Fibromyalgia For Dummies E-Book

Roland Staud

• Herausgeber: John Wiley & Sons
• Kategorie: Ratgeber
• Sprache: Englisch

Seitenzahl: 556

Veröffentlichungsjahr: 2011

Beschreibung

Your easy-to-follow guide to the latest research, treatments, and medications!

The pain you suffer from fibromyalgia syndrome (FMS) is not in your imagination. FMS is a real medical problem that can be as debilitating and demoralizing as it is mysterious. Fibromyalgia For Dummies, Second Edition, brings you the latest scientific findings on the symptoms and causes of this disease and guides you toward proven, practical steps you can take reduce or eliminate FMS-related pain.

This plain-English guide is fully updated with the latest fibromyalgia treatment options, and evaluations of new medications that have shown great promise in reducing pain. You'll discover how to spot an array of symptoms and their possible causes, work with your physician to develop a treatment plan, and manage your pain at home and in the office. You'll learn how to:

• Identify your FMS trigger points
• Cope with chronic pain and sleep problems
• Find medications that work for you
• Locate a physician who can really help you
• Make healing lifestyle changes
• Use hands-on therapies to alleviate pain
• Find effective over-the-counter and prescription medications
• Choose among alternative therapies and treatments
• Reduce the emotional distress caused by FMS
• Help a child with FMS

Featuring moving and inspiring stories from fellow FMS sufferers who share their stories and offer invaluable tips on working your way back to wellness, Fibromyalgia for Dummies, Second Edition offers serious and sensitive guidance to help you overcome FMS and start being yourself again.

Leseprobe

Fibromyalgia For Dummies®, 2nd Edition

by Roland Staud, MD,with Christine Adamec

Fibromyalgia For Dummies®, 2nd Edition

Published byWiley Publishing, Inc.111 River St.Hoboken, NJ 07030-5774www.wiley.com

Copyright © 2007 by Wiley Publishing, Inc., Indianapolis, Indiana

Published simultaneously in Canada

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Library of Congress Control Number: 2007935017

ISBN: 978-0-470-14502-9

Manufactured in the United States of America

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About the Authors

Roland Staud, MD, is a rheumatologist and a professor of medicine at the University of Florida in Gainesville, Florida, as well as a noted and internationally renowned medical researcher. Dr. Staud’s continuing and cutting-edge research on fibromyalgia is supported by the National Institutes of Health and other funding organizations. His research has clearly demonstrated that patients with fibromyalgia syndrome (FMS) have detectable central nervous system abnormalities of pain processing resulting in increased pain sensitivity and prolonged pain experiences.

Dedicated to helping FMS patients by sharing his knowledge as much as possible, Dr. Staud is greatly appreciated by attendees at major national and international fibromyalgia and arthritis conferences, where he is a frequent speaker. He is also on the editorial boards of Pain and European Journal of Pain. In addition, he is a reviewer for the Clinical Journal of Pain, Journal of Pain,European Journal of Pain, and Pain. He has authored many medical journal articles on fibromyalgia and other topics.

Dr. Staud is a diplomate of the American Board of Rheumatology and the American Board of Internal Medicine. He is a member of the American College of Rheumatology, the International Association for the Study of Pain, the American Pain Society, and the International MYOPAIN Society. Dr. Staud is licensed to practice medicine in Florida.

Christine Adamec has been a freelance writer for more than 20 years, concentrating on self-help and medical/health issues. She has authored or coauthored 14 books, including The Encyclopedia of Diabetes (Facts On File, Inc.) and How to Stop Heartburn (Wiley), and has written numerous magazine and newspaper health features. Ms. Adamec is a member of the American Society of Journalists & Authors.

Dedication

Dr. Staud: I would like to dedicate this book to all the fibromyalgia volunteers who participated in my studies at the University of Florida, helping me to characterize the abnormal pain mechanisms of fibromyalgia syndrome.

Christine Adamec: I would like to dedicate this book to my ever-patient husband, John Adamec.

Authors’ Acknowledgments

We would like to acknowledge the assistance of the following individuals: Jeff Hargrove, PhD, an associate professor of engineering at Kettering University in Flint, Michigan, and adjunct assistant professor of medicine at Michigan State University; Joseph Kandel, MD, an author, a neurologist, the medical director of Neuroscience and Spine Associates in Naples, Florida, and associate clinical professor at Wright State University School of Medicine in Dayton, Ohio; and Alec Sohmer, Esq., an attorney from Brockton, Massachusetts, who assists people who have fibromyalgia and other medical problems with Social Security disability claims.

In addition, we thank Marie Mercer, reference librarian at the DeGroodt Public Library in Palm Bay, Florida, and Mary Jordan at the Central Library Facility in Cocoa, Florida, for their assistance in locating very hard-to-find journal articles on fibromyalgia. We would also like to thank the many people with fibromyalgia who frankly and candidly responded to questions on how fibromyalgia has affected their lives and how they have coped with it.

Publisher’s Acknowledgments

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Contents

Title

Introduction

About This Book

Conventions Used in This Book

What You’re Not to Read

Foolish Assumptions

How This Book Is Organized

Icons Used in This Book

Where to Go from Here

Part I : The What, When, and Why of Fibromyalgia

Chapter 1: Yes, Fibromyalgia Is Real

Dumping Your Doubts about Whether FMS Is Real

Examining the Symptoms, Causes, and Pain Problems Associated with Fibromyalgia

Considering Who Gets Fibromyalgia

Looking at Related Medical Problems

Do You Have Fibromyalgia? A Self-Test

Finding a Doctor Who’s a “True Believer” in Fibromyalgia

Treating the Problem

Making Lifestyle Changes: Pulling Yourself into a Non-Fibro World

Coping with Fibromyalgia at Home and on the Job

Chapter 2: Recognizing Key Symptoms of Fibromyalgia

Describing Where It Hurts: Almost Everywhere!

Being Terribly Fatigued

Facing Fibro Fog: Mental Malaise

Weathering Your Reactions to Weather

Dealing with Common Sleep Disorders

Experiencing Related Medical Problems

Chapter 3: Understanding Possible Causes of Fibromyalgia

Down But Not Out: Physical Trauma

Catching Fibromyalgia

Regarding Gulf War Syndrome

Studying Chemical Imbalances

Examining Environmental Causes

Exploring Other Theories

Looking to the Future

Chapter 4: Understanding Fibromyalgia Pain

Grasping Pain and Why People Have to Have It

Regarding the Different Kind of Pain That’s Fibromyalgia

Working with Your Doctor to Manage Fibromyalgia Pain

Part II : Finding Out Whether You Have Fibromyalgia

Chapter 5: Who Gets Picked to Have Fibromyalgia?

Looking at the Numbers: Who Has Fibromyalgia?

Wondering Why Women Suffer More than Men from Fibromyalgia

Considering How Fibromyalgia Relates to Women’s Ages

Fibromyalgia and Men: It Isn’t Just a Woman Thing

Chapter 6: Identifying Diseases Often Confused with Fibromyalgia

Understanding the Uncertainty

Chronic Fatigue Syndrome

Myofascial Pain Syndrome

Arthritis

Thyroid Disease

The Other Suspects

Chapter 7: Working with a Good Fibromyalgia Doc: You Need a True Believer

Working with Your Primary-Care Doctor

Looking Elsewhere for a Doctor: How to Know if It’s Time

Considering Types of Specialists

Finding a Good Specialist or a New Primary-Care Doctor

Interviewing Your Physician Candidate: What’s Up, Doc?

Chapter 8: Getting Physical: Your Initial Exam and Diagnosis

Diving into Your Medical History: What the Doctor Should Ask You

Volunteering Info if the Doc Doesn’t Ask You about It

Getting All Your Questions Out in the Open

Identifying the Tender Points of Fibromyalgia

Test-ifying about FMS

Part III : Looking At All Your Treatment Options

Chapter 9: Medicating the Problem: Over-the-Counter Drugs May Help

Considering Guaifenesin

Relieving Pain with Painkillers

Warming Up to Cold Remedies for Fibromyalgia

Talking about Topical Remedies

Chapter 10: Prescribing Health with Medications

Relaxing Your Fibromyalgia: Muscle Relaxants

Easing Pain with Painkillers

Lessening Pain with Lidoderm

Reducing Inflammation with Non-Steroidal Anti-Inflammatory Drugs

Fighting Fibromyalgia with Antidepressants

Other Medicines Prescribed for Fibromyalgia

Opening Your Eyes to Sleep Remedies

Pondering Future Remedies

Chapter 11: Using Hands-On Therapies

Heating Up the Problem: Heat Therapy

Chilling Out! Icing the Pain

Wetting Down Your Fibromyalgia Symptoms

Rubbing Out the Problem: Massage Therapy

Magnetically Decreasing Your Pain: Transcranial Magnetic Stimulation

An Electrifying Solution: Transcutaneous Electrical Nerve Stimulation

Considering Chiropractors

Chapter 12: Considering Alternative Remedies and Treatments

Thinking Through Alternative Remedies

Fighting Fibromyalgia Naturally with Herbs and Supplements

Pinning Down a Solution: Acupuncture

Homing In on Homeopathy

Beating Fibromyalgia with Botox Injections

Taking On Tai Chi

Repelling Magnet Therapy

Part IV : Modifying Your Lifestyle: Small Changes, Big Results

Chapter 13: Depressurizing Yourself: Controlling the Stress-Eyed Monster

Knowing When You’re Too Stressed

Chilling Out with Relaxation Therapy

Stress-Busting with Biofeedback Therapy

Mesmerizing the Pain: Hypnotherapy

Meditating, Doing Yoga, and Praying

Chapter 14: Sweet Dreams! Combating Sleep Disorders

What Is Sleep?

Understanding the Importance of Sleep Stages

Identifying Key Sleep Problems

Analyzing Your Sleep: A Self-Test

Adjusting Your Lifestyle to Cope with the Problem

Slipping into Slumber Using Medications and Other Remedies

Chapter 15: Exercising, Losing Weight, and Avoiding Trigger Foods and Drinks

Exercising to Relieve Fibromyalgia Pain

Exploring Pain-Relieving Exercises

Losing Weight to Decrease Pain and Fatigue

Discovering Dietary Effects: Good Foods/Bad Foods

Chapter 16: Coping with Emotions: Your Own

Dealing with Depression

Determining If It’s an Anxiety Disorder

Taking Your Emotional Temperature

Finding a Therapist

Treating Emotional Problems with Medication

Part V : Managing Fibromyalgia at Work and at Home

Chapter 17: Working with Fibromyalgia — Or Going on Disability

Explaining Fibromyalgia to Your Boss and Co-Workers: Should You?

Deciding Whether You Should Stay at Your Job

Getting Your Insurance Company to Pay for Treatment

Taking the Next Step if FMS Is Disabling

Finding an Attorney to Help You

Chapter 18: Helping Loved Ones Deal with Your Fibromyalgia

Understanding How Fibromyalgia Can Affect Your Relationships

Moving Yourself to a Better Frame of Mind

Opening Up for Some Honest Dialogue

Anticipating Difficulties

Knowing How to Respond to “Helpful” Comments

Helping Your Significant Other Cope

Explaining Fibromyalgia to Your Kids

Joining a Support Group

Chapter 19: Helping Someone You Care About Who’s Hurting

Understanding without Feeling Their Pain

Coping with Your Own Emotions

Going to Support Meetings

Chapter 20: Parenting a Child or Adolescent with Fibromyalgia

Looking at Fibromyalgia Symptoms in Children and Teens

Accurately Diagnosing the Problem

Finding Help for Your Child with FMS

Treating a Child with Fibromyalgia

Including Your Children Who Don’t Have Fibromyalgia

Working with Your Child’s Teacher

Dealing with Jeers from Peers

Part VI : The Part of Tens

Chapter 21: Ten Alternative Remedies That Help People with Fibromyalgia

Herbs

Magnesium

Echinacea

Green Tea

Massage Therapy

Aromatherapy

Mud Baths

Acupuncture

Homeopathy

Transcutaneous Electrical Nerve Stimulators

Chapter 22: Ten Mistakes to Avoid When You Have Fibromyalgia

Ignoring Your Pain and Hoping It Goes Away

Believing a Doctor Who Says Fibromyalgia Is “All in Your Head”

Trying One Medication or Therapy, and If It Doesn’t Work, Giving Up

Assuming That the Problem Is All Your Fault

Assuming That the Problem Is Everyone Else’s Fault

Turning to Alcohol or Other Substances

Believing That All Your Problems Are Caused by Fibromyalgia

Overeating to Make Yourself Feel Better

Feeling That You’re a Defective Person Because of Your Fibromyalgia

Trying to Hide Your Symptoms from Family, Friends, and Others

Chapter 23: Ten Ways to Beat the Effects of Brain Fog

Avoiding Brain and Energy Drains When You’re Hurting or Tired

Asking Others to Help You Stay On Task

Making Lists and Checking Them Twice

Banning Self-Blame

Avoiding Blaming Others

Getting Enough Sleep

Keeping a Calendar of Activities

Watching What You Eat

Putting Things in Their Places

Catching Yourself Slipping Away

Chapter 24: Ten Myths about Fibromyalgia

People with Fibromyalgia Are Lazy or Crazy

Fibromyalgia Symptoms Are a Way to Get Attention

People with FMS Just Want Drugs

Looking Well Means You Are Well

Pain Is Pain: It’s All the Same

Feeling Good Today Means You’re Well

Relaxing Will Cure What Ails You

Taking Some Pills Should Fix You Right Up

Ignoring the Problem Will Make It Go Away

Therapy Always Works

Part VII : Appendixes

Appendix A: Glossary

Appendix B: Fibromyalgia Medications

Pondering Prescribed Medications

Other Medications That May Help

Reviewing Over-the-Counter Medications

Appendix C: Resources and Support

Organizations

Finding Information on the Internet

Pondering Publications

: Further Reading

Introduction

F ibromyalgia is a chronic medical problem that can be terribly aggravating and sometimes even maddening for people who have it, especially if they aren’t receiving the latest medications or treatments, such as those discussed in this new edition of Fibromyalgia For Dummies. But if you have fibromyalgia, you may find comfort in the fact that you’re not alone. Fibromyalgia affects 6 million or more people in the United States and millions more in other countries. You can also find comfort in the fact that many effective options may help you significantly decrease the problems that you’re experiencing, problems that stem from fibromyalgia.

Also known as fibromyalgia syndrome (FMS), fibromyalgia’s major symptom is pain in the muscles, tendons, and bones throughout the body. (And for some people, the pain and its location vary from day to day.) FMS pain often occurs without a specific cause or injury. In other cases, it may be linked to an injury (such as from a car crash), may be tied to a traumatic event (such as past physical or sexual abuse), or may be connected to combat experiences (such as in the Iraq War or past service in Vietnam).

Yet some people, including some doctors, persist in thinking that fibromyalgia is just another word for hypochondria — or maybe even slacker or goof-off. They think that people who say they have fibromyalgia symptoms are really lazy or crazy — or both. They dismiss FMS as just another “disease of the month.”

They’re wrong. The pain isn’t imaginary, and the problem is no fad. At the University of Florida, I’ve conducted studies that have proven that subjects diagnosed with fibromyalgia suffer heightened pain sensitivity and low pain threshold, and that they retain their pain longer than those individuals without the syndrome.

It’s true that if fibromyalgia sufferers can be depressed, anxious, or stressed, they’ll feel worse. But depression, anxiety, and stress don’t actually cause fibromyalgia. People with FMS will have pain whether they’re upset or not. But their pain often increases when they’re distressed.

What does fibromyalgia feel like? Many people say that to truly understand how FMS can be experienced, you need to imagine how you feel when you have the flu. Recall the aching and pain in parts of your body or in your entire body. Then multiply those achy feelings by about ten times. Now imagine feeling that way nearly everyday. That is what fibromyalgia feels like for a lot of people. Pretty nasty.

The good news is that you can feel much better with both the traditional and alternative medications and treatments, as well as with the lifestyle choices, that I describe in this book. They work for other people, and they can help you (or someone you know who suffers from FMS), too.

About This Book

Although this is a new edition, my two primary goals in writing this book remain the same:

I want to show that fibromyalgia pain is real — and now there’s more evidence than ever to help me prove that. This goal is important because some doubters are still out there.

I want to discuss the pain of FMS and provide the most current information on medications, alternative remedies, lifestyle changes, and other treatments that work.

You don’t have to read this book from the first page straight on through to the end — although you certainly can if you want to. You may instead want to read Chapter 1 to get a feel and flavor for the rest of the book. Then you can use the table of contents at the front of the book or the index in the back to help you move on to the chapters that interest you the most.

Also, keep an eye out for the many personal stories that I’ve sprinkled throughout the book. These anecdotes come from real people who suffer from fibromyalgia.

Conventions Used in This Book

The following conventions are used throughout the text to make things consistent and easy to understand:

All Web addresses and e-mail addresses appear in monofont.

New terms appear in italics and are closely followed by an easy-to- understand definition.

I use bold to highlight the action parts of numbered steps or keywords in bulleted lists.

Sidebars, which are enclosed in a shaded gray box, include information that may fascinate you but that isn’t critical to your understanding of FMS.

Also, you may have noticed that two names appear on the front cover, but I use the singular pronoun I in the text. I do so because this book reflects only my views as a medical professional, while Christine Adamec, an experienced medical writer, assisted with the preparation and production of the book. Thus, she’s also credited on the cover.

What You’re Not to Read

You can read this book in any order you want, dipping into it to find the information you need and then moving on. You can safely skip the sidebars (text in gray boxes); they contain interesting information, but they’re not critical to the subject at hand. Finally, you can skip any text marked by the Technical Stuff icon (for more on this icon, see “Icons Used in This Book,” later in this Introduction).

Foolish Assumptions

In writing this book, I’m making some basic assumptions about you. I’m assuming that:

You have fibromyalgia, think that you have it, or you have a friend, child, teenager, or other family member with FMS, and you want information in order to be able to help.

You want information on pain relief and remedies.

You’re curious about alternative remedies and treatments, and want to know what works and what to avoid — and you need some basic guidelines on how to know the difference.

How This Book Is Organized

Fibromyalgia For Dummies, 2nd Edition, is divided into seven convenient parts, starting with what fibromyalgia is, moving to who’s most likely to have it, and zeroing in on the many ways to deal with the pain, fatigue, and other common symptoms that fibromyalgia sufferers share. Here’s how it breaks down.

Part I: The What, When, and Why of Fibromyalgia

In the first four chapters, I cover the realities of fibromyalgia. I offer a self-test, in case you need help in determining whether you may have FMS. The various symptoms of fibromyalgia are important to understand, and I cover them in detail in Chapter 2. I also talk about possible causes of fibromyalgia in Chapter 3. Nobody knows exactly what causes FMS, but there are some intriguing theories about the perpetrators of this medical problem (such as, it may be in your genes). Chapter 4 covers pain and its purpose, including good pain and bad pain. Most fibromyalgia pain is bad pain, so don’t imagine that I think otherwise, because I don’t! However, you need to manage FMS pain, instead of having that pain manage you.

Part II: Finding Out Whether You Have Fibromyalgia

To know whether you may have FMS, it helps to consider patterns found among people already diagnosed. You can still have FMS even if you don’t fit neatly into one or more of these categories, but it’s less likely. I cover this information in Chapter 5. Then, moving to Chapter 6, I describe medical problems often confused with fibromyalgia, such as chronic fatigue syndrome, myofascial pain syndrome, arthritis, lupus, Raynaud’s phenomenon, and thyroid disease. Some people have more than one of these medical problems — I hope you won’t have “all of the above.” Next, Chapters 7 and 8 walk you through working with your primary-care doctor, and, if needed, finding a new physician.

Part III: Looking At All Your Treatment Options

Here’s where I talk about what to do about your fibromyalgia. In Chapter 9, I cover over-the-counter medications, such as aspirin, guaifenesin, and dextromethorphan, as well as different categories of medications, such as antihistamines and topical remedies applied to the skin. And I describe the full gamut of prescribed remedies for FMS in Chapter 10, including some new medications that you need to know about. I then talk about some hands-on therapy that can help you, such as icing or heating the painful spots or applying direct massage to your hurting areas, in Chapter 11.

In Chapter 12, I cover alternative remedies and treatments that may help you feel better, such as herbs, supplements, Botox treatments (not just for facial wrinkles anymore!), acupuncture, tai chi, and other complementary medicine choices, as well as some treatments that you really should steer clear of and some advice on how to tell the good guys from the scammers out there.

Part IV: Modifying Your Lifestyle: Small Changes, Big Results

You can make some nonmedical lifestyle changes to ease your pain. In Chapters 13 and 14, I tell you how you can control stress using relaxation therapy, hypnotherapy, meditation, and yoga, and provide details on how to get a good night’s sleep. In Chapter 15, I include important information on exercising, losing weight, and making key dietary changes that may help considerably. In Chapter 16, I cover dealing with the emotional fallout of FMS, and, if you need a therapist, I offer advice on finding a good one.

Part V: Managing Fibromyalgia at Work and at Home

You can’t switch FMS off and on (if you could, it’d always be in the off position!), so the illness affects you both at work and at home. In Chapters 17 and 18, I discuss how you can help your family, friends, co-workers, and even your boss to help you. Sometimes, work may become impossible, and you may need to apply for a disability — an important subject I also cover. I offer Chapter 19 for those who don’t have FMS themselves, but who have a friend or family member who’s hurting — and whom they want to help. I also include a chapter on children and adolescents with fibromyalgia, in case your child, or the child of someone you know, suffers from FMS.

Part VI: The Part of Tens

This part presents helpful information in lists of ten items each. You can read about ten pieces of advice on remedies related to fibromyalgia. Another list offers ten mistakes to avoid when you have FMS. I also have ten ways to beat brain malaise (fibro fog). Last, I debunk ten myths about FMS.

Part VII: Appendixes

In this part, I provide a glossary of commonly used terms related to fibromyalgia. I also offer an up-to-date appendix of over-the-counter (OTC) drugs and prescribed medications that are useful to many patients with FMS. I include the brand and chemical names of the drug, common starting dosage, symptoms it combats, and side effects.

Another appendix is an Internet resource guide of interesting Web pages where you’ll find resources and articles to read as well as support groups to contact online. And, in case you’re not a Nethead, I offer an appendix of helpful organizations to contact through the mail. I also provide a list of publications devoted to fibromyalgia.

Icons Used in This Book

To help you remember the important points of each chapter, this book marks certain paragraphs with the following helpful icons:

This icon denotes critical information that you really need to take away with you. Be sure to read it.

When you see this icon, you find a helpful hint for coping with fibromyalgia that may save you time or money. Or maybe both!

The Warning icon cautions you against something that’s potentially harmful. Be sure to read and heed these icons.

When I get a bit technical on you, I use this icon. You can safely skip any paragraphs marked by the Technical Stuff icon — of course, if you read them, you’re sure to discover something interesting.

Where to Go from Here

After you’ve read this book and started using my suggestions to begin your journey to less pain and better health, I hope that you’ll experience the considerable improvement that many others have felt. In particular, I hope you maintain your personal commitment to managing your own health. I also hope that you’ll be well armored against attacks from people out there who somehow still (and wrongly!) think that fibromyalgia is fake. Fibromyalgia is a real medical problem; it’s not something that’s in your head. But it’s also a real medical problem that you can successfully control.

Part I

The What, When, and Why of Fibromyalgia

In this part . . .

Fibromyalgia is a real medical problem — no matter what you may have heard from other people (including some doctors!) who act as though they know what they’re talking about. Fibromyalgia isn’t “just in your head” — actually fibromyalgia pain and tenderness are usually spread throughout the entire body!

In Part I, I describe the key aspects of fibromyalgia that you need to know, such as exactly what fibromyalgia is and what the major symptoms are. I include a fibromyalgia self-test that you can take. I also discuss intriguing theories on why you and others may have developed fibromyalgia. I cover car crashes, infections, autoimmune systems run amuck, traumatic experiences, genetic predispositions, and other theories. Pain is the main problem with fibromyalgia, and I devote an entire chapter to this topic (quite painless to read), which I hope will provide good insight into what’s actually going on with your poor aching body.

Chapter 1

Yes, Fibromyalgia Is Real

In This Chapter

Considering symptoms, causes, and the pain aspect

Knowing who gets fibromyalgia

Looking at medical problems confused with fibromyalgia

Finding a good doctor

Exploring over-the-counter and prescribed medications and alternative remedies

Considering how fibromyalgia affects work and family

Improving sleep, decreasing stress, and dealing with emotional effects

Knowing that fibromyalgia syndrome (FMS) is a real medical problem that needs to be dealt with is an important first step toward mastering your fibromyalgia — and moving toward that place where you can start to feel like you’re making progress. Sure, you can try to ignore the problem. But mostly, it won’t let you.

Fibromyalgia has many aspects to consider. In this chapter, I line up the major issues for you and refer you to chapters later in this book where I discuss how fibromyalgia affects you individually and what treatments and medications may work best for you.

Dumping Your Doubts about Whether FMS Is Real

Many people spend months or years questioning their fibromyalgia symptoms, sometimes wondering if they’re imagining how bad the symptoms are. After all, if you feel terrible one day and then significantly better or almost normal the next day, you may start to think that maybe you were exaggerating the pain and fatigue of the previous day.

The thing is, most people can’t remember pain well. They can remember that they had pain, but they can’t remember what it actually felt like. (This is generally a good thing!) As a result, people experiencing the ups and downs of pain and other symptoms that accompany fibromyalgia worry sometimes that perhaps the problem isn’t that big of a deal and could even be all in their heads. Consequently, they may try to ignore the problem and hope that it’ll go far, far away — preferably today.

But if you have fibromyalgia (and I recommend that you take my self-test later in this chapter to see whether you could be a possible candidate), simply ignoring the problem doesn’t work. The sooner you acknowledge that fibromyalgia is a real and long-term problem, the sooner you can work toward reclaiming your life.

You can gain enormous control over the symptoms that stem from your fibromyalgia, but only rarely can you eradicate them altogether. Most people have plenty of room for improvement, however.

Examining the Symptoms, Causes, and Pain Problems Associated with Fibromyalgia

Fibromyalgia isn’t a one-size-fits-all kind of medical problem, but I can make some descriptive generalizations about it regarding symptoms, causes, and pain.

Sizing up the symptoms

Many people with fibromyalgia report that the following statements are true about their fibromyalgia symptoms. In fact, most people with fibromyalgia say that they have at least several, if not all, of these symptoms (which I cover in much more detail in Chapter 2):

Flu-like pain that can be severe

A constant feeling of extreme fatigue

Several tender body areas that hurt

Overall body aches

Depression and/or anger

Feeling very anxious

Muscle stiffness and pain

Chronic back pain

Insomnia

Worsening of pain after physical activity

Mental malaise and confusion, often referred to as fibro fog

Many people with FMS have other pain-based medical problems as well, which I also cover in more depth in Chapter 2. Some examples of the array of medical conditions that people with fibromyalgia may experience, on top of the fibromyalgia that they already have (as if FMS isn’t enough), include

Restless legs

Irritable bowel syndrome

Interstitial cystitis (a chronic, painful bladder condition that may feel like a constant bladder infection)

Tension headaches or migraine headaches

Benign joint hypermobility syndrome (BJHS; an often painful form of hereditary joint hyperextension)

Attention deficit hyperactivity disorder (ADHD)

Chronic fatigue syndrome

Considering causes

No one knows for sure what causes fibromyalgia, but physicians and other experts have many fascinating theories to explain what may induce the onset of FMS. The cause could be hormones or an autoimmune problem or biochemicals gone awry, chronic stress, 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. Individuals who have been abused as children or adults are more likely to develop fibromyalgia than others.

The cause could also be a combination of different factors coming together at just the right time (or the wrong time when you think about it) for you to develop FMS. For example, maybe you got the flu, and then were involved in a serious accident. Or some other awful combination may have occurred.

As researchers (like me) continue to study this medical problem, they move closer to the truth. Speculating about causes can be fascinating, and Chapter 3 offers some common theories for what causes fibromyalgia.

Pondering pain

Thinking about pain is certainly no fun, and yet pain is part of what makes us alive and human. But when pain runs rampant in our bodies, extracting particular pain in certain parts of it, it becomes a major problem, and fibromyalgia pain can be very intense. I talk about the purpose of pain and how and why it needs to be managed in Chapter 4. It may sound like a chapter to avoid, but hold on! You need to read it because it includes some important and useful ideas.

And by the way, I’m not just saying that I believe that the pain and symptoms of fibromyalgia are real because I’m a nice guy who doesn’t want to hurt your delicate feelings. I think that I am here to help you, but even more important, I’m a physician who’s a clinical researcher, and I’ve proven in my studies on the pain of people with fibromyalgia that their pain (and yours) is real.

My studies, as well as the studies that have been done by other researchers, have shown that the pain sensations experienced by people with fibromyalgia (especially women) are actually more intense, and the pain lasts longer than does the pain of people who don’t have fibromyalgia. Read Chapter 4 for further information on the ins and outs of fibromyalgia pain.

Considering Who Gets Fibromyalgia

Just about anyone of any age can develop fibromyalgia, but most research so far indicates that the majority of people with FMS are of the female persuasion, partly because women are more sensitive to pain than men. This is a time where a little equal opportunity of pain would be preferable (if you’re a woman). But who gets fibromyalgia isn’t about fairness.

Although women are the primary sufferers of fibromyalgia, many men have been diagnosed with FMS, too, and some men with fibromyalgia go undiagnosed for years. For more information about some of the major patterns that have been identified so far among people who develop fibromyalgia, which you may share with these fellow sufferers, be sure to read Chapter 5.

What about children and adolescents? Do they have fibromyalgia? Sadly, yes. If your child or teenager has FMS, he may have a difficult time because most physicians, as well as the general public, still don’t realize that kids can experience chronic pain from FMS. Instead, they think kids are faking it when they say that they’re too sick to go to school. Maybe they are, but then again, maybe they’re not. Skip ahead to Chapter 20 for some advice on how to tell the difference.

Looking at Related Medical Problems

Sometimes, people strongly suspect (or are sure) that they have fibromyalgia. Instead, however, they may have arthritis, Lyme disease, lupus, thyroid

dysfunction, Raynaud’s phenomenon, or a variety of other common and not-so-common medical problems. And sometimes people have both fibromyalgia and other serious medical problems. Having fibromyalgia doesn’t exempt you from getting sick with other illnesses (even though it seems like it would be only fair that it should).

With the existing array of possible medical problems and their often- overlapping symptoms, even doctors can become confused sometimes about which is which when they’re working on a diagnosis. A good doctor is up to this task, of course, as long as you don’t expect instant results on your first visit.

For example, suppose that one of your primary symptoms is extreme fatigue, possibly to the point of total exhaustion — even though you haven’t been doing anything more strenuous than using the remote control to change channels. This action may use up one calorie or less, but you feel like you’ve climbed Mount Everest. Maybe your problem is fibromyalgia, but maybe not.

Extreme tiredness is one of the possible symptoms of many medical problems, including hypothyroidism, anemia, chronic fatigue syndrome, Lyme disease, arthritis, and — oh, yes — fibromyalgia, too. No wonder sorting it all out can be so hard sometimes! To find out more about illnesses often confused with FMS, and how doctors sort them out, read Chapter 6.

Do You Have Fibromyalgia? A Self-Test

Only your physician can diagnose you with fibromyalgia and then treat you. Reading this book is a very good idea, but it still doesn’t really cut it when it comes to making an actual diagnosis in your own individual case. What I can give you is a simple self-test to use to help you determine if you may have fibromyalgia syndrome.

Grab a scratch piece of paper and jot down your answers to the following “yes” or “no” questions. Then, read my analysis at the end of the list. If you think that you may be a possible candidate for fibromyalgia, make an appointment with your physician and find out for sure.

1.Do you have a lot of pain in certain specific areas of your body? If so, do these areas lack any obvious damage (such as bruising or swelling)?

2.Is your overall body pain sometimes severe?

3.Do you have trouble sleeping on three or more nights per week?

4.Do you feel exhausted about half the time or more?

5.Do people often say that you look sick?

6.Do you turn down social invitations rather than risk having to go out feeling achy and tired?

7.Do you find yourself wondering whether your aches and pains will ever go away or if you’ll feel like this forever?

8.Are you always losing things and forgetting things? Do you have so much mental confusion that you sometimes wonder if it could be an early onset of Alzheimer’s disease?

9.Are you having trouble finding any real pattern to your pain — because some days it’s bad and some days it’s not?

10.Have you started to feel “down” about your pain and fatigue? Are you wondering whether depression could be the underlying problem?

If you answered “yes” to as many as three or more of these questions, you may have fibromyalgia, although every person’s case is different. That’s why even if you only answered “yes” to one or two of the questions, but you think that you may have fibromyalgia, a consultation with your physician is a good idea.

Now, here’s some explanation of what may be happening to you, depending on your answers to Questions 1 through 10. Keep in mind, though, that only your doctor can actually diagnose you with fibromyalgia.

Question 1: If you’re experiencing pain in specific parts of your body, but you’re not seeing bruises or any apparent evidence of tissue damage (and neither is your doctor), these painful areas may be the muscle pains characteristic of fibromyalgia. Read Chapter 8 for more information on tender points.

Question 2: If you said that your pain is sometimes very severe, this is another indicator that you may have fibromyalgia. Be sure to consult a physician to find out.

Question 3: If you have trouble sleeping three or more nights per week, this is serious. The problem may or may not be connected with fibromyalgia (although nearly everyone with FMS has sleep problems), but it’s important to resolve your serious sleep deficit. If you’re a walking zombie because you’re not getting enough sleep, you can’t perform well at work or home, nor will you be a happy person.

Also, if you’re prone to developing fibromyalgia, this continuing bad pattern of a lack of sleep every night will make your other symptoms, such as your pain and fatigue, much worse.

Question 4: Severe fatigue is a chronic problem among nearly everyone who has fibromyalgia. Often, it’s linked to a lack of sleep. But it may also be an element of FMS as a medical problem. You may also have chronic fatigue syndrome or thyroid disease, and your doctor will need to help you sort it out.

Question 5: If you agreed that those you care about, or maybe even strangers around you, are commenting that you look sick, something about you probably doesn’t look right. You may be displaying your chronic pain and associated depression on your face without even knowing it.

On the other hand, other people tell individuals with fibromyalgia that they look “fine” and “great,” and the pain and symptoms are not reflected in the face or body language of the fibro sufferer. If this has happened to you, you’re definitely not alone.

Question 6: If you’re turning down invitations that you would have accepted in the past, have a serious talk with yourself to find out why. Is it because of pain and fatigue? Or could you be having a problem with depression or anxiety — both very common problems for people with and without fibromyalgia?

Question 7: When your pain is constant and chronic, asking yourself if it’s ever going to end is only natural. But what you need to do is consult with a physician. You may have fibromyalgia, or you may have another problem altogether. Don’t wait for the pain to magically disappear. Take action.

Question 8: If you constantly lose things or forget things, you may have the “fibro fog” that often stems from fibromyalgia. You may also have attention deficit hyperactivity disorder (ADHD). Another possibility is that you may have neither of these but you’re simply trying to do too many things at once, and you need to take some things off your plate.

How do you know which it is? You make a stab at analyzing what you’re forgetting and when. If you can’t even begin to do that, and you’re also experiencing chronic pain, fatigue, and sleep problems, you may have fibromyalgia. But see your doctor to find out for sure.

Question 9: If your pain is severe on some days and then far less of a problem on other days, and you think there doesn’t seem to be any pattern to it at all, you may be experiencing the chronic ups and downs of fibromyalgia.

Pain that can appear in one part of your body one day and migrate elsewhere on another day is a common symptom of FMS, as are days when you feel really bad and other days when you feel only mildly bad.

Question 10: If you don’t seem to enjoy anything anymore and maybe are sort of overwhelmed by your many aches and pains, you may have depression. Many people with fibromyalgia have both depression and FMS. You could also have a problem with an anxiety disorder, such as generalized anxiety disorder (GAD), where you are overwhelmed with extreme worry.

But before rushing off to the nearest psychiatrist to ask for the latest antidepressant or anti-anxiety medication approved by the Food and Drug Administration (FDA), as a first step, consider talking to your regular doctor or to a pain specialist. Why? Your primary problem may actually be fibromyalgia, and if your medical problem is treated and then your symptoms subsequently improve, so may your sad mood. Many doctors prescribe antidepressant medications to treat pain and FMS. Get more details on this in Chapter 10.

This test is just a starting point. If you’re really concerned that you may have FMS and/or another chronic illness, make an appointment with your doctor.

Finding a Doctor Who’s a “True Believer” in Fibromyalgia

Although I believe that most well-educated physicians are at least aware of the existence of fibromyalgia and its basic symptoms, and also know that it’s a valid problem that needs to be treated, I also know that a few doctors out there still haven’t gotten the word yet. If your doctor isn’t helping you with your FMS symptoms, you need to help him understand it. Taking this book to your appointment and showing him what you’re reading is a good start.

A good doctor will consider your symptoms as valid, take a complete medical history, and perform a physical examination. Read Chapters 7 and 8 for more details.

Sometimes, no matter what you do, a particular physician isn’t working out for you. Maybe the two of you have a personality conflict, or maybe he thinks that you should just tough out your fibromyalgia. Or maybe the problem stems from something else altogether. Whatever it is, sometimes, you just need to find a new doctor. (I’ve devoted a significant part of Chapter 7 to help you find a new doc, if that’s what you need to do.)

After you find a good doctor who’s interested in working with you, she can formulate a plan for you to follow — one that’s doable in your life. Usually, such a plan involves medications to take (over-the-counter and/or prescribed drugs and, sometimes, supplements or alternative remedies, too), as well as advice on basic lifestyle changes that you can make to improve your health. Some of these lifestyle changes may involve foods to eat or avoid (for example, foods high in caffeine may make you feel worse), exercises to perform, and other therapies that may improve your symptoms.

Treating the Problem

When you have fibromyalgia, at least some of the time you may want to take some medications, whether they’re over-the-counter drugs; prescribed medications, such as muscle relaxants or painkillers; or other medications such as prescribed or over-the-counter topical ointments that can help to ease your pain and symptoms. I cover these topics thoroughly in Chapters 9 and 10. You can also often gain benefit from hands-on therapy, including heat, ice, and massage therapy, all covered in Chapter 11.

And don’t forget about the promise of alternative remedies! People with fibromyalgia have some very intriguing choices to consider, including acupuncture, acupressure, biofeedback, herbal or homeopathic remedies, and neurofeedback. Read more details about all these different choices in Chapter 12.

Making Lifestyle Changes: Pulling Yourself into a Non-Fibro World

As you work to pull yourself farther back into the non-fibromyalgia world, you may sometimes feel like a person loaded down with 50 pounds of extra weight, trying to slog your way through the swamp. During your struggle you watch others on dry land with no heavy packs dart by you, maybe waving at you and telling you that they’ll see you later.

If you want to improve your quality of life and be able to reduce your backpack of troublesome symptoms, consider the following basic ideas:

De-stress yourself. Stress is a normal part of life, but if you have fibromyalgia on top of the usual daily stresses, or maybe with some extra stress thrown in once in a while, you’re in a bad situation. Stress can greatly worsen the chronic pain, fatigue, and other symptoms of the person with fibromyalgia. Be sure to read Chapter 13 for my suggestions on relaxation therapy, hypnosis, meditation, and other methods to “de-stress” yourself. They work!

Improve your sleep to decrease your pain. Don’t kid yourself. Five or even six hours of sleep each night aren’t enough. So, if insufficient sleep is a problem for you, as it is for many people with fibromyalgia, face up to it. You may need medication (such as a sleep aid or an antidepressant or anti-anxiety medicine), an alternative remedy (such as valerian or melatonin), or another form of treatment to solve this no- or low-sleep problem that you’re going through. Read Chapter 14 for some ideas on how to resolve sleep problems and help yourself feel better.

Exercise. Unless you’re an exercise-aholic, you probably don’t much like the idea of exercising (most people don’t), and the mere thought of it may be nearly migraine inducing for some readers. But the fact is, aerobic exercise will usually help you to limber up and lose weight, making you more mobile and also helping you to feel better. So consider “getting physical.” Read Chapter 15 to find out more about the benefits of exercises and for some specific, FMS-friendly exercises you can try.

Exercise shouldn’t hurt a lot, nor should it be really unpleasant and something to dread. If you hate swimming or bicycling, don’t use those activities as your exercises. Maybe walking would suit you better, or maybe dancing or some other form of aerobic exercise with your partner or a friend. You can exercise in many different ways: Be creative and find the best ways for you.

Pay attention to your emotions. Stress isn’t the only problem that people with fibromyalgia often face. Depression and anxiety are also very common, and they may be problems that you face. These problems are treatable and, in Chapter 16, I talk about how to know if you may have a problem, and how to identify a good therapist to help you, if you need one.

Coping with Fibromyalgia at Home and on the Job

Unfortunately, fibromyalgia doesn’t end at 6 p.m. or whenever you arrive home from work, nor does it go away when you wake up in the morning, struggling to get ready for another day at work or at home. When you have FMS, it’s always there on the sidelines, waiting to jump on you yet again with its aggravating symptoms.

You also need to keep in mind that other people you interact with on a daily basis (your partner, children, friends, co-workers, and other family members) are directly affected by your fibromyalgia, even if they don’t have FMS themselves.

Virtually anyone you interact with on a regular basis needs some understanding of what you need from them, whether you tell them that you have fibromyalgia or not. (Some people with fibromyalgia tell everyone that they have “arthritis” because they think that it sounds better.)

Even as you become more aware of your symptoms and how best to resolve them, you still have to deal with the “non-fibro” world, comprised of your family members who don’t have fibromyalgia, your fellow workers, and many others you interact with. You need to develop workable strategies to cope with these varying situations and come up with a winning game plan for your life. I cover these topics in Chapters 17 and 18.

Working with fibromyalgia at work

Many people with fibromyalgia continue to work full-time or part-time, despite their pain and fatigue. They struggle with what to do when their symptoms make it hard to continue to work.

Many people worry about whether they should tell others at work about their FMS, whom they should tell, what they should say, and so much more. In Chapter 17, I provide a thorough overview of these issues and how they’ve affected real people. I also include advice from an attorney expert in getting people with FMS approved for Social Security disability.

Handling fibromyalgia with family and friends

Even the most loving family members and friends usually don’t really understand fibromyalgia if they don’t have it themselves. And even if they do have FMS, too, their symptoms may be very different from what you experience, and the intensity of their symptoms may be better or worse than the way your symptoms grab hold of you.

As nice as it would be if this were true, the reality is that fibromyalgia isn’t a quickie one-time explanation. For people to understand what your problem is, especially the people with whom you share your home and your life, helping them get a clue about what you’re going through and what you need takes a lot of work.

You have to be candid, and you also need to know how to respond to the dumb things that people often say to people who have fibromyalgia. Read Chapter 18 for more information on how (and also how not) to explain fibromyalgia to your children of all ages, your partner, and other family members and friends, so that they can better understand what’s really going on here.

Don’t miss the information that I provide on sex and fibromyalgia for readers who are sensing that their partners are maybe feeling a teensy bit deprived in this area of life. (Thinking about sex when you hurt is a hard thing to do, but it’s not hard for your non-FMS partner to think about it. Finding common ground is a good idea.)

Sorting it out when you don’t have fibromyalgia

Maybe you don’t have fibromyalgia, but you live with someone who does, and you really want to understand the problem and to help as much as possible. But where do you begin? Not to worry, I’ve provided a chapter just for you — Chapter 19.

This chapter describes techniques to assist you in helping your friend or loved one deal with FMS, and it also tells you some things you should not do or say because they drive most people with fibromyalgia wild. (People who do have fibromyalgia may enjoy reading Chapter 19, too, and sharing it with their friends and family members who don’t have FMS.)

Chapter 2

Recognizing Key Symptoms of Fibromyalgia

In This Chapter

Regarding the pain and stiffness

Analyzing the fatigue

Sorting out fibro fog

Coping with your body’s reaction to weather changes

Suffering from sleep problems

Identifying related medical problems that you may have

For Sandy, the horrible pain is what bothers her most about her fibromyalgia. Sure, she has some other symptoms that bother her as well, such as fatigue and chronic muscle stiffness, especially in the morning. But only the severe pain counts, in her mind.

For Lisa, the pain is also terrible, but she thinks that if she weren’t so horribly tired all the time, maybe the pain drugs that she takes would allow her to actually accomplish something — anything. As it is, it’s like she’s trapped in quicksand.

Andy, another person with fibromyalgia, says that he feels overwhelmed by everything. The pain. The constant tiredness. The confusion. The frequent headaches. Andy wants it all to go away — preferably right now.

In this chapter, I cover key symptoms of fibromyalgia, including — first and foremost — the pain and stiffness that nearly everyone complains about. I also cover the extreme fatigue that causes constant problems for most people with fibromyalgia syndrome (FMS). In addition, I include information on what some people with fibromyalgia call fibro fog, which is really a sort of temporary mental confusion resulting in difficulty concentrating.

I also cover syndromes and diseases commonly associated with fibromyalgia, such as irritable bowel syndrome, interstitial cystitis, chronic headaches, chronic heartburn, depression, and arthritic conditions. You may be interested to discover that some treatments for these individual ailments are similar to (or the same as) treatments recommended for fibromyalgia.

Describing Where It Hurts: Almost Everywhere!

Most people with fibromyalgia say that the widespread pain drives them the most crazy. Sure, they don’t like fatigue or muscle aches, nor do they enjoy fibro fog. These symptoms are common for many people with FMS. But they may seem minor league compared to the hurting-all-over pain, which can sometimes escalate from mild or moderate to severe pain.

Eva has had FMS for years, and says that if you want to understand how FMS feels, imagine a giant truck ran over you — and backed up and ran over you again.

Feeling the aches and body pains of your fibromyalgia — but being unable to show proof

You probably find it hard to explain to people where you hurt. You can get pretty strange looks when you say that you hurt almost everywhere. Not just in your back, legs, neck, or other sites of your body. All those places may hurt, and maybe other places, too. Nor do you have visible damage to point to. No broken bones, no gushing wounds, not one bruise to show someone, “Here is where it hurts me the most. Look at this.”

Laboratory tests can’t diagnose fibromyalgia — at least, not yet. Tests can only tell you that you don’t have other medical problems known to cause pain. You shouldn’t, therefore, be surprised if doctors can’t find anything except some tender points, where you wince when pressure is applied there. (Read more about the tender points of fibromyalgia in Chapter 8.)

So you have no hard evidence that you can present for your pain. And yet you continue to hurt and hurt and hurt and hurt.

As an FMS sufferer, you’re not alone in regard to a lack of specific laboratory findings. People with chronic migraine headaches, tension headaches, and back pain have recurrent pain, and often doctors find no specific abnormalities. In fact, many chronic-pain conditions lack overt physical findings. But remember, you don’t have to prove to anyone — including your doctor — that you hurt. You know that you have pain, and that should be good enough for your physician.

Focus on finding a knowledgeable doctor who can diagnose your illness. If you have FMS, you’ll also have classic symptoms, such as chronic widespread pain and tenderness as well as fatigue, insomnia, and distress. A doctor who takes a thorough medical history, performs screening tests for other possible diseases, and does a careful physical examination can diagnose most FMS sufferers. (See Chapter 7 for advice on finding a good fibromyalgia doctor.)

Suffering from muscle stiffness — especially in the morning

Many people with fibromyalgia say that the severe muscle stiffness and achiness is the worst in the morning. You may wake up and feel as though you’ve already participated in a major marathon — or maybe as though gremlins beat you all night long. The stiffness may diminish as you move about, but usually it doesn’t go away completely. People with arthritis also often experience muscle stiffness, so maybe in the past, doctors told you that your problem was arthritis.

You may have both arthritis and fibromyalgia. Unfortunately, having fibromyalgia doesn’t exempt you from other medical problems. If you suffer from chronic stiffness, turn to Chapter 15, which includes some good, easy stretching exercises to help you with this problem.

Tammy, whose fibromyalgia was diagnosed several years ago, feels that one of the hardest parts is the severe morning stiffness. In fact, when she gets up in the morning or rises after sitting for a long period, her husband calls her contortions her “rigor-mortis walk” because her movements look so stiff. (Tammy says that she doesn’t mind his teasing because he’s supportive and understanding of the problems that she faces with fibromyalgia.)

Singling out a source of your pain: You can’t

When you try to analyze where all this pain is coming from — the master generator of your agony — you most likely can’t figure it out. Nor can you deduce why you’re experiencing it. However, you may have found out that stress makes almost all your symptoms worse. Your doctor may often be puzzled by these questions, too. (Read about possible causes of fibromyalgia in Chapter 3.)

Some experts believe that extreme exercise or injuries from a car accident or a fall may induce FMS. But you probably haven’t been exercising like crazy because you’ve felt too bad to exercise a lot (or at all). You probably haven’t just fallen or had an accident or injury, either.

Chronically feeling your pain

Another key aspect of fibromyalgia is that the pain is