Question re: lupus and fibromyalgia

z's playa · Mar 16, 2006

It may be I'm too tired to see it but...what is it you are skeptical about? The siezures? The lupus? The doctor's comment?

Z

LoriAlabamaRN · Mar 16, 2006

I have fibromyalgia, but I've always worked. I'm not sure about the lupus though... is your question whether or not this woman should work?

Thunderwolf, MSN, RN · Mar 16, 2006

Moved to General Nursing Discussion forum.

chadash · Mar 16, 2006

I think she may be asking if these problems will impact longevity, and if not working will improve her chances of a longer life.

gr8rnpjt, RN · Mar 16, 2006

From what I know, fibromyalgia is not fatal. Lupus can be if it attacks the internal organs.

Focker, CRNA · Mar 16, 2006

From the tone of your post, saying she "claims" to have a seizure disorder, and these other ambiguous and very difficult to diagnose or verify medical conditions, I would agree with you.I know this is insensitive, but she sounds like a hypochondriac to me. I don't want to discredit the diagnosis of fibromyalgia, or insult anyone on this board, but in my limited experience, people with fibromyalgia oftentimes have psych issues (which kind of brings up a chicken or the egg question). The fact that this woman seems desperate for someone to tell her how sick she is, or agree with her, would make me skeptical too. Her symptoms could be psychosomatic, but in any case the doctor she should probably be seeing is a psychiatrist.

sphinx, BSN, RN · Mar 16, 2006

Is this woman a patient of yours or just "someone you know"? If she is not a patient, what basis do you have for doubting her? Just because she hasn't had a seizure in 2 years? Maybe she is on meds for the seizures. Fibromyalgia is not in your head, it is very real and often accompanies autoimmune disorders like Lupus. There is no cure for Lupus, but it can go into remission. Meanwhile, you take meds for it that can have some not so nice side effects. Both the Lupus and the Fibro can seriously impact your quality of life, but not fatal, although Lupus can adversly affect your organs...not sure if that can lead to fatality in the long run, but medications these days are pretty good. It's not all that uncommon to be on disability on these things. As for the doctor saying make a choice between working and living long enough, well maybe she just needs a second opinion, esp if she does wish to continue working.

gr8rnpjt, RN · Mar 16, 2006

but in my limited experience, people with fibromyalgia oftentimes have psych issues
I take serious issues with this statement. Since, admittedly, you have limited experience, how can you paint with such a broad brush?
For the record, I do have fibromyalgia. I have had it for 30 years. No psych issues here, though.

KAW1962 · Mar 16, 2006

Thank you for all of your feedback. I'm not doubting she had a seizure, because she did, but the reason I ask is because I didn't think having A seizure necessarily constituted a seizure disorder. She went from having one seizure which later became one seizure in which she had an arrest (the cardiac arrest part came later). People can have one seizure for a variety of reasons, sometimes even unknown to doctors, and never have one again.

What I am skeptical about is what her doctor told her. I have had several patients with fibromyalgia and lupus (not necessarily together), but I have never had anyone tell me they were prohibited from working because it might kill them. What they have been told is to maintain a healthy diet, take frequent rest periods, exercise, etc. I just don't know what to think.

chadash · Mar 16, 2006

From the tone of your post, saying she "claims" to have a seizure disorder, and these other ambiguous and very difficult to diagnose or verify medical conditions, I would agree with you.I know this is insensitive, but she sounds like a hypochondriac to me. I don't want to discredit the diagnosis of fibromyalgia, or insult anyone on this board, but in my limited experience, people with fibromyalgia oftentimes have psych issues (which kind of brings up a chicken or the egg question). The fact that this woman seems desperate for someone to tell her how sick she is, or agree with her, would make me skeptical too. Her symptoms could be psychosomatic, but in any case the doctor she should probably be seeing is a psychiatrist.

You mentioned that oftentimes people with fibromyalgia have psych issues. Could you expand on that? Are there paticular psychiatric disorders that you see more often than others? Any connection with childhood abuse?

Any personality types more prone?

Focker, CRNA · Mar 16, 2006

You mentioned that oftentimes people with fibromyalgia have psych issues. Could you expand on that? Are there paticular psychiatric disorders that you see more often than others? Any connection with childhood abuse?
Any personality types more prone?

First off, note that I qualified my statement by stating my "limited experience" and I said "often." In my case, the people who I have come into contact with that have had fibromyalgia, have informed me themselves that they had that condition. Often the family of my actual patients, these people, without any prompting from me, felt the need to tell me how sick they have been over the past few months/years as they are visiting their intubated relative who is on multiple vasoactive drips. Without delving into the specifics of each encounter, suffice it to say that on multiple occasions, different people with fibromyalgia displayed a similar pattern of abnormal attention seeking behavior. Those people undoubtedly had issues, any one of you that met them would come to the same conclusion, I promise.

I do not assume that everyone with fibromyalgia is faking it, or has "psych issues." On the contrary, I am aware that I may have come across many people with fibromyalgia that did not divulge that information to me. Therefore the few that I came into contact with may have been a disproportionately small part of the population of people with fibromyalgia. Regardless, the initial statement of the OP fit the pattern that I am familiar with, leading me to make the comparison of her patient to the people that I have come across.

I hope that explains in a little more detail why I think it is justifiable to be skeptical of the OP's patient. I am not trying to discredit the illness of people with fibromyalgia, just to point out that it is used by some disingenuous people to their own ends.

Also, just because you may be skeptical does not mean that you can treat the patient any differently, but if you keep that in mind, it may open up different avenues of treatment, i.e. psychiatrist.