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Preparing for your appointment

By Mayo Clinic staff

You're likely to start by first seeing your family doctor or primary care provider. Because the symptoms of chronic fatigue syndrome can mimic so many other health problems, you may need patience while waiting for a diagnosis. Your doctor must rule out a number of other illnesses before diagnosing chronic fatigue syndrome.

Here's some information to help you prepare for your first appointment, and what to expect from your doctor.

What you can do

  • Write down any symptoms you're experiencing, including any that may seem unrelated to the reason for which you scheduled the appointment. For example, while fatigue may be affecting you most, other symptoms, such as memory problems or headache, are important to share with your doctor.
  • Write down key personal information, including any recent changes or major stressors in your life. These psychological challenges can play a very real role in your physical well-being.
  • Make a list of your key medical information, including any other conditions for which you're being treated and the names of any medications, vitamins or supplements you're taking.
  • Take a family member or friend along, if possible. Sometimes it can be difficult to soak up all the information provided to you during an appointment. Someone who accompanies you may remember something that you missed or forgot.
  • Write down questions to ask your doctor. Creating your list of questions in advance can help you make the most of your time with your doctor.

For CFS, some basic questions to ask your doctor include:

  • What are the possible causes of my symptoms or condition?
  • What tests do you recommend?
  • If these tests don't pinpoint the cause of my symptoms, what additional tests might I need?
  • On what basis would you make a diagnosis of chronic fatigue syndrome?
  • Are there any treatments or lifestyle changes that could help my symptoms now?
  • What activity level should I aim for while we're seeking a diagnosis?
  • Do you recommend that I also see a mental health provider?

In addition to the questions that you've prepared to ask your doctor, don't hesitate to ask questions during your appointment at any time that you don't understand something.

What to expect from your doctor
Your doctor is likely to ask you a number of questions. Being ready to answer them may reserve time to go over any points you want to spend more time on. Your doctor may ask:

  • What are you symptoms? In what part of your body do they occur?
  • When did you first notice these symptoms?
  • Have your symptoms gotten worse over time?
  • Does anything make your symptoms better or worse?
  • Do your symptoms include any problems with memory or concentration?
  • Do your symptoms include problems with sleep?
  • How often do you feel down or depressed?
  • How often do you feel stressed or anxious?
  • How much do your symptoms limit your ability to function? For example, have you ever had to miss school or work because of your symptoms?
  • Are your symptoms causing difficulty in your marriage or other important personal relationships?
  • What treatments have you tried so far for this condition? How have they worked?
  • Have you been diagnosed with any other medical conditions, including mental health problems?
  • What do you think is causing your pain?

What you can do in the meantime
While you're waiting for your appointment, you may find some relief by using over-the-counter pain relievers such as aspirin, ibuprofen (Advil, Motrin, others) or acetaminophen (Tylenol, others).

To boost your chances of sleeping well at night, skip naps during the day and go to bed at a regular time each night. Other adjustments that may help you rest well at night include light exercise and stretching several hours or more before bedtime, as well as avoiding caffeine, alcohol and nicotine.

Tests and diagnosis Complications
References
  1. Bennett RM. Fibromyalgia and chronic fatigue syndrome. In: Goldman L, et al., eds. Goldman: Cecil Medicine. 23rd ed. Philadelphia, Pa.: Saunders Elsevier; 2007. http://www.mdconsult.com/das/book/body/133386890-3/833235176/1492/1050.html#4-u1.0-B978-1-4160-2805-5..50300-1_13277. Accessed April 22, 2009.
  2. Engleberg CN. Chronic fatigue syndrome. In: Mandell, GL, et al. Mandell, Bennett, & Dolin: Principles and Practice of Infectious Diseases. 6th ed. Philadelphia, Pa.: Churchill Livingstone Elsevier; 2005. http://www.mdconsult.com/das/book/body/133386890-5/833235546/1259/1004.html#4-u1.0-B0-443-06643-4..50130-6_4604. Accessed April 22, 2009.
  3. Chronic fatigue syndrome: Symptoms. Centers for Disease Control and Prevention. http://www.cdc.gov/cfs/cfssymptomsHCP.htm. Accessed April 22, 2009.
  4. Chronic fatigue syndrome: Possible causes. Centers for Disease Control and Prevention. http://www.cdc.gov/cfs/cfscauses.htm. Accessed April 22, 2009.
  5. Chronic fatigue syndrome: Who's at risk. Centers for Disease Control and Prevention. http://www.cdc.gov/cfs/cfsatrisk.htm. Accessed April 22, 2009.
  6. Marshall GS, et al. Chronic fatigue syndrome.. In: Long SS, et al., eds. Long: Principles and Practice of Pediatric Infectious Diseases. 3rd ed. Philadelphia, Pa.: Churchill Livingstone Elsevier; 2008. http://www.mdconsult.com/das/book/body/133386890-6/0/1679/204.html#4-u1.0-B978-0-443-06687-0..50203-4--chapter1. Accessed April 22, 2009.
  7. Gluckman SJ. Treatment of chronic fatigue syndrome. http://www.uptodate.com/home/index.html. Accessed April 22, 2009.
  8. Teitelbaum J. Chronic fatigue syndrome. In: Rakel RE. Integrative Medicine. Philadelphia, Pa.: Saunders Elsevier; 2007. http://www.mdconsult.com/das/book/body/133386890-7/833236431/1494/94.html#4-u1.0-B978-1-4160-2954-0..50051-X_2429. Accessed April 22, 2009.
  9. Chronic fatigue syndrome: Treatment options. Centers for Disease Control and Prevention. http://www.cdc.gov/cfs/cfstreatmentHCP.htm. Accessed April 22, 2009.
  10. Chronic fatigue syndrome: Support groups. Centers for Disease Control and Prevention. http://www.cdc.gov/cfs/cfssupport.htm. Accessed April 22, 2009.
  11. Patel G, et al. Complementary and alternative medicine for noncancer pain. Medical Clinics of North America. 2007;91:141.

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June 19, 2009

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