Fibromyalgia

CHATSDALE · Sep 22, 2004

TIGGER fibro is a chronic pain.....i have never been to er for fm pain but i have it every day..some days it is really bad some days it can be a minor inconveniece...i know there are a lot of people like you who don't believe in pms or cfs or anything that doesn't show up on a lab slip...but all these sufferers can't be wrong...we have a woman at work who says that her daughter just "wants to hurt" and that she just wants sympathy and that she is lazy and wants someone to do her work...i can't understand anyone who doesn't like their own children....i guess it takes all kinds

DavidFR, BSN, MSN, RN · Sep 22, 2004

This sums it up. This is an Emergency Nursing forum. The majority of patients who come to the ER from FM pain are a crock of doo. They are drug seeking. I agree that this dx seems like a catch all and for us ER nurses- the overflow that we see are usually the ones that are drug seeking because they are in the ER and are usually stating "my pain management doctor won't see me anymore" because they caught on to this persons act. If there are real FM patients out there- I am sorry but the not so real ones are giving you and the dx a very bad rap. I only see the abusers on methadone, oxycontin and they come to the ER to get pain meds (like we have anything stronger) You can see a FM patient a mile away and at triage you are just anticipating it coming out of thier mouth. My aunt got Dx with FM and I can testify that she is crazier than a loon and no more had FM than myself. Sorry if I seem cold but this dx bugs me to no end. It's nothing to obtain it other than multiple doctors appt's, multiple vague pain complaints and no pain medicine that will stop it.
So be it.

My partner has FM and has only once been to ER - when the pain was so bad he was begging me to cut his leg off. He had taken all the pain meds he had and couldn't take any more of what was in the house or he'd overdose.

There was a time when people with MS were disbelieved, told it was all in their heads, workshy, attention seeking etc. You display the attitude of somebody who can't bare the fact that they don't understand something, and herein lies the problem - when patients get dismissed through the arrogance of health care professionals who can't admit that here is a disease we don't fully understand yet, so we'll dismiss it rather than admit there are gaps in our knowledge. These patients bug you because you are unable to explain their symptoms, and you don't like the feeling of inadequacy that leaves you with. I suggest you learn to do your job with a little more compassion. Fortunately, we didn't come accross you in ER, but kind nurses who listened and didn't judge.

Trauma Columnist · Sep 22, 2004

Please keep on the subject. Personal attacks or mudslinging will not be tolerated. Thanks.

missmercy · Sep 22, 2004

"ifthere are real fm patients out there- i am sorry but the not so real ones are giving you and the dx a very bad rap. "

if? wow! -- spare me. i know that there are a number of people who are not truly fm patients who covet and abuse the diagnosis -- and you are right, they do give those of us who actually do suffer from it a more difficult time getting help to deal with our diagnosis.

gotta tell you, those of us who actually do have fm are probably more fed up with, angry at and or discusted by those who don't that are abusing the system, their doctor, the er.... they do give the diagnosis a bad rap -- they can cause people who are otherwise kind, caring and competent nurses into skeptical, harsh and close minded people. they make getting help when we really need it a major impossiblity.

"my aunt got dx with fm and i can testify that she is crazier than a loon and no more had fm than myself. "

i am sorry that you feel that your aunt was misdiagnosed. many people are. however, many are not. fm is a very real diagnosis and although it often is used when the doc is at a loss for what else to call something, that doesn't mean that those who truly suffer with it are the issue -- and yet we are called drug seekers and crazy by "professionals".

i avoid the big drugs like the plague -- i avoid having them in the house -- don't want them around. have had to go to the docs office on occasion when the pain got too intense to handle it without help. yes, i have even gone to the er. thankfully, the er nurses i have dealt with have been compassionate and realized that the pain i am trying to deal with is very real and not a result of depression and/or a need to procure drugs.

i have just come off an extremely long night -- pain so bad that i couldn't lay still, and muscle spasms like crazy! no trip to the er -- just lots of pacing, soaking in a tub of hot water repeatedly, relaxation techniques and anti-inflamitory meds to no avail. please don't lump us all into your warped "crazy, drug-seeking" box! we don't all belong there!! some of us are doing our best to survive without bothering you, but there are times -- when we really may need to come to you for help -- would hope you could be there for us and not just assume that we are in the other category!

CHATSDALE · Sep 22, 2004

TRAUMA---i wasn't trying to 'sling mud' but it is frustrating to hear people disregard a dx that causes such an impact on your life....

teeituptom, BSN, RN · Sep 22, 2004

I Agree With Mattsmom, There Are A Number Of Patients Out There Who Do Suffer Real Pain And In Turn Get Depressed. I Really Would Say That The Pain Causes The Depression.

And coversely you could say depression manifests as pain

DavidFR, BSN, MSN, RN · Sep 23, 2004

Please keep on the subject. Personal attacks or mudslinging will not be tolerated. Thanks.

Nobody is slinging mud. People are debating. Is this a forum or not?

When people make judgements on issues which affect others' lives, it's going to get heated.

missmercy · Sep 23, 2004

I have been giving this alot of thought since yesterday -- the fact that this is posted in the ER nurse forum really is significant -- unfortunately, often the patients who are frequent flyers to the EDs with a FM diagnosis probably are working the system. I believe that there are a few of us who -- on rare occasions may have to go to the ED if the pain reaches the unbearable level and it's 3A. For the most part, those who are working with an understanding, knowledgable physician to control their symptoms and beat FM are not presenting routinely in the ED. Chronic illness shouldn't be treated in the ED -- the out of the blue slams may need some ED interverntion, but as a rule, chronic illness should be treated on a consistant basis -- a long-term regime established with the person's physician. You are right, when a topic like this is addressed, it can get heated -- it is a very emotional thing to have the thing that plagues your life seemingly dismissed as nonexistant, insignificant or pschosomatic. Maybe we get frustrated because we have heard it so often and it is so discouraging. Those of us who suffer with FM -- but are consistantly consulting with our physicians and following care regimes DO get peeved when others abuse the diagnosis, jade our fellow nurses and give us a bad rap.

That said: I truly understand where the folks who are expressing questions about FM's legitamacy -- due to the FFs and fakers. I am sorry if I was not polite and closed minded to your side of the issue. Hope that you can forgive the emotionally charged responses you get and that you will be able to keep in mind that while there are fakers, there are also folks that truly suffer with this who ARE NOT FFs or fakers.

RNin92 · Sep 23, 2004

It is unfortunate that FM patients are sometimes treated poorly or with cynicism from the healthcare providers.

It is equally unfortunate that some back pain sufferers are treated poorly.

And migraine patients.

And diabetics.

And asthmatics...

The problem as I see it, is really the type of patient that becomes the FF. It isn't so much the Dx...it's the behavior.

There are a multitude of chronic conditions out there...with millions of sufferers...and yet only a handful become a problem to the healthcare system.

It is the behavior...not the Dx.

The behavior is the same for the FM FF as it is for the FF back pain patient, as the FF migraine patient...and so on...

missmercy · Sep 23, 2004

It is unfortunate that FM patients are sometimes treated poorly or with cynicism from the healthcare providers.
It is equally unfortunate that some back pain sufferers are treated poorly.
And migraine patients.
And diabetics.
And asthmatics...
The problem as I see it, is really the type of patient that becomes the FF. It isn't so much the Dx...it's the behavior.
There are a multitude of chronic conditions out there...with millions of sufferers...and yet only a handful become a problem to the healthcare system.
It is the behavior...not the Dx.
The behavior is the same for the FM FF as it is for the FF back pain patient, as the FF migraine patient...and so on...

Good point! And while many are under very competent physicians care -- there are obviously going to be occurances where they are going to need help -- during an "off hour" time frame. It is sad that many chronic issue patients do not feel comfortable going into an ED or med-center because of the response to the BEHAVIORS of the ffs who may be abusing the system -- using the ED for their "primary source of health care". Unfortunately, some EDs do form some opinins r/t chronic patients based on the chronic abusers -- which is understandable considering that they see alot of that.

mattsmom81 · Sep 23, 2004

I think lumping FMS and other chronic pain sufferers into some kind of group that is disbelieved is dangerous personally. I've cared for so many chronic pain patients who have either themselves (or a healthcare workers has missed it) written themselves off while infarcting a bowel, having an MI, etc because they are 'used to' living with pain and ignoring it. I try so hard not to stigmatize my patients.

I'm not an expert but I know FMS pain is unusual... it moves but has distinctive 'spots' it moves to; anything out of the ordinary just might warrant a trip to the ER. I almost brought my DH to the hospital one night (he does not have FMS but chronic pain)..he has spinal stenosis but had such a severe bout of pain he was vomiting, sweating...the pain was also higher than normal and radiating so I was very concerned. I suppose we would have gotten rolled eyes from ER staff had I brought him in. We just have to go with our gut and do what we think is best.

I'm sure ER gets tired of dealing with chronic pain that exacerbates, but hope they keep an open mind. Failure to treat pain is a bigger deal now than it used to be.

CHATSDALE · Sep 23, 2004

There was an article in current READERS DIGEST about a drug called provigil===is anyone familiar with this drug...would i be a benefit to FM or CFS pts???i