This article is not about symptoms and remedies. There are plenty of Web sites and books that will run down those lists for you. Certainly you and your health care provider need to address your specific symptoms as best you can.
The fact is there are many valid approaches to treating symptoms: nutrition, acupuncture, homeopathy, supplements, herbs, prescription drugs, naturopathy, craniosacral therapy, Reiki treatments, massage. The list moves along. Interestingly, there is rarely an approach that always works for every person who tries it - especially with syndromes like CFS. My personal slant? I think the type of treatment you choose is perhaps not as important as your underlying beliefs about the therapy, your intentions, your faith in your doctor and then the same from the other side - the beliefs and intentions of your practitioner and their faith in your intention to be healed. The body will receive what the mind allows.
Let me also mention briefly that, although it seems logical to want to fight what's happening to our bodies, the battle metaphor seems like a pretty ungentle, unloving stance to me. With chronic illness, it's not like we can "conquer" whatever invaded our bodies and be done with it. Pollutants, sleep disturbances, pain, lowered physical activity - all seem to work against us, but any sense of power we might gain by declaring war on our bodies is negated by the implied rejection of our physical selves. If you find it useful to use this type of metaphor, be conscious of what you are battling. We want to work with our body, not against it.
That said, there are things we can do to optimize the day-to-day quality of our health. These are lifestyle practices we can adopt so our health care provider is not working alone, rather, their good work is enhanced by our own behavior. We might feel too weighed down by symptoms to make much effort, but small steps are quite alright. Every time we do even one little thing to improve our situation we empower ourselves, we are loving ourselves, reclaiming control, saying we're worth it and creating hope. Now that's a good place to move towards, eh?
Nutrition
I certainly don't claim to be a nutritionist, so I won't get too technical on you. There's so much information out there, much of it conflicting, so I choose to let my own common sense guide me. I also learn from the reports of many people with chronic illnesses. I will remind you that all bodies are not alike, so I offer this information in case it's useful to you.
Food allergies and sensitivities can aggravate symptoms, especially joint pain, abdominal distress and digestive disturbances. You can experiment on your own if you suspect a specific allergy. Eliminate the suspected food for at least three weeks and see how you feel. There are much more intense ways to go about this, in which case you should be under a doctor's care.
Some simple switches in the way you eat might help. Try fruit for dessert (it can be dark chocolate-dipped strawberries), snack on nuts, buy organic, add just one more serving of vegetable or fruit to your day. I would love to do an experiment one day on my theory that if everyone simply added one extra serving of fruit or vegetable a day, we could toss all weight-loss diets away forever. Notice I added to everyone's diet! Whatever you are eating, try to keep it pure: avoid processed foods. Lastly, many people benefit from several small meals a day instead of three larger meals.
When we are tired and bored and there's not as much pleasure in our lives as we're used to, it's easy to fall head over heels in love with sweets. If you have ever considered reincarnation and wondered why we come back, I might just venture that it could be for the cheesecake! At any rate, watch the sugar intake, not because of the potential weight gain or even cavities, but because it can mess with your energy.
Some foods have become known as "superfoods," meaning they are loaded with good things for your health and so we want to include them in our diets. Here are a few of them: soy, blueberries, avocado, walnuts, pumpkin, garlic, green/red/white tea, pomegranate, oats and yes, a little dark chocolate (can you say nirvana?)
Warming spices can really help with the chills. During cold weather I add a touch of cinnamon to my foods and beverages or might chew on candied ginger or drink ginger tea.
It can be challenging to eat healthy foods when aching and fatigued, but this may be when we most need to. Poor nutrition causes lack of energy, among other things, and that lack of energy makes it more difficult to prepare nourishing meals. Try using your peak hours earlier in the day to prep everything you'll need for your meals. Lay out pots and utensils, chop fresh produce and keep in the fridge until needed. You know, like on the televised cooking programs - everything is all lined up which makes it look so easy. When I'm tired and I've done this prep work, what's left appears so low-impact that I can usually manage it.
Physical Activity
It's important to get some type of exercise in your day. Inertia breeds inertia. Anyone who's had the flu can tell you this. For many of us it's difficult to know where the line is drawn between helping and hurting. With CFS we don't rebound so well, so what energizes a healthy person may put us to bed for a few days. Be sensible.
Gardening does qualify as exercise. For those of us who can sit for ten minutes of weed-pulling, this counts.
Many of us can handle physical activity in small doses only. Some studies have suggested that breaking our activity up into smaller segments is equally as beneficial as an hour-long session. Women can keep hand-held weights around and pick them up for a few bicep curls when able. Current wisdom suggests that such weight bearing activity is important for women's bone health.
A little yoga also goes a long way - not only does it help you maintain your range of motion - it calms you, keeps you flexible and soothes your muscles. Plus you can do it at home in your pj's! You don't have to do a whole class on dvd or at the gym, just select a handful of poses that stretch you where it's needed and do them when you can. There are a lot of good books on yoga for specific benefits.
What do I do? I frequently change routines and respond to my body's fluctuating energy levels. Sometimes I go to a gym and use the treadmill, elyptical, cycle and weight machines. I might go for a yoga or NIA class. At one time my energy was high enough to stick with a step aerobics class for several weeks! I also worked out at Curves 2-3 times a week for 4 months or so. Interestingly, I can rally for shopping, travel and kayaking most of the time. And I use the stairs at work.
Mostly, however, I don't have gym-energy and so have a back-up home routine that I can most often manage. I have 5# weights lying around and pick them up a few times a week for some bicep curls and several other moves. From there I do some yoga - tree pose and warrior pose, forward bends. I might add a few moves I learned in ballet class years (well, decades) ago.
I would like to say that if you think it's not exercise unless you're going to the gym, think again. Do what you can. Don't sweat it if it doesn't amount to much. Suspend your expectations and be surprised at how your abilitiy might fluctuate from day-to-day or season-to-season. Don't force it or you'll hate it. For me, it helps to have that back-up routine to defer to on my low days.
Fatigue
In my own experience my fatigue is chronic, meaning it rarely abates to a pre-CFS state. It feels like an overall tiredness and sometimes weakness. Most days I can make the effort to be active and it pays off and others I begin right out of bed feeling like I need a good night's sleep. While the fatigue associated with chronic illness may be difficult to resolve, there are lifestyle choices I can make to minimize or prevent adding more fatigue via my behavior:
Aspire to strike a balance between pleasurable activities and those that are mundane, stressful or plain necessary. Avoid filling your day exclusively with work tasks and chores that must be done. When we have little energy to work with we often use it to do the laundry, run errands or pay the bills. How about including or replacing one of those with a quiet walk, puttering in the garden or going to lunch with a friend?
A real challenge can be fighting the body's natural reaction to fatigue through craving foods that boost energy - namely sugar and caffeine. Maintaining steady blood sugar levels creates sustainable energy and with adequate energy the body won't crave a quick fix.
Pace yourself and don't forget to pace yourself! When I was at my worst, I would lug the vacuum out of the closet and plug it in one day and would have to wait up to several days to have the energy to sweep it across one area rug. I get the pots and pans out for cooking hours ahead of time and then rest before the actual food preparation must take place. I rarely leave the house more than once on any given day. I am good for a maximum 2-hour visit with others - I don't have the energy to listen, let alone speak, after that. Between each activity is a rest period...dust, rest with a magazine; walk the dog, take a nap; fix lunch, write a letter; and so on.
Get daily doses of natural light and fresh air. Many of us hole up inside our homes where we can control the temperature and comfort ourselves with pajamas and cushiony furniture. I'm more likely to make it outside if I wear layerable clothes and put on shoes or slippers that can go outdoors. A full-spectrum light box can be a good winter alternative.
Get enough good-quality sleep. Read the next section of this article for help with insomnia and related challenges.
Sleep
Sleep can be illusive for many with a chronic illness. Some of us will need acupuncture, homeopathy (some type of treatment), herbs or prescription drugs to get to sleep. Let me attempt to make a list of things you can do on your own to decrease sleep disturbances and maybe eliminate the need for chemical or other assistance.
Control the bedroom temperature. Too hot and too cold can make it hard to fall asleep and stay asleep.
Use comfortable bed linens - heck, go for luxurious if you can afford it.
Allow quiet time before going to bed. I seem to need a couple of hours of quiet. Conversations might get my energy up too much, especially if there's any stress (good or bad) that comes with it. I don't answer the phone after 8pm and I read for and hour before turning in.
If pain keeps you up or awakens you in the night, you may need to take over-the-counter pain killers or herbs/remedies as prescribed by your health care provider (naturopathic or homeopathic practitioners are more versed in the use of such things). A hot bath and gentle stretching before bed can also help.
Keep the bedroom dark so you won't be disturbed when the sun comes up or be kept awake by other sources of light.
Many would advise that your bedroom not have a lot of electric appliances. Not only do they often make subtle noises that can be disturbing, even on an unconscious level, but electromagnetic waves are considered harmful.
Warm milk at bedtime? Ewww! But many swear by it, and if you aren't repulsed by the thought of drinking warmed milk from a cow, you could try it.
A routine bedtime/wake-up time is said to be helpful - Ive been practicing this for years and usually sleep okay. Bedtime rituals can also act as a cue for the body/mind to quiet down and prepare for sleep. I allow myself to wake up naturally on most mornings and I tend to awaken at the same time each day. I figure this is what my body needs and leave it at that.
An active day really helps the sleep. Some exercise as tolerated or any type of stimulation before evening can be helpful.
I personally have trouble falling asleep if I eat my evening meal later than 7pm. I have taught myself not to eat any meal to the point that my stomach is full. I stop eating when I feel satisfied, as opposed to full. Not only does this keep me from grabbing my belly with an "ugh" after a good meal, but it means there's room for dessert if anybody happens to be serving up some!
Naps during the day would mess with my abillity to sleep at night. Not everyone has this issue.
Try not to do or think about stressful things near your bedtime, or you might find yourself ruminating too much to fall asleep. Avoid stress as much as possible as a general rule.
Keeping too close track, tallying up your hours of sleep or lack thereof is unproductive unless your doctor is asking you for the information. Having an idea in your head that you must sleep X-number of hours each night sets you up to be stressed when you don't meet it.
Some of you may sleep many hours each night. Is this because it takes you too long to fall asleep? Do you awaken during the night and have trouble returning to sleep? Is your slumber interrupted by sleep apnea? This is a personal thing. Explore potential resolvable causes with your health care practitioner. Practice going to bed and getting up the same time each day to re-set your rhythm. Don't stress it unless you feel it messes with your energy when you are awake.
When I feel too hyper to fall asleep at my bedtime, I focus my mind on repeating a mantra so I cannot ruminate about other things. I often use the word "lullabye."
There are many teas that can help you to sleep. Chamomile is one that is well known. If your bladder can handle it overnight, these can really help.
A lot of people use a relaxation technique to help them fall asleep. You can start with the toes and tense and release muscles, working your way up the body. Tensing the muscle first helps to relax it more completely upon release. Plus, it teaches you through contrast how to locate where you are carrying tension.
For women, menopause can interfere with sleep. This is easily resolved with herbs.
A lot of people advise you to get up and watch television or read for awhile if you can't fall asleep. Many do this and it works for them. I don't normally do this. If I am still not asleep after an hour I try not to stress it. I am relaxing, at least. Surely that's worth something. My body needs sleep, but it also benefits from my stillness, closed eyes, slowed breathing and being horizontal so my body gets a break from holding me upright.
Restless Leg Syndrome can be a sleep thief. Talk to your doctor about this if it is a problem for you.
sleep, pretty darling, do not cry. And I will sing a lullabye.
-The Beatles, from Golden Slumbers
