Course
Introduction
| Course
| Introduction
| Who Gets CFS?
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The symptoms of CFS resemble those of many illnesses, including Multiple Schlerosis, chronic Lyme disease, mononucleosis, and other illnesses. Therefore, the first step in diagnosing CFS is usually to rule out other diseases by using a variety of medical tests. However, right now no test can show that someone definitely has CFS, only that they don't have other illnesses. People with CFS often have out-of-normal scores on some tests, but none of these are reliable enough to be used in diagnosis.
Therefore, diagnoses usually rely on the patient's report of the symptoms. This is difficult because each person uses their own language to describe symptoms. Non-medical people don't understand the medical definitions of terms like fatigue, tiredness, and sleepiness. (Fatigue refers to the feeling a healthy person gets after hard exercise, tiredness refers to the feeling the day after a poor night's sleep, sleepiness refers to a desire to sleep.) Furthermore, many patients don't recognize their minor symptoms because they are masked by major symptoms or they don't think they are important enough to tell the doctor.
A thorough diagnostic interview can take several hours and most doctors can't spend this much time with their patients. When the primary care physician does not make the diagnosis of CFS, patients are often referred to specialists who focus on particular symptoms, but cannot diagnose the disease as a whole.
Some doctors are unfamiliar with CFS and some refuse to diagnose it. This is not surprising considering that information about CFS was not available at the time most doctors were trained. The general feeling toward CFS among doctors has changed significantly over the last decade and continues to change today.
Another difficulty in diagnosing CFS is the lack of a true understanding of what CFS is. In 1988, the United States Centers for Disease Control (CDC) wrote a research definition for CFS. This definition identifies a precise group of people with very similar symptoms in order to standardize subjects in CFS research. But it excludes people who may have CFS but don't have the precise pattern of symptoms listed at the time they are examined.
In 1994, the CDC released a revised case definition which attempted to include more people. However, all definitions based on symptoms are arbitrary by nature. That's why some doctors who have seen many cases of CFS say they do not rely on a list of symptoms to make a diagnosis; they say they can "sense" a case because the patterns are so similar.
| Course
| Introduction
| Who Gets CFS?
|