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Tired? Then go to sleep or take a few days off – such advice was heard by Barbara at work, when her state of weariness, problems with concentration and general breakdown was already noticeable by everyone around. And get a good night’s sleep? She had not known this state for eight years. Reason? Chronic fatigue – a mysterious ailment that turned her life into a streak of torment. And not only hers. Chrome Fatique Syndrome attacks more and more often, “hiding” under various symptoms – that is why it is so difficult to diagnose.
They are educated, ambitious, in their prime and without the strength to live. They are united by frustration, resignation and doubt about the daily lack of energy, which does not pass even after a night’s sleep or some other form of relaxation. The latter term has been a pure abstraction for them for many years. But they try not to give up and still fight for themselves – although this fight in many cases resembles a fight with windmills, because even specialists who still try to determine the etiology of this disease do not know how to overcome insidious chronic fatigue:
The exact cause of the problem is unknown, although there are many theories, ranging from viral infections to stress. Some experts believe that chronic fatigue syndrome can be caused by a combination of several different factors, explains Bartosz Pawlikowski from the Medevac Clinic in Łódź, a specialist in dermatology and drip therapy practitioners in the treatment of chronic, multifactorial diseases. “Fatigue can be a symptom of many diseases, such as infections or mental disorders,” he adds. Therefore, in making a proper diagnosis, it is important to thoroughly analyze the patient’s health, which will allow to determine the basis of the everlasting feeling of exhaustion. And often it is also based on another, coexisting problem, which is also typical for this disease – explains the doctor.
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What is chronic fatigue?
Chronic Fatique Syndrome (CFS), also known as Chronic Fatigue Syndrome (CFS), is a complex disorder characterized by a feeling of extreme exhaustion that has been present in a patient for at least six months. Its diagnosis, apart from the constant feeling of exhaustion, is determined on the basis of 8 key symptoms, of which the patient must meet at least 4, which are:
1. Loss / impairment of memory or concentration.
2. Sore throat / hoarseness.
3. Enlarged lymph nodes in the neck or armpit.
4. Unexplained muscle aches.
5. Pain that travels from one joint to another without swelling or redness.
6. Headache different than usual, different intensity.
7. Sleep that gives no rest.
8. Extreme exhaustion lasting more than 24 hours after exercise or mental exertion.
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Common symptoms, unclear cause
The first mentions of permanent, long-term fatigue appeared even in the second half of the 80th century, but their professional place in the literature and entry into the register of diseases as Chronic Fatique Syndrome CFS received only in the 2,3s of the next century (initially referred to as “yuppie flu” – young people, famous for their career rush, suffering from burnout syndrome). However, as research shows, this disease can catch us at any age – even in children. According to the US Centers for Disease Control and Prevention (CDS), up to 30% of children and adolescents suffer from this condition. Most often, however, it attacks women aged 40-40, although it also often occurs in the next age group of 50-XNUMX, also in men.
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Despite the definition of a disease entity by the American Center for Disease Control (1988), sometimes some doctors are still skeptical about this disease, using in-depth diagnostics to determine the “specific” cause of these symptoms. And their reasons may result from a combination of many factors that negatively affect people born, for example, with a predisposition to this disease. It is presumed that such factors may be:
Viral infections (Epstein-Barr virus and human herpes virus type 6),
Disorders of the immune system,
Hormonal imbalance (disturbances in the level of hormones in the hypothalamus, pituitary, adrenal glands).
It happens, however, that the tests show nothing and the patient often remains on his own, suffering from constant ailments. This was the situation experienced by Ms Barbara, now a 45-year-old communications and PR manager. For years, the woman worked in a corporation twelve hours a day. At first it seemed to her that it was a normal exhaustion resulting from active working life, but when this state began to drag on indefinitely, she went to an internist:
– During the day I still felt like sleeping, while I disturbed my sleep at night. It was accompanied by fatigue, problems with concentration at work, generally poor psychophysical condition and frequent infections – recalls the woman. I was ordered basic blood tests, but these showed nothing, so the doctor saw no point in further diagnosis. – Maybe if it was about depression, which is so much talked about now, and not chronic fatigue syndrome, then it would be different? You would end up with good advice from work like – “go to sleep” – and that’s it. And so for many years I had to struggle with this problem myself, unsuccessfully seeking help.
It was different with Mr. Bartek – a 39-year-old career counselor, who remembers the beginnings of his career at school as a period of constant throat infections and weakness, accompanied by insomnia, muscle pain and metabolic problems. Here, the knowledge of the subject about CFS was demonstrated by an ENT specialist who, during one of her subsequent visits, diagnosed a crooked nasal septum and decided to approach the matter holistically:
– She started asking questions about the body, stress, lifestyle. After an in-depth interview, she concluded that these were symptoms of chronic fatigue syndrome, but the underlying cause could be a medical problem. She decided that it should be verified – she recommended surgery of the nasal septum and further tests – the man recalls.
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Diagnosis by exclusion
Determining whether there is actually chronic fatigue syndrome is usually an elimination pathway in which an attempt is made to first rule out other serious diseases that may have symptoms similar to CFS, including:
· Lyme disease,
Diabetes
Anemia,
Thyroid diseases, e.g. hypothyroidism,
Tumors,
Autoimmune diseases (e.g. lupus),
· Mononucleosis,
· multiple sclerosis,
Sleep disorders,
Psychological conditions – e.g. schizophrenia, bipolar disorder or depression.
In the case of the latter, however, it happens that some CFS patients also struggle with it, but it is emphasized that it may coexist with this disease as often as other chronic diseases. This was the case with Mr. Marcin – a 46-year-old former journalist who has been struggling with depression for 15 years, and fatigue is practically non-stop – with short breaks associated with an improvement in mood:
– I never sleep normally, and when I wake up, I immediately feel spit out and resigned. I force myself to work, overcome with fatigue, black thoughts, a sense of hopelessness. As I noticed, the intensification of depressive symptoms leads to the deepening of the feeling of fatigue – says the man.
Depression can accompany chronic fatigue syndrome, but it can also be an unpleasant consequence when proper treatment is not undertaken:
– I work from home on commission; due to my condition, it is difficult for me to imagine a full-time job – says Mr Marcin. After every long time I leave the house, I am completely exhausted and unable to do anything. Due to my back disease, I should exercise regularly, but I don’t have the strength to do it. Chronic fatigue increases depression, so it’s kind of a vicious cycle. Most of the time, I just feel like a zombie – a living dead.
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How to cure chronic fatigue?
Chronic Fatigue Syndrome is currently treated symptomatically, depending on the symptoms present. In the case of extreme exhaustion, patients are offered, inter alia, intravenous vitamin C treatment:
– Vitamin C administered in a drip during the day relieves the state of extreme fatigue, and given in specific cycles under the supervision of a doctor, it significantly reduces the state of psychophysical exhaustion – explains doctor Bartosz Pawlikowski. This method also reduces the susceptibility to systemic infections, which contribute to a lasting feeling of fatigue or inaugurate a long-term process. Studies on intravenous vitamin C have shown that the condition of permanently exhausted patients quickly improves if the initial level of vitamin C in the body is lower and slightly slower if it is higher, but in both cases it has a stimulating effect and reduces symptoms – explains the specialist .
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When CFS is accompanied by depression, so-called antidepressants, which also reduce the symptoms of fatigue, such as insomnia or pain. In the treatment of chronic fatigue syndrome accompanied by sleep disorders, the doctor also introduces short-term hypnotic therapy to restore the natural sleep phase and the ability to regenerate the body. However, the effects of such treatment depend primarily on the individual condition of the patient and not always the chosen therapy leads to success, although it may have a positive effect on some health aspects:
– I still take strong antidepressants and go to a psychologist, register temporary improvements, but I do not feel a permanent change – this is how Marcin sums up his path to recovery.
A two-track approach also helps to tame the disease – psychological consultations, arranging current affairs, the current lifestyle, the rhythm of the day and giving a new look and approach to everyday events, combined with physical activity, which worked for Mrs. Barbara:
– I was helped by a change of job, that is, leaving the “corpo”. I signed up for tango lessons, I started painting pictures and making jewelry, I went to psychotherapy. I also introduced a certain routine, some repetitive activities, especially at bedtime. I also took care of the same hour of going to bed and sleeping for a minimum of 8 hours – she emphasizes.
In Mr. Bartek’s case, the chronic fatigue syndrome disappeared after an operation of the nasal septum, after which – as he emphasizes – his life changed by 180 degrees. Problems with sleep, frequent infections and problems with metabolism are gone. As you can see, the diagnosis through elimination – although it can be long – is not always doomed to failure, and it can clearly reveal the essence of the problem.
CFS is a disease that, like any other, needs to be approached seriously and carefully. Although we do not know the exact cause of its occurrence yet, it can be successfully called a disease of the XNUMXst century – a disease of lack of time, a disease of permanent stress, a crazy pace of life. It is necessary to fight its symptoms so that our everyday life does not suffer from it. A lot also depends on ourselves – how we live, how we eat, how we rest and whether we can do it.
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Specialist consultation: lek. med. Bartosz Pawlikowski from the Medevac Clinic in Łódź, specialist in dermatology, practitioner of IV therapy in the treatment of chronic, multifactorial diseases.