Journal of IiME Volume 2 Issue 2 www.investinme.org R Reeaassoonnss wwhhyy MMEE DDooeess NNoott BBeelloonngg ttoo tthhee MMUUSS CCaatteeggoorryy (continued) Australia The diagnosis was approved in Australia at the start of 1990. USA In USA the situation is different because they have compiled their own clinical version of ICD. The American CDC published a summary of Chronic Fatigue Syndrome and its Classification in the ICD 31. March 2001 by Donna Dean. It can be found in the archives of Co-Cure or at the following link: http://www.co-cure.org/ICD_code.pdf In the summary it says that ICD-9 was published in 1975 and that the description Benign Myalgic Encephalomyelitis can be found in the alphabetical index and is referred to as code 323.9. 4. The illness was accepted and treated a long time ago in Norway – before 1990 ME is a syndrome diagnosis, and it has been documented that ME was accepted in Norwegian neurology from before 1990. In an article in Tidsskrift for Den Norske Lægeforening (1991;111(2):232) ( Journal for The Norwegian Medical Association) a neurologist, chief consultant Ragnar Stien MD, employed by the Rikshospitalet in the neurology department, confirms that fatigue/tiredness is not a new condition. Dr Stien thought that the Fatigue Syndrome could partly have an organic cause. He thought that the most correct description to use was Post Viral Fatigue Syndrome, a diagnosis he himself had given to a number of patients. Dr Stien demanded that there was extreme asthenia, the patient had muscle pain during physical activity and evidence pointing to a viral infection before. He had examined 20-30 patients with this illness presentation in the 1980s. His impression was that the patients affected suffered from ”abnormally strong fatigability” (p. 232). They had to rest ”hours after minimal exertion”. Even though at that time there was no Invest in ME (Charity Nr. 1114035) scientific evidence to rely on, Dr Stien felt that the patients were so severely affected that the cause was organic. Professor and specialist in general practice medicine, Dr Even Lærum, employed at the Institute of General Practice Medicine, Oslo, underlined the importance of performing a thorough physical examination. He had no objection in using the diagnosis of Chronic Fatigue Syndrome if the patient had extreme fatigue and one could not find other explanations. The treatment was symptom oriented, lifestyle changes and that patients should not put pressure on themselves (TNLF, 1991;111(2):232).The use of the diagnosis was also implemented at the same time by the Neurology department, Haukeland University Hospital. Dr Aarli and Dr Haukenes published an article on the illness in 1995. Here is an extract from this article: ”All experience so far has shown that this illness cannot be beaten by training, because enforced training seems to make the condition worse. This is similar to Post Polio Syndrome, where it has been shown that physical training often makes the muscular weakness worse. Acknowledgement by others that the symptoms are real can be important so as to avoid adding reactive extra symptoms.” (Haukenes and Aarli, 1995:3021) ”... it is patients who have had normal function and work capacity who after a viral illness present with considerable tiredness where causality seems to be connected to the infection as a triggering event ” (ibid.) ”It is well known that an acute infection can be followed by a fatigue syndrome that goes away. The special with this condition is that the fatigue, or exhaustion, lasts so long.” (p. 3017) “ (continued on page 70) Page 69/74

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