Posted by dazedandconfused on August 20, 2004, at 12:57:05 [reposted on August 20, 2004, at 13:41:42 | original URL]
In reply to Re: Ilene - how was your CFS diagnosed? » dazedandconfused, posted by Larry Hoover on August 20, 2004, at 12:20:32
> > Ilene,
> > If you don't mind my asking. The reason is I have been wallowing around for the past four years not making much progress. Suffered episode of major depression four years ago which lifted within the year. However, still have not returned to my initial level of functioning. Major symptoms are debilitating fatigue, hypersomnia, daytime sleepiness. Kept blaming it on depression and/or meds. But the bottom line is I don't feel sad....just so tired. My therapist agrees I don't have major depression but still have dysthmia. Have tried several different meds which don't seem to be doing anything. Starting to search for physical reasons for fatigue...thyroid is fine. My PCP seems to think it is probably CFS. Been to an allergist who told me I was allergic to everything and probably have CFS. Referred to rheaumatolgist.
> >
> > Bottom line, how do you tease out the fatigue,etc. of CFS from good ole' depression.
> >
> > Thanks so much in advance!
> >
> > dazed
>
> It's tough. Traditionally, CFS is a diagnosis of exclusion. Check everything else, and if you don't find a diagnosis, you might have CFS. Check my first post, above. The first link gives some ideas of some biochemical abnormalities that you might be able to test for. Also, your experience with environmental sensitivity is also commonplace, with the same cause as CFS.
>
> For me, it was achieving the stable mood, and then recognizing that a host of symptoms that were once thought to be aspects of severe major depression did not remit along with the mood. This second group of symptoms varies together, suggesting they have a similar cause, and perhaps, treatment. Because you have hypersomnia, and daytime fatigue, it's possible you have a sleep disorder, rather than CFS. Just a thinking point.
>
> CFS is a bit$*. It helps to gently push yourself, then rest, then push a tad harder, then rest, and so on. Gradually build endurance, but always rest after the efforts. It's been called the finger method, because if you spread your hand in front of your face, you see finger-space-finger-space.... the idea is a finger of exercise (a peak on a graph of activity) is followed by the space of rest (a trough on a graph of activity). Over time, your endurance can build substantially. But always be wary of what I call the energy budget.
>
> When I look at what I have to accomplish, or what I would like to accomplish, I assess it in regards to my daily energy budget. I awake with some amount of energy, and I've got a little "savings", so if I need a little extra for that day's budget, it's available to me. But just as with money, if I spend it today, it's not available tomorrow. What I must always guard against is going into the red, overdrawing my energy account. If I let that happen, I fall down, go boom.
>
> Lar
>
>Hey Larry,
Let me start by saying I'm amazed at your wealth/breadth of knowledge and am so glad you share so freely with this board. I lurk often, post seldom, and always read your posts (though many go over my head).What you describe is exactly my experience. My mood is fine...not sad at all. I would not describe myself as a moody person. Frustrated. That I can't do more. That nothing seems to help. That I don't feel like I have a defnitive diagnosis. That my cognitive skills have declined.
I have considered getting a sleep study done. PDOC (who is great) tells me it doesn't matter what causes the sleepiness / fatigue, treatment is the same. Which is true to some extent. But I firmly believe a firm diagnosis is necessary. If for nothing else, to know which message board to post to:). By the way, I have started perusing the immunesupport.com website.
A couple of notes/questions.
1. What makes you think a sleep disorder vs. CFS? I thought hypersomnia and daytime sleepiness were also symptoms of CFS.
2. Again with the diagnosis. I also have major organizational / concentration / ADD symptoms. Neuropsych. testing showed no abnormalities. I can of course hyperfocus on some stupid test in a test setting, but I still can't balance my checkbook. Or clean my house. Or keep up with laundry. I have enormous difficulty comprehending what I read. Or I fall asleep when I read. Now I find out CFS can include cognitive / ADD like symptoms. Again, how do you tease it out? (other than relying on the "experts"). Basically, I piddle around my house all day, do minimal housekeeping, peruse the internet (obsessively) trying to figure out what is wrong with me, and get nothing done. Many unfinished projects, disorgnaization, etc. Basically overwhelmed with the tasks of daily life...not anxiety overwhelmed. Just feel busy all day, and get nothing done. Haven't worked since I got sick (married...luckily)
3. What's your opinion on the use of stimulants and Provigil in the treatment of CFS?Okay, this is a long enough. Very interested in any info you have. I would like to respectfully post another message to you over on alternative about treatments.
THANK YOU!!!
dazed
poster:dazedandconfused
thread:379959
URL: http://www.dr-bob.org/babble/health/20040729/msgs/379970.html