Chronic fatigue syndrome (CFS) 

Dr Charles Shepherd, medical adviser to the ME Association, and who has ME, describes the symptoms, diagnosis and treatments for ME, also known as chronic fatigue syndrome.

Learn more about CFS

Transcript of Chronic fatigue syndrome (CFS)

My name's Dr Charles Shepherd, advisor to the ME Association,

which is a self-help support charity for people with ME/CFS.

ME/CFS, it's an illness which normally starts suddenly, acutely.

It often follows an infection, which may be a fairly trivial infection,

and it tends to affect people in their 20s, 30s, 40s,

although children can be affected, as can more elderly people.

I first got involved with ME/CFS after catching it myself.

I was working as a hospital doctor, one of my patients had shingles,

and I caught a dose of chicken pox,

and that's what triggered my ME/CFS off in the first place.

A lot of people don't realise that it's a very debilitating illness.

It involves a combination of symptoms, in particular

muscle symptoms, exercised-induced muscle fatigue and quite often pain,

brain symptoms, problems with memory, concentration, attention span,

problems with balance, not being able to stand up properly,

and also just not feeling well, continuing to feel flu-like.

It's an illness which is going to affect

every aspect of what you try and do.

It's an illness which can, in most cases, be diagnosed by your GP,

but you'll probably need to ask for a double appointment.

Your GP really should take a detailed history

to make sure he's not missing other causes of an ME/CFS-like illness,

because a lot of different illnesses can present with these symptoms.

So after taking a detailed history,

your GP will want to do a range of investigations

to rule out things like kidney disease, thyroid disease

and other illnesses which can cause ME/CFS-like symptoms.

If he's not sure,

your GP can refer you to a hospital specialist

for a more accurate diagnosis.

There are five key aspects in management of this illness.

First of all is getting activity management correct,

getting the correct balance between activity and rest.

Secondly, drugs,

which can be helpful for treating pain and sleep disturbance,

although we don't have a drug to cure this disease.

Thirdly, sensible use of alternative and complementary therapies.

Fourthly is dealing with work and education where that's relevant.

And fifthly is dealing with emotional, psychological problems

if they arise.

Unfortunately, we don't have a drug treatment that will cure ME/CFS

or effectively treat it.

And this means that the outlook is quite often unpredictable.

But we do know people tend to fall into one of three broad groups.

First of all are those who make slow but steady improvement.

Secondly, a group who tend to follow a rather up and down, erratic course,

but they eventually stabilise and follow this pattern.

But thirdly, there are a small,

perhaps 20, 25 per cent of people who fall into a severe category

who remain housebound, bed-bound, even wheelchair-bound.

The good news for children and adolescents with this illness

is that, on the whole, their outlook is far better than adults,

and a lot of them do return to full normal health.

This illness affects all parts of the person's life,

not just the medical aspects.

It affects their family, their relationships, their finances,

what they do in relation to work, school, social activities.

And all these things are going to be affected, and likely for some time.

It's something people have to come to terms with

and get whatever help, in the various different areas,

that they feel is going to make them improve from those points of view.

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