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Weekend House Call: More than half a Million Americans have Chronic Fatigue Syndrome
Aired August 09, 2003 - 08:27 ET
THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.
THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.
CAROL COSTELLO, CNN ANCHOR: Weekend House Call with Dr. Sanjay Gupta starts now.
DR. SANJAY GUPTA, CNN CORRESPONDENT: Good morning and welcome to Weekend House Call.
According to the CDC, more than half a million Americans have it. It's Chronic Fatigue Syndrome, although fatigue hardly begins to describe it. Many sufferers are home bound, bedridden, unable to work. That makes the achievement of one Chronic Fatigue Syndrome patient, Laura Hillenbrand, all the more remarkable. She's the author of a book you may have read, "Sea Biscuit," which has been on the best seller list for 69 weeks now. And this is, and it's also the basis of this summer's hit movie, which many of you have seen.
Beth Nissen visited her at her home.
(BEGIN VIDEOTAPE)
08070003.v84
(END VIDEOTAPE)
GUPTA: OK, well, it's estimated between 500,000 and 800,000 Americans suffer from Chronic Fatigue Syndrome. That number could even be low, since diagnosing the disease is sometimes difficult. There's no diagnostic test for CFS and no known cause or cure.
The official definition of Chronic Fatigue Syndrome is a debilitating fatigue lasting at least six months with at least four of the following eight symptoms: impaired memory or concentration; sore throat; muscle pain; multi-joint pain; tender lymph nodes in the armpit and neck; headaches of a new type, patter or severity; physical discomfort or malaise after exercise lasting more than 24 hours; and sleep difficulties or unrefreshing sleep.
Very interesting.
We're going to answer your questions about CFS. Call us at 1- 800-807-2620 or e-mail us at housecall@cnn.com.
And to help answer your questions, we are joined by a very special guest.
Dr. Veeraindar Goli joins us from Duke University.
Good morning, sir.
DR. VEERAINDAR GOLI, DUKE UNIVERSITY: Good morning.
How are you doing?
GUPTA: I'm doing well.
He's a Chronic Fatigue specialist.
Listen, if you're at home and you're watching this today, you're probably not alone if you have CFS. A lot of e-mails coming in, a lot of phone calls coming in.
Let's go straight to our first e-mail on this topic.
GOLI: OK.
GUPTA: Now, the first question actually coming from Beth in Oregon. The question is, "Does Chronic Fatigue Syndrome flare up after an illness? And, alternatively, if you have Chronic Fatigue Syndrome, are you more susceptible to get viral or bacterial infections?"
Dr. Goli, what do you say about that?
GOLI: Beth, actually, it's a very good question, because a lot of the patients who have Chronic Fatigue Syndrome have a fairly sudden onset. In fact, they relate it to a viral infection and then they start having severe fatigue symptoms. So it's not uncommon for Chronic Fatigue to happen immediately after an acute illness.
GUPTA: OK, so it really can go both ways there, first the fatigue, then the illness, or vice versa.
GOLI: That's right.
GUPTA: OK.
Angie from Indiana is on the phone with us.
Welcome to House Call, Angie.
ANGIE: Thank you.
I've been suffering from symptoms for the past 20 or 30 years. How do I find a doctor open to this diagnosis? In the Chronic Fatigue Chronicles it said that sometimes people go to an average of 100 doctors before diagnosis.
GOLI: Right. Yes.
GUPTA: Dr. Goli, that's a common problem, isn't it, with this? Twenty to 30 years she's had the symptoms now. What do you tell someone like her?
GOLI: Well, that's not uncommon. In fact, a lot of the patients we see have been to at least 10 to 15 doctors before they can go to one doctor who can actually try to help them. This is a pretty complex problem. One of the reasons is because there's no objective finding in Chronic Fatigue Syndrome. A lot of the doctors who see Chronic Fatigue patients get somewhat uncomfortable with the fact that they don't know how to help these patients or they don't have any clear idea about what -- what to look for.
And when you present with fatigue and four of the eight symptoms that you presented, then there's no real medications out there that will help you, unless you use a multi-disciplinary treatment modalities.
GUPTA: Interesting. Before we go to our next question, doctor, what kind of doctor are you and what kind of doctor is it, a neurologist, psychologist, psychiatrist, that typically treat Chronic Fatigue?
GOLI: Well, you need a doctor who understands your symptoms. If it is a primary care doctor, if it is a psychiatrist or a neurologist, it does not really matter. If you have an internist who can actually help you, who has a specialization in Chronic Fatigue Syndrome, it does help.
GUPTA: OK, great.
Dr. Goli, we're going to go to our next question.
Bobby from Arkansas, welcome to House Call.
Good morning.
BOBBY: Good morning.
My question is I have Epstein-Barr and they're saying that it's not curable and it's not treatable. Is there anything I can do for that?
GUPTA: I'm sorry, you say you have what, now?
BOBBY: Epstein-Barr.
GUPTA: Epstein-Barr, right.
BOBBY: Yes.
GUPTA: Got it.
So, Dr. Goli, you know, one thing about Chronic Fatigue Syndrome, it's a mimicker, isn't it? It mimics a lot of other diseases.
GOLI: It does.
GUPTA: He's talking about Epstein-Barr here. What do you tell him?
GOLI: Oh, Epstein-Barr, yes. That is one of the conditions that mimics Chronic Fatigue. In fact, infectious mononucleosis, Epstein- Barr virus, after they have the infection, the symptoms that they have are so similar to Chronic Fatigue Syndrome that you treat it almost very similarly.
GUPTA: OK, and Dr. Goli, no surprise to you then, so many phone calls coming in here.
GOLI: Yes.
GUPTA: A lot of people very interested in this.
Jan from Minneapolis, welcome to House Call.
JAN: Yes, I have a 17-year-old daughter that just over a year ago had a really bad case of mono and now she has been diagnosed with CFS. She just is not functioning at 17. She is in all the time. She has severe headaches. She sleeps all the time, muscles aches and the thing that has depressed her now is she's 17 and in the last nine months has put on 36 pounds.
GUPTA: Wow.
JAN: And yet she does eat well, because I'm diabetic and she eats a lot of my meals. And we just don't know what to do for her and it's just getting worse by the day.
GUPTA: That's got to be so hard. I mean, 17 years old, this can obviously affect your entire life.
Dr. Goli, do you see many young people with this, as well?
GOLI: Well, absolutely. In fact, the condition can start any time in adolescence and go on to adulthood. So the problem is that once you find out what the symptoms you have, you really need to find out a game plan. And the plan is to try to find out, you keep a diary of your symptoms and try to see how much fatigue you have and what kind of symptoms -- what kind of treatments can help you.
And I just want to emphasize the fact that there's no one medication or modality that will help.
GUPTA: All good advice. And we're going to get so much more of it.
We do have to take a quick break, though.
When we come back, we're going to have so much more -- diagnosing CFS. There's no test for it so how can you tell the difference between Chronic Fatigue Syndrome and depression, for example? That's going to be interesting.
Call us with your questions, 1-800-807-2620, or e-mail us at housecall@cnn.com.
We'll be right back.
COMMERCIAL
GUPTA: Did you know that Olympic skater Amy Peterson and soccer star Michelle Akers both struggle with Chronic Fatigue Syndrome?
(BEGIN VIDEOTAPE)
DARYN KAGAN, CNN ANCHOR: When you say worst, what does worst feel like for people who don't know what that feels like?
MICHELLE AKERS, U.S. WOMEN'S SOCCER TEAM: It's like just feeling totally empty on the inside. It's like there's no reserve, no energy. It's like a black hole in the very depths of your soul.
(END VIDEO CLIP)
GUPTA: This is Weekend House Call and we're talking about Chronic Fatigue Syndrome. Many think it's not a real disease. But for the people who have it, it can be truly devastating.
We want to hear from you. Call us with your questions. Our number is on the screen, 1-800-807-2620. Or send an e-mail question to housecall@cnn.com.
While we get your phone calls lined up, let's check today's health quiz.
What was the popular name for Chronic Fatigue Syndrome in the 1980s? We'll have the answer in 30 seconds.
Stay with us.
COMMERCIAL
GUPTA: All right, checking our health quiz, we asked, "What was the popular name for Chronic Fatigue Syndrome in the 1980s?" The answer, the yuppie flu. The disease got that name because initial studies showed it actually affected mainly white female pitfalls from well to do families. New studies show that Chronic Fatigue Syndrome affects people of all ages, races and socioeconomic groups, but women do seem to be more affected than men.
We're getting a lot of phone calls in. We are joined by Dr. Veeraindar Goli from Duke University.
Welcome back.
GOLI: Thank you.
GUPTA: Thank you for joining us.
GOLI: Thank you.
GUPTA: We're going to go right to the phones.
Dean, welcome to House Call.
DEAN: Yes, good morning, folks.
My question was regarding the related to depression when it comes to Chronic Fatigue. How often is long-term bouts of depression? And also the fact that does this Chronic Fatigue lead to depression and vice versa?
GUPTA: A very good question. A lot of, again, we're talking about this mimicking and the difficulty with diagnosis here, Dr. Goli.
What do you tell Dean?
GOLI: Well, the truth is it's like the chicken and the egg syndrome. Chronic Fatigue and depression have many features that are very similar. At the same time, it's not the same condition. People who suffer with chronic fatigue can develop depression in the later stages of the illness. Now, that doesn't mean that their fatigue is really because of their depression.
So, you know, you have to differentiate. There are some features that are different in Chronic Fatigue and depression.
Now, people with depression can have excessive guilt, whereas in Chronic Fatigue, guilt is not a predominant feature. And people with depression may have sleep disturbance. People in Chronic Fatigue also have sleep disturbance, but the sleep disturbance is slightly different. The people with Chronic Fatigue have what you call an unrefreshing sleep. They can sleep for about eight or 10 hours, but they wake up tired.
In depression, they really don't sleep well. So that...
GUPTA: And I...
GOLI: Oh, go ahead.
GUPTA: Go ahead.
No, that's all good information. I should point out, as well, as people are listening at home, that everyone has these symptoms from time to time, right?
GOLI: Yes.
GUPTA: But we're talking about prolonged periods here.
GOLI: That's right.
GUPTA: OK. All right.
GOLI: Yes.
GUPTA: Phone callers, stand by. We're going to go straight to one of our e-mails now. Dave from Canada is asking, "Have there been any recent developments in understanding the cause and possible cures of Chronic Fatigue Syndrome? I've had this idea for eight years and am particularly interested particularly in pain management techniques when dealing with this condition."
Again, this has been around for, you know, several decades now, Dr. Goli.
GOLI: Yes.
GUPTA: Has there been significant progress made?
GOLI: Well, there's a lot of progress being made. The Centers for Disease Control has criteria for Chronic Fatigue. It's a revised criteria. And there's centers across the nation that are looking at different immunological and neurological conditions that can co-mimic and cause Chronic Fatigue.
But the observation from the gentleman in Canada is a very, very good observation. The treatment strategy that you use for Chronic Fatigue is very similar to what you would you would do for pain management, which is another chronic condition, you know.
GUPTA: Right. And I mentioned, as well, Chronic Fatigue is sort of an unfortunate name, in a way, because it is certainly much more than fatigue.
GOLI: Yes.
GUPTA: Another e-mailer coming in now, Asia from Atlanta, here in Atlanta, asks, "Does regular exercise help or does it actually worsen Chronic Fatigue?"
Dr. Goli?
GOLI: Well, if you -- there is evidence to suggest that greater exercise is helpful for Chronic Fatigue Syndrome but not just regular exercise, that is, without supervision. So you want to really titrate your exercise to your fatigue. Some of my patients have actually told me that it's almost like a rechargeable battery. You don't want to discharge completely. What you want to do is do a little bit at a time until you conserve your energy.
GUPTA: That's interesting.
GOLI: Another interesting comment one of my patients did make is that energy becomes a real commodity for these patients.
GUPTA: That's very interesting stuff. And I know a lot of people are listening at home either who have it or who know someone who has it who are listening intently.
Phone callers, as well, stand by.
When we come back, we're going to look at some treatment plans for patients with Chronic Fatigue Syndrome and the recovery rate, as well. We'll also find out if kids can get Chronic Fatigue Syndrome. The answers, all of those answers, when Weekend House Call continues.
Stay with us. COMMERCIAL
GUPTA: All right, if you'd like more information about Chronic Fatigue Syndrome, check out this Web site. Go to www.cfids.org. You'll also find listings and links for local support groups in your area.
Well, there's no cure for Chronic Fatigue Syndrome, but there are several treatments available to help provide relief for symptoms. Work out a treatment program with your doctor that's tailored individually for you. That's very important.
Treatment can include gradual exercise, education about the illness and developing practical coping skills. As sleep is often disturbed, developing a normal sleep pattern is very important. Having extra sleep, including daytime naps, does not improve the condition.
Medication has a very limited role in the treatment of CFS, Chronic Fatigue Syndrome, as well. Some people require medication for various symptoms such as pain relievers. Many people with Chronic Fatigue Syndrome improve with time and some do recover completely. Important information to know.
We have an e-mail question now coming in from Michael in California. He asks, "What are the best ways to support a family member with Chronic Fatigue Syndrome?"
And we're joined again by Dr. Veeraindar Goli to help us work through that.
Dr. Goli?
GOLI: Yes, well, that's a good question, because when someone in the family has a chronic condition like Chronic Fatigue Syndrome, the entire family is affected. The first thing the family can do is to be understanding. And by understanding, I don't mean they are to be sympathetic. They are to be empathetic, understand that the person is suffering from a condition that at this point in time they may not have any control over.
GUPTA: And I want to be just clear, Dr. Goli, as well, you know, you're obviously a Chronic Fatigue Syndrome doctor. But there are a lot of doctors out there who don't get this either, isn't that true?
GOLI: Right. That is absolutely true because there are two camps. Some doctors believe that there is something that exists like Chronic Fatigue Syndrome, but as there are some doctors that are very clear about their opinion. They say it doesn't exist. The point is that if there's a patient who has fatigue, it is real, and it's real for them. And it is not in their head. That's one thing.
The second thing is there is definitely a clinical syndrome. Thirdly, what patients look for when they go from doctor to doctor is they're trying to validate their problem, period. The one thing most of the doctors need to do is to validate that that patient is suffering from something.
GUPTA: That's very...
GOLI: They may not understand at this point in time what that something is, but it's not just in their head.
GUPTA: And that validation is so important, finding a doctor who does that for you.
GOLI: Absolutely.
GUPTA: And going to another e-mail now. Debra from Illinois asking again about children. "Do children get Chronic Fatigue Syndrome? And, if so, are their symptoms different than those of adults?"
What do you say to her, Dr. Goli?
GOLI: Well, that's a wonderful question. I don't think anyone has a good answer at this point in time. There are some studies being done in children and teenagers, but I just don't have the data or information to tell you whether they have enough evidence to show Chronic Fatigue in children.
GUPTA: Although you did mention that it can start very early in age.
Going straight to our phone callers now...
GOLI: Yes?
GUPTA: Remy in California, welcome to House Call.
REMY: Good morning.
GUPTA: Good morning.
GOLI: Hello, Remy.
GUPTA: It's very early there for you in California, isn't it, remit?
REMIT: Yes, it is.
GUPTA: What's your question?
REMIT: Quick questions. I've been trying, I'm a computer consultant for an e-business and I have to travel, but I have Chronic Fatigue. I've been trying chelation therapy. Do you have any other suggestions about the benefits of chelation therapy? Are there some oral medications to take care of Candida and some of the other complications of CFS?
GUPTA: Why don't you explain chelation therapy first, Dr. Goli, and then see -- does that have any relevance? GOLI: Well, chelation therapy is something we normally don't use in our clinics. There's a lot of controversy around the use of chelation therapy. This is -- I'm not an expert in it, but I must tell you that there is an I.V. infusion of a substance that basically removes certain heavy metals from the body. Am I correct, Laura?
GUPTA: Yes, Remy. Yes, I think that's absolutely right. And the whole focus is actually trying to remove some potential toxins that might actually be causing that.
GOLI: Yes, exactly, toxins.
GUPTA: Is it -- is Chronic Fatigue Syndrome related to toxins? Do you think chelation therapy would help them?
GOLI: Well, the thing is there's no one single therapy that does help. If chelation therapy did help for you, it may be OK. But in general I don't necessarily think anyone would endorse chelation therapy for Chronic Fatigue Syndrome. And like I said, one of the first, the first things to understand for treatment is there are hundreds of treatments out there for Chronic Fatigue Syndrome.
GUPTA: Right.
GOLI: How do you choose what's the best one? The first thing to do is to think about whether it does any harm. If the treatment does no harm, that's the first criteria. The second criteria is does it do any good?
GUPTA: Right.
GOLI: And if it does any good, if it does good in one patient, it doesn't necessarily mean it translates to other people because there are subsets of Chronic Fatigue Syndrome that may respond to certain treatments better than others.
GUPTA: All right, Dr. Goli, stay with us.
We're going to have some final thoughts and wrap this all together in just a moment.
GOLI: Sure.
GUPTA: Stay with us.
COMMERCIAL
GUPTA: All right, welcome back.
We've been talking about Chronic Fatigue Syndrome with Dr. Veeraindar Goli from Duke University.
A final thought, sir?
GOLI: Well, a couple of final thoughts. First and foremost, start looking for a cure. The second thing is, you know, use a common sense rational approach. Pace yourself. Don't push yourself. And have a treatment plan that does not include one single pill or cure.
GUPTA: All right, thank you so much for joining us this morning, sir.
Validating Chronic Fatigue Syndrome is the first step, sometimes, to treating it. That's what we tried to do this morning.
That's all the time we have for today.
And make sure to watch tomorrow's Weekend House Call when we talk about kids and sports. Our parents pushing their kids too hard? That's tomorrow at 8:30 a.m., 5:30 Pacific.
Remember, this is the place for the answers to your medical questions.
Thanks again for watching.
I'm Dr. Sanjay Gupta.
I'll see you tomorrow.
TO ORDER A VIDEO OF THIS TRANSCRIPT, PLEASE CALL 800-CNN-NEWS OR USE OUR SECURE ONLINE ORDER FORM LOCATED AT www.fdch.com
have Chronic Fatigue Syndrome>
Aired August 9, 2003 - 08:27 ET
THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.
CAROL COSTELLO, CNN ANCHOR: Weekend House Call with Dr. Sanjay Gupta starts now.
DR. SANJAY GUPTA, CNN CORRESPONDENT: Good morning and welcome to Weekend House Call.
According to the CDC, more than half a million Americans have it. It's Chronic Fatigue Syndrome, although fatigue hardly begins to describe it. Many sufferers are home bound, bedridden, unable to work. That makes the achievement of one Chronic Fatigue Syndrome patient, Laura Hillenbrand, all the more remarkable. She's the author of a book you may have read, "Sea Biscuit," which has been on the best seller list for 69 weeks now. And this is, and it's also the basis of this summer's hit movie, which many of you have seen.
Beth Nissen visited her at her home.
(BEGIN VIDEOTAPE)
08070003.v84
(END VIDEOTAPE)
GUPTA: OK, well, it's estimated between 500,000 and 800,000 Americans suffer from Chronic Fatigue Syndrome. That number could even be low, since diagnosing the disease is sometimes difficult. There's no diagnostic test for CFS and no known cause or cure.
The official definition of Chronic Fatigue Syndrome is a debilitating fatigue lasting at least six months with at least four of the following eight symptoms: impaired memory or concentration; sore throat; muscle pain; multi-joint pain; tender lymph nodes in the armpit and neck; headaches of a new type, patter or severity; physical discomfort or malaise after exercise lasting more than 24 hours; and sleep difficulties or unrefreshing sleep.
Very interesting.
We're going to answer your questions about CFS. Call us at 1- 800-807-2620 or e-mail us at housecall@cnn.com.
And to help answer your questions, we are joined by a very special guest.
Dr. Veeraindar Goli joins us from Duke University.
Good morning, sir.
DR. VEERAINDAR GOLI, DUKE UNIVERSITY: Good morning.
How are you doing?
GUPTA: I'm doing well.
He's a Chronic Fatigue specialist.
Listen, if you're at home and you're watching this today, you're probably not alone if you have CFS. A lot of e-mails coming in, a lot of phone calls coming in.
Let's go straight to our first e-mail on this topic.
GOLI: OK.
GUPTA: Now, the first question actually coming from Beth in Oregon. The question is, "Does Chronic Fatigue Syndrome flare up after an illness? And, alternatively, if you have Chronic Fatigue Syndrome, are you more susceptible to get viral or bacterial infections?"
Dr. Goli, what do you say about that?
GOLI: Beth, actually, it's a very good question, because a lot of the patients who have Chronic Fatigue Syndrome have a fairly sudden onset. In fact, they relate it to a viral infection and then they start having severe fatigue symptoms. So it's not uncommon for Chronic Fatigue to happen immediately after an acute illness.
GUPTA: OK, so it really can go both ways there, first the fatigue, then the illness, or vice versa.
GOLI: That's right.
GUPTA: OK.
Angie from Indiana is on the phone with us.
Welcome to House Call, Angie.
ANGIE: Thank you.
I've been suffering from symptoms for the past 20 or 30 years. How do I find a doctor open to this diagnosis? In the Chronic Fatigue Chronicles it said that sometimes people go to an average of 100 doctors before diagnosis.
GOLI: Right. Yes.
GUPTA: Dr. Goli, that's a common problem, isn't it, with this? Twenty to 30 years she's had the symptoms now. What do you tell someone like her?
GOLI: Well, that's not uncommon. In fact, a lot of the patients we see have been to at least 10 to 15 doctors before they can go to one doctor who can actually try to help them. This is a pretty complex problem. One of the reasons is because there's no objective finding in Chronic Fatigue Syndrome. A lot of the doctors who see Chronic Fatigue patients get somewhat uncomfortable with the fact that they don't know how to help these patients or they don't have any clear idea about what -- what to look for.
And when you present with fatigue and four of the eight symptoms that you presented, then there's no real medications out there that will help you, unless you use a multi-disciplinary treatment modalities.
GUPTA: Interesting. Before we go to our next question, doctor, what kind of doctor are you and what kind of doctor is it, a neurologist, psychologist, psychiatrist, that typically treat Chronic Fatigue?
GOLI: Well, you need a doctor who understands your symptoms. If it is a primary care doctor, if it is a psychiatrist or a neurologist, it does not really matter. If you have an internist who can actually help you, who has a specialization in Chronic Fatigue Syndrome, it does help.
GUPTA: OK, great.
Dr. Goli, we're going to go to our next question.
Bobby from Arkansas, welcome to House Call.
Good morning.
BOBBY: Good morning.
My question is I have Epstein-Barr and they're saying that it's not curable and it's not treatable. Is there anything I can do for that?
GUPTA: I'm sorry, you say you have what, now?
BOBBY: Epstein-Barr.
GUPTA: Epstein-Barr, right.
BOBBY: Yes.
GUPTA: Got it.
So, Dr. Goli, you know, one thing about Chronic Fatigue Syndrome, it's a mimicker, isn't it? It mimics a lot of other diseases.
GOLI: It does.
GUPTA: He's talking about Epstein-Barr here. What do you tell him?
GOLI: Oh, Epstein-Barr, yes. That is one of the conditions that mimics Chronic Fatigue. In fact, infectious mononucleosis, Epstein- Barr virus, after they have the infection, the symptoms that they have are so similar to Chronic Fatigue Syndrome that you treat it almost very similarly.
GUPTA: OK, and Dr. Goli, no surprise to you then, so many phone calls coming in here.
GOLI: Yes.
GUPTA: A lot of people very interested in this.
Jan from Minneapolis, welcome to House Call.
JAN: Yes, I have a 17-year-old daughter that just over a year ago had a really bad case of mono and now she has been diagnosed with CFS. She just is not functioning at 17. She is in all the time. She has severe headaches. She sleeps all the time, muscles aches and the thing that has depressed her now is she's 17 and in the last nine months has put on 36 pounds.
GUPTA: Wow.
JAN: And yet she does eat well, because I'm diabetic and she eats a lot of my meals. And we just don't know what to do for her and it's just getting worse by the day.
GUPTA: That's got to be so hard. I mean, 17 years old, this can obviously affect your entire life.
Dr. Goli, do you see many young people with this, as well?
GOLI: Well, absolutely. In fact, the condition can start any time in adolescence and go on to adulthood. So the problem is that once you find out what the symptoms you have, you really need to find out a game plan. And the plan is to try to find out, you keep a diary of your symptoms and try to see how much fatigue you have and what kind of symptoms -- what kind of treatments can help you.
And I just want to emphasize the fact that there's no one medication or modality that will help.
GUPTA: All good advice. And we're going to get so much more of it.
We do have to take a quick break, though.
When we come back, we're going to have so much more -- diagnosing CFS. There's no test for it so how can you tell the difference between Chronic Fatigue Syndrome and depression, for example? That's going to be interesting.
Call us with your questions, 1-800-807-2620, or e-mail us at housecall@cnn.com.
We'll be right back.
COMMERCIAL
GUPTA: Did you know that Olympic skater Amy Peterson and soccer star Michelle Akers both struggle with Chronic Fatigue Syndrome?
(BEGIN VIDEOTAPE)
DARYN KAGAN, CNN ANCHOR: When you say worst, what does worst feel like for people who don't know what that feels like?
MICHELLE AKERS, U.S. WOMEN'S SOCCER TEAM: It's like just feeling totally empty on the inside. It's like there's no reserve, no energy. It's like a black hole in the very depths of your soul.
(END VIDEO CLIP)
GUPTA: This is Weekend House Call and we're talking about Chronic Fatigue Syndrome. Many think it's not a real disease. But for the people who have it, it can be truly devastating.
We want to hear from you. Call us with your questions. Our number is on the screen, 1-800-807-2620. Or send an e-mail question to housecall@cnn.com.
While we get your phone calls lined up, let's check today's health quiz.
What was the popular name for Chronic Fatigue Syndrome in the 1980s? We'll have the answer in 30 seconds.
Stay with us.
COMMERCIAL
GUPTA: All right, checking our health quiz, we asked, "What was the popular name for Chronic Fatigue Syndrome in the 1980s?" The answer, the yuppie flu. The disease got that name because initial studies showed it actually affected mainly white female pitfalls from well to do families. New studies show that Chronic Fatigue Syndrome affects people of all ages, races and socioeconomic groups, but women do seem to be more affected than men.
We're getting a lot of phone calls in. We are joined by Dr. Veeraindar Goli from Duke University.
Welcome back.
GOLI: Thank you.
GUPTA: Thank you for joining us.
GOLI: Thank you.
GUPTA: We're going to go right to the phones.
Dean, welcome to House Call.
DEAN: Yes, good morning, folks.
My question was regarding the related to depression when it comes to Chronic Fatigue. How often is long-term bouts of depression? And also the fact that does this Chronic Fatigue lead to depression and vice versa?
GUPTA: A very good question. A lot of, again, we're talking about this mimicking and the difficulty with diagnosis here, Dr. Goli.
What do you tell Dean?
GOLI: Well, the truth is it's like the chicken and the egg syndrome. Chronic Fatigue and depression have many features that are very similar. At the same time, it's not the same condition. People who suffer with chronic fatigue can develop depression in the later stages of the illness. Now, that doesn't mean that their fatigue is really because of their depression.
So, you know, you have to differentiate. There are some features that are different in Chronic Fatigue and depression.
Now, people with depression can have excessive guilt, whereas in Chronic Fatigue, guilt is not a predominant feature. And people with depression may have sleep disturbance. People in Chronic Fatigue also have sleep disturbance, but the sleep disturbance is slightly different. The people with Chronic Fatigue have what you call an unrefreshing sleep. They can sleep for about eight or 10 hours, but they wake up tired.
In depression, they really don't sleep well. So that...
GUPTA: And I...
GOLI: Oh, go ahead.
GUPTA: Go ahead.
No, that's all good information. I should point out, as well, as people are listening at home, that everyone has these symptoms from time to time, right?
GOLI: Yes.
GUPTA: But we're talking about prolonged periods here.
GOLI: That's right.
GUPTA: OK. All right.
GOLI: Yes.
GUPTA: Phone callers, stand by. We're going to go straight to one of our e-mails now. Dave from Canada is asking, "Have there been any recent developments in understanding the cause and possible cures of Chronic Fatigue Syndrome? I've had this idea for eight years and am particularly interested particularly in pain management techniques when dealing with this condition."
Again, this has been around for, you know, several decades now, Dr. Goli.
GOLI: Yes.
GUPTA: Has there been significant progress made?
GOLI: Well, there's a lot of progress being made. The Centers for Disease Control has criteria for Chronic Fatigue. It's a revised criteria. And there's centers across the nation that are looking at different immunological and neurological conditions that can co-mimic and cause Chronic Fatigue.
But the observation from the gentleman in Canada is a very, very good observation. The treatment strategy that you use for Chronic Fatigue is very similar to what you would you would do for pain management, which is another chronic condition, you know.
GUPTA: Right. And I mentioned, as well, Chronic Fatigue is sort of an unfortunate name, in a way, because it is certainly much more than fatigue.
GOLI: Yes.
GUPTA: Another e-mailer coming in now, Asia from Atlanta, here in Atlanta, asks, "Does regular exercise help or does it actually worsen Chronic Fatigue?"
Dr. Goli?
GOLI: Well, if you -- there is evidence to suggest that greater exercise is helpful for Chronic Fatigue Syndrome but not just regular exercise, that is, without supervision. So you want to really titrate your exercise to your fatigue. Some of my patients have actually told me that it's almost like a rechargeable battery. You don't want to discharge completely. What you want to do is do a little bit at a time until you conserve your energy.
GUPTA: That's interesting.
GOLI: Another interesting comment one of my patients did make is that energy becomes a real commodity for these patients.
GUPTA: That's very interesting stuff. And I know a lot of people are listening at home either who have it or who know someone who has it who are listening intently.
Phone callers, as well, stand by.
When we come back, we're going to look at some treatment plans for patients with Chronic Fatigue Syndrome and the recovery rate, as well. We'll also find out if kids can get Chronic Fatigue Syndrome. The answers, all of those answers, when Weekend House Call continues.
Stay with us. COMMERCIAL
GUPTA: All right, if you'd like more information about Chronic Fatigue Syndrome, check out this Web site. Go to www.cfids.org. You'll also find listings and links for local support groups in your area.
Well, there's no cure for Chronic Fatigue Syndrome, but there are several treatments available to help provide relief for symptoms. Work out a treatment program with your doctor that's tailored individually for you. That's very important.
Treatment can include gradual exercise, education about the illness and developing practical coping skills. As sleep is often disturbed, developing a normal sleep pattern is very important. Having extra sleep, including daytime naps, does not improve the condition.
Medication has a very limited role in the treatment of CFS, Chronic Fatigue Syndrome, as well. Some people require medication for various symptoms such as pain relievers. Many people with Chronic Fatigue Syndrome improve with time and some do recover completely. Important information to know.
We have an e-mail question now coming in from Michael in California. He asks, "What are the best ways to support a family member with Chronic Fatigue Syndrome?"
And we're joined again by Dr. Veeraindar Goli to help us work through that.
Dr. Goli?
GOLI: Yes, well, that's a good question, because when someone in the family has a chronic condition like Chronic Fatigue Syndrome, the entire family is affected. The first thing the family can do is to be understanding. And by understanding, I don't mean they are to be sympathetic. They are to be empathetic, understand that the person is suffering from a condition that at this point in time they may not have any control over.
GUPTA: And I want to be just clear, Dr. Goli, as well, you know, you're obviously a Chronic Fatigue Syndrome doctor. But there are a lot of doctors out there who don't get this either, isn't that true?
GOLI: Right. That is absolutely true because there are two camps. Some doctors believe that there is something that exists like Chronic Fatigue Syndrome, but as there are some doctors that are very clear about their opinion. They say it doesn't exist. The point is that if there's a patient who has fatigue, it is real, and it's real for them. And it is not in their head. That's one thing.
The second thing is there is definitely a clinical syndrome. Thirdly, what patients look for when they go from doctor to doctor is they're trying to validate their problem, period. The one thing most of the doctors need to do is to validate that that patient is suffering from something.
GUPTA: That's very...
GOLI: They may not understand at this point in time what that something is, but it's not just in their head.
GUPTA: And that validation is so important, finding a doctor who does that for you.
GOLI: Absolutely.
GUPTA: And going to another e-mail now. Debra from Illinois asking again about children. "Do children get Chronic Fatigue Syndrome? And, if so, are their symptoms different than those of adults?"
What do you say to her, Dr. Goli?
GOLI: Well, that's a wonderful question. I don't think anyone has a good answer at this point in time. There are some studies being done in children and teenagers, but I just don't have the data or information to tell you whether they have enough evidence to show Chronic Fatigue in children.
GUPTA: Although you did mention that it can start very early in age.
Going straight to our phone callers now...
GOLI: Yes?
GUPTA: Remy in California, welcome to House Call.
REMY: Good morning.
GUPTA: Good morning.
GOLI: Hello, Remy.
GUPTA: It's very early there for you in California, isn't it, remit?
REMIT: Yes, it is.
GUPTA: What's your question?
REMIT: Quick questions. I've been trying, I'm a computer consultant for an e-business and I have to travel, but I have Chronic Fatigue. I've been trying chelation therapy. Do you have any other suggestions about the benefits of chelation therapy? Are there some oral medications to take care of Candida and some of the other complications of CFS?
GUPTA: Why don't you explain chelation therapy first, Dr. Goli, and then see -- does that have any relevance? GOLI: Well, chelation therapy is something we normally don't use in our clinics. There's a lot of controversy around the use of chelation therapy. This is -- I'm not an expert in it, but I must tell you that there is an I.V. infusion of a substance that basically removes certain heavy metals from the body. Am I correct, Laura?
GUPTA: Yes, Remy. Yes, I think that's absolutely right. And the whole focus is actually trying to remove some potential toxins that might actually be causing that.
GOLI: Yes, exactly, toxins.
GUPTA: Is it -- is Chronic Fatigue Syndrome related to toxins? Do you think chelation therapy would help them?
GOLI: Well, the thing is there's no one single therapy that does help. If chelation therapy did help for you, it may be OK. But in general I don't necessarily think anyone would endorse chelation therapy for Chronic Fatigue Syndrome. And like I said, one of the first, the first things to understand for treatment is there are hundreds of treatments out there for Chronic Fatigue Syndrome.
GUPTA: Right.
GOLI: How do you choose what's the best one? The first thing to do is to think about whether it does any harm. If the treatment does no harm, that's the first criteria. The second criteria is does it do any good?
GUPTA: Right.
GOLI: And if it does any good, if it does good in one patient, it doesn't necessarily mean it translates to other people because there are subsets of Chronic Fatigue Syndrome that may respond to certain treatments better than others.
GUPTA: All right, Dr. Goli, stay with us.
We're going to have some final thoughts and wrap this all together in just a moment.
GOLI: Sure.
GUPTA: Stay with us.
COMMERCIAL
GUPTA: All right, welcome back.
We've been talking about Chronic Fatigue Syndrome with Dr. Veeraindar Goli from Duke University.
A final thought, sir?
GOLI: Well, a couple of final thoughts. First and foremost, start looking for a cure. The second thing is, you know, use a common sense rational approach. Pace yourself. Don't push yourself. And have a treatment plan that does not include one single pill or cure.
GUPTA: All right, thank you so much for joining us this morning, sir.
Validating Chronic Fatigue Syndrome is the first step, sometimes, to treating it. That's what we tried to do this morning.
That's all the time we have for today.
And make sure to watch tomorrow's Weekend House Call when we talk about kids and sports. Our parents pushing their kids too hard? That's tomorrow at 8:30 a.m., 5:30 Pacific.
Remember, this is the place for the answers to your medical questions.
Thanks again for watching.
I'm Dr. Sanjay Gupta.
I'll see you tomorrow.
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