In this 3-part blog series, Dr. Bateman brings you some of her pearls of wisdom on treatment of ME/CFS, honed in her many years of caring for thousands of ME/CFS patients…
Lucinda Bateman, MD, specializes in the diagnosis and management of unexplained chronic fatigue, ME/CFS and fibromyalgia. She is the cofounder of OFFER, the Organization for Fatigue and Fibromyalgia Education and Research and has served on the Solve ME/CFS Initiative’s Board of Directors in the past. In 2015, Dr. Bateman will be the lead clinical investigator on the $500,000 research study awarded to SMCI from the Falk Medical Research Trust. This award gives us the opportunity to further grow the SolveCFS BioBank and to extend the exciting results generated by SMCI funded investigator Dr. Patrick McGowan.
Learn more about the grant awarded to SMCI to fund this study HERE
Learn more about Dr McGowan’s SMCI funded research HERE
And access the paper describing his exciting results HERE
In part 1, Dr. Bateman spoke about building emotional resilience and achieving the most restorative sleep possible. Read part 1 HERE
In part 2, Dr. Bateman discussed achieving reasonable pain control and balancing physical pacing with physical conditioning. Read part 2 HERE.
These pearls of wisdom aren’t listed in any particular order; each of them are helpful in managing ME/CFS patient care. Hopefully the information shared in these posts will help you identify areas you and your health care team can explore.
Pearl 5: Identify and treat comorbid conditions
There are a number of medical conditions, often subtle in presentation, that frequently overlap or occur in combination (are comorbid) with ME/CFS. These conditions have well known diagnostic and treatment plans that a medical professional can follow whether familiar with ME/CFS or not. Since each untreated condition may worsen ME/CFS symptoms, any improvement in symptoms of comorbid conditions is progress in reducing the severity of ME/CFS.
Here are some of the more common comorbid conditions present in people with ME/CFS:
- Sleep disorders (such as obstructive or central sleep apnea; restless legs syndrome, periodic limb movement or myoclonus; excessive sleepiness)
- Allergies, chronic sinusitis and reactive airway disease (asthma)
- Irritable bowel syndrome (IBS), reflux and heartburn (GERD), lactose intolerance, celiac disease
- Focal pain conditions such as osteoarthritis, cervical or lumbar disc disease
- Primary or secondary mental health conditions (such as attention deficit disorders, depression, anxiety)
- Metabolic syndrome (primary or secondary) and type II diabetes
- Hormone imbalances or dysregulation (such as menopause, low testosterone, hypothyroidism, polycystic ovarian syndrome)
- Chronic or recurrent infections (such as herpes or shingles outbreaks)
- Vitamin D and vitamin B12 deficiency or “low normal” values People with ME/CFS should learn about their own comorbid conditions, and in partnership with a medical professional, see that they get the best supportive treatment available.
* In the Institute of Medicine (IOM) report on ME/CFS, released earlier this week, one of the recommendations dealt with the issue of comorbid conditions, stating that physicians should diagnose ME/CFS if diagnostic criteria are met, following an appropriate history, physical examination, and medical work-up. The committee clearly called for the removal of the exclusionary rule; existing criteria specify that if fibromyalgia, Lyme disease or a host of other known co-morbid conditions are diagnosed, then ME/CFS cannot be diagnosed. Comorbid diseases frequently occur and the committee stated that it is incumbent upon the physician to make the ME/CFS diagnosis as well and then do all they can to treat it. In the past, the exclusionary rule for ME/CFS diagnosis has slowed research progress. This new recommendation should improve research effectiveness and progress in the future.
The relevance of these clinical pearls of wisdom depends on the features of each individual’s illness, but each of them benefit CFS patients by improving functionality and quality of life. With a chronic condition like ME/CFS, this can go a long way toward helping patients manage their illness while we search for targeted interventions and ultimately a cure.