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Extracts from
This excellent Australian book by Jacqueline Finch, herself a CFS survivor, covers many issues of importance to people living with Chronic Fatigue Syndrome, including symptoms, diagnosis, stress management, food and chemical intolerance, undertaking study, Australian Social Security benefits, accommodation and employment. Throughout the book quotations from the stories of CFS sufferers illustrate people's real experiences in dealing with these issues. The book contains 289 pages of helpful information and advice.
GETTING A DIAGNOSIS
What constitutes a diagnosis of CFS?
The cost of getting a diagnosis and receiving treatment
Communicating with your doctor
List of rights concerning your doctor
Other medical services available (in Australia)
MANAGING IGNORANCE, CRITICISM AND DISBELIEF
Ordering details for this book
Getting a diagnosis is not easy, though it is one of the most important things to do for yourself and your recovery. If you suspect that you may have Chronic Fatigue Syndrome, it is vital that you see a doctor who has experience with this illness and who also believes that this is a physical rather than a mental illness. If you continue seeing a doctor who either does not believe that Chronic Fatigue Syndrome is a legitimate illness or who has the best intentions but knows very little about the diagnosis or management of this illness, then you delay receiving a diagnosis one way or the other.
Not knowing just what is wrong with you can be very disempowering. You may find that you believe that it is 'all in your head' and you are 'going mad'. Uncertainty about what is happening is a shortcut to profuse worrying and may leads to depression which, in turn, may lead to feelings of suicide. However, getting a diagnosis can be quite a relief.
When I finally got a diagnosis I felt many things. Relief ... as I finally knew that others would believe me now that I had a diagnosis. I was sane because it was an illness. I also felt like I had something to work with, that at least now I knew what was going on and I could do something about it. I was able to deal with my confusion by reading books about this illness and getting appropriate help. - Louise, aged 35.
You can find a doctor who has experience with this illness by either asking others who have Chronic Fatigue Syndrome to recommend a doctor to you or by contacting the M.E./CFS Society in your State.
Getting a diagnosis of Chronic Fatigue Syndrome is often very difficult. This is due to a variety of factors. Doctors may not know what is happening to you, your symptoms may present the picture of another illness or be viewed as psychiatric in origin, or your doctor may quite simply not want to give you a diagnosis due to the 'effect it may have on you'. To be correctly diagnosed with Chronic Fatigue Syndrome the following criteria must be met:
It is a good idea to see a doctor who bulk bills as it can be very expensive if you need to visit often or need extensive blood or allergy tests. There are a number of doctors and other professionals who work in the area of Environmental Medicine. Some of these doctors do not bulk bill but you can claim the cost of the consultation from Medicare. However, Medicare will only refund to you the standard consultation fee which is often very much lower than what some such doctors themselves are charging as their consultation fee. Some people with CFS say that these doctors have helped them immensely; others disagree. It is not productive for me to enter the debate. My advice is that you inform yourself on everything that a type of treatment entails before embarking upon it. You can contact your M.E./CFS Society to ask their advice.
It is worth remembering that most people get better or improve with time, so to conclude that one of the many therapies attempted was specifically beneficial is often difficult.
I went to an environmental medicine 'doctor' (he wasn't a real doctor) and was told when I made my appointment that it was $85 for a half hour consultation. I was very sick and had tried many avenues so I thought "What the heck. I'll go." Be warned. I paid much more than the consultation because I was told that I needed many specialised vitamins and tests that were only available from this surgery. The vitamins had this doctor's name on the packaging. I saw this doctor about four times and it always cost me between $250 and $400. I stopped going because I couldn't afford to see him and because he wasn't a medical doctor I couldn't get any money back from Medicare. I couldn't honestly say he made me any better either. Maybe he would have in time but I couldn't afford his fees. - Peter, aged 30.
I went to Dr ___ (name omitted) who fixed up my allergies and made me feel heaps better. I had to have many tests and make big changes to my diet as well as have lots of intravenous vitamins. It took a long time and was very expensive but I think it was worth it. - Gay, aged 21.
It is very important to be able to communicate openly with your doctor. It is not good for your health and peace of mind to go home after a consultation with your doctor with many questions unasked. I believe that the more you know about your illness the more control you have, even if that only means making the decision to rest.
When I became ill I made a plan to put everything on hold, look after myself and rest, rest, rest. Because I knew that this was not going to be the year that I returned to work full-time and all my other pursuits, I gave myself permission to stop worrying and let myself rest. This wasn't easy all the time but knowing what the future was likely to be and what I could do to help myself, helped immensely. - Joan, aged 37.
It is important to remember that your doctor is not psychic and that he/she needs you to tell them what is happening. One way that I found useful in the beginning of my illness was to keep a 'symptoms list' and tick them off every day. This allowed me not to expend too much energy trying to explain what I often found hard to articulate. It also helped me remember what the previous week, fortnight, month had been like.
A 'symptoms list' will allow your doctor to understand your general of state of health at a glance. A 'symptoms list' will help both of you notice patterns in your symptoms. For example, you may not always have a sore throat but find that your thinking is always fuzzy when your throat is sore and your lymph nodes tender. I believe that the responsibility for good communication lies equally between you and your doctor. However, if you feel that your doctor is not listening to you, doesn't believe you, patronises you or doesn't respect you, then change your doctor. After all, you are paying them to provide you with a service. If you were unhappy with the quality of service from your hairdresser, you would not hesitate to try another. Why should a doctor be any different?
It is important that your doctor be honest with you. Although it can be disappointing, it is, in my opinion, preferable that your doctor say that they are unable to help more than support you and offer symptomatic relief whilst the illness takes its course. The responsibility for communicating with your doctor rests between the two of you.
My doctor gives me the impression that he feels let down by the fact that I am not significantly improving. There have been times when he has been obviously annoyed that an intervention hasn't worked. This is okay but more often than not I support him by minimising what is happening to me. - Sarah, aged 40.
Having my doctor explain to me that nothing more can be done at this stage and that all I can do is continue my current treatment and rest was a relief. When he said that this was the score and explained to me how I could help myself, I felt okay. It enabled me to work out a recovery plan. I still see my doctor for my usual treatment. Now we talk about my progress and how life is for me now rather than "I'll do this test on you," or "Go see this person." I am grateful to my doctor for his honesty. - Pen, aged 27.
You have a right to choose your own doctor.
You have a right to seek a second or third opinion.
You have a right to change your doctor.
You have a right to ask your doctor questions about your health and/or treatment.
You have a right to cease any treatment you are not happy with.
You have a right to say no.
You have a right to tell your doctor that you disagree.
You have a right to be listened to and treated with respect by your doctor.
You have a right to ask your doctor for a referral to a specialist of your choice.
Women's Health Centres: Women's Health Centres offer a range of services such as doctors, family planning, counselling and alternative therapies like acupuncture and massage. All centres bulk bill for medical treatment and are subsidised for other treatments. Some services are free to women who are income assessed, although donations are accepted. You can find Women's Health Centres listed in the phone book.
Community Health Centres: Community Health Centres offer similar services as Women's Health Centres, though the services may differ from location to location. They bulk bill and offer other services such as counselling for free. You can find Community Health Centres listed in the phone book.
Psychiatrists: As Psychiatrists are able to offer bulk billed services, they are often more financially accessible to a person who is on Sickness Allowance or the Disability Support Pension.
Psychologists: As they are unable to bulk bill they can be very expensive particularly if you intend to see them over a long period of time. At the time of writing, psychologists' fees range from between $60 to $90 per hour. Fees may be negotiable depending on the provider.
Specialist doctors: These doctors generally offer bulk billed services. If not, their fees are mostly reclaimable from Medicare. Specialists of relevance to people who have Chronic Fatigue Syndrome are immunologists, endocrinologists, allergists, neurologists and physicians.
Your local hospital Accident and Emergency: To use in an emergency. There have been various reports, both positive and negative, of experiences going to Accident and Emergency Centres for CFS related problems. If you expect that the staff will manage your prevailing problem rather than understand the bigger picture of Chronic Fatigue Syndrome, then you won't be disappointed.
I went to a doctor at a medical centre near where I live one evening as it was late. I was sick and my usual doctor was not available at that hour. I told him that I had an incredibly sore throat, was losing my voice, was unable to fully open my mouth and told him that I thought I either had the flu or wisdom teeth problems. I also told him that I had Chronic Fatigue Syndrome and had been experiencing an acceleration of my symptoms which was concerning me. I tried to describe the feelings of overwhelming weakness, the draining of energy from my limbs, the dizziness and the feeling of not having enough energy to breathe. His response was to say that I was experiencing panic attacks and should increase the medication I am taking to stop my heart from racing. (My pulse rate was normal). I denied that I was experiencing panic attacks and said that my experience of doctors was to compartmentalise certain symptoms as panic attacks and that I was not suffering one. Regardless, he remained fixed and rigid in his assessment. I found his insistence that I was having panic attacks because I had a cold immensely patronising. His final diagnosis: viral laryngitis/pharyngitis. No treatment.
The next morning I went to my dentist who on hearing of my symptoms (sore throat, loss of voice and unable to fully open my mouth, immediately diagnosed an infection around the wisdom tooth. This was confirmed on oral examination. Apparently, these are standard symptoms for an infection around the wisdom tooth. Treatment: antibiotics.
So, in reality, it was quite normal for me to experience an acceleration of my CFS symptoms as my body was fighting an infection. I wrote to this doctor with my complaint and the final diagnosis. My hope is that the next time someone with Chronic Fatigue Syndrome goes there and tries to explain what they are feeling like, he might think twice, listen and maybe admit that he does not know, rather than glibly making a diagnosis.
I tell this story because I believe that there are a significant number of doctors who do not believe that CFS is a legitimate illness. If you feel that you are not being listened to, not taken seriously or you suspect that something other than what they diagnose is causing the problem, seek another opinion.
Trying to explain symptoms like these to doctors was of course awful. I'd start describing them and see a look come into their eyes as though they thought I was either a terrible hypochondriac or else a bit or a weirdo. I was also seeing a naturopath at this time but whilst being sympathetic and understanding of my problems she did not help much with the symptoms. - Kate.
My specialist told me to exercise. His advice ranged from “take a walk around the block and if you feel okay increase it by another 300 metres the next day” to “get a personal trainer and do exercises to increase your aerobic capacity.” At that stage I was already walking around the block or to the shops and back, so I decided to make inquiries regarding a personal trainer at my local gym. A personal trainer was going to cost me in the vicinity of $800 for six one hour sessions. If I could last the one hour sessions there was no way I could afford the cost!
Resources that I have read on M.E./CFS contain conflicting advice. Some advise gentle exercise, some say do not. Well meaning friends who do not have M.E. and have no idea that on many occasions I have difficulty doing the basics, like lifting my arms, suggest that doing a one and a half hour yoga session regularly will recharge my energy and I will feel better because they do.
The voice inside my head tells me that lifting two kilo weights will help me get my strength back. Dutifully, I try using these once in a while, amazed that I can’t even get through the suggested warm-ups.
One week I felt so good that I decided swimming was the exercise for me. So never doing things by halves, I purchased a block of twenty-five entry tickets to my local pool, planning to go there three times a week. I was going to tone up, get fit, increase my strength and my aerobic capacity and I was going to enjoy doing it. Knowing how small my threshold for exercise was I took it slowly. I swam four lengths of the pool very slowly over a period of an hour with a long break in the middle. I honestly believed that I was not over-doing it. Prior to becoming ill I used to swim a lot, so I viewed my four slow laps as a very gentle reintroduction to the water. I was shaky when I got home, but was totally unprepared for the relapse that lasted six months or so. I haven't been swimming since!
Many months later a friend lent me her rowing machine. I tried it a few times and then spent hours lying down getting over the experience. I had it at home for another month, often sitting and staring at it, before I returned it.
So, feeling the internal and external pressure to exercise and not being able to meet even the basic expectations of myself and others, I have had to rethink what exercise means to me. As I am not confined to bed with this illness I was able to enumerate my daily movements and see this as exercise. Every time I walk up and down the stairs at home I see this as exercise. To me ALL housework is exercise. Vacuuming, cleaning the bath, hanging out the washing. When I do the shopping I give myself a ‘brownie point’. Sometimes I do a small amount of gardening. When I am feeling up to it I take a walk down at the water near where I live or simply walk a block two around my neighbourhood. Any one of these on any one day is enough for me, otherwise I overdo it and pay for it.
I have noticed that my capacity for exercise, especially walking, changes from day to day, week to week. There are times when all I can do is get out of bed and lie on the lounge downstairs. Consequently, shopping or housework is out of the question. On such days I take it easy. Sometimes I have to do nothing for weeks on end. When I’m feeling as though I have some energy in reserve, that’s when I go for a walk.
I have also noticed that the less physical energy I expend, the more I am able to do. If I go out to have dinner with friends, it is better that I do not have to walk too far from the car to the restaurant. If I do make the mistake of walking too far, I don't have the energy to enjoy the company, the food or tolerate the noise around me. Staying there any longer becomes a struggle and I just want to go home and lie down.
While at a university residential last year I hired a motorised scooter to carry me the long distances between lectures, the dining room and my accommodation. I underwent months of having a mental and emotional struggle with myself about being openly and visibly disabled, but I had literally no option except to hire this scooter. When we picked it up I almost cried and when we got to university and I got on it I felt so conspicuous and anxious. I wanted to go home immediately. The next day I was in love with it. It gave me so much freedom. Although I was highly visible on it I would have been just as visible limping around trying to cover the distances involved. This way every one accepted that I was disabled, but didn’t ask too many questions though I did confuse them when I drove up to the dining room and walked in like nothing was wrong with me!
While my fellow students were walking the kilometre to the next class and sweltering in the heat or getting blasted by the rain, I was zipping along beside them or roaring full speed ahead just for the fun of it. I couldn’t count the number of people who said that they were jealous and wanted one too. Having this scooter allowed me to keep energy in reserve and be able to participate with minimal ‘brain fog’ in the classes. I always had a ready seat as well, so I didn’t have to stand around waiting for things to begin.
Doing the shopping in the morning can, and usually does, totally wreck me for the rest of the day and usually the following day as well. The scooter, much to my amazement helped me cope with the rigours of participating in the university programme. Yes, I was exhausted on day three, but was able to manage the further two days required. Yes, my overall health and energy levels deteriorated for months afterwards, but being able to complete my studies made it worth it.
This was a big lesson to me. I found that if I don’t push myself physically (and almost everything is pushing myself) I can do a lot more which in turn gives me back some of my quality of life. When my body is not too tired I find that I can think and express myself better.
A friend who has had CFS for seven years and who doesn’t ‘exercise’ at all said to me that she consumes 100% and more of her capacity in doing only the bare essentials. When I look at myself I have to agree that this applies to me also. ‘Deliberate exercise’ at this stage in my energy levels would only serve to send me backwards. Experience has taught me that. I just can’t push myself in any way whatsoever at this stage of the illness.
I did hear a specialist at a seminar recently say that people with CFS should NOT exercise during the acute stage of the illness, but increase their exercise after that stage has passed. I agree. However, I think it is of utmost importance that you decide what and how much exercise you can do. If walking to the bathroom and having a shower is as much as you can manage, then do only that much. Don't try to push yourself by attempting to do that little bit more. The aim is to retain as much mobility as necessary to give you a decent quality of life. As your health and capabilities improve, then you can increase your overall exercise.
As CFS is characterised by recurrence of viral symptoms, ie. ‘flu-like symptoms, aches and pains, ‘brain fog’ etc, when I have a flare-up of these symptoms I personally try not to do much at all. I just simply let my body take time off while it is dealing with this flare-up. When this has passed I start again. It seems to me that the problem with people who have CFS is that when they have some energy they go overboard, using it all up and then paying for it by having a relapse. Motivation and desire is not the problem. The problem is trying to not overdo it when there are no clear guidelines as to how and when one has overdone it. As a friend once said to me: “My body keeps changing the goal posts and I don’t know which way to go.”
Over the past five years that I have had CFS I have more or less come to understand what my personal limits are in regards to energy output. Someone once told me that I should not do more than 75% of what I think I am capable of. For a long time I tried to keep my energy output within this guideline. In reality though I can only achieve around 50% of what I want to do before rapid health decline sets in. Being mindful of your particular energy capacity and trying to keep just that little bit in reserve helps to prevent a relapse.
It is also important to realise that ‘brain exercise’ such as reading, thinking, holding conversations etc also use up energy and overdoing it on this level can also cause an exacerbation of your symptoms and cause a relapse. Monitoring brain output is much harder to measure than physical expenditure of energy though there are some clear-cut pointers that will let you know when you are overdoing it. ‘Brain fog’ is where you feel that you are ‘thinking through cotton wool’, when it is hard to get your thoughts together, when you find that you can’t find the words or when you can't follow or understand the conversation, when you start to feel mental strain and get a headache, when your eyes have difficulty focusing and you feel irritable. A11 these are signs that it is time stop, close your eyes and rest. Decreasing energy output also includes mental output, not only physical energy expenditure.
It is particularly important that you do as little as possible in the early stages of the illness, as ‘aggressive rest’ at this stage is thought to determine more favourable outcome of the illness as a whole. Trying to push through continuing to work or exercising to get through it will only serve to prolong the illness and more than likely increase the severity. When in a relapse it is also vital that you rest as much as possible.
The Prince of Wales Hospital (Sydney) team of specialists dealing with CFS recommend that people do stretching exercises daily. They do not recommend exercise when in the acute stage of CFS, during a relapse or that you push yourself ‘beyond the wall’. They recommend that if what you did makes you feel bad tomorrow or if you are unable to repeat it, then you have done it and need to cut back accordingly. The aim is to get to do a comfortable amount daily without sending yourself backwards physically.
Many people who have CFS can do more exercise than I can at the moment. Many come nowhere near being able to do what I can. That is the mystery of this illness. It affects us all differently though there are many points of similarity. Listen to your body and let yourself be the best judge of what are capable of doing at any given time. Try not to let guilt, unrealistic expectations or other people force you into what you know is overdoing it. I do think that it is a good idea to include in your daily routine gentle stretching and walking when you are on the road to recovery. What and how much you do should be governed by your body, not some regime that is designed to get you from point A to point B. There is no magic answer to how much exercise someone with CFS should be doing. Unfortunately the majority of us find out the hard way by doing too much and subsequently suffering for it. Remembering to rest and to reduce energy expenditure by at least 40% will go a long way to helping you discover what your limits are.
I have walked as much as physically possible throughout the illness, although there have been weeks when this has not been possible. My husband and I had been walking for years prior to the onset of my illness, and have continued to make this a priority in our lives whenever possible. The level of walking naturally varies according to my condition at the time, but can vary from a 5 km brisk walk two to three times a week to 500 m once a week when on a low ebb. I believe this has been an important part of my mental, as well as physical, well being. - Glenda, aged 47.
[Before I became ill] Very active, land holder, sailing, squash, bushwalking, swimming. Now occasional quiet walk, swim. - Frances, aged 48.
For exercise I try to swim most days for twenty mins or so, Just normal walking around a shopping centre, or through my big house, vacuuming etc. and a little gardening. I certainly can't play tennis any more. - Jane, aged 65+.
This is not possible. I would love to walk but I am too slow and suffer the next day. I did try swimming for a while but that also didn't work. I find that the only exercise I get is cleaning the house and sometimes a bit of time in the garden. On bad days I find myself very immobile which is very frustrating and even on my better days I cannot move freely. - Ann, aged 39.
Exercise is confined to a walk of about 1 km which I manage most days (moving very slowly). This takes about half an hour and seems to be the limit of my physical activity at present. - John.
People who are ignorant about how Chronic Fatigue Syndrome affects the person who has it, who don't believe that it exists or who believe that they have the answer to what you should do to get better can be very cruel. Sometimes this is unintentional and, despite being hurtful, is well meaning. Sometimes their comments reflect their fear. Either they are afraid for you, afraid for themselves or they have great difficulty coping with the concept of chronic illness. Sometimes people will use your illness as a way of getting back at you and deliberately set out to hurt you. They may be jealous if you are not working or jealous of you receiving Sickness Benefits or having a Disabled Parking permit or they may be just having a bad day and lash out at what is an easy target - you. Sometimes they are simply self-righteous and believe that they know better than you. No matter what their motive is, being on the receiving end of 'advice' and/or criticism can be emotionally very painful. It can shatter your confidence.
It is hard to articulate how this illness affects you when you have an open and sympathetic ear. It's harder when you face self-righteousness, disbelief and antagonism. Five years into the illness I have been reduced to tears after being told what to do by a friend who insisted that he knew what was best for me, despite my trying to tell him what my pain and energy levels were like. I felt demeaned and invalidated. I felt as though he did not listen to me. I came away feeling that he held the opinion that I was lazy, unmotivated to change or take action to improve my health. I also felt that he did not believe that I was either ill or disabled. I was personally very surprised at becoming so distressed during the interaction. I had thought that after five years I would be able to protect and defend myself from a situation like this. I was wrong.
Being aggressively challenged by anyone about CFS can be a nasty and harrowing experience even if you feel that you have prepared yourself for such eventualities of life. The bottom line is that anyone who attacks you openly or covertly about CFS is saying to you that you are wrong, that you are unable to effectively manage your life, that you are lazy or unmotivated, that your experiences are not real. Those people who repeatedly try to give you advice are insinuating ignorance or lack of research on your part. Disbelief and antagonism also have a negative effect on those close to the person who has CFS, such as partners and family.
I am personally sick of people who proceed without invitation to give me advice about what they think I should do to get better. I have noticed that they cannot seem to get beyond the "F" word. All they seem to focus on is the fatigue, and with that in mind, proceed to give me advice.
I think there is an enormous difference between chronic fatigue and Chronic Fatigue Syndrome, though they do not seem to be listening when I explain the difference. I am sure that, if I used the term Myalgic Encephalomyelitis to describe my illness, I would not be subjected to unsolicited advice as they would be overwhelmed by imposing medical terminology. However, Chronic Fatigue Syndrome seems to be a community accessible term and, as such, seems to give licence to many healthy lay people to become instant diagnosticians and therapists. I sometimes feel that the only way I can stop people trying to tell me how to run my life is to become aggressive. I generally do not, but sometimes it gets close.
An interesting observation is that, on the most part, friends do not ask how they can best understand or help me. They just become experts and proceed to lecture me on what I should do. I understand from speaking with others who have a chronic illness that this is a common experience.
I would not wish this illness on anyone and I know that it is difficult for anyone who has not experienced the overwhelming fatigue that is CFS to understand just what it is like and the extent to which it impacts on a person's life. I just wish people would refrain from pontificating on medical matters and offering gratuitous advice. It would be good not to talk about my illness. I generally do not bring it up, but when I do, it would be nice if they could simply listen to what I was saying and maybe accept that they do not understand. I, like everyone else I know who has CFS, have tried almost everything possible in an endeavour to get well. We have become educated about our illness. We have done research and we have made the necessary changes in our life. I would ask that, rather than assume that we are unmotivated or uneducated about our illness, people stop and listen to us and refrain from passing judgment.
I have had a variety of advice and comments regarding my management of CFS from friends, acquaintances and professionals. The following are some of the more memorable:
Doctor: "Have a baby."
Friend: "How much of it is psychological?"
Friend: "I get tired too!"
Friend: "You need to have a holiday."
Friend: "You sleep too much. That's why you are tired."
Friend: "Eat more garlic."
Osteopath: "Try running around the block."
Acquaintance: "All you have to do to get rid of CFS is raise your level of consciousness."
Acquaintance: "Have you tried _____ (product name omitted)? I had CFS for many months and took (product) and was feeling better within five hours and back at work after ten days."
I have found that being on the receiving end of comments like these seems to put me on the defensive. I have many times tried to explain what CFS is like for me only to go home feeling angry and frustrated. However, it is a fact of life. People just don't know and often feel that the advice they are giving you will help to make you feel better. Also many people who have 'miracle cures' don't really have CFS at all.
It is important to remember that being chronically ill often makes us feel vulnerable and this vulnerability is what makes us take these comments as personal criticisms. Sometimes it is criticism, but how we deal with these comments and how much they whittle away at our confidence and self esteem is entirely personal.
Mother: "Oh. Medibank pay for your treatment. Do they consider it a real illness then?" - Sharon, aged 45.
Father: "It's all your fault for being a fat slob and not getting off your backside and getting back to work." - Clypei.
I'm a secondary school teacher with CFS. I'm trying to hold down my job. When I explained my two week absence to my boss he said: "I've seen it in many women your age. Why don't you stay home and have babies. Your hormones are playing up." - Joy, aged 30
I have not had too many bad experiences with people telling me to 'get well'. Most of my friends sympathise and do all in their power to help. My family have always been totally understanding and supportive. Only one friend has insinuated that I should pull myself together and get on with things, but I take no notice and only hope sincerely that she never finds herself in this position. - Ann, aged 39
Reproduced by kind permission of the Author
Copyright Jacqueline Finch, November 1995
Energy in the Red: Living with Chronic Fatigue Syndrome by Jacqueline Finch, 1995
Available from the author:
Jacqueline Finch
PO Box 868
LEICHHARDT NSW 2040
Australian orders: send cheque or money order for $25 plus $3 postage per
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Also available from: the
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