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Perhaps you remember the story of the Holy Grail that was purported to have the miraculous power of restoring health for anyone who found and drank from it. Legend has it that King Arthur sought this divine relic and sent his trusted knights to seek it out.
 

I occasionally lecture on the Holy Grail because the myth parallels what I hear daily in my practice of medicine: patients on a mission to find a miraculous panacea. This is particularly the case for persons with CFS or FM.

Humiliated by doctors who don't understand and rejected by a medical system that relegates CFS and FM to "mental disorders," many begin a pilgrimage to find anyone and anything that might help. Like the Knights of the Roundtable, they make perilous journeys, fight battles along the way and overcome numerous challenges. Most end up worn out and frustrated.
 

There are a few souls who do find a panacea of sorts. Like Galahad, they discover that reaching the goal is less important than the journey itself. These souls discover that when they've seen all the doctors, tried all the drugs, and explored all the alternatives, the most effective treatment for CFS and FM comes from within: they learn to deal with the illness.

While medications may palliate the terrible symptoms, these valiant heroes have learned that CFS and FM are best managed with adaptation and lifestyle changes that lead to new meaning and self worth.
 

When I first discovered Bruce Campbell's book, I knew that I was close to the Grail. For years I had strived for a cure for CFS/FM, but had come to realize that medically I could only treat the symptoms and optimize my patients' health. Time and nature cured the patient, provided he or she could adapt to a new lifestyle.

It was Campbell's book that outlined these adaptations. Since that time, I have encouraged virtually all of my patients to read this book and follow Campbell's advice. He has traversed the dark moors of this illness himself, and he teaches firsthand how to slay the invisible dragon of this illness.
 

There are no known prognostic factors for recovery from CFS or FM, but from years of experience I can tell you two things. First, those who do poorly are generally overwhelmed by depression and a lack of support. Second, those who do extremely well all share a positive attitude and willingness to adapt.

They take control of their own lives and develop new meaning and self worth out of the illness process. As Victor Frankl wrote in his 1959 book Man's Search for Meaning, we cannot always choose what life gives, but we can choose how to respond to it.
 

Most authorities on CFS and FM agree that there are four steps that predictably lead to improvement in CFS and FM. These are: 
 

1. Symptom management. Treat symptoms such as pain and sleep disruption that exacerbate and perpetuate the illness.
    
2. Pacing. Ensure rest periods and set reasonable limits on daily activities.
    
3. Counseling. Address depressed mood, anxiety, and emotional stresses; and learn effective coping skills.
    
4. Activity. Take regular low level aerobic exercise. 

The book in your hands is a practical self-help guide organized into individual lessons that one can read, assimilate, and put into practice on a regular basis, say one chapter per week. It will walk you step-by-step through the process of adapting to this illness.
 

Your doctors can help with symptom management and counseling. This volume can guide you through the rest. This book offers hope to those with CFS/ME and FM. There may be no known cure for these conditions, but the book in your hands makes it clear that there are many means to improving quality of life.
 

Charles W. Lapp, M.D.
Director, Hunter-Hopkins Center
Assistant Consulting Professor, Duke University Medical Center
May 1, 2010
Charlotte, North Carolina