What is it?
Chronic fatigue syndrome is a debilitating illness characterized by severe fatigue lasting six months or longer that does not improve with rest, and often worsens either immediately or within 24 hours of physical exertion. Debilitating for many CFS sufferers means not even being able to perform the most basic of personal care functions: getting out of bed, brushing their teeth, getting dressed, eating, having a bath. During these times a CFS patient is completely reliant on other people to take care of them and their household.
It is one of the hardest conditions to diagnose because, aside from the fatigue following physical exertion, its symptoms are also characteristic of other illnesses, which are usually ruled out before testing for CFS.
How Common is it?
Chronic fatigue syndrome is also known as myalgic encephalomyelitis (ME) or chronic fatigue immune dysfunction syndrome (CFIDS). It is estimated that 1 million Americans have CFS, and 80% of those identified are not receiving appropriate medical care. “Researchers at DePaul University estimate that every year CFS costs the U.S. economy $17-24 billion” (www.cfids.org). It is more prevalent than lung cancer and AIDS (Carruthers/van de Sande), and can strike people of all ages, races, ethnic origins and socio-economic groups. It is twice as prevalent in women as in men. After 25 years of more than 5,000 studies, there is still no known definitive cause, diagnostic test, or universally recognized or accepted treatment.
Symptoms and Diagnosis
The fatigue in chronic fatigue syndrome is more than just being tired. It is characterized as a bone-deep fatigue, profound exhaustion, poor stamina, that does not resolve with rest and persists, either constantly or recurringly, over 6 months or more. Fatigue can be a symptom associated with many physical and psychological conditions, but when it is so prolonged without letting up and is aggravated by physical exertion, investigation will tend toward CFS.
In more detail, according to Carruthers and van de Sande, “the patient must have a significant degree of new onset, unexplained, persistent, or recurrent physical and mental fatigue that substantially reduces activity level” and “[t]here is an inappropriate loss of physical and mental stamina, rapid muscular and cognitive fatigability, post exertional malaise and/or fatigue and/or pain and a tendency for other associated symptoms within the patient’s cluster of symptoms to worsen.” The recovery period from such periods can be 24 hours or longer.
*Note: The CDC definition of CFS from 1994 recognizes that post-exertion fatigue is a symptom of CFS, but does not officially name it as a distinctive symptom – one that could be used to differentiate the potential presence of CFS from among a variety of other illnesses with similar symptoms. Physicians who specialize in treating CFS patients, are aware, however, of the connection between post-exertion fatigue and CFS. The Canadian Clinical Case Definition published in the Journal of Chronic Fatigue Syndrome in 2003, and has been widely accepted by many countries and organizations, including the American Association for Chronic Fatigue Syndrome, as the most accurate definition of CFS, beyond the Fukuda criteria that is commonly espoused by the CDC. The members of Expert Consensus Panel who produced the Canadian Clinical Case Definition were chosen by Health Canada.
More Than Fatigue
While fatigue is a major symptom of CFS, it is not the only symptom. It is the combination of symptoms that may lead doctors to a diagnosis. The next article, “Chronic Fatigue Syndrome More than Fatigue” will examine those symptoms.
Sources: http://bodyandhealth.canada.com; www.drpodell.org; www.cfids.org; “Chronic Fatigue Syndrome” by K. Kimberly McCleary and Suzanne D. Vernon, PhD, The Pain Practitioner, American Academy of Pain Management, Vol. 20, No. 1, Spring 2010, Pgs 14-17, accessed through www.cfids.org; www.cfids-cab.org/MESA (Myalgic Encephalomyelitis Society of America); “Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: A Clinical Case Definition and Guidelines for Medical Practitioners (an Overview of the Canadian Consensus Document)” by Bruce M. Carruthers and Marjorie I. van de Sande accessed through www.cfids-cab.org; www.dictionary.com