End Fatigue

Finding a Physician

Having developed an effective treatment protocol for fibromyalgia and chronic fatigue syndrome over the last twenty years, and having proven it to be effective in two studies-one a well-done randomized, double-blind, placebo-controlled trial-my colleagues and I have now turned to our goal of making effective treatment available to the well over 50 million people worldwide who suffer from these illnesses. Training and encouraging physicians so that people would have proper access to care has been a full-time job-to the point that I am now a member of the "Two million mile club" on American Airlines. Fortunately, writing this chapter is now much easier than it was five years ago and people all over the country can finally get the care they need!

People ask me "how can I talk my doctor into giving me the treatment that I need?" In most cases, the answer is that you can't. Most doctors, appropriately enough, will not do the things that they are not properly trained in. This does not make them a bad physician. If you came to me and said "Dr. Teitelbaum, I would like you to do a heart bypass operation on me," I would say "I'm sorry, I am not trained in this, and I can't." If you then gave me a copy of a book called "From Bypass to Fantastic" and a scalpel, well, you still would not want me performing surgery on you. This would not make me a bad physician, and your doctor not treating you for CFS/FMS does not make them a bad physician either. The best thing to do is to go to a physician who specializes in treating these complex syndromes.

Holistic Physicians

In the past, these doctors were simply not available, or at best hard to find. This has changed. Now, as CFS/FMS is going mainstream, and more physicians are being trained in Complementary Medicine, it is getting easier to get the treatments you need.

Most physicians that know how to help CFS/FMS patients are considered holistic. These doctors usually have advanced training in using natural therapies and also spend a lot of time exploring the scientific literature. They also allow the longer visits needed to treat CFS/FMS. Unfortunately, because of the way insurance company payments are made, many doctors cannot afford to sustain a practice based on just a few long visits per day. They need to fit as many patients into their office as possible-in the fewest amount of time. Because of this, most physicians who can effectively deal with these illnesses do not participate with insurance. Fortunately, the biggest expense is for testing and medications, which often are covered.

When looking for a physician, I would ask the following questions:

1. Do they specialize in treating CFS/FMS and recognize it as a real and physical illness?

2. Will they prescribe the medications needed for you to get 8 hours of sleep a night?

3. Do they use bioidentical hormones based on your symptoms-even if the tests are normal?

4. Will they treat for Candida with Diflucan for 6 weeks?

5. Do they give nutritional IVs (e.g.-Standard IVs or Myer's Cocktails)?

If the answer to these 5 questions is yes, you have a physician who is likely to be able to help you!

More Good News

In addition to these resources, a national chain of Fibromyalgia and Fatigue Centers was established in 2004. Several years ago Bob Baurys, a prominent businessman, came down with chronic fatigue syndrome. He went through the same difficult experience working with physicians that most of you have gone through. He finally was lucky enough to find a physician who was trained in using the protocols in this book and recovered. This businessman was shocked that people with CFS and fibromyalgia did not have proper access to care -- especially having gone through the process himself. Fortunately what this businessman does is to set up health care systems with his compassionate associate, Sue Hrim RN.

When I traveled to these centers in 2006 to evaluate their program, I was deeply impressed with the level of care they were able to provide. They had created what I have been working to see happen for decades, and it felt as if this was the culmination of 30 years of my work. I am now national medical director of The Fibromyalgia and Fatigue Centers (FFC), with centers across the country (www.FibroAndFatigue.com). The centers accept patients from around the world and, after an initial in-person visit, they can manage care via phone if you do not live near a center. Since opening its first center in Dallas in January 2004, the Fibromyalgia & Fatigue Centers have treated over 5,000 patients and have an 80% success rate within four visits to the centers.

To give you an idea of what you should expect from your doctor in CFS/FMS care, I will give you an overview of the treatment at the centers. Because CFS/FMS are complex diseases that involve multi-system disturbances and abnormalities, your physicians should spend time with you, at least an hour at the new patient visit then dedicate at least 30 to 60 minutes for follow up appointments. Your doctor should do a comprehensive evaluation and extensive lab work in order to develop a treatment plan unique to your specific needs.

The approach at the FFC includes a six-step integrated program that works to address the underlying dysfunctions that cause your illness. They use a patient-centered, holistic treatment and plan of care that treats the whole body. No matter what physician you choose, you'll want to be sure that he or she is similarly interested in your complete recovery, not just a remission of symptoms. As you know, successful treatment of these diseases requires a plan tailored to the individual. Your treatment, then, may occur in one order, while another person might occur in one completely different. And of course, multiple steps are often initiated simultaneously. Be sure that your physician uses a similar flexible approach.

At the FFC, we use steps which follow the protocol in this book. Generally, these can be broken down as follows:

1. Stabilize the patient by addressing pain and sleep disturbances;

2. Enhance the mitochondria by improving nutrition;

3. Balance the hormones by evaluating hypothalamic, thyroid, adrenal, ovarian/testicular and pituitary function;

4. Evaluate infectious components and treat underlying infections;

5. Address unique etiologies such as neurotoxins and coagulation defects;

6. Provide individualized maintenance program with the minimal amount of medications and supplements needed to keep you well.

Use these steps as guidelines when talking with prospective health care providers about their treatment methods and strategies. For more information on the Fibromyalgia and Fatigue Centers, see www.FibroAndFatigue.com