Chief complaint: Fatigue, lack of concentration.

Western diagnosis: Chronic fatigue syndrome/ myalgic encephalomyelitis (CFS/ME)

Medical history: Male, 48y. On 30th August 2009, he went to climb mountain, walked about 10 miles. Thereafter, he felt very tired.
Unfortunately, he caught common cold at that time too. Three days later, symptoms of cold disappeared, but he felt exhausted, both
physically and psychologically. He even felt tired when walking stairs. Meanwhile, he noticed that his concentration became so poor
that he could only read one page of newspaper. He went to see his GP, and was given the diagnosis of ME. GP gave him Fluoxetine
(anti-depressant), and told him to take some gentle excise. He followed, but without any improvements.

He had one similar attack in January 2009 after a trip to Spain, recovered 4 months later with the help of CET. Therefore, this time he
went back to CET again, unfortunately no magic the second round. By the time he came to me, he had had 12 weeks off-work.


Symptoms on first visit: Fatigue/exhaustion, not even alleviated after good rest, worse in the morning; could walk for 10 minutes most
days, some days, he could shower and come down stairs but could only walk back up later in the day. Unable to leave the house on
most days. Insufficient concentration, unable to read the front page of the paper, unable to drive. Poor memory, palpitation, weak
legs, poor sleep, normal appetite, urine and stools. No obvious sore throat, arthralgia, and skin rashes.

He has common cold almost every year, and normally has cold hands.

Has hyperlipidemia history.

Pulse exam: deep (in Chi part), weak (in Cun part)

Tongue exam: pink tongue, thin white coating, moisture.

TCM Diagnosis: Xu Lao (Spleen and Kidney Qi deficiency, disharmony between Yin and Yang)

Point Prescription: Sishencong (EX), Hegu (LI4), Zhongwan (RN12), Qihai (RN6), Guanyuan (RN4), Zusanli (ST36), Sanyinjiao (SP6)

Herbal Formula: Yang Dan Tang (self-prescribed formula)

Lifestyle prescription: take a nap (20-30 minutes) around noon; sun-bathing back (sitting or lying with back towards the sun) if
possible.

Results:  

Stage one (29/10/2009 – 03/12/2009)
Less tired, physical strength recovered 50%, he could go out for a walk about 15 minutes everyday. Concentration improved
(recovered 40%). Had one fit of cold during this time, recovered 2 days later without taking any medication.

Stage two (04/01/2010 – 18/02/2010)
He was in a much better state of mind. He could read for 2 hours consecutively. Physical strength recovered 60%, could walk 20-25
minutes everyday. Since the beginning of this fit, he could only drive 10 minutes with the company of his wife. However, at the end of
January he drove 40 minutes to Bolton, still with his wife’s company, but without any discomfort during the whole journey.

Stage three (25/02/2010 – 13/05/2010)
Physical strength recovered 70%. He walked 40 minutes everyday for exercise, plus 15 minutes Qigong practice in the morning. From
29th April, he started driving to work unaccompanied and working 2 hours a day.

Stage four (27/05/2010 – 24/06/2010)
No symptoms at rest. His working hours had been increased from 2 hours per day to 4.5 hours to 8 hours. He felt he had a nearly full
recovery both physically and psychologically, although still had reaction after strenuous physical activity. He went back to work full-
time (office work) again.

Diagram below shows the improvement of his condition according to Dr. Charrles Shepherd’s CFS Disability Scale.























Link to YouTube video made by patient himself
http://www.youtube.com/watch?v=i9odMty8iAg
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Case Studies -  Chronic Fatigue Syndrome (CFS/ME)