Fibromyalgia

Specialties Emergency

Published

What are your opinions, nurses? Is Fibromyalgia a justified condition or just a basket term ? I am interested in your feedback. It seems like we see a large number of patients (usually women) with "fibromyalgia" and the numbers are getting larger and larger.

I even had a patient tell me that fibromyalgia patients were predisposed to trigeminal neuralgia. :eek:

It has also been reported that patients with Fibromyalgia have 3-4 times the amount of Substance P found in the cerebrospinal fluid as of that in healthy individuals.

Fibromyalgia since it is so vague, has taken over for the "soft tissue injury" pain med seekers as they have milked that to death. I see that but I also know fibromyalgia is a true ailment. Differentiating between the drug seekers and the depressed "I want some attention" patients and those TRULY seeking some help and not necessarily pain meds to give quick relief but those that are seeking a long term treatment that will lessen or relieve the muscle pain.

Until there is a test to determine fibromyalgia the true suffers will suffer and the seekers will get the drugs they seek.

sigh... :rolleyes: The practice of medicine is based on principles of diagnostics and treatment. what a chaotic world it would be if we were to accept anyones vague complaint about anything they were experiencing at any given time as a new disease.....[/quote

sigh...didn't know you practiced medicine. Well excuse me. :uhoh3:

Veetach and SmilinBluEyes...I never meant this to become a free for all

attack and defend. GRANTED, we have different opinions, but...WE ALL Practice medicine in our own ways...just because we have different

TAGS. or designations does it make us any less the healers...doctors are the

CURANDERAS... in other words, they CURE. Nurses CARE. Some of us are still

in the Newtonian Age of Medicine...the Einsteinian age is now here, with its

attendant re-emergence of holistic, homeopathic alternative(alternative, meaning one can CHOOSE to use or ignore...here, there is no right or wrong choice...it is just INDIVIDUAL choice!) I have chosen, I admit in self-defence, the holistic way, because every person is an INDIVIDUAL. JUST as I believe that every person and make fantastic art, and believe it or not, EVERY person

can SING....how's THAT for scary thought??? Be careful; holism might make us more enlightened...SPIRITUS

PS IF, and I mean, IF y'all wanna jump down my gullet cause y'all might think

I took the wind out of certain sails, by all means go ahead...it AIN'T for me to judge, cause that is the LORD'S prerogative...I just go where He tells me:chair:

Specializes in ER, ICU, L&D, OR.
I am sure in the minds of some others here, PMS does not exist, either. Cause there is NO definitive and objective test to PROVE it does. So kinda like many things unseen, lack of faith makes it NOT so. Let one of your loved ones suffer a "non-existant" condition and see how quickly you jump on the band wagon to become a believer! :)

I never discuss PMS

Specializes in ER, ICU, L&D, OR.

What is discussed here is all that it is, discussed here.

You tell me you hurt in the ER, I will med you with whatever the doctor orders. And not even think anything about it. And I will recheck your vitals and your rsponse to it in 15 to 30 minutes and document it. Im a firm believer in keeping everything simple at work.

ER nurses are a proud and pompous lot, you have to be to work ER. But is ER the proper place for all the FFers with Chronic pain of anykind. Is ER turning into an Extended Pain Care Clinic. Isnt chronic pain, whatever the source best handled by a Primary Care Physician. Isnt that better than frequently hopping from one ER to another.

I mean no disrespect to anyone with FM, who truly has it. But there are those who abuse it as a Dx along with all the other chronic pain syndromes.

Answer this

Is the ER the best place to handle these problems.

Veetach & teeituptom ( and others too)

I think you have a good point -- ER should not be a place for the long term or routine treatment of chronic pain. It is too easy for a person to avoid trending, adequate research into symptoms and finding a physician who is skilled and trained to deal with their pain. Our ERs are filled with folks who just don't want to wait 'til monday (many who really COULD) or who don't want the "bother" of finding a regular doc. And that takes up some of the time that those folks who are legitimate ER patients NEED!!! So, I can sure understand your frustrations!! I hope you aren't feeling too terribly beaten up by us all :rolleyes: -- I think you sound like a couple of pretty intelligent people (especially avoiding the PMS discussions!!-- that could get ugly fast!) and I am sure you are good nurses! I would merely caution that sometimes you come across as pretty severe. I am sure that if I were to visit your ER, presenting with severe FM symptoms that you would be gracious, professional and hopefully that you wouldn't be muttering about me. As I understand your postings, your frustrations seem to center around ffs and their abuse of the system.

If I remember correctly, the thread did start with questioning the validity of the diagnosis and it did get rather nasty toward folks who "claim" to have it. I think those of us with it can't help but get a bit defensive when we are lumped together with hypocondriacs, drug seekers and such -- wouldn't you?! I am sorry if I offended you with my responses.

I know that what I suffer with and DEAL with is real. I know that it is not merely uncomfortable, but painful and life altering. However, I also relaize that there are many out there who may be abusing the dx, may be abusing the ER and the system as a whole and that you probably see lots of them. Just remeber, we aren't all that way!

Posted by teeituptom: Is the ER the best place to handle these problems.

No, and the problems faced by ERs today are the exact same ones we faced in the early 70s. You will never change the patients, you have to change the system. Reserve the ER for emergencies and funnel the others down the hall to your primary care center staffed by MDs, PAs, and NPs.

No, and the problems faced by ERs today are the exact same ones we faced in the early 70s. You will never change the patients, you have to change the system. Reserve the ER for emergencies and funnel the others down the hall to your primary care center staffed by MDs, PAs, and NPs.

Well, until EMTALA laws change...there isn't an ER in the country who will redirect someone back to the PMD's office.

Personally, I don't think directing someone to their PMD is "refusing care" but I am a nurse not a litigator. No one wants to be the one to stand up and recognize that our EDs are overcrowded not because of overpopulation or an aging society...but because of misuse of the ED as a clinic.

The ED is definetly NOT the place for chronic pain sufferers or drug seekers. We are MIS-treating both. It has nothing to do with the disease process or diagnosis...

But the problem is bigger than all of us...

Why do the PMDs send their patients into the ED for an "office"/non-emergent problem?

Why do the PMDs have office hours only until 4pm...most families have 2 working adults?

Why do we have a public aid system set up with few clinics to back them up?

The ED is not going to change until society changes...and I just don't see that happening.

Specializes in pediatrics, geriatrics, med-surg, ccu,.

I agree whole heartedly that the ER is not the place for chronic pain sufferers or the minor colds, flu's, etc.. but with today's society and our economy it is difficult for people to find a PMD that will accept a patient with no insurance, on medical cards, medicaid etc... Our hospital tried to start a clinic for those minor injuries, colds, flus etc but it didn't last very long. Probably about a year. The difficulty was finding physicians to staff it. So we are back to having a very busy ER. It is sad that with all the technologies that are now available that people can't afford health care but that is the way things are. So our ER's will continue to get abused.

Boy oh boy....I'm not sure if I should even comment. I'm almost embarassed to admit I suffer from FM.......have for about 15 yrs now. Depressed?? Sometimes I am. If you can't imagine moderate to severe pain 24 hours a day, then you don't know what 'we' go through. You get really sick and tired of hurting all the time. You know how you hurt when you feel sick?? How your skin even hurts just to touch it??

Please don't judge those of us with FM as people who are babies or can't handle 'alittle pain'. We are everywhere and all we are asking is that people TRY to understand we just want some relief. Those of us who are nurses should be the most understanding. Please don't ROLL YOUR EYES when you see FM as a dx....

I also agree that the ER is just that......emergency room. I worked in ER years ago and we would have the same people come in night after night. It would be nice to have a special screening room for all those who are not in immediate need of care.

Posted by RNin92: Well, until EMTALA laws change...there isn't an ER in the country who will redirect someone back to the PMD's office.

Read my post again. I said direct them "down the hall" to your fast track or own primary care center. Lack of primary care acess 24 hours a day is one reason people go to the ER even when it is not the appropriate place. It's the only place open 24/7. Market it as such and let the masses in.

Specializes in Oncology, ID, Hepatology, Occy Health.

I believe this is a real disease and not a wastebasket diagnosis.

I live with a fibromyalgia sufferer, who was not depressed before this terrible disease. I have seen an energetic go-getter who loved life turned into a miserable heap who is some days tired out by taking a bath. Please let's not marginalise this disease just because we don't yet fully understand it.

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