Category Archives: Opinion

THE DOCTORS 101 CHRONIC SYMPTOMS & CONDITIONS #39: Chronic Fatigue (CFS)

Fatigue is a common symptom and I have discussed it previously; look for “energy and fatigue”. Certain individuals, usually in their 30s and 40s, develop severe fatigue that is unrefreshed by sleep, and interferes with their normal activity.

Sometimes CFS is accompanied by sore throat, swollen glands, and Headache. The doctor usually finds no physical,laboratory or clinical abnormalities. If This fatigue continues on for many months, and is life-changing it has been called chronic fatigue syndrome, or CFS.

There is another similar chronic problem that is called fibromyalgia, and some authorities think of them as the same problem. To be diagnosed as CFS, The patient needs to have difficulties with memory, focus and concentration, or dizziness that worsens with moving from laying or sitting to standing.

I had had two such patients when I was in practice, Who were sent to me to rule out allergies. I found no such allergies and tried to encourage a healthy lifestyle including good sleep, diet, and exercise. My patients seem to get better with some exercise, although exercise often causes more fatigue according to the literature.

I have heard many causes postulated for this condition such as hormonal difficulties, immune system problems, or psychological factors. Infections particularly have been suspected such as cytomegalovirus, herpesviruses, or Epstein-Barr virus, but nothing consistent has shown up.

Since sleep does not restore energy, consulting a sleep center to rule out sleep apnea is reasonable. Such a condition following in the wake of COVID-19 would probably be attributed to that condition. Perhaps CFS is indeed due to an as yet undiscovered viral infection. Please check out the accompanying Mayo clinic summary.

—Dr. C.

Read more

DOCTORS PODCAST: MEDICAL & TELEHEALTH NEWS (MAR 2)

A bi-weekly podcast on the latest medical, science and telehealth news.

THE DOCTORS 101 CHRONIC SYMPTOMS & CONDITIONS #38: HEMATURIA

Pink urine! You can imagine my shock. What could it be? I exercise more than 1½ hours a day. Could it be myoglobin? I put beets in my daily osterizer “shake”: could the color be from the anthocyanins from beets?

I took a urine specimen to the lab, and the color turned out to be from Hemoglobin, the most likely cause all along. There were lots of red blood cells in my urine and the test strip was strongly positive for Hemoglobin. I called a urologist, who said I needed a Urine culture for infection, and a “CT Urogram”, to check for cancer, kidney stones and other problems.

You should always check with your doctor with Hematuria, and I am no exception. My Urology appointment was in 1 week. I got a urine culture, Cell cytology (for cancer), a CT Urogram, and a urine culture before the visit. I wanted to save time by scheduling a Cystoscopy at the time of the first visit, but couldn’t arrange it.

I went for the appointment. They took a blood pressure, but didn’t check my urine, which I thought was negligent. I had been regularly checking my urine for blood by a test strip, and it was negative. The appointment lasted only minutes. My old urologist always checked my urine on every visit, regardless of whether it was a regular check or to consult for a problem. If I were a Urologist, you can be sure I would have my microscope ready, have the nurse collect the urine, spin it down, and put the sediment under the microscope for me to check.

When I was in medical practice as an allergist, I would have my nurse check any sputum the patient produced smeared on a slide, stained and dried. Microscopic examination of urine and sputum takes only seconds and yields lots of information. In my opinion, 50 years of Insurance surveillance and governmental regulations, including restrictions on lab work done in the doctor’s office and Hippa privacy laws, have handicapped Doctors and are partly responsible for the costly, dysfunctional system that is modern medicine.

Sorry for the Sermons. Visible blood in the urine-Gross Hematuria- requires that you see your Doctor and find the cause of that blood. Please see the 2 appended Mayo Clinic articles for more detail.

–Dr. C.