This Past Week

Last week was another rocky one. I went to a new rheumatologist who suggested that I might also have rhemuatoid arthritis. However, she couldn't make a determination until she can examine me further. She barely touched me and I wanted to cry (and did). To help with the fibromyalgia pain, she put me on Lyrica in addition to my other meds. Also, she ordered a sleep study.

On Saturday night I completed the sleep study. The clinic said that I have an apnic episode EVERY MINUTE. Can you believe that?!? That means that I have to jar myself awake each minute to tell my body to breath again. The longest period of time that I wasn't breathing during the study was 42 seconds while the average as 19 seconds. My oxygen levels got down to 86% and my AH1 score was 66. Although it wasn't the funnest thing being hooked up to so many wires, I now now that I have SEVERE sleep apnea. Hopefully I will get my c-pap machine sometime between now and August 29th. I have an appointment for the 29th, but am hoping someone cancels before then.

Understanding fibromyalgia - Source: Journal of Pain, Aug 2009

Understanding fibromyalgia: Lessons from the broader pain research community – Source: Journal of Pain, Aug 2009

by David A Williams, Daniel J Clauw
July 31, 2009

Fibromyalgia (FM) is a chronic pain condition marked by centrally mediated augmentation of pain and sensory processes. Skepticism has marked the history of this condition, but more recent study has identified neurobiological underpinnings supporting many of the symptoms associated with this condition. Early research in FM had unprecedented latitude within the rheumatology community to borrow heavily from theory and methods being applied in chronic pain research more generally. These insights facilitated rapid advances in FM research, not the least of which was the abandonment of a peripheral focus in favor of studying central [nervous system] mechanisms associated with central augmentation.

Currently, rapid-paced discovery is taking place in FM genetics, patient assessment, new therapeutic targets, and novel methods of treatment delivery.

Such insights are not likely to be limited in application just to FM and could have relevance to the broader field of pain research as well.

Perspective: This manuscript reviews:
• The history of FM and its diagnosis,
• Evidence supporting central augmentation of pain in FM,
• Potential mechanisms of central augmentation,
• Current approaches to integrated care of FM,
• And areas of active collaboration between FM research and other chronic pain conditions.

Source: Journal of Pain, Aug 2009;10(8):777-91. PMID: 19638325, by Williams DA, Clauw DJ.Chronic Pain and Fatigue Research Center, The University of Michigan, Ann Arbor, Michigan, USA. [E-mail: daveawms@umich.edu]

The Past Two Weeks

The past two weeks have been very rough for me. I have been feeling more in pain and more hopeless. The doctor has written me a note to be out of work until August 10 hoping that I will have time to start feeling better. However, I haven't been sleeping much at all. Over this past weekend, I only got a total of 12 hours sleep; 4 hours on Friday and 8 hours on Saturday. Last night I didn't go to bed and just napped today.

Because of all my recent problems, I have made the decision to stop the National Institutes of Health study for the drug Neurotropin. Although I don't feel that the study drug is causing the problems, my doctor has recommended that I go off of it and start back on some supplements. I might even start going back to acupuncture since I absolutely love it and it seems to help.

My husband is still so supportive of me. I could not do this alone. He calls my work and takes my doctors notes in for me. This really relieves some of the stress for me. I just want to thank him for being my shoulder to lean on. Without him I would be much worse.

PMDD and Fibromyalgia: Similarities and Common Features

The Premenstrual Syndrome and Fibromyalgia: Similarities and Common Features - Source: Clinical Reviews in Allergy and Immunology, Jun 26, 2009

by Daniela Amital, Howard Amital, et al.
June 27, 2009

The aim of the study was to assess the clinical similarities and common features of fibromyalgia syndrome (FM) and premenstrual dysphoric syndrome (PMDD). Thirty young patients who met the diagnostic criteria for PMDD were included in the study and compared to 26 women belonging to the medical staff of a general psychiatry department [control group].

All enrollees were interviewed and examined by a skilled physician. They completed the following nine survey items: demographic information, clinical health assessment questionnaire, fibromyalgia impact questionnaire, sleep and fatigue questionnaires, Sheehan disability scales, SF-36 assessment for quality of life, visual analog scale for pain, Mini International Neuropsychiatric Interview (MINI) questionnaire (assessment of coexistent psychiatric conditions), and the premenstrual severity scale.

Additionally, each individual underwent a physical examination measuring the classical tender points and was asked to describe the distribution and continuum of her pain or tenderness.

The premenstrual dysphoric syndrome group scored significantly higher in the measures of pain and tenderness as well as in severity of premenstrual symptoms compared to the control group.

Five patients in the PMDD group and none in the control group had FM.

Quality of life measured by the SF-36 was higher in the control group than in the PMDD group, and correlated with the degree of tenderness reported.

Psychiatric comorbidity was significantly more common in the PMDD group, affecting 16 of the 30 PMDD patients compared to only 3 of the 26 control patients.

In this study, patients with PMDD were found to have:
• Higher levels of tenderness,
• Higher psychiatric comorbidity,
• Greater level of physical disabilities,
• And a lower quality of life.

These parameters were highly correlated with a lower pain threshold.

Source: Clinical Reviews in Allergy and Immunology, Jun 26, 2009. PMID: 19554481, by Amital D, Herskovitz C, Fostick L, Silberman A, Doron Y, Zohar J, Itsekson A, Zolti M, Rubinow A, Amital H. Department of Psychiatry 'B', Ness-Ziona Mental Health Center, Tel-Aviv University, Ness-Ziona, Israel. [E-mail: howard.amital@clalit.org.il]

My Fibromyalgia Journey - The Past Few Months

I was officially diagnosed with fibromyalgia in September 2008. Since I have tried every thing that my doctor has recommended including acupuncture, supplements, vitamins, cymbalta, prozac, wellbutrin, abilify, tresidone, flexeril, skelaxin, ibuprofen, and ambian. I have been to close to nearly 200 doctor's visits in the past year including chiropractors, physical therapists, mental health therapists, hematologist, and my regular medical doctor. My next appointment visit is next week with a rhumatologist to see if there is any other thing that could possibly be wrong or if there is something that could further help. My state of health has been deteriorating for several months even though I have tried all of these things. I have even started a clinical trial of a new drug called neurotropin at the National Institutes of Health. However, this drug does not seem to be helping at this time. Right now I am at my wit's end. Currently I do no chores around the house because I am so fatigued and hurt. My husband brings me food, does dishes, washes laundry, cleans, and even helps me get ready in the mornings. I am so ready to move back home so I can have more of a support system from my family since socially my life is void. This is why when I feel even a little bit better, I think I should do something other than lay in bed and feel sorry for myself. Unfortunately, this is not very often at all. I haven't been home for Christmas or Thanksgiving in several years and miss my family terribly. As of right now, I am even out of work under doctor's orders until cleared by a specialist.

This blog will be my means of documenting my issues, including pain and fatigue.

More pictures of the double rainbow....

Somewhere Over The Rainbow....

The rain was misting and the sun was shinning just at the right angle to make this beautiful double rainbow. This picture was taken off my balcony.

I will post more later.