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When I talk with CFS patients who have been struggling for a long time and listen as they describe their symptoms, I sometimes question whether they actually have CFS. Not from the perspective of a medical practitioner but from the straight forward CDC definition. Here it is again as a refresher.
Centers for Disease Control - Chronic Fatigue Syndrome
A clinician should consider a diagnosis of CFS if these two criteria are met:
1. Unexplained, persistent fatigue present for 6 months or more that is not due to ongoing exertion;
is not substantially relieved by rest, is of new onset (not lifelong) and results in a significant reduction in
previous levels of activity.
2. Four or more of the following symptoms are present for six months or more:
o Impaired memory or concentration
o Postexertional malaise (extreme, prolonged exhaustion and sickness following physical or mental activity)
o Unrefreshing sleep
o Muscle pain
o Multijoint pain without swelling or redness
o Headaches of a new type or severity
o Sore throat that's frequent or recurring
o Tender cervical or axillary lymph nodes
As we’re all too aware, CFS (Fibro, ME, etc) is a waste basket diagnosis. If a clinician can’t determine a known disease for a patient and if the above fits, then you get the ‘no diagnosis’ diagnosis of CFS. It translates as “I can’t find anything physically wrong with you but you seem to be sick”. Unfortunately, some patients are receiving this diagnosis before they have been thoroughly evaluated and tested for known diseases. If you have health insurance or can pay for a thorough examination, do consider it. Even if you were tested at one time, it may have been a few years ago. Medical knowledge is expanding rapidly and not every physician is a good diagnostician. Each medical specialty has a different view of the biomedical pathways of the body. A neurologist will evaluate you differently from a rheumatologist. And if this process does generate a hard diagnosis, it might be easier to treat than CFS. Granted, some of the alternative diagnoses are not something that you really want to have but known is an advantage in seeking treatment.
I’ve also encountered the flip side of the CFS diagnosis. Lay people and physicians who’ve never met a particular patient declaring (based on anecdotal information) that the patient doesn’t even have CFS. They state confidently that the patient actually has ‘fill in diagnosis of the week here’. This always amuses me but I’m concerned about the desperate patients who are sent on pointless, energy wasting disease chases.
From my perspective, when it comes to a diagnosis, information and hard data rule. Followed by a chaser of common sense (more on that in my next blog).
So what’s your definition of CFS? Serious, laughable, irreverent, fun? Please COMMENT or send them in and I’ll post them. You can use the Contact Form or send an email to Martha at DefeatCFS dot net.
Look for a weekly posting on Tuesdays. And consider being part of the conversation.
Be Well Again,
Martha
Centers for Disease Control - Chronic Fatigue Syndrome
A clinician should consider a diagnosis of CFS if these two criteria are met:
1. Unexplained, persistent fatigue present for 6 months or more that is not due to ongoing exertion;
is not substantially relieved by rest, is of new onset (not lifelong) and results in a significant reduction in
previous levels of activity.
2. Four or more of the following symptoms are present for six months or more:
o Impaired memory or concentration
o Postexertional malaise (extreme, prolonged exhaustion and sickness following physical or mental activity)
o Unrefreshing sleep
o Muscle pain
o Multijoint pain without swelling or redness
o Headaches of a new type or severity
o Sore throat that's frequent or recurring
o Tender cervical or axillary lymph nodes
As we’re all too aware, CFS (Fibro, ME, etc) is a waste basket diagnosis. If a clinician can’t determine a known disease for a patient and if the above fits, then you get the ‘no diagnosis’ diagnosis of CFS. It translates as “I can’t find anything physically wrong with you but you seem to be sick”. Unfortunately, some patients are receiving this diagnosis before they have been thoroughly evaluated and tested for known diseases. If you have health insurance or can pay for a thorough examination, do consider it. Even if you were tested at one time, it may have been a few years ago. Medical knowledge is expanding rapidly and not every physician is a good diagnostician. Each medical specialty has a different view of the biomedical pathways of the body. A neurologist will evaluate you differently from a rheumatologist. And if this process does generate a hard diagnosis, it might be easier to treat than CFS. Granted, some of the alternative diagnoses are not something that you really want to have but known is an advantage in seeking treatment.
I’ve also encountered the flip side of the CFS diagnosis. Lay people and physicians who’ve never met a particular patient declaring (based on anecdotal information) that the patient doesn’t even have CFS. They state confidently that the patient actually has ‘fill in diagnosis of the week here’. This always amuses me but I’m concerned about the desperate patients who are sent on pointless, energy wasting disease chases.
From my perspective, when it comes to a diagnosis, information and hard data rule. Followed by a chaser of common sense (more on that in my next blog).
So what’s your definition of CFS? Serious, laughable, irreverent, fun? Please COMMENT or send them in and I’ll post them. You can use the Contact Form or send an email to Martha at DefeatCFS dot net.
Look for a weekly posting on Tuesdays. And consider being part of the conversation.
Be Well Again,
Martha
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