| Onset
| |
| | of isolation he suffered directly
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| Some cases of CFS start gradually, but
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| | contributed to his strong Christian faith
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| the majority start suddenly, often
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| | and his choice to become a song-writer
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| triggered by a 'flu-like viral or similar
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| | and singer.
|
| illness. People with CFS may improve or
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| | Post-exertion symptom exacerbation
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| recover after several months, or many
| |
| | One of the most common and recognizable
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| years, or not at all. It is not known
| |
| | aspects of CFS is what is called
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| whether any CFS sufferer has truly
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| | "post-exertional malaise". When people
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| recovered to pre-illness levels, or
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| | with CFS exert themselves beyond their
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| whether their symptoms have merely
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| | limits (and their limits may change
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| subsided enough for them to live a more
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| | daily), their symptoms worsen. Exertion
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| normal life. Some sufferers have a
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| | includes cognitive effort. The harder the
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| remission for months or years only to
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| | exertion and the longer it lasts, the
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| later relapse, often more severely.
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| | worse the symptoms will be afterward, and
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| Sudden onset cases
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| | with greater recovery time. Although
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| Many people with CFS report a sudden,
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| | symptoms may increase immediately and
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| drastic start to their illness. Some
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| | proportionally, usually their full extent
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| people can remember a specific day or
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| | is delayed by 24 or more hours, which can
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| even hour when they first became ill.
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| | make judging appropriate activity
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| Often CFS starts with, or is triggered
| |
| | difficult.
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| by, another illness. Many people report
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| | A cyclical pattern can occur when
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| getting a case of the 'flu', exposure to
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| | patients work harder because they "feel
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| an allergen (a cough or sniffle caused by
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| | better" or are having a "good day",
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| paint, a new pet, or construction dust),
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| | leading them to think they can exert
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| or a severe infection such as bronchitis,
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| | themselves more than usual. However, the
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| from which they seem never to fully
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| | excess exertion leads to worse symptoms
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| recover and which slowly evolves into
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| | on the following day. Thus it is
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| CFS. Some patients claim that
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| | difficult for patients to maintain an
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| vaccination, especially with recombinant
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| | even level of activity, or to tell if
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| vaccine against hepatitis B, is another
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| | they are improving. In sufferers without
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| cause of acute onset CFS. Other patients
| |
| | a diagnosis of CFS, or a proper
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| begin with Lyme disease, which despite a
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| | understanding of how CFS affects
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| standard course of treatment, may
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| | exertion, this can lead to a "downward
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| 'evolve' clinically from the symptoms of
| |
| | spiral", where a sufferer will try to
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| acute Lyme to those of CFS. Because CFS
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| | work harder to make up for the previous
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| symptoms bear a striking similarity to
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| | day's lack instead of resting. This
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| those of late-stage Lyme disease,[9] this
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| | exhausts them further, and often can
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| has become an area of great controversy.
| |
| | trigger a relapse or worsening of their
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| Some clinicians assume the Lyme infection
| |
| | condition. If the original exertion,
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| has been eradicated after a course of
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| | which can be physical or mental in
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| treatment and diagnose CFS by the Fukuda
| |
| | nature, was particularly severe, the
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| definition, while others treat such cases
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| | sufferer may deteriorate to a point where
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| as seronegative, chronic Lyme infection
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| | they are unable to care for themselves.
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| (see The Lyme controversy). Other,
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| | Many cases then result in hospitalisation
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| noninfectious triggers may include car
| |
| | because the condition has deteriorated a
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| accidents, moving house, and stressful
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| | great deal.
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| life situations. Some patients say they
| |
| | However, it must be noted that patients
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| felt unusual or uneasy for a short period
| |
| | may deteriorate due to external
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| (days or weeks) before the onset.
| |
| | stressors, complications, co-morbid
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| Gradual onset
| |
| | illness, or for unknown reasons, and in
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| Other cases have a very slow, gradual
| |
| | those cases, patient exertion cannot be
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| onset, sometimes spread over years.
| |
| | blamed for a patient's deterioration.
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| People with gradual onsets may not
| |
| | Also, some patients have a progressive
|
| realize there is anything wrong for quite
| |
| | course which cannot be explained through
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| some time. Patients may believe they have
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| | activity levels.
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| a minor illness, or ascribe their
| |
| | When the illness is coupled with
|
| weakened condition to stress, and assume
| |
| | unaccommodating family, friends,
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| they will improve with time. It is only
| |
| | colleagues, often due to stigma, and
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| when the patient realized that their
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| | social repercussions such as financial
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| condition is truly debilitating, or the
| |
| | needs, housing problems, the struggle to
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| stress is removed and the symptoms
| |
| | obtain disability benefits or insurance,
|
| remain, that the patient will begin to
| |
| | discrimination and misconception within
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| seek treatment.
| |
| | the care sector, it can put demands on
|
| There is no standard course for CFS. For
| |
| | the sufferer exceeding their safe
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| a patient to be officially diagnosed with
| |
| | capabilities. Many sufferers describe
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| chronic fatigue syndrome, the symptoms
| |
| | needing to do things for themselves in
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| must have persisted for at least six
| |
| | the times they feel better simply because
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| months. However, the Fukuda paper also
| |
| | there is no-one to delegate to.
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| contains a definition of "chronic
| |
| | Duration
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| fatigue" which is reserved for those who
| |
| | People with CFS may improve after a few
|
| do not meet the full criteria for CFS.
| |
| | months, or after many years, or never at
|
| Since the 50% rule of Holmes et al was
| |
| | all. They may reach a plateau at some
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| dropped, it is possible that there are
| |
| | constant level of health, or may
|
| people with CFS whose level of disability
| |
| | progressively decline. Often, the
|
| is so low that they never seek treatment,
| |
| | symptoms change over time, or cycle
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| or receive an accurate diagnosis, though
| |
| | irregularly. Relapses are common,
|
| this is not permitted by the Canadian
| |
| | especially after stressful life events or
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| definition.
| |
| | additional illness. Exertion can cause
|
| Activity levels
| |
| | not merely a relapse, but a worsening of
|
| Activity levels vary widely among CFS
| |
| | overall health. Undiagnosed cases of CFS
|
| patients. While some are able to lead a
| |
| | often worsen as the sufferer attempts to
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| relatively normal life, others are
| |
| | return to a 'normal' level of activity,
|
| totally bed-bound and unable to care for
| |
| | only to make their condition worse
|
| themselves. Almost all patients find they
| |
| | through exertion.
|
| must drastically reduce their activity
| |
| | Of those CFS patients moderately to
|
| from pre-illness levels, regardless of
| |
| | severely affected, many may expect to
|
| their previous level of athleticism, and
| |
| | remain so for an indeterminate period,
|
| must severely modify or give up physical
| |
| | even for the duration of their life. It
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| hobbies and exercise. Many patients find
| |
| | is not known whether any patients truly
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| themselves unable to work full-time, or
| |
| | 'recover' entirely from the illness, or
|
| at all. A considerable number of CFS
| |
| | merely recuperate enough to regain
|
| cases in many countries are on disability
| |
| | previous levels of activity. Few patients
|
| benefits or private insurance, or have
| |
| | report a total 'cure'. CFS can prove to
|
| made claims and been denied.
| |
| | be fatal, as in the case in the UK of
|
| One notable CFS sufferer is soccer legend
| |
| | Sophia Mirza, where the coroner recorded
|
| Michelle Akers, who reported struggling
| |
| | a verdict of "Acute anuric renal failure
|
| with the illness for many of the later
| |
| | due to dehydration arising as a result of
|
| years of her career. However, more severe
| |
| | CFS". The pathologist said, "ME describes
|
| sufferers felt that an active
| |
| | inflammation of the spinal cord and
|
| professional athlete "poster child" like
| |
| | muscles. My work supports the
|
| Akers helped to trivialize the syndrome
| |
| | inflammation theory. There was
|
| in the eyes of the public, and made it
| |
| | inflammation in the basal root ganglia."
|
| much more difficult for highly
| |
| | (It should be noted that inflammation of
|
| incapacitated patients to be taken
| |
| | the 'muscles' is erroneous, as opposed to
|
| seriously. It is worth noting that the
| |
| | the CNS inflammation, as this has never
|
| condition can strike persons of all
| |
| | been a criteria for a ME diagnosis). CFS
|
| activity levels, and that patients may
| |
| | has been linked[1] to heart damage and
|
| have had high levels of physical health
| |
| | cardiac arrest among other causes of
|
| and activity before onset.
| |
| | death; research has not yet progressed to
|
| Another sufferer was Stuart Murdoch of
| |
| | determine whether this is in fact the
|
| the Scottish indie-rock band, Belle &
| |
| | case, and some patients die from
|
| Sebastian. Murdoch was afflicted before
| |
| | co-morbid diseases. To date there is one
|
| graduating from university and was unable
| |
| | study on CFS life expectancy
|
| to work. He has commented that the degree
| |
| |
|
