Journal of IiME Volume 4 Issue 1 www.investinme.org An Effort to Influence Medical Textbook Writers (continued) all patients. For example, the Envelope Theory recommends that patients with CFS pace their activity according to their available energy resources. In this approach, the phrase, “staying within the envelope,” is used to designate a comfortable range of energy expenditure, in which an individual avoids both over-exertion and underexertion, maintaining an optimal level of activity over time. Some people with CFS need to be encouraged to increase their activity, as they have the appropriate amount of perceived energy to do so. However, there are also people with CFS that need to be encouraged to do less in order to decrease the discrepancy between perceived and expended energy. This theory emphasizes the need to understand the differential needs of subtypes of patients with CFS. The key is to not over-expend their energy supplies or consistently go outside their “envelope” of available energy. Rather than a cure, this approach focuses on improving the ability of patients to cope with this illness. References 1. Jason, LA, Benton, M, Johnson, A, & Valentine, L. The economic impact of ME/CFS: individual and societal level costs. Dynamic Medicine. 2008;7(1):6 2. Anderson, JS & Ferrans, CE. The quality of life of persons with chronic fatigue syndrome. Journal of Nervous and Mental Disease.1997;185:359-67. 3. Buchwald, D, Pearlman, T, Umali, J, Schmaling, K & Katon, W. Functional status in patients with chronic fatigue syndrome, other fatiguing illnesses, and healthy individuals. American Journal of Medicine. 1996;101;364-70. 4. Holmes GP, Kaplan JE, Gantz NM, et al. Chronic fatigue syndrome: a working case definition. Annals of Internal Medicine. 1988;108(3):3879. 5. Hyde BG, JA; Levine, P. The clinical and scientific basis of myalgic encephalomyelitis/chronic fatigue syndrome. Ottowa, Ontario: The Nightingale Research Foundation; 1992. 6. Jason L, Richman J. How science can stigmatize: the case of chronic fatigue syndrome. Journal of Chronic Fatigue Syndrome. 2007;14(4):85103. 7. Fukuda K, Straus SE, Hickie I, Sharpe MC, Dobbins JG, Komaroff A. The chronic fatigue syndrome: a comprehensive approach to its Invest in ME (Charity Nr. 1114035) definition and study. International Chronic Fatigue Syndrome Study Group. Annals of Internal Medicine. 1994;121(12):953-9. 8. Carruthers BM, Jain AK, De Meirleir KL, et al. Myalgic encephalomyelitis/chronic fatigue syndrome: clinical working case definition, diagnostic and treatment protocols. Journal of Chronic Fatigue Syndrome. 2003;11:7-116. 9. Joyce J, Hotopf, M, Wessely, S. The prognosis of chronic fatigue and chronic fatigue syndrome: a systematic review. Journal of Chronic Fatigue Syndrome. 1998;4(1):80. 10. Jason L, Porter N. Shelleby E, Bell DS, Lapp CW, Rowe K, De Meirleir K. A case definition for children with myalgic encephalomyelitis/chronic fatigue syndrome. Clinical Medicine: Pediatrics. 2008;1(1):1-5. 11. Jason LA, Richman JA, Rademaker AW, et al. A community-based study of chronic fatigue syndrome. Archives of Internal Medicine. 1999;159(18):2129-37. 12. Jordan KM, Jason LA, Mears CJ, et al. Prevalence of pediatric chronic fatigue syndrome in a community-based sample. Journal of Chronic Fatigue Syndrome. 2006;13(2/3):75-8. 13. Jason LA, Taylor RR, Kennedy CL. Chronic fatigue syndrome, fibromyalgia, and multiple chemical sensitivities in a community-based sample of persons with chronic fatigue syndrome-like symptoms. Psychosomatic Medicine. 2000;62(5):655-63. 14. Friedberg F, Jason LA. Understanding chronic fatigue syndrome: an empirical guide to assessment and treatment. Washington, DC: American Psychological Association; 1998. 15. De Lange, FP, Kalkman, JS, Bleijenberg, G, Hagoort, P, van der Meer JWM, & Toni, I. Gray matter volume reduction in the chronic fatigue syndrome. NeuroImage, 2005;26:777-781. 17. Patarca-Montero, R, Mark, T, Fletcher, MA, & Klimas, NG. Immunology of chronic fatigue syndrome. Journal of Chronic Fatigue Syndrome, 2000;6:69-107. 18. Peckerman, A, Chemitiganti, R, Zhao, C, Dahl, K, Natelson, BH, Zuckler, L, Ghesani, N, Wang, S, Quigley, K, & Ahmed, SS. Left ventricular function in chronic fatigue syndrome (CFS): data from nuclear ventriculography studies of responses to exercise and portural stress. Federation of American Societies for Experimental Biology. 2003;17(F Suppl: Part 2), A853. 19. Scott LV, Dinan TG. The neuroendocrinology of chronic fatigue syndrome: focus on the Page 19/56

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