Memory And Concentration Problems
Memory aids, like organizers and calendars, can help with memory problems. For people with ME/CFS who have concentration problems, some doctors have prescribed stimulant medications, like those typically used to treat Attention-Deficit / Hyperactivity Disorder . While stimulants might help improve concentration for some patients with ME/CFS, they might lead to the push-and-crash cycle and worsen symptoms. Push-and-crash cycles are when someone with ME/CFS is having a good day and tries to push to do more than they would normally attempt .
Activate Your Lifestyle Again
The human body is designed to move, and if it sits too long, everything stagnates. Staying in motion increases blood flow, which washes out toxins, stimulates healing, and increases oxygen delivery to tissues. It also stimulates endorphins, the natural feel-good chemicals that reduce pain and stimulate immune functions, as well as stem cells, which are necessary to repair damaged tissues.
That said, experts warn that if you have chronic fatigue and overdo it, theres a risk of setback and post-exertional malaise , which is a worsening of symptoms such as fatigue, sleeplessness, cognitive issues, pain, dizziness, and more. So keep in mind that becoming active again must be a delicate balance between moving enough to gain benefit, but not so much that it aggravates inflamed tissues and causes further damage. Try these suggestions for starting slow and easy:
Treat The Worst First
Start by listing your worst symptomsthe ones that make it hardest to get through the day. With your doctor, focus first on treating those symptoms. Decide whether a specialist might be helpful for any of them.
The most common ME/CFS symptoms can also be the most treatable.
Symptoms worse after activity
Learning how to manage your activity can help you be as active as possible without causing your symptoms to get worse. This includes:
- Estimating how much energy you have on a given day. This is sometimes called your energy envelope. You spend only that much energy, and not more.
- Estimating how much energy an activity takes and how long you can do that activity. You stop when you reach that time, and then take a break.
- Not pushing yourself to get more done on days you feel well.
- Adapting activities to make them easier. One example is sitting down while doing the dishes.
Sleep
Good sleep habits can help improve the quality of your sleep. If you also try medicine for sleep, its best to start on a low dose. Certain antidepressants help with sleep, mood, and chronic pain, so your doctor may suggest trying one.
Feeling dizzy or weak while sitting or standing
Your doctor may have you wear pressure stockings, put your legs up while sitting, or increase your salt intake. Your doctor may also suggest medicines like fludrocortisone or midodrine.
Pain
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What Is The Prognosis
The clinical course of CFS varies considerably among persons who have the disorder. The actual percentage of patients who recover is unknown, and even the definition of what should be considered recovery is subject to debate. Some patients recover to the point where they can resume work and other activities, but continue to experience various or periodic CFS symptoms. Some patients recover completely with time, and some grow progressively worse. CFS follows a cyclical course, alternating between periods of illness and relative well being.
Chronic Fatigue Syndrome Diagnosis
When a doctor attempts to make a chronic fatigue syndrome diagnosis, there are a few things that they will look for. First, the most obvious sign is that the patient is consistently tired. Now, most people over the age of twelve cant remember the last time they werent at least a little bit tired, but for people with chronic fatigue syndrome, its very different.
Their fatigue makes it difficult to carry out daily tasks or even to think clearly. Its like no matter how much sleep they get the night before, they feel like they havent slept in days. Obviously, this makes living with the condition difficult, and it is this level of fatigue that doctors look for when making a chronic fatigue syndrome diagnosis.
But the fatigue must also be chronic, which means it lasts for at least 3 to 6 months. This chronic fatigue is a sure sign that you may be suffering from chronic fatigue syndrome, but there are a few other symptoms that will make the diagnosis a sure thing. And these are the symptoms we discussed earlier. People with chronic fatigue syndrome often manifest those physical signs like muscle pain and a sore or swollen throat.
These symptoms combined with the chronic fatigue are usually enough to make a solid diagnosis. The doctor will then try to rule out any other possible explanations before making their final diagnosis of chronic fatigue syndrome.
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Exercise And Physical Therapy
People with CFS often avoid exercise altogether as it can seem to make symptoms worse. This can lead to a sense of mistrust of ones body. For these reasons, a gradual physical activity program can be helpful. It is important to begin with activities that can be achieved. For example, if a person suffers from dizziness and loss of balance, a program of stretching exercises done from a seated or lying position would be more safe and comfortable than those that involve standing or balancing.
For many people with CFS, programs of strenuous aerobic exercise may make symptoms worse. If this is the case, daily, gentle exercise should be directed toward goals of maintaining flexibility, mobility, and accomplishment, and of gradually increasing strength and endurance .
I Dont Have Insurance How Can The Affordable Care Act Help Me
If youre uninsured or have been denied coverage in the past for ME/CFS, the Health Insurance Marketplace may be able to provide you with access to affordable coverage. With health insurance plans in the Marketplace, you can no longer be refused coverage just because you have a pre-existing health condition. Medicaid and the Childrens Health Insurance Program also cant refuse to cover you or charge you more because of a health condition. They also cant charge women more than men. Learn more about the Affordable Care Act and the Health Insurance Marketplace at Healthcare.gov.
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Chronic Fatigue Syndrome: Gradually Figuring Out Whats Wrong
In 1983, a health professional in her 30s walked into my office and said, Ive been healthy all of my life. A year ago, I came down with some kind of virus sore throat, aching muscles, swollen lymph glands, fever. My fatigue was so bad I was in bed for nearly a week. Many of the symptoms gradually improved, but the terrible fatigue and difficulty thinking have not gotten better. Theyre so bad I cant fulfill my responsibilities at home or at work. This illness is affecting my brain, stealing my energy, and affecting my immune system. Its keeping me from realizing my dreams.
Theres a piece of advice attributed to a famous physician, William Osler, that every medical student probably has heard: Listen to your patient. The patient is telling you the diagnosis. But I wasnt sure it applied in this case.
I Don’t Have Insurance How Can The Affordable Care Act Help Me
If you’re uninsured or have been denied coverage in the past for ME/CFS, the Health Insurance Marketplace may be able to provide you with access to affordable coverage. With health insurance plans in the Marketplace, you can no longer be refused coverage just because you have a pre-existing health condition. Medicaid and the Children’s Health Insurance Program also can’t refuse to cover you or charge you more because of a health condition. They also can’t charge women more than men. Learn more about the Affordable Care Act and the Health Insurance Marketplace at Healthcare.gov.
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What Causes Chronic Fatigue Flare Ups
Chronic fatigue syndrome may appear suddenly or more slowly over time. It may follow an infection, typically, but not always, viral. Other possible triggers can be trauma, surgery and stressful major life events. However in some cases there may be no identifiable trigger for chronic fatigue syndrome.
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Depression Stress And Anxiety
Adjusting to a chronic, debilitating illness sometimes leads to other problems, including depression, stress, and anxiety. Many patients with ME/CFS develop depression during their illness. When present, depression or anxiety should be treated. Although treating depression or anxiety can be helpful, it is not a cure for ME/CFS.
Some people with ME/CFS might benefit from antidepressants and anti-anxiety medications. However, doctors should use caution in prescribing these medications. Some drugs used to treat depression have other effects that might worsen other ME/CFS symptoms and cause side effects. When healthcare providers are concerned about patients psychological condition, they may recommend seeing a mental health professional.
Some people with ME/CFS might benefit from trying techniques like deep breathing and muscle relaxation, massage, and movement therapies . These can reduce stress and anxiety, and promote a sense of well-being.
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Continued Research Should Lead To Better Understanding And Treatments
A great deal more is known about ME/CFS today than 35 years ago. With continued and expanded support from the NIH, CDC, and private foundations dedicated to ME/CFS, I expect a lot of progress in the coming decade. Instead of doctors saying, The tests came back normal, there is nothing wrong, they will say, Tests showed us what was wrong, and we have treatments to fix it.
And doctors will recognize the wisdom of the wise advice we all learned in medical school: Listen to your patient. The patient is telling you the diagnosis.
What Is Myalgic Encephalomyelitis/chronic Fatigue Syndrome
Myalgic encephalomyelitis/chronic fatigue syndrome is a complex and disabling disease. It has been classified as a neurological disorder by the World Health Organization, though it affects many parts of the body, including the brain and muscles, digestive, immune and cardiac systems.
The term myalgic encephalomyelitis means pain in the muscles, and inflammation in the brain and spinal cord. Scientists are starting to understand some of the biological changes in the bodies of people with ME/CFS, although they have not yet found how to prevent, or cure it.
Research has found that ME/CFS is associated with problems involving:
- The bodys ability to produce energy at a cellular level
- Immune, neurological and hormonal systems
- Blood pressure and heart rate regulation
- Cognition how quickly information is processed
ME/CFS affects men, women and children of all ages, ethnicities, and socioeconomic backgrounds. 75-80% of people with the disease are female. It is estimated that up to 600,000 Victorians may be living with ME/CFS, and as many as 90% are undiagnosed.
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Why Read This Summary
Data from other countries indicate that chronic fatigue syndrome is relatively common , although good epidemiological data for the United Kingdom are lacking. Many different potential aetiologies for CFS/ME have been investigated, including neurological, endocrine, immunological, genetic, psychiatric, and infectious, but the aetiology cannot yet be fully explained. CFS/ME can cause prolonged illness and disability and substantially affect patients and their families. Although most patients have mild or moderate symptoms, some have severe CFS/ME and are housebound or even unable to move from their bed. Uncertainties about diagnosis and management may exacerbate the impact of symptoms, and patients often encounter delays in diagnosis and difficulty accessing information, support, and potentially helpful therapies.1 This article summarises the most recent guidance from the National Institute for Health and Clinical Excellence on diagnosing and managing this condition.2
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Other Drugs Being Investigated For Cfs
Rituximab
Rituximab is a biologic drug used to treat the autoimmune disease rheumatoid arthritis and certain cancers. The drug targets and blocks the activation of certain type of B cells. A small early-stage trial investigated rituximab’s effectiveness in treating CFS. Results suggest that the drug may improve fatigue and other symptoms in some people with the disease. The results are preliminary and further study is needed before it can be determined if rituximab is likely to be helpful in treating CFS.
Rintatolimod
In 2016, Rintatolimod an antiviral and immunomodulatory agent, was approved for the treatment of chronic fatigue syndrome in Argentina. It is also available now in Canada and Europe, but is still not approved for use in the United States. It is the only drug to receive an approval for the treatment of chronic fatigue syndrome anywhere in the world.
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Committee’s Deliberation And Consensus Process
The committee carefully considered the testimony and public commentsreceived and the results of the literature review as it deliberated onits recommendations concerning symptoms and abnormalities that mustbe present to make the diagnosis of ME/CFS, symptoms andabnormalities that can support the diagnosis but are not required in allcases, and exclusionary and comorbid conditions. The committeeadapted a GRADE grid to record individual judgments asto whether there is sufficient evidence that certain symptoms andabnormalities define either ME/CFS or a particular subtype of ME/CFS . The collated judgments were used to facilitate furtherdiscussion, which led to consensus among the committee members on finalrecommendations regarding diagnostic criteria. The committee thenconsidered the recommended criteria and revisited the public comments toinform its decision making on whether a different name or set of namesmight be appropriate for ME/CFS.
What Is Chronic Fatigue Syndrome
Chronic fatigue syndrome is not very well understood on a number of levels. While we know that chronic fatigue syndrome causes, obviously, chronic fatigue, we dont yet know why. Some doctors have speculated that the source of the condition might be in the immune system, suggesting that it is an autoimmune disorder.
An autoimmune disorder is a condition where the bodys immune system begins to attack the body because it thinks that a persons own cells are actually an invading foreign cell. This produces conditions like celiac disease and psoriasis. Its possible that this could explain the symptoms of chronic fatigue syndrome. Fatigue is common among autoimmune disorders.
And the fact that some of the symptoms of chronic fatigue syndrome include things like muscle pain and swollen lymph nodes suggests that there may be an immune system component as well. At the moment, there simply is no solid answer to what causes chronic fatigue syndrome.
But it is still possible to get a solid chronic fatigue syndrome diagnosis.
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Impact And Prognosis Of Me/cfs
Pharmacoecon Open.
BMC Public Health.J Chronic Fatigue Syndr.
Br J Occup Ther.
- Mild: mobile and self-caring may continue working but will have reduced other activities
- Moderate: reduced mobility, restricted in instrumental activities of daily living, needs frequent periods of rest usually not working
- Severe: mostly housebound limited to minimal activities of daily living severe cognitive difficulties may be wheelchair dependent
- Very severe: mostly bedridden unable to independently carry out most activities of daily living often experience extreme sensitivity to light, sound, and other sensory input
Am J Epidemiol.Chronic Illn.
Qual Life Res.Disabil Rehabil.Occup Med .
Rehabil Psychol.Front Pediatr.Fatigue.
Potential Harm From The Label
Some GPs believed that the label of CFS/ME can be helpful for the patient in giving a name to their symptoms:
âSome people like a label, some people like to know whatâs causing their symptoms whether itâs the truth or not and some people are looking for a label to attach to their symptoms.â
However, this value was generally considered to be limited and short-lived:
âAt a superficial level itâs empowering because it gives them control over their life and their work, but at a deeper level it prevents them from engaging fully with the existential conditions of their life which is what they canât cope with.â
Furthermore, the majority of GPs felt that the label of CFS/ME could be harmful because it did not offer a clear management pathway for either the GP or the patient:
âI try to avoid it because once you give them the label youâre actually setting them off on a track which will get them nowhere.â
âOnce you start labelling a patient if youâre not careful you might have a self-fulfilling prophecy.â
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Complementary And Physical Therapies
There are several complementary and physical therapies that may help relieve symptoms in CFS. Acupuncture, tai chi, massage, meditation, relaxation therapy and yoga may help people to relax and increase energy, as well as treat muscular aches and pains.
Heat packs, warm baths and gentle stretching exercises may help with muscle and joint pain. TENS transcutaneous electrical nerve stimulation can also provide relief from muscle pain.
Chronic Fatigue Syndrome is a chronic illness characterized by extreme fatigue that lasts for more than six months. This fatigue cannot be explained away by an underlying medical condition. In fact, one of the diseases principle challenges is that its impossible to diagnose with laboratory tests. However, some professionals believe it is closely related to adrenal fatigue or system wide inflammation of the body.
The process for diagnosis usually begins with ruling out possible underlying diseases and chronic conditions until the only choice left is chronic fatigue syndrome. Left untreated, it decreases stamina, memory and concentration.
Chronic fatigue syndrome can result in strained relationships with friends and family, especially when it remain undiagnosed and/or untreated. Guilt, anxiety and anger are all common emotional responses for those fighting chronic fatigue.
Can Covid Cause Chronic Fatigue Syndrome
A team of researchers, including two from Johns Hopkins Medicine, have published a review article highlighting similarities between certain lingering symptoms following COVID-19 illness a condition called long COVID and myalgic encephalomyelitis/chronic fatigue syndrome , a debilitating, complex disorder
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