I ended my last post with the promise of information regarding what Fibromyalgia is, as well as discuss the “causes” of Fibro, how to find a doctor that is familiar with it, and obtaining the right diagnosis.
I shall begin by saying that there are no known absolute causes of FMS. There are theories as to what causes it. Some of the top theories include: (taken directly from Fibromyalgia for Dummies, by Roland Staud, M.D. and Christine Adamec, Medical Writer, 2002, Wiley Publishing, Inc. -- pg. 11) "The cause could be hormones or an autoimmune problem or biochemicals gone awry, or it may be related to a previous trauma, such as an injury that you incurred in a car crash or in another serious accident."
It is important to note the emotional side of it as well. If an individual suffers from depression or another mental disorder, the symptoms of Fibromyalgia can become exacerbated. It is important to discuss with your doctor what the possible cause can be.
In terms of finding a physician who understands the dynamics and troubles of Fibromyalgia, this may be difficult at first, but do not let it deter you from reaching your goal of finding a doctor and exploring pain and symptom management. Along with the cause being in the grey area, you must know that there is also no cure for FMS. But fear not, if you are suffering, there are a great many things that can be done to help alleviate the symptoms. These can include medication, life-style changes, complimentary therapies (Chiropractic care, Physical therapy, Massage therapy, etc.) a change in diet, - or any combination of these.
While many physicians are at least familiar with FMS, some are not quite well versed in it's symptoms, etc. You can work with your existing family doctor and explore the syndrome together, or look for another doctor that is well educated to it's effect, pain, symptoms, etc. The best place to start would be to gather a complete medical history, and perform a full medical examination. Once that is completed, the two of you can create a treatment plan that can include any of the suggestions recently mentioned. It is likely that your beginning treatment plan will include medications, either prescribed or over-the-counter (or both), some basic life-style changes, minor diet changes, and what I like to call "Soft" exercises.
"Soft" exercises for me in my pain management is Yoga (which helps with fatigue really well), doing basic exercises using a yoga ball (55cm size would be my recommendation as some days you may not feel quite steady and anything larger may put you at risk for a fall or a twist that you don't want) Books that outline types of exercises on the Yoga ball can be found at most book stores and certainly online. I also try to walk everyday, even if it is just to the end of the street and back. In the colder months, that will prove impossible, because any extened exposure to the elements can cause more pain than anything, but there are things that can be done inside during the winter that can be equivilent. If it is in your budget, perhaps you could invest in a treadmill.
It is important to note that IMMOBILITY can be as bad as MOBILITY. So make sure that you are getting up and moving around every day, even if you are in the middle of a flare. Sitting on the edge of the couch and doing some simple deep breathing, and stretching can make a world of diference.
MEDICATIONS:
I am not a doctor, and therefore, will not recommend anything. This is for you and your doctor to determine what will work best for you. But I will tell you MY experiences/ progressions with medications.
When I was diagnosed in 2006, I was put on Cymbalta. This is an anti-depressant that claims to help with the physical symptoms of depression (pain, etc.) and has been shown to improve the symptoms of FMS in some patients. I was also given Neurontin. I did NOT like this as it made me so loopy, I could not focus on anything, drive, and at times, felt as though I was not walking straight.
Please note: Anything that I may tell you about my medications is MY story, I do not want it to deter you from trying these medications. Each person is different and medications will affect each person differently.
After those two, I was given countless NSAID's ('Non-steroidal Anti-Inflammatories' - such as Tylenol, Ibuprofen, etc.) I was also given a low dose of an anti-depressant, of which we had to cycle through a few of them as well, to find one that I could tolerate. My pain continued to get worse and my tolerance for it diminished. We then tried narcotic pain medication. We started out with Tylenol-Codeine 3, it didn't work out..too many unpleasant side-effects. We then went to Vicodin, then Norco - both hydrocodone and it had absolutely no effect on me. Next we tried Darvocet (also a Narcotic) and that worked for about one and a half years.
The thing with Narcotic pain meds is, one: they have the potential to be very addicting rather quickly, and two: you may have to continue to increase the dose as your body will begin to build a tolerance to them. This is what I experienced with the Darvocet. We increased the dose twice, then the frequency, then as with many narcotic pain meds - my body got so used to it, that it began to lose it's effectiveness. From there we attempted Vicodin again - still did not work, and now for the past six months, I have been on Percocet (Oxycodone). This seems to work very well, but even within six months, we have had to adjust the dose and frequency already. I am however, NOT addicted to it. It take is as prescribed and it is working well.
Some may not tolerate Narcotic pain meds well due to the side effects. I certainly would encourage you to explore Non-narcotic meds to help manage your symptoms, if that is what you and your doctor decide to do before progressing to Narcotics.
Another medication, that you may have seen commercials for is a medication called: Lyrica (Pregabalin) that can start at 25mg and go as high as 100mg capsules (if I remember correctly)
http://www.lyrica.com/fibro_homepage.aspx
I am currently taking 100mg capsules three times a day. It seems to be helping and I take it faithfully. I have enclosed that link so that you can explore the medication's website. It is very informative about more than just the medication itself.
Well, I should get off to bed, but I will return soon and offer more information as much as I can. As always, you are welcome to contact me with any questions, comments, etc. Take care and remember that you are not alone in this battle for relief.
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