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Dr. Andrew Rynne

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Suggest ways to manage pain when diagnosed with fibromyalgia

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Dr. Seikhoo Bishnoi

Psychiatrist

Practicing since :2007

Answered : 5046 Questions

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Posted on Fri, 3 Mar 2017 in Mental Health
Question: I was diagnosed with fibromyalgia over ten years ago. I now find myself having anxiety attacks the night before and the day of a doctors visit due to all of the stigmas attached to "us". I feel absolutely hopeless in finding someone in the medical field whom will not only take the time to listen but understand. Take me for example I am one of the ones most doctors would classify as a "pill seeker". The only relief I get from the pain is with pain medication and strong muscle relaxers. However I don't see myself as a "pill seeker". If I was just looking for narcotics my dad would gladly supply me with as many Roxys and metadones I want. My life has gone from being an extremely active person to having to lay in the bed (literally) 95% of my day. I have tried PT, it made my body go into extreme flares that I had to be carried to the restroom. I have done the 30 minutes a day mild exercise to find myself in a worse position than before. (yes I gave it a good month and a half) I now find myself making excuses on why I can't go to the doctor because they make me feel like I'm a hypochondriac. Then you go to some doctors (most recent for me was a neuro surgeon for pinched nerves in my neck one day my ring and middle finger along with my thumb just the tips had a hypothermia feel. Like I lost feeling but I didn't. It's still like that) who as soon as they hear the word fibromyalgia its a catch all. You have a broke pinky toe, fibro. Pink eye, fibro. It truly gets overwhelming depressing and makes me just want to give up on it. Is there any advice you can give me to maybe communicate better with my physician. I mean I have a purple tone "lace like pattern" all over my body, I look like a cheetah and it's nothing to them. How do I regain control of my doctors visits and my life with this painful disease? I have taken Lyrica, it intensified my anxiety 100% and gave me suicidal thoughts. Neurontin and my body do not get along. I am suppose to be on 120 mg of Cymbalta a day but my Medicade cut me down to 30. I also take Topamax 25mg for migraines, zanaflex 2mg, omeprazple 40 mg (not sure why I'm on this, told Dr. I randomly choke on random things and sometimes regurgitate my food??) Lunesta 3mg, klonopin .5 mg, and today was put on a depo shot. I only have one ovary left and my Dr doesn't want to send me into early menopause (37) from what I'm reading the side effects for the depo are what and what, if not a tad more than menopause. Also if my material grandmother has osteoporosis is that something I should let my OB know about?
I'm so sorry for the million topic changes and questions of this inquiry, I truly am. With the brain fog it's kind of hard to stay on track. However I need and would appreciate any advice you could give me. I'm at my wits end.
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Answered by Dr. Seikhoo Bishnoi 17 hours later
Brief Answer:
Proper medicines help to control the symptoms.

Detailed Answer:
Hi, thanks for asking from HCM for your health related doubts

Please excuse me for late reply due to busy schedule. I have read the query and understand your concern. Fibromylagia is a diagnosis made later in the course of treatment. Once the diagnosis is made a lot of doctors become biased towards the diagnosis and they sometimes overlook or ignore the symptoms patients are suffering. This is happening in your case too. If you are getting relief of pain from pills then there is nothing wrong in that.

If we consider your recent complaints like the hypothermia like feel on ring, middle finger and thumb then that could occur due to a number of situations like Vitamin B12 deficiency, neuritis or due to compression. This can cause such symptoms. So that should be evaluated.

For flbromyalgia commonly SNRI drugs are used. You are currently on 30 mg of Duloxetine (after being cut down from 120) and this is not a sufficient dose for symptoms. Increasing the dose again would help in better control. Other drugs like Venlafaxine can be tried if your symptoms are persistent.

How to approach a physician ? Well that is a difficult thing to predict because different doctors have different approaches. Some have empathetic approach towards patients and they listen their patients. First of all explain your symptoms to doctor and don't jump over diagnosis or what you think directly. Diagnostic work is doctor's work and not of patient's. Don't mention what specific medicines you want instead tell the doctor what he/she thinks best for you should be given. This will help in elaborating your problems in detail and they will listen your details.

If your maternal grandmother was suffering from Osteoporosis then that is not a significant thing. Osteoporosis can occur in any individual after 40s and proper calcium diet helps to reduce the risk.

Thanks. Hope this helps.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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