CFS

I recently completed my paeds placement on an oncology ward at a children’s hospital. My patient for my final assessment ended up being a teenage girl with chronic fatigue syndrome – the fact that my assessment pt was not an oncology patient and she had a condition I’d never treated before is another issue that I won’t go into now… So, having never treated a pt with CFS before, I was pretty nervous before my assessment and I’ll admit I also had some preconceptions about this patient before I had even met her.

The concept of someone missing a month of school only to sit at home sleeping and watching tv all day was quite foreign to me. Admittedly, I’m not the most motivated person I know, but I just couldn’t grasp the notion of this syndrome. My initial thoughts were to get her into physio and work her hard in hope that she’d ‘snap out of it’ and realise that her behaviour was inappropriate. But as I read further into her notes and when I met her, I discovered that her father had CFS for 15 years (having a close relative with CFS is one of the classic clinical presentations of pt’s with CFS). I realised that it was only natural for her to behave in the same way she had seen her father behave her whole life. When we had our first session together, in the subjective the patient described all the activities she wants to get back into and gave me a perfect list of goals of rehab that were actually SMART (specific, measureable, etc, etc). So it seemed like this girl was aware of her condition and knew that things had to change, she just needed some extra help to get her there because she wasn’t able to get it at home.

I only saw this patient once but even in that one session I gave her exercises to do on the ward outside of physio which she happily agreed to. It’s possible she was just doing an act on me by falsely leading me to believe that she would do them, but I really hope for her sake that she was compliant with the rest of her rehab and can get over her condition. I feel that I learnt a lot from this situation because I was a little judgement initially, but after this experience I’ve learnt not to have any preconceived opinions about patients and simply treat the patient that presents to me on the day.