Oral And Dental Issues
Dental and orofacial problems are found in many young people with ME/CFS, but are often neglected because the young patient is too ill to make dental office visits. Correction of dental problems can improve overall health. Commonly reported problems are xerostomia , dental caries, periodontal disease, bruxism, temporomandibular joint disorder and impacted third molar teeth.
Dental visits can be stressful, result in lingering discomfort and debilitating fatigue and recovery can be prolonged. Young patients with ME/CFS and orthostatic problems might not tolerate prolonged sitting in the dental chair and some young patients have difficulty in maintaining an open mouth for the duration of dental treatment.
During dental procedures, discomfort can be minimized by the use of a mouth prop to maintain an open posture of the mouth. The smallest size mouth prop that is effective should be used. Dentists also need to be familiar with the clinical features of OI and be prepared to treat patients at risk of developing syncope. Treatment planning of elective dentistry in more extensive cases should allow time between appointments to recover from fatigue.
Treatment for dental caries and periodontal disease follows standard dental practice. For those who might be concerned about whether mercury amalgam fillings should be avoided, all scientific and medical/dental organizations support the safety of amalgam.
Is There A Chronic Fatigue Syndrome Test
There is no available test or bio marker for the illness. And, what makes this disorder baffling is the severity, type and number of symptoms individuals suffer from.
No single cause of chronic fatigue syndrome is known, and in fact it can be caused by multiple things, but it is likely that a trauma or several traumas of some description triggered it.
For example, trauma can come from one or more of the following:
- Hormone imbalance, such as adrenal fatigue.
- Bacterial infections, such as pneumonia.
- Immune system problems.
- Viral infections, such as glandular fever.
- Trauma from physical accidents.
How To Get A Proper Diagnosis
How do you know if you have true CFS or just an underlying thyroid condition or both?
If you meet all the diagnostic criteria for CFS, then you are dealing with a real case of chronic fatigue. But for most people, they want to know what caused it to start in the first place. This is when you should seek out a thyroid trigger.
Since low levels of the thyroid hormones T3 and T4 can be a contributing factor to debilitating fatigue, getting the right thyroid labs tests is a crucial first step. Test Free T3 and Free T4 to assess how much thyroid hormone your body has available for use. TSH is a meaningless test when it comes to ruling out thyroid-related issues with CFS because in most cases, TSH will appear normal, which is how a thyroid condition gets overlooked in the first place.
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Forms Of Oi In Me/cfs
Orthostatic hypotension is defined by a sustained BP reduction of at least 20 mm Hg systolic or 10 mm Hg diastolic during the first 3 min after assuming an upright posture . This problem is rarely seen in children except at times of febrile illness, acute dehydration, hemorrhage, adrenal insufficiency, excessive histamine release, or as a response to certain medications.
A more common pediatric variant, termed initial orthostatic hypotension , is characterized by a transient drop in BP immediately after standing, but resolving within 60 s. Its recognition requires a continuous beat-to-beat BP measurement device. The diagnosis is missed by standard, automated sphygmomanometer measurements . Although this is not usually a condition that requires clinical treatment, chronic orthostatic symptoms in those with IOH have been reported , suggesting that they can develop other orthostatic abnormalities on more prolonged monitoring.
Postural Tachycardia Syndrome
Postural tachycardia syndrome is increasingly being recognized as the most common form of OI in pediatric ME/CFS. As is the case for pediatric ME/CFS, postural tachycardia syndrome is more common in females than males, is more common after the onset of puberty, and often follows an apparent infectious illness .
Neurally Mediated Hypotension
When Should I Call The Doctor About Chronic Fatigue Syndrome
People seek medical care when the fatigue and cognitive difficulties of chronic fatigue syndrome affect their quality of life. People who have questions about a particular treatment should contact a qualified health-care provider, local medical society, or university medical school for additional information.
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Definition Of Chronic Fatigue Syndrome:
Chronic fatigue syndrome or CFS is a complicated disorder that is characterized by an extreme and unusual feeling of fatigue and tiredness that does not go away with rest. Rather, it lasts long, limiting your ability to do ordinary daily activities.
Chronic fatigue syndrome or CFS should not be confused with general exhaustion and fatigue that can be generally associated with a cause in other words it has no specific cause. Chronic fatigue syndrome is also referred to as myalgic encephalomyelitis , systemic exertion intolerance disease , chronic fatigue immune dysfunction syndrome and also post-viral fatigue syndrome .
How Is Me/cfs Treated
Right now, there is no cure or FDA-approved treatments for ME/CFS. But, there are things you and your doctor can do to help ease your symptoms. Because the symptoms of ME/CFS vary from person to person, the management plan you discuss with your doctor may look very different from the plan of another person with ME/CFS.
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Diagnosis Of Chronic Fatigue Syndrome:
Since there are no lab tests that can screen the chronic fatigue syndrome, it is quite difficult to diagnose this disorder or condition. Probably that is the reason why more than 80% people in USA are left undiagnosed of chronic fatigue syndrome. If you have chronic fatigue syndrome or CFS, you might not get the specific symptoms that most diseases are associated with and since you do not even look sick, it is extremely difficult to diagnose chronic fatigue syndrome.
If you are having the above mentioned symptoms and extreme fatigue for more than six months, then it is highly possible that you are having chronic fatigue syndrome. However, it is also important that you make sure that your fatigue is not cured with bed rest and is not associated with any other disease.
When diagnosing chronic fatigue syndrome, the symptoms of this disorder can be misdiagnosed as some other disease. Hence, it is very important that you make sure you do not confuse chronic fatigue syndrome with those diseases such as
Prevalence And Clinical Features
It is difficult to establish the prevalence of CFS, since it depends on the diagnostic criteria used and the study population. Initial research suggested a prevalence between 0.002% and 0.04%. . However, latest epidemiological studies in the USA and in the United Kingdom show prevalence rates ranging from 0.007% to 2.5% of the general population. These rates increase up to 0.5-2.5% when the population assessed includes individuals seen in primary care facilities instead of the global population. In the United Kingdom, according the Oxford criteria , the prevalence in the global population has been estimated in 0.6%. In Japan the prevalence has been found to be 1.5% in the general population. Thus, the prevalence in the general population appears to be much higher than previously indicated. Even with strict criteria for CFS, it is estimated that approximately 1% of the adult population experiences this condition. Interestingly, a large part of this group remains unrecognized by the general practitioner. A striking similarity in lifestyle pattern between SF, CF and CFS calls for further research.
CFS mainly affects young adults from 20 to 40 years, although the symptoms also exist in childhood, adolescence and in the elderly . It has a 2-3 times higher prevalence in women than in men. No evidence exists showing that any socio-economic group is more affected than others .
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Fukuda Research Case Definition For Chronic Fatigue Syndrome
Patients can be classified as having CFS if they meet the following criteria:
1. The individual has had severe, clinically evaluated, persisting or relapsing fatigue for six or more consecutive months. The fatigue is not due to ongoing exertion or other medical conditions associated with fatigue. The fatigue significantly interferes with daily activities and work.
2. The individual has four or more of the following symptoms, persisting, or relapsing and concurrent with the fatigue:
Post-exertional malaise lasting more than 24 h
Significant impairment of short-term memory or concentration
Pain in the joints without swelling or redness
Headaches of a new type, pattern, or severity
Tender lymph nodes in the neck or armpit
A sore throat that is frequent or recurring
3. A thorough medical history, physical examination, mental status examination, and laboratory tests are necessary to identify other conditions with similar symptoms that require treatment. The diagnosis of chronic fatigue syndrome cannot be made without such an evaluation.
Myalgic Encephalomyelitis/chronic Fatigue Syndrome: Fact Sheet For Schools
Myalgic encephalomyelitis/chronic fatigue syndrome is characterized by the bodys inability to produce sufficient energy for the normal range of human activity and the patients energy reserves are substantially reduced. The main symptoms include:
Severe, overwhelming fatigue with loss of mental and/or physical stamina and a substantial reduction in ability to take part in personal, educational and/or social activities.
The cardinal symptom of worsening of symptoms and malaise following minimal physical or mental exertion which can persist for hours, days, or weeks and is not relieved by rest
Cognitive problems , unrefreshing or disturbed sleep and a variety of painful conditions . Cognitive problems may worsen with prolonged upright posture.
There is no medical test for the illness. The diagnosis is made from the characteristic pattern of symptoms some or all of the above symptoms must be present every day for at least 6 months, symptoms must be moderate or severe, and other fatiguing illnesses must be ruled out by history, physical exam, and medical testing
Additional symptoms are often present and include:
Orthostatic intolerance, which is the development of symptoms due to prolonged upright posture that result in lightheadedness , increased fatigue, cognitive worsening, headaches, and/or nausea.
Hypersensitivities to light, noise, touch, odors, and/or medications.
Gastrointestinal symptoms such as abdominal pain, nausea, and/or loss of appetite.
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The Importance Of Education
The physician might need to take an active role in supporting young people with ME/CFS and ensure that they receive an education that is appropriate for their physical condition. Long-term follow-up of young people with ME/CFS shows that engagement in education is a key issue that improves their ability to function regardless of whether or not they recover . Students can become demoralized if they are asked to withdraw from school. Education helps students to fulfill their aspirations and allows important aspects of their lives such as socializing with their peer group, to develop . It widens the range of possible occupations in later life. Work that is low skilled is usually more physically demanding. Although students with ME/CFS have cognitive dysfunction and reduced energy reserves, intellectual reasoning is frequently retained and most students with ME/CFS are capable of keeping up with their peers in some academic classes provided that the number of their classes is strictly limited .
The Possible Impact Of Me/cfs On The Family
A child or adolescent affected with ME/CFS presents challenges for the entire family. The challenges are similar to those faced by families of children with other chronic illnesses such as leukemia or juvenile rheumatoid arthritis, but with the additional challenges of widespread disbelief in the authenticity of the illness, the pervasive social stigma associated with a diagnosis of ME/CFS and a paucity of medical professionals who are knowledgeable about the illness.
In our experience, the majority of families draw on their strengths. The parents are usually able provide the necessary care, and siblings learn to cope with diminished parental attention. When families cope well with their childs illness, the risk of emotional damage to siblings is minimized.
Research has shown that siblings of young patients with ME/CFS are more anxious than normal adolescents. Siblings identified factors having a negative impact on their lives, as lack of knowledge about the illness, change in their role in the family, lack of communication within the family, new restrictions placed on family life, change of parental focus, emotional reaction to having a sick sibling, and the social stigma of being the sibling of a young person with ME/CFS. Communication within the family, social support and extra activities were found to have a positive impact .
Helpful strategies to support the family can include:
Participation of both parents in the evaluation and management of the patient.
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Severity Of Chronic Fatigue Syndrome Symptoms
Symptoms vary widely in severity and people may have some symptoms more severely than others. However, the following definitions are provided by NICE to provide a guide to the level of impact of symptoms on everyday functioning:
Features of mild chronic fatigue syndromeThese include:
- You are able to care for yourself and do some light domestic tasks but may have difficulties with mobility.
- You are usually still able to work or attend education, but to do this you have probably stopped all leisure and social pursuits.
- You often have reduced hours, take days off and use the weekend to cope with the rest of the week.
Features of moderate chronic fatigue syndromeThese include:
- You have reduced mobility and are restricted in all activities of daily living.
- However you may have peaks and troughs in your level of symptoms and ability to do activities.
- You have usually stopped work or education, and need rest periods, often resting in the afternoon for one or two hours.
- Your sleep at night is generally of poor quality and disturbed.
Features of severe chronic fatigue syndromeThese include:
- You are unable to do any activity for yourself, or you can carry out minimal daily tasks only .
- You have severe cognitive difficulties and may depend on a wheelchair for mobility.
- You are often unable to leave the house or you have a severe and prolonged after-effect if you do so.
- You may also spend most of your time in bed and are often extremely sensitive to light and sound.
Signs You Could Have Chronic Fatigue Syndrome
Chronic Fatigue Syndrome or Myalgic Encephalomyelitis is a complicated disorder. Youre exhausted all of the time. But the symptoms dont stop there. Weve compiled 25 signs of Chronic Fatigue Syndrome for you to explore. If you are looking for answers, this is a great place to start.
The information provided on this website is not meant to be used, nor should it be used, to diagnose, treat, cure, or prevent any disease or medical condition. This information has NOT been evaluated by the FDA. This website is not intended as a substitute for the medical advice of a physician. The reader should regularly consult their doctor in matters relating to his/her health and particularly with respect to any symptoms that may require diagnosis or medical attention. Full Disclosure Policy, Legal Clause, and Terms and Conditions Click HERE.
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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.
Alternative And Holistic Therapies
Alternative or holistic therapies may provide some comfort to those with a long standing illnesses but be cautious of any method that claims to offer a cure for chronic fatigue. If the therapy has not been published in respected peer-reviewed journal or is expensive you should talk to your GP before trying it. Until further research is done, no-one can be certain whether someone with CFS/ME might benefit from alternative therapies.
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Chronic Fatigue Syndrome: Diagnosis And Treatment
JOSEPH R. YANCEY, MD, Fort Belvoir Community Hospital, Fort Belvoir, Virginia
SARAH M. THOMAS, MD, Fairchild Air Force Base, Washington
Am Fam Physician. 2012 Oct 15 86:741-746.
Patient information: See related handout on chronic fatigue syndrome, written by the authors of this article.
Chronic fatigue syndrome is a widespread problem. It is estimated that more than 2 million Americans have CFS, many of whom have not been diagnosed.1 Women are twice as likely as men to have CFS,1 and it is more common in persons older than 40 years.1,2 There is not an established racial or educational predilection.1,2 CFS is often mentally and emotionally debilitating, and persons with this diagnosis are twice as likely to be unemployed as persons with fatigue who do not meet formal criteria for CFS.3 In 2002, the estimated annual cost of lost productivity was $9.1 billion dollars in the United States.4 In addition to economic hardships, persons with CFS are more likely to report subjective functional impairment than those with chronic fatigue.3
SORT: KEY RECOMMENDATIONS FOR PRACTICE
Persons with chronic fatigue should have an evaluation, including history, physical examination, and initial laboratory testing .
SORT: KEY RECOMMENDATIONS FOR PRACTICE
Persons with chronic fatigue should have an evaluation, including history, physical examination, and initial laboratory testing .
Sore And Discolored Throat
A sore throat is a common complaint in CFS and may be accompanied by a dark red to purple discoloration may be seen at the back of the mouth and throat. This is known as crimson crescents. It is specifically the anterior tonsillar pillars that are discolored, which are the mucous membrane that lies just in front of the tonsils.
These structures may become red in color when inflamed as part of a sore throat or inflamed tonsils . However, the reason why this discoloration occurs in chronic fatigue syndrome is unknown. It a common sign in CFS can also occur in other conditions apart from tonsillopharyngitis and CFS.
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