Dr. Donohue: "Try Exercise for Chronic Fatigue"

A friend clipped and mailed to me a health advice column that appeared recently in an Akron, Ohio, newspaper. I assume that the friend was trying to tell me that what I need is more exercise.


TO YOUR HEALTH

Try Exercise Program for Chronic Fatigue


Dear Dr. Donohue:

Will you write about chronic fatigue syndrome? I have been diagnosed with it after years of a worsening mystery illness and many doctor appointments and with several misdiagnoses. I am now under the care of a doctor who is a leading clinician in the field. I was stunned to learn the seriousness of the illness, including brain and nervous system inflammation, cognitive difficulties, streaks of muscle pain, nausea, and grinding exhaustion. I was shocked to learn that I am 100 percent disabled. My goal is to pass to others information about this illness. It might help them. --B. D.


Dear B. D:

Chronic fatigue syndrome is an illness that is difficult to have and difficult to treat because it is one of those illnesses whose cause remains unknown. By definition, it is fatigue that lasts more than six months. The fatigue does not improve with rest. In addition to exhaustion, memory impairment, joint pain, diffuse muscle pain, new headaches, tender neck nodes, sore throat, and sleep that doesn't refresh can be part of the syndrome.

It sounds ridiculous to suggest exercise for people with chronic fatigue. However, a graded exercise program often can improve many symptoms. Exercise should be both aerobic and anaerobic exercise. Aerobic exercise is exercise that continuous movement of large muscles, like leg muscles, for a somewhat prolonged period of time. Initially, the time is short, whatever the person is able to do. Five minutes is enough; if that is too much, take it down a couple of minutes. Walking is aerobic exercise. The goal is to slowly but persistently increase both the exercise time and intensity. Anaerobic exercise is weightlifting. Don't start with heavy weights; three pounds is enough. Again, the goal is to increase the time spent lifting and the amount lifted.

I'm sure your doctor ran through a battery of tests to exclude illnesses that rob a person of energy: low thyroid hormone output, sleep apnea, anemia, and adrenal glads that are not functioning.

--END [bolding mine M.]


This column would have appeared across the US, not just in an Akron, Ohio, newspaper.

Yesterday I wrote to Dr. Donohue urging him to do some research on exercise intolerance in ME/CFS. I directed him to the Pacific Fatigue Lab and enclosed an abstract of research done at the lab, Postexertional Malaise in Women with Chronic Fatigue Syndrome.

If anyone else cares to write to Dr. Donohue, his address is PO Box 536475, Orlando, FL 32853-6475, USA. No email is provided at his column. Information about Dr. Paul Donohue is available at the syndication company, King Features, and contact information for the syndication company is at the website:

http://kingfeatures.com/features/columns-a-z/to-your-good-health/

I also wrote to my friend thanking him for alerting me to this column and in this way helping me advocate for better media coverage about ME/CFS.

Thanks Merry for alerting us about this. All these ignorant doctors and people need to be informed as soon as possible before they can do more damage.

Ya ever feel that maybe stupidity is contagious?

I mean regardig the medical world's gross idiocy on this issue

BECOMING AN MD LOWERS YOUR IQ 50 POINTS! FILM AT 11!!!!

They just keep pushing things that make us worse. And it's the name. They can lump anyone into the CFS name. If they would just let us get away from that horrible name and put the chronic IMMUNE DYSFUNCTION back into it, it would weed out the people who do not have this and would benefit from getting their butts moving. But those of us who are genuinely ill with a disease, we can't. It makes us worse.

How do they reason people who are sporty got cfs?? I have had cfs now for 10 yrs and it has only been the last 12 months that my ability to do any sort of exercise on a semi regular basis has now dried up, I cant say it has helped my cfs.

they dont get it???

What other excuse do they have? They are all sadists?

Thanks, Merry, for bringing this up. I too saw this column in my local New England newspaper. The positive side of it was that the writer testified accurately about this illness. At least Dr. Donahue included it in his column and at least there is the writer's experience noted. However, Dr. Donahue has to act like the doctor who has something helpful to add, so he probably just went to either the CDC website or some such place and pulled off that advice which was disseminated by the British Medical Journal, I believe, after a study with very weak results was performed on those meeting the broadest criteria for this condition--namely, one indistinguishable from Depression. I expect that most of the subjects were depressed because the somewhat favorable results for GET and CBT are valid for those with Depression, though not for us. This weak study which continued the confusion of us with people who are depressed has been hashed over in great detail on this and other forums. I agree it is maddening and discouraging to see false information continue in circulation like this.

Thanks, Nielk, SilverbladeTE, Carrigon, heapsreal, and Sing for your righteous indignation.

Sing, I agree that "B. D.," the person who asked about chronic fatigue syndrome, did a good job of explaining, in a few words, the problem of getting a diagnosis and the seriousness of the disease.

I might write more here except I've just had my exercise for the day -- I went to the grocery store -- and oddly enough I don't feel better.

Unfortunately, a doctor doesn't have to be either stupid or sadistic to give this advice. If he or she is a general practitioner, they're not going to be an expert in every disease they encounter. So they consult the "best" sources of information, the CDC, Medscape, the Mayo Clinic, or their medical school textbooks. And they'll find exactly what Dr. D said. In fact, it would be considered irresponsible for a doctor writing a column for a general audience to write something different from those mainstream sources.

Until we can get what's out on the CDC website changed, and until we get some REAL experts instead of Gijs Bleijenberg or Peter White writing the medical textbooks, that's not going to change. Without that, even if we present research to the contrary or cite experts from the IACFS/ME, we have no credibility. And you can't exactly blame the Dr Donohue's of the world, or the thousands of ordinary family physicians we have to go to.

Because Dr. Donohue's answer did read as a cut and paste job, I had supposed he'd simply gone to the CDC website or similar. But why from the list of treatment options listed at the CDC website did he choose only graded exercise therapy? The guy's a dipshit.

He advertises himself as offering "experienced medical advice to help you with nearly 40 health conditions" at this website:

http://www.rbmamall.com/drdonohue.html

Buy his booklet on Chronic Fatigue Syndrome today!

Sorry, ixchelkali, I can't agree. I do blame the Dr. Donohues of the world.

Studity involves bad ideas, ignorance, or excessive self interest .

A smart person under the influence of bad ideas can wind up finding even smarter and more ingenious ways to be stupid. To deal with bad ideas requires scepticism, sometimes even cynicism. Where is the evidence? How is it justified? Does this really further your goals?

To deal with ignorance requires education - NOT just facts, but how to think. Reason, logic, the scientific method, backed by an effective investigative media (which is lacking these days) are the counters to ignorance. Alas, nothing can ever completely cure ignorance, the world is simply beyond the full understanding of mere mortals.

To deal with excessive self interest we require effective laws (including investigating and enforcing institutionss) as well as social disapproval. If society approves of stupidity, its a lost cause until you can get enough people to change their minds.

A smart person in the service of stupidity is far more dangerous than an average person in service to stupidity.

Bye, Alex

I think we nailed it on this thread. And quickly too!

Alex
hehe alas, very very true!
most of the world's worst screw ups/horrors are when intelligent folk think they are "doing the right thing!"

and to paraphrase a famous saying,
"graded exercise for ME"
is like ******* for virginity!

LOLOL Thanks for the chuckle Merry.

Alex, Silverblade, Sing, and Wayne, thanks for your input and good humor. What a team! As Sing said, nailed it.

That's where I disagree with you my friend. It is pretty easy and rather appropriate to call out the flawed logic of a GP who says "You're only ill because you think you're ill, and we won't be giving you any tests, because that would be a waste (nothing will show up), because the lack of positive tests shows there's nothing wrong with you even though we haven't giving you those tests or any adequate tests".

Failing to blame the GP's is an enormous problem. Nothing of this is a mere accident, it's a serious failure of their duty to healthcare, they are guilty at the very least of supreme carelessness, and arrogance that goes beyond grand, all at the detriment of our healths. If the law punished them for this negligence and disrespect of the scientific method, then we wouldn't be facing all of these problems, our lives would be significantly different (at least mine would), but they carry on because they know they can get away with sloppy work and carelessness because they have no one to answer to.

Spend all the money in your bank account, and more will magically show up the next day, too!

These idiots with no credentials and no credibility in ME/CFS need to STFU.

What about those of us who don't have chronic immune dysfunction but don't have just chronic fatigue either. What label would you give them? I think you're presenting a false dichotomy between immune dysfunction and chronic fatigue/depression/laziness.

Do these idiots even stop to consider that part of the definition of CFS is "FATIGUE THAT DOESN'T IMPROVE WITH REST?" Even a normal, healthy person requires rest to recover from exhaustion and fatigue. If a person has CFS and can't regenerate after rest, how is taxing the system even further going to help?

As alex3619 suggested, ignorance is one thing, stupidity is quite another. If a person can't even see the logical contradiction in saying that when you are fatigued and can't recover from rest then to recover you should fatigue yourself further, they have no business even having "MD" after their name. That's just pure stupidity.

Exactly. If your car is out of gas and you can't get any more gas. Your car is going to sit there and not move. If someone comes along and tells you to still attempt to drive it without gas, it's completely ridiculous. It's still not going to move. And you will probably ruin the engine trying.

They are deliberately looking to make us worse. Does the medical industry make more money if we are bedbound? Well, probably, because if they make us so sick that we need nursing home care, they get to take all our money for that.