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CASE NOTES
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PROGRAMME INFO |
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Dr Mark Porter gives listeners the low-down on what the medical profession does and doesn't know. Each week an expert in the studio tackles a particular topic and there are reports from around the UK on the health of the nation - and the NHS.
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Contact Case Notes |
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PRESENTER |
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"I spend half my week practising medicine and the other half writing and talking about it as a GP in Gloucestershire. Working on Case Notes has been a boon for both me and my patients. One of the principal aims of the programme is to keep our listeners up-to-date with the latest developments in healthcare, and to accomplish that I get to interview a wide range of specialists at the cutting edge of medicine. A rare privilege that ensures our listeners aren't the only ones to learn something new."
Mark Porter
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PROGRAMME DETAILS |
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 Full programme transcript >>
M.E.
Chronic fatigue syndrome 鈥 otherwise known as M.E. - is thought to affect at least a quarter of a million people across the UK, many of whom are children.
To find out more about the condition, and its management in today鈥檚 NHS, Dr Mark Porter travelled to The Royal National Hospital for Rheumatic Diseases in Bath to spend a day with Dr Esther Crawley 鈥 the only paediatrician in the country who specialises in CFS / ME.
Symptoms
Symptoms in people with CFS / M.E. are typically worse a day of two after physical, emotional or cognitive exertion. One of the major contributors to the fatigue central to CFS is thought to be poor quality sleep. Other symptoms include nausea, headaches and bouts of infections like tonsillitis.
On good days sufferers naturally do more than usual, but then end up dealing with the 鈥減ayback鈥 later. In the case of school children that鈥檚 often towards the end of the school week. Flare ups can be triggered by physical, emotional or cognitive stressors, and other insults like viral infections 鈥 typically coughs and colds at this time of year.
Case Notes听 talks to Dr Crawley鈥檚 younger patients about how they cope with CFS. Thirteen year old Amy has been so badly affected by chronic fatigue syndrome that she rarely leaves her house 鈥 and when she does it鈥檚 in a wheelchair. She longs to join her friends living a normal life, and Dr Crawley helps her to devise a plan so she can cope with a much-wanted Christmas shopping trip.
Teenager Olly had been recovering well from a prolonged episode of chronic fatigue following Dr Crawley鈥檚 advice to restrict his sleep, pace his activity and take regular rests. However, he suffered a setback when he started college and has to scale-back his activity.
Activity programme
Our reporter Anna Lacey met up with Alex Woolnough and his father Mike at Great Ormond St Hospital in London, where Alex seems to be benefiting from a graded activity programme designed to help him deal with his chronic fatigue.
Some people claim an activity programme actually makes many people worse, and that Cognitive Behavioural Therapy just reinforces a widely held misconception that CFS / M.E. is primarily psychological in origin. Dr Esther Crawley, however, disagrees.
NICE guidelines
The National Institute for Clinical Health and Excellence has recently published guidelines on the treatment of CFS/M.E., including best treatments and how urgently cases should be referred to a specialist paediatrician.
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