Today was my quarterly visit with rheumy for PSA. He said he feels the Enbrel and Methotrexate is keeping my PSA 'under control' but clearly I have something else going on. He handed me a brochure for Fibromyalgia and said to read it and tell him if the symptoms sounds like my continued pain. The answer is definitely. You all probably know this but he said PSA and Fibro is very common, as is RA and Fibro. Learn something new every day. He is changing some of my meds around and go back in 2 months. I have vaguely heard of Fibro but never really paid attention. guess I should now. How about any of you folks? Is this really that common? Any secrets to keep the double dose of pain under control - best we can? Open for any help. Thank you all.
slb
While its not uncommon, it is also common for docs to add the fibro Dx when they are running out of options. Its not near the diagnoses of exclusion that it used to be. Bens friends BTW has a fibro board. In any even before i would EVER allow that Dx added to my "permanent record" I would be sure. There are 18 points of pain, it takes eleven for Dx:
http://www.health.com/health/gallery/0,,20345635,00.html
Its not right, but a lot of treatment doors close with a fibro Dx and there are still more than a few docs who don't "believe in it" treating it almost like a mental health issue. Use of the narcos and hyperanalgesia is also often confused with fibro. If you have had any use of the the opiads beyond a short course (10 days or less)m I'd look at that too.
Thanks Lamb. I will check out your link and gather more information.
They have found only two types of medications to be truly effective against Fibro. Anti-siezure meds and a couple of classes of antidepressants. (one class does on thing the other a differnt) an you can only take one. Traditional pain medications are found to aggravate it. The tendency of more than a few docs is to do as little as possible, and pain management centers tend to shy away as well. So what happens is you have a big flare going on and your pain is eminating from one of the trigger point areas. Is it PsA or is it Fibro? They are treated differently. Say you are taking a biologic and have a pain flare. This isn't a try this and call me in few days situation.You don't know whats working and whats not. There is overlap in treatment to be sure (Tricyclics, and injections the biggest area) But unless you have an excellent Doc (and it sounds like Breckstar has a good one) who is very familiar with and responsive to your needs., your case becomes VERY complicated and you are as likley to get poor treatment or NO treatment as not. Not to mention there are more than a few (usually PCP docs) who believe fibro is "all in the head" The fibro boards ar full of people for whom they have recieved a fair amount of treatment without effect end up being Dx by some ignoramous as having some type of somayic disorder.
I'm not TRYING to be discouraging, but one does not want to collect any more diagnoses than they have to or are absolutley CERTAIN apply. We all like answers, that doesn't mean GETTING them is a good thing. The harder you become tyo treat the more likley it is you don't get treated. The mor Dx you have the morelikley you will be considered somatic when you need help the most.
I'm sort of glad that we don't have "signatures" on this board. It seems there are always a few who find it necessary to list every disease/diagnoses they have ever had right down to I kid you not once I saw listed "medial agnal" better known as a hangnail in the middle of your finger. Now to give the devil due these can turn into a herpetic whitlow which is when a hangnail gets puffyand red. Those of us on Biologics or MTX should consider calling the doc for a quick course of acyclovir if it doesn't clear up pretty quickly.
Now I'm not accusing ANYONE of anything. just a word of caution that others might..... Accepting easily any diagnoses when one is chronically ill to begin with can have a negative effect. (not to say a positive effect if its right)
Lovemydogs said:
Why do you say treatment doors close with a dx of fibro? Just curious...