Chronic Fatigue Syndrome Care Program – Providing a Unique Clinically Monitored Evaluation & Management of the Chronic Fatigue Syndrome and Fibromyalgia – Basic understanding of the disease process and Ayurveda -with helpful tips

In this blog we will discuss different aspects we have used to design the Chronic Fatigue Care Program based on our research and how it help the basics understand of the disease and amelioration of the symptoms.

In our Chronic fatigue care program we provide a unique clinical management for chronic fatigue and fibromyalgia patients and its medical evaluation and treatment protocal. We will discuss this in this blog for benift of patients with chronc fatigue and fibromyalgia who are still suffering from the persistent symptoms.

Chronic fatigue syndrome as described by the CDC- Center of Disease Control and Prevention in USA -as the presence of severe chronic fatigue lasting for more than 6 months with no other medical or psychiatric cause. And associated one of the four symptoms from six namely frequent sore throat, tender cervical or axillary lymph nodes, impairment of memory and concetration from basline self reported by person, muscle pain,multiple joint pain without any swelling , post exersional malaise and unrefreshing sleep.

If you or someone you know has this or almost something similar then may having or may in early form of chronic fatigue syndrome. Hope this article help further understanding.

As Chronic Fatigue syndrome is a complex, multifaced problem involvement of muti-organs or system and there is no one specific drug treatment that treats all , we have noticed that patient keep on having lingering symptoms day in and day out. Some live a misearble life it is very severe but keep on working because they are mentally strong but still take toll on them. Many are caring mothers who takes care of family day in and out inspite of severe fatigue they have. Chronic fatigue involes both gender slightly more in females than males. Specially involvment of female gender of young and middle age woman. Men are also involved with this and affecting there personal and professional life. It evntually affects there working capacity socially and professionally and detoriation of health over years. Over the period of years in some it may further progress and in some stays the same with limitng daily activty of the life. We have looking into this and have designed an integrative approach of medical tretment for this complex disease.

Most of chornic fatigue symptom patient when they get medically evaluated don’t have any major disease process but have the persistent functional problem at work and at home and affecting to varying degree of social and professional life. With no specific solution to the problem that they have found that has helped them. They feel very frustrated at times about this and are looking for solution how it may help them. As it is a step by step process and involves multiple steps it becomes a complex solution for many. There is lot of literature around but few clinical practises which has special interest in treatment of patient of chronic fatigue given the labour intesive care and time requirement.

Now lets talk about what needs to be done for a medical evluation for the chronic fatigue so that one don’t have any major disease that needs to be treated. From mordern medical perspective and evluation one needs to rule out any anemia, thyroid disorder, connective tissue disorder like lupus, sleep apnea, sleep interuption, depression, infectious cause like Mono or any drug side effect, cancer to name a few. From the Ayurvdic perspective ( Indian Traditional medical science) one needs to understand one’s own Prakruti ( genetics) and the Vikruti ( imbalance of forces or toxin accumuation in the body) with change in Prana ( energy flow) and Tejas ( normal or abnormal metabolism). We need to intergrate this all to understand the whole body complex of the patient to understand the chronic fatigue that one has and to treat it. By combining this approach the understanding of the disease helps to alleviation of the symptoms.

The above list morden medical work up are some common things that we have seen in our practice that work up has already been done by other health care professionals before we see the patient refered to us . This is a work up already not done then we do it when we see the chronic fatgiue patient to rule out any major disease process they have before we start the Ayurvedic evaluation and treatment. Ayurveda works great in this sets of patients. Goal is to use the multi disciplinary approach to treat the chronc fatigue and fibromyalgia and not to use only one approach as its efficay is less.

In spite of this above diseases been ruled out and still the patient is suffering from the persistent fatigue day in and out with no more relief. As there is no specific one drug that helps all. This are the group of patients that we would like to help and medially treat and do a regular follow up. Our goal with the treatment is to allevate the symptoms, improve the quality of life, improve sleep and digesion and relaxation.

In this group of patient we do a regular medical evaluation and follow up very closely on multiple visits to get them slowly better. We have seen that only a very close clinical follow up in this set of patients works and as they get better a long term follow is needed like 2 year follow up. Many respond very nicely based on what one has and there compliance with medical therapy. The key is a close follow up on regular basis at short interval like every 1-2 weeks intially then every 2-3 weeks and then on monthly basis. A longer duration follow up don’t work as it is difficult to remember things discussed more than 1-2 weeks and its implimenetation in early phases. Body needs to be resynchronized to a new time phase, energy phase and mental phase so there is improvement in the energy level. Because of this longer duration like every 3 or 6 month interval follow up don’t work. This is our observation. Also not every one can learn multiple things in one visit or two. Has anyone learned the whole calculus or math or science in one or two class although one may have the whole text in front of them? This is not even possible for our smarted and most intelligent who are great enginers in their field or army major or professors.

The reason of this chronic fatigue is a complex process of disease is a mutiple involvement of the dhatus or tissue in the body with impairment of the energy flow or Prana in the body. This is a key area that needs to be address and without that chances of improvement is less. The improvement is a very slow process. It is like driving without any accident in a ongoing snow storm slowly but very carefully so we still stay in the lane and dont get thrown out of the road and still reach the destination very careful. This requires lot of discipline and patients. For improvement of the Chronic fatigue if one has more then 5 years then it is a key without which we have seen that it don’t get better. If it does temperatory it relapses back. Goal is to get better and to stay better. It is like one has to loss weight do it very slowly and stay slim after that and not to have regain the weight back in next few months or in year or two.

Once a medical evlaution by a standard medical guideline is done and any major disease is ruled out then one is left with understanding of his/her own disease ( body type or indiviulized treatment) process where we help the patient and it requires mulitple sessions for many hours over in a year and its modification needed and a follow up.

To start the whole process we need the medical records, x-ray , ct scan reports, blood report, medicatin There whole medical record needs to be evaluated completely since there birth to evluate the diseses that happened and drugs taken. It is a very detailed process takes hours to go through so that graually can improve the energy flow or Prana in the body and elimnation of the Ama or toxins. This is a very slow process and time is a healing factor. If combined with correct understanding of the disease that is unique for that patient improvement is seen . Individulized treatment protocal is used and not a group therapy. There is no guarantee that every one improve but we have seen most do improve.

What we have found in this sets of patients is that fibromyalgia is a different set of a disease process from non-fibrromyalgia group of patients but both will be suffering from persistent fatigue but needs to be treated differently. Treatment managment is different with different herbs based on Ayurveda and the different diet management.

We use the examination of the patient’s pulse by Ayurvedic pulse analysis and diagnosis for assessment of the Prakruti ( genetics) , Vikruti ( imbalance) and Prana (energy flow) and organ pulse ( like liver, heart, stomach and its energy flow low or high or normal) . It gives an indepth knowledge of there toxin built up and abnormlity in the energy flow. This is a very key for Ayurvedic analysis in supplements to the questions of symptoms.

Usually there are set of common problem that Chronic fatigue has and its understand may further help to alleviate the symptoms. It is the involvement of the poor digesion, heart burn or GERD, irregular eating and sleeping habits, abnormal elimnation process, sleep interuption, frequent anger or frustration or control issues at minor things etc. This are few to named but other causes like remote drug side efffet etc also needs to be ruled out. Patient may have multiple involvement and each of them needs to be address one by one like unturning the stone slowly with time and to be treated with holistic approach and minimizing the need of the drugs as they cannot digest the drugs including supplements like vitamins.

So if you or some one you know has similar persistent symptoms then a health care professional who provide this kind of understanding with use of standard medical approach combined with alternative & integrative medical approach like Ayurveda can help. Ayurveda is the Traditional Indian medical science which has classified the chronic disease process and how to treat it with use of speicific herbs which is sutable for that body type and disease.

In this article we try to provide the basic of the disease and hope will throw some light on the disease and will help you. If you or someone has persitent fatigue don’t ignor it and needs to be treated. If it persist on long run may affect the sleep, digesion and emotional issues and immunity.

If you see health care professional in your area then ask of do they use this kind of an intergrative medical approach that we have discussed. If they cannot provide then frankly ask them who can provide in your area as not all physician are comfortable treating the chronic fatigue patient.

If you want can always call us if interested to join our chronic fatigue care program at 717-338-9797. It will be a videoconference or telephonic regular follow up if you don’t live around Gettysburg, PA area, USA. Best wishes and good luck.

This entry was posted in Ayurveda, Chronic Fatigue Syndrome, Chronic Fatigue Syndrome Program and Fibromyalgia Care Program, Sleep apnea and tagged , , , , , . Bookmark the permalink.

6 Responses to Chronic Fatigue Syndrome Care Program – Providing a Unique Clinically Monitored Evaluation & Management of the Chronic Fatigue Syndrome and Fibromyalgia – Basic understanding of the disease process and Ayurveda -with helpful tips

  1. Kiran Viramgama M.D. says:

    Thanks for the feed back. We see patient with chronic fatigue and we have used this approach in many patients and has go better. May be next year we will write about the case report. I am glad your family loves the approach.

  2. Kiran Viramgama M.D. says:

    We may consider it next year writing a ebook or research articles or more blog articles. If you have similar blog and want to share info we can do it. I did send you e-mail it came back. If you like then you can send us e-mail :

  3. Kiran Viramgama M.D. says:

    I am not technically sure of that. Tech support may be taking care of that for the website.

  4. Kiran Viramgama M.D. says:

    I am glad you like it. If you have question you can always ask on comment or if you want email : Best wishes

  5. Kiran Viramgama M.D. says:

    This is the clinical approch that is described is what we use in our chronic fatigue clinic and chronic fatigue program. Thanks for the feedback.
    Dr. Viramgama

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