Question:
I went to see a new primary care doctor, to "test
him to see how he feels about chronic pain and fibromyalgia." He said and
this is his exact words: "Fibromyalgia isn't a real disease, it is caused
from either depression and possibly in my case being overweight You will
find that most doc's feel that way. Until you are prepared to deal with
your depression and weight, I am NOT your doctor. I would not feel right
giving your narcotics with your other problems." WOW!!! What a wonderful
Monday, I wanted to punch him, but I was just so depressed I couldn't. NOT!
I would not want him my doctor anyway! I can't believe his lack of
knowledge and human kindness. He has just met me and how in the world
within a 15 minutes session could he tell all of this about me? So now the
search continues for a doctor. I live in Oregon, near Eugene, if anyone has
any recommendations.
Answer:
I wish you luck in finding a good dr. and that you didn't feed into the bs
that he gave you. When I went to the rheumy for the first time after seeing
many other drs., I was very depressed. Thankfully he knew that the
depression was caused by the fibro, not the other way around.
There are people who suffer from depression and display a lot of the
symptoms of fibro, but do not have fibro. I have had depression throughout
my life and received treatment for it. But, the depression I was
experiencing when I was diagnosed was directly related to the devastating
affects this DD had on me.
Also, the weight issue is another bogus way to dismiss fibro. I have always
been thin, most of the time way too thin and I still have fibro. Therefore,
in my opinion, weight has no bearing on fibro.
Here is a link that lists drs. in Oregon who are recommended for fibro.
http://www.co-cure.org/USA_OR.htm
Gee always dealing with pain, I lost my job, income, lost many friends, lost
many of my hobbies and things I like to do, Love ... what's that?
Lost the ability to lift even a bag of kitty litter life.
Duh I wonder why I am depressed?
I was not depressed before all the losses. In fact I was far from it.
I wonder what would happen to some of these Drs. if you were to give them a
condition that causes chronic pain and disability and then take away their
income and job along with everything they ever worked for and enjoyed and the
people they liked, loved and cared for and thought were their friends, and then
tell them tough just live with it or there is nothing wrong its all in your
head.
how do we do it? How do we set up sensitivity training for MD's?
It's not hard concerning the blind or amputees/para- & quadraplegics....but
FM presents some interesting symptoms.
Fibro fog is easy enuff, as is fatigue....in fact they had fog LOTS because
of sleep deprivation during residency training.
But the muscle pain, flu-like symptoms, limbs that feel like lead all the
time..and the extra pain of flare?
Hmmm..I say we beat 'em up with big ol' sandbags. Then tell 'em to
exercise and pop anti-depressants. LOL
I had an endocrinologist who also believed that FM was caused by
depression or "was an autoimmune disease that had not yet manifested
itself." It's what she was taught in med school. I brought her some
articles, but finally gave up and got a better endocrinologist. My
endocrinologist does not treat my FM, but it is important to me to work
with people who do not dismiss my condition. If I ask my current
endocrinologist about something to do with the biochemistry of FM, she
will at least try to find me the answer.
The research shows clearly that FM is biochemically different from
depression (there are several studies on this). Although many of us
suffer from low seritonin, the low seritonin is currently thought to be
caused by other biochemical imbalances in the central nervous system.
Also, not all people with FM suffer from depression, a good many do not,
and so any theory of FM has to account for people who have symptoms of FM
but are not depressed. Depression is usually accompanied by high levels of
adrenal hormones such as norepinepherine, epinepherine, and cortisol. This
is not true in FM, instead there is low norepinepherine, low ephinepherine
production in response to stress, and normal or low cortisol. In fact,
some of us are helped by norepinepherine reuptake inhibitors.
The weight gain issue is a problem for many of us. Studies have not found
that losing weight helps FM pain. But weight gain, depression, and
widespread pain can also be symptoms of thyroid disease, so it is
important to make sure thyroid tests are done. I have both FM and thyroid
disease, a combination that is not uncommon, but can be difficult for
doctors to sort out. By the way, I have not suffered from serious
depression since I balanced out my thyroid horomones with synthroid,
though my FM pain and sleep probems have been difficult to control.
A non-narcotic pain med that addresses FM type pain and can also help with
sleep is neurontin. Neurontin is a fairly new treatment for FM, though it
has been used for other kinds of neuropathic pain for some time. It seems
to block the transmission of the exaggerated pain response caused by high
levels of substance p. It isn't for everyone, but it might be something to
ask a doctor about. For most people the side effects are low (once you get
used to the darned stuff). I am giving it a try. I found it difficult to
get to the right doseage, but I was running out of medication options so I
stuck with it, and it seems to be helping quite a bit at this point.
Here are a couple of websites that may be useful for educating doctors
(those that are willing to learn something).
Georgetown University Chronic Pain and Fatigue Research Center
Educational information on Fibromyalgia
http://www.georgetown.edu/departments/pharmacology/fmscfs/fibro.htm
Oregon Fibromyalgia Foundation
http://www.myalgia.com/
