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According to Derek Enlander, M.D., "I consider exercise from different points of view with FM and CFS. CFS patients’ prominent symptom is fatigue. This word is not truly descriptive of what these patients feel. When we use the word fatigue, the average person typically thinks tired from activities such as work, physical exertion, or lack of sleep. CFS patients feel a different type of “fatigue.” At times, they feel they cannot lift an arm or leg without significant effort. Their energy base is depleted. Therefore, I suggest my CFS patients do only slow, very graded exercise. Exercise is a very slow and tedious but necessary aspect of recovering to a more productive level of functioning. If CFS patients overdo exercise or any physical activity, immediate repercussions typically occur. At times, CFS patients do have spurts of energy and typically overdo because suddenly they can do things. One of the hardest obstacles to learn with CFS is to find balance in all things. Patients walk a fine line regarding exercise and physical exertion. CFS patients have relapses that often last for several days before they recover. I tell patients to follow this rule: “only do 50% of what you think you can do.” I prefer my CFS patients to begin with stretching exercises, then begin walking perhaps a block or to the end of their driveway and back if necessary. Walking can be done at their own pace, place and distance, so as to not overtax their bodies. Then, very slowly progress to 2 minutes twice a day with exercise that is not of a strenuous nature, but include something different." (Source: www.ImmuneSupport.com. Originally published in Pro Health's Healthwatch CFS & FM Treatment Guide. To read the complete interview online, click on the following link: Derek Enlander, M.D., on the Treatment of Chronic Fatigue Syndrome and Fibromyalgia.)

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