I went to see my doctor in Barcelona again in August 21st 2006. The reason was that my symptoms had worsened in the last few weeks. This could be explain by various factors:
a) I am starting to work again, and I am increasing the number of days I work to 3, which definitely has an impact on my energy level, I am not always fit to go to the office, and on top of that I am experiencing stress when I am there. Somebody is sitting in my chair and I am switching chairs every week whenever there is a place free. I think I need reinvent a job that I can do with the flexibility that I need with my condition, and preferably in a different environment.
b) Additionally, I stopped with the cycle of antibiotics, and I wonder if that could have an impact and leave my immune system more vulnerable to inflammations due to high elastase levels.
c) Besides, I develop some yeast infection and fungi overgrowth. My doctor in Amsterdam indicated me a cream of Ketoconazol 20mg and Fluconazol 100gr/day until it goes. My doctor in Barcelona agreed with the treatment, although proposed a different doss: 150gr a week during 4 weeks.
Fluconazole is very often given in CFS to decrease the yeast in the intestines and elsewhere in the body. Fungi seem to grow more easily in CFS patients, and most patients get a good benefit from the fluconazole the first time they use it. Certainly the treatment I followed with azithromycin could also have caused some yeast overgrowth.
I took 10 days fluconazol 100gr/day, and it has been effective with the fungi, therefore I have already quit fluconazol, and I only keep on taking the cream for a few days as prevention.
Among the symptoms that have worsened since I do not take antibiotics, the most visible one is the fatigue and the lack of restorative sleep. When I wake up, my respiration acts as if I just run 10 floor stairs, I feel exhausted and with strong breathing. Despite of this, my doctor in Barcelona expects the polisomnography results to be normal, because this exertion after waking up is a very common symptom of this illness and not necessarily will be reflected in the sleep study they just did to me last week.
Another symptom that is worse now is the sore throat, but is also part of the immune dysfunction in the words of my doctor, is not a real faringitis, because there is no pus, there is only inflammation of the throat as a result of an hyperactive immune system to all the aero-viruses that come in through the nose and the mouth. I do not smoke already for 3 years, but I started to smoke socially and very occasionally. She warned me that this is not the time to start smoking because the hydrocarbons you inhale may have a negative toxicity in CFS patients as it has been suspected with other metals such as copper, mercury, etc. So basically, do not smoke in general, but even less if you have an immune dysfunction.
And the third thing that has worsened is the muscular pain and joint pain. This part worries me more, because apart from the general muscle and joint pain, my RSI symptoms are coming back to my arm and my shoulder and that is quite painful when it happens, and this painful symptoms worsen when i am more anxious or stressed.
My doctor has not changed my medication, and hesitated to continue with antibiotics, but decided to wait a bit longer to see the evolution of the symptoms, because it could be just a dip in a fluctuating pattern as it is normally the case.
The only thing She added is a special ginseng that is called Denterococo in order to get more energy. The rest of the treatment remains the same: Antioxidants, Vitamin C, Vitamin B-12, do not work too hard, take good sleep, energy management and rest.