Spreading Your Eggs…

The most consistent treatment advice that all the experts in FM try to promote is a multi-faceted comprehensive treatment approach. do_not_put_all_your_eggs_in_one_basketThose who have followed this blog for a while know that I have always promoted this advice: this means NOT putting all your eggs in one basket…

Over time, you can validate what works best to alleviate your pain. A number of lifestyle changes and other treatment methods can have a cumulative positive effect on the pain you experience.

Here is a list of some commonly used treatment options:

  1. Conventional medicines — Your doctor will work with you to discover what prescription medicines may work best for you. Options are many including pain and antidepressant medicines.
  2. Nutrition and diet — Some researchers believe that the foods you eat can affect FM symptoms.
  3. Dietary Supplements — Vitamins and minerals play important roles in health and maintenance of the body.
  4. Exercise — Exercise helps relieve joint stiffness and can help alleviate some of the pain as well. Short workouts have been proven to help many of us. Pain may initially increase, but then gradually decreases. Hydrotherapytai-chi and yoga are excellent forms of exercise. These forms of exercise incorporate relaxation and meditation techniques. Deep breathing and slow movement will reduce your stress level and increase your fitness.
  5. Physiotherapy — A physiotherapist can help you with stretching and good posture. Stretching will reduce joint and muscle stiffness. This therapist can also  help you with relaxation techniques, another powerful FM treatment option.
  6. Relaxation therapy — Stress aggravates FM. Reducing stress will provide you with a more restful sleep, improving symptoms.
  7. Massage therapy — This is another great relaxation technique.
  8. 270. aspirinOver-the-counter drugs — You will need to work with your doctor. Always talk to your doctor about any over-the-counter medications you plan to take.
  9. Herbal remedies — Many herbs have medicinal healing powers. Again, you must talk to your doctor when using herbal remedies
  10. Chinese medicine — Consider exploring Chinese medicine which places great emphasis on herbal remedies and incorporates life energy healing techniques.
  11. Homeopathy — Visit a homeopathic specialist. They specialize in natural remedies to illnesses.
  12. Acupuncture — Modern adherents of acupuncture believe that it affects blood flow and the way the brain processes pain signals. Studies have shown this may be effective for FM.
  13. Chiropractic care—Chiropractors specialize in spinal problems, which can be a major source of pain for some people.

Your odds of gaining a significant reduction in symptoms, and improving your quality of life through a combination of many different treatment options, is pretty good…if you get the right combination.

There are thousands of different options and combinations of options. What works best?

Somehow you have to record all the treatments you are trying, how you feel on a particular, what happens when you add a new modal. It’s not easy…I can’t even keep track and that’s part of the reason I started this blog…you forget that you took that extra pain-killer because your head was killing you on Wednesday, or that you missed your hydrotherapy session because your stomach was acting up.

That really is the great challenge with fighting Fibro – the BEST combination of treatments will be different for each individual. (Isn’t that the bit that sucks the most? Hearing that everyone is different?)

We need to remember that we (YOU) are the centre point of treatment, by focusing on treatments that match our own lifestyles, abilities, symptoms and resources. The problem is that a personalized treatment approach to FM relief cannot be developed without a firm understanding of the symptoms and co-morbid conditions that require treatment (and I’ve been trying to research it all for over a year…and I keep finding new symptoms!).

We must also establish a trustworthy support team to assist us in pursuing not only all the different treatment options, but the execution of the treatments chosen. Effective teams typically include the patient’s primary care physician, various specialists (e.g., rheumatologists, neurologists, dietitians, psychologists), as well as friends, family, and even members of fibromyalgia support groups.

And finally (if all of that was not enough), specific and achievable goals must be set in order to measure the effects of EVERYTHING!

Weighing-up-the-benefits-with-the-risks-of-virtualisation

It is vitally important to constantly and consistently observe and evaluate the treatment methods being used. Through this whole process, we get frustrated over and over again! Our reality is an ongoing trial-and-error approach to treatment. AAARGGGGHHHH!

However, it is crucial to treatment success and must be embraced as a necessary evil.

When trying to determine a personalized course of treatment, we need to forget the agendas of physicians, pharmaceutical companies, and other external entities. Our decisions need to be driven by both symptoms and causal factors. Examples of important questions to ask during this process include:

  • What symptom do I want to address?
  • How will this particular treatment impact that symptom?
  • What are the potential side effects of this treatment?
  • Does this treatment have the potential to interact with other treatments I am using?
  • What will this treatment cost?
  • What are my expected results and in what time frame should I anticipate to note results?

Throughout this process, it is important to remember that successful relief is highly individualized (again!) and will vary between patients. What appears to be a miraculous treatment for me may fail to provide any benefit to you.

This whole process takes more time (yes! most of us have had to wait years for a diagnosis and now we have to take more time!).

A trial and error evaluation process is most effective when employed in a scientific manner meaning that different treatment elements should often be tested in isolation. I know that when I read about CoQ10 and D-Ribose and Sam-E, I started taking them all at the same time. I am now no longer able to tell which supplement or combination of supplements is actually driving the results they may experience. It is impossible to accurately measure specific results to associate with any individual option, so I need to start again…again!

If you’d like to see iHerb’s selection of supplements, click here. Use Coupon Code LHJ194 to get $10 off any first time order over $40 or $5 off any first time order under $40.

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Getting Wired!


In the first randomized, controlled trial of cranial electrical stimulation (CES) therapy in patients diagnosed with FM, individuals with FM were divided into three groups: active CES device therapy, a sham device, and usual care alone.

npp2011225f2Those individuals using the active device had a greater decrease in average pain than individuals using the sham device or receiving usual care alone over time.

Preliminary analyses of the functional magnetic resonance imaging data on a subset of six participants from each of the two device groups show that individuals using an active CES device had a decrease in activation in the pain processing regions of the brain compared to those using a sham device.

The decrease in activation in the pain processing regions may indicate a decrease in neural activity in these regions that may be related to decreased pain. But, as this is the first study of its kind – this kind of therapy cannot guarantee us less pain yet. Cranial Electrotherapy Stimulators are available but their worth to us has not been proven.

(Please do not use your TENS unit on your head!)

 

Riding the Wave – Part 1

thinkHave a positive attitude!

How many times have we heard that one?

While our emotions cannot cause FM, they no doubt affect our symptoms. But how can we maintain good thoughts when we feel so lousy? This challenge, of course, does not exclusively affect FM patients, but to any time when things do not go as we wish. But in our case, seeing the positive presents a continuous struggle.

Yet our moods are not necessarily in tune with our physical state. You can probably recall times that despite much pain or fatigue, you were able to cope and even achieve high spirits. Perhaps the weather was perfect, good friends visited, you just accomplished something or helped somebody, making you feel good about yourself. Other times, depression seems to take hold even when our physical discomfort is at a manageable level. Why is this? Answering this question is the key to finding optimism.

FM can feel like a swim in the ocean – sometimes it is dark, grey and turbulent, and it seems you have fallen and the waves continue to crash over you, as you struggle to rise, only to be knocked down yet again. But that same ocean sometimes allows us to find a wave we can ride smoothly to the shore.

What can we do when we feel under the waves? How can we find the strength to climb back on top, and the patience to know that we will?

There are 10 cognitive exercises you can use to maintain a positive attitude. So I don’t overload you, today I will only present 4 and the remaining exercises will continue in tomorrow’s post.

1. Expect bumps!

Aluminum-Speed-Bumps-Ahead-Sign-K-2059It is important to acknowledge that we will sometimes feel down. Who wouldn’t in our condition? But by expecting rather than dreading down time, such periods become more tolerable. In addition, recognizing that we will have blue periods helps keep them in perspective. You will be able to say to yourself, “I was depressed before, and got out of it; this time, too, it will pass.” It is easy to forget that before our illness, there were times we felt down. Now these periods are wrapped up in our medical problems; but everyone gets depressed some of the time. After accepting that you will sometimes feel sad, and even experience self-pity, you can concentrate on ways to shorten these periods and make them fewer and farther between.

2. Track the changes.

Keeping track of moods helps put ups and downs into perspective. During your best times, make a conscious attempt to capture the feeling. Leave notes on your wall attesting to the way you feel. Living with FM easily creates a Jekyll-and-Hyde persona, where your optimistic self and your flare-up self may as well be two different people. When we feel bad, it becomes quite difficult to imagine that things can be otherwise.

Similarly, during times of improvement, it’s amazing how quickly we may forget how bad a previous period was, making subsequent flare-ups not only intolerable but shocking. Counting and measuring the duration of the bad times – as well as the good ones – can put them into perspective. It may be that over time, our worst occurs about once a month, although it feels much more frequent. This knowledge is empowering, because we can remind ourselves that a bad flare is, for example, our monthly temporary setback, and find ways to ride it out until our baseline returns.

3. Stock-pile fun distractions.

What things make you happy? We all need to keep lists of the things that make us happy. One of the cruelties of our condition is that when we need distractions most, we are least equipped to seek them out. For this reason it is important to compile a list of your favourite activities when you are feeling optimistic to be used when you most need them.

People with FM often describe how even their worst pain can be put on a back burner, so to speak, when they become engrossed in an activity. This is not only a psychological but a physiological response: your brains can only process so much input at once. When you are engrossed in a beautiful movie, talking to a good friend on the phone, or listening to your favourite music while lying on a heating pad or in the bathtub, you can trick your pain receptors into leaving you alone!

4. Shape your perspective.

glassIs the glass half empty or half full?

Perspective determines, quite literally, how you view the world.

In Western culture, much emphasis is placed on independence, individualism, and achievement. Through this lens, developing a condition that makes us feel dependent and less productive is likely to be a huge disappointment. You are forced to adapt to a sudden, new condition by adopting a perspective that accommodates change. Your perspective is shaped by the comparisons you make and the expectations you create.

Consider, for example, the immigrant who had been practicing medicine in his home country, but flees to the US to escape a repressive political regime. Here he works as a janitor; after years of medical study, he has lost a prestigious and rewarding occupation. Yet he is thankful for the opportunity to work and wakes each day driven by hope, perhaps, of a better future for his children. Yet his difficulties are also quite apparent. What keeps his spirits up and makes him thankful rather than bitter? His perspective.

…to be continued tomorrow…

 

No News is Good News

Today was NEWS DAY.

Good news: the lesion on my liver is Focal Nodular Hyperplasia (what? you don’t remember my anatomy lesson from the other day?) That means I don’t need to lose any part of my liver. I will have to have an ultrasound in one year, in two years then five years – just in case.

Expected news: my gallbladder is coming out – on November 9th. It’ll be a laparoscopic cholecystectomy (that’s just the big word for gallbladder surgery!) so I’ll only have tiny, little scars. And my surgeon, Mr B, is open to letting me stay in hospital longer than normal (it’s normally only an overnight stay) to keep an eye on my pain.

Bad news: ummm, you know what? I can’t think of any at the moment. That’s something new, isn’t it?