Just Tired, or is it ME? - It Feels Like
Being in the Final Stages of AIDS for 11 Years. Tom Kindlon - a Sufferer
from Chronic Fatigue Syndrome - Talks to Kathryn Holmquist
Working late, I email Tom Kindlon at 12.15
a.m. about an interview concerning the debilitating condition he has
suffered from for 11 years, ME (myalgic encephalitis), also known as chronic
fatigue syndrome (CFS). His email reply bounces back at 1.10 a.m., I
respond, and at 1.45 a.m. he replies a second time. He too is burning the
midnight oil.
Tom helps his mother Vera run the ME/CFS Association from the home they
share, informing others about a disease with no known cause and no proven
treatment that may spontaneously disappear - or last a lifetime.
Tom's is an extreme case; most newly diagnosed sufferers recover within two
years. When we eventually speak for a pre-arranged half-hour telephone
interview, Tom turns out to be an articulate young man. When I ask him about
his nightowl habits, he explains that 'sleep reversal' is a classic symptom
of ME. While after a late night I'll rise at 7 a.m. to get the children up
and off to school, Tom will remain in bed until noon and will go to sleep
again at 3 or 4 a.m.
Taking tricyclic antidepressants has improved his sleep pattern. At one
stage, his regular bed-time was 6 a.m. When he rises, he sits in front of a
light box to prevent SAD (seasonal affective disorder) caused by living in
darkness. His body temperature has remained below 97F for the past six
years. 'I wear lots of T-shirts and two woolly jumpers as well as a coat and
a cap (which also doubles to keep out the overhead lights) in the house to
keep warm all year around,' he says.
Tom (27) experienced the first symptoms of ME when he was 16 years old,
after a bout of flu. At the time, he played rugby for Belvedere and enjoyed
cricket, tennis and cross-country running. He participated in the Young
Scientists' competition three times, winning once, and belonged to Mensa.
Advised to cut back on sports due to his fatigue, he focused on academic
life and did well at Trinity College Dublin until, at 21, he was forced to
give up his studies in mathematics after his hands clawed up in pain during
his second-year exams. After a month, he followed advice to exercise more,
but this gave him severe muscle pain which eventually required 100 sessions
of physiotherapy. If he tried to walk he developed shin splints, and the
pedals in the car were painful to push.
Eventually, his GP recommended him to Prof Austin Darragh in the Blackrock
Clinic. Learning that he was a classic case of ME was 'a great relief', says
Tom. 'It was much harder psychologically when I did not know what was wrong
with me. Once I knew other people who had it and started reading about it,
it was a great comfort,' he says. Tom has since learned that overdoing it
can prolong the course of ME. He is convinced that exercising during the
early years of his illness caused his condition to become so entrenched that
he cannot watch a sitcom without losing concentration, cannot read a book
and sometimes garbles his words. Yet he remains motivated and keeps up with
the latest research about ME via the Internet. One study compared the mental
toll of ME to mild Alzheimer's disease, Tom tells me.
Another found that people with ME have same quality of life as people with
AIDS two months before they die. Tom has to ration and prioritise his energy
expenditure, so he rarely leaves the house except for essential travel to
doctors and when he does he needs a wheelchair. He can walk the 15 yards to
the car but after that he's wrecked. His bedroom and bathroom are
downstairs, to spare him the exertions of the staircase, which could send
him into relapse.
His social contact is limited to one dinner with friends per month, although
he has 19-year-old twin siblings living at home who bring friends and life
into the house. Other than that, he is confined to phone calls and the
Internet, both of which must be carefully rationed to half-hour spells,
followed by complete rest. This he achieves through progressive muscular
relaxation, a form of meditation. If Tom overdoes it on one day, he pays for
it the next. 'It's like having the flu and a hangover and feeling like you
just ran five miles - all at once.'
For years, ME was thought to be a psychiatric condition, until enough
evidence emerged to justify its classification by the World Health
Organisation as a neurological disorder. According to a reliable review of
the literature by the National Institutes for Health in the US, 'several
different routes to chronic fatigue syndrome may exist. In some people, a
persistent viral infection may provoke ME/CFS symptoms, and virologists
continue to explore this possibility. Vulnerability to CFS may be associated
with a subtle immune system defect. It also appears likely, however, that
CFS involves interactions between the immune and central nervous systems,
interactions about which relatively little is now known.'
As he waits for a cure, Tom spends his precious moments of energy informing
others about ME, which gives him a sense of fulfilment. In his enthusiasm,
he stays on the telephone with me for an hour - longer than the half-hour we
had agreed. After warning him a few times when we reach the half-hour mark,
I eventually force a goodbye for the sake of Tom's health.
The next day he emails me: 'You were right, I did overdo it with the
interview. That's what's so hard with the illness - it's hard to know when
one has overdone it. My glands (lymph nodes) are now swollen in my neck, I
have a sore throat, headache and am finding it difficult to keep my eyes
open to do this. Hopefully, if I have longer rest periods tomorrow and the
next day, and shorter periods of activity, I should be feeling a bit better
in a day or two.' As part of ME Awareness Week (May 8th-14th) Prof Austin
Darragh will give a free public lecture on ME this evening at 8pm at the
Royal Dublin Hotel, O'Connell Street, Dublin.
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