Chronic Fatigue Syndrome, now more commonly called Chronic Fatigue and Immune Dysfunction Syndrome or simply CFIDS, is a complex illness, characterized by severe, debilitating fatigue and many other symptoms. It is also considered an invisible illness, because there are few obvious signs of illness. While the cause and cure are unknown, CFIDS symptoms can be managed.
HOW IS IT DIAGNOSED?
While there is no one definitive test for CFIDS, there are some standard tests commonly used to diagnose CFIDS. At the onset of illness, the most common symptoms are sore throat, fever, tender lymph nodes, and muscle pain. Diagnostic criteria, developed by the U.S. Centers for Disease Control (CDC), include:
1. Clinically evaluated, unexplained persistent or relapsing chronic fatigue that is of new or definite onset (i.e., not lifelong); is not the result of ongoing exertion or substantially alleviated by rest; and results in a substantial reduction in previous levels of occupational, educational, social or personal activities.
2. Four or more of the following symptoms: substantial impairment in short-term memory or concentration; sore throat; tender lymph nodes; muscle pain; multi-joint pain without joint swelling or redness; headaches of a new type, pattern or severity; unrefreshing sleep; and post-exertion malaise lasting more than 24 hours. These symptoms must have persisted or recurred during six or more consecutive months of illness and must not have predated the fatigue.
ARE THERE OTHER SYMPTOMS?
Some secondary symptoms reported by people diagnosed with CFIDS include: visual disturbances; cognitive problems; psychological problems; chills and/or night sweats; dizziness and balance problems; sensitivity to heat and/or cold; irregular heartbeat; numbness, tingling and/or burning sensations; dryness of the mouth and eye; bloating; nausea; sleep disorders; decreased libido (sex drive); ringing in the ears (tinnitus); allergies and sensitivities to noise, light, odors, chemicals and medications; weight changes without changes in diet; and seizures. Early in the illness, patients often sleep a lot, but as CFIDS progresses, it may be difficult for patients to fall or stay asleep. Generally, the symptoms develop initially over a few hours or few days, and most patients can recall the onset of these symptoms with great specificity.
WHAT IS THE TREATMENT?
There are three methods for the treatment of CFIDS:
Lifestyle Issues: This is the most important of the three methods, and the one over which the patient has greatest control. Extremely critical is the setting of reasonable limits by the patient, for both work and lifestyle activities. Setting the limits may require taking a short- or long-term leave from a job. Reasonable limits, however, should set soon after onset to help ensure the individual is able to continue working. Reduction of stress is very important since excessive stress may cause symptoms to increase severely. Some limited exercise is excellent, but over-exertion can cause a severe relapse. No exercise at all can cause a patient to be unable to even get out of bed. Nutrition and vitamins are also an important lifestyle factor.
Symptom Relief: The most important treatable symptoms are sleep disorders, which are treated with prescription medications, and fatigue, which might be treated with vitamin B-12 injections and Coenzyme Q10. Other treatable symptoms are cognitive dysfunction and pain.
Primary Therapy: This attempts to modulate the immune system, however, the main treatments are the use of gamma globulin and Kutapressin, neither of which have been proven effective for everyone with CFIDS.
WHAT ABOUT FINDING A PHYSICIAN
The patient should try to find a CFIDS-knowledgeable physician. Routine medical tests usually yield normal results, and the symptoms can be mistaken for other infectious diseases or illnesses, although most can be ruled out with basic diagnostic tests. It usually takes a lot of time and patience for the doctor and patient to go through the process of ruling out other possible causes of the symptoms.
WILL I RECOVER?
CFIDS is not a progressive disease, but it may stay around for years. The most intense symptoms usually occur in the first year, then tend to stabilize. Most patients do eventually recover—some fully. There is no way to predict the course of the illness in an individual patient. Many patients get well within two years, and patients with an intense initial onset of the illness tend to recover more quickly.
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