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Suggest treatment for fibromyalgia and pulmonary hypertension

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Posted on Fri, 20 Feb 2015
Question: I am a 68 year old female. I struggled with MCTD for 20 years. I am now in remission according to blood work, but I honestly don't feel any better. I also have Sjogrens, IC, fibromyalgia, pulmonary hypertension (a result of several PEs 10 years ago), congestive heart failure, Afib, and ILD currently in remission. In September I experienced a Tokotsubo cardiomyopathy with respiratory failure. I was ventilator dependent and comatose for two weeks. During this time all of my pain meds were stopped. I do not recall any withdrawal illness. I have 2 issues: pain & fatigue. I am told I cannot take NSAIDS because of Eliquis. I will be anticoagulated for life because I had the PEs while on plaquenil and NSAIDS. I have a new pain management doc who has returned the Lyrica at a much lower dose: 100mg bid; reduced from 200mg tid. I was taking morphine sulfate, 60mg bid. I used 10-20mg oxycodone bid for breakthrough. I also used zanaflex or skelaxin. I stopped Ambien in XXXXXXX after a sleep cooking episode.
I am afraid the fatigue cannot be relieved; however I don't want to sit here and suffer for the rest of my life. Is there anything that could help?
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Answered by Dr. Naval Mendiratta (51 minutes later)
Brief Answer:
measures to combat chronic fatigue

Detailed Answer:
Good evening

Thank you for writing on health care magic

I have gone through your history. You seem to have had a rough path and been on lot of medications. As for the fatigue it is a very common problem in long term illness. The signal from brain gets altered and tends to cause increased fatigue irritability and forgetfulness

To combat fatigue I would suggest:

1. Get your vitamin d levels checked and supplement it with the same if the levels are low

2. You can ask your rheumatologist to switch to dulane or tryptomer instead of pregabalin. It will help combat the fatigue

3. You need to start exercising a bit as it helps on the flexibility. It will be a not distressing initially but as you keep working it will get better.it will help the fatigue and will be good for heart as well

4. Try lowering the stress levels in your life. You can try meditation if it helps

Hope the information was useful. Do let me know for more queries. Would be happy yo answer then

Regards
Dr naval
Above answer was peer-reviewed by : Dr. Shanthi.E
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Answered by
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Dr. Naval Mendiratta

Rheumatologist

Practicing since :2007

Answered : 748 Questions

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Suggest treatment for fibromyalgia and pulmonary hypertension

Brief Answer: measures to combat chronic fatigue Detailed Answer: Good evening Thank you for writing on health care magic I have gone through your history. You seem to have had a rough path and been on lot of medications. As for the fatigue it is a very common problem in long term illness. The signal from brain gets altered and tends to cause increased fatigue irritability and forgetfulness To combat fatigue I would suggest: 1. Get your vitamin d levels checked and supplement it with the same if the levels are low 2. You can ask your rheumatologist to switch to dulane or tryptomer instead of pregabalin. It will help combat the fatigue 3. You need to start exercising a bit as it helps on the flexibility. It will be a not distressing initially but as you keep working it will get better.it will help the fatigue and will be good for heart as well 4. Try lowering the stress levels in your life. You can try meditation if it helps Hope the information was useful. Do let me know for more queries. Would be happy yo answer then Regards Dr naval