Fibromyalgia is a chronic, widespread, debilitating disease that often manifests as diffuse pain, constant muscle aches and overwhelming fatigue. Although it affects about 2-6% of the general population (about five million people), fibromyalgia is not a contagious disease. Women are about 9 times more likely to be diagnosed than men, and it is most prevalent in prevalent in people between 20-50 years of age.
Fibromyalgia usually displays a variety of symptoms including generalized aches and pains, increased sensitivity of the skin, chronic fatigue, weakness or dizziness, muscle stiffness or joint pain and migraine headaches. Symptoms of fibromyalgia vary greatly between individuals but almost all suffer from an associated sleep disorder. Depression, anxiety, irritable bowel syndrome, numbness and tingling of the extremities and heightened sensitivity to stimuli may also be present.
Currently, there is no known specific cause of fibromyalgia. Popular opinion suggests a disorder in pain perception and processing in the pathways to the brain. Research has shown that fibromyalgia patients have elevated levels of substance P (involved with enhanced pain perception) and a lower than normal production of natural stress hormones. Another theory revolves around a sleep disturbance as the cause, because many fibromyalgia patients cannot attain deep sleep. Still other theories have implicated reduced immune system function, environmental toxins, abnormal hormonal fluctuations, viral causes, genetic links and dysfunctional neurotransmitters. Although exciting new research is constantly being done, the cause of fibromyalgia remains elusive and has the medical world stumped.
Diagnosis of fibromyalgia is based on a specific set of criteria, including a physical examination or observation, and the symptoms described by the patient. Ruling out other possible diseases is key. Currently, there are no conclusive laboratory tests to identify fibromyalgia but for diagnostic purposes, there has to be a history of diffuse pain lasting longer than three months. Another diagnostic requirement is the presence of at least 11 "tender points" out of a possible 18 and these are typically located at elbow and knee joints, the neck, shoulders, lower back and hips...
Individual cases of fibromyalgia have a wide variability, but many patients also suffer from other disorders as well. These comorbid syndromes commonly include chronic clinical depression, lyme disease, chronic fatigue sydrome, premenstrual syndrome, restless legs syndrome, spinal disorders, or hypothyroidism. There are also many factors that can aggravate fibromyalgia. Severe weather changes, nutritional deficiencies, over-exertion, increases in stress levels, allergies and cold weather have all been shown to contribute to flare-ups.
Treatment of fibromyalgia has historically been inadequate at best. There is no cure for the disease and therapies are usually aimed at alleviating the symptoms and improving quality of sleep. Medications commonly prescribed for fibromyalgia include conventional analgesics, low-dose antidepressants, muscle relaxants and sleep-inducing agents. Alternative therapies that have shown some promise include acupuncture, chiropractic care, physical therapy, meditation or relaxation techniques and a gentle aerobic exercise program. Other important considerations to prevent fibromyalgia from flaring up include a regular sleep routine, emotional and physical stress reduction, good social support networks and strategies to conserve energy and minimize triggering factors.
Fibromyalgia can be a very difficult disease to live with because of its chronic, disabling nature and the presence of widespread skepticism. There is often no objective evidence of physical illness and the disease is very poorly understood. Sufferers of fibromyalgia face accusations of laziness or feigning illness. Social activity and recreation is often be avoided and the patient's career is usually affected as well. Although fibromyalgia can affect every aspect of its victims' lives, it does not have to be as devastating as it once was. With advanced scientific research and promising new treatments waiting in the wings, anything's possible.
Disclaimer: The information presented here should not be interpreted as or substituted for medical advice. Please talk to a qualified professional for more information about fibromyalgia.
Thursday, February 1, 2007
Diagnosis and Treatment of Fibromyalgia
Wednesday, January 24, 2007
Lyme Disease Alert: I was Bitten by a Tic
Because I live in Minnesota and our family has a cabin in the North woods, I'm aware of Lyme disease. Our family is so aware of it that one member tacked a photo of a tic bite to the kitchen counter. We've found crawling tics on floors, our clothes, our beds, and our bodies. Tics are hardy little devils and you think you've killed one, only to have it walk away. That's why we wrap tics in cellophane tape, pinch the tape hard, and seal the edges tightly.
A month ago, when my husband and I were working at the cabin, I was bitten by a tic. The bite itched, but I didn't pay any attention to it because I thought it was a mosquito bite. (I try not to scratch mosquito bites because the itch goes away faster if you don't.) After the skin around the bite turned red I began to get suspicious. Then a red circle appeared, a so-called "bull's-eye," and it became as hard as plastic. My bite looked just like the cabin photo.
Antibiotics are the standard treatment for suspected Lyme disease and I started taking doxycycline twice a day. I'm still taking it and will take it for 21 days. The doxycycline makes me a bit nauseous, unfortunately. The American Lyme Disease Foundation (ALDF) has posted a treatment table of prescribed dosages for adults and children on its website. The ALDF has also posted information on Lyme disease tests, though doctors disagree on their accuracy.
According to the Centers for Disease Control and Prevention (CDC) Lyme disease may cause loss of muscle tone in the face (Bell's palsy), severe headaches, a stiff neck, shooting pains that wake you up, heart palpatations, dizziness from these palpatations and severe joint pain. About 60% of the patients who weren't treated for Lyme disease had "intermittent bouts of arthritis, with severe joint pain and swelling," according to the CDC. Additional symptoms include numbness and/or tingling hands and feet, concentration problems, and memory loss.
I haven't had any of these symptoms, thank goodness, and don't want you to have them. How can you prevent Lyme disease? Mayo Clinic recommends wearing long-sleeved shirts and pants. Spray yourself with insect repellent before you go outside. If you find a tic on your body remove it carefully with tweezers and put antiseptic on the site. Cutting foliage away from your house or cabin may also help to prevent tic bites.
Most important, if you have what I experienced - a distinct bite, red skin or rash, and a "bull's-eye" - see your doctor immediately.
Lyme disease is more prevalent than you may think and CDC statistics confirm this. In 2004, 19,804 cases of Lyme disease were reported, which works out to 6.7 cases per 100,000 people. In the 12 states where Lyme disease is most common, the average was 27.4 cases per 100,000 people.
Being bitten by a tic has reminded me that I have to check my body often for tics and bites, something I failed to do. I was so busy stripping wallpaper that I forgot to think about tics. Though I wore long-sleeved shirts and jeans while I was at the cabin, these clothes didn't prevent the bite. We've informed all family members about my bite and told them to be on the alert for tics.
You should inspect your pets regularly for tics as well. After one visit to the North woods we found more than 40 tics on our Golden Retriever and removing them took hours. This brings up another prevention tip, which is staying on established trails and paths. Be alert to Lyme disease and do everything you can to protect yourself.
Copyright 2006 by Harriet Hodgson
Harriet Hodgson has been a nonfiction writer for 27 years and is a member of the Association of Health Care Journalists and the Association for Death Education and Counseling. Her 24th book, "Smiling Through Your Tears: Anticipating Grief," written with Lois Krahn, MD is available from http://www.amazon.com. A five-star review of the book is posted on Amazon. You'll find another review on the American Hospice Foundation website under the "School Corner" heading.
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