Mystery Malady

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Mystery Malady

Chronic fatigue syndrome difficult to diagnose

Daytona Beach News-Journal - Daytona Beach,FL*

By MARGIE SCHLAGETER

Staff Writer

http://www.newsjournalonline.com/NewsJournalOnline/Lifestyle/Headline

s/lifeHEAL01033208.htm

In medical school, Melody Hanger would greet each new day with

energy and enthusiasm, even though she had been up for 24 hours

straight.

The year was 1981, and she was in classes at the University of South

Florida and on call every other night at Tampa General Hospital

through her surgical and obstetrics/gynecology residencies.

Adrenaline and catnaps kept her refreshed.

Today the 43-year-old physician concedes, " There's never a day I

feel like getting out of bed. " She wakes up late after spending 12-

13 hours in bed but almost never feels rested.

" In the fall of 1999 my life was turned upside down, " says Hanger.

That's when her suspicions were confirmed; she was diagnosed with

chronic fatigue syndrome.

Now, the medical school diploma that she received at the age of 25

and once proudly displayed in her office is packed away among other

things no longer relevant, somewhere in the Ormond Beach home she

shares with her mother.

Chronic fatigue syndrome is disabling and " one of the most common

chronic illnesses of our time, " according to Dorothy Wall in " An

Introduction to Chronic Fatigue Syndrome. " Its symptoms include

incapacitating fatigue and post-exertion malaise, impaired memory or

concentration, flu-like aching, headaches, muscle and joint pain,

sensitivities to noise and light and others that can trap the ill

person in a web of debilitating symptoms.

Dr. Luckey Dunn of Daytona Beach, regional campus dean for Florida

State University College of Medicine, noted that chronic fatigue

syndrome has overlapping symptoms with fibromyalgia -- and other

conditions -- that make it difficult to diagnose. From a clinical

standpoint, the physician has to be primarily concerned with

treating the symptoms, Dunn said.

Dr. Kohen, a rheumatologist in Daytona Beach, said that in

his field chronic fatigue is the most misunderstood condition,

adding that many doctors don't recognize it. Kohen said he treats

many patients with fibromyalgia, the term he uses to encompass those

conditions that may include chronic fatigue syndrome.

According to the Arthritis Foundation, research has established that

when " deep " sleep is disrupted, fibromyalgia symptoms are

aggravated. The fatigue and other common symptoms reinforce the

thinking that chronic fatigue and fibromyalgia are the same.

The diagnosis, however, can be tricky. Kohen begins by ruling out an

underlying medical condition before doing various tests to pinpoint

the diagnosis.

Hanger takes 40 different natural remedies for her symptoms, a

treatment recommended by her physician, Dr. R.H. Keller, of

Hollywood, Fla.

After completing medical school, Hanger did her family practice

residency at Halifax Medical Center and eventually accepted a

position as a primary care physician with the Veteran's

Administration Clinic here. In 1997 she began to be unusually tired

at work and would rest during her lunch hour and again before she'd

drive home. She had flu-like symptoms and recurring infections,

missing a lot of work. Like so many others dealing with chronic

fatigue syndrome, she was embarrassed by her symptoms and inability

to pinpoint the illness, and coped by isolating herself.

Hanger began to experience problems with her short term memory as

well, and would constantly double and triple check everything she

did, which only added to her stress. Eventually she realized she

could no longer work.

In retrospect, she says, her illness was most likely triggered by

chemical sensitivities -- the VA clinic had mold issues and was

declared a " sick building. " When the facility was cleaned with

strong chemicals, she suffered dizziness, nausea, nose bleeds and

her nails turned blue. One theory involving the illness is that a

person may have a genetic predisposition, which is activated by one

of many triggers, Hanger said. She believes the chemicals in the

cleaners were that trigger.

Hanger has maintained her medical license, but due to her illness

she can no longer practice medicine.

" I was always high functioning, loved studying, loved working, loved

being a doctor, " she said. Now she's lost her identity -- and the

profession that had been her focus since childhood.

margie.schlageter@...