AHMF: Conf 2001: R Vallings

Diagnosis and Management of Chronic Fatigue Syndrome

R.Vallings, MB BS (Lond)

Auckland, New Zealand
Contact Details:
Rosamund Vallings
140 North Road,
R.D.2 Papakura Auckland,
1730 New Zealand
E-mail: Vallings@xtra.co.nz
Phone/fax: 9534 3346

During the past 15 years the author has seen over 2000 patients diagnosed with Chronic Fatigue Syndrome according to the current criteria. A management strategy for General Practitioners has been developed. This incorporates making the diagnosis by careful history taking, full clinical examination and utilising any locally available laboratory tests. Other diseases are excluded, though continual surveillance is considered vital, as over time one third of patients initially referred did have alternative diagnoses eventually. Sending specimens for appropriate overseas testing is considered (eg to Bioscreen in Australia), as this can help formulate a management plan.

Issues covered then include finding suitable stress management approaches, an individually prepared gentle exercise plan, general nutritional advice with consideration of supplements, the importance of addressing sleep issues, hormonal assessment and therapeutic options.

Listening to the patient's needs and education about this illness can be addressed by the GP, but the implications of time available and cost of consultation have to be considered. A patient booklet has therefore been produced to re-affirm all of the above recommendations following consultation. Patients are also offered the opportunity to attend group therapy workshops focussed on education about the illness and sensible health management. Patients are assigned to groups according to age, duration of illness and particular health concerns. Groups are held in different areas and in New Zealand are fully government funded. Most people attend an initial introductory series of 4 sessions, followed by a more advanced course.

The paper presented will outline the above in detail.