Hope is faith holding out its hand in the dark.  -George Iles

Thursday, June 18, 2009

Ask Dr. Gott

Cause of chronic fatigue can be difficult to diagnose
Dear Dr. Gott: I'm a 47-year-old female who has struggled with fatigue for years. I was having a hard time getting up to go to work. While at work, I was falling asleep on my half-hour lunch break for two hours. 

My primary-care physician sent me to an endocrinologist who didn't discover anything. I've lost my job and insurance and am just as tired today. Breakfast acts as a tranquilizer and sends me off to sleep again. I battle taking naps all day. I had a heart attack at 44 and know I have had hepatitis C for at least 11 years. My doctor didn't see any connection. 

Dear Reader: While suffering from a heart attack at 44 is not unheard of, you are young and should be at the top of your game. I wonder what, if anything, preceded the attack. Do you have chronic fatigue syndrome? Do you have a family history of heart disease? Was your diet improper? Did you suffer from high-cholesterol levels? Do you have unrelated medical conditions? Were you inactive and/or overweight? Did you get regular medical checkups? If you can answer "yes" to any of my questions, were positive measures taken to work toward a healthier lifestyle? If so, what was the outcome? 

If you can pinpoint the initial stage for your symptoms, you might be headed in the right direction. For example, was the attack followed by the fatigue, or did the exhaustion precede it? Are you on any medication that could have an unwanted and uncommon side effect of fatigue? 

It's time to wipe the slate clean and begin from scratch with 
a new physician, at least until things get sorted out. You will need blood work, follow-up on your hepatitis C, referral to a cardiologist and perhaps a referral to other specialists and thyroid testing. Even if you have to borrow the money, it will be well spent if it gets you back on your feet.

By PETER GOTT, M.D. Newspaper Enterprise Association
Published: 5/28/2009  2:25 AM
Last Modified: 5/28/2009  4:05 AM

Write Dr. Gott c/o United Media, 200 Madison Ave. 4th floor, New York, NY 10016.
By PETER GOTT, M.D. Newspaper Enterprise Association

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