Flat Tired
Like a nightmare that never ends, you fill up the tank in the morning, shift into drive, and cruise the straight and narrow all day, only to find yourself on the side of the road, “flat tired.” Sound familiar? Well, take solace in the fact that you’re not alone. It is estimated that at least 500,000 people in the United States, and most likely many more, find themselves on the proverbial shoulder of the road with chronic fatigue syndrome (CFS) or a CFS-like condition.
Although its cause remains a mystery, like a sudden pneumatic blowout, its effects are evident. One’s normal activities begin to stagnate, and good sleep, whatever that is, simply is no match for the strong and noticeable fatigue that takes over our daily existence. Pedal to the metal, in the form of caffeine and psychostimulants, is no match for the sputter of depressed physiologic machines of all ages and social and economic classes. Women are diagnosed with the malady two to four times more often, and Shakespeare’s “rose” or chronic fatigue syndrome would smell as sweet, whether it be called myalgic encephalomyelitis, postviral fatigue syndrome, or chronic fatigue and immune dysfunction syndrome.
CFS is a chameleon and a great imitator rolled into one. It can begin after a minor illness, such as a cold, or during a period of excessive stress. Finding its cause is infinitely more difficult than pinpointing that obnoxious rattle and hum of a recently purchased used car. Diagnosis is difficult because its symptoms mimic those of other more common diseases, such as influenza. Headache, tender lymph nodes, fatigue and weakness, muscle and joint aches, and inability to concentrate are all part and parcel of CFS, and yet they are nonspecific. Unlike influenza symptoms, however, which disappear in a few days or weeks, CSF symptoms taunt us, demoralize us, and then retreat, only to reappear, like a red dashboard light, when our rpm’s increase.
If that were not enough, not all members of the medical community have embraced the idea of a syndrome that cannot be better defined by specific clinical sign or laboratory test. Furthermore, many patients with CFS also have major psychiatric illnesses, such as depression, which of themselves, and also by virtue of the medicines used to treat them, can cause some of the CFS symptoms. This has led sympathetic clinicians to consider CFS as part of a range of illnesses that have fatigue as a major symptom, and to formalize its diagnosis specifically, only when four of the seven possible symptoms mentioned previously are present and the other causes of the same symptoms have been ruled out.
So, where does that leave us? Do we trade in our old vehicles, or do we still have a few good years left in them? A good doctor, like a good mechanic, must first make an accurate diagnosis before that decision can be made. Diseases that have similar symptoms to CFS must be ruled out. Only then can measures be taken to jumpstart physiology and recharge our proverbial batteries. When a battery cable will just not do the trick, a highly nutritious diet, stress control, a monitored exercise regimen, frequent rest breaks throughout the day, and judicious use of sleeping pills, antidepressants, and analgesics can go a long way to resurrecting fallen soles.
Although its cause remains a mystery, like a sudden pneumatic blowout, its effects are evident. One’s normal activities begin to stagnate, and good sleep, whatever that is, simply is no match for the strong and noticeable fatigue that takes over our daily existence. Pedal to the metal, in the form of caffeine and psychostimulants, is no match for the sputter of depressed physiologic machines of all ages and social and economic classes. Women are diagnosed with the malady two to four times more often, and Shakespeare’s “rose” or chronic fatigue syndrome would smell as sweet, whether it be called myalgic encephalomyelitis, postviral fatigue syndrome, or chronic fatigue and immune dysfunction syndrome.
CFS is a chameleon and a great imitator rolled into one. It can begin after a minor illness, such as a cold, or during a period of excessive stress. Finding its cause is infinitely more difficult than pinpointing that obnoxious rattle and hum of a recently purchased used car. Diagnosis is difficult because its symptoms mimic those of other more common diseases, such as influenza. Headache, tender lymph nodes, fatigue and weakness, muscle and joint aches, and inability to concentrate are all part and parcel of CFS, and yet they are nonspecific. Unlike influenza symptoms, however, which disappear in a few days or weeks, CSF symptoms taunt us, demoralize us, and then retreat, only to reappear, like a red dashboard light, when our rpm’s increase.
If that were not enough, not all members of the medical community have embraced the idea of a syndrome that cannot be better defined by specific clinical sign or laboratory test. Furthermore, many patients with CFS also have major psychiatric illnesses, such as depression, which of themselves, and also by virtue of the medicines used to treat them, can cause some of the CFS symptoms. This has led sympathetic clinicians to consider CFS as part of a range of illnesses that have fatigue as a major symptom, and to formalize its diagnosis specifically, only when four of the seven possible symptoms mentioned previously are present and the other causes of the same symptoms have been ruled out.
So, where does that leave us? Do we trade in our old vehicles, or do we still have a few good years left in them? A good doctor, like a good mechanic, must first make an accurate diagnosis before that decision can be made. Diseases that have similar symptoms to CFS must be ruled out. Only then can measures be taken to jumpstart physiology and recharge our proverbial batteries. When a battery cable will just not do the trick, a highly nutritious diet, stress control, a monitored exercise regimen, frequent rest breaks throughout the day, and judicious use of sleeping pills, antidepressants, and analgesics can go a long way to resurrecting fallen soles.
Copyright 2004, Albert M. Balesh, M.D. All rights reserved.
posted by Dr. Al at
7/09/2006 12:01:00 PM
2 Comments:
Very best site. Keep working. Will return in the near future.
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