The CDC definition of chronic fatigue is presented. As a research tool, the definition has failed to allow research to define differences between ill people and well people. The Paill Spectrum model explains why. The Paill Spectrum model says fatigue is part of a cluster of symptoms with sweaty hands, dizziness or loss of balance, mood swings and even rage. Other symptoms include specific sore areas in the body: shoulders, elbows and stomach amongst others.
Chronic Fatigue, Chronic Fatigue Syndrome
Chronic Fatigue Syndrome is a construct made by doctors to find a definition of a medical illness that would enable them to learn what is different about the people who suffer from this illness, as distinct to normal people who do not have the illness. To assist researchers to unravel the mysteries of chronic fatigue and Chronic Fatigue Syndrome, the “syndrome” lists a group of symptoms, signs, and tests that hopefully describe a unique illness.
For a positive diagnosis of Chronic Fatigue Syndrome, both of the major criteria + at least six symptoms + two physical signs must be present.
Major Criteria:
Minor Criteria: Symptoms
Minor Criteria: Physical signs
Physical signs must be documented by a doctor on at least two occasions at least one month apart.
The definition of Chronic Fatigue Syndrome should identify a subgroup of patients distinctly different from normal people. This sounds like truth. It is not though. The Paill Spectrum model predicts that that there are faults in this approach to the definition of a disease that may be responsible for “Chronic Fatigue Syndrome.”
Perhaps the CDC model is wrong. Perhaps chronic fatigue syndrome does not even create an illness measurable in "degrees Celsius".
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The key problem, with the CDC definition such as the definition of Chronic Fatigue Syndrome, is that it misses the obvious fact that not everyone with a disease necessarily has the same symptoms or all the symptoms. Many people often lack particular symptoms, or experience symptoms in a way that makes them look like different symptoms.
For example, I have many patients who sleep an extra hour or more per day, compared to the average adult. Yet, they would argue vigorously, that they do not have any chronic fatigue and are not tired. The Paill Spectrum model would predict that they fall within the definition of Paill Spectrum chronic fatigue. Sleeping for an extra hour per day, even if you feel well is not normal. The average adult should sleep for seven and a half hours per day normally only.
Many people also seem to get better and to often stay better. They stop complaining. This implies that they no longer have the chronic fatigue syndrome. The Paill Spectrum model would predict that they still do have the Paill Spectrum Chronic Fatigue Syndrome. People may apparently have no symptoms, but part of the problem is knowing where to look and what to, look for. The arrival of a bit more weight over the last few years sounds like nothing important. The Paill Spectrum model predicts that this is a sign of the relentless progression of the disease. Back to Chronic Fatigue top
The question again is who is affected, by what, and when?
Who has this condition and is sick?
Who does not have this condition and is well?
To date, the CDC definition has not achieved any poignant insights or breakthroughs in understanding for researchers. Even clinical doctors, generally do not use it.
The definition is an attempt to define what is unknown. Understandably, the definition could easily get it wrong. It is very difficult to define the unknown.
There are criteria in the definition that relate to other conditions, which are complications of chronic fatigue syndrome. Some criteria just should not be there. (E.g. "degrees Celsius") There are important missing criteria.
Research attempts to discover differences between "haves" and "have-nots". By drawing conclusions about these differences, hopefully an understanding of the disease will eventuate. The "haves" should have the disease and the "have-nots" do not have the disease.
The problem for chronic fatigue researchers is that the underlying cause of Chronic Fatigue Syndrome is common in patients both with and without the syndrome. In fact, many patients do not even think they have any symptoms at all. The disease has a wide spectrum of "activity". Even people with the disease, may or may not have particular metabolic changes.
There is no difference between the affected and the not affected, because the unaffected patients have been misdiagnosed. In Australian parlance, this can be summarised by the term, there are rabbits on both sides of the fence. (This refers to a very famous and enormously expensive structure spanning Australia: namely, the “rabbit proof fence”. The problem for this fence, which aims to stop the spread of the rabbit plague into the northern states, is that there are rabbits already on both sides of the fence. A fact conveniently overlooked in the politics of the situation. Back to Chronic Fatigue top
Paill Spectrum has an interesting range of seemingly unrelated complications that become problems needing treatment, in their own right. Many of these are not even recognised as being related.
This is where the definition of a syndrome like the chronic fatigue syndrome is incorrect.
People get aches and pains. Some patients become restless and sleepless. Tendons can develop sensitive spots and chests get fleeting sharp pains that are not heart attacks. Dizziness attacks are often accepted as a part of life. Other patients get weird depressions and weird ideas. Children cannot spell.
Worst of all, doctors usually do not recognise that many of these symptoms may be rated or even important.
All that is needed to diagnose Paill Spectrum dyslexia is a simple memory test. Most doctors refer their patients for extended assessments by Allied Health professionals, who in hours- long assessment protocols executed in children with memory and concentration problems, fail to recognise the basic underlying problem of speech symbol processing and distortion. A diagnostic memory test can take as little as two minutes with obvious easily interpretable results forthcoming.
Doctors interpret all these symptoms in many different ways. Treating these symptoms can be very difficult, even if it is suspected that Paill Spectrum is the cause. Back to Chronic Fatigue top
The CDC type definitions of Chronic Fatigue Syndrome miss hallmark criteria of Paill Spectrum infection. These important criteria include sore elbows, (where the tendons arise: called golfers' and tennis elbows); sore parasternal areas, sore Achilles tendons and sore bases of the long bones of the foot (Metatarsal V in particular).
Paill Spectrum causes Chronic Fatigue.
Paill Spectrum causes Chronic Fatigue Syndrome (like symptoms)
Paill Spectrum causes Fibromyalgia (like symptoms).
Paill Spectrum causes a range of psychiatric syndromes and even behavioural problems.
Paill Spectrum causes personality changes.
Paill Spectrum also causes a range of other symptoms and illnesses.
I had a circular from the local CFS Society that stated that the Society believed that 1-2% of the population has chronic fatigue syndrome and 1-2% of the population has Fibromyalgia. The Paill Spectrum model would suggest numbers even higher than these. Many people do not complain of symptoms and accept their symptoms as a normal part of aging or as being work related. So many of the cases remain unknown or hidden. Back to Chronic Fatigue top
The definition of Fibromyalgia focuses on the soft tissue sore spots. Unfortunately, the tendon origin sites are more characteristically affected in Paill Spectrum disease. The aches in the upper shoulders and arms are just not as easily or reliably assessed as symptoms of tenderness in sites such as the elbows or chest. There is a definite subgroup of patients who experience these symptoms, but it is not the majority of patients.
The existing clinical definition of Fibromyalgia is wrong. It misses hallmark symptoms and signs. The diagnosis cannot be confirmed by blood testing. Doctors do not even agree on the distribution of sore spots.
Paill Spectrum has a definite range of clinical symptoms and signs that can be recognised reliably in the majority of cases from even early stages. Paill Spectrum has blood tests that can confirm the presence of illness; the responses of illness to treatment, treatment failures for specific reasons and can identify relapses both on clinical and blood test criteria. Back to Chronic Fatigue top
Statistics from Support Associations suggest 1% of the population suffers from each of Chronic Fatigue Syndrome and Chronic Fatigue. The Paill Spectrum model would predict that about 10-15% of the population suffers from at least a bit of fatigue due to Paill Spectrum Infection. Many would not even call it fatigue.
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CD Book Information
The CD Books are not currently available. (Planned release date is early 2008).
More information is available on Paill Spectrum in Dr. Andrew Xxxxx’s two CD Books:
The CD Book with much more specific medical detail is called CTC-DTM . This CD gives full detail on identification of symptoms, signs of illness as well as full detail on treatment.
CTC-PSS is a discussion on the development of the Paill Spectrum model and the treatment of Chronic Fatigue. A number of cases are included to teach identification of key symptoms & signs on medical history & examination. :-0 Back to Chronic Fatigue top
Accessing Information
Downloadable Information files (zip = pdf +mp3), are available directly through the web site.
(File on the Download Page: approximately 12MB download). :-? :-O
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The Paill Spectrum Disease Model has been developed by Dr. Andrew Xxxxx. It will be some time before the knowledge of the syndrome becomes independently tested and accepted. Disclaimer