Wednesday, March 26, 2014

2014 IACFS/ME Conference -- Staci Stevens

Effective Management of Activity Intolerance
 
www.WorkwellFoundation.org -- used to be Pacific Fatigue Lab -- now in Ripon CA, with an affiliated site in Santa Ana
 
The Stigma of CFS/ME
 
great reception from physical therapist community -- they educated PTs to not overdo us
 
biological basis for activity intolerance
 
post-exertional malaise -- "this is not a normal response"
at 24 hours, 85% of controls had recovered from the exercise test -- zero of the CFS patients
at 48 hours, 100% of controls had recovered, but only one of the PWCs
 
EVERY other diagnosis can duplicate the results on Day 2, EXCEPT us
 
something is wrong with recovery system, metabolic system
 
objective measures of fatigue:
VT and peak workload and oxygen consumption
 
PWC cannot reproduce on Day 2, substantially less than Day 1
 
this may serve as a biomarker
 
"a broken energy production system"
 
Aerobic exercise -- CO2 byproduct, oxygen dependent, 30-36 ATP per unit of glucose
Anaerobic -- lactic acid is byproduct, no oxygen needed, 2 ATP per glucose
 
she worked with a marathon runner who lost half her capacity with CFS, but her heart rate did not do what a deconditioned person would do -- on Day 2, just walking into the office exceeded her threshold
 
if you can't talk, that's over the threshold for healthies -- CFS always has shortness of breath
 
she cannot cure, but can improve quality of life
 
energy conservation therapy is regularly provided for other sources of fatigue (e.g., cancer)
 
do not know about oxygen delivery, oxygen utliization
 
"for you guys, sitting up is like running a marathon"
 

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