Why I am so tired?
Feeling tired is extremely common in those living overseas (and at home as well). Overwork, worry and failing to take regular time off are probably the commonest causes. You may have trouble getting on with a colleague, have frustration at work and too much or too little, to do. You may be bored or homesick, losing sleep, or beginning to suffer from stress without realizing it. If the reason is not obvious to you, ask your friends, who may have better insight than you.
What is Chronic Fatigue Syndrome (CFS)?
CFS is puzzling and frequent illness that has become well known over the past decade. It goes under a variety of names, including myalgic encephao-myelitis (ME), yuppie disease and the post-viral syndrome. Quite apart from its debilitating symptoms, those who have it often face further problems with doctors, friends and colleagues who may ignorant or unsympathetic. CFS patients therefore often have to run their own ‘public relation bureau’. This can be especially difficult among expatriates and overworked colleagues. Estimates suggest that at least 1% of the population have CFS, and fatigue states of various types are common in travel and tropical clinics.
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The symptoms of CFS
• Profound tiredness and a sense of weakness or aching in the muscles.
• Mental exhaustion
• Memory loss
• Poor concentration
• Changes in sleep pattern
The treatment of CFS
See a doctor
Identify and then regularly consult a sympathetic doctor. If you think your symptoms fit into this category you should see a medic who has time, experience and sympathy with the condition, and access to laboratory tests. A hurried consultation with an uninformed and unsympathetic doctor should be avoided! This may mean waiting till you return to your home, and even then doctors will need to be chosen with care.
Some other illnesses, including some tropical diseases, can mimic CFS, and it is important both medically and for your peace of mind that these are discussed and excluded, if necessary by further tests or a specialist referral.
Accept your diagnosis
Once CFS has been confirmed as your diagnosis, accept this without guilt or shame. Recent research has confirmed the existence and ‘respectability’ of CFS.
Set up an appropriate lifestyle
Balance: The key to recovery is learning to balance input (rest, encouragement, support) with output (physical and mental exercise and other activity). This in turn depends on learning to identify and carry out the maximum activity that does not worsen your symptoms over the following days. The amount of activity takes careful working out, and to start with it may be surprisingly little. It will also vary from day to day.
Sleep: In the early days of CFS, many feel a need or even a hunger for sleep. At this stage extra sleep or rest is an essential part of treatment. It can include a long lie-in, an afternoon nap or early night. It night-time sleep is a problem it is worth first reducing the amount of daytime sleep you take and or gently increasing your amount of daily exercise.
Work: Work and responsibility need to be removed or reduced to a level at which gradual recovery is possible. This means that reduce hours, or time away from work, is usually necessary to begin with. You will also need to avoid situations where you need to pre-plan activities or make diary entries that may be hard to cancel. It is hard to predict how you feel one day, week or month in advance, and it is helpful not take on irrevocable commitments.
Exercise: It is important even from the earliest days to take some exercise so as to keep your muscles in trim. Walking is obviously sensible, to which swimming and a gentle exposure to a favorite sport can be added. Absorption in sedentary hobby, reading or studying will provide useful mental exercise.
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Avoid too high expectation from ‘magic remedies’
Some individuals claim that special diets or other inputs will help to bring recovery. Try these extras if you wish, but do not be disappointed if they are not successful as you hoped. An increasing number of CFS sufferers claim a daily cold bath improves their energy level.
An unexpected bonus
Many have found that being forcibly cornered by chronic fatigue syndrome has deepened their spiritual life or helped them gain other valuable insights. Many active people need red traffic lights. It may, however, only be after your recovery that you begin to see the benefits of your illness.
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