Fatigue Syndrome

I feel so tired today…

admin — Fri, 13 Mar 2009 03:29:19 +0000

This is how it starts. You just had your morning coffee and nevertheless feel like going straight back to bed. You don’t find the car keys, arrive late at work, need a lunch break lasting for hours, mess up your desk and finally back home fall asleep after ten minutes in front of the TV. And not just for one day - it goes on, it gets worse and finally you feel like you never want to get up again.

In the beginning you think it could just be a bad period or a fit of midlife crisis, then it gets scary and finally it’s hell: you lose your job, lose your friends, lose your family and your life is in shambles.

What’s wrong?

You don’t know. You went to several doctors; they never found anything.

Possibly you suffer from Fatigue syndrome - the condition where the doctor never finds anything.

Chronic Fatigue Syndrome (CFS) is estimated at an incidence of four per thousand among US adults. And it is characterized by the absolute absence of measurable, provable clinical findings - no lab and no radiology will show any abnormal results.

The doctor says I am ok…

admin — Fri, 13 Mar 2009 03:28:59 +0000

Sure he does. Chronic Fatigue Syndrome is one of the most elusive conditions one can possibly suffer from. It is so elusive that it was only in recent years acknowledged by big medical organizations as a possibly debilitating illness. It is so elusive that there still are specialists who doubt that it even exists. It is so elusive that the diagnosis finally will be based on exclusion - when the doctors checked virtually everything and found nothing, but you are still tired, cannot concentrate and find no relieve neither by rest nor by sleep, than they possibly will conclude it is CFS.

But until then it is a long way to go and a costly one at that, if you don’t have full insurance cover. So many cases of Chronic fatigue Syndrome will eventually go undetected, and the victims likewise be stigmatized for life as lazybones: full resolution of the condition is reported in not more than 10% of the clinically diagnosed cases.

Being elusive on one hand but debilitating and almost incurable on the other, many experts today even demand a renaming, claiming that “Fatigue Syndrome” just sounds too vague and too harmless a name for a condition that clearly threatens a person’s very existence: benign myalgic encephalomyelitis, chronic fatigue immune dysfunction syndrome, chronic infectious mononucleosis, epidemic myalgic encephalomyelitis, epidemic neuromyasthenia, myalgic encephalomyelitis, myalgic encephalitis, myalgic encephalopathy, post-viral fatigue syndrome and raphe nucleus encephalopathy are just some of the recently suggested names for CFS.

Associated conditions

admin — Fri, 13 Mar 2009 03:28:40 +0000

To make things eve more complicated, it seems that a number of other conditions are frequently connected to or overlapping with Chronic Fatigue Syndrome. In such cases Chronic fatigue Syndrome can only be diagnosed after the other conditions have been established and treated or mysteriously resisted the standard treatment procedures.
These include thyroid disorders, anemia, diabetes, fibromyalgia, multiple chemical sensitivity, Gulf War syndrome and post-polio syndrome, irritable bowel syndrome and temporomandibular joint pain and chronic pelvic pain syndrome.

So this is quite a number of conditions to be either diagnostically excluded or treated in the first place.

There also exists an overlapping with severe depression. But until now it could not be established whether depression was an underlying cause for Chronic Fatigue Syndrome or just a consequence of suffering from a chronic illness. As a matter of fact people suffering from any chronic illness will show a much higher tendency to develop a severe depression than healthy persons.

Social stigma and other implications

admin — Fri, 13 Mar 2009 03:28:24 +0000

In the US 24% of the adult population were found to have at least once had fatigue lasting 2 weeks or more; about 50% of these persons were convinced that their fatigue had no medical cause. In another study, 24% of the respondents complained about at least one episode of prolonged fatigue (>1 month). If such a fatigue persists beyond 6 months it is defined as Chronic Fatigue.

A British study shows that 77% of the 240,000 people in the UK with CFS have lost their jobs. 25% are house or bed bound, 38% lost their ability to drive a vehicle, 39% complained about a permanent reduction in employment opportunities and 77% reported that their social contacts decreased significantly under CFS.

Given such figures, it is quite surprising that some people seriously wanted to rename Chronic fatigue Syndrome into “yuppie flu” and other discriminating names, several “scientific” publishers in fact went as far as to describe Chronic Fatigue Syndrome as a new kind of hysteria that got fashionable in the 90’s.

So be prepared: you most likely will find that the world does not welcome you in your new state.

I have CFS. And what now?

admin — Fri, 13 Mar 2009 03:28:07 +0000

Yes, that is the question!

Doctors not only are unsure what CFS actually implies, they are also virtually clueless on what causes the condition.

They are even debating what “type” of condition we are talking about: is it genuinely a neuralgic disorder or the effect of an undetectable virus infection, or a degeneration of the central nervous system or maybe a somatic manifestation of a severe depression or maybe not even somatic but just psychic… questions over questions, and no answers to them. It really seems Chronic Fatigue Syndrome is one of the hardest riddles left in the medical sciences.

But you are not looking for answers to riddles, are you?

You are looking for relief and cure. So what can the clueless doctors do for you?

They usually will do what they can - which is to try everything that could possibly help. As there is no cure in sight, the will try all those therapies that until now have shown a reasonable success rate.

If this does not sound good for you, than something else might: there is no proof that Chronic Fatigue Syndrome will reduce your average life expectancy, and in about 30% of treated cases for adults, but more than 80% for children, a significant improvement can be stated.

Treatments

admin — Fri, 13 Mar 2009 03:27:38 +0000

Cognitive behavioral therapy (CBT) is a kind of psychological training that helps you to better understand your condition and to arrange your life accordingly. If this does not sound like much, maybe some figures do better: in several large scale surveys more than half of CFS patients have confirmed that cognitive behavioral therapy led to a remarkable improvement of their symptoms.

Graded exercise therapy (GET) is basically a step-by-step fitness training where types and times of exercises are closely monitored and compared with the patient’s subjective exhaustion observations. GET is aimed at finding a daily physical fitness program for you exactly as hard as you can handle without aggravating the Fatigue Syndrome. Again large-scale patient surveys have shown that it works for most people and will result in a reduction of fatigue.

There are mixed results to be reported for different medications. CFS patients seem to react rather sensitive to most types of medication, especially of the sedative types. But still some people show improvements under treatment with anti depressants and so called immunomodulatory agents. These are substances, which either stimulate or suppress your immunity system or parts of it. Their prescription will be preceded by diagnostic analysis of your immune system’s parameters - if there are any irregularities found your doctor might try to improve your Chronic Fatigue Syndrome by modifying your immune system.

A very recent approach is by a leaf called Kratom. This leaf comes from mitragyna speciosa, a wild growing tree from the jungles of South East Asia. In its area of origin Kratom has long been used as a painkiller with strong stimulating properties, and as trials are still running, obviously a number of people with Chronic Fatigue Syndrome find that the stimulating agents of Kratom are helping them to overcome their Fatigue symptoms.

So how will my life go on with Chronic Fatigue Syndrome?

admin — Fri, 13 Mar 2009 03:27:21 +0000

It mainly depends how well you can handle the symptoms.

Your first concern might be your working place. Cognitive behavioral therapy (CBT) and graded exercise therapy should help you to get a better understanding of how much labor and stress you still can endure without your symptoms getting worse. And then most likely it will need some fine-tuning - you can work less hard, fewer hours long or both. Once you have found the right level you can try to improve on that later on.

The very same principles apply to your private life. Try to find a level that still is acceptable for all involved persons. If you have children at an age where they still need your daily care, talk to them, explain the situation and see if there are some minor tasks and errands of which you could be relieved without your children feeling neglected - parental love after all is not something defined by laundry or candy shopping.

And even if your doctor has not found anything that in his opinion would warrant any medication, you still might like to give it a try. You could ask your doctor to prescribe antidepressants and you might like to go online shopping for kratom. If none of these drugs bring any improvement after a period of time, you can stop taking them.

But sometimes they will, and a severe handicap like Chronic Fatigue Syndrome should always imply that you take every chance for improvement you can see - and if it was just for knowing that you really tried.