my previous e-mail, based on the information provided and on reviewing the content of your website, our understanding is that your organisation does not meet the criteria for registration – either as an organisation that funds or carries out research, or as a local organisation representing a group’s interests in the absence of a national organisation. As a result, we are unable to register Law and Health as a stakeholder organisation.
Just to confirm, you will still be able to access all of the committee meeting minutes which will be published on the NICE’s website during the development of the guideline. You will also have access to all of the guideline documents at the point of consultation on the guideline. You will be able to submit comments on the guideline at that point and those comments will be considered by the committee, however you won’t receive a formal response.
If you would like to like to make a complaint about the decision or about the way your registration application has been handled, please contact [Associate Director] in NICE’s Corporate office (or by mail at National Institute for Health and Care Excellence, 10 Spring Gardens, London, SW1A 2BU)
I replied as follows and then contacted the relevant Associate Director: this is the correspondence from that exchange:
My reply to NICE – 17 August 
This is not only about access to information but also proper recognition of a legitimate stakeholder. Your response is based purely on opinion and does not contain any reasoning behind your decision. 
The lack of a proper structure in your replies suggests that NICE is making up the rules as it goes along and then marking its own homework after the event. This allows an inappropriate degree of control over the process without any independent scrutiny or review mechanism .
As I said before, NICE is a publicly-funded body, created by statute, and an executive branch of a governmental department. As such, it is required to be fair, transparent and accountable. This stakeholder selection process fails to meet those standards. 
You will be aware from reading my blog that I have lived with ME, in varying degrees of severity, for 37 years. As a result, my resources – both in health terms and financially – are limited. I am therefore not in a strong position to pursue this process any further. Ultimately, it concerns a point of principle and the outcome will not change anything for the benefit of the millions of people who live with this illness worldwide. 
My main purpose for the years that remain to me is to continue to do as much as I can to improve the shocking conditions with which those with ME have lived for many decades. There would seem to be little to be gained from wasting more time and further exacerbating my health by pursuing this process. However, after due consideration, I have decided to send this email separately to the Associate Director as a formal complaint, not in the expectation of any progress, but because this situation needs to be addressed at the most senior level within the NICE structure. 
NICE to me – 20 August
Thank you for your below email, which I will investigate and respond to under NICE’s complaints policy. In line with the timescales within the policy, I hope to send you my response within 20 working days.
To inform my response, it would be helpful to know more about the research you fund and carry out in relation to this area.
My reply to NICE – 22 August
My complaint is that NICE is not operating in a fair and transparent manner in relation to applications to become a stakeholder in the ME/CFS guidelines in development process.
  • The original application online submission form is very short and, unless a screenshot is taken, no record of it remains with the applicant
  • As I recall, no proof of the organisation’s activities is required at the time of application
  • After submission of the application, NICE then apparently conducts its own investigation of the organisation without transparency or accountability in its methodology and in the absence of formal criteria. The investigation procedure is not made clear as a part of the process
  • In my case, NICE assigned me as a stakeholder to a different organisation (QMUL) without consultation or notification. I discovered this purely by chance after the event
  • The appeal/complaints procedure is unclear and appears unstructuredI am surprised, therefore, to be asked at this very late stage to justify Law and Health’s application to meet NICE’s requirements to become a stakeholder and without knowing what those requirements are. The blog on the website (link at the foot of this email) contains the information which supports my application as an organisation that funds OR carries out research. [continues…..]
  • Law and Health was created in 2012 to publish my research on the so-called “Secret Files on ME”. It now consists of Professor Robin Callender Smith and myself
  • The organisation was set up earlier than expected for reasons which are explained in the About section. It was therefore created before I had formulated in full how it was going to operate, including the title and full remit of the organisation 
  • Further research followed later, some of which is to be found in the “CATEGORIES” section of the blog. Inevitably, there is also a large amount of background work which is not documented  
  • As a result of the “Secret Files” work, people began to contact us (including from outside the UK), seeking advice and assistance. We always respond where possible and practical although the work is limited by my health 
  • We provide our own funding for specific projects. However, this is not shown in the blog for reasons of patient or client confidentiality and data protection
  • To the best of our knowledge, no other organisation carries out the same functions as Law and Health
As I have said previously, “NICE is a publicly-funded body, created by statute, and an executive branch of a governmental department. As such, it is required to be fair, transparent and accountable. This stakeholder selection process fails to meet those standards.”
The final cut…..
NICE to me – 31 August 
Thank you for responding with the further information below, which I have used to inform my review of your complaint about NICE’s decision not to register Law and Health as a stakeholder for the NICE guideline on ME/CFS. I have also reviewed your email exchanges with NICE’s Centre for Guidelines, the information on, and discussed your complaint with management in NICE’s Centre for Guidelines.I have undertaken my review in accordance with NICE’s published complaints policy and procedure, having had no prior involvement in this matter.
Firstly, thank you for your interest in engaging with the development of this guideline and I am sorry that you have found the experience unsatisfactory.
I am also sorry for the misunderstanding that led to you initially being registered on behalf of Queen Mary University of London (QMUL). I see that X explained the reason why this occurred in his email to you on 10 August, and apologised for the confusion caused. He also advised that anyone not registered as a stakeholder could still submit comments on the draft guideline.
I understand the central element of your complaint to be NICE’s decision not to accept Law and Health as a registered stakeholder, and its actions in doing so, which you believe represent a failure to act in a fair, transparent and accountable manner.
To manage the involvement of the large number of organisations who wish to contribute to the development of our guidelines, NICE has published the following criteria for establishing who can register as a stakeholder:
a)National organisations for people who use health and social care services, their families and carers, and the public
b)Healthwatch organisations
c)National organisations that represent health and social care practitioners and other relevant professionals whose practice may be affected by the guideline
d)Companies that manufacture medicines, devices, equipment or adaptations, and commercial industries relevant to public health, excluding the tobacco industry
e)Tobacco industry organisations who register to participate are automatically registered as respondents
f)Public sector providers and commissioners of care or services
g)Private, voluntary sector and other independent providers of care or services
h)Government departments and national statutory agencies
i)Organisations that fund or carry out research
j)Overseas agencies with a remit covering England
k)Local or regional groups representing people who work in, or use health and social care services can register as stakeholders only when there is no national organisation that represents the group’s specific interests.
Those not meeting the criteria to register as a stakeholder can still submit comments on the draft scope and guideline. But, due to resource constraints, NICE does not individually respond to these. The criteria are available on the NICE website, along with detailed information on how guidelines are developed.
Based on the information provided in your correspondence and on reviewing the content of, the Centre for Guidelines decided that Law and Health does not meet the criteria for registration. The initial decision was based on criteria (a) and (k), with subsequent consideration of criterion (i).
As noted above, I have reviewed the information provided in your emails to NICE and your website, and having done so, I agree that the decision not to register Law and Health as a stakeholder under these criteria was appropriate and reasonable. In particular I noted the following statement under the “about” tab of the website:“Independent status: The views expressed in this blog are my own. I am not affiliated to any other group or professional body relating to ME or CFS issues.” Also, I was unable to find any reference elsewhere on the internet to Law and Health that would indicate Law and Health is operating as an organisation at a national scale, and I am mindful that, as per your email to me on 22 August, the organisation consists of two people. I also considered the additional information you helpfully provided to me about the research work undertaken, alongside the information on your website, but having done so, support NICE’s earlier decision this does not fulfil criterion (i). For while ‘research’ is not publicly defined for the purpose of this criterion, it typically relates to organisations undertaking peer reviewed primary research, such as universities.
I have considered the decision making process within the Centre for Guidelines and am satisfied this was appropriate, with views taken from senior management in the Centre, and NICE’s Public Involvement Programme.
In terms of independent review or scrutiny of NICE’s decisions about stakeholder registration, I would highlight that the complaints process provides for this, and details of this option were given to you by X. I have not previously been involved in this matter, and work in a separate part of NICE to the Centre for Guidelines, and so have reviewed this from an independent position. Also, the complaints process provides opportunity for further independent review and challenge of my response. Given this, and the significant amount of information on the NICE website about our guidance and the way we produce this, I believe NICE does act in a fair, transparent, and accountable manner.
I do however appreciate your concerns about the stakeholder registration process, and agree that it would be helpful if further information is publicly available on how NICE defines the stakeholder registration criteria. This would further help transparency and mitigate any perception that NICE is acting in an inconsistent manner, or seeking a post-hoc rationalisation of its decisions. As a result of your complaint, I am recommending this is considered further.
I am not pursuing this any further as there is nothing to be gained and my resources have reached their limit.
This is a deeply flawed process and does not inspire confidence for any of NICE’s activities which are, we must remember, intended to “provide national guidance and advice to improve health and social care”.
8 Comments leave one →
  1. melamine permalink
    September 28, 2018 11:49

    Bottom line, government bureaucracies and health care are an unhealthy mix in my experience and opinion.


  2. jacqui butterworth permalink
    September 28, 2018 11:59

    All to put sufferers off who know more about the disease Karina. I was diagnosed 30yrs ago ME but 17yrs later private tests showed Lyme-NHS doctors do not accept the tests- whether it is ME/Fibro or Lyme and co infections NICE and doctors just know nothing.


  3. September 28, 2018 16:35

    Valerie, your experience mirrors mine, both in 2017 and in 2018 with NICE.
    In 2007, I decided to “abstain” from direct involvement though I supported the action and JR against NICE.

    In 2017, I was outraged at NICE breaching Government Guidance on Public Consultation (issued in 2016). I suggest that they would likely be challenged on this breach.
    I rang them, told them they had to extend beyond their state deadline and asked if I could speak to their legal department. They told me that they don’t have one…….!

    They did extend the deadline however and had to contact everyone to that effect.
    I applied to register as a Stakeholder and was accepted.
    They accepted my consultation response and it’s on the website.
    I made a formal complaint about the form we were made to use to submit too.

    Then in January, they said they had “made an error in registering me as a stakeholder ” and removed me, requiring I went through the tedious process of re registering with nationally acceptable organisation.

    NICE are a complete and utter shambles!


  4. Bianca permalink
    September 28, 2018 21:55

    Thank you so much for all your efforts, for trying so hard. I’m so sorry to hear about all the unnecessary and unfair resistance 😦


  5. September 30, 2018 20:55

    Sorry that you are being given the Dickensian ‘Circumlocution Office’ treatment by NICE, but I suppose it is not entirely unexpected. I would have thought you would have qualified under g) as a private provider of ‘services’, in addition to the categories from which they have retroactively excluded you!

    Can you not get around this impasse by inviting more powerful like-minded people like Lady Mar onto your ‘board’, or perhaps join up with a more general legal rights blog like UK Human Rights Blog, under a new category of rights to health, if they don’t already have someone covering that area? Your blogs would be quite complementary, I think, and they even appear quite similar in design:

    With some imagination you ought to be able to fit into one of their stakeholder categories, as there really is nobody else specifically covering the law as it relates to rights of people with physical illnesses, though there are several in the field of mental illness (Council for evidence-based Psychiatry, being a notable recent addition.).

    Good luck.


    • October 1, 2018 11:37

      Thank you for your comments and suggestions, Steve.

      I have now exhausted the complaints procedure with NICE. I don’t think any more can be achieved by revisiting it and arguing about categories. The effort involved in trying is simply not worth it as it will not fundamentally change the outcome of the review process.

      I wouldn’t invite anyone else to become involved in my application as my argument is that I am independent of all other stakeholder groups which is why I should be treated as a stakeholder in my own right.

      I am familiar with the UKHR blog, having followed it for several years. I have previously had some contact with them and it was not helpful so I would not approach them again.

      Thanks and best wishes.


      • October 1, 2018 23:58

        Sorry to hear UKHR blog weren’t very helpful. It seems crazy that we have several organisations dealing with legal aspects of mental health, but, apparently, none dedicated to helping obtain the right services for the physically ill under a ‘right to health’ (Maybe the international Human Rights Watch can start something?).

        As for getting more names on your ‘board’, I wasn’t really expecting it would resolve your current situation: more to give you more clout another time.

        Anyway, it is always good to read your well argued and researched blogs whenever you have time for them, and I do hope your health allows you to continue despite the setbacks. (y)

        Liked by 1 person


  1. Karina Hansen wins | FibrOuch_ME/CFS BloG

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