Conditions We Treat

What is Myalgic Encephalomyelitis (ME)?

Myalgic Encephalomyelitis, also known as Chronic Fatigue Syndrome (ME/CFS), is a complex and debilitating condition characterized by severe fatigue that is not alleviated by rest. ME/CFS can significantly impact a person’s daily functioning and quality of life. It is a chronic condition, and symptoms may persist for many months or years.

Symptoms of Myalgic Encephalomyelitis:

The symptoms of ME/CFS can vary from person to person and may fluctuate in intensity over time. Common symptoms include:

1. Fatigue: Overwhelming and persistent fatigue that is not relieved by rest.
2. Post-Exertional Malaise (PEM): Worsening of symptoms after physical, mental, or emotional exertion.
3. Cognitive Difficulties: Problems with memory, concentration, and thinking (often referred to as “brain fog”).
4. Unrefreshing Sleep: Poor quality sleep and waking up feeling unrefreshed.
5. Pain: Muscle and joint pain, headaches, and sore throat.
6. Flu-like Symptoms: Recurrent sore throat, tender lymph nodes, and flu-like symptoms.
7. Orthostatic Intolerance: Dizziness, lightheadedness, and feeling faint upon standing.
8. Sensitivities: Increased sensitivity to light, noise, odors, and certain foods.
9. Gastrointestinal Issues: Nausea, abdominal pain, bloating, and irritable bowel syndrome (IBS)-like symptoms.

Causes of Myalgic Encephalomyelitis:

The exact cause of ME/CFS is not yet fully understood. It is believed to be a complex interplay of genetic, environmental, and immune system factors. Some potential triggers and contributing factors include viral infections, immune dysfunction, hormonal imbalances, and physical or emotional stress. Research is ongoing to better understand the underlying mechanisms.

Diagnosis of Myalgic Encephalomyelitis:

Diagnosing ME/CFS can be challenging, as there are no specific laboratory tests or imaging studies that can definitively diagnose the condition. Diagnosis is typically based on the following:

1. Medical History: Detailed discussion about your symptoms, their onset, and duration.
2. Physical Examination: Ruling out other possible causes of fatigue and assessing for specific ME/CFS symptoms.
3. Diagnostic Criteria: Meeting the criteria set by internationally recognized guidelines, such as the 2015 National Academy of Medicine criteria.
4. Exclusion of Other Conditions: Other potential causes of fatigue and related symptoms need to be ruled out through appropriate testing.

Treatment of Myalgic Encephalomyelitis:

There is currently no cure for ME/CFS, and treatment focuses on managing symptoms and improving quality of life. A multidisciplinary approach is often necessary, involving various healthcare professionals. Treatment strategies may include:

1. Pacing and Activity Management: Learning to balance activity and rest to prevent overexertion and manage symptoms.
2. Symptom Relief: Medications may be prescribed to alleviate specific symptoms such as pain, sleep disturbances, and depression.
3. Sleep Management: Establishing healthy sleep habits and addressing sleep disorders, such as insomnia or sleep apnea.
4. Supportive Therapies: Physical therapy, occupational therapy, and alternative therapies, such as acupuncture or mindfulness, may be beneficial for some individuals.
5. Collaborative Care: Working with a healthcare team that specializes in ME/CFS to provide comprehensive support, education, and management of the condition.

Conclusion:

Myalgic Encephalomyelitis is a chronic and complex condition that requires a comprehensive and individualized approach to management. If you suspect you may have ME/CFS, consult with a healthcare
professional who is knowledgeable about the condition. With proper care, symptom management, and support, it is possible to improve quality of life and achieve a better level of functioning.

Myalgic Encephalomyelitis Resources

What is Fibromyalgia?

Fibromyalgia is a chronic condition characterized by widespread pain, fatigue, and heightened sensitivity to touch. It is a complex disorder that affects the musculoskeletal system and often coexists with other conditions such as sleep disturbances, cognitive difficulties, and mood disorders. Fibromyalgia can significantly impact a person’s quality of life, but with proper management, symptoms can be improved.

Symptoms of Fibromyalgia:

The symptoms of fibromyalgia can vary among individuals but commonly include:

1. Widespread Pain: Chronic and widespread pain affecting multiple areas of the body, including muscles, joints, and tendons.
2. Fatigue: Persistent fatigue, feeling tired even after sleep, and a lack of energy.
3. Cognitive Difficulties: Problems with memory, concentration, and thinking, often referred to as “fibro fog.”
4. Sleep Disturbances: Difficulty falling asleep, staying asleep, or waking up feeling unrefreshed.
5. Sensitivity to Touch: Increased sensitivity to pain, temperature, pressure, and even light touch.
6. Stiffness: Morning stiffness and muscle stiffness after periods of inactivity.
7. Headaches: Frequent tension headaches or migraines.
8. Gastrointestinal Issues: Digestive problems such as irritable bowel syndrome (IBS), abdominal pain, bloating, and constipation.
9. Mood Disorders: Anxiety, depression, and mood swings.

Causes of Fibromyalgia:

The exact cause of fibromyalgia is not known, but it is believed to involve a combination of genetic, environmental, and psychological factors. Potential contributing factors include:

1. Abnormal Pain Processing: People with fibromyalgia may have an amplified response to pain signals.
2. Neurochemical Imbalances: Imbalances in neurotransmitters, such as serotonin, dopamine, and norepinephrine, may play a role.
3. Sleep Disturbances: Disrupted sleep patterns and poor sleep quality can contribute to fibromyalgia symptoms.
4. Stress and Trauma: Physical or emotional trauma and chronic stress may trigger or exacerbate fibromyalgia symptoms.

Diagnosis of Fibromyalgia:

Diagnosing fibromyalgia can be challenging as there are no specific laboratory tests or imaging studies that can confirm the condition. Diagnosis is typically based on the following:

1. Medical History: Detailed discussion about your symptoms, their duration, and impact on daily life.
2. Physical Examination: Assessing specific tender points on the body as outlined in diagnostic criteria.
3. Diagnostic Criteria: Meeting the criteria established by recognized guidelines, such as the American College of Rheumatology (ACR) criteria.
4. Exclusion of Other Conditions: Other potential causes of symptoms need to be ruled out through appropriate testing.

Treatment of Fibromyalgia:

Fibromyalgia is a chronic condition, and treatment aims to manage symptoms and improve overall well-being. Treatment strategies may include:

1. Medications: Pain relievers, antidepressants, anticonvulsants, and sleep aids may be prescribed to manage pain, improve sleep, and address mood disorders.
2. Lifestyle Modifications: Regular exercise, stress management techniques, maintaining a consistent sleep schedule, and practicing good sleep hygiene.
3. Physical Therapy: Exercise programs, stretching, and low-impact aerobic activities under the guidance of a physical therapist.
4. Complementary and Alternative Therapies: Massage, acupuncture, yoga, and mindfulness techniques may provide additional symptom relief for some individuals.
5. Supportive Therapies: Support groups and counseling can help individuals cope with the challenges of living with fibromyalgia.

Conclusion:

Fibromyalgia is a chronic condition characterized by widespread pain, fatigue, and increased sensitivity to touch. It requires a multidisciplinary approach for management, including medications, lifestyle modifications, and supportive therapies. With proper care and self-management strategies, individuals with fibromyalgia can experience improved symptom control and a better quality of life. It’s important to
work closely with a healthcare professional to develop a personalized treatment plan that meets your specific needs.

Fibromyalgia Resources

What is Long COVID?

Long COVID, also known as post-acute sequelae of SARS-CoV-2 infection (PASC), refers to a condition where individuals experience persistent symptoms or new symptoms that last beyond the acute phase of COVID-19 infection. Even if you had a mild or moderate COVID-19 infection, you may still develop long-lasting symptoms that can significantly impact your daily life.

Symptoms of Long COVID:

Long COVID symptoms can vary widely and affect different body systems. Some common symptoms include:

1. Respiratory: Shortness of breath, chest tightness, cough, and lung inflammation.
2. Neurological: Brain fog, memory problems, difficulty concentrating, headache, dizziness, and sleep disturbances.
3. Fatigue: Persistent exhaustion, weakness, and reduced stamina.
4. Cardiac: Chest pain, palpitations, and abnormal heart rate or rhythm.
5. Musculoskeletal: Joint and muscle pain, weakness, and inflammation.
6. Psychological: Anxiety, depression, mood swings, and post-traumatic stress symptoms.
7. Gastrointestinal: Abdominal pain, nausea, diarrhea, and loss of appetite.
8. Other: Loss of taste or smell, skin rashes, hair loss, and menstrual irregularities.

Causes of Long COVID:

The exact causes of Long COVID are still being researched. It is believed that the persistence of the virus, immune dysregulation, inflammation, and organ damage may contribute to the development of long-lasting symptoms. Other factors, such as pre-existing health conditions, age, and genetic predisposition, may also play a role in the severity and duration of symptoms.

Diagnosis of Long COVID:

Diagnosing Long COVID is based on a combination of medical history, symptom presentation, and exclusion of other possible causes.
Healthcare professionals may perform various tests and evaluations, including:

1. Medical History: Detailed discussion about your COVID-19 infection, symptom onset, and progression.
2. Physical Examination: Assessing your current symptoms and physical signs.
3. Laboratory Tests: Blood tests to evaluate organ function, inflammation markers, and other relevant parameters.
4. Imaging Studies: Chest X-rays or CT scans to assess lung involvement.
5. Specialist Referrals: Referral to relevant specialists, such as pulmonologists, cardiologists, or neurologists, for further evaluation.

Treatment of Long COVID:

The management of Long COVID focuses on relieving symptoms and improving overall well-being. Treatment strategies may include:

1. Symptom Management: Medications to address specific symptoms, such as pain relievers, inhalers, sleep aids, or antidepressants.
2. Rehabilitation: Physical therapy, occupational therapy, and speech therapy to regain strength, improve mobility, and address cognitive impairments.
3. Pulmonary Rehabilitation: Breathing exercises, respiratory therapies, and exercises to improve lung function and alleviate breathlessness.
4. Psychological Support: Counseling, cognitive-behavioral therapy, and support groups to address mental health challenges associated with Long COVID.
5. Lifestyle Modifications: Rest, balanced nutrition, hydration, and gradual return to physical activity based on individual capabilities.
6. Collaborative Care: Working closely with a healthcare team that includes various specialists to provide comprehensive care and support.

Conclusion:

Long COVID can have a significant impact on individuals even after the acute phase of COVID-19 infection. If you are experiencing persistent or new symptoms following COVID-19, it is important to seek medical attention and discuss your concerns with a healthcare professional. With proper management, support, and time, many individuals with Long COVID experience gradual improvement in their symptoms and quality of life.

Long COVID Resources

What is Dysautonomia?

Dysautonomia refers to a group of conditions that affect the autonomic nervous system, which is responsible for regulating involuntary bodily functions. These conditions disrupt the normal functioning of the autonomic nervous system, leading to a wide range of symptoms that can affect multiple body systems. Dysautonomia can significantly impact a person’s daily life, but with proper management, symptoms can be improved.

Symptoms of Dysautonomia:

Dysautonomia symptoms can vary widely among individuals but commonly include:

1. Orthostatic Intolerance: Dizziness, lightheadedness, or fainting upon standing (orthostatic hypotension).
2. Tachycardia: Rapid heart rate or palpitations.
3. Blood Pressure Fluctuations: High or low blood pressure that is not easily regulated.
4. Gastrointestinal Issues: Nausea, bloating, constipation, or diarrhea.
5. Sweating Abnormalities: Excessive sweating or inability to sweat.
6. Temperature Regulation Problems: Sensitivity to heat or cold.
7. Fatigue: Persistent fatigue and reduced stamina.
8. Cognitive Dysfunction: Problems with memory, concentration, and thinking.
9. Sleep Disturbances: Insomnia, restless sleep, or excessive daytime sleepiness.

Causes of Dysautonomia:

The causes of dysautonomia vary depending on the specific condition. Some forms of dysautonomia are acquired, resulting from other medical conditions or as a side effect of certain medications. Others may be primary, meaning the dysfunction occurs without an underlying known cause. Some common causes and contributing factors include:

1. Autoimmune Disorders: Certain autoimmune conditions can target the autonomic nervous system.
2. Genetic Factors: Some forms of dysautonomia have a genetic basis.
3. Infections: Certain viral or bacterial infections can trigger dysautonomia.
4. Medications: Some medications can affect autonomic nervous system function.
5. Trauma: Injuries, such as head trauma, can lead to dysautonomia.

Diagnosis of Dysautonomia:

Diagnosing dysautonomia can be complex and may involve multiple medical specialists. The diagnostic process typically includes:

1. Medical History: Detailed discussion about your symptoms, their onset, and duration.
2. Autonomic Testing: Specialized tests to assess autonomic nervous system function, such as tilt table testing, thermoregulatory sweat testing, heart rate variability analysis, or 10 minute stand test.
3. Laboratory Tests: Blood tests to rule out other potential causes of symptoms.
4. Specialist Referrals: Consultation with various specialists, such as cardiologists, neurologists, or gastroenterologists, to assess specific symptoms and underlying conditions.

Treatment of Dysautonomia:

While there is no cure for dysautonomia, treatment focuses on managing symptoms and improving quality of life. Treatment strategies may include:

1. Lifestyle Modifications: Increasing fluid and salt intake, wearing compression stockings, and adopting a regular exercise routine
   under medical guidance.
2. Medications: Prescribed medications to manage specific symptoms, such as beta-blockers for tachycardia or medications to increase blood volume.
3. Dietary Changes: Adjustments to diet, such as smaller and more frequent meals, to alleviate gastrointestinal symptoms.
4. Physical Therapy: Exercises and techniques to improve strength, endurance, and balance.
5. Supportive Therapies: Support groups, stress management techniques, and relaxation exercises to improve overall well-being.

Conclusion:

Dysautonomia is a group of conditions that affect the autonomic nervous system, leading to a variety of symptoms that can significantly impact daily life. While there is no cure, proper management and treatment can help alleviate symptoms and improve quality of life. It is important to work closely with a healthcare professional experienced in dysautonomia to develop an individualized treatment plan that addresses your specific needs. With the right support and strategies, individuals with dysautonomia can lead fulfilling lives and effectively manage their symptoms.

Dysautonomia Resources

What is Mast Cell Activation Syndrome?

Mast Cell Activation Syndrome (MCAS) is a complex disorder that involves the abnormal activation and release of mast cells in the body. Mast cells are a type of white blood cell that play a crucial role in the immune system. When mast cells become overactive, they release various substances, such as histamine and other inflammatory mediators, which can cause a wide range of symptoms throughout the body.

Symptoms of Mast Cell Activation Syndrome:

The symptoms of MCAS can vary widely among individuals and may affect different systems of the body. Some common symptoms include:

1. Skin: Flushing, itching, hives, rashes, swelling, and angioedema.
2. Gastrointestinal: Abdominal pain, bloating, diarrhea, nausea, vomiting, and acid reflux.
3. Respiratory: Wheezing, shortness of breath, coughing, and nasal congestion.
4. Cardiovascular: Rapid heartbeat, low blood pressure, lightheadedness, and fainting.
5. Neurological: Headaches, migraines, brain fog, dizziness, and anxiety.
6. Musculoskeletal: Joint and muscle pain, stiffness, and weakness.
7. Fatigue: Chronic fatigue, weakness, and malaise.
8. Other: Mood swings, menstrual irregularities, and allergic reactions to various triggers.

Causes of Mast Cell Activation Syndrome:

The exact causes of MCAS are not yet fully understood. In some cases, it may be associated with genetic mutations or other underlying conditions, such as allergies, autoimmune disorders, or chronic infections. Environmental triggers, such as stress, certain foods, medications, temperature changes, or physical exertion, can also provoke mast cell activation in susceptible individuals.

Diagnosis of Mast Cell Activation Syndrome:

Diagnosing MCAS can be challenging due to its complex and varied nature. A comprehensive evaluation by a healthcare professional is necessary. The diagnosis may involve:

1. Medical History: Detailed discussion about your symptoms, triggers, and family history.
2. Physical Examination: Identifying physical signs and symptoms.
3. Laboratory Tests: Blood and urine tests to measure mast cell mediators and markers.
4. Provocation Testing: Controlled exposure to triggers to observe allergic or mast cell responses.
5. Genetic Testing: In some cases, genetic analysis to identify specific mutations.

Treatment of Mast Cell Activation Syndrome:

The goal of treatment is to manage symptoms, reduce the frequency and severity of reactions, and improve quality of life. The treatment plan may involve:

1. Trigger Avoidance: Identifying and avoiding triggers that provoke mast cell activation.
2. Medications: Antihistamines, mast cell stabilizers, leukotriene inhibitors, and anti-inflammatory drugs may be prescribed to manage symptoms.
3. Epinephrine Autoinjector: Some individuals with severe reactions may be advised to carry an epinephrine autoinjector for emergency use.
4. Lifestyle Modifications: Stress management techniques, dietary changes, and maintaining a healthy lifestyle may help in symptom management.
5. Specialist Care: Working with an allergist/immunologist or a specialist in mast cell disorders for optimal management and support.

Conclusion:

Mast Cell Activation Syndrome is a complex condition that requires a multidisciplinary approach for diagnosis and management. If you suspect that you may have MCAS, it is important to consult with a healthcare professional who specializes in this area. With appropriate treatment and lifestyle modifications, it is possible to achieve symptom control and improve your quality of life.

MCAS Resources

What is Ehlers-Danlos Syndrome (EDS)?

Ehlers-Danlos Syndrome (EDS) is a group of genetic disorders that affect the connective tissues in the body. Connective tissues provide support, structure, and elasticity to various organs and joints. EDS can lead to a wide range of symptoms and complications that vary in severity. It is important to note that EDS is a chronic condition and requires long-term management.

Symptoms of Ehlers-Danlos Syndrome:

EDS can affect multiple body systems, and symptoms may vary among individuals. Common symptoms include:

1. Joint Hypermobility: Increased flexibility and loose joints that may be prone to dislocation or chronic pain.
2. Skin Hyperextensibility: Stretchy, fragile skin that bruises easily and is prone to scarring.
3. Easy Bruising: Vulnerability to bruising from minor trauma.
4. Wound Healing Issues: Delayed wound healing and increased risk of developing atrophic scars.
5. Chronic Pain: Persistent, widespread pain in muscles and joints.
6. Fatigue: Constant tiredness and low energy levels.
7. Gastrointestinal Problems: Digestive issues such as acid reflux, constipation, or irritable bowel syndrome (IBS).
8. Autonomic Dysfunction: Dysregulation of the autonomic nervous system, leading to symptoms like orthostatic intolerance (dizziness upon standing) and heart rate abnormalities.
9. Dental and Oral Health Issues: Increased susceptibility to dental problems, such as gum disease, tooth decay, and temporomandibular joint (TMJ) disorders.

Causes of Ehlers-Danlos Syndrome:

EDS is primarily caused by genetic mutations that affect the production or structure of collagen, a major component of connective tissues. Collagen provides strength and support to the body, and alterations in its structure can lead to the characteristic symptoms of EDS. EDS can be inherited from one or both parents, and the specific genetic mutations involved can vary among individuals.

Diagnosis of Ehlers-Danlos Syndrome:

Diagnosing EDS requires a comprehensive evaluation by a healthcare professional experienced in connective tissue disorders. The diagnosis process may include:

1. Medical History: Detailed discussion about your symptoms, family history, and medical background.
2. Physical Examination: Assessment of joint hypermobility, skin elasticity, and other physical features associated with EDS.
3. Genetic Testing: In some cases, genetic testing may be conducted to identify specific gene mutations associated with EDS.
4. Specialist Referrals: Consultation with various specialists, such as geneticists, rheumatologists, or dermatologists, depending on the specific symptoms and concerns.

Treatment of Ehlers-Danlos Syndrome:

Currently, there is no cure for EDS. Treatment focuses on managing symptoms, preventing complications, and improving quality of life. Treatment strategies may include:

1. Pain Management: Medications, physical therapy, and lifestyle modifications to alleviate chronic pain.
2. Joint Support: Assistive devices, bracing, or physical therapy exercises to improve joint stability and prevent dislocations.
3. Wound Care: Special attention to wound care and proper management of injuries to promote healing and reduce scarring.
4. Cardiovascular Monitoring: Regular cardiac evaluations to detect and manage potential heart-related complications.
5. Gastrointestinal Management: Dietary modifications, medications, and lifestyle changes to address gastrointestinal symptoms.
6. Psychological Support: Counseling or support groups to help cope with the emotional and psychological impact of living with a chronic condition.

It is crucial to work closely with a healthcare team familiar with EDS to develop a personalized treatment plan that addresses your specific needs and symptoms.

Conclusion:

Ehlers-Danlos Syndrome is a genetic disorder affecting connective tissues, resulting in a range of symptoms and complications. While there is no cure, proper management and support can significantly improve quality of life. Working closely with healthcare professionals, following treatment recommendations, and making necessary lifestyle adjustments can help individuals with EDS effectively manage symptoms and minimize potential complications.

EDS Resources