An Attitude of Gratitude

By Earthypoet – Irvine, CA

When I responded to the job posting for a “new online health care company” I had no idea what to expect, and then I received an email back with more information about the company. So I Googled the name of the CEO and discovered that she founded the National Fibromyalgia Association. My heart began to beat faster as I read more about Lynne Matallana and her new project, the Community Pain Center. I knew right then that this was my dream job and I was going to get it. I could see how all my past experiences—everything I had been through—was for a purpose: to help others with chronic pain.

You see, I was diagnosed with fibromyalgia in 2011. In addition to anxiety, depression, and feeling fatigued all the time, I had been experiencing an intense burning sensation in the backs of my legs and buttocks that wouldn’t go away. Then my right arm would periodically go numb and my neck and right shoulder became extremely tense and hurt like I had torn muscles. The doctor couldn’t find any damage, so he sent me to a massage therapist to loosen the tension. I had regular massage every week for a few months and still didn’t notice improvement. I eliminated processed foods from my diet and tried to exercise, but found that it just created more pain.

After several visits over the course of a year, my doctor asked me several questions about my physical abilities, mental/emotional state, pain, sleep, and stiffness, and then applied pressure to the 18 tender points (I was sensitive to 16), and then just like that, with a sympathetic smile, he said, “fibromyalgia.” He explained that fibro is a disorder of the central nervous system and how it processes pain signals. He even drew me a picture, pointing out the difference between normal and fibro. I was devastated to hear that there is no cure and all we could do is manage symptoms.

I began physical therapy to ease me into a simple exercise routine, which helped reduce the pain. My physical therapists also performed myofascial release, which relaxed my muscles and improved my poor circulation. Stretching throughout the day has also been somewhat beneficial, and eliminating processed foods and sugar has reduced my inflammation.

I also tried acupuncture twice a week for a few months, but found that the only relief it gave me was from menstrual cramps. My doctor put me on Cymbalta, which did not have good results for

me. My depression only got worse. Almost everything I have tried has only provided me with a little relief. What provides me with the most relief is not focusing on myself.

So, I’ve grown accustomed to the fact that I always have pain. I accept that. And now I can continue to do what makes my heart sing and that is to help others. When I am in the service of others,

my mind doesn’t dwell on me and my struggles.  When I am more concerned about what I can bring to the world rather than what I can get from it, I hardly notice the pain. And this, my friends, is why developing content for the Community Pain Center is my dream job.

Not only do I get to spend my day planning and creating the most relevant and informative content that will help our members, but I get to be part of this community of people just like me, who know what it’s like to live with pain every day, yet persevere, so that we can make a difference in the way pain is perceived and treated. I am truly grateful for my pain today because it gives me the opportunity to be part of this amazing community.

 

Fibromyalgia Awareness and Understanding Physician Survey Results

By Penn, Schoer and Berland Associates, Inc.

Methods

  • First, doctors were questioned about fibromyalgia’s validity as a real medical disorder, and the reasons for this belief
  • Next, the questionnaire assessed their knowledge of fibromyalgia’s symptoms and causes
  • Doctors were then asked about the issues involved in diagnosing this condition
  • Next, doctors read and evaluated a series of statements about attitudes towards fibromyalgia, its causes and treatments, and fibromyalgia patients.
  • Finally, doctors were asked about their own experiences in treating or referring patients with this condition.
  •  

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Differences in sociodemographic, clinical, psychosocial and health care characteristics between men and women diagnosed with fibromyalgia [Article in Spanish]

By Ruiz Pérez, Ubago Linares MC, Bermejo Pérez MJ, Plazaola Castaño J, Olry de Labry-Lima A, Hernández Torres E.

Rev Clin Esp. 2007 Oct;207(9):433-9.

Escuela Andaluza de Salud Pública. Granada. España. isabel.ruiz.easp@juntadeandalucia.es

INTRODUCTION: Health differences between men and women are determined by biological differences although health services often contribute to gender inequalities. Very few studies that analyze gender differences have been made up to date in these patients. This study aims to analyze sociodemographic, clinical and psychosocial differences between men and women diagnosed with FM and to examine the differential impact of their symptoms on their usual activities, including work environment, and the response these patients obtain from the health care system.

MATERIAL AND METHODS: A descriptive cross-sectional survey was carried out with all the patients diagnosed with FM in 2003 in three clinics rheumatology units of a university hospital in Spain.

RESULTS: The sociodemographic characteristics were very similar in men and women.However, there was a greater proportion of men diagnosed with FM on sick leave, compared to women with the same diagnosis. Men had a worse perception of their health, a higher percentage of psychiatric history and current mental illness and more impact of the disease.

DISCUSSION: This is one of the first studies in Spain
examining the differences between men and women diagnosed with FM. The results obtained in this study corroborate that, as in other diseases, there are gender differences in the clinical and psychosocial characteristics of men and women diagnosed with FM.

 

Differential efficacy of a cognitive-behavioral intervention versus pharmacological treatment in the management of fibromyalgic syndrome.

By García J, Simón MA, Durán M, GCanceller J, Aneiros FJ.

Psychol Health Med. 2006 Nov;11(4):498-506.

Department of Psychology, University of A Coruña, and Department of Anaesthetic, Critical Care and Pain Treatment, University Hospital Complex of Santiago de Compostela, Spain.

Given that studies about the differential efficacy of existing treatments in fibromyalgia syndrome are scarce, the aim of this study was to compare the differential efficacy of a cognitive-behavioral and a pharmacological therapy on fibromyalgia. Using a randomized controlled clinical trial, 28 fibromyalgic patients were assigned to one of following experimental conditions: (a) pharmacological treatment (i.e., cyclobenzaprine), (b) cognitive-behavioral intervention (i.e., stress inoculation training), (c) combined pharmacological and cognitive-behavioral treatment and (d) no treatment. The results show the superiority of cognitive-behavioral intervention to reduce the severity of fibromyalgia both at the end of the treatment and at follow-up. We conclude that cognitive-behavioral interventions must be considered a primary treatment of fibromyalgia syndrome.

 

Pain in Spanish rheumatology outpatient offices: EPIDOR epidemiological study [Article in Spanish]

By Gamero Ruiz F, Gabriel Sánchez R, Carbonell Abello J, Tornero Molina J, Sánchez-Magro I.


Rev Clin Esp. 2005 Apr;205(4):157-63

Servicio de Epidemiología, Hospital Universitario de La Princesa, Madrid.

OBJECTIVE: To establish the prevalence and characteristics of rheumatologic pain in Spanish adult population cared in specialized rheumatology offices. DESIGN: Cross selection study in a population of patients cared in rheumatology offices of public Spanish hospitals. SUBJECTS: 1,134 patients selected through random sampling based on waiting lists of patients, during a period of 1 week, in rheumatology offices of each participating hospital.

MAIN OUTCOMES OF THE STUDY: Reason behind the consultation (a new patient [NP] or a patient for revision [RP]), characteristics of the patient (sex, age, habits [alcohol/tobacco], marital status), location, type, intensity, duration, tolerance and management of pain; treatment (pharmacological or non-pharmacological) carried out; satisfaction with the treatment; and association with fibromyalgia.

RESULTS: The prevalence of pain in NP was 98.6% and in RP 95.1%, with a global prevalence of 96%, predominating mainly in adult sedentary women with fibromyalgia. The frequency of acute pain was 20.9% and this of chronic pain 79.1% [corrected] The prevalence of fibromyalgia was 12% (2.2% in men, and 15.5% in women). The most prevalent pattern of current dominant pain was this of the mechanical type. More frequent associated pathologies were: hypertension (21.7%), depression (14.4%), gastrointestinal diseases (13.8%) and anxiety (13.4%). All variables analyzed in the study showed changes according to age, sex, and type of patient (NP or RP). Most used treatment was pharmacological; more than 57.6% of patients were receiving NSAIDs. In NP, medical prescriber of the treatment was first the general practitioner (56.1%) followed by the rheumatologist (14.1%); in PR the first one was the rheumatologist (69.9%) followed by the general practitioner (16.5%).

CONCLUSIONS: Our results show that the prevalence of the rheumatologic pain is very high, predominating mainly in adult women with fibromyalgia. Pain location, intensity, and type, associated pathology, and treatment vary according to age, sex, and type of patient. The most commonly used drugs for pain management were NSAIDs (58%); opiodes were only used in 6.4% of patients even though pain was intense in more than two-thirds.

 

Assessment of fatigue in patients with fibromyalgia and chronic widespread pain. Reliability and validity of the Swedish version of the MFI-20.

By Ericsson A, Mannerkorpi K.

Disabil Rehabil. 2007 Nov 30;29(22):1665-70.

Department of Rheumatology and Inflammation Research, Sahlgrenska Academy, Göteborg University, Göteborg, Sweden. anna.ericsson@vgregion.se

OBJECTIVES: Fibromyalgia (FM) and Chronic Widespread Pain (CWP) are common diseases in primary care and, in addition to the pain they cause, fatigue is a major problem. Fatigue is regarded as a multidimensional concept and instruments assessing fatigue should therefore cover several different dimensions. The Multidimensional Fatigue Inventory (MFI-20) measures five different dimensions of fatigue. The aim of the study was to investigate the test-retest reliability and convergent construct validity of the Swedish version of the MFI-20 in female patients with FM or CWP.

METHODS: To investigate the convergent construct validity, 166 female patients with FM or CWP completed the Swedish version of the MFI-20 and a Visual Analogue Scale (VAS) measuring global fatigue. Thirty-six of the 166 patients completed the Swedish version of the MFI-20 on two occasions, one day apart to evaluate the test-retest reliability.

RESULTS: Spearman’s correlation coefficient revealed a significant association between each of the five subscales of the MFI-20 and the VAS for global fatigue. General Fatigue had the highest correlation with the VAS (rs = 0.62, p < 0.001), while Reduced Motivation had the lowest (rs = 0.32, p <0.001). The intra-class correlation coefficients (ICC) were satisfactory for all the five subscales of the MFI-20.

CONCLUSION: The results of this study indicate that the Swedish version of the MFI-20 is a reliable tool for assessing the degree of fatigue in patients with FM or CWP. This study also supports the theory that fatigue is a multidimensional concept and different aspects of fatigue should be measured separately.

 

Young women with fibromyalgia in the United States and Sweden: perceived difficulties during the first year after diagnosis.

By Liedberg GM, Burckhardt CS, Henriksson CM.

Disabil Rehabil. 2006 Oct 15;28(19):1177-84

Department of Neuroscience and Locomotion, Section of Occupational Therapy, Faculty of Health Sciences, Linköping University, Sweden. gunilla.liedberg@inr.liu.se

PURPOSE: The major symptoms of fibromyalgia (FM)–pain, tiredness, disrupted sleep, and muscle weakness–severely impact everyday activities, including the paid work role of women who have had FM for a long time. There are no prospective studies on young and newly diagnosed women with FM. The aim of the present study was to describe and compare difficulties young and newly diagnosed women in Sweden and the United States experienced during their first year after diagnosis.

METHOD: Three interviews, 6 months apart, were conducted, with 49 Swedish and 45 US women between the ages of 18 and 39. Five open-ended questions were asked concerning physical, psychological and social difficulties and limitations, and factors that increased or decreased their difficulties and limitations. At interviews 2 and 3 the women were also asked about ways of preventing their difficulties. The answers were written down and analysed by a content analysis approach.

RESULTS: Consistent categories of difficulties were reported: symptoms, movements, activities, moods, social network, external factors and coping strategies. More US women were working outside their homes than were their Swedish counterparts and they expressed more difficulties compared with the Swedish women.

CONCLUSIONS: In general, difficulties decreased and coping strategies increased over the 1-year period in both groups of newly diagnosed, young women.

 

Prevalence of fibromyalgia and chronic widespread pain.

By Lindell L, Bergman S, Petersson IF, Jacobsson LT, Herrström P.

Scand J Prim Health Care. 2000 Sep;18(3):149-53.

Primary Care Centre Hertig Knut, Halmstad, Sweden.

OBJECTIVE: To explore the prevalence of fibromyalgia and chronic widespread musculoskeletal pain in a general population using the criteria of the American College of Rheumatology from 1990.

DESIGN: Structured interview and clinical examination, including tender-point count and pain threshold measured with adolorimeter, of subjects with suspected chronic widespread musculoskeletal pain.

SETTING: The general population in south-west Sweden 1995-1996. SUBJECTS: 303 individuals with suspected chronic widespread pain were identified in a previously defined cohort containing 2425 men and women aged 20-74 years. 202 individuals were invited and 147 agreed to participate.

MAIN OUTCOME MEASURES: Tenderpoint count, pain threshold and prevalence of chronic widespread pain and fibromyalgia.

RESULTS: The prevalence of fibromyalgia was estimated to 1.3% (95% CI 0.8-1.7; n = 2425) and that of all chronic widespread pain to 4.2% (95% CI 3.4-5.0; n = 2425). The mean pain threshold measured with a dolorimeter was lower in subjects with chronic widespread pain (p < 0.01) and correlated with the number of tender points (r = -0.59, p < 0.01) but could not be used to distinguish the subjects with fibromyalgia.

CONCLUSION: Compared to other studies, fibromyalgia and chronic widespread musculoskeletal pain seemed to be relatively rare conditions in the south-west of Sweden.

 

Differences between patients with chronic fatigue syndrome and with chronic fatigue at an infectious disease clinic in Stockholm, Sweden.

By Evengård B, Jonzon E, Sandberg A, Theorell T, Lindh G.

Psychiatry Clin Neurosci. 2003 Aug;57(4):361-8

Department of Laboratory Medicine, Karolinska Institute at Huddinge University Hospital, Stockholm, Sweden. birgitta.evengard@labmed.ki.se

Background data were collected from patients presenting with fatigue at the clinic of infectious diseases at Huddinge University Hospital, Stockholm. The main purpose was to look for differences as to demographic and functional status for patients fulfilling criteria for chronic fatigue syndrome (CFS) and chronic fatigue (CF). A cross-sectional questionnaire survey was performed using a variety of instruments. A thorough medical investigation was performed. No difference was found as to social situation, occupation and illness attributions for patients in the two categories. Patients with CFS reported in general a higher degree of ‘sickness’ with more self-reported somatic symptoms, more self-reported functional impairment and more absence from work. A higher degree of psychiatric comorbidity was observed in CF than in CFS patients. A majority of CFS patients (80%) had an acute infectious onset compared to 43% in the CF group. Presently used criteria might, according to findings presented here, define two different patient categories in a population characterized by severe, prolonged fatigue. Because CFS patients (compared to patients with CF) have more somatic symptoms, more often report an infectious, sudden onset and have less psychiatric comorbidity, and CF patients seem to have more of an emotional, burn-out-like component one could speculate about the existence of different pathogenetic backgrounds behind the two diagnoses.

 

Tender point count and total myalgic score in fibromyalgia: changes over a 28-day period.

By McVeigh JG, Finch MB, Hurley DA, Basford JR, Sim J, Baxter GD.

Rheumatol Int. 2007 Sep;27(11):1011-8

Health and Rehabilitation Sciences Research Institute, School of Health Sciences, University of Ulster, Jordanstown, Belfast, Northern Ireland. j.mcveigh@ulster.ac.uk

Tender point count (TPC) is central to fibromyalgia syndrome (FMS), and with total myalgic score (TMS) is often used to monitor the patient’s condition. This study aimed to determine the stability of TPC and TMS over time, and to examine how well these measures reflected patients’ perceptions of their condition. Twenty-four patients with FMS completed the Fibromyalgia Impact Questionnaire (FIQ) and a visual analogue scale (VAS) measuring well-being, at entrance into the study, and 7 and 28 days later. There was no significant change in TPC (P = 0.074), FIQ score (P = 0.291) or VAS (P = 0.079) of well-being with time. However, mean TMS score did change over time (P = 0.021). There was no correlation between total FIQ score and the other measures (all P-values > 0.05). The significant change in TMS over time may reflect the natural fluctuation in the clinical presentation of FMS.