Thursday, March 28, 2024

Symptoms Of Chronic Fatigue Flare Up

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How Is Chronic Fatigue Syndrome Treated

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Treatment is determined by your healthcare provider and based on:

  • Your overall health and medical history
  • Extent of the condition
  • Your tolerance for specific medicines, procedures, or therapies
  • Expectations for the course of the condition
  • Your opinion or preference
  • Medicine, including corticosteroids, antidepressants, and others
  • Light-intensity aerobic exercise
  • Dietary supplements and herbal preparations
  • Psychotherapy and supportive counseling

British Columbia Specific Information

Many Canadians are affected by complex chronic diseases . CCDs are illnesses that last a long time, require treatment and management, and often do not get better on their own. Fibromyalgia , Myalgic Encephalomyelitis , which is also called Chronic Fatigue Syndrome , and Chronic Lyme Disease are examples of complex chronic diseases.

To learn more about fibromyalgia, myalgic encephalomyelitis or chronic Lyme-like disease, visit HealthLinkBCs Complex Chronic Diseases health feature.

Pacing Activity For People With Me/cfs

Pacing, or keeping within your available energy, is a self-management strategy to help people with ME/CFS make sure that they dont overdo activity or exercise. It reduces the likelihood of triggering PEM and can help reduce symptoms. Pacing is not a cure for ME/CFS and does not treat the underlying, physical cause of the disease.

The goal of pacing is for activity to be sustainable, so that the person can have some stability in their symptoms and what they can do each day. Pacing should be used in conjunction with rest.

The most challenging aspect of pacing is that PEM is very often delayed by as much as 24-48 hours, which can make it difficult to recognise when youve done too much. Using tools like an activity diary or heart rate monitor help you learn about your body and how much activity you can safely tolerate.

Suggestions on how to pace yourself include:

Recommended Reading: How Do You Get Rid Of Chronic Fatigue Syndrome

When Should You Call Your Doctor

It’s important to talk to your doctor about any symptoms you may have.

  • Severe fatigue that lasts longer than 2 weeks, causes you to limit your usual activities, and does not improve with rest.
  • Sleep problems that last for more than 1 to 2 months. These problems may include being unable to fall asleep or stay asleep, tossing and turning, and waking up feeling tired or not rested.
  • Swelling in the glands in your neck or armpits that lasts for at least 2 weeks.
  • Severe fatigue along with frequent urination , extreme thirst, weight loss, or blurred vision. Fatigue that occurs with some or all of these may be a symptom of undiagnosed diabetes.
  • Severe headache that does not improve with home treatments.

Linear Relationships Between Patient Cytokine Responses And Symptoms Of Fatigue And Pain

10 Causes of Fibromyalgia Flares #fibromyalgiacauses

At baseline, the cytokine that had the strongest association with higher baseline fatigue in CFS patients was higher IL-6 . Higher baseline IL-6 was also associated with higher reported levels of physical fatigue at 48 h . Predictive relationships between changes in cytokines/ligands at 8 h post-exercise and SF severity at 48 h were also examined in all CFS patients using linear regression. Greater increases in IL-6 and in CD40L predicted greater increases in physical fatigue, accounting for 43% and 31% of the variance in fatigue increases, respectively , and increases in IL-6 also accounted for 29% of the variance in increased pain . However, although the relationship with CD40L was robust, the relationships between IL-6 and both physical fatigue and pain increases were strongly influenced by the patient showing the largest IL-6 increase. When reexamined after removal of that individual, these relationships were no longer significant . Still, when considered together with the associations between higher baseline IL-6 and greater fatigue, these observations encourage continued research attention to IL-6 as well as CD40L in relation to SF.

Relationship between increases in IL-6 from baseline to 8 h post-exercise and increases from baseline to 8 h post-exercise in CD40L as they relate to increases in physical fatigue from baseline to 48 h post-exercise in CFS patients.

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Other Chronic Fatigue Syndrome Symptoms:

Because ME/CFS is a multi-system illness, it can actually create a truly astounding set of symptoms. So whilst some regard the above list to be the core Chronic Fatigue Syndrome symptoms, there are actually many other symptoms. These include but are not limited to:

  • Pain including muscle aches, migraines and headaches
  • Gastrointestinal disturbance including diarrhoea, constipation and other difficulties
  • Low grade fever
  • Dry or sore eyes, sometimes described as pain behind or inside the eyes
  • Need to urinate, often along with unquenchable thirst
  • Muscle twitching described by some people as jolts or flashes
  • Chills and cold hands or feet
  • Strange smell sensations often described as ammonium
  • Allodynia which is when your skin hurts to be touched
  • Paresthesia which are sensations such as itching, numbness, tingling, burning or a feeling that something is crawling on you
  • Profuse sweating
  • Painful or swollen lymph nodes
  • Temperature or weather sensitivity
  • Canker sores and infections in the mouth

How Is It Diagnosed

To be diagnosed with ME/CFS, you must have all of these symptoms: footnote 1

  • Major decrease in your ability to do the things you did before you got sickincluding work, school, social, or personal activitiesthat has continued for more than 6 months.
  • Worsening of symptoms after being mentally or physically active .
  • Sleep problems, including not feeling rested after sleeping .
  • Extreme fatigue that is:
  • New or has not been a life-long problem.
  • Not caused by being active for a long period of time.
  • Not much better after resting.

You must also have one or more of these symptoms:

  • Problems with concentration, short-term memory, or using the correct word .
  • Feeling dizzy or faint while standing or sitting upright that gets better when you lie down .

Doctors may also use a variety of tests to confirm a diagnosis or to rule out other conditions.

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Our Chronic Fatigue Management Programs

At Beyond Pain, we not only aim to address your chronic fatigue but provide you with the tools to empower yourself on your journey to recovery. This is why our fatigue management programs are always tailored to suit the individual. Because we are all different, to succeed, it makes sense to design programs with individualised long term goals in mind. All our programs feature:

Goal setting andenjoyable activities

We believe it is vital that your rehabilitation program is based on what you want to achieve. This way we can help you work towards that. When you dont have clear goals, you wont have a clear sense of direction. Once you set your goals, we will help you to achieve them in a manageable way.

Stretch & exercise programs

We will teach you our program and show you how to set the numbers yourself and do them to a level you can manage. This will stop you from push yourself too hard and save you money in the longer term because you will know how to set up a program that works for you. Its not about pushing, its about pacing.

Relaxationtechniques

We will teach you different types of relaxation techniques so that you can use whichever works best for you when you need it. They range from short 30 second techniques to the longer 20 minute techniques. Our techniques are also versatile- they can be performed at home, at work or on the tram.

Managing flare-ups & setbacks

Getting a betternights sleep

Getting into theright mindset

Returning to work / activity in a helpful way

What Are The Symptoms

LIVING WITH A CHRONIC ILLNESS – FIBROMYALGIA FLARE UP

Symptoms can vary with ME/CFS. If you have ME/CFS:

  • You feel exhausted all or much of the time. And it doesn’t get better with rest.
  • Your symptoms often flare up after a mental or physical activity that used to be no problem for you. There may be a day or two delay before it starts. And it may take days, weeks, or more to feel better.
  • You have problems sleeping. Or you may wake up feeling tired or not rested.
  • It may be harder for you to think clearly, concentrate, and remember things.
  • You may feel dizzy, weak, or in more pain when you have been standing or sitting upright for a long time.
  • You may also have headaches, muscle and joint pain, a sore throat, and tender glands in your neck or armpits.

Depression is common with ME/CFS, and it can make your other symptoms worse.

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Facts About Chronic Fatigue Syndrome

  • The CDC estimates up to 2.5 million Americans have ME/CFS.
  • Anyone can get it, including children and teens.
  • It’s most common in women in their 40s and 50s.
  • Women are more likely to develop it than men.
  • Most cases are mild or moderate.
  • About 1 in 4 people with the condition have severe symptoms.

If you have mild ME/CFS, you can probably manage on your own. Moderate symptoms can make it hard for you to move around. For example, you might need to sleep in the afternoons.

Severe symptoms can impact your quality of life and abilities as badly as if you had lupus, heart disease, or rheumatoid arthritis.

How Can I Care For Myself With Chronic Fatigue Syndrome

In addition to the treatments above, there are things you can do to help manage this condition, such as:

  • reducing your stress
  • getting plenty of rest
  • making sleep a priority if you are having trouble sleeping, check out these tips to improve your sleeping habits
  • eating a healthy diet to make sure your body is getting the nutrients it needs
  • having plenty of salt if you have low blood pressure and a tendency to feel dizzy or even faint on standing
  • learning to prioritise the things you need to get done, and then pacing yourself by dividing them into short times of activity with rest breaks in between
  • learning mindfulness, meditation or creative visualisation
  • getting out into nature regularly, listening to music and enjoying your pets
  • developing a support network of understanding friends and family/whnau for when you need help
  • joining a support group if there is one in your area
  • talking to your doctor about whether there are any medications or supplements that may help you.

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My Definition Of A Flare

I call it a flare when my ME/CFS sends me to bed for a few days, when I cant function in an upright position for a few days in a row. If I can still function upright, and dont struggle to move my limbs, then I dont usually consider it a flare.

For a comparison, functioning upright on a good day means being seated, with back and often arm support, drawing or painting for a few minutes or scrolling social media or typing on this blog. It happens in short sessions, sometimes up to an hour at a time if Im doing really well, but often shorter bursts with rests between.

I can move or change position without too much fuss and I can get up for water or toileting without getting breathless and utterly drained.

At the end of the day I have a piece of art, a blog post or draft, or a few granny squares crocheted I have tangible evidence that today was productive. On flare days, that doesnt happen. I dont finish anything unless it had already been started and worked on in the days before, but usually my flare days are just me, lying on my bed or sofa with Netflix and naps being the order of the day.

This is not a relaxing time, it is filled with pain, discomfort, weakness and shaking. The inability to move without sending my heart rate soaring and becoming breathless.

Get Specialist Care When You Need It

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Visit your doctor every few months to help track your symptoms and check for any need to change your treatment.

Get specialized care if you need it. For example:

  • A rehabilitation specialist can help you treat pain and improve your ability to do your daily tasks.
  • A pain management specialist can offer a number of pain treatments.
  • There are some specialists who work with experimental treatments such as antiviral medicines.

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How Is Chronic Fatigue Syndrome Diagnosed

CFS diagnosis depends on two criteria:

  • Severity and duration. The severe and chronic tiredness lasts for more than 6 months and other medical conditions have been ruled out.
  • Number of symptoms. Four or more symptoms of CFS are present.
  • A specific treatment for CFS has yet to be proven effective. Vitamin supplements and medicines have some benefit. Many treatments just relieve the symptoms of CFS.

    How Is Me/cfs Diagnosed

    There’s no single test to detect ME/CFS. A diagnosis is made after other possible known causes for symptoms have been excluded.

    The earlier the illness is recognised, the sooner you can get help to manage your symptoms. Many people with ME/CFS find it helps to keep a diary of their symptoms so that they can take this to their GP or specialist.

    Your GP will usually:

    • do a physical and mental examination to rule out other conditions
    • ask about recent travel, tick or insect bites, unusual infections, and drug and alcohol use
    • review current medication

    They may be able to make a diagnosis after 3 or 4 months of seeing a pattern of symptoms. Anyone suspected of having ME/CFS should be considered for routine blood tests to identify other possible illnesses. More investigation may be needed if the diagnosis remains in doubt.

    Some people with ME/CFS also have another long-term condition and it’s important that you talk to your GP about how to manage the symptoms of the 2 conditions.

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    Diagnostic Criteria For Me/cfs Using The National Academy Of Medicine Clinical Criteria

    For a diagnosis of ME/CFS, the person must have the following three symptoms:

  • Substantial reduction in functioning and persistent and profound fatigue for at least 6 months. The person is unable to undertake the same level of activity before they became ill. Their fatigue is not the result of significant exertion and is not substantially alleviated by rest.
  • Post-exertional malaise.
  • Diagnosis also requires at least one of the following two symptoms:

  • Cognitive impairment .
  • Orthostatic intolerance .
  • It is important to note that these are not the only symptoms of ME/CFS, just the minimum needed to meet the diagnostic criteria.

    While diagnosis requires that a person has had symptoms continually for six months, early intervention with pacing and rest can help reduce symptoms, improve quality of life and reduce the risk of exacerbating the disease. Research suggests that patients who are able to pace their activity and not push themselves tend to do better in the long term. Pacing and rest can start even prior to an official diagnosis.

    While there is currently no cure and no evidence-based treatments, it is important to find a doctor who is not only sympathetic to ME/CFS, but can work with you to help manage your symptoms.

    What A Flare Feels Like

    HAVING A CHRONIC PAIN AND FATIGUE FLARE UP AND DONT KNOW WHY?

    I feel heavy in my limbs, Im trembling inside and visibly shaking at times, its exhausting to move, even just holding my phone is a chore. Talking is hard work, eating literally drains every drop of energy from my body and I just collapse into sleep without warning.

    Its like somebody pulled the plug and all my fuel just drained out and I can no longer function. At all.

    Not only has all my power been drained from my body during a flare, but my ears, nose and eyes become super sensitive. Every rustling of every packet echoes in my brain, confusing my thoughts and disabling my speech. Every tick-tock of the watch across the room and even my own heartbeat or pulse becomes loud and annoying.

    Voices, people, movement around me, it all becomes a loud echoing mess in my head. Its so hard to concentrate or focus on anything. I cant make decisions. I cant remember things. Words drop out of my head while Im speaking and Im left frustrated as I cannot make myself understood. Just decide for me, its easier that way.

    I can smell garbage decomposing in bins down the street and the sunlight I love so much causes me physical pain. When things dont taste the way they should, things dont smell right, and everyday sounds disable me and send shooting pains throughout my body. That is what an ME/CFS flare is like for me.

    Many of these symptoms are present daily anyway, but during a flare they become so intense, they are all consuming.

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    Myalgic Encephalitis / Chronic Fatigue Syndrome

    Last edited 11/2021 and last reviewed 11/2021

    Managing flare-ups in symptoms and relapsein myalgic encephalitis /chronic fatigue syndrome

    Explain that flare-ups and relapses can happen in ME/CFS even if the person’s symptoms are well managed.

    Tell people with ME/CFS that:

    • they are likely to be having a flare-up if they experience a worsening of their symptoms beyond their normal day-to-day variation, which lasts a few days

    • a relapse is when there is a sustained and marked exacerbation of ME/CFS symptoms lasting longer than a flare-up and needing substantial and sustained adjustment of energy management.

    Include guidance on managing flare-ups and relapses in the person’s care and support plan.

    Evaluate and investigate any new symptoms or a change in symptoms and do not assume they are caused by the person’s ME/CFS.

    Discuss and agree self-management strategies with the person with ME/CFS to help them respond promptly if they have a flare-up or relapse, and record these in their care and support plan. This should include:

    For a flare-up:

    • identifying possible triggers, such as acute illness or overexertion

    • temporarily reducing their activity levels

    • monitoring symptoms, recognising that although flare-ups are transient, some will develop into a relapse

    • not returning to usual activity levels until the flare-up has resolved.

    For a relapse:

    • possible causes of the relapse, if known

    • the nature of the symptoms

    • the severity and duration of the relapse .

    Definitions:

    Energy management

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