scholarly journals The Disrupted and Realigned Self: Exploring the Narratives of New Zealanders with  Chronic Fatigue Syndrome/Myalgic Encephalomyelitis

2021 ◽  
Author(s):  
◽  
Lara Joyce Milka Bell

<p>Chronic Fatigue Syndrome/Myalgic Encephalomyelitis (CFS/ME) causes pronounced, debilitating fatigue that is not alleviated by rest, along with muscle and joint weakness, pain, cognitive difficulties and can be worsened through mental and physical exertion. However, it is also without an aetiology, and there is little consensus amongst both medical and patient spheres as to what CFS/ME actually is. In this thesis I draw on interviews with people with CFS/ME and participant observation in a patient-led support group in order to explore the way in which CFS/ME shaped participants’ identities and narratives of the self. I argue that participants moved through two stages that I call ‘The Disrupted Self’ and ‘The Realigned Self’. Falling ill with CFS/ME rapidly disrupted participants’ understandings of the bodies, their position within their family and the community, interactions with doctors, and all the usual markers on which they had previously formed their self-identities. In this state, I argue that participants and those with whom they engaged viewed both CFS/ME and my participants as liminal, ‘betwixt and between’ (Turner 1969) social roles and contemporary New Zealand ideals of illness, the individual, and the ‘sick person’. As the initial disruption and confusion of falling ill subsided, however, my participants worked to develop a new secure self-identity, the ‘Realigned Self’. They move into a normalised long-term liminal state by prioritising their health, adjusting their expectations of their body, developing their own conception of the aetiology of CFS/ME and forming a positive narrative of their new lives. This identity work utilised wider cultural ideals about the active, responsibilised and authentic self; common to late modern contemporary life (Beck and Beck-Gernsheim 2001, Desjarlais 1994, Giddens 1991, Rose 1996). Yet this realignment was often not reflected in the views of my participants’ friends, families and doctors. This illustrates the diverse perspectives and different degrees of liminality that exist within experiences and narratives of CFS/ME and contested illnesses.</p>

2021 ◽  
Author(s):  
◽  
Lara Joyce Milka Bell

<p>Chronic Fatigue Syndrome/Myalgic Encephalomyelitis (CFS/ME) causes pronounced, debilitating fatigue that is not alleviated by rest, along with muscle and joint weakness, pain, cognitive difficulties and can be worsened through mental and physical exertion. However, it is also without an aetiology, and there is little consensus amongst both medical and patient spheres as to what CFS/ME actually is. In this thesis I draw on interviews with people with CFS/ME and participant observation in a patient-led support group in order to explore the way in which CFS/ME shaped participants’ identities and narratives of the self. I argue that participants moved through two stages that I call ‘The Disrupted Self’ and ‘The Realigned Self’. Falling ill with CFS/ME rapidly disrupted participants’ understandings of the bodies, their position within their family and the community, interactions with doctors, and all the usual markers on which they had previously formed their self-identities. In this state, I argue that participants and those with whom they engaged viewed both CFS/ME and my participants as liminal, ‘betwixt and between’ (Turner 1969) social roles and contemporary New Zealand ideals of illness, the individual, and the ‘sick person’. As the initial disruption and confusion of falling ill subsided, however, my participants worked to develop a new secure self-identity, the ‘Realigned Self’. They move into a normalised long-term liminal state by prioritising their health, adjusting their expectations of their body, developing their own conception of the aetiology of CFS/ME and forming a positive narrative of their new lives. This identity work utilised wider cultural ideals about the active, responsibilised and authentic self; common to late modern contemporary life (Beck and Beck-Gernsheim 2001, Desjarlais 1994, Giddens 1991, Rose 1996). Yet this realignment was often not reflected in the views of my participants’ friends, families and doctors. This illustrates the diverse perspectives and different degrees of liminality that exist within experiences and narratives of CFS/ME and contested illnesses.</p>


2016 ◽  
Vol 24 (2) ◽  
pp. 264-275 ◽  
Author(s):  
Ashley Mai Williams ◽  
Gary Christopher ◽  
Elizabeth Jenkinson

Chronic fatigue syndrome/myalgic encephalomyelitis can limit functional capacity, producing various degrees of disability and psychological distress. Semi-structured interviews explored the experiences of adults with chronic fatigue syndrome/myalgic encephalomyelitis being physically dependent on other people for help in daily life, and whether physical dependency affects their psychological well-being. Thematic analysis generated six themes: loss of independence and self-identity, an invisible illness, anxieties of today and the future, catch-22, internalised anger, and acceptance of the condition. The findings provide insight into the psychological impact of dependency. Implications for intervention include better education relating to chronic fatigue syndrome/myalgic encephalomyelitis for family members, carers, and friends; ways to communicate their needs to others who may not understand chronic fatigue syndrome/myalgic encephalomyelitis; and awareness that acceptance of the condition could improve psychological well-being.


Medicina ◽  
2021 ◽  
Vol 57 (1) ◽  
pp. 43
Author(s):  
Esme Brittain ◽  
Nina Muirhead ◽  
Andrew Y. Finlay ◽  
Jui Vyas

Background and objectives: To explore the impacts that Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) has on the patient and their family members using the WHOQOL-BREF (Abbreviated World Health Organisation Quality of Life questionnaire) and FROM-16 (Family Reported Outcome Measure-16) quality of life assessments. Materials and Methods: A quantitative research study using postal questionnaires was conducted. A total of 39 adult volunteers expressed an interest in participating in the study: 24 returned appropriately completed questionnaires. Patients with ME/CFS completed the WHOQOL-BREF and up to four of their family members completed the FROM-16 questionnaire. Results: ME/CFS negatively affects the quality of life of the patient (median scores WHOQOL-BREF: Physical health = 19, Psychological = 44, Social relationships = 37.5, Environment = 56, n = 24) and their family members’ quality of life (FROM-16: Emotional = 9.5, Personal and social = 11.5, Overall = 20.5, n = 42). There was a significant correlation between the patient’s reported quality of life scores and their family members’ mean FROM-16 total scores. Conclusions: This study identifies the major impact that having an adult family member with ME/CFS has on the lives of partners and of other family members. Quality of life of ME/CFS patients was reduced most by physical health compared to the other domains. Quality of life of family members was particularly impacted by worry, family activities, frustration and sadness. This highlights the importance of measuring the impact on the lives of family members using tools such as the FROM-16 in the ME/CFS clinical encounter and ensuring appropriate support is widely available to family members.


2021 ◽  
Vol 8 ◽  
pp. 204993612110093
Author(s):  
Sonia Poenaru ◽  
Sara J. Abdallah ◽  
Vicente Corrales-Medina ◽  
Juthaporn Cowan

Coronavirus disease 2019 (COVID-19) is a viral infection which can cause a variety of respiratory, gastrointestinal, and vascular symptoms. The acute illness phase generally lasts no more than 2–3 weeks. However, there is increasing evidence that a proportion of COVID-19 patients experience a prolonged convalescence and continue to have symptoms lasting several months after the initial infection. A variety of chronic symptoms have been reported including fatigue, dyspnea, myalgia, exercise intolerance, sleep disturbances, difficulty concentrating, anxiety, fever, headache, malaise, and vertigo. These symptoms are similar to those seen in myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS), a chronic multi-system illness characterized by profound fatigue, sleep disturbances, neurocognitive changes, orthostatic intolerance, and post-exertional malaise. ME/CFS symptoms are exacerbated by exercise or stress and occur in the absence of any significant clinical or laboratory findings. The pathology of ME/CFS is not known: it is thought to be multifactorial, resulting from the dysregulation of multiple systems in response to a particular trigger. Although not exclusively considered a post-infectious entity, ME/CFS has been associated with several infectious agents including Epstein–Barr Virus, Q fever, influenza, and other coronaviruses. There are important similarities between post-acute COVID-19 symptoms and ME/CFS. However, there is currently insufficient evidence to establish COVID-19 as an infectious trigger for ME/CFS. Further research is required to determine the natural history of this condition, as well as to define risk factors, prevalence, and possible interventional strategies.


Biomolecules ◽  
2021 ◽  
Vol 11 (7) ◽  
pp. 961
Author(s):  
Paula Fernandez-Guerra ◽  
Ana C. Gonzalez-Ebsen ◽  
Susanne E. Boonen ◽  
Julie Courraud ◽  
Niels Gregersen ◽  
...  

Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is a heterogeneous, debilitating, and complex disease. Along with disabling fatigue, ME/CFS presents an array of other core symptoms, including autonomic nervous system (ANS) dysfunction, sustained inflammation, altered energy metabolism, and mitochondrial dysfunction. Here, we evaluated patients' symptomatology and the mitochondrial metabolic parameters in peripheral blood mononuclear cells (PBMCs) and plasma from a clinically well-characterised cohort of six ME/CFS patients compared to age- and gender-matched controls. We performed a comprehensive cellular assessment using bioenergetics (extracellular flux analysis) and protein profiles (quantitative mass spectrometry-based proteomics) together with self-reported symptom measures of fatigue, ANS dysfunction, and overall physical and mental well-being. This ME/CFS cohort presented with severe fatigue, which correlated with the severity of ANS dysfunction and overall physical well-being. PBMCs from ME/CFS patients showed significantly lower mitochondrial coupling efficiency. They exhibited proteome alterations, including altered mitochondrial metabolism, centred on pyruvate dehydrogenase and coenzyme A metabolism, leading to a decreased capacity to provide adequate intracellular ATP levels. Overall, these results indicate that PBMCs from ME/CFS patients have a decreased ability to fulfill their cellular energy demands.


BMJ Open ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. e041947
Author(s):  
Pamela G Mckay ◽  
Helen Walker ◽  
Colin R Martin ◽  
Mick Fleming

ObjectiveTo explore the relationship between symptoms of chronic fatigue syndrome (CFS)/myalgic encephalomyelitis (ME) and fibromyalgia (FM). The hypothesis predicated that there would be no significant differences between the group’s symptom experience.DesignA quasiexperimental design. Structural equation modelling (SEM) and invariance testing.ParticipantsMales (M) and females (F) >16 with a confirmed diagnosis of CFS/ME or FM by a general practitioner or specialist. CFS/ME (n=101, F: n=86, M: n=15, mean (M) age M=45.5 years). FM (n=107, F: n=95, M: n=12, M=47.2 years).Outcome measuresDiagnostic criteria: the American Centers for Disease Control and Prevention (CDC) for CFS/ME and the American College of Rheumatology (ACR) criteria for FM. Additional symptom questionnaires measuring: pain, sleep quality, fatigue, quality of life, anxiety and depression, locus of control and self-esteem.ResultsInvariance was confirmed with the exception of the American CDC Symptom Inventory, Fibromyalgia Impact Questionnaire and Hospital Anxiety and Depression Scale (p<0.05) based on five questions. Consequently, it was erroneous to conclude differences. Therefore, the Syndrome Model was created. SEM could not have tested the ACR previously, as it comprised a single data point. Thus, it was combined with these three questionnaires, increasing the data points, to create this new measurable model. Results confirmed no significant differences between groups (p=0.07 (p<0.05)).ConclusionParticipants responded in a similar manner to the questionnaire, confirming the same symptom experience. It is important to consider this in context with differing criteria and management guidelines, as this may influence diagnosis and the trajectory of patient’s management. With the biomedical cause currently unclear, it is the symptom experience and the impact on quality of life that is important. These findings are meaningful for patients, clinicians and policy development and support the requirement for future research.


2021 ◽  
pp. 1-14
Author(s):  
C. (Linda) M.C. van Campen ◽  
Freek W.A. Verheugt ◽  
Peter C. Rowe ◽  
Frans C. Visser

BACKGROUND: Finger plethysmography derived stroke volumes are frequently measured during tilt table testing. There are two algorithms to determine stroke volumes: Modelflow and NexfinCO Trek. Most tilt studies used Modelflow, while there are differences between the two algorithms. OBJECTIVE: To compare stroke volume indices by Nexfin CO Trek (SVINexfinCOTrek) with suprasternal Doppler derived SVI (SVIDoppler) in healthy controls (HC) and myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) patients during tilt testing. These patients may have a large SVI decrease during the tilt enabling a large range of SVI to be studied. METHODS: One hundred and fifty-four patients and 39 HC with a normal tilt test were included. Supine and end-tilt SVIDoppler and SVINexfinCOTrek were compared using the Bland-Altman analysis. Also, the effect of calibrating supine SVINexfinCOTrek to SVIDoppler was studied RESULTS: Supine and end-tilt SVINexfinCOTrek were significantly higher than SVIDoppler: both P< 0.005. Bias, limits of agreement, and percent error (PE) were high with PE’s between 37 and 43%. The calibration procedure resulted in an acceptable variance with a PE of 29%. CONCLUSIONS: SVINexfinCOTrek overestimates stroke volumes compared to SVIDoppler, leading to high PE’s. Calibration reduced variance to an acceptable level, allowing SVINexfinCOTrek to be used for assessment of SVI changes during tilt testing


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