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Winter
2001
Considerations
for
seeing CFS patients
Individuals
with chronic fatigue syndrome (CFS)
have special needs practitioners should consider during office visits. Here are some suggestions
to help you provide optimum care:
-
Provide a place to lie down. CFS patients may not be able to sit up
for long periods of time in the waiting room, your office, or the exam room. They may also be too self-conscious
to ask for a place to rest.
-
Expect body temperature abnormalities. CFS patients often have low
body temperatures and get chilled quickly; they may need a sheet or blanket to be comfortable. Practitioners
should also be aware that for CFS patients, a normal temperature (98.6) may actually indicate a fever.
-
Draw patients out verbally. The cognitive problems in CFS patients
may make it difficult for them to express themselves during the verbal part of the examination. Make questions
very specific so that a long response is not required. They may also underreport the type, duration, and
severity of symptoms, especially in regard to chronic pain.
-
Acknowledge the illness. Saying “you look great” or “you seem much
better” can be very discouraging given the fluctuations in symptom severity most patients experience.
These types of remarks can be interpreted by patients that the physician does not accept or understand
the daily reality of living with CFS.
-
Address sensitive issues. It will be difficult for some patients to
discuss loss of libido, changes in appetite and weight, and the need for home services, such as help with
house cleaning, errands, and bathing. You may need to initiate the conversation.
-
Account for medication sensitivity. CFS patients are hypersensitive
to medicines, foods, and vaccines. Many also experience unusual side effects. Try prescribing a quarter
to a third of the normal initial dosage to start and then increasing slowly as necessary to achieve symptom
relief.
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