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here comes trouble

  This isn’t meant to be an educational post about fibromyalgia but for those of you who aren’t familiar, here’s the brief wikipedia explanation:

 Fibromyalgia, meaning muscle and connective tissue pain (also referred to as FM or FMS), is a medically unexplained syndrome characterized by chronic widespread pain and a heightened and painful response to pressure (allodynia). Other core symptoms are debilitating fatigue, sleep disturbance, and joint stiffness. Some patients may also report difficulty with swallowing, bowel and bladder abnormalities, numbness and tingling (paresthesia), and cognitive dysfunction.  Many patients diagnosed with fibromyalgia also have psychiatric disorders.  Because fibromyalgia involves more than just pain, the term “fibromyalgia syndrome” is often used; not all affected persons experience all associated symptoms.

Also, nor is this post meant to bash fibromyalgia.  However, if the disease process isn’t clear to you or you’re confused, then you’re starting to catch on.  Clinically, fibromyalgia is diagnosed with the following criteria (from the Mayo Clinic):fibromyalgia-pressure-points

    • Widespread pain lasting at least three months
    • At least 11 positive tender points — out of a total possible of 18

Seems kinda wierd to me.  But that’s probably the just the fear of the scientifically unknown coming out in me.  I’m not trying to be sarcastic either.  I believe that there is probably some pathophysiologic process underlying fibromyalgia but who the hell knows.  These patients are definitely experiencing “pain” but what is the source of that pain?  Is there even a tangible source?  When you think about it, pain is really just our subjective interpretation of noxious stimuli.  You can have noxious stimuli without pain (e.g. with anesthetic), and you can have pain without noxious stimuli (called allodynia). 

  I gotta be honest here, after all that I still don’t know what the hell this disease is.  I mean, I’ve been in constant pain since July and my whole body aches but I’m pretty sure that’s from getting my ass kicked on a near-daily basis and not fibromyalgia.   But I digress. 

  Anyway, is it just me or are most of these fibromyalgia patients a little weird?   (Losing readership losing readership… AHAHAHAHAHAHAHAHAHAHA)  NOTE: I did not say ALL–just most of these patients.  I don’t know if there’s some pathophysiologic connection between the cause of pain in these patients and weirdness (I mean like borderline schizotypal weird and not “enjoys lobster-flavored ice cream” weird), but there you have it.  My personal “N” for seeing these patients is small but I’ve heard it from a lot of other physicians too.  Probably insensitive pricks like myself.  But to be fair, I don’t know if it’s on the patient or if it’s on the doctors.  Most of these patients’ doctors I think get so frustrated with their non-specific and recalcitrant symptoms that they end up putting these patients on so much pain killer and anxiolytics that it would be hard not to be nuts.  Actually, now that I think about it, everyone I’ve seen with fibromyalgia has been on a shit-load of meds so this could very well explain it. 

  Probably a little of both.  But find out for yourself.


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