Everyone experiences tiredness. Whether it be from a lack of sleep, over-exertion or simply not being kind to oneself, fatigue is a part of ordinary, everyday life. But in the case of those suffering from Chronic Fatigue Syndrome, also known as Myalgic Encephalomyelitis or ME for short, tiredness is far from normal. It is both extreme and constant and can be seriously debilitating. Commonly referred to as CFS/ME, the illness is a long-term one and can affect anyone at any time, both children and adults. Women have found to be more susceptible to it than men and the average age at which it can occur is from the mid-20s to the mid-40s.
The primary symptom is, as the name suggests, considerable tiredness and a general feeling of ill-health. But these are by no means the only symptoms of CFS/ME. Someone suffering from this disease may also experience problems sleeping, pain in their joints or muscles, headaches, a sore throat or glands that are painful but not swollen, feelings of dizziness or nausea, heart palpitations or flu-like symptoms.
Many people with CFS/ME report that exercise, especially over-exercising, exacerbates their symptoms. They also point out the lack of consistency in the severity of their symptoms. They can range from mild to severe from day to day or they may even differ from one hour to the next.
The exact cause of CFS/ME remains unknown, although there are several theories. Many people with the illness have said that it began in a way that was comparable with the flu. This has led some scientists to believe that infection is the root cause. Another theory is that changes in the person’s immune system and the subsequent handling of infection or stress are to blame. Another common theory is that stress which alters the body’s chemistry is the cause, as often patients diagnosed with CFS/ME report experiencing physical or emotional stress prior to becoming ill.
Genetics may also play a part, as studies conducted on twins and families suggest that a combination of genes and environment may play a role in causing CFS/ME. But at the time of writing, an exact cause has yet to be determined.
It is not uncommon for CFS/ME to be mis-diagnosed as another ailment with similar symptoms, thus a GP must carefully analyse the symptoms until they are satisfied that they have eliminated all other possible diagnoses. The diagnosis may involve blood and urine tests and questions concerning the patient’s medical history. The longer the symptoms persist, the more likely a diagnosis of CFS/ME will be made, as most other illnesses with similar symptoms tend to get better in their own time.
There are numerous treatments available for CFS/ME and each course of treatment will be tailored to the patient’s individual needs.
This is because there is no individual treatment that works for everyone. GPs will work with their patients to develop a treatment plan that takes into account individual circumstances and needs. This may involve certain lifestyle changes, the need for a specialist treatment or perhaps a combination of both. Whatever is decided upon, the treatment will be regularly reviewed and updated as and when necessary.
One possible specialist treatment is cognitive behavioural therapy (CBT). This is usually recommended if the symptoms are mild or moderate. CBT will help the patient to take control psychologically by confronting feelings that may exacerbate the symptoms, better understand how behaviour affects the condition and generally feel more in control of the symptoms. The use of CBT, however, is not to suggest that CFS/ME is a psychological condition.
Another possible treatment is Graded exercise therapy (GET). The purpose of this is to gradually increase the amount of time the patient can carry out a physical activity. It usually consists of physical exercise that increases the heart rate, perhaps through swimming or walking. As the patient’s physical capabilities increase, the therapy will be adapted accordingly in terms of the intensity of the exercise and the length of time it is conducted.
CFS/ME cannot be cured by medication alone, but nonetheless certain medication may be prescribed to assist with certain symptoms. Headaches, for example, can be countered with tablets from the local pharmacy, as can muscle and joint pain. GPs can prescribe strong painkillers, although these will mostly be used for short-term bases. In addition, antidepressants may be able to assist with sleep issues.
In terms of lifestyle changes, it is important for the patient to maintain a healthy and balanced diet. If the symptoms of CFS/ME are making this prohibitive for the patient, practical advice will be offered on what steps to take to amend it. Special diets that exclude certain food types are generally not recommended to patients with CFS/ME and neither are supplements such as vitamin B12 or vitamin C.
It is also important for patients with CFS/ME to develop a steady sleeping pattern if they do not already have one. A lack of sleep, or a restless sleep or excessive sleep may aggravate their symptoms. Doctors will generally advise the patient to change their sleep pattern gradually and will monitor their progress at regular intervals. Should the patient require rest through the day, advice will be provided on the best way to do this. Relaxation techniques such as breathing exercises may be recommended too.
It’s important to note that there are several methods commonly used by people with CFS/ME to manage their condition that are not recommended. For example, pacing, that is to balance rest and activity in such a way that fatigue and similar symptoms are not worsened. Complementary medicines are also not recommended. In both cases, it is because insufficient or no research exists to prove their effectiveness in helping to manage CFS/ME.
CFS/ME is by no means a lifelong illness and, with the proper support and treatment, patients can expect to overcome the symptoms and lead a healthy life.
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