Topic: Medical Care
Where Did Fibromylagia Come From?
Fibromyalgia used to be known as Rheumatism, a term more commonly used in the days of yore which referred to a rheumatological condition of achy muscles and joints with fatigue. In the mid-20th century the name was changed to Fibrositis. When it was later changed to Fibromyalgia the definition of the illness changed somewhat and its list of symptoms has greatly broadened and expanded over the years. The current list of symptoms and secondary ailments attributed to either being 'caused' by Fibromyalgia or being a co-condition to it still continues to grow. Fibromyalgia's primary symptoms include widespread muscle and joint pain with chronic fatigue, daily or frequent cognitive and memory impairments (brain fog), and a pair of sleeping disorders- insomnia, and the inability to reach or stay in restorative stage 4/delta wave deep sleep.
The secondary symptoms lists now includes: various digestive problems; irritable bowel syndrome; irritable bladder/interstitial cystitis; edema/fluid retention syndrome; dry eyes and dry mouth (Sicca Syndrome); gynecological problems in women; erectile dysfunction in men; painful sexual intercourse for both sexes, but this occurs much more often with women; chronic headaches; yeast infections/intolerances; depression and anxiety; restless leg syndrome; heart palpitations; dizziness and lightheadedness; balance problems; sinus problems/environmental allergies; delayed food allergies and intolerances; hypoglycemia; Raynaud's phenomenon (cold hands and feet); tingling and numbness of the limbs (neuropathy); mitral valve prolapse; thyroid disorders; endometriosis; TMJ; and various other ailments. The problem with this growing list secondary symptoms is these same conditions and symptoms also occur in many people on their own and have nothing whatsoever to do with a diagnosis of fibromyalgia. Many of these symptoms can also be associated with other illnesses and diseases, including those with symptoms similar to fibromyalgia, and that includes illnesses that are either occasionally or frequently mis-diagnosed as being fibromyalgia.
Some doctors and medical researchers make little or no distinction between Fibromyalgia and Chronic Fatigue Immune Deficiency Syndrome/Myalgic Encephalomyelitis (CFIDS/ME) an autoimmune condition caused by chronic viral infections which is also known as Chronic Fatigue Syndrome. Others in the medical profession view CFIDS/ME and Fibromyalgia as being separate, yet related conditions.
Fibromyalgia- The Medical Land of Confusion
Some in the medical community view fibromyalgia as a rheumatological disorder and others view it as a neurological one. A few say it is an autoimmune condition, but that premise has largely fallen out of favor. Some say the condition is mainly caused by the prolonged sleep disorders. Others view its cause as a combination of dysfunctions involving the thyroid, adrenal, and pituitary glands and/or the hypothalamus. Some view the problem as the retention of too much phosphate in the body due to a genetic defect. Some say it is caused by or is related to Attention Deficit Disorder/Attention Deficit Hyperactivity Disorder; while others view it as a form of Post Traumatic Stress Disorder. There is also a growing school of thought within the medical community which believes some/many/most fibromyalgia patients experienced physical and/or sexual abuse either during childhood or adulthood, and their illness is a psychosomatic response to the prolonged stress related to being victims of abuse. A few out there try to link fibromyalgia to the mental illnesses Disassociative Disorder/Multiple Personality Disorder via these physical/sexual abuse traumas. A few believe in a genetic link between fibromyalgia and autism. Some believe fibromyalgia is a form of Dysautomia- an autonomic nervous system dysfunction disorder. Others claim the cause is completely unknown (and some think the cause is irrelevant). Unfortunately, these conflicting views are the ones often most strongly favored in the medical community and bear the strongest influence regarding patient treatment and care.
Typically drug treatment involves taking antidepressants, anticonvulsants, pain medications, neuropathy medications, and possibly anti-anxiety drugs. In addition, fibromyalgia patients, depending upon both their doctors' viewpoints regarding illness treatment and the types of coverage their health insurance plans offer for fibromyalgia, may undergo physical therapy aimed specifically geared towards fibromyalgia patients, and/or may go to pain management clinics. They may be treated with various forms of therapeutic massage, and/or with chiropractic treatments. They are encouraged to take up a gentle lower impact exercise routine, which may include T'ai Chi or yoga exercises.
Other treatments for fibromyalgia (sometimes depending on whose theory you are following) may possibly involve:
Guifenesein Therapy- This treatment involves taking twice-daily doses of Guifenesin, an expectorant found in cold medicines, to rid the body of excess phosphates. This protocol also involves completely avoiding products which contain salicylates, both in oral form (Aspirin and Pepto Bismol, for example), and avoiding the use of skin care products that contain salicylic acid, including certain natural botanical extracts. A lower carb diet is also recommend with this protocol.
Cognitive Behavioral Therapy- This short-term psychotherapy helps patients learn to deal with the emotional aspects of living with chronic illnesses and to help them feel better about themselves as people living with chronic illness. It involves changing one's thinking and viewpoints regarding his/her illness and its life-impacting symptoms.
“Cognitive Behavioral Therapy for Fibromyalgia” a patient study article by Robert Bennett and David Nelson can be found here: www.myalgia.com/Treatment/Bennett%20Nelson%20CBT%202006.pdf
Cranialsacral Therapy- From Wikipedia: (links within text removed) “A craniosacral therapy session involves the therapist placing their hands on the patient, which they say allows them to tune into what they call the craniosacral system. By gently working with the spine, the skull and its cranial sutures, diaphragms, and fascia, the restrictions of nerve passages are said to be eased, the movement of cerebrospinal fluid through the spianl cord can be optimized, and misaligned bones are said to be restored to their proper position. Craniosacral therapists use the therapy to treat mental stress, neck and back pain, migraines, TMJ Syndrome, and for chronic pain conditions such as fibromyalgia.” http://en.wikipedia.org/wiki/Cranial-sacral_therapy
There is some skepticism and controversy regarding the use and effectiveness of this treatment that is not just limited to its use for fibromyalgia patients.
Regulating Dopamine Levels- Rheumatologist Dr. David Dryland has developed a protocol to treat fibromyalgia based upon the viewpoint that fibromyalgia is the result of a decrease in levels of the neurotransmitter dopamine. His treatment involves off-label use of the drugs Mirapex and Requip to regulate dopamine levels. Mirapex and Requip are used to treat restless legs syndrome and Parkinson's disease, Parkinson's being a disease involving a decrease in dopamine levels.
Support Groups- Fibromyalgia patients are very strongly encouraged to bond with fellow fibromyalgics through either or both internet-based and real world local support groups, more so than patients who live with other chronic illnesses. Emotional bonding and support with fellow fibromites, and other emotional based 'issues' plays a much greater role within the concept of 'healing' for fibromyalgia patients. The number of online forums and message boards and all those patients posting to these fibro forums very much eclipses the number of forums (and patients) who focus on other illnesses and diseases. The sheer number of patients, and the growing number of newly diagnosed fibro patients who are now joining the “oldbies” at those cyber message boards, indicates just how much of a fad the fibromyalgia diagnosis has become.
Medical Marijuana- While it is more often prescribed for cancer patients, AIDS patients, MS patients dealing with severe pain, and the like; a few physicians will prescribe medical marijuana to their fibromyalgia patients although this practice is quite controversial.
Long-term Psychotherapy/Psychiatric Care- It's not usual to hear that someone who has been diagnosed with fibromyalgia is either in therapy with a psychologist; or even more common, is seeing a psychiatrist who has diagnosed the patient with, and is treating him or her with psychotropic medications for: depression, and/or anxiety, and/or ADD/ADHD, and/or Obsessive Compulsive Disorder, and/or PTSD. In at least one state, Fibromyalgia is listed as being a psychiatric disorder instead of a rheumatological one with that state's SSA Disability program. Hence is such states the primary care physician who may be assigned to the disabled patient and whose medical assessments, opinions and treatment plans counts most when it comes to that disabled patient's status and care via his/her Disability case workers is often a psychiatrist, not the patient's rheumatologist, or his/her general family practice doctor or whomever else the patient is receiving medical care from on a regular basis. All of these realities should give anyone who receives the fibromyalgia diagnosis themselves or who has a loved one who recently received this diagnosis pause. This is a glaring Patient Beware red flag.