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Case History: Resistance to Getting Well

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In my last health tip I promised you a story that would illustrate the concept of resistance. Here’s a case history (patient’s name changed) from my files.

Catherine, a pale thin woman in her thirties, was into her third year with chronic fatigue syndrome (CFS). She’d been “everywhere,” including the Mayo Clinic, but no one had been able to answer her question: why am I ill? All treatments, conventional and alternative, had given her only temporary relief before they stopped working or were discontinued by her because of side effects.

Catherine had read many books on CFS, and had even traveled to the author-physicians for treatment, again with no results. She had plumbed the depths of the internet, where she was active in chronic fatigue chat rooms; she was also a member of her local CFS support group.

On her first visit to me, Catherine was accompanied by her elderly father. She’d canceled her two earlier appointments at the last minute, citing a flare-up of her fatigue. Her father had pulled his car as close as possible to our front door, carrying in for her both her purse and a shopping bag filled with medical records and supplements. She leaned heavily on his arm. He then arranged her comfortably across two chairs, covered her feet and legs with a blanket, and went out to park the car.

In our initial conversation I learned that at one time Catherine had been on her way to a high-powered law career. When I asked about her life, she told me her childhood had been difficult–her mother had died suddenly when she was eight and her father was a recovering alcoholic. She couldn’t remember much about her childhood, except that she was unhappy most of the time. To compensate, she’d done extraordinarily well in both high school and college, where she’d been popular, athletic, and smart. She was accepted into a highly competitive law school and seemed to know what she wanted in life: to scale the ranks of a prestigious downtown firm, full partnership in record time.

She’d gotten her wish, and was recruited directly from school. The work, as any fledgling lawyer knows, was brutal. Seventy-hour weeks were common, and expected if partnership was your goal. And then, after about four years of late nights at the office and frozen dinners at midnight, Catherine collapsed with the flu.

Her life would never be the same.

It was flu season, and many in her office were ill, but hers was different. She never felt well again after this flu. Tired, achy, feverish, she found that she couldn’t get out of bed to do anything except use the toilet or heat up food.

After a couple of weeks of this, she’d staggered to her doctor, who ran a few tests, prescribed some antibiotics, and reassured her she’d get over it. A month later, Catherine was back again, no better. By this time, her father was stopping by her apartment with groceries and helping with housekeeping. Her doctor ran a whole battery of tests, but again, nothing significant turned up.

Catherine knew she couldn’t return to her job feeling like this, so she applied for disability insurance at work, and it provided enough money to get by for the next few weeks. She’d heard her doctor mention the possibility of CFS, read about it constantly on the internet, and decided this was indeed what she had. There seemed to be a lot of paths she could follow, and eventually one would lead her to wellness.

Three years later, her law career was history. Now she was on long-term disability and had moved in with her father. He was spending his retirement years driving her to doctors, food shopping, and helping her fill out the seemingly endless insurance and disability forms.

The Mayo Clinic had confirmed a diagnosis of CFS, with a treatment plan consisting of antidepressants, stimulants, physical therapy, and exercise, but Catherine rejected it all as impossibly difficult or fraught with side effects. Alternative practitioners, including MDs, chiropractors, acupuncturists, and homeopaths, had tried a smorgasbord of unconventional therapies. Nothing ever worked.

Next time: more on Catherine and the conclusion to her story.


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DIAGNOSE-IT-YOURSELF: COVID-19

Far and away, the commonest phone call/e mail I receive asks about COVID-19 diagnosis.
Just print this out, tape it on your refrigerator door, and stay calm.

ALLERGIES

• Runny nose
• Sneezing
• Red, swollen eyes
• Itchy eyes and nose
• Tickly throat
• No fever

COLD
• Runny nose
• Sneezing
• Sore throat
• Mild muscle aches
• Mild dry cough
• Rarely a low fever

STREP THROAT
• Painful sore throat
• Hurts to swallow
• Swollen glands in neck
• Fever

FLU (Standard seasonal flu)
• Fever
• Dry cough (no mucus)
• Sudden onset over few hours
• Headache
• Sore throat
• Fatigue, sometimes quite severe
• Muscle aches, sometimes quite severe
• Rarely, diarrhea

CORONAVIRUS-COVID 19
• Shortness of breath
• Fever (usually above 100 degrees)
• Dry cough (no mucus)
• Slow onset (2-14 days)
• Mild muscle aches
• Mild fatigue
• Mild sneezing

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