Brief Answer: Hi Detailed Answer: Hello, Thanks for your query. I appreciate your efforts for medical consultation in so much distress. Important aspects of your query are: • 51 year old female • Known case of knee replacement with Donner bone • Complaints of: Chronic fatigue Chronic fatigue syndrome (CFS) is one of the difficult diagnosis to make as it is a diagnosis of exclusion. The fatigue should not be due to: -Medical conditions like chronic illness, thyroid imbalance, anemia etc -Psychological conditions like anxiety, depression or stress Many people do not fully recover from CFS even with treatment. Usual treatment response is 20-50%. Following steps will help you in treatment: -Examination of general physician to rule out medical causes or medicine side effects for fatigue. -Cognitive behavioural therapy (CBT): from nearby psychologist. -Graded exercise therapy (GET): Start with daily morning walk. -Activity scheduling: Fix time meals, sleep and wake up.. assign time for some leisure activities. -Treatment with antidepressants like fluoxetine I hope this information has been both informative and helpful for you. In case of any doubt, I will be available for follow ups. Wish you good health. Regards, http://bit.ly/Dr-Ashish-Mittal

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