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drusso

drusso

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You're right You don't look sick, Get the Hell out of my office!
 
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I don't look sick

Until the doc knocks on the door. Then the river starts flowing
 
Fibro.....ahh gotta love the fibro patients. Chronic Lyme, POTS syndrome and seronegative RA also fit this mold.

Reminds me of a recent new patient. Mid 40s with "chronic Lyme " for a decade. Went to multiple ID docs and no one could find Lyme or any evidence of Lyme. They were all "quacks" except the one who started him on methadone and saved his life.
 
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We should make Fred Wolfe get one on his forehead.
 
Last edited:
geauxg8rs said:
I am assuming they are doing these tats under general anesthesia since even their skin feels like it is on fire?
Click to expand...
oh no. getting the tat either "doesnt hurt" (while a 27 gauge needle causes a 101 decibel scream) or the end results justifies the pain (but a 10 minute walk never will).
 
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drusso said:
Fibro tattoo. Saw one of these today on a patient. It's their badge of honor....look for purple ribbons and butterflies on your patients--confirms the diagnosis.

View attachment 193317
Click to expand...
So this is really something FM patients carry around/ send/ TATTOO on themselves? I am doing a search....
 
It is a nice contrast to the knuckletats in Bic blue ink. Fibro patients have "hate" and "hurt" on theirs.
 
Choosing wisely...

When is FMS ever the right diagnosis to make when 35% of those diagnosed
will seek and obtain SSDI. This is modern day railway spine.

Arthritis Care Res (Hoboken). 2014 Sep;66(9):1354-63. doi: 10.1002/acr.22305.
Social security work disability and its predictors in patients with fibromyalgia.
Wolfe F1, Walitt BT, Katz RS, Häuser W.
Author information

Abstract
OBJECTIVE:
To determine prevalence and incidence of US Social Security Disability and Supplemental Security Income (SSD) in patients with fibromyalgia and to investigate prediction of SSD.

METHODS:
Over a mean of 4 years (range 1-13 years), we studied 2,321 patients with physician-diagnosed fibromyalgia (prevalent cases) and applied modified American College of Rheumatology (ACR) 2010 research criteria to identify criteria-positive patients.

RESULTS:
During the study, 34.8% (95% confidence interval [95% CI] 32.9-36.8%) of fibromyalgia patients received SSD. The annual incidence of SSD among patients not receiving SSD at study enrollment was 3.4% (95% CI 3.0-3.9%), and 25% were estimated to be work disabled at 9.0 years of followup. By comparison, the prevalence of SSD in rheumatoid arthritis (RA) patients with concomitant fibromyalgia was 55.6% (95% CI 54.3-57.0%) and was 42.4% in osteoarthritis (OA). By study conclusion, 31.4% of SSD awardees were no longer receiving SSD. In univariate models, incident SSD in patients with fibromyalgia was predicted by sociodemographic measures and by symptom burden; but the strongest predictor was functional status (Health Assessment Questionnaire disability index [HAQ DI]). In multivariable models, the HAQ DI and the Short Form 36-item health survey physical and mental component summary scores, but no other variables, predicted SSD. Fibromyalgia criteria-positive patients had more SSD, but the continuous scale, polysymptomatic distress index derived from the ACR criteria was a substantially better predictor of SSD than a criteria-positive diagnosis.

CONCLUSION:
The prevalence of SSD is high in fibromyalgia, but not higher than in RA and OA patients who satisfy fibromyalgia criteria. The best predictors of work disability are functional status variables.
 
If you don't recognize them, they don't listen. Gotta give the diagnosis. Then cymbalta, lyrica, tpi only if completing daily aerobic exercise, lots of cbt. maybe weed qhs.
 
PainDrain said:
Fibro.....ahh gotta love the fibro patients. Chronic Lyme, POTS syndrome and seronegative RA also fit this mold.

Reminds me of a recent new patient. Mid 40s with "chronic Lyme " for a decade. Went to multiple ID docs and no one could find Lyme or any evidence of Lyme. They were all "quacks" except the one who started him on methadone and saved his life.
Click to expand...

This has got to be a template on one of the addict websites or something. I've seen this exact BS story three times over the last month.

I guess studies show that 10% of the time it works every time.
 
Fibromyalgia and Hyperbaric Oxygen Therapy: Encouraging Results in Small Study
Results of a small study published in the June edition of the journal PLOS ONE found that women with fibromyalgia experienced relief from pain and other symptoms after undergoing hyperbaric oxygen therapy. Brain scans of the patients showed that 2 months of hyperbaric oxygen therapy, most often associated with treating “the bends” in scuba divers, may have also repaired abnormal brain activity in pain-related areas of the brain, the researchers said. Lead study author Shai Efrati, MD, director of the Sagol Center for Hyperbaric Medicine and Research in Tel Aviv, Israel, stated “70% of the patients could not be categorized as suffering from fibromyalgia at the end of the treatment.”

According to the American College of Rheumatology (ACR), fibromyalgia affects 9 times more women than men. Symptoms include chronic widespread pain, intense pain in response to pressure on certain body parts, fatigue, and poor sleep. The condition is poorly understood and has not been traced to a single cause. Physical or emotional factors may trigger symptoms, the ACR says. Fibromyalgia is typically treated with a combination of therapies, including drugs, lifestyle changes, and cognitive behavioral therapy. In this study, 48 women who had been diagnosed with fibromyalgia at least 2 years earlier were placed in 2 groups. Half underwent 40 hyperbaric oxygen therapy treatments over 2 months. The treatments were given 5 times a week in sessions of 90 minutes each. During the treatment, patients breathed 100% oxygen pressurized to twice the normal air pressure. The therapy is thought to increase oxygen flow to body tissues, improving healing. Fibromyalgia is not currently one of the FDA-approved conditions for hyperbaric oxygen therapy, which continues to be tested for this and other “off-label” conditions.
 
Drug Approved. Is Disease Real?
By ALEX BERENSON
Published: January 14, 2008
Fibromyalgia is a real disease. Or so says Pfizer in a new television advertising campaign for Lyrica, the first medicine approved to treat the pain condition, whose very existence is questioned by some doctors.

drugs190.jpg

Jamie Rector for The New York Times
Lynne Matallana, who says she has fibromyalgia, said the drugs would aid acceptance.

Related
Times Health Guide: Fibromyalgia
paingraph190.gif




Prozac brought depression into the mainstream.

But other doctors — including the one who wrote the 1990 paper that defined fibromyalgia but who has since changed his mind — say that the disease does not exist and that Lyrica and the other drugs will be taken by millions of people who do not need them.

As diagnosed, fibromyalgia primarily affects middle-aged women and is characterized by chronic, widespread pain of unknown origin. Many of its sufferers are afflicted by other similarly nebulous conditions, like irritable bowel syndrome.

Because fibromyalgia patients typically do not respond to conventional painkillers like aspirin, drug makers are focusing on medicines like Lyrica that affect the brain and the perception of pain.

Advocacy groups and doctors who treat fibromyalgia estimate that 2 to 4 percent of adult Americans, as many as 10 million people, suffer from the disorder.

Those figures are sharply disputed by those doctors who do not consider fibromyalgia a medically recognizable illness and who say that diagnosing the condition actually worsens suffering by causing patients to obsess over aches that other people simply tolerate. Further, they warn that Lyrica’s side effects, which include severe weight gain,dizziness and edema, are very real, even if fibromyalgia is not.

Despite the controversy, the American College of Rheumatology, the Food and Drug Administration and insurers recognize fibromyalgia as a diagnosable disease. And drug companies are aggressively pursuing fibromyalgia treatments, seeing the potential for a major new market.

Hoping to follow Pfizer’s lead, two other big drug companies, Eli Lilly and Forest Laboratories, have asked the F.D.A. to let them market drugs for fibromyalgia. Approval for both is likely later this year, analysts say.

Worldwide sales of Lyrica, which is also used to treat diabetic nerve pain and seizures and which received F.D.A. approval in June for fibromyalgia, reached $1.8 billion in 2007, up 50 percent from 2006. Analysts predict sales will rise an additional 30 percent this year, helped by consumer advertising.

In November, Pfizer began a television ad campaign for Lyrica that features a middle-aged woman who appears to be reading from her diary. “Today I struggled with my fibromyalgia; I had pain all over,” she says, before turning to the camera and adding, “Fibromyalgia is a real, widespread pain condition.”

Doctors who specialize in treating fibromyalgia say that the disorder is undertreated and that its sufferers have been stigmatized as chronic complainers. The new drugs will encourage doctors to treat fibromyalgia patients, said Dr. Dan Clauw, a professor of medicine at the University of Michigan who has consulted with Pfizer, Lilly and Forest.

“What’s going to happen with fibromyalgia is going to be the exact thing that happened to depression with Prozac,” Dr. Clauw said. “These are legitimate problems that need treatments.”

Dr. Clauw said that brain scans of people who have fibromyalgia reveal differences in the way they process pain, although the doctors acknowledge that they cannot determine who will report having fibromyalgia by looking at a scan.

Lynne Matallana, president of the National Fibromyalgia Association, a patients’ advocacy group that receives some of its financing from drug companies, said the new drugs would help people accept the existence of fibromyalgia. “The day that the F.D.A. approved a drug and we had a public service announcement, my pain became real to people,” Ms. Matallana said.

Ms. Matallana said she had suffered from fibromyalgia since 1993. At one point, the pain kept her bedridden for two years, she said. Today she still has pain, but a mix of drug and nondrug treatments — as well as support from her family and her desire to run the National Fibromyalgia Association — has enabled her to improve her health, she said. She declined to say whether she takes Lyrica.

“I just got to a point where I felt, I have pain but I’m going to have to figure out how to live with it,” she said. “I absolutely still have fibromyalgia.”

But doctors who are skeptical of fibromyalgia say vague complaints of chronic pain do not add up to a disease. No biological tests exist to diagnose fibromyalgia, and the condition cannot be linked to any environmental or biological causes.

The diagnosis of fibromyalgia itself worsens the condition by encouraging people to think of themselves as sick and catalog their pain, said Dr. Nortin Hadler, a rheumatologist and professor of medicine at the University of North Carolina who has written extensively about fibromyalgia.

“These people live under a cloud,” he said. “And the more they seem to be around the medical establishment, the sicker they get.”

Dr. Frederick Wolfe, the director of the National Databank for Rheumatic Diseases and the lead author of the 1990 paper that first defined the diagnostic guidelines for fibromyalgia, says he has become cynical and discouraged about the diagnosis. He now considers the condition a physical response to stress, depression, and economic and social anxiety.

“Some of us in those days thought that we had actually identified a disease, which this clearly is not,” Dr. Wolfe said. “To make people ill, to give them an illness, was the wrong thing.”

In general, fibromyalgia patients complain not just of chronic pain but of many other symptoms, Dr. Wolfe said. A survey of 2,500 fibromyalgia patients published in 2007 by the National Fibromyalgia Association indicated that 63 percent reported suffering from back pain, 40 percent from chronic fatigue syndrome, and 30 percent from ringing in the ears, among other conditions. Many also reported that fibromyalgia interfered with their daily lives, with activities like walking or climbing stairs.

Most people “manage to get through life with some vicissitudes, but we adapt,” said Dr. George Ehrlich, a rheumatologist and an adjunct professor at the University of Pennsylvania. “People with fibromyalgia do not adapt.”

Both sides agree that people who are identified as having fibromyalgia do not get much relief from traditional pain medicines, whether anti-inflammatory drugs like ibuprofen — sold as Advil, among other brands — or prescription opiates like Vicodin. So drug companies have sought other ways to reduce pain.

Pfizer’s Lyrica, known generically as pregabalin, binds to receptors in the brain and spinal cord and seems to reduce activity in the central nervous system.

Exactly why and how Lyrica reduces pain is unclear. In clinical trials, patients taking the drug reported that their pain — whether from fibromyalgia, shingles or diabetic nerve damage — fell on average about 2 points on a 10-point scale, compared with 1 point for patients taking a placebo. About 30 percent of patients said their pain fell by at least half, compared with 15 percent taking placebos.

The F.D.A. reviewers who initially examined Pfizer’s application for Lyrica in 2004 for diabetic nerve pain found those results unimpressive, especially in comparison to Lyrica’s side effects. The reviewers recommended against approving the drug, citing its side effects.

In many patients, Lyrica causes weight gain and edema, or swelling, as well as dizziness and sleepiness. In 12-week trials, 9 percent of patients saw their weight rise more than 7 percent, and the weight gain appeared to continue over time. The potential for weight gain is a special concern because many fibromyalgia patients are already overweight: the average fibromyalgia patient in the 2007 survey reported weighing 180 pounds and standing 5 feet 4 inches.

But senior F.D.A. officials overruled the initial reviewers, noting that severe pain can be incapacitating. “While pregabalin does present a number of concerns related to its potential for toxicity, the overall risk-to-benefit ratio supports the approval of this product,” Dr. Bob Rappaport, the director of the F.D.A. division reviewing the drug, wrote in June 2004.

Pfizer began selling Lyrica in the United States in 2005. The next year the company asked for F.D.A. approval to market the drug as a fibromyalgia treatment. The F.D.A. granted that request in June 2007.

Pfizer has steadily ramped up consumer advertising of Lyrica. During the first nine months of 2007, it spent $46 million on ads, compared with $33 million in 2006, according to TNS Media Intelligence.

Dr. Steve Romano, a psychiatrist and a Pfizer vice president who oversees Lyrica, says the company expects that Lyrica will be prescribed for fibromyalgia both by specialists like neurologists and by primary care doctors. As doctors see that the drug helps control pain, they will be more willing to use it, he said.

“When you help physicians to recognize the condition and you give them treatments that are well tolerated, you overcome their reluctance,” he said.

Both the Lilly and Forest drugs being proposed for fibromyalgia were originally developed as antidepressants, and both work by increasing levels of serotonin and norepinephrine, brain transmitters that affect mood. The Lilly drug, Cymbalta, is already available in the United States, while the Forest drug, milnacipran, is sold in many countries, though not the United States.

Dr. Amy Chappell, a medical fellow at Lilly, said that even though Cymbalta is an antidepressant, its effects on fibromyalgia pain are independent of its antidepressant effects. In clinical trials, she said, even fibromyalgia patients who are not depressed report relief from their pain on Cymbalta.

The overall efficacy of Cymbalta and milnacipran is similar to that of Lyrica. Analysts and the companies expect that the drugs will probably be used together.

“There’s definitely room for several drugs,” Dr. Chappell said.

But physicians who are opposed to the fibromyalgia diagnosis say the new drugs will probably do little for patients. Over time, fibromyalgia patients tend to cycle among many different painkillers, sleep medicines and antidepressants, using each for a while until its benefit fades, Dr. Wolfe said.

“The fundamental problem is that the improvement that you see, which is not really great in clinical trials, is not maintained,” Dr. Wolfe said.

Still, Dr. Wolfe expects the drugs will be widely used. The companies, he said, are “going to make a fortune.”
 
Wasnt Fibromyalgia "invented" at the annual Rheumatology meetings in Hawaii? Why cant we agree on something like that.....in Hawaii?
 
Doctodd said:
Wasnt Fibromyalgia "invented" at the annual Rheumatology meetings in Hawaii? Why cant we agree on something like that.....in Hawaii?
Click to expand...

I like this idea. How about a syndrome describing people in the 30-55 age group, who smoke, live sedentary lives, are overweight to obese, lack personal responsibility, are depressed, dependent on various public resources, would rather treat their medical problems with pills instead of making significant lifestyle changes...... Oh wait. I just described fibromyalgia.
 
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Eur Psychiatry. 2000 Aug;15(5):295-301.
The impact of life events in female patients with fibromyalgia and in female healthy controls.
Anderberg UM1, Marteinsdottir I, Theorell T, von Knorring L.
Author information

Abstract
The aim was to investigate if female fibromyalgia patients (FMS) had experienced more negative life events than healthy women. Furthermore, the life events experienced in relation to onset of the FMS were evaluated. Another important area was to investigate the impact of the events experienced in the patients compared to healthy women. A new inventory was constructed to assess life events during childhood, adolescence and in adulthood as well as life events experienced in relation to the onset of the disorder. Forty female FMS patients and 38 healthy age-matched women participated in the study. During childhood or adolescence 51% of the patients had experienced very negative life events as compared to 28% of the controls. Conflict with parents was the most common life event. Before onset, 65% of the patients experienced some negative life event. Economic problems and conflicts with husband/partner were common. During the last year, 51% of the patients had life events which they experienced as very negative, compared to 24.5% of the controls (P < 0.01). Stressful life events in childhood/adolescence and in adulthood seem to be very common in FMS. Furthermore, the life events were experienced as more negative than the life events experienced by healthy controls.
 
Pain
Is just weakness leaving the butterfly tattoo
 
There's this big self help group i heard about.......and everyone is in it......it's called LIFE.
 
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Man I wish I could go back about 15 years and start a cord blood company. What a gimmick!! Convince a group of emotionally fragile people (new parents) that their kid may one day get a horrible disease and all they need to do is pay you a grand to harvest and save the cord blood.
 
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