FAQ

A. Apparent complete cures do occur but are usually seen only in the first two years of illness. Studies of the Lake Tahoe epidemic in 1985 suggested that 90 percent apparently recovered within two years of onset.

Unfortunately, as time goes by and especially after two to five years of illness, there are fewer and fewer complete cures. However, recovery to near-normal function is seen, even after five years or longer.

Most patients with over-five-year illness are at best functionally better adapted to varying degrees rather than cured. We are not sure anyone ever truly recovers from CFS after two years.

A. Treatment expenses can vary from $100 to $500 per month or more, especially if there is no drug coverage. The important thing to know here is that treatment can be prioritized to fit most any budget and there are ways to minimize treatment costs.

We have not found that the amount spent on treatment correlates well with outcome.

A. It often does and the mechanism is probably hormonal. However, after delivery, the patient can worsen for awhile and then usually returns to pre-pregnancy baseline, though we have seen significant improvements after a pregnancy.

The biggest challenge is the stress of caring for a new child. How this turns out and the assistance for childcare is critical to the long-term outcome of pregnancy in CFS.

A. We approach each patient as an individual with unique strengths and weaknesses. We evaluate certain tests, historical aspects of their illness and other findings and make a “to do” list.

We follow the general outline described in the treatment philosophy.

A key test is the terrain map using echocardiography which establishes both qualitative and quantitative aspects of each person’s illness. High on the list of interventions is the use of transdermal cell signaling factors to adjust a corrupted phenotype of gene expression.

We also attempt to define and treat any evidence of gut dysbiosis. We are very keen on adjusting the redox state which is a key therapeutic idea.

We concentrate on certain protective measures, especially the brain and reducing mediators of oxidative stress. We are always thinking of the biological terrain and how to best leverage its return to normal physiology.

A. Not in the traditional sense. What they have is evidence of cellular energy problems reflected in the heart. We do rarely see morphological changes of early diastolic heart failure.

We very commonly see evidence of diastolic dysfunction, low cardiac output and patent foramen ovale. We almost never see evidence of a low ejection fraction or visually obvious LV systolic dysfunction.

A. Dysbiosis is a term that signifies an altered gut microbial ecology associated with features of gut motility disturbance, digestive malfunction, gut immune disruption and food intolerances.

It is universal in CFS and must be aggressively addressed though it may not be primary. In our opinion, the primary problem is reduced cellular energy and its ubiquitous effects on autonomic balance, pH balance and redox issues.

Despite its secondary role, dysbiosis nevertheless might account for most of the symptom misery of CFS.