[KaroSnowQueen]

I disagree with those of you who are so skeptical of
FM. I have not been officially diagnosed, but the doc has mentioned it as a possibility to me.
If you wake up after two days off hurting worse than you did during a 3 day stretch of 12's, it's not a good thing. I do not take pain meds any stronger than OTC. I have Skelaxins, which I take a half one a day while I'm working to keep the pains down.
And hypoglycemia is a common ailment in my family, seems to be the family precursor to DM, low sugar for years and years and years and BAM! DM.
I realize there are indeed drug seekers and lazy bums that we see daily in our work, but to tar those of us who are truly feeling miserable with the same brush is not fair.

[Helen Robinson]

Originally Posted by cbarnett2

It is so sad to hear "health professionals" take these types of views of their patients...

There will always be Hypochondriacs and Drug Abusers among us and unfortunately they do misuse the health system in many cases. They were here before fibromyalgia and they will certainly be around in years to come.

But to discount a person whom you just made first contact with because they are suffering from a condition that is commonly used as a means to an end by hypochondriacs and/or drug abusers is IMHO beyond unprofessional and to me sounds very similar to discriminations of the past... like assuming everyone with HIV/AIDS is or was a heroin user, a homosexual, or a prostitute.

I am starting to wonder how many here slept through their "Medical Ethics" class in nursing school.

I take personal offense to the above quoted comment as hypoglycemia is very common in my family. My newborn daughter was kept in the hospital because she was hypoglycemic on delivery and took more than 24 hrs to maintain a normal blood sugar. She is 3 yrs old and still has symptoms from time to time. I am no endochronologist but I do know that hypoglycemia is widely acknowledged by DRs as closely related to diabetes and or a precursor to diabetes and IS a real condition that myself, my sister, my mother, and brother have dealt with for years.

As for FM I was diagnosed at 19 by a rheumatologist who based his DX on the pressure point test. I have never accepted narcotics, antidepressants, or sleep aids for my problem, although I think that these can be helpful to some with correct supervison (as with any condition requiring pain management). I prefer to work on keeping my weight and stress under control and stay active...but you know weight, stress, and inactivity are a common cause of a long list of medical problems people have...

I know with great certainty that I would be very critical of anyone's ability to care for me if I arrived in their ER and got the old eye roll when I mention that I have a history of FM and hypoglycemia...I believe that I would have a valid reason to question their ability to care for me properly because of their ignorance...

BTW I do not apologize for rambling...

I too have FM I have tried NSAIDS and have been acussed of not taking my meds as I should----This disease is such a mimic of other processes that it is very hard to tell if it just the aches and pains due to FM Or more serious to justify seeing the doc and which doc! I now have L4 & L5 degenerations with Ostio with min. bulge.....Depending on how much pain depends on the pain med---Yes I have tried neurotin and the others in that class the side effects did not justify the means---So I keep going and rest when I must from much proding from familly and friends and then off I go I do not not not have depression....Amitriptiline 25mg only helps to relax the body a bit to sleep---But now with the muscle cramps oh wow try this; for relaxing you can't sleep walk or rest when the happen mostly at night ..Oh welll we all go through our own hell's so thoes of you who doubt I sure hope you never acquire this phenomonom......

[teeituptom]

If I ever wake up pain free
I will know Im dead

[Jenn CLPN]

We see many fibromyalgia cases in our office. There is no blood test or x-ray that diagnoses it. The doctor has to decide that according to symptoms. You have to have at least "12" trigger points or painful areas(where FMS usually occurs). He puts many people majority woman on SSRi's, flexeril and elavil in the eveing to sleep. He also recommends some sweaty type of exercise if you can tolerate it like speed walking or the bike. Alot of people find that hard because when your in pain you cant exercise. We give the patients a pamphlet from the arthritis foundation telling them in detail what they can expect, there are many different feeling FMS patients get.

[RainbowSkye]

To all those suffering from fibromyalgia:

I absolutely believe this condition exists.

However, most of the people I see in the ER where I work who tell me they have fibromyalgia have never seen a rheumatologist, are on no home medications (or just ran out on Friday), are allergic to Toradol and "all NSAIDS" and have visited one of the other local ERs four or five times in last week. They call in advance to see which ER doctor is on duty (or just drive by the hospital as they know each doc's car) because they know who will prescribe what. This is my reality.

Gee whiz, this is a bit different from the people who see their rheumatologist, take their prescribed medications and use other techniques to help control their symptoms. These are the patients I do not see in the ER seeking fibromyalgia pain relief (although I may see them if they have a broken arm, need stitches, whatever).

[RNin92]

Originally Posted by RainbowSkye

To all those suffering from fibromyalgia:

I absolutely believe this condition exists.

However, most of the people I see in the ER where I work who tell me they have fibromyalgia have never seen a rheumatologist, are on no home medications (or just ran out on Friday), are allergic to Toradol and "all NSAIDS" and have visited one of the other local ERs four or five times in last week. They call in advance to see which ER doctor is on duty (or just drive by the hospital as they know each doc's car) because they know who will prescribe what. This is my reality.

Gee whiz, this is a bit different from the people who see their rheumatologist, take their prescribed medications and use other techniques to help control their symptoms. These are the patients I do not see in the ER seeking fibromyalgia pain relief (although I may see them if they have a broken arm, need stitches, whatever).

Funny how those same people make it from your hospital in the "deep south" to mine in Illinois!!!

Like I said before...it's not the disease/disorder...it's the behavior.

Using the ED for a drug-dealer is costing millions in healthcare dollars and clogging up the system from effectively treating "emergently ill/injured" patients.

Not to mention...we are doing no favors for these people by assisting in their addiction.

[yaddadoit]

Wow! Just read this thread and I'm really surprised and disappointed by it.
I was taught that certain responsibilities went hand in hand with having a nurses license. One of those responsibilities is to keep up with current medical issues and education. Another is to treat our patients (yes, even the drug seekers!) with respect. I encourage everyone who hasn't done it to study up on fibromyalgia. After reading some of the posts here and the amount of condemnation and lack of respect (these are my interpretations of some of these posts-- I apologize in advance if I misintrepreted!) I understand exactly why patients would Dr. shop or call in advance to find out who is working in the ER before they come in. Why waste their time to come in if they are just going to be met with disrespect and disbelief? There has been a lot of time and research spent on Fibromyalgia by very highly educated people. It amazes me that some nurses who seem so unfamiliar with fibromyalgia and have so many questions about it can just disregard all of the research that has been done and just decide that certain patients are drugseekers/lazy/depressed because an MD has diagnosed that patient with fibromyalgia. Have we now decided that doctors are not qualified to diagnose? Wow! As for the patients (and coworkers!) with fibromyalgia--my heart goes out to you for the suffering you have and will experience with this awful disease. May your paths always cross with respectful, educated medical professionals.

[MzUnderStood]

Once apon a time, PMS was all in the mind...

Never judge another until you have walked in their shoes.

[SmilingBluEyes]

Originally Posted by teeituptom

If I ever wake up pain free
I will know Im dead

I guess if you wake up with FM pain, bad enough, you may just wish you were.....


dead.

[auroranae]

I am a nurse who was recently diagnosed with Fibromyalgia. I have done alot of research on this and in many ways it is a catch all term. There are some lab tests that may suggest you have it, but the only way to confirm diagnosis is based upon the "pain points" the patient has. There are a total of 18 pain points that are associated with Fibromyalgia and a patient must have pain in at least 11 of these points on a consistent basis. Most patients do not have pain in all places at once, but rather a few places that are always painful such as knees, ankles, wrists, etc and then random transient pain to the other pain points such as neck, shoulders, hips, feet, calves etc. There is also another group of symptoms that go with fibro... severe fatigue and weakness, memory loss- short term and often described as a "foggy" feeling or "forgetting what I am about to say", as well as insomnia. Because of this CFS is also thought to be part of the fibromyalgia family of illnesses.
Please note that the ONLY treatment for fibromyalgia is palliative. This means that the symptoms are treated since the cause is not yet understood. The palliative treatment is to treat the insomnia and increase physical activity. By increasing the amount of "good sleep" or REM sleep, which many fibro patients never cycle to before waking, and thereby increasing the amount of serotonin secreted by the brain, you can, in many cases, improve the patients pain tolerance. Serotonin is a natural pain reducer or anesthetic so the patient may experience pain, but it will be less severe and less debilitating and therefore, more tolerable. THe only way to increase serotonin secretion at this time is with drugs that are commonly prescribed for depression. Amitryptilline is the drug of choice, but patients with other health issues may be given paxil as a substitute.
There has been some correlation between depression and Fibro, but it has been found that it is a result of severe insomnia causing a reduced secretion of serotonin. Once that has been treated the depression symptoms are gone. But, the anti-depressant tx will continue to prevent insomnia from returning. These are not psych patients, they are neuro and rheumatic patients. Many have multiple disciplines affected by the fibro.
More than 70% of patients with fibromyalgia also have GI probs- namely IBS, but less than half of patients with a primary diagnosis of IBS have fibromyalgia. A large number of patients with fibro are later found to have Lupus. Many Lupus patients have fibro as secondary diagnosis. You can have fibro without Lupus, but some studies suggest that if you have Lupus, you will have or develop Fibro at least to some degree.
The most affected population for Fibromyalgia is women, the same basic group as those for Lupus and Rheumatic problems. Because of this, it is thought that these 3 illnesses are closely related which makes it harder to pinpoint the cause of any one of them.
Oh- and Fibromyalgia is considered a SYNDROME- which means it is a group of symptoms that alone may be a minor problem- ie: pulled muscle, sprain, digestive disorder, but when found together are something with a totally different cause and do not necessarily respond to treatment as separate problems. For example- treating IBS with traditional meds will in all liklihood not be as effective, if at all, in a patient with Fibro. The reason is not yet understood, but perhaps will soon be.
The reason for the sudden onset of this diagnosis is simple... it was only recently in medicine that woman's complaints have been really looked at and studied. PID is a recent dx as is Pelvic Congestion Syndrome. Does not mean they haven't been there, just means that doctors are actually listening to women's complaints and in so doing are starting to note patterns that were previously not seen.
40 years ago cancer was considered a catch all term for patients with various illnesses that a doctor could not diagnose or that did not respond to treatment. There were many doctors who did not "believe" in cancer. Because of this many people died who could have been treated successfully. Looking back it seems silly that doctors thought it a made up illness. I wonder if the same will be said of these "catch all" neuro and rheumatic illnesses and syndromes that we are seeing more of these days.
When treating a patient - with any illness- it is important to remember that you can NEVER know what they are going thru unless you too have gone thru it. Therefore, you can NEVER judge a patient. No matter how nuts they may seem, one day it may be you that is being looked at that way.
BTW- I was diagnosed with Fibro but am having symptoms that have affected my heart as well. I have been to see a rheumatologist who gave me the fibro dx but dismissed Lupus even though I exhibit many of the symptoms and have a familial tendency.
Her official report read" Patients with fibromyalgia are typically overwieght and inactive...Returning to work is recommended to prevent inactivity which will only exaccerbate the pain and symptoms of fibromyalgia". Even a learned person who nearly exclusively sees patients with fibro is not above stereotyping and in so doing may actually be causing more harm than good. According to her report I should be working my nursing job-- I am a visitng nurse and drive 100-150 miles a day seeing patients for 12-14 hours a day. I am currently unable to walk up a flight of stairs carrying a laundry basket or vacuum AND mop my floor in the same day with becoming short of breath, so fatigued that I cannot think or function, or experiencing such pain in my body that to move is nearly impossible. Add to that the still unknown heart problem- Pericarditis of unknown origin- again not a symptom of fibro at all...
well, taking care of my 6 children and trying to lead as normal a life at home is hard enough, but to be told that unless I am going to a paying job I am inactive is very frustrating and very predjudiced thinking.
I am sorry this is so long, but as nurses we must remember that to judge someone can prevent us from providing the care they need. I am on the other side of that judgement now and it is not a nice place to be. My pain and symptoms are very real, as is my fear that I may not be able to return to work, go to my son's baseball games, see my daughter's dance recital, keep my other daughter in college, because I am in pain and many times unable to walk or drive, or remember what I was doing or saying, or take care of my family the way a mother is supposed to. And because people tend to disregard my illness because it is "a catch all term".