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Thursday, April 21, 2011

A Family Doctor's Tale - CHRONIC FATIGUE

DOC I HAVE CHRONIC FATIGUE 

Chronic Fatigue is a collection of symptoms with the predominance of severe fatigue(tiredness) which can last for months or years.

There are 2 main causes of Chronic Fatigue 

1.Pathological Chronic Fatigue :
Viral Infections may be a trigger
Others are:
Anemia
Dehydration and electrolyte disturbance
Diabetes
Fibromyalgia
Heart disease
Hypothyroidism
Narcotics
Paraneoplastic syndrome
Pulmonary disease
Renal disease
Chemotherapy

2.Psychological Chronic Fatigue :
Anxiety
Depression
sedentary lifestyle
Sleep disorders

Symptoms are:
1.Severe fatigue that prevents the patient from getting up of bed

2.weakness in the limbs

3.Pain in the head, abdomen, or muscles of the limbs

4.Poor appetite

5.reluctance to take part in social activities

6.Tired after any physical or mental exercise

7.difficulty in concentration

Diagnosis is by:
1.Blood tests to exclude anemia and infections

2.Tests to exclude diabetes, low thyroid hormones, endocrine disease

3.Psychological evaluation

Treatment is by :
1. No specific treatment eexcept for rest

2.Counseling in cases of psychological causes

3.Gradual return to work or school

4.Treat underlying causes such as diabetes, hypothyroidism

Prognosis:
usually good

P.S (on 22nd April 2011)

----------------------------------


I was advised by my expert readers that what I was writing about is Chronic Fatigue and not Chronic Fatigue Syndrome. Having gone through all their comments and their links, they are all correct and this post is all about Chronic Fatigue.

I am grateful for all these experts for their comments.

Please send me more comments.

15 comments:

Pam Bryan said...

Hello Kenneth,
It's great to see another life-learner. It's a great way to go through life.

While it is good to see you are learning about fatigue I'm afraid your teachers are confusing 'chronic fatigue' with 'chronic fatigue syndrome' and they are very different things. The confusion arises mostly through definitions created by the CDC many years ago.

Unfortunately 'chronic fatigue syndrome' now referred to as ME/CFS (myalgic encephalomyelitis) is MUCH more complex than simple fatigue the 'cause' is simply not understood yet, but it is not anything of the things you have listed, which are more correctly, possible causes for chronic fatigue.

Unfortunately the prognosis for true ME/CFS is NOT good. People are truly very ill with what is more correctly understood as a NeuroEndocrineImmune (NEI) condition. Many treatments and approaches can alleviate symptoms and make life more bearable, so far they do not seem to get to the root cause or provide a cure.

You can learn more here http://phoenixrising.me/ where there are currently some great summaries from the recent State of Knowledge meeting sponsored by the NIH in the US. You can view the videos from the SoK here Day 1: http://videocast.nih.gov/launch.asp?16575
Day 2: http://videocast.nih.gov/launch.asp?16571
Agenda: https://www.infinityconferences.com/...557/Agenda.htm and I'm sure you will find them very interesting.

If you have any interest in healthcare politics, you'll find http://www.oslersweb.com/ interesting indeed.

kennethk said...

You are right. I was thinking more about chronic fatigue.
Thanks for letting me know.
Kenneth

kennethk said...

You are all correct. I was thinking more of chronic fatigue
Thanks for letting know.
Kenneth

mikerosss said...

Pretty nice post. I just stumbled upon your blog and wanted to say that I have really enjoyed browsing your blog posts. In any case I’ll be subscribing to your feed and I hope you write again soon!

Phoebe Snowden said...

Dear Dr.,
There is no such diagnosis as "Psychological Chronic Fatigue Syndrome". Perhaps you are referring to "idiopathic chronic fatigue"? "Chronic Fatigue Syndrome" refers to a specific illness, defined originally by the CDC in 1988 during a "Chronic Fatigue Syndrome" epidemic by Holmes, and later revised in 1994 by Fukuda. Here is the Fukuda definition to better help you correctly diagnose your patients: http://www.cfids-me.org/cdcdefine.html

Justin Reilly, esq. said...

This is misinformation. CF is not synonymous with CFS. ME ("CFS") is a specific neuro-immune disease. Please change "CFS" to "CF". Thanks.

Justin Reilly, esq. said...

OK, I see you have. I got sent a link to an earlier version posted on an ME forum.

Justin Reilly, esq. said...

I see your responses are "I meant CF, not CFS." OK, well please change it.

kennethk said...

Thank you Justin.
As you can see I have already change the title to chronic fatigue
Thanks for your comments
kenneth

kennethk said...

Hi
Thank you for your comments. I am really glad that there are people reading my blog.
All these additional information on the chronic fatigue syndrome will let other readers have a better picture of the CFS.
Thank you again
Kenneth

kennethk said...

Hi Jan W
I am glad to receive all the information of Chronic Fatigue Syndrome. In due time I will try to write a simplified article on Chronic Fatigue Syndrome.
Thank you for your help
Kenneth

SlowDescent said...

Dear Family Doctor: You wrote about CFS when I was enduring a particularly bad stretch of that illness, and though I wanted to comment, I wasn't coherent enough to do so. I am glad that you received such articulate comments from others, and I admire your enlightened response to them.

I am sure you can imagine how distressing it is for CFS patients to interact with doctors who confuse their illness with "chronic fatigue," or who believe the condition springs from "inappropriate illness beliefs" and refer the sufferer to a psychiatrist. In my experience of trudging from doctor to doctor, their minds are often closed and their manner condescending.

In the best-case scenario, the doctor acknowledges that (s)he knows nothing whatsoever about the illness, make some sincere but misguided suggestions (take iron for more strength!) and sends you out the door feeling worse than you were when you arrived. In my case, they also provide some kleenex for the exit, as encountering ignorance or helplessness from one's doctor is in the face of this causes deep despair.

For this reason, I thank you for your fair, open-minded response.

Pam Bryan said...

Hi Kenneth,

Thanks so much for your positive and open minded response. Best wishes for your ongoing studies. The world will be a better place with more inquisitive Dr's such as you practicing.

Pam

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