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Chronic Fatigue Syndromes

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Chronic Fatigue Syndromes (CFS/M.E) and fatigue variants including;  Over Training Syndrome, Da Costa’s Syndrome, Long Covid, Post Sepsis Syndrome, and Late Lyme Disease:

The treatment model that is used for chronic fatigue syndromes are very person centred and depend very much on individual goals, values, and level of presenting disability.

Where appropriate Pam promotes a joint approach of safe rehabilitation strategies alongside emotional and psychological management of the presenting fatigue condition.

Chronic fatigue syndromes are associated with deep grieving for a person’s lost functioning and their lost time and experiences with their loved ones, this causes much pain and suffering within the condition.  Therapy can be a safe space to process and give space to these painful feelings and emotions.

Where rehabilitation is safe, appropriate, and desired by the client, Pam calls upon a number of different strategies and interventions.  These include helping people to regain further functioning in their desired areas in a safe way that does not trigger a post exertional malaise response.

The idea behind fatigue rehabilitation is to build up a person’s energy baseline incrementally, carefully, and safely always reflecting their current level of disability and limitation whilst also carefully monitoring their post exertional malaise response, with the idea of gently pushing up just below their baseline before their post exertional malaise is triggered thus eliminating any ill effect from rehabilitation.

Too many CFS/M.E sufferers have been recommended more generalised graded exercise programmes that are not person centred enough and that are not based upon a person’s very unique set of symptoms, post exertional malaise patterns, and level  of current disability and limitation.  This has therefore triggered setbacks for fatigue sufferers and for this reason Graded Exercise Therapy (GET) is generally no longer recommended in The National Institute for Health and Care Excellence (NICE) guidelines for treatment of CFS/M.E in the UK.

Even with this removal of GET from the NICE guidelines, in general physical well-being and the reduction of physical limitations remain very important to people.  Any worsening or decline in physical health due to deconditioning can have a great impact on a person’s overall well-being and quality of life.

Improvement of physical limitations through the impacts of deconditioning or gently encouraging less physical limitations in CFS/M.E  is something Pam can safely work with should a person desire to do so.

In order to achieve rehabilitation Pam uses safe strengthening and stretching exercises that are always positioned in line with the complete range of disability levels seen in CFS/M.E from the severe, to the mildly affected.  No matter how badly affected an individual is with the condition, there is always somewhere to start.

Pam also uses an incremental increase in baseline of more generalised daily activities, gradually building towards the daily activity levels desired by an individual.

In milder cases of fatigue, Pam can also use individual exercise preferences as end goals to build towards using a person’s preferred method of movement, strengthening, and reconditioning where it is safe to do so and is in line with a person’s current disability level.

Pam can also use someone’s daily step baseline to looks for fatigue patterns, she can use step ranges and incremental increases to manage fatigue boom and busts and for reconditioning, and likes to use Fitbits for this purpose.

Pam looks at sleep patterns and looks at any amplifying factors to the syndrome associated with sleep.  Dependant on a person’s sleep being a factor in their condition, Pam will call upon her CBT toolkit to help with lack of sleep or oversleeping if it is contributing towards, or maintaining fatigue issues.

If there is any predisposing factors that are adding to the current maintenance of a person’s condition, Pam will help detangle these and will also help people understand these predisposing factors and what might have led a person to become a sufferer if it is more unclear.

If relevant Pam can help with any trauma associated with living with the condition, and can also help with any unprocessed trauma that might still be contributing to ongoing fatigue.

Pam can also help with other areas such as diet management for reduction in fatigue levels, or with return to work or study plans, should this help be desired or inline with a person’s therapeutic goals.