CFS/ME

Fatigue is a symptom of just about everything, from depression to fever. But Chronic Fatigue Syndrome is different.

The fatigue is constant, made worse by exertion (often very little exertion), but not made much better by rest.

Sufferers tend to have a lot of other symptoms, ranging through;

  • headaches,
  • fuzzy-headedness (also known as brain-fog),
  • impairment of memory and concentration,
  • daytime drowsiness,
  • sleep disruption,
  • various aches and pains,
  • bowel upsets,
  • loss of temperature regulation (vulnerability to cold or to heat)
  • allergies and immune dysfunctions
  • … and so on.

There is no “magic bullet”; no drug, vitamin, diet or psychological therapy that guarantees a cure. But all of these can be helpful. What we have to do is try to identify the factors that are important for you - and there is real progress on that.

My advice, as in all complex problems, is that if anyone tells you “this treatment will work for you”, walk away swiftly. A wise colleague said that “doctors operate in a sea of uncertainty” and that’s certainly true of CFS.

Which is why at some stage in a first consultation I usually like to ask “What do we know, really know, about your illness?” If we start with the known factors we can then go on to look at the probable ones, then the possibles.

What do we do?

First, we take a detailed history (you may be able to provide one already written up). Sometimes the major suspects become apparent then; sometimes not. You have probably tried several treatments or measures before coming to us; we need to make sure that these were done thoroughly enough, and then learn from the outcomes. If there is unfinished business, such as a diet which you are only part-way through, we will probably recommend that you finish it before moving on.

Then, we aim to address the complexity of the problem by asking the crucial question - What do we know? - and doing a “situation report”.  Typically there are some questions that can only be answered by lab tests, and we will set these up for you.

At a second consult, we will look at the lab tests together, and there may be results from other treatments that you have been finishing off, or that have seemed sensible to try first. From all this we can prepare an initial Care Plan and move forward.

The following discusses in a bit more detail some of the factors that we know from experience are important in tackling CFS.

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