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CASE EM is a 48 year old female diagnosed with CFS in March 1992, and FMS in June 1994. She had an unremarkable medical history until 1982 when she was hospitalized with the flu, then later needed a hysterectomy. In late 1987, her mother died. Following a Hepatitis A vaccination in June, 1988 (EM considers this pivotal in her medical history), she experienced gradual failing health by developing growing tiredness, malaise, weakness, fever, joint pain, ocular migraine headaches, atopic rhinitis, psoriasis, and hyperactive airways (asthma). After a flu shot in December, 1991, she was unable to continue working. Her symptoms are cyclic, with her having about 2 - 5 “good” days a month. Her last severe relapse lasted 2.5 years. EM admits to not liking to take medications, and will discontinue therapies periodically to “give her body a rest and see how her CFS/FMS is doing”. Since 1992, she has had unsuccessful CFS/FMS treatment with the following medications: fluoxetine, clonazepam (initially helped with sleep), amantadine, amitriptyline, sertraline. She decided not to take selegiline or methylphenidate when prescribed, because she was uncertain how she would respond to these medications. Tramadol is extremely helpful for her pain, although she occasionally uses oral narcotic pain medications. Gabapentin was extremely helpful for her RLS; however, she developed side effects to it after having an adverse reaction to a subsequently prescribed dose of mirtazapine. In frustration and concern for her failing health, EM decided to try alternative medicine. She notified her physician that she started taking about 17 different vitamin and/or herb products. After 4 months, EM felt somewhat better, but 2 months after that, the vitamin and herb products started to make her feel nauseated. She now only takes a multi-vitamin, and vitamin E in addition to pain medication, hyoscyamine, albuterol inhaler, and loratadine. She stopped physical therapy due to intolerable pain. EM remains hopeful that some future therapy will eventually relieve her from the symptoms of CFS and FMS. |