Treatment:
Supportive Therapy
With no known cause or cure for chronic
fatigue and immune dysfunction syndrome (CFIDS), treatment is based on relieving
symptoms and, more specifically, the severity of symptoms. Treatment options are
supportive in nature in that they can provide a measure of comfort and symptom
relief without the use of medications.
A candid conversation between the primary
treating physician and the person with CFIDS (PWC) is essential to finding
therapies that may prove helpful.
Supportive, symptomatic therapy is
individualized. The following dimensions should be considered as treatment is
planned: the PWC's medical, social and financial resources; general physical,
mental and emotional health status; personal preference and individual
abilities.
Therapy Options
Exercise/Physical
Therapy/Massage
Therapies to help PWCs maintain some level of
flexibility and muscle tone may be needed to relieve pain and reverse
deconditioning that may have occurred. There are conflicting opinions on the
benefits of exercise because of the resulting relapses and fatigue that PWCs
often experience. A physical therapist or exercise physiologist, together with
the PWC, can develop a personalized plan that maximizes the capabilities of the
PWC while ensuring that symptoms are not exacerbated by too vigorous exercise.
Generally, the PWC begins very slowly (1-2 minutes of gentle stretching each day
for a week) and gradually increases activity level (add one minute each week, as
tolerated.) Even severely affected PWC's may benefit from an activity plan that
is individualized to their situation.
Occupational Therapy
CFIDS can
have a profound effect on a PWC's ability to
work. The inability to perform
on the job may require minor
adjustments for those with mild symptoms, while those with more severe symptoms
may be unable to work at all. An occupational therapist can assess the PWC who
remains on the job and recommend approaches to help utilize energy more
efficiently. Disabled PWCs who are considering a return to work or need to
develop energy-saving strategies may also benefit from a consultation with
an occupational therapist.
Nutrition Therapy
A well
balanced diet provides a healthy foundation for everyone. The American Dietetic
Association's food pyramid guidelines are designed to promote good
nutrition. PWCs who have
allergies, digestive disorders, and other food-related problems may wish to
visit a registered dietitian who can outline nutritional needs (and necessary
supplements), determine substitutes for problem-causing foods that have been
eliminated from the diet and provide tips for meal planning and preparation that
help conserve energy.
Dietary/Herbal
Supplements
Several dietary and herbal supplements are reported to have immune- and energy-boosting
properties and some PWCs have experienced symptom improvement when taking
these products. Using common sense to ensure safety when taking
these supplements is important. The primary treating physician needs to be
informed of any supplement use to avoid the possibility of interactions with
medications being taken, as well as to help track response to therapy. PWCs need
to be alert to products that come with outlandish promises and "magical cures"
and thoroughly investigate these product claims before purchasing and using the
product.
Sleep Therapy
Unrefreshing sleep is a much-reported symptom and is one of eight symptoms
in the CFIDS case definition. Sleep
management techniques may help PWCs. Sleep studies can be done to identify any
primary sleep disorders to rule out an underlying physiological cause for sleep
disturbances such as sleep apnea. Sleep centers can also assist PWCs with
various sleep management techniques. In addition, PWCs need to be alert to the
possibility that some medications and supplements may interfere with
sleep.
Mental Health Counseling
Anxiety and depression are potential effects of CFS
as PWCs strive to cope with the life-altering changes that occur with
a chronic illness. The primary treating physician may conduct a brief mental
health evaluation and, if necessary, make a referral to a mental health
professional who can conduct a more in-depth assesment and assist the
PWC in making positive adjustments.
Cognitive Behavioral Therapy (CBT)
This
form of therapy combines cognitive therapy with behavioral
therapy and focuses on the person's thoughts, assumptions, beliefs and habitual
reaction to these thoughts and beliefs. During CBT, PWCs learn methods to help
re-direct thinking processes and take steps to modify their reactions.
Relaxation techniques, such as deep breathing or meditation, are often utilized
in CBT. There is evidence that this therapy has helped some PWCs cope better
with the effects of a chronic, unpredictable illness, although it doesn't offer
a cure.
Summary
In addition to the
modalities suggested above, complementary therapies, such as acupuncture, yoga
and tai chi can offer some benefit. Overall, it's important to remember
that responses vary: what works for some people does not work for others. PWCs
often try multiple diverse treatments for symptom relief. PWCs who are aware of
treatment options and are willing to frankly discuss these with their primary
treating physician will likely have greater opportunities for symptom
management.
Articles of Interest
Related Information
|
