OCR Text |
Show Chronic Fatigue Syndrome, recognized asa real disease since 1988, remainsdifficult Doctor,Why Ami to treat. Here’s how totell if you actually have it and how to deal with it. uarjean Ng Always So Tita BY DR. ISADORE ROSENFELD OW OFTEN DO 1 hear, “Doctor, why am I so tired? What can I commonhealth complaintof adults of both sexes. Everyoneis tired now and then,and the reasonis usually obvious: You maynothave beensleeping well because you're depressed, anxious, have a large prostate that makesnaturecall too often,or are taking caffeine or some medication that keeps you awake. Or you're taking a that sedates you duringthe day, such asa tranquilizer, a blood-pressure-lowering drug or a painkiller, Or you're suffering from jetlag. If you can identify the problem—whateverit is —and correct it, your energy will return. Continuous fatigue for no apparent reason is nature's signal to you that something is wrong. In additionto the causes mentioned above, a variety of other conditions—ranging from some that are easily managedtoseriousdiseases like cancer—can make you tired. You maybe anemic for any oneof several reasons, or perhapsyourliver, thyroid or kidneys aren't working properly. The list is long. However,there is onekindoffatigue unlike any other—a bone-breakingtired- nessthat prevents you fromgetting out ofbed in the morningevenafter a good Rosenteld: +| “it’s not ~| all in your head.” night’s sleep. You continue to feel worn out no matter how muchyourest. You can’t workorplay, and all you're able to dois vegetate at home. Whenyoutell yourdoctor aboutit, he or she performs a thorough checkup,butthe tests come back “normal.” The diagnosis? Chronic Fatigue Syndrome(CFS). This condition was first formally char- acterizedas a real illness by the Centers for Disease Control and Prevention o~S Dr. Isadore (CDC) in 1988. In 1994, with no specific test yet available to identify the disease, the CDC expanded andrefined its criteria for Chronic Fatigue Syndrome(see box below). Fatigue is so commonin daily life Do You Have CFS? © is not the result of continuous exertion (such asa strenuous job or exercise program). © is notalleviated byrest. © results in a substantial reduction in work and in social or personal activities. 2) The exclusion by a doctor of any other medical condition that might account for the fatigue. 3) A combination of at /east four of the following symptoms for at least six months: Qinability to concentrate tance asa clinical entity, some doctors (and probably mostofyourfriends)still view CFS as nothing more than depression. Theyinsist thata real “condition” would produce some abnormalities in a physical exam orblood tests. I too usedto be skeptical about CFS. I wassure it was“all in the head.” But I’ve changed my mind. I’m now con- ¥ The criteria for a diagnosis of Chronic Fatigue Syndrome, according to the CDC: 1) Persistent or recurring protound fatigue for at least six months that... Qi loss of short-term memory thatreliablestatistics are difficult to obtain, but an estimated 800,000 Americans suffer from the profound symptomsassociated with Chronic Fatigue Syndrome. Thoughit can strike anyoneat any age, it’s three times more commonin women, for reasons unknown.Despiteits accep- fa ttist bate headaches of a new type, pattern or severity unretreshing sleep () prolonged fatigue sore throat (24 hours or more) tender lymph nodes after physical muscle pain exertion 1you meet these criteria, see a doctor. For more No matter how muoh worn /nformation on CFS, write to: CFIDS Association of America, P.O. Box 220398, Dept. P, Charlotte, N.C, 28222-03986; or call 1-800-442-3437, vincedthatit is a real disorder—probably due to some derangementof the immunesystem,possibly triggered by a still unidentified infection,viral or bacterial, or an allergy or hormonalimbalance. The bottom line, however,is that the cause or causesofthe syndromeremain a mystery. Patients with Chronic Fatigue Syndromeare more than just profoundly tired, They haveother typical symptoms too. Most are depressed—and who can blamethem,feeling the way they do? In addition, they complain frequently offlulike symptoms and arelikely to have low blood pressure, poor shortterm memory,trouble thinking clearly and a tendencyto be irritable. From time to time they have a sore throat, and the glands in the neck and armpit may be enlarged and tender. Somepatients also complain of joint and muscle pain and are diagnosed as having fibromyalgia (see PARADE,July 18, 1999), Even PAGE 18 OCTOBER 31, 1999 PARADE MAGAZINE |