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Your Doctor's Role

If you are not able to access a provider who is an expert on CFS/FM, your next best bet is to find a doctor who is empathetic and willing to help. This person may be your existing primary care doctor or someone else you find who either knows about CFS/FM or is willing to learn about it. 

There are four ways your doctor can help if you have CFS or FM:

1) Establish a diagnosis, if you aren't sure you have CFS or FM
2) Treat the major symptoms of the two conditions
3) Treat other conditions that often accompany CFS and FM
4) Provide usual primary care
While your doctor's role is important, you should recognize that there is no known cure so far for either CFS or FM, so there are limits to what your doctor can do. Medical treatment does not treat the disease; it only palliates the symptoms. The key to recovery in both conditions is acceptance of the illness and adaptation to it by means of lifestyle changes, for which medical treatment is no substitute.
Four General Treatment Rules
In considering medications and other treatments, there are four general rules that your doctor should follow:
  • No medication works for everybody, so you and your doctor will probably have to experiment to find what works for you. 
  • People with CFS/ME and FM are extremely sensitive to medications (especially sedating ones), so your doctor should start with low doses and increase slowly. Start low, go slow! 
  • Multiple medications are often required to address the numerous symptoms of the two conditions. This “rational polypharmacy” is not unusual or unexpected, and should not deter your doctor from helping you. Your doctor is likely to make one change at a time, so you and she can determine the effectiveness and side effects of each medication. 
  • Your doctor may have to replace medications periodically, since it is not unusual for people with the two conditions to develop tolerance to medications. 
For more, see Dr. Lapp's article on the self-help program website How Your Doctor Can Help If You Have CFS/ME.

Also, Dr. Lapp and other US doctors who specialize treating people with ME/CFS have created a six-page guide for primary care doctors to help them diagnose and treat people with ME/CFS. The guide can be read, printed and downloaded here.











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