Saturday, April 21, 2007

CFS vs Society

Chronic Fatigue Syndrome or CFS is a working case definition for the neuroimmune disorder known as Myalgic encephalomyelitis (ME) since 1956. ME has been included in the classification of the World Health Organization (WHO) as a disease of the central nervous system since 1969. In the ICD-10, ME is the only disorder listed in the tabular classification under G93.3, Post-viral fatigue syndrome (PVFS). In 1993 the term Chronic fatigue syndrome (CFS) was added to the alphabetic list of the classification with the same designation.

In the 1950s, the public eye was caught by several outbreaks of a mysterious illness that resembled, but proved not to be, poliomyelitis. Afterwards, it was established that the disorder was primarily found among the general population and the epidemic form was the exception. Autopsy findings, both on monkeys and on the rare human casualties, led to the conclusion that the disorder was caused by inflammation of the brain and the spinal cord, and in 1956 it was named accordingly as Myalgic encephalomyelitis. Despite the existence of non-epidemic cases, the disorder was soon dismissed by some as mass hysteria and interest dropped, to be rekindled only after a similar outbreak at Incline Village, Lake Tahoe, Nevada in the mid-1980s.

Unaware of the earlier findings, researchers now attached a different kind of name to the phenomenon: Chronic Fatigue Syndrome (CFS), after the symptoms rather than the (there unestablished) nature of the disorder. The Centers for Disease Control & Prevention published a first working case definition for CFS in 1988 even though by then the CDC were aware of the ME connection. The use of a syndrome definition had the advantage that the diagnostics were simplified. Research picked up considerably, and more so after the criteria were relaxed in 1994. The obvious drawback was the possibility of misdiagnosis.

Lacking a diagnostic laboratory test of any kind, CFS has frequently been mis-diagnosed, for example in patients presenting CFS symptoms with similar biological conditions or infections (such as Lyme or Epstein-Barr) (the latter of which is often the cause of glandular fever, or infectious mononucleosis), or psychological conditions (ranging from depression to hypochondria). A lack of information and awareness has led to many patients being stigmatized, sometimes as hypochondriac or lazy, yet at other times as over-active and perfectionistic.

The U.S. Centers for Disease Control & Prevention (CDC) have now recognized CFS as a serious illness and launched a campaign in June 2006 to raise public and medical awareness about it.

http://en.wikipedia.org/wiki/Chronic_fatigue_syndrome


Notwithstanding the “social stigma” attached to societies or so called special interest groups(SIG) of patients, doctors, specialists, bureaucrats, insurers, and government agencies, the dilemma of who’s treating whom in the social order remains a mystery – akin to the illness itself.

The range of response to action is as varied as the SIGs themselves. To start, the patients who have CFS are in fact the only credible group in the entire social spectrum because they are only complaining of symptoms, not knowing what to make of them, and relying on someone to, at the very least, understand the complications, and at the most, help do something about it like maybe some kind of treatment.

But unfortunately no, our social organization tends preclude not only erring on the side of caution but also outright ignoring the fact that there is no right way to do a wrong thing. Instead it’s full speed ahead to misdirection to someone else who also does not know what to do if something varies from the book of guidelines, protocol, or instruction. Bureaucrats are the worst offenders because it appears to be their job to misdirect or at least admitting to know nothing about anything upon pointed questioning.

The dark side of the medical community is characterized by IME or independent medical examinations by the miscreants of the medical community that sell their so called credibility favors to bureaucratic pimps to evade the costs to actually do research and look after the sick and suffering. Of course they get paid handsomely for this diversion of money to forestall science and social development.

At least this gives some point of reference of who to turn to for help because there are some genuine medical practitioners who can easily be identified by actually helping, in the form of treatment and medical reports that can help to understand the etiology and treatment.

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