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Treating chronic fatigue syndrome

During Akron Children Hospital’s recent Annual Pediatric Update for the Practicing Physician, keynote speaker Dr. J. Carlton Gartner urged doctors who treat chronic fatigue syndrome (CFS) to focus on restoring function versus making a diagnosis.

Dr. Gartner, professor and vice chairman of pediatrics at Thomas Jefferson University, Wilmington, Del., discussed promising research into causes of CFS, such as inflammation from viruses, as well as orthostatic intolerance, which is like a dizzy spell when you change positions quickly.

He proposed physicians first rule out autoimmune conditions (such as lupus), chronic infections (such as Lyme disease), psychiatric disorders, toxins and drug side effects, and next treat CFS symptoms.

CFS was recently renamed systemic exertion intolerance disease at the 2015 Institute of Medicine conference. Criteria for this condition include 6 months of fatigue, post-exertional malaise, unrefreshing sleep, cognitive problems and orthostatic intolerance.

Although many at this national conference reported on potential causes, Dr. Gartner believes CFS is a multi-factorial disease that requires a rehabilitation approach.

He cited studies showing that patients benefit the most from cognitive-behavioral therapy and graded exercise, especially adolescents.

This therapy seeks to accentuate positive aspects in a patient’s life and maintain a base level of activity. Examples of graded exercise include a slow, steady increase in walking while avoiding bursts of activity and a change in the sleep/awake cycle.

Other important parts of the rehabilitation process, according to Dr. Gartner, include psychological counseling, fluid volume increases, sometimes medications, and more importantly, exercise and restoration of function.

melo.michelson@gmail.com' About Melonie Michelson

Melonie Michelson is a freelance writer and science educator who spent over 30 years working as a genetic counselor and educator at Akron Children’s Hospital. During that time, she developed and coordinated Akron Children’s fetal treatment center and publications such as Teaching Human Genetics: Resources for Science and Biology. After having a child with a genetic condition, she switched career paths from journalism to medical genetics.

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