The Chronic Fatigue Syndrome
It's symptoms, causes, diagnosis, and treatment
with some details presented as mixed acronyms
by Max Banfield ©
I conservatively estimate that in 38 years I have been doing more experiments on my own health than any other 10,000 researchers put together, and some of my ideas, methods, and conclusions have been copied by others who are taking the credit, but it would be impossible for anyone else to know what, why, or how I did most of it, or to have any real capacity to comprehend what was involved. Needless to say, the copies are not as good as the original.
The Google search engine lists many websites which contain my ideas and methods, but mine is not on the top 10 list, and is so far away that most people won't find it. See here.
You can find it now, so congratulations!!!
Read that page, or continue reading this page, or use the index to search for specific topics of your interest, and you will know that I did the research and developed the ideas and methods.
There was a time when I would provide information about the nature of chronic fatigue symptoms and how to avoid problems, but nowadays I am aware that my ideas are being stolen by copyright thieves who then get them published in scientific journals so that they can take the credit, while later describing me as a fringy kook who has had nothing published in the "real" medical literature.
Therefore, with regard to the return on investment of my time and evaluations, I now think twice, and decide not to give any of my better methods away, or I write them in code for my own benefit, in a way that no-one else can understand or steal.
Until such time as I have a way of getting the credit for my own efforts to help other people, that will be the way it stays.
The copies are not as good as the original
In a recent article in SA ME/CFS societies journal Talking Point, Issue 1, 2013, Tom Kindlon provides a chart which shows that 51.24% of graded exercise therapy patients reported harmful effects, 19.91% of Cognitive Behaviour Therapy patients had worse problems after treatment, and 2.5% had problems after using Pacing methods.
In another tweet Cort Johnson provides a link to the Health Rising webpage called "What stops you from pacing? . . . An inquiry into pacing in chronic fatigue syndrome and fibromyalgia" where there are some comments about what modern patients are expected to do, and a discussion about all of the problems which occur here.
When I discussed my methods with the head of a research institute in 1982, they were based on my own personal experience, and I made recommendations on how to avoid problems, and I advised the instructor to let me know if there were any and I would tell him what to do. None of the volunteers reported problems, so I didn’t have to do anything, but when I eventually phoned the instructor, after 24 weeks of training twice per week, our discussion revealed that everything I predicted had occurred precisely, without any problems.
From what I have read of those modern procedures, they are obvious attempts to copy mine, in slightly different ways.
However there were at least three important facts that I took into account that I have never published, and that modern researchers can’t copy, which accounts for why they get up to a 50% harm rate.
They were obvious to me, because I did the experiments on myself 7 years earlier, and I know exactly what the problems are.
People who use the guidelines which I wrote in 1982, as the basis of their training programs should call them "The Banfield Principles", and get my written permission to use them, and or pay me a license, or discuss them in public under my name, otherwise they are committing the intellectual property crime of copyright theft, and falsely claiming them to be their own, or other researchers ideas, which is fraud.
It is also disrespectful to the person who tried to help, and not a good way to continue in the future. See a report on my publications here.
The difference between my helpful methods, and modern harmful methods
(My second report on Tom Kindlon's investigation into the harm being done by PACE trials)
In 1975 my objective was to stop taking the conventional treatments of medication, which were making me worse, with a more effective method. One of my first attempts was to exercise slowly and regularly until I returned to normal fitness and health again.
My health did begin to improve very slowly for about 12 weeks, but then stayed at the same level, which was below normal, according the independent scientific measurements which I found later.
Seven years went by when I met the head of the Fitness Research Institute where I trained, and told him that I could design a program which would be helpful to other patients and he invited me to do so.
However he said I would need to apply for a government grant to get a basic grant and official approval,
I told him that it would be unlikely that the government would do that because if I proved it was real, physical, and chronic they would have to start paying pensions etc, and that would cost them a lot of money.
He therefore advised me not to apply for that reason, but to do so to help some patients improve their health, and improve that scientific data available on the illness.
I applied for a grant, official approval was given, and the project proceeded, and the facts which I had determined in 1976, were confirmed in the first successful 12 week project, and reconfirmed and established as correct in the second project,
I had established and proven a set of principles which made it safe and useful for other patients to exercise.
However, i have found recently, that soon after I did my research, that other people were copying, or stealing my ideas and methods, and getting millions of dollars in grants to use them, but more than 50% of patients have reported that more harm has been done to their health than good. i.e. they were worse after the exercise program in instead of better.
The most obvious explanation for that, is that the people who stole my ideas were applying for research funds on the basis that exercise could "cure" the problem, and save employers, insurance companies, and governments billions of dollars in compensation payout's etc.
In that process the researchers would have been guessing, experimenting, encouraging, and forcing the patients to go faster and faster until they returned to normal health, and many of them would have exceeded their limits, and experienced some adverse responses and dropped out of training.
Also those researchers would have reported the good results to get more funds, and would not have mentioned the true extent of the harmful effects, or would have blamed the patients by arguing that they were just lazy, or didn't want to co-operate or get better, or were afraid of exercise, or were mentally ill etc.
My objective was to improve my own health, and my methods were effective for myself, and for some, but not all patients with those problems, and who trained according to my instructions.
However, the people who have copied me have had different motives, and have essentially messed up a good idea, and caused a lot of harm to a lot of patients.
The critics of the modern method, such as Tom Kindlon, and others have valid points to make, but it isn't necessary to stop the exercise programs altogether, because it is an additional form of treatment which will suit some patients when nothing else does.
Finally, all types of treatment are aimed at helping, but there are side effects or adverse responses which need to be considered when using each of them.
As they say . . . "The benefits need to out way the harm".
The changes in treatment of chronic fatigue which I produced between 1975 and 2013
In 1975 I had very disabling symptoms and had been consulting doctors and being treated for several years but nothing was showing on any diagnostic test, and nothing was helping. I was then referred to a psychiatrist and explained that I had abdominal pain which seemed to get worse each time I leaned toward a desk. He said that it was the doctors job to treat pain, and only wanted me to answer questions such as 'did I like my mother', or 'what was my early childhood like'. Those questions were utterly irrelevant, stupid, and useless.
I then took some extended sick leave, but didn't recover so I asked about being granted superannuation entitlements and leaving work. I was told that there was nothing physically wrong with me and that I should go back to work and work hard or I would be sacked.
I therefore had no choice but to resign from work without pay.
I had been prescribed an addictive drug called sodium amytal, a barbiturate for about a year, and was on a dosage of 500mg, and advised to increase it to 750mg, but that would have become even more difficult to stop taking if I took the higher dose, so I stopped taking it and went through three months of extreme withdrawal effects.
I was offered other treatments such as work as a carpenter, but I explained that leaning toward a desk or a kitchen sink caused me abdominal pain, and that leaning toward a carpenters bench would do the same. I was also sent to a house where there was a room with a table which six or more men were sitting and gluing ice-cream sticks together to make small model houses or cars. They all looked utterly bored and miserable, and I knew that sort of "occupational therapy" would be an utterly useless way of curing my ailments. The type of treatment offered to other patients was deep sleep therapy where the doctors were eventually sued and jailed for their methods, and frontal lobotomy, where the patients developed irreversible brain damage and became human vegetables, and electro convulsive therapy.
I therefore decided to treat the ailments myself. Within a year I had joined an exercise class at a medical research institute where I was told that there was nothing physically wrong with me and that I should ignore my symptoms and run faster and faster until I was cured.
That advice caused worsening symptoms so I slowed down and determined my own methods of exercising.
Within a year I had identified that I had physical limits, and that I needed to start at a low level, and progress at a very gradual rate, and stay below the level which caused the worst of the symptoms. That method improved my health, but I reached a level which was below normal health, and stayed there despite increasing the amount, speed, and number of days that I exercised. I therefore had a scientifically measurable chronic physical impairment.
I then had periods of up to three months at a time where I was severely disabled by fatigue, but by the fourth year I was able to determine that in order to prevent such episodes I needed to reduce the number of activities I participated in each day, and get rest in between, and although It didn't cure the problem, I haven't had severe fatigue since.
Seven years later the head of the Fitness Research Institute where I trained invited me to design a research project for other patients with the same ailment, which I did, and within two years I was able to scientifically prove everything. The guidelines which I wrote for the instructor contain the methods of success (and are the template from which modern treatment methods have been based).
In 2007 I joined Wikipedia and by 2008 came under a lot of criticism from two anonymous editors who were calling me a worthless, non-notable fringy kook whose ideas were nonsense and rubbish, but noticed that while they were deleting my contributions, other editors were rewording it and adding it to other pages. I have since been banned and seen more editors set up brand new pages, and steal my ideas and methods, and have found other pages such as the chronic fatigue syndrome which are dominated by my methods without mentioning my name as the source.
I have also seen in 2012 that a London researcher named Simon Wessely has been given the John Maddox Prize for his courage in science, and then a knighthood. The gullible public are supposed to believe that he, a psychiatrist developed an entirely physical exercise method for treating an entirely physical symptom of fatigue.
It is not only Simon Wessely that has stolen my ideas, but also Peter White, and many other people, and they are giving my methods names such as PACING, and calling them the "tools" which help patients to understand and control their symptoms.
Now university professors are teaching their students those tools such as . . .
1. Their condition needs to be understood as physical with no known cause.
2. That they can try exercise as a treatment
3. That they must start very slowly at a low level
4. They must progress very slowly in order to gain improvement over the training period.
5. That if they get distressing symptoms they can slow down, recover, and start again.
6. They are also advised to be very careful in how to change their lifestyle to reduce their daily activities
7. They teach many more of the detailed ways that I adjust lifestyle.
(However, they can't teach them many of the principles which are important for success because I have never published them).
The professors get paid, and the doctors, specialists, or physical therapists give that advice to patients, and the patients are grateful, and the doctors say . . . 'that will be 500 dollars, will you pay cash or cheque'. . . and medical insurance funds pay for most of it.
They may deserve their money for leaning my methods and recognising that they are the best in the world today, but they want people to believe that those ideas came from highly intelligent, highly qualified researchers, and that I am just a worthless non-notable fringy kook.
I would therefore like the support of all patients, regardless of their disease, as well as the recognition for all ethical members of the medical profession and the public.
How to prevent the harmful effects of exercise in the chronic fatigue syndrome
If I was to write an essay on how and why the modern researchers such as Simon Wessely and Peter White were causing 51% of patients in exercise programs to be worse after than before they started, then they or other researchers would steal the ideas and claim the credit to create the impression of being intelligent, and to get gratitude, and more research funding and promotions or awards etc.
Needless to say that I started with very severe CFS in 1975, and knew what the problems were, and when I experimented with my own health there were situations in which I knew that most people wouldn't do it, but I saw no alternative, so I kept on experimenting and making mistakes and learning from them.
By the time I was asked to design a research project in 1982 seven years had passed, and I knew a lot more about the topic than anyone else, and was interested in getting more useful information, so I had many ways of making sure that none of the patients did anything wrong or came to any harm.
When I read about the 51% of harm being done by modern researchers I knew what they are doing wrong, but it simply isn't worth my while doing anything about it until I can guarantee that I get the credit, and the benefits for what I have done in the past, and what I do in the future.
How I stop copyright thieves from stealing my ideas and taking credit for them
For the past 37 years I have been providing detailed descriptions of chronic fatigue symptoms and developing methods of treating them as they occurred to me. Consequently the ideas were produced in a random manner. Therefore, at various stages I reconsidered them and put them together in an orderly arrangement, such as predisposing factors, cause, aggravating factors, and treatment.
When I presented new ideas on my webpages on the internet they also occurred randomly, and I became aware that a person, or many people were copying them and claiming them to be their own ideas, as if they thought of them, and they would copy (or steal) my ideas and present them in a well written and orderly manner so that their articles looked better, and gained better Google search engine rankings than mine.
I therefore decided to start a new webpage (this one) and present my ideas in an easily readable sequence.
However, since I started, it has become apparant that the more accurately and precisely that I provide my ideas, the more easily other people can copy them, and appear to be experts on the topic.
Therefore there is no advantage to me in doing it, so I have not completed this page.
All new ideas are now presented in code.
Hence, the copyright thieves can't copy me any more.
In fact, in 2007, when it became obvious that other people have been copying me, I didn't publish my ideas at that time, which I had been preparing since 2005.
The essay on this webpage here, is based on more than 35 years of research and was started on this page on 19-10-12. Many of the accurate and detailed descriptions of symptoms and how to manage them are based on my own observations and conclusions and are subject to my copyright. See my other page on CFS here, and a summary of my formal research here.
The previous attempts by other authors to treat CFS as if it is just normal tiredness, or simply due to lack of exercise have not been effective.
The main feature which distinguishes the various types of chronic fatigue syndrome from normal health is the abnormal physical and physiological response to physical exertion. See here
My publications relating to the Chronic Fatigue Syndrome
My interest in health began in 1975, and my publications relating to the Chronic Fatigue syndrome include . . .
A review of one of my ideas by the editor of the Scientific Australian in December 1977.
A series of 15 essays in the Australasian Nurses Journal between 1978 and 1983.
Some of the 100 other essays, small booklets, or letters to newspapers between 1980 and 1993.
A research project about chronic fatigue and exercise at the South Australian Institute For Fitness Research and Training between 1982-4 with regular newspaper reports on the purpose and success. e.g. see here and here.
A book about undetectable illnesses called The Posture Theory which started as a few pages and increased to 1000 pages between 1994 and 2000, which included at least 2 sections related to the various causes and types of chronic fatigue. It was sold to public and school libraries in Australia, New Zealand, the United States, and South Africa. See here.
A website about undetectable illnesses which began in about 1993 and continues to this current time, which includes webpages about The Chronic Fatigue Syndrome. here.
An essay about Da Costa's Syndrome which I wrote for Wikipedia between 2007 and 2008 here
I described the symptoms in more detail, and more accurately than had ever been done before, which has enabled other people to properly understand them for the first time, and to treat them more effectively since. It would be impossible for anyone to treat that ailment effectively unless they had read or learned about my ideas and methods.
Three of my earliest theories
The Glandular Theory
In 1977 I approached the editor of a magazine called The Scientific Australian to discuss one of the earliest of my many theories about the cause of various health problems which included chronic fatigue. I told him that I had the disorder which attracted a lot of prejudice, and that I wanted the theory published, but not my name.
He made the compromise of only mentioning my first name and then wrote a summary of the idea and it was presented in the December 1977 edition on page 34 and 35.
The third paragraph of that article begins with the words "Max, a South Australian . . . "
He reported my observations and findings that there was an abnormal pattern in the way the body responded to exercise and exhaustion where the person became fatigued more readily than normal, and it persisted longer afterwards.
I told him that it was likely that the strains on the glandular system which occurred during pregnancy or stress could damage the glands and reduce their ability to respond and bring the bodies normal functions back as quickly as usual, and that I identified the problem as a form of disequilibrium. I also suggested that the way to treat the ailment was to take the strain off the system by restricting activity to moderate exercise levels, and avoiding extremes of emotion.
The Autonomic Nervous System Theory
Some time during 1979 I became aware that the nervous system of patients with persistent fatigue continued to act as if the person was under stress after the stress had ceased, so I wrote an essay called Exhaustion in the Effort Syndrome and posted it to a N.S.W. Nurses Journal called The Lamp where it was published in their January 1980 edition on page 11.
I suggested that the delay in the recovery from stress was due to some form of injury or abnormality of the autonomic nervous system which plays a major part in regulating the bodies functions. Such a fault would explain why the patients continued to experience exhaustion despite the fact that they had stopped all activity and tried to recover by resting.
The involvement of a fault in the nervous system would also explain why the patients had problems with fatigue even if they were not exercising, because the nervous system reacts in healthy people, and over-reacts in chronic fatigue patients in response to a wide variety of other stresses such as noise, injury, shock, or emotion etc.
(one of the modern labels for CFS is dysautonomia,
The Posture Theory
My third theory was presented in a series of essays which were published in the Australasian Nurses Journal, including one called "Some Hypothetical Mechanisms For The Symptoms of Neuroses During Pregnancy And Exercise".
I became curious about a research procedure called Valsalva's maneuver which was a method of producing stress in a laboratory. Essentially the person is asked to hold their nose and mouth shut, and try to breath out with force. The process increases the air pressure in the lungs, and slows the flow of blood from the feet to the brain, causing the typical symptoms of stress such as changes in blood pressure etc.
In other words it is a scientific method which is used to create stress in a person using an entirely physical procedure which has no psychological cause at all.
I therefore presented the idea that poor posture could put pressure on the chest and slow the flow of blood to the brain to cause such symptoms as tiredness etc. I also explained that the constant and repetitive activity of leaning toward a desk when doing sedentary work could cause strain on the nervous system and damage it, and further suggested one of many ways in which it could affect blood flow. For example, the pressure on the blood vessels in the chest could strain and ultimately weaken the blood vessels below the chest, so that they functioned less efficiently and caused more persistent problems with faintness and fatigue.
Over the previous four years I had described how poor posture could compress the chest to cause chest pain, the stomach to cause stomach pains, and the respiratory muscles to cause breathlessness etc, so when I developed a mechanism for the postural cause of fatigue I wrote another essay combining all of those ideas into one and called it The Posture Theory. However, when preparing that essay I called it "The Matter of Framework", and it was published by the Australasian Nurses Journal in the June 1980 edition on pages 27-29.
Why critics don't bother me
When I was 25 years old I had many health problems including fatigue which were not being relieved by treatment, and I gained the general impression that they were considered to be rare, mysterious, undiagnosable, trivial, and temporary, so I began to study medicine and do my own research and determine my own methods of treating them.
Since then I have learnt that in the decades before the treatments have involved forced exercise training, and punishment, which included ridicule, confinement to isolation wards, and death by firing squad. See one of my reports here. There have also been attempts to cure the problem by electro convulsive therapy and frontal lobotomy. In my case the treatment had been medication which involved many different pills and capsules such as valium, and barbiturates which are chemically addictive, toxic, and fatal when taken in the long term. Had I taken the prescribed dose of sodium amytal when it was increased to 750mg per night I would have been dead by the age of 26. I am now in my sixties.
I have therefore never been concerned about criticism from people who question the value of my ideas and methods because mine are obviously better than all previous methods.
(if you read the literature you will find that some of the methods which I developed have actually been used in the past - For example, moderate exercise has been recommended in the past after the harmful effects of forced exercise were discovered. Nevertheless, by 1975 all of those ideas had been forgotten or abandoned and I was being encouraged to exercise at high levels. It was obvious to me that such activity was foolish so I had to develop the method of staying within my limits. By establishing that basic principle it was possible to continue, and that is what I was recommending for other patients with similar problems when I designed a successful research program at the South Australian Institute for Fitness Research and Training in 1982. I had produced a more reliable method which enabled some patients to train consistently. See here and here and here).
The Banfield Theory for the Chronic Fatigue Syndrome
The chronic fatigue syndrome involves a set of many and varied symptoms which are associated with an abnormal pattern of tiredness, and an occasional tendency to feel faint when moving from the laying to the standing position, and a reduced capacity for exertion. Those particular features are caused by a weakness in the walls of blood vessels which results in a tendency for blood to pool in the abdominal and leg veins, and an inefficient flow of blood to the brain. There are various intrinsic or external mechanical factors which could explain the poor vascular tone. ©
The chronic fatigue syndrome is a medical condition which involves a set of symptoms that mainly include breathlessness, lower left sided chest pains, palpitations, faintness, and fatigue.
It is a very common aliment and has been extensively researched for more than a century, during which time it has been given more than 100 different labels, which essentially mean exactly the same thing, although there are some minor differences in the definitions, and there may be some different causes and types. Each type has the same five symptoms somewhere in their list.
The cause is unknown but there is extensive evidence that it has a physical basis of some sort.
Many patients have up to 20 or more additional symptoms which vary from time to time in the same patient and from person to person, but some are more common than others.
For example, in many people abdominal pains are the main additional symptoms, where it has been called the abdominal type. In others headaches are a significant problem, in which case it has been called the cerebral type, and in some cases anxiety or depression are features, so it is called the psychological type etc.
The condition is more often seen in sedentary workers, who have thin and stooped physiques and long, narrow, flat, or receding chests, and is rare in physically fit manual or farm laborers. However, it can and does sometimes affect people of any physique including those of athletic or stocky build.
Various studies have shown that some people appear to be born with it, indicating a genetic cause, and in others it develops during childhood. It may occur so gradually that the person cannot say when it began, and is not able to identify which factor was responsible. In other cases it begins after a period of prolonged and severe physical exertion in the cold and rain, while being poorly fed for many days, weeks, or months, and has also been attributed to overwork. In some cases it appears to follow a period of infection such as typhoid, malaria, glandular fever, or even influenza, where the person may spend several months recovering from the fever, but continue to have problems with fatigue thereafter. In other cases it appears to follow a period of personal or business stress.
in the early stages a small number of cases respond to rest, good nutrition and moderate exercise, and the person returns to normal health. However, it is described as chronic because periods of fatigue usually persist as a recurring feature.
Long term follow up studies by researchers such as Edmund Wheeler in 1950 have shown that a person whose main symptom is fatigue and who is able to continue full time employment despite the symptoms, will still be employed 20 years later. However those who are only able to do part time work, may try to become involved in full time work on numerous occasions, and soon become too exhausted to continue, so that they have a history of recurring fatigue until they accept their limitations and will be found to be still working on a part time basis later. Similarly those who are unable to sustain employment initially will still be unemployed 20 years later. See reference number 13 here.
It therefore presents as an impairment to exertion and lifestyle, rather than a life threatening disease, and most people adapt to it in their own way. There are many ways of preventing the recurrence of symptoms and minimising, relieving, or managing them, but there is no known cure. In that regard it is similar to other chronic illnesses such as arthritis diabetes.
The main symptoms of the major type of chronic fatigue syndrome
It doesn't matter what label the ailment is given, and there are many more than 100, because, by far the most characteristic symptom is an abnormal response to physical exertion, where, in some cases there are very few symptoms at rest, but the pulse and breathing rate increase abnormally during exertion, and increase out of proportion as the level of exercise increases. Also, if the person exercises beyond their capacity the symptoms are slower than usual at returning to their normal level.
The symptoms also include an abnormal form of breathlessness with the person reporting an occasional need to get an extra deep breath. That symptom can occur at rest, and is more frequent during exertion, and does not exist in any other ailment.
See one of my detailed descriptions of the abnormal responses to exertion here.
Nevertheless there are other types which have different symptoms and causes.
The breathlessness is described as a difficulty getting a full breath where the person inhales until they can go no further and still feels as if they need more air. It has sometimes been called "air hunger" because the person appears to be trying to eat air as they gasp deeply two or three times in a row to get the oxygen they need.
It is due to an inefficient function of the breathing muscles, and a failure of the diaphragm to relax fully during the exhalation phase, so the person does not the full amount of oxygen they need each time they breath in. The net result is that their body gradually builds up an oxygen debt until they have to force themselves to take an extra deep breath, and or multiple deep breaths etc. There also appears to be an inefficiency in the way that oxygen and carbon dioxide are transferred between the lungs and blood stream etc.
The breathlessness can occur only two or three times a day, or many times every hour in some circumstances, and can be so mild as to go unnoticed, or so forceful that it is obvious. For example, in some cases the person will bend over and place their hands on their knees to gain leverage as they forcibly breath in. It is more frequent in cold weather, and when a person is wearing tight waist belts or chest straps which interfere with the full expansion of the chest during inhalation.
It was one of the most widely known and common features of nineteenth century women who wore very tight waisted corsets, and who typically relieved the symptom by asking someone to unlace the garment. Nowadays girdles would have a similar, but less severe effect.
It also tends to be more frequent when talking because air needs to be exhaled from the lungs and passed through the throat and vocal cords to produce the sound of voice. Hence with less oxygen in the lungs the inefficient breathing process may require the patient to take extra breaths.
The palpitations can occur at any time as a perception or pounding of the heart which appears to be more forceful than usual, and is different to normal palpitations. It may be related to the abnormal shape of the spine and chest where the heart is in a smaller space, and in closer contact to the chest wall where its pumping action can be more easily felt. It is sometimes induced by changes in body position, such as bending, or when moving from the standing position and laying down on the flat of the back, perhaps because it brings the breastbone toward the heart. That problem can sometimes be relieved by sitting up, or moving to a different position, or laying with the head elevated on two pillows with another one under the arch of the upper back to raise the chest etc.
Relaxing drinks such as alcohol can sometimes relieve that symptom but needs to be used judiciously to avoid addiction. Deep slow breathing etc, and Yoga techniques may also be useful.
Lower left-sided chest pains
The main type of chest pain is a sharp stabbing sensation which occasionally occurs between the third or fourth ribs below the left breast. It feels as if a sewing needle has suddenly been thrust into the chest to a depth of two or three centimetres and out again within an instant. In the past many doctors and patients have mistaken for heart disease when in fact, it isn't. Experimentally it has been relieved by injecting a pain killing drug in the area of tenderness which often exists in that site. Similar pains occur less commonly on the right side, and in other parts of the chest.
A different type of pain, more severe and lasting longer, can occur on the extreme left and right side of the chest between the armpit and the hips, and is most likely due to the typical stooped physique and chest shape which affect the biomechanial efficiency of lifting heavy weights at awkward angles, and causes severe muscle cramps in those areas.
The faintness is very closely related to the fatigue because the cause is inefficient blood flow between the feet and the brain, which results in a reduced supply of oxygen and nutrients to the brain. It can be induced by factors which increase the air pressure in the chest and compress the blood vessels passing through it. Hence it can occasionally occur when leaning toward a desk, kitchen sink, or washing machine. Similarly it is more likely to occur when wearing tight waist belts and chest straps and again, it was a very common and widely known feature of nineteenth century women who wore whalebone corsets which were extremely tight around the waist and chest, and interfered with the natural flow of blood between the feet and brain. Other factors include gravitational and centrifugal forces which affect the weak flow of blood. For example moving from the laying to the standing position can induce faintness. In such cases it may sometimes occur then standing up suddenly to get out of bed first thing in the morning. It can occur rarely, or once or twice a months or every day for several weeks, in which case it is usually associated with the fatigue.
The centrifugal forces can produce faintness when the person is standing in an elevator which suddenly starts its upward move, or in an airplane as it accelerated to get into the air, or decelerates on landing. It can also occur on spinning and swirling entertainment rides at country shows. etc.
The fatigue involves two aspects. The first is the abnormal pattern of sleep which results in abnormal tiredness, and the second is the reduced capacity for exercise and the abnormal physiological response to it.
One of the symptoms which occasionally occurs in the chronic fatigue syndrome is a difficulty in concentrating or thinking, which I have considered for the purposes of understanding and controlling it. Someone else has given that symptoms the label of "brain fog".
However, I have not published much about it, but it has become the subject of research and many patients complain about it, and ask questions.
Nevertheless. like many aspects, my ideas are stolen, and somebody else takes the credit for them, so it is no longer worth my while to publish information, and it wont' be until I get some major recognition for the other ideas which I have already produced.
In fact, it is not even worth my while discussing anything about it, because copyright thieves are watching my website etc. and can reword my suggestions and get them published in top quality research journals to claim the credit. Other people will repeat the process of arguing that the "respectable", highly qualified researchers have had the information published in "modern" "mainstream", "peer reviewed" journals, and I am just a fringy kook.
My coded response explains that without my ideas they will have to . . .
The tiredness in the chronic fatigue syndrome is not normal, but is related to an abnormality in the stability and regulation of the sleep pattern. It may sometimes appear to be normal, but is easily disrupted by the same variety of factors which influence the sleep of healthy people. For example, any change in daily routine such as the need to hurry and rush about has the risk that tiredness will be excessive the next day, and more likely to produce an accumulative effect.
More commonly the usual problem is the tendency to wake up from a nights sleep and still feel tired, or to feel tired during the morning. With practice it is possible to take rests when necessary. For example, having naps if they feel tired at 9 a.m., in which case it may only require fifteen or twenty minutes of rest to become as refreshed as if a full 8 hours sleep has been achieved. Similarly they may feel tired again at noon, or 2 p.m. or 5 p.m. etc. Taking naps can sometimes relieve the tiredness, but not always, and continuing to stay awake is sometimes possible but again there is the tendency for the effects to accumulate.
Some people have applied the same advice to CFS patients as is given to healthy people, with the suggestion that they just ignore the need for sleep, or as they say, 'fight' your way through it and stay awake so that you feel tired at night when you are supposed to. However, in CFS the lack of sleep during the day is more likely to leave the person in an agitated or nervous state where it is impossible to get to sleep at the normal time in the evening. Hence it makes a difficult problem worse.
Sleeping in response to the sense of tiredness is the easier thing to achieve than fighting against it, and it usually leaves the person calm and refreshed and more likely to be able to sleep at night.
Another problem is the tendency to wake up in the middle of the night and have difficulty getting back to sleep again, and in some cases to wake up several times. Sometimes it is difficult to get back to sleep each time, and sometimes it isn't.
Establishing a good understanding of the sleep pattern and how to manage it is useful. Excessive amounts of coffee during the day can make sleep difficult, and warm milk is used by some people to assist with getting to sleep at night. Some people find that the breathing and distraction techniques of meditation assist in gaining sleep more easily during naps and at night, and others just rest and relax during that process. It is not absolutely essential to gain rest every time, but it is useful.
Various other standard methods of assisting with sleep are also useful.
A final problem is the tendency for tiredness and fatigue to accumulate so gradually over a period of weeks or months that the person doesn't notice it. When they ultimately realise that they are extremely fatigued, and exhausted, they stop to rest, but find that they don't recover immediately, and that it may take weeks or months to return to the feeling of well being again.
Developing a good understanding of the problem and adjusting lifestyle accordingly can prevent such recurrences of prolonged exhaustion.
Other limitations and how to treat them properly. The Dale comparison
Physical Limitations - a reduced capacity for exertion
The weakness of blood flow and the abnormality in the breathing pattern contribute to the lower than normal aerobic capacity and reduced capacity for physical exertion. It is not due to laziness, lack of exercise, or the fear of exercise, and the symptoms are quite different to the normal response to exertion.
In some cases the symptoms are not particularly problematic during rest, and hence it has previously been called the "Effort syndrome" because they always occur during exertion, and increase out of proportion as the level of exercise increases. At some point significantly below normal the symptoms of rapid heart beat, breathlessness, faintness and dizziness make it impractical to continue exercising to the maximum level that is possible for healthy individuals. If they persist above the level which produces such a response they are likely to experience symptoms for the next few hours, and may take days or weeks to recover from the after effects.
Consequently many patients find it very easy to manage and limit the symptoms, because, as long as they spend time involved in minor physical activities and don't exceed their physical limits they don't get any problems of significance. For example, some people are bed ridden but most CFS patients are able to walk about, even briskly, but need to avoid running to catch a bus, lifting heavy objects, exercising at high levels, or climbing steep slopes. Hence the activities which are useful in maintaining reasonable health need to be determined according to each individuals capacity.
That is something that only the patient can determine, perhaps with some educational guidance, and becomes easier with practice.
The parallels. Also the L-factor.
How to prevent problems with execise in CFS
I have never published the main way I prevented problems when exercising with CFS.
How to improve gradually KT&IN
How to develop methods Don't do what Rome did
The condition can affect people of any shape or size but itt is more likely to affect individuals who have thin and stooped physiques, and long, narrow, flat, or receding chests, and sedentary workers who avoided or never played sport, and it is less common among physically fit manual or farm laborers.
Some people appear to have been born with the condition, indicating that it can have a genetic cause, and in other cases it appears to run in families.
It is more common in women than men, and often occurs or starts during a pregnancy.
It is also more likely to affect adults who had multiple infectious illnesses and surgical procedures during childhood,
Soldiers who were diagnosed with the condition during war were usually former sedentary workers who had minor indications of the typical symptoms prior to enlistment and it was more common in the army where strenuous marching was required, and less common in the navy and air force.
The original text with supporting references for this section can be seen in my essay about Da Costa's syndrome here.
Physiological abnormalities related to exercise
Chronic fatigue patients have a low aerobic capacity or level of fitness which is not related to the lack of exercise and breathing patterns and other symptoms which are not the normal response to effort. They have poor diaphragm movement and reduced chest expansion at rest, and during exercise training such as walking, jogging, or running "they have an easily induced oxygen debt". Their breathing become disproportionately shallow, oxygen consumption is lower, and blood lactate levels are higher than normal, in some cases more than double. As the intensity and duration of the exercise increases the physiological abnormalities increase out of proportion to a degree which is consistent with their reported limitations. There is also an abnormal pooling of blood in the abdominal and peripheral veins, and a slow return of pulse rate to normal after exertion.
The original text with supporting references for this section can be seen in my essay about Da Costa's syndrome here.
The type of breathlessness which involves a difficulty of breathing in as if meeting an obstruction near the end is so unique that it only exists in the chronic fatigue syndrome and no other illness, and as such it is used as a diagnostic indicator. The doctor who suspects that the patient has CFS from the description of other symptoms will observe the patient in his peripheral vision, and if he notices frequent sighs or more importantly the typical forced breath he will view it as confirmation, but further biological verification is needed.
Exercise tests which measure pulse rate and blood pressure while the patient is riding a stationary ergometric cycle can be used to confirm the diagnosis. The patient is first tested at rest, and then after three minutes of peddling against a the wheel while a low brake pressure is applied. After a three minute rest the patient is asked to peddle for another three minutes of cycling against a higher level of resistance, and then the measurements will be taken again and proceeded until they can't go any further. The graph of the results indicates their aerobic capacity and if it is lower than the level expected by a person who is unfit due to lack of exercise, then it indicates abnormally low capacity and CFS.
Tilt table tests can also be used to confirm the abnormalities in blood flow throughout the body which indicates the weakness in the tone of blood vessels that causes it. Pulse and blood pressure monitors are placed on the wrists and ankles etc. while the patient is tilted from the laying to the standing position, and at various angles, and then from the left to the right etc. The difference in the results from those of a healthy person indicates orthostatic variations indicative of CFS.
A new diagnostic method
In October 2012, I determined an entirely new way of researching and diagnosing the chronic fatigue syndrome, and may report the method later. I call it the Diagnostic Attenuation Study which I may report on later. The DATT method.
In December 2013 I devised another new method of diagnosing CFS called the TCS (re - the ST).
Treatment - the Banfield principles ©
In the past exercise programs have often been recommended as a treatment for CFS but have almost always failed because patients generally complain about the symptoms and drop out in large numbers, and become highly critical of the effects. However exercise does have some value for some patients if conducted in consideration of the following facts.
The capacity for exercise in the chronic fatigue syndrome varies considerably from one person to the next, so any exercise regime needs to be adapted to each individual.
Also, there are many healthy people who never exercise, and yet continue to lead long and healthy lives, so obviously exercise is not absolutely essential, and the same thing applies to CFS.
In that regard patients should not feel under any obligation to force themselves to exercise if they don't want to, and, in fact, if the level or type of exercise aggravates their symptoms they should avoid it.
Nevertheless, regular exercise improves the fitness and capacity of healthy people, and where possible the same applies to chronic fatigue patients, but although they may be able to make some gains, in many cases it will not be possible to regain normal levels.
Each person should therefore gain an understanding of their own capacity and exercise within it.
If the person is so exhausted that they are confined to bed, then rest may be the best possible treatment but most people have the capacity to get out of bed and walk bout the house, and that basic exercise is better if and when the person can do it, and regular walking in a comforatable manner, will assist in gaining improvements,
Most CFS patients can walk to and from shops, and along the beach, and in general terms the more the better, and where possible over a period of time (weeks or months) it may be possible to increase the distance and the pace to brisk walking. The gains in fitness level will make it possible to feel more comfortable in their sense of well being, and in their capacity for other activities in life.
Most people with CFS find that strenuous exercise such as lifting heavy weights or climbing steep slopes aggravates their symptoms, so they should avoid them. Similarly they may have problems when bending or stretching, or particularly with squatting down, so avoid such activities.
The objective of exercising within limits as a regular part of daily activities, or on a regular basis in training courses, is to improve to the best level possible, and to recognise when the optimum has been achieved and then stay within the new upper limits.
It may not be possible to reach normal levels, and as such attempts to do so could make the problem worse, so if that is the case then it isn't necessary, or worth the trouble.
The exercise limitations
Why exercise response varies
Harmful effects of exercise in CFS and how to avoid them
There are many ways of preventing the harmful effects of exercise which I have briefly discussed here.
I may discuss them in more detail later, but they essentially involve Sts & H&H.
Methods of preventing problems in extreme cases relate to the CS co-incidence.
The people who are causing harmful effects are not taking everything into consideration.
DFI & DTO
Severe cases of CFS
Some patients with chronic fatigue are bedridden, so it isn't possible to use exercise as a treament in which case a different method is required. The Lbc method.
Rest and the LTR factor
See my YouTube video about treating CFS breathing abnormalities here.
See my YouTube video about treating CFS faintness (orthostatic intolerance) here.
The WV technique which I may report on later.
Improving the amount of sleep a person gets can reduce the problem of tiredness during the day.
Methods which I use include having a comfortable mattress, and keeping warm with quilts in winter.
Also the CS comparison
My other methods include EL & ED
Good tips from another website worth considering are sleeping on water mattress, or an air mattress where the level of firmness is adjustable. They also recommend heated mattresses for winter time. (Those tips were from a link provided by healthythinker on Twitter, and the website article was written by Richard Arnold on the CNN money website here
to be continued . . .
Why do different people think different things about the cause of the chronic fatigue syndrome
A virus - Many people report that they were healthy and participated in sport up until they experienced a viral infection of some sort, such as glandular fever, typhoid, Q-fever, or even the flu. They became exhausted during that period, and after recovering from the infection they continued to have problems with fatigue. See here.
Stress - Many people report that they were healthy and fit up until a period of stress in their lives such as the death of a parent, or a financial crisis, or a traumatic event such as a war. See again here.
However there is incontrovertible proof that stress is not the cause in many cases. The Bv & CFS.
Poor Posture - Many people were fit and healthy, but had thin and stooped physiques and gradually develop health problems, including fatigue, until it interferes with their capacity for exertion etc, and begins to interfere with their normal activities of life. Such physique has been observed and referred to as typical since this type of ailment was first studied more than a century ago. See here.
Other condiderations - CPD versus VE
The cause of one of the main symptoms
I determined the cause of one of the main symptoms of CFS in late 2013. it involves an observation, a theory on cause, the effect, and the result.
I have a methematical formula for predicting and preventing relapses which I may discuss later. The LF & SR & GTP.
Relapses occur because of Kg/iR
The D/R incompatibility.
The PTFt vs CTFLw D/PTFt vs CTFIw priniciple
Epidemiology (i.e. how common is it)
Conservatively the chronic fatigue syndrome affects 2-4% of the population, making the world total of 200 million, with some estimates of 10-15% or higher. It can be genetic where some patients appear to be born with it, and it can affect children, and two thirds of the adult patients are women;
Famous people with CFS
Charles Darwin, Florence Nightingale, Paul Robeson, Leight Hatcher, Michael Crawford & Greg Page See more details here.
Types of CFS
The characteristic feature of CFS is the abnormal response to exertion, and the other main features are chest pains. palpitations, breathlessness, faintness and fatigue.
There are literally dozens of other symptoms involved, but generally one predominates over the others.
The abdominal type - abdominal pain
The cerebral type- headaches
The cardiovascular type - chest pains etc
The muscular aches type - muscular aches and pains
The psychological type - anxiety or depression
For example, if the persons other main symptom is headaches, then they don't necessarily have abdominal pain etc.
In other cases the person may become abnormally breathless during exercise, but never ever get aches and pains in their arm or leg muscles.
In other cases the person may have dozens of physical symptoms but the don't worry about them and never get depressed.
What CFS is not
The chronic fatigue syndrome is not just normal tiredness, it is not imaginary, it is not due to the lack of exercise, or the fear of exercise, and the symptoms are not the normal response to exertion. it is not due to laziness and is not malingering, or an attempt to get sympathy or a conscious or sub-conscious faking of symptoms to get some sort of financial compensation or other gain. The symptoms are not the same as those of anxiety, and are not caused by panic induced hyperventilation, and are not panic attacks or mental breakdowns, and it is not delusion or depression or any other complicated or mysterious psychological disorder. However, psychological factors may play a part in some cases, and some people may become anxious or depressed by the symptoms and the limitations to their lifestyle.
Regardless of the cause it is a chronic physical impairment.
References See here.
See my other webpage about Chronic fatigue syndrome and exercise research here,
and my research project here,
and about the Chronic fatigue syndrome and Da Costa's syndrome research history here,
and the essay about Da Costa's syndrome here.