Myalgic Encephalomyelitis and Chronic Fatigue Syndrome - Case Study Example

DOES MYALGIC ENCEPHALOMYELITIS (ME) EXIST? By of the of the of the School 14 July Introduction In our day to day lives, we get tired. Depression is part of life, but the mystery of chronic fatigue syndrome is that it is not what we experience on a daily basis. The earliest trait of this illness is pronounced fatigue that is sudden and characterized by relentless or deterioration, causing an early and easy exhaustion as well the feeling of hangovers by someone who apparently has no reason for the feeling. Myalgic Encephalomyelitis is an incapacitating disorder and is also known as the Chronic Fatigue Syndrome. It is known to affect both the physical and psychological functions of the body. For a long time, the condition had not been understood neither was it being treated as a specific disorder. Cognitive Behaviour Therapy (CBT), which is used together with other physical and medical therapies, has in recent years been used to treat Myalgic Encephalomyelitis. According to the National Alliance for Myalgic Encephalonyletis, Myalgic Encephalomyelitis is a chronic neuro-immune disease (2014). The disease causes a vital immune and cardiovascular inefficiency and results in poor functioning of the central nervous system. Myalgia means a muscle pain, while encephalomyelitis means inflammation of spinal cord and brain (NHS, n.d.). A rough estimate of close to 250,000 people in the UK has Chronic Fatigue Syndrome (NHS, n.d.). This proves that there is existence of this disease. It exists as either moderate or mild stage and can be at the worst case scenario known as severe condition. When a victim is at the mild situation, he can be able to look after himself but rest is paramount. At the moderate situation, there is reduced mobility and unstable symptoms with disturbed sleep patterns, especially afternoon sleep. The worst case is the severe situation; though one may be able to handle minimal tasks, mobility is highly affected (Stoff and Pellegrino, 1992). The term Myalgic Encephalomyelitis is said to have been created in 1956 to give a description to an outbreak of fatigue in Britain. A similar disease was reported in Nevada, USA and was referred to as the chronic fatigue syndrome. The disease appears as cluster outbreak and has been reported in wide locations such as New Zealand, Iceland and North Carolina. Myalgic Encephalomyelitis affects all ages and races. Origin, Causes and Treatments The cause of CFS is not exactly known, though there have been various theories explaining the cause, these include: • A viral illness. • Problem in the immune system. • Hormone imbalance. • Stress and emotional trauma. The exact cause of Myalgic Encephalomyelitis is still under intensive discussion and research, because several factors are involved. Researchers and medical practitioners also suggest that ME/CFS can follow an acute infection like fever and infection of the respiratory organs. Further research suggests that environmental pollution, severe trauma like surgery or an accident, and chemical contacts are other causes. According to MECFS, “Recent research is finding strong links with food mal-absorption, food intolerance and gut symbiosis” (n.d.). ME/CFS often appears through other medical conditions such as fibromyalgia. This is a common condition given to a group of conditions characterised by pain and muscle stiffness. The prevalence of such conditions leads to deterioration of body immunity and quality of life, and can contribute to severity of ME/CFS. There is no specific cure for CFS and the treatment undertaken is meant to reduce the symptoms. Since different people respond differently to ME treatment, every victim has a specific plan tailored to him. As suggested by NHS (n.d.), some of the treatment methods are:- • Cognitive behavioural therapy. • A programme for therapy exercise. • Control of pain, nausea and sleeping issues. Such treatments help improve CFS in most cases and even though people do not make full recovery, the condition may reduce. Otherwise, it may get to a worse situation. Other treatment options available include: Change in lifestyle: This should form a vital part of the care and management plan. It is essential to address issues such as diet, sleep, work and education (Totten, 2014). An activity referred to as pacing is mostly recommended. It is a strategy whereby the patient is required to balance moments of rest and duties. As indicated by HDL 2003, in one postal survey comprising more than 2000 ME patients with severe condition, 89% responded positively to pacing and their suggestion was that it was of great help (Totten, 2014). Cognitive behavioural therapy: This is a psychological intervention undertaken on a face to face basis and may be conducted in a group. It promotes a collaborative approach to difficulties by use of a diary to identify problems and moods on day to day feelings. The therapists identify the problems and practices of the victim eliminating those that cause the problem and those that are totally unhelpful to an individual. Proper practice of CBT requires appropriate skills usually acquired through attendance of trainings and medical supervisions (Meirleir and McGregor, 2003). Morriss and Petrie (2002) further prove that CFS patients can prolong their lives through cognitive behavioural therapy. They assert that, “this approach aims to show patients that activity can be steadily and safely increased without exacerbating symptoms” (Morris and Petrie, 2002, p. 115). It is important for the family members and friends of the victim to understand that while ME is real and debilitating, it also has mental impact on the well-being of the individual (Turp, 2001). Graded Exercise Therapy: This is one of the elements found in the care and management plan for CFS/ME patient. It recognises that the decline in physical activity due to ME/CFS can slow down the rehabilitation process. The return to full fitness should therefore be taken gradually. The problem with many patients is that they are so much reluctant to carry out therapy exercise. They develop the fear from someone they know to have undergone similar process. Exercise programmes for such people should be administered by physiotherapists with enough experience to fit patients through realistic exercise (Montero and Richardson, 2001). Counselling: Through counselling, many patients get access to beneficial advice on how to best manage their lives. Locally based counsellors are best suited for the task due to their understanding. The diagnosis for ME is provided by a doctor having attributed the symptoms to no other disease. As it stands, it is a much worrying condition and needs careful diagnosis. This is because it is a medical condition that would have a major impact in one’s life. Diagnosing ME is very difficult because its symptoms are familiar to those of many other diseases. When conducting the diagnosis, the physicians have to use the elimination method by eliminating the diseases that have a similarity to ME, such as multiple sclerosis and lupus, and as Leonard advises, “in follow up visits, physicians need to be alert to any cues or symptoms that might indicate a diagnosis other than CFS” (Fernie and Murphy 2009, p. 2). CBT is a psychological therapy that provides a solution to ME by looking at social factors such as thoughts, behaviour, emotions, physiology and environment (Fernie and Murphy, 2009). The use of this approach does not mean that one has a psychological disorder. The key thing with CBT is that most of the illnesses have a psychological facet. Responses to illnesses are much dependent on thoughts and behaviours. Since there is no definitive knowledge about the disease, M.E. has required a broadened approach of involvement that includes attention to the physical, spiritual, social and cultural practices of the victim. Further strong advocacy within communities and government would improve the life of the person with ME and the family, even if the root cause of the disease is not yet known (Montero and Brotherston, 2001). Learning how to handle fatigue allows people with CFS to improve their level of functioning and value of life, regardless of their symptoms. The rehabilitation process evaluates the individual and teaches him or her on how to plan activities so as to take full advantage of periods when feeling better. The unavailability of proven effective treatment for the disease creates a frustrating situation to the patient and the medical practitioner. However, there is an encouragement to them as “experts recommend that people with CFS try to maintain good health by eating a balanced diet and getting adequate rest” (Leonard, 1997, p. 4). This should be accompanied by light exercise to avoid causing more fatigue. Evidence for the Existence of ME ME/CFS is a disorder for which there are limited truths about it and how it occurs and manifests itself. Montero and Brotherson assert that “it appears to be a multilevel disease that has complex meanings and outcomes” (2001, p. 11). The complexity does not only complicate the family members, but also the medical practitioners. It is important to acquire knowledge of the interactions to shape the reality of their experience with the disease, as well as the contests of the lives that the affected people have lived. This debilitating disease is estimated to affect a huge number of people. The number is approximately eight million people in America and around 250,000 people in United Kingdom (Totten, 2014). Further widespread of the disease around the world can be evidenced by the approach of international consensus criteria; the proposal has been able to treat around 50000 individuals (Totten, 2014). Leonard attributes the lack of clinical marker for CFS to lack of sufficient data on those with CFS; he says that “the lack of clinical or laboratory marker for CFS has muddled efforts to determine how many people the illness affects” (1997, p. 3). Based on a study in three US cities by the Centres for Disease Control and Prevention, CFS cases in America are found to be close to 4 to 10 for every 100000 grownups (Leonard, 1997). Though the method used to get this data may not be accurate, it provides enough evidence that indeed the disease exists among the people. Meester, Zibadi and Watson (2010) argue that there could be up to 1800000 people suffering from ME/ CFS in Britain and up to 9 million in America. CFS Case Definition The work of medical researchers rekindled huge interest to work more on CFS; this became apparent that CFS case description was required so that scientists could have an easy comparison and achievement of the results. In late 20th century, a group of CFS experts were convened to tackle the problem and basing on the available information, the group published Annals of Internal Medicine; it had firm symptom and physical criteria by which the scientists would evaluate CFS patients (Leonard, 1997). Myalgic Encephalomyelitis, abbreviated as M.E. is a condition that first came into being in 1934. It was then recognized by the World Health Organisation in 1969 as a neurological disorder. In 1988, Chronic Fatigue Syndrome CFS was then accepted as an alternative name for Myalgic Encephalomyelitis. This therefore shows that even though there is the use of the two names, that is Myalgic Encephalomyelitis and Chronic Fatigue Syndrome, these two diseases have a slight difference, but the names can be used interchangeably since there are more similarities than differences. Differences between ME and CFS Although the symptoms of CFS and ME are similar, there are small variations that bring out the differences. These are as follows: Myalgic Encephalomyelitis Chronic Fatigue Syndrome Includes organ disease. Organ disease occurrence in CFS has been avoided and in case primary and secondary organ disease occurs, then the cause would be taken to be fatigue and illness, but not CFS. Its definition includes acute and gradual onset illness. Its definition does not include acute and gradual onset illness allowing physicians to include definitional characteristics into the CFS illness spectrum (Hyde, 2010). Its research includes exhaustive testing. Most physicians avoid exhaustive testing (Hyde, 2010) ME patients are investigated from the inception of an illness. During the composition of CDC definition, CFS patients were not investigated in the first six months, rather, a statement was just given to suggest that CFS is characterised by an illness of 6 months. Chronic fatigue not an essential characteristic. Chronic fatigue is a vital characteristic of the chronic phase. Similarities A patient diagnosed with either CFS or ME is chronically and potentially sick with missed classical disease entity. However, with an initial diagnosis of ME and CFS, the disease could be treated. Conclusion Myalgic Encephalomyelitis and Chronic Fatigue Syndrome are two in one diseases that have been found hard to separate. The names are used interchangeably depending on the region. The characteristics of the two are closely related, as evidenced by the fact that Myalgic Encephalomyelitis was first used before physicians came up with the term Chronic Fatigue Syndrome. However, regardless of the naming of the illness, what remains vital is the care and mode of handling the patients. Reference List Fernie, B. and Murphy, G., 2009. Coping better with Chronic Fatigue Syndrome?Myalgic Encephalomyelitis. London: Karnac Books. Hyde, B., 2010. Missed Diagnoses: Myalgic Encephalomyelitis & Chronic Fatigue Syndrome. London: Lulu.com. Leonard, B., 1997. Chronic Fatigue Syndrome: Information for Physicians. Collingdale: DIANE Publishing. MECFS, n.d. What is ME/ CFS? [online] Available at: [Accessed 14 July 2014]. Meester, Fabien D., Zibadi, S. and Watson, Ronald R., 2010. Modern Dietary Fat Intakes in Disease Promotion. New York: Springer Science & Business Media. Meirleir, K. and McGregor, Neil R., 2003. Myalgic Enncephalomyelitis/Chronic Fatigue Syndrome. Florida: CRC Press. Montero, Roberto P. and Brotherston, N., 2001. Adolescence and Myalgic Encephalomyelitis/ Chronic Fatigue Syndrome. Florida: CRC Press. Montero, Roberto P. and Richardson, J., 2001. Enteroviral and Toxin Mediated Encephalomyelitis/Chronic Fatigue Syndrome and other organ Pathologies. Florida: CRC Press. Morris, Rona M. and Petrie, K., 2002.Chronic Fatigue Syndrome. London: Routledge. National Alliance for Myalgic Encephalonyletis, 2014. Introduction to M.E. [online] Available at: [Accessed 14 July 2014]. NHS, n.d. Chronic Fatigue Syndrome (CFS). [online] Available at: [Accessed 14 July 2014]. Stoff, Jesse A. and Pellegrino, Charles R., 1992. Chronic Fatigue Synd. New York: HarperCollins. Totten, Christopher W., 2014. An Architectural Approach to Level Design. London: CRC Press. Turp, E., 2001. Chronic Fatigue Syndrome/ME. London: Jessica Kingsley Publishers. Read More