Question re: lupus and fibromyalgia

KAW1962 · Mar 17, 2006

Gee, I never thought I would create such controversy. In my personal experience as a nurse, I have had one patient with fibromyalgia that had no accompanying psych disorder. I worked with a nurse with fibromyalgia, and I never doubted that her symptoms were real. She was then finally and accurately diagnosed with vasculitis. Who'd ever though that a simple aspirin would be the treatment of choice for her?

All of the other patients I have had with fibro also had either depression, some type of anxiety disorder, or were bipolar.

Now back to the original subject of my post. What would you then say if the person in question also had a history of involuntary committment to a psych hospital for psychotic delusions and she had her children removed from her twice because their apartment was literally filled with trash?

I didn't intend to be deceptive. I just wanted your honest opinions based on your experiences with this type of patient.

chadash · Mar 17, 2006

And I still am wondering if anyone has any info about a connection between fibromyalgia and abuse victums. Any one know?

Multicollinearity, BSN, RN · Mar 17, 2006

And I still am wondering if anyone has any info about a connection between fibromyalgia and abuse victums. Any one know?

I don't know of any studies, but for whatever it's worth - both of the women I described in my above post were abused as children.

chadash · Mar 17, 2006

That has been my observation too. All fibro pts I have know have a history of abuse. If anyone knows of any studies, pass it along! Thanks!!

Multicollinearity, BSN, RN · Mar 17, 2006

That has been my observation too. All fibro pts I have know have a history of abuse. If anyone knows of any studies, pass it along! Thanks!!

Well, I just googled the topic and found this: http://jaapa.com/issues/j20050901/articles/fibro0905.htm

" There are also associations between FMS and physical or emotional trauma10 and between tender points and childhood abuse.11 An estimated 53% to 65% of women with FMS were abused as children.12 A number of patients have low levels of serotonin and norepinephrine, high levels of substance P, abnormalities in imipramine uptake receptors, and neurohormonal disturbances including low levels of growth hormone and hypothalamic-pituitary-adrenal axis hypofunction.13

Most recently, evidence has pointed toward a state of central hyperexcitability and abnormal sensory processing in nociception and less toward psychological factors.14,15 Patients with FMS have lower pain thresholds and increased sensitivity to pressure and thermal stimuli compared to controls, suggesting a central neurobiological mechanism of increased pain sensitivity.16 Gracely and colleagues used functional MRI scans to demonstrate that the pain felt by FMS patients is real.17 "

Editorial Team / Admin · Mar 17, 2006

hello, chadash,

not sure how accurate this link is: http://www.myalgia.com/abuse.htm

here is a link from emedicine that might be helpful, too:

childhood physical, emotional, or sexual abuse appears to be a common antecedent of anxiety, somatization, and chronic pain in many adults.

http://www.emedicine.com/med/topic790.htm

Multicollinearity, BSN, RN · Mar 18, 2006

Thank you for posting that link, I found it interesting. I am trying to understand this increased perception of pain/discomfort and I think I have an example with my mother. She has fibro plus BPD.

Recently she was telling me on and on about something that is wrong with her mucous membranes, how inflamed they are, they hurt etc. So I said my usual thing - go see your doctor. She refused saying nobody understands her. She was convinced that she had some rare illness. I told her that I think she has allergies. She got mad and said it is not simple allergies. Well I know from years of this, that something that rates a 2 for me on a scale of 1-10, is a 10 for her.

So anyway, call me devious, but I got tired of the phone calls with the talk of her having some rare disease of her mucous membranes :uhoh3: . So I told her I had done a Medline search and that I had a pill for her to try. She asked what it was and I told her, it's a medication called loratadine which can help with diseases of the mucous membranes .

So the pill cured her 'rare mucous membrane disease' that was ruining her life. She went to the doctor asking for it. He referred to allergies and she INSISTS she does not have allergies, but a "severe disease of the mucous membranes ruining my life that is cured by coincidence with antihistamines."

I am trying to wrap my head around that this is really someone's reality, but it's just too much for me right now.

scizzerin · Mar 18, 2006

I have lupus, and lt can be affected by work. What type of work is she required to do? Some jobs with a high stress factor can "trigger" symtoms. My lupus attacked my kidney's until ESRD, dialysis and finally transplant, so yes, potentially life threatening.

chadash · Mar 18, 2006

Wow! thanks for these articles. You all are google-er extroidenaires (excuse my spelling!)

My sisters would describe the abuse they experienced as horrific. (earlier, they would say "what abuse?") Two of the 3 term their pain as excruciating. The other uses the description "constant, but she keeps going.."

Two have up to this point been unable to work, and mom is sick most days, though she has other health problems that contribute to that. It is just plain heartbreaking.

bethin · Mar 18, 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.

Know plenty of people with fibromyalgia. None of them have psych problems. Your experience is just that: limited.

Saying people with fibromyalgia often times have psych issues is stereotyping. If you label everyone who has fibromylagia as a psych patient you could miss something really important. Please try to keep an open mind.

CHATSDALE · Mar 18, 2006

i have been to er with a broken leg, with pul emb, with celluitis, child birth

those who work the er are limited in their exposure to the vast number of people who work and who cannot find a dx for the aches and pains that others cannot see

i don't take prescription drugs for this...lortab was given to me post lumpectomy and it put me to sleep...so way i could function while taking this med

had a satisfactory childhood without abuse . i am afraid that too many nurses observe without observing at all..if something doesn't fit into their preconceived notions they disgard it...

KAW1962 · Mar 18, 2006

I have lupus, and lt can be affected by work. What type of work is she required to do? Some jobs with a high stress factor can "trigger" symtoms. My lupus attacked my kidney's until ESRD, dialysis and finally transplant, so yes, potentially life threatening.

Thank you for sharing your personal experience. I appreciate any insight regarding the potential effects of lupus and fibromyalgia. The last job held by the person in question was working in a womens' clothing store, although I am not sure in what capacity.