This is a personal log I have started to keep track of my progress with trying to sort issues that trouble me from time to time as a patient of Chronic Fatigue and anorexia. My condition is further complicated by Orthostatic Hypotension and an allergy to air pollution. I am constantly fatigued and repeatedly go through acute episodes of throat and chest infections and stomach flu. These episodes usually last for months further compromising my ability to get proper nourishment and fresh air. During these periods I lose strength and it becomes extremely difficult for me to leave the confines of home. My intent in this post is to keep a record of my progress for myself while sharing my experience with others. I’d love to hear from the readers of this blog. Please leave a comment if you have a suggestion or anything you want to share. I will update this post from time to time.
Taking an objective view of my condition this is where I stand. Chronic Fatigue is a syndrome with no treatment. I am stuck in a town where air pollution is high. I don’t know if Orthostatic Hypotension is treatable. Doctors don’t take it seriously. Throat and chest infections and stomach flu need to be treated as and when they occur. Deviations in health due to malnutrition need to be handled on an ongoing basis.
Here is some more background of my case. I remain tired between 8am and 2pm. This pattern of feeling tired and not being able to function for a part of the day is typical of CFS patients. Sometimes it is so bad that I cannot do little things like shower or eat. Fatigue is common to many illnesses including depression. The difference is that a patient with depression will always feel better after exercise but a Chronic Fatigue patient will feel worse after exercise, like in my case. A CFS patient truly has low energy levels whereas a depressive does not want to do anything but has the strength because there are no physiological issues. Therefore if a depressive pushes herself hard enough she can function normally. A CFS patient will usually want to push herself and most times over estimates her physical ability. Due to these subtle but extremely important differences most CFS patients are diagnosed as depressives and are mistreated further complicating their lives. We need to understand that diagnosis of depression is simply the opinion of the psychiatrist and the opinion does not have any scientific basis. Because a lot of skill is needed to distinguish between depression and chronic fatigue, CFS patients are inevitably put on psychiatric medication for long periods of times without any progress. The symptoms of Chronic Fatigue, Hypothyroidism (including sub-clinical Hypothyroidism) and Depression are very similar and are often misdiagnosed by most health professionals. The psychiatrist also has a vested interest in treating the patient and I haven’t come across one who has ever said that “you are not depressed but have another condition so I am referring you to xyz. Send a perfectly healthy individual to a psychiatrist and he will be put on powerful addictive medication for life or at least till he develops a condition as a side effect.
No health professional ever want to make the effort to understand the subtle differences between Chronic Fatigue and Depression. It probably does not make economic sense for them. The return on investment is not there. If you go to a doctor with this condition every one of them will point you towards a psychiatrist who will happily give your condition a label and give you a hand full of brain altering medicines. The only gainers in this are the large pharmaceutical companies and the psychiatrist. In addition to not understanding CFS, there are a lot of lab results doctors cannot interpret or at least do not understand their significance. There is no treatment for CFS which is my underlying condition. But other conditions arising out of this underlying issue can be treated. Lives of CFS patients are complicated by improper sleep, improper diet patterns and not getting enough fresh air and sunlight simply because we are often too tired to do anything.
Coming back to the task at hand, I am currently trying to get the following out-of-range test results evaluated. Low MCHC can mean a hypochromic anemia, a problem absorbing iron, gastrointestinal tract tumors, internal bleeding or another specific condition. High RDW can mean impaired heart or lung function red blood cell production increases to compensate for impaired heart or lung function. I my case High RDW and orthostatic hypotension may be worth evaluating.
Low Mean Corpuscular Hemoglobin Concentration (MCHC)
31.1 lab range> 33.4 – 37
High Red Cell Distribution Width –SD (RDW-SD)
53 lab range> 39 – 46
High Red Cell Distribution Width –CV (RDW-CV)
14.9 lab range> 11.5 – 14.5
In patients of CFS and anorexia anemia is common because of improper diet patterns, low immunity and repeated infections. These results may have less significance for a person who has normal energy levels and is functioning normally. But for someone like me who has CFS further complicated by anorexia the proper interpretation can mean a lot. I have decided to meet all the doctors I can till I find someone who understands the significance or is willing to at least spend the time to interpret the results.
I also have a condition in which my supine or lying down blood pressure is 30 points higher than when I am upright. This condition is known as “Orthostatic Hypotension”. This condition can affect your ability to function and can make you feel tired. The only solution I got from the cardiologist who diagnosed this was that I raise my bed on the head side by about 8 inches. I haven’t really researched this condition much and am not sure at this point how serious the condition is.
Matters are further complicated with high serum Amylase which can mean “leaky gut”. I haven’t found any endocrinologist who understands what this means and if it can be treated. Most endocrinologists only seem to work with thyroid and diabetes patients.
In addition to this my basal temperature remains low and ranges between 95 and 96 degrees Fahrenheit. This is one more thing Health care professional do not understand. Low basal body temperature can mean a hypothyroid condition. In my case this is ruled out. I have tried T3 supplementation treatment but the temperature remains low. Low basal temperature means that there is something wrong. This can however not be conclusive and requires other tests. What it indicates for sure is that metabolism is not functioning at an optimum level and energy production is low, further adding to a fatigued feeling. Because doctors do not understand this they are unable to help.
It is highly probable that all these conditions if occurring separately in a patient may not mean much but when they affect one person they become a problem for the patient. But the issue here is that a cardiologist will only look at heart issues. An endocrinologist will look at thyroid and related issues. An internist does not have enough experience with such issues. To top it no health professional is inclined to keeping himself up-to-date with new developments or studying what he did not learn in school. Most doctors I have met can only seem to be able to treat you if you have a “popular” for lack of a better word, disease or condition.
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Doctor Chandran, Katwaria Sarai on March 21, 2015
With this in mind I visited my first doctor today. His answer was “these results mean nothing. They are used to evaluate cancers and diseases like that”. My tests show high amylase also so I asked him to look at that test result. He was unable to give me a reasonable response to that. He then asked me “Have you seen a psychiatrist”. This sort of answered my question so I thanked him and politely left his office. However during the discussion I asked him if he could give me something for anemia on clinical basis. He agreed and prescribed Fersolate, an iron supplement. For my CFS his answer was that I look too energetic to be suffering from Chronic Fatigue. He also suggested that I should find another doctor and get admitted to hospital for a few days to be evaluated for Chronic Fatigue. However this is already an established condition.
March 25, 2015
I have responded positively to Fersolate. My clinical symptoms and a positive response to the iron supplement seem to be clearly pointing towards anemia. Not knowing what to do and who to go to next, I have decided to at least get an anemia profile blood lab test done. This test will include 28 tests of 6 part Hemogram, 7 tests of lipid profile, 3 electrolytes, 3 Iron deficiency tests, Folic acid, Thyroid Stimulation Hormone, Diabetic Profile 2 tests, Vitamin B-12, Vitamin D and Ferritin.
