Fatigue Syndrome Can Take Toll in Many Ways : This debilitating ailment can cause hardships that drive away family and friends. But it doesn’t have to be that way, as many sufferers in Orange County find.

Imagine having the kind of flu that makes you so tired and achy you can hardly move--and that you never get over.

Or waking up after eight hours of sleep feeling you had never been to bed.

Or being so exhausted after going out for an evening with friends that you have to stay in bed for a week.

If you’re a victim of chronic fatigue syndrome, you don’t have to imagine. You know.

And you’d feel a lot better if your loved ones, friends and co- workers knew more about this often-misunderstood disease, so they wouldn’t think you’d gone crazy, turned into a hypochondriac or conveniently invented an illness that would allow you to run for cover instead of facing the difficulties in your life.

Michael Tangney, a 35-year-old Anaheim resident, has been suffering from chronic fatigue syndrome for about seven years, and, he says, “I still feel like an 80-year-old man when I get up in the morning.”

He was putting in 16 hours a day building his own vending machine business and working a night job when he got sick.

“I felt weak and run-down all the time, and it got worse and worse,” he says.

His co-workers on the night shift let him know they thought he was just being lazy when he started taking breaks and calling in sick. A tall, lean, handsome man who shows no visible signs of illness, he went to several doctors who were unable to give him a diagnosis. One told him he was working too hard and advised him to take a vacation.

He eventually gave up his job and his business--he hasn’t been able to work in three years--and watched his savings dwindle as he sought elusive medical answers. Meanwhile, with no family nearby, he became increasingly withdrawn as the friends gradually dropped out of his life.

Tangney, who has never been married, even stopped dating because he couldn’t spend an evening out without waking up the next day “feeling like someone beat me with a sledge hammer.”

Besides, he added, “I was ill-tempered most of the time. It ruins your whole personality when you never feel well. It’s like dragging an anchor around all the time.”

In 1989, he finally found out that he had chronic fatigue syndrome and learned that there was no cure for the illness that forces him to spend most of his time “lying around like a vegetable.”

“People say you get CFS because you’re depressed, but they’re wrong,” he says. “You’re depressed because you feel lousy.”

Doctors still have more questions than answers about chronic fatigue syndrome--which was officially named just three years ago by the Centers for Disease Control in Atlanta--but the illness is decidedly not a product of anyone’s imagination.

It is real--and often devastating, says Dr. M.A. Afrasiabi, an endocrinologist who treats chronic fatigue syndrome victims at Rushmore Medical Center in Huntington Beach.

Although statistics are hard to come by because chronic fatigue syndrome is difficult to diagnose, medical experts estimate that the disease has hit as many as 2 million to 5 million Americans, two-thirds of whom are women. In the past three and a half years, about 2,000 chronic fatigue syndrome patients--including Tangney--have been identified and treated at Rushmore, which has a support group that meets the last Thursday of every month (for information, call (714) 891-7756).

Because chronic fatigue syndrome so changes the lives of many of its victims, it takes a heavy toll on relationships, Afrasiabi notes. For married couples, the vow to remain committed “in sickness and in health” may be put to the ultimate test. And everyone close to the victim may have to reach down to his or her own depths of compassion and patience to remain supportive over the uncertain course of this lingering, debilitating illness.

The fact that so little is known about chronic fatigue syndrome makes it harder for patients and their families to come to terms with this mysterious disease, which has been dubbed the “yuppie flu” because most victims are high-achieving professionals between ages 25 and 45.

Afrasiabi said a diagnosis is made by ruling out other diseases that might cause excessive fatigue and identifying a set of symptoms that persist or recur over a period of six months and reduce normal activity by 50% or more.

In addition to fatigue, the most common symptoms include headaches, joint and muscle aches, chills or low-grade fever, tender lymph glands, sore throats, sleep disorders, depression and neurological problems such as confusion and memory loss.

Chronic fatigue syndrome, which doctors believe may be triggered by stress, has no predictable pattern: Some victims have brief episodes followed by symptom-free periods while others feel sick all the time. The symptoms may last for weeks--or years.

No one knows what causes chronic fatigue syndrome, but it is believed to be an immune system disorder that somehow interferes with the body’s ability to control common viral infections.

Although the cure remains as mysterious as the cause, Afrasiabi says patients may find some relief when their symptoms are treated with such remedies as aspirin and antidepressants. But he stresses the importance of lifestyle changes when he counsels his patients.

Afrasiabi tells them: “You have to lead a new life now, including plenty of rest, more appropriate nutrition, family support and understanding, and stress management.”

Afrasiabi, who reassures family members that chronic fatigue syndrome is not contagious, says he has seen patients who took his advice make an 85% comeback. However, he adds, most of his patients are functioning at about 60% of their normal level of activity. (One study several years ago in Boston showed that 25% of chronic fatigue syndrome patients are either bedridden or unable to leave their homes most of the time, while 40% work part time and 33% work full time.)

Afrasiabi says the financial burden on those who are unable to work often becomes a source of stress in relationships. Couples also get into trouble when a spouse doesn’t believe the disease is real and resists taking on responsibilities that the chronic fatigue syndrome victim can no longer handle. And sometimes the depression that results from being ill all the time drives both friends and loved ones away.

In these cases, Afrasiabi often refers patients to Susan Ramsey, a Corona del Mar marriage, family and child counselor who found out she had chronic fatigue syndrome about two years ago and wasn’t able to work for six months. Gradually--with rest, a healthy diet, antidepressant medication and a determination to reduce the stress in her life--she’s been able to resume a normal life.

It helped a lot, she says, that her “significant other” was supportive. When she called him on sleepless nights, he was always ready to listen without making judgments, she says.

Some of her clients haven’t been as fortunate.

“Their body is like the body of someone else, and their spouse is saying, ‘Buck up--you can handle this.’ ”

Often, they respond by “trying to beat themselves into performing the way they did before”--and end up feeling sicker, Ramsey says.

She has seen marriages break up because the spouse of a chronic fatigue syndrome victim couldn’t handle the demands of the illness. But she’s also seen marriages grow stronger when the couple confront the illness together.

Elaine, a 43-year-old Fountain Valley resident who asked to remain anonymous, feels lucky to have a husband who has been supportive throughout her long battle with chronic fatigue syndrome.

She started getting sore throats and feeling weak in 1985, when she was going through a particularly stressful time at work. About a year later, she found out she had chronic fatigue syndrome and has been home on disability since mid-1987.

With the support of her husband and two grown daughters, one of whom still lives at home, she has learned to cope with an illness that has required her, against her nature, to become a dependent person.

“Your whole life changes,” says Elaine, who suffers daily headaches, muscle pain and extreme fatigue. “You either learn to live with it or it will destroy you.”

Elaine spends most days alternating between brief periods of low-key activity around the house and bed rest. Her husband, Wes, and daughters do all of the grocery shopping and household chores so she can save her energy for the time she shares with them.

She acknowledges that her illness has been a hardship for her family. Wes has had to take on extra work to make up for the loss of her salary, and they’ve had to scale down their lifestyle. They’ve also had to slow down and plan more, weighing every activity against the toll it will take on Elaine’s health.

She feels her family has been able to accept these changes because of her attitude.

“If I am constantly depressed and feeling sorry for myself because I can’t do things, I’ll make everyone in my life miserable and they won’t want to be around me,” she says. “I’ve learned to live within the boundaries that have been set for me.”

She knows other chronic fatigue syndrome victims who have trouble in their relationships because they keep denying that they are sick and try to do too much--or never stop feeling sorry for themselves.

She advises them: “Stop thinking so much about yourself and start thinking about others. If you make wise choices, it will make it easier for your family.”

Elaine has struck a kind of bargain with her family that seems to work for everyone. She explains: “No one asks more than I can give them, and I give them everything I have to give.”

Wes says Elaine’s commitment to her family has made it easier for him.

“There is only so much energy available, and the family is her first priority,” he says. “If her energy went elsewhere, it would be harder to accept.”