M.E.

First time one of my friends mentioned M.E was in the form of an online conversation and I thought my friend was talking about 'ME'. Then I was wondering why he used block capitals if he was referring to 'ME' and then I thought that it was a rude think to do!!

Then he explained that he was referring to 'Myalgic Encephalitis' otherwise known as Chronic Fatigue Syndrome or Post-Viral Encephalitis. As of yesterday, my GP seems to like the term Chronic Fatigue Syndrome. I was aware of this syndrome but I had never seen one with it and did not know much about it other than the fact that is one of the reasons people are tired all the time. Initially, I thought it would a diagnosis of exclusion like IBS (Irritable Bowel Syndrome) where all their tests come back normal and you just give them a diagnosis to make them happy, although there is nothing much you can do for them. So with M.E I thought it is just one way to give a reason for their tiredness despite all their tests being normal and you saying there is nothing much I can do to help you overcome this!

However, after doing some reading on it, there seems to be an organic cause to it. Apparently, it comes up after glandular fever or a viral illness and it presents with specific physical symptoms. These symptoms are swollen glands and aches all over the body similar to fibromyalgia in a way. On top of that there comes the tiredness which can be rather limiting. A lot of people need to take time off work and this has a major impact on their lives.

When I asked my GP if there are a lot of people who suffer from this, he said that he only has about 3-4 patients with this problem, and guess what ! Yesterday was my M.E. as I got to see two of them!!

For one of them it was a recent diagnosis, so it did not seem to affect her in a big way where she would need to take time off work. However, she mentioned how her social life has deteriorated as she comes back from work and then she just needs to rest and cannot go out or lead a normal social life. Furthermore, she deals with it by not leading a stressful lifestyle and giving more time to herself to do things. She has been on holiday recently and she enjoyed that without feeling very tired. Nevertheless, she was not sure about travelling for work. She seemed rather concerned as she was not sure whether that would get her very tired and could be potentially very stressful at a point where she will not be able to cope.

As this is an illness associated with a viral cause, there is no specific
drug treatment you can offer the patient.

The main things to consider is conservative treatment such as an M.E. service or support group where these patients can receive counselling. Furthermore, this patient mentioned that such a service exists in her area and they will hold yoga classes, something which proves to be beneficial for this condition.

The next patient was not a recent diagnosis so he looked into his illness and developed the 'traffic lights system' , a way to distinguish his bad days from his good days. Red light was a bad day where he would be incapable of doing anything and might just stay in bed all day. Orange light was a day where he could carry out minimal tasks, tasks that do not require much energy or strenght. Finally, green light meant that he felt good in himself and could do almost anything a normal human being could do. I thought this was an interesting way to look at things and keeping a diary was definitely benificial for both the patient and the GP.

It is important to note here that there is a psychosocial impact of this illness as tiredness can lead to frustration, as most people feel they are not able to do as much as they would like to be doing. This can lead to depression, which can have a lot of after-effects. My GP seemed to believe that a good treatment for people with M.E. seemed to be SSRIs (antidepressants) such as fluoxetine (Prozac).

This learning on M.E. has helped me understand this disease much better and definitely it would be something I would consider on a differential for tiredness. Also, I know now to look onto people with M.E. with more empathy and understand the limitations and psychosocial impact of their illness.