DEAR DR. DONOHUE: For 18 months I have dragged myself along, barely able to do my job and keep my house like I used to. I have seen five doctors and have been tested for every imaginable disease, including tuberculosis. The doctors can’t find what’s wrong with me. My current doctor thinks I have chronic fatigue syndrome. How is that diagnosis made, and what can be done for it? – A.A.

ANSWER: Chronic fatigue syndrome is a state of incapacitating weariness that has lasted for six or more months and has forced people to cut back on their work, at home and in the office, and has made them give up most of their social and recreational activities. Sleep doesn’t restore energy. Many CFS patients complain of trouble concentrating and remembering. Their throat might hurt, or their lymph nodes might be tender. Sometimes joints ache, but they are not red or swollen.

There is no blood test, no X-ray nor any scan that can prove the diagnosis. Doctors have to consider and look for the many other causes of fatigue, things like hypothyroidism, anemia, hepatitis, depression, cancer and, yes, tuberculosis. If none can be found, then the diagnosis of CFS is on more certain ground.

Physical activity increases the exhaustion of CFS, but exercise is essential. Without exercise, muscles shrink and become deconditioned. Perhaps, at first, only a few minutes of exercise can be tolerated, but you should begin a modest program and very gradually increase the time devoted to it. You can break exercise into several short daily sessions. Elavil, an antidepressant, often restores refreshing sleep. It’s not given for its antidepressant action. Cognitive behavior therapy aims to root out perceptions that keep CSF patients viewing their plight as hopeless. You shouldn’t view your situation as being beyond recovery.

The booklet on chronic fatigue syndrome explains this malady in greater detail. Readers can obtain a copy by writing: Dr. Donohue – No. 304, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.75 U.S./$6.75 Can. with the recipient’s printed name and address. Please allow four weeks for delivery.

DEAR DR. DONOHUE: I had to go through the flu just as you described. I think I got it on a plane. Two sneezing gentlemen were seated next to me. It started abruptly after arriving home, and I wasn’t able to leave my bed for the next three days.

The reason why I am writing is this: I cannot take flu shots because I am allergic to eggs, and I was told the vaccine is based on eggs. How can I protect myself? – E.R.

ANSWER: What kind of allergic reaction do you have to eggs? If it’s a severe one, with your body breaking out in hives, your blood pressure dropping and you gasping for breath, you must not take a flu shot. If it’s a mild reaction, you can still have the shot. The flu virus for the vaccine is grown in eggs, and some egg protein might still cling to it. A time is coming when the vaccine will be made differently.

If there’s an outbreak of flu in your area and you haven’t had a flu shot, you can take Tamiflu (oseltamivir) or Relenza (zanamivir) to prevent influenza (flu) infection.

DEAR DR. DONOHUE: I am a female, age 74 and in good health. I take medicine only for blood pressure, which is under good control.

I see my doctor every three months. I told him I didn’t want to come in during flu season. He told me it was a virus and not contagious.

What do you think? Should a healthy person go into a doctor’s office and be exposed to the flu? – E.V.

ANSWER: The influenza (flu) germ is a virus, and it is contagious. It’s caught by breathing in the virus that’s been expelled from an infected person via coughing or sneezing. Doctors’ offices are places where sick people congregate, and some might have the flu. It’s good to be on guard against infection, but being too much on guard isn’t necessary. You’re too much on guard. However, if you want to eliminate even a slight chance of flu exposure, make the appointment anyway and cancel it if there is an outbreak. Or, better yet, have a yearly flu shot.

Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475. Readers may also order health newsletters from www.rbmamall.com

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