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Chronic Fatigue Syndrome (CFS/ME)
CFS/ME is an illness with a recognisable pattern of symptoms. The main symptom is profound fatigue but it is common to have other symptoms.
Comprehensive medical assessment is needed to exclude other possible medical conditions that can present with similar symptoms. If symptoms persist once doctors have ruled out other identifiable causes then the patient should access appropriate advice and treatment.
Research shows that some treatments can be effective in CFS/ME. The treatment plan needs to be negotiated and tailored to the individual needs of each patient.
An important objective of treatment is to help support the CFS/ME patient to make changes that can positively affect their health and wellbeing, such as physical rehabilitation, sleep management, pain management, coping with set backs, pacing and goal setting.
Our multidisciplinary team has over ten years of experience in treating CFS/ME.
Symptoms
The main symptom in CFS/ME is fatigue but it is common to have other symptoms such as muscle and joint pain, sleep disturbance, headaches, sore throats, tender lymph glands, concentration and memory problems.
Assessment
Screening tests to exclude other possible medical conditions that can present with similar symptoms should always be performed before the diagnosis is confirmed.
If the symptoms have been present for more than six months and are preventing the person from living a normal life then, provided the doctors have ruled out other causes, they should diagnose CFS/ME.
Causes
Some people develop CFS/ME after a viral or bacterial infection while others may develop the illness after distressing or stressful life events. As with other illnesses, such as heart disease, there appears to be a range of predisposing, triggering and maintaining factors in CFS/ME. These factors may vary between individuals. Symptoms can get worse with exertion, infection, stress or sometimes for no apparent or identifiable reason. CFS/ME is associated with other conditions such as fibromyalgia and irritable bowel syndrome.
Management
All patients receive a comprehensive clinical assessment. Medical assessment includes a detailed medical history, examination and investigations if appropriate. Investigations are needed to exclude other medical conditions that can present with similar symptoms. These investigations should have been performed within the previous six months prior to their referral.
Sometimes patients with CFS/ME are confused by their medical contacts because they may have received conflicting explanations for their symptoms along with conflicting advice as to how best to recover. Sometimes the information they receive is profoundly pessimistic and only serves to increase their concerns and distress. Receiving a diagnosis of CFS/ME, gaining an understanding of the illness, recognising that effective treatments are available and realising that the majority of people with CFS/ME sufferers do get better can be reassuring and represent the beginning of recovery.
After the comprehensive multidisciplinary assessment an individual treatment plan will be jointly negotiated and tailored to the individual needs of each CFS/ME patient. The treatment plan is based on the current scientific, medical and therapeutic evidence.
An important objective of treatment is to help support the CFS/ME patient to make changes that can positively affect their health and wellbeing, such as physical rehabilitation, sleep management, pain management, coping with set backs, pacing and goal setting.
Aims of treatment
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Share current knowledge and understanding of CFS/ME
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Reduce the impact of fatigue and other distressing symptoms
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Strategies for dealing with relapses and set backs
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Improve sleep pattern
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Reduce pain
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Improve physical functioning
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Improve psychological wellbeing
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Promote a return to a more normal lifestyle
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Support, when possible, a return to productive vocational activity
References
Action for ME Guidance on the management of CFS/ME Wells:AfME
The Chief Medical Officer's Working Group Report on CFS/ME. (2002) London DoH
Further information
http://www.nice.org.uk/ CFS/ME Guidelines
Sussex ME/CFS Society www.measussex.org.uk
Action for ME (AfME) www.afme.org.uk
Please call 020 7936 3454 or email
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