The Questions of Chronic Fatigue

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Chronic Fatigue Syndrome is an illness fraught with many questions and very few answers. Doesn't everyone get tired? Isn't everyone fatigued and exhausted at times? The ill-named illness implies a simple tiredness that doesn't begin to aptly describe the many symptoms of chronic fatigue syndrome.

"Doctor, I'm so tired. I don't have the energy to function. Even though I'm exhausted, I don't sleep well at night. I wake up feeling as if I haven't slept at all," sufferers explain to the expert, hoping for a cure, or at least some answers. The doctor runs a battery of medical tests, and the results return essentially normal. Perhaps he will prescribe short-term sleep medication. But the sickly fatigue continues, mimicking the flu. Simple activities such as taking a shower and dressing are still monumental efforts.

"Doctor, I have terrible pain in my neck, shoulders, wrists, and hands." The doctor asks questions, orders more tests and x-rays. All results return essentially normal. No indication of carpal tunnel syndrome, arthritis, multiple sclerosis or lupus. The doctor prescribes aspirin, ibuprofen and other non-prescription medications that do not help.

"Doctor, the pain in my hands is better but now my back and hips are killing me. I have a headache, sinus drainage and a cough that won't go away. I feel feverish off and on but the thermometer rarely registers it." The doctor refers the patient to a variety of specialists including endocrinologists, rheumatologists, infectious disease specialists and allergists. All results of the exams and tests are essentially normal.

"Doctor, I can't concentrate, can't remember things. I feel like I'm in a fog. Mental tasks that used to be easy are now a chore, sometimes an impossible chore." After an extended period of time, often years, the doctor(s) decide the problem is psychological, perhaps depression, perhaps burn out. The next referral is to a psychiatrist.

The psychiatrist asks questions regarding sadness, hopelessness and suicidal tendencies.

"Doctor, I'm frustrated, not clinically depressed. No one has been able to provide any answers and now you're insinuating it's all in my head. Anyone would feel depressed after what I've been through. Also, after suffering all this time, I'm angry. My boss things I'm malingering. Family and friends think I'm lazy or crazy. Sometimes I wish I would break a leg just to show I'm hurting--and to get some rest. Perhaps if people could see some bandages I would get the emotional support I need. I have no energy to cope with the skepticism and scorn. This stress, or any kind of stress, drains my already depleted energies and causes more pain".

The doctors have no answers. The symptoms mimic so many other diseases that doctors, as well as patients, have been confused and frustrated over the identification, causes and cures of chronic fatigue syndrome. The uninformed question hypochondria. The knowledgeable suggest chronic fatigue syndrome.

In 1988 the Center for Disease Control dubbed the illness chronic fatigue syndrome, an innocuous name for this noxious disease. In the past, various other names have been used: myalgic encephalomyelitis, post-viral fatigue syndrome, neurasthenia, chronic mononucleosis and more recently, chronic Epstein-Barr disease. Medical researchers continue to search for answers. Although CFS is not a life threatening illness, (though the severely affected sometimes wish they would die) the quality of life is severely affected. Some people are bedridden, unable to continue any productive activity. Some can function at an abnormally low level, requiring rest at frequent intervals. The symptoms wax and wane and can be treated with minimal, if any, results. Stress and physical activity aggravate the symptoms. Rest is essential and limited exercise is beneficial.

"Doctor, I'm going to an herbalist. Perhaps nature's healing herbs will provide some answers." The doctor shrugs his shoulders. "Perhaps."

Maureen M. Quinn is a freelance writer who lives in West Bend