More About Fibromyalgia

Wow, I was surprised to see in my comments that so many others have FMS too and I appreciated everyone's advice and input.

I walked on the treadmill several times since I last posted and I think I feel better. I seem to have more energy than I usually do and although I feel a little sleepy in the afternoon I haven't taken any marathon naps in over a week. My ankle bothers me some when I walk and so I'm hoping to use the leather brace while I'm exercising. I've been hesitant to do that because the last time I walked on the treadmill with it, I got blisters on my foot.

The main problem I'm having now with pain is in my wrists, thumbs and shoulders. I think the surgery will help alleviate the pain in my shoulders but I guess I'm going to have to go and get a shot of cortisone in my thumbs. . I imagine this all ties in with FMS somehow. I wonder if a lot of people who are overweight also have FMS?

I found another article by Dr. Weil:

With fibromyalgia, a syndrome that combines pain, fatigue, anxiety, and depression, you have to separate “cause” from “trigger.” New research suggests that this mysterious syndrome is caused by imbalances of chemicals and hormones in the nervous system that amplify sensation, making even a slight touch feel painful. In a study published last year, Daniel Clauw, MD, a rheumatologist at the University of Michigan, used MRIs to show what happens in the brains of fibromyalgia patients in response to minimal pressure to their left thumbs – blood rushes to areas involved in pain perception. To get the same response from healthy people Clauw had to apply twice the pressure.

The super-sensitivity to pain that characterizes fibromyalgia seems to be genetic. The disorder runs in families, and researchers have identified one gene believed to be involved in the syndrome. Patients also have higher than normal levels of a neuropeptide called substance P that is involved in pain signals and subnormal levels of serotonin and norepinephrine, hormones that modulate pain.

If you are born with a predisposition to fibromyalgia, you still need to experience an event to trigger the disorder – that is, something must happen to set it off. This can be a viral infection, emotional stress, an accident or injury or even exposure to certain drugs or chemicals. My colleague Iris Bell, MD, PhD, Professor of Psychiatry and Director of Research here at the Program in Integrative Medicine, tells me that multiple chemical sensitivity (MCS) and fibromyalgia often overlap. In fact, according to a recent paper in the Annals of Internal Medicine, 33 percent of fibromyalgia patients also suffer from MCS. Dr. Bell adds that 60 percent of all MCS patients are able to identify the specific exposure that set off their initial reaction.

We may soon have new drugs to improve treatment of fibromyalgia by reducing substance P and increasing levels of norepinephrine and serotonin. In the meantime, your best bet for dealing with this condition is 30 minutes of daily aerobic exercise such as swimming, walking or biking. Breath work, meditation and yoga can help you cope with stress, and acupuncture, manipulation, and massage may help relieve symptoms.

I was thinking about what my trigger might have been because I don't seem to remember that I always had this kind of trouble with pain and fatigue. I thought of a couple of things -- my son and I were in an accident that totalled the car in 1995. Neither of us were seriously injured at the time but within the month, my appendix ruptured and I had to have emergency surgery. After that, I had a lot of trouble maintaining my fitness routine (walking and swimming) but I figured it was just because of recovering from surgery.

The other trigger I thought of would be Rich's death. That's when I can clearly remember the beginning of problems with pain and marathon sleeping. I gained more than 50 pounds and was diagnosed with sleep apnea. So grief could be a trigger too because of the deep emotional stress?

There's one big problem I see at the end of that article. It talks about increasing the levels of norepinephrine and serotonin...I'd have to check it out but I do believe my meds inhibit those because of my anxiety and depression. Isn't norepinephrine like adrenaline? And I take an SSRI...which is supposed to inhibit the uptake of serotonin? Back to the online textbooks...