Chronic Fatigue Clinic
The Chronic Fatigue Clinic is aimed to assist patients that have been suffering with tiredness for 6 months or longer, with tiredness being of sufficient severity to interfere with their usual daily activities. The clinic is run by Dr David Tadj, who is a senior clinician at Pioneer Health and has a long standing interest in Chronic Fatigue.
Chronic Fatigue can impose a considerable disease burden on patients and is frequently associated with significant dysfunction and disability. Patients with chronic fatigue are often unable to achieve their full potential in the spheres of work, home and social activities. Unfortunately, there is no single cure as fatigue is a symptom rather than a specific disease diagnosis. The approach taken in the Chronic Fatigue Clinic is to identify the underlying cause(s) of a given patient’s fatigue, and bring about improvement of the fatigue by treating the underlying cause(s) or diagnoses.
The Chronic Fatigue Clinic is a private billing clinic and payment will be expected following your appointment. The fee for a Chronic Fatigue Clinic appointment is $300. A Medicare rebate applies (in most cases) and can be transferred electronically immediately after payment. The typical fatigue assessment cycle will occur over three appointments. Chronic Fatigue Clinic appointments can be made by calling 9842 2822.
In the Chronic Fatigue Clinic patients receive a detailed and thorough assessment of their complaint, to allow the doctor to discover the underlying cause(s) of the patient’s fatigue. This detailed assessment is essential in chronic fatigue assessment and treatment. The assessment takes the form of the doctor taking a detailed history, performing a comprehensive examination and then ordering appropriate investigations for that patient. It should be remembered that 80% of the doctor’s information used to arrive at a diagnosis, comes from the patient history. Investigations, such as blood test and imaging, add relatively little information to the overall clinical picture. Hence the doctor will spend most of his time listening to the patient’s complaint, in order to obtain this important clinical information.
Once this assessment is completed, the doctor can usually diagnose one or several underlying conditions causing or contributing to the patient’s fatigue. Once these diagnoses have been made, the doctor will tailor an appropriate management plan for that patient’s list of diagnosis.
It is because the above process is time consuming and cannot easily be performed in the usual 10-15 minute general practice appointment slots, we have set up our dedicated Chronic Fatigue Clinic. Appointments at this clinic are of 30 minutes duration. Most chronic fatigue patients can be assessed, investigated, diagnosed and provided with a treatment plan over three such appointments. Complex patients may require additional appointments.
Many chronic fatigue patients have availed themselves of alternatives treatments, by the time they present for formal medical assessment of their fatigue. The Chronic Fatigue Clinic utilises an evidence based, best practice medical model. The clinic generally does not recommend alternative or complimentary treatments that are not evidence based. Patients that insist on alternative or complimentary treatments are generally supported in their choice, provided that those alternative or complimentary treatments are safe and not unreasonably expensive.
Chronic Fatigue Syndrome (CFS), also known as “Myalgic Encephalomyelitis”, is a complicated disorder, characterized by extreme fatigue that cannot be explained by underlying medical conditions, lasting for more than 6 months. There are no specific investigations for this disorder. The cause of Chronic Fatigue Syndrome is still unknown, though there are a number of theories as to the aetiology. There are also no specific treatments for the condition.
It is important to realise that Chronic Fatigue Syndrome is very much a diagnosis of exclusion. This means that the diagnosis of CFS should only made after a detailed and rigorous assessment process. It is also our recommendation, that once the diagnosis of CFS has been made for a patient, that this patient should ideally be reassessed periodically. This is because many patients who have been given a diagnosis of Chronic Fatigue Syndrome, including some who have joined CFS support groups, have subsequently been diagnosed with other underlying (and often treatable) medical conditions that caused their fatigue.
Patients who have been given a diagnosis of Chronic Fatigue Syndrome are welcome to book into the Chronic Fatigue Clinic. Our approach will be to provide these patients with the same detailed assessment described above. Our aim is to carefully assess for underlying conditions that cause the fatigue. Usually such underlying conditions, once identified, are treatable.