When hardly anything works: chronic fatigue
Going to school, cycling a bit, meeting friends - all far too strenuous. This or worse can be the case for people suffering from chronic fatigue syndrome, also known as myalgic encephalopathy (ME). A difficult, very complex clinical picture.
Chronic fatigue is much more common in adults than in children and adolescents, but can occur from the age of ten to eleven. It is currently estimated that there are around 30,000 to 40,000 children in Germany who are affected, so it's really not nothing.
What is so difficult and complicated about this disease? Above all, the fact that there are still no really clear diagnostic criteria. In other words, there are no blood values that prove the disease, no MRI or X-ray findings that can show it. Ultimately, it is a diagnosis that is made when many, many other things have been ruled out. So thyroid disorders, infections, psychiatric illnesses such as depression - all these things must be ruled out and the child or young person must have demonstrably increased fatigue and exhaustion for more than three months.
In everyday practice - and we are not exempt from this - it is unfortunately sometimes the case that these children are categorised somewhere else far too quickly and no thought is given to this diagnosis.
Treatment is complex and difficult. It should take place in specialised centres or outpatient clinics and is very, very lengthy.
The issue of cause/trigger is also complex. A genetic predisposition is suspected, as is a connection with previous viral illnesses. Other factors, e.g. emotional stress or serious injuries, could also play a role. The causes have not been conclusively clarified.
If you want to delve deeper into the topic, you should read this review by Swiss paediatricians: https://www.paediatrieschweiz.ch/chronic-fatigue-syndrome-bei-kindern-und-jugendlichen-mehr-als-nur-muedigkeit/
Further interesting tips
Child Day Care Act
There is still good news from the bureaucratic jungle! The certificate in accordance with §4 of the Child Daycare Act is no longer required. From now on, parents can simply show the yellow booklet and vaccination card when their child is to go to a community centre or child minder.
Blood sampling
Today we are focussing on taking blood samples. This is not such an uncritical issue in the paediatric practice because very few children find it cool. So here are a few things to bear in mind.
Cough
"Houston, we have a problem," was the emergency call from the Apollo 13 mission. In the paediatrician's office, it's "Cough, do we have a problem?" Because a cough, even a long-lasting cough, does not automatically mean that there is a serious problem.