At the March 27 Healthy Woman Ladies Night Out at Fallbrook Library, Dr. Alexander Delgadillo presented the program on “Fibromyalgia Facts and Myths.” He started out with the fact that women are seven times more likely than men to develop fibromyalgia.
It is most often diagnosed in middle age and more prevalent with age he said, adding that two percent of the U.S. population has fibromyalgia (6-7 million people).
Delgadillo pointed out the economic effects of fibromyalgia as working adults who have it miss work more often and have higher medical costs than most people. Mortality for fibromyalgia sufferers is similar to the general population, but the death rate from suicide and injuries are higher among fibromyalgia patients
One myth is true – fibromyalgia is not a disease, he said; “It is a disorder, or syndrome. In 1990, the American College of Rheumatology defined the syndrome and published criteria to identify and treat fibromyalgia.” These guidelines also led to funding for much-needed research.
According to Delgadillo, the disorder has been around for over 2000 years; the description of Job’s condition in the Bible sounds like fibromyalgia. Florence Nightingale was also thought to have suffered from it in the 19th century.
Fibromyalgia patients have chronic widespread pain present for at least 3 months in both sides and above and below the waist. To be diagnosed with the disorder they must have 11 of 18 “tender point sites” with moderate pressure. Those sites include the base of the skull, around the neck and shoulders, the hips, elbows and just above the knees.
Another myth is that fibromyalgia is all in the patient’s head.
That is false, Delgadillo said, although it is easily misdiagnosed as depression anxiety or trauma. It has been proven however, that patients with fibromyalgia feel pain more acutely than other people. The fact is that a 50 percent lower stimulus intensity evokes pain in fibromyalgia patients when compared to normal healthy people. The disorder can be genetic and associated with depression in families.
There are a wide range of symptoms besides pain sensitivity including sleep issues, headaches, panic attacks, eye irritation, impaired memory, allergies, abnormal tastes, faintness, low grade fever, salt and sugar cravings, constipation, diarrhea, bladder infections, reproductive problems, restless legs, acne, tingling and burning skin. So, no two fibromyalgia patients are alike.
Fibromyalgia can be triggered by physical trauma, including acute illness, physical injury, surgery, or a motor vehicle accident. Other triggers include chronic stress, emotional trauma, and emotional, physical or sexual abuse.
While fibromyalgia and chronic fatigue syndrome patients both suffer from low energy levels, they stem from different causes. Delgadillo said fibromyalgia patients are more likely to have thyroid complications while chronic fatigue sufferers have more problems with adrenal function. So, they have different treatments.
In 2010, revised criteria replaced the tender point scale with the widespread pain index (WPI) as well as a measurement of symptom severity scale (SS). The WPI number is determined by the number of 19 specific anatomic areas in which the patient has felt pain in the previous week.
The SS score is determined by having the patients rate the severity of three common symptoms – fatigue, waking unrefreshed, and cognitive problems – on a scale from 0 to 3 (with 3 being the most severe. Additional points can be added for the presence of other symptoms like irritable bowel syndrome, insomnia, depression, etc.
Yet another myth is that fibromyalgia is not treatable. On the contrary, the FDA has approved three medications. Pregabalin (Lyrica) minimizes neuron transmissions that affect pain nerve signals; duloxetine (Cymbalta), an anti-depressant, increases serotonin and norepinefrine to calm pain signals; and milnacipran (Savella), an antidepressant, has an effect on brain chemicals by increasing calming pain signals. Other treatments include use of antidepressants, analgesics, NSAIDS, opiates and anti-anxiety agents.
There is also treatment for psychological factors, besides diet, exercise and education. Delgadillo advised fibromyalgia sufferers to avoid high carbohydrates, reduce high fructose corn syrup and corn syrup foods. He said eating veggies and protein is helpful as is eating a balanced diet. The vitamins B complex, B6, B12, C, and others have been found useful, especially ribose which is a natural sugar that does not increase blood sugar levels.
He also recommended yoga which has been found to reduce pain, fatigue and depression. He said aerobic exercise has also been shown to relieve pain sensitivity for fibromyalgia patients while weight training reduces trigger points and pain sensitivity as well as promoting better sleep.
Delgadillo concluded with, “Educate yourself, exercise, eat healthy and sleep smarter; get help if you are suffering, you are not alone.”
There will be no Ladies Night Out event in April as the committee prepares for the program’s seventh anniversary dinner in May.
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