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What is Chronic Fatigue Syndrome?

Chronic Fatigue Syndrome is something of a medical mystery. Not well-understood by the medical profession, it is a debilitating disease with the capacity to affect many parts of the body including the central nervous system, cardiovascular, endocrine, gastrointestinal, and immune systems, and muscles and joints. While it seems that each sufferer can have a unique set of symptoms, some things present in common.

If a patient displays four or more of these symptoms: unrefreshing sleep, cognition problems, muscle and joint pain, headaches, sore throat, swollen or tender lymph nodes, post-exertional malaise, and suffer from severe fatigue, they may have Chronic Fatigue Syndrome.

Three symptoms seem to be universal: fatigue, sleep abnormalities, and impaired cognition. Most patients report severe fatigue following even minor amounts of mental or physical exercise. Sleep problems run the gamut from insomnia, to sleep apnea, to excessive sleep, with one factor in common. Unrelenting exhaustion exacerbates each of these debilitating symptoms. Cognitive abnormalities include a decreased ability to think clearly and problems with short term memory. In the severely affected, even the ability to understand the speech of others and to speak themselves, can be compromised.

Neurological symptoms abound. The patient may experience something called parasthesia, bizarre physical sensations such as numbness, prickling or swirling sensations, and clumsiness of the hands and fingers. Vertigo and dizziness are very common. Bright or flashing lights, rapidly changing visual stimuli, and sounds that may not affect others, can bring on debilitating responses requiring them to retreat to a quiet place. Sensitivities to common chemicals, with resultant incapacitating symptoms, may also occur.

A vast array of gastrointestinal problems can occur. Food allergies can appear, in individuals who previously had none. Irritable bowel syndrome, dramatic weight gain or weight loss, are widespread.

One of the hallmark symptoms of Chronic Fatigue Syndrome is called post-exertional malaise. This means that after a person exercises or has exerted themselves more than usual, even if they feel alright after the exertion, they experience a severe ‘flare up’ of their symptoms in the following hours and days. Patients often refer to this flare as a “crash”, a state of exhaustion, mental confusion, and a proliferation of neurological symptoms far out of proportion to the physical exertion that precipitated it. A crash can last for days or weeks, even months, or in the very severely afflicted, years.

Burdened by a name that doesn’t begin to describe the intensity of the affliction, CFS remains one of the least researched of all diseases. It ranks in the bottom 5% in research funding, though the costs to society are enormous, with 1-4 million Americans afflicted and millions more worldwide. A disability rate of at least 25%, and 25 billion dollars a year in economic losses, is still only registering as a blip on the radar of funding and research.

The impact of Chronic Fatigue Syndrome, for the individual, for families, and for society at large, is huge. More needs to be done to understand the causes and to provide treatment for this scourge.

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