Causes: A Mash Up with Mayo Clinic’s Guide to CFS
Scientists don't know exactly anything. Maybe it’s that horrible
hookup from 1988—can you call it a hookup if there was no up.
Scientists don’t know why your nerves respond one way
while your lover’s respond another. They don’t know half
of what the brain can do, and there’s no money
in what causes chronic fatigue syndrome. It may be a combination of factors—
your fatness, the Twizzlers that caused that, your hatred
of birds, Coldplay, Holly Hunter, and almost all Spielberg films.
It may be that candy bar you lifted from the convenience store
or the day you skipped school to sit in a deer stand with your dad.
It may be the hunt shack where the carcasses swayed like heavy bags
and the floor sloshed with blood and hose water. It may be the iron
taste that place left in the back of your throat. It might be anything.
Anything might affect people who were born with a predisposition for the disorder.
Some of the factors that have been studied include:
Suspicious viruses to which no conclusive link has yet been found.
Immune system problems—but it's unclear if this impairment
is enough to actually cause the disorder.
People who have chronic fatigue syndrome also sometimes experience
abnormal blood levels of hormones, but say you’re middle-aged
anyway, say hypothalamus, pituitary glands or adrenal glands.
But the significance of these abnormalities is still unknown.
Think of your body as Stonehenge. At least in the right light,
you cast some stunning shadows. Now if only the sky would clear.
You might be at risk of having CFS if
1. Your blood is the soft blue on the inside of a clam shell.
2. You’d gladly walk out into the December sea, let it steal you.
3. You think that might be the only way to see God.
4. That is only on days you believe.
5. On the other days, you get out of bed anyway.
6. You know the difference between this pain and depression.
7. You are a middle-aged woman who works hard to look 35.
8. You know you can’t pull that shit off much longer.
9. Your uterus is unused.
10. Also unused: salad forks.
11. Difficulty managing:
b. kitchen knives
c. peanut butter jars
d. shoe laces
e. a tooth brush
f. the grocery cart
g. the snow shovel
h. the old yellow dog’s death on a week your husband was away on business
i. the imaginary crashing of every plane your husband steps on to
12. Difficulty stating the precise difficulty.
13. Sex is a factor:
a. having more won’t help matters.
b. having more makes you more fatigued.
c. having any makes you more fatigued.
d. thinking about having any makes you more fatigued.
e. you cannot remember more fatigued than what.
14. Once a horse brushed you off against a low hanging limb, you chose the fall to the grass, but only after the branch concussed you. You had to get back up on the horse to get home. It was Iowa. The grass was tall. If only you could have lain there and slept for a bit. If only you hadn’t thought it was such a pretty day for a ride.
Treatment focuses on symptom relief. There are 8 diagnostic symptoms. You have 32. You may need a cookie. You may need a glass of zinfandel. You may need yoga or Tai Chi. You may need your head examined. You may need your nose pierced. You may need several hours of Unsolved Mysteries. You know you need roller skating, the strobe-glittered circles, the Sugar Hill Gang, The hippie to the hippie, the hip hip a hop, and you don't stop, your moves smooth even skating backwards in the opposite direction.
Creating Your List of Questions in Advance Can Help You Make the Most of Your Time with Your Doctor
How can muscle fatigue hurt like seeing a room
full of kids coupled in make out corners or spinning
a bottle, like watching them smoke and split
a Schlitz, when you’re the Dead Dad girl
who leaves the party with two boys—just friends—
to see who can leap the farthest off the swing,
who can catwalk the top beam of the swing set
without falling, who can remember the correct words
to Does Anybody Really Know What Time It Is,
who can harmonize the background vocals
with the most precision. What are the possible causes
of my symptoms or condition. What tests do you recommend
for the heartache of loving both those boys later
on—in different years, for different years—
for thinking you’d loved with a love that was more
than any love anybody had ever loved, for knowing
now, thirty-five years later, maybe you were not
wrong. If these tests don't pinpoint the cause
of my symptoms, what additional tests might I need.
What if I’ve written out the girl who was with us
that night, who called herself my best friend until
she unfriended me in an age long before unfriending,
the girl who buried her toes in the playground sand
and pointed out constellations and refused
to speak of any matters beyond algebra and civics
and God, the girl who was angry with me for being angry
with God, the girl who framed her life with the Bible
until her college breakdown. What if I never spoke
to her after that. What if her Bible held her together
partially. Do you recommend that I also see a mental health provider.
Are there any treatments that could help my symptoms now.
What if I wanted more from my faith
than commandments and platitudes. What if I wanted
an explanation there was no explanation for.
Note: Italicized passages are borrowed from the Mayo Clinic’s Guide to CFS
Leah Nielsen's first book of poems, No Magic, was published by Word Press, a division of WordTech Communications, in 2005. No Magic is set in the Midwest, and through the use of of Norse mythological tales and scenes of daily farm life, explores the mythic status of the speaker’s deceased father. Her current project, Side Effects May Include, uses experimental forms to examine the medical and cultural treatment of pain. Poems from this collection have been published or are forthcoming at thediagram.com, Sycamore Review, Red Mountain Review, Fourteen Hills, Indiana Review, and Hotel Amerkia. In December 2013, Side Effects May Include will be published as its own volume through The Chapbook, a literary journal dedicated to small collections of poetry. She serves as a faculty advisor for Persona, the campus literary magazine. She is also the Faculty Center co-coordinator. Her teaching focuses on writing: Introduction to Creative Writing, Poetry Writing, and composition. She helped design and piloted a course, Career Preparation for Writers, that helps students navigate the transition to a professional writing career.