Fibromyalgia - page 2

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... Read More

  1. by   ikimiwi
    as an ER nurse, I do see many people comming in with fibromyalgia and also on oxycontin, but I do have FM, diagnosed 15 years ago. I work 3 12's, 1100 to 2300, the worst times in our ER. The pain i have from running my butt off is different that the fibro pain. I do take a lot of motrin. Then again I am not whiny, depressed or drug seeking. It is a real disease, but unfortunatly, there are many whining, pathetic people in the world, and we see more than our share in the ER. 15 years ago my doc sent me to a support group, but not my style, but they were all hard working women, not typical of the patients we see. They would be at their primary's office, not the ER..........Well, so much for whining ,this was my daily
  2. by   vwgirl
    Fibromyalgia is still very poorly understood; I did a paper on it last month for one of my BSN classes, and I chose this topic because one of my best friends (also a nurse) has fibro and I have watched it affect her. The depression that goes along with the fibro is a chicken-or-the-egg type deal; researchers are not sure which comes first. There is recent research that shows fibro patients have increased levels of something called Substance P, which affects how are bodies perceive pain. Fibro was not officially diagnosed until the '80s, and there is still a lot of underlying speculation that this is a "made up disease" as there is no specific lab test to diagnose it. It is a shame, really, my friend is a wonderful nurse who has been disabled by her pain, plus she had to fight for 8 years for her disability. It makes me greatful for just being able to function (pretty well!) on most days!
  3. by   vwgirl
    Quote from Silkybo
    Everyone I know with fibromyalgia is A. A hypochondriac B. Clinically depressed or C. a drug seeker. I dont believe in this diagnosis. Throwing oxycontin at aches and pains is like killing mosquitos with a sledgehammer. I am not against appropriate pain meds, especially in the terminal patient....dose 'em up, I say, but not for people who are just not facing life square on...I hurt too after lifting obese geriatrics all night, but Im not going to whine for narcs!
    Ok, but my friend who had fibro is A. in recovery from drug addiction (she was active for years PRIOR to her fibro developing), and B. not depressed but takes Elavil for sleep (a classic fibro symptom), so she must be a hypochondriac? She also does a wonderful job of "facing life square on" as she is one of the most spiritual people I know and draws her strength from God.
  4. by   vwgirl
    Quote from traumaRUs
    It does seem to be the diagnosis of the day. Here in central Illinois - we have the guru of fibromyalgia - an MD that "discovered it" and treats it agressively! I'm with the above posters - think it has more to do with depression than a true physical diagnosis.
    I thought depression was a true physical diagnosis? At least endogenous depression.
  5. by   dianah
    I think a little more research and objective "digging" is in order here, as I see a lot of label-slapping (I know we all do it). I have a friend who suffers (yes, SUFFERS) from FM. She is not drug-seeking, she mostly suffers in silence, gives more than her 110% at work, is NOT a hypochondriac (maybe FM pts DO have lots of different pain than just "normal" aches and pains), and if I had to endure what she daily endures, I'd be clinically depressed too (don't even know if she is)!
    YES, for some folks a little medical knowledge (and the most recent article in Reader's Digest) is a dangerous thing. Too bad this condition is so hard to diagnose and treat. These difficulties make it a perfect condition for drug-seekers and others to claim, making it also difficult for health care workers to separate the "truly got its" from the "wannabes."
    Treatment is very individualized (gee, imagine that: what works for some doesn't work for others), e.g:
    My friend has trouble sleeping. It's not that she's not tired (she's exhausted) or that she doesn't schedule regular sleep hours, some exercise, good food, etc. She just can't sleep for more than 1 -2 hr at a time and wakens only to toss and turn, night after night, waiting for the alarm clock to go off, knowing she HAS to go to work no matter how tired she is (keep the job for the insurance, can't use up all sick time, gets dinged on annual review for "using too much sick time," etc . . .). Some sleep aids help, others don't. She tries to get by without taking drugs for sleep; sometimes she succeeds, sometimes not. And that's only one small facet of what she deals with, having FM.
    I hope all who truly suffer from FM are able to find a compassionate PCP who is committed to helping them live a semi-"normal" life, be it with holistic treatments, acupuncture, drugs, whatever -- within the twists and turns of this confounding ailment.
    I apologize for this rambling post yet hope I have made my point; my feelings get in the way of a logical presentation at times.

    We now return you to your regularly scheduled program.
    Last edit by dianah on Mar 20, '04
  6. by   vwgirl
    Fibro patients classically have "non-restorative sleep"; they rarely get into the deep sleep stage, no matter how tired they are. The diagnostic criteria for fibro as far as the aches and pains go are defined by 18 tender points that must be painful upon palpation with 4 kg of force. Just having regular ol' "muscle aches" after a hard day doesn't do it for a diagnosis.
  7. by   teeituptom
    Very Interesting
  8. by   dianah
    Thank you vwgirl. I personally haven't researched this, have only observed what my friend endures. Peace to all.
  9. by   veetach
    who else sees the direct correlation between Fibromyalgia and the Chronic Fatigue Syndrome that we dont hear about anymore?

    Depression is a real condition, as for the other two, I am highly doubtful. I dont want to offend anyone, but usually these patients are very proud of their diagnosis. And they remind me of this many times while I am taking care of their "exacerbation".
  10. by   molecule
    my hunch is there are an array of auto-immune disorders triggered by stress. Our modern lives are wearing people out with poor diet, too little excercise, social isolation, toxic assaults and on and on. as is our way we will look to weaknesses in the individuals while neglecting the public health implications.
  11. by   Brickman
    Have there been any double blind studies treating Fibromyalgia with antidepressants?
  12. by   CCU NRS
    Quote from vwgirl
    Fibro patients classically have "non-restorative sleep"; they rarely get into the deep sleep stage, no matter how tired they are. The diagnostic criteria for fibro as far as the aches and pains go are defined by 18 tender points that must be painful upon palpation with 4 kg of force. Just having regular ol' "muscle aches" after a hard day doesn't do it for a diagnosis.
    Is this a new qualifier, I was under the impression that FM was basically Dx'd by R/O everything else?

    I know that many people seem to have a Dx of depression first and C/O unrelenting/undefinded abd. pain that is only alleviated by narcs and these same people have usually been R/O for every possible GI ailment.

    There is often a large correlation between abd. disorders and depression, IBS, reflux, etc. with these the chicken and egg theory has often been applied.

    I personally tend to see FM Dx's when nothing will help with pain except narcotic intervention. Is this because there is FM or because there is no real problem except a need for narcs?
  13. by   NotReady4PrimeTime
    The "tender point" diagnostic criterion has been in use for several years. An individual should have 11 or more of the 18 points elicit pain when pressed by an examiner, but not all tender points are painful all the time, so a number of exams are often needed. The pain I experience when my tender points are pressed is exquisite, but completely different from muscle strain pain. The worst ones are on either side of my sacrum. It's a very bad thing when my hubby is giving me a back massage and forgets... especially since I have had an occupational back injury and that's where it hurts when I aggravate it. I fortunately don't have a sensation of pain all the time, only when I'm very tired, but those tender points hurt whenever and however they're pushed. Since I started walking my dog daily and taking 5-HTP to help me get a better sleep, I feel much better. No narcs for me... if there's one thing I hate worse than pain, it's barfing! No TCAs either.