3. Fibromyalgia

 


1)** FIBROMYALGIA (F.M.), an
arthritic type of condition  standing for:
     Fibro          - Fibrous tissue
     My          - muscle
     Algia          - pain
Approximately 75% of M.E. patients have a
diagnosis of F.M. as well as M.E.   Fibromyalgia
produces some of the symptoms of M.E., although
not all.  There are many more "F.M. only" people
than M.E. people. The definition for Fibromyalgia
is a  "non-articulate rheumatic condition of
wide-spread pain and fatigue" or  a "soft tissue
condition".   A good longer definition for
Fibromyalgia is located in (#88011 Video1@4:49).

     a)** Dr. Mohammed Unis (94/06) believes
     that Fibromyalgia is a condition that can be
     a secondary problem in addition to a major
     illness such as Lupus, Irritable Bowel
     Syndrome, or it can be the primary
     condition.

2)**^ If you skipped the previous chapters, and
started reading this FM one please go back.  The
preceding chapters have a lot of details on why
both M.E. and FM are talked about
interchangeably through the Manual.  So in
essence almost the whole book is on FM.  I do not
consider them the same illness which is why I
name this the "M.E. & FM Manual" the "&" is to
show the two are different using a "/" infers that
they are two different names for the same illness
and they are separate.

3)**^ Are M.E. and FM the same illness?  If
anyone tells you that everything points to them
being the same or not the same they are wrong. 
No one knows for sure.  I try throughout this
Manual to show the facts and not my opinion, so
far the facts from what experts and other people
say is that 60% feel they are different, but cousins
just as GWS (Gulf War Syndrome), Multiple
Sclerosis, lupus, Post-Polio Syndrome, lyme and
mabe MCS are.  My personal view is 90% that
they are not the same illness, 10% is because they
appear so closely related.
How is it that so many M.E. people have FM, but
so many FM people do not have M.E.  I talk about
this in many other chapters but will review it
quickly here.   FM can be a primary or secondary
illness, just like Sleep apnea can be a primary
condition all on it's own or a secondary condition
with insomnia.  Every person with Sleep apnea is
not necessarily an insomniac and every insomniac
does not have to have sleep apnea.  Further
examples are:
- NMH (nuraly mediated hypotension) can
be a primary condition on it's own or can
be a secondary illness with M.E.; this is a
good example because in (1996) some were
trying to say NMH was the cause of M.E.
and this has been shown not to be the case,
but that NMH is a common symptom.
-In the same way arthritis can be a
secondary illness due to a car accident that
caused spinal damage.  
-Or sever severe Fatigue may be a
secondary illness with Cancer or MS.
-IBS (irritable bowel Syndrome)   may be a
primary illness or a secondary one with
Severe allergies.
Since FM can be a secondary condition with so
many other illness it would make sense that it
could be a secondary illness to M.E.


4)** Diagnosing F.M. & M.E. 

     a)** F.M. is usually diagnosed by a
     rheumatologist who specializes in
     rheumatic and arthritic conditions.

     b)** M.E. is usually diagnosed by an
     infectious disease or internal medicine
     specialist.

     c)** One of the diagnostic tools used for
     F.M. is whether or not the patient has at
     least 11 of the 18 tender points for
     Fibromyalgia.  

     d)** An aid to determine which of these
     two illnesses you may have, is to start an
     exercise program.  After a period of two
     months of daily walking only two blocks,
     (once your muscles are back in shape) if
     you are feeling slightly better, you may
     have Fibromyalgia only.  However, if you
     are feeling more exhausted with more
     cognitive and neurological problems, you
     may have M.E., or (M.E. and F.M.)   
     Moderate exercise has been proven to be
     harmful and reduces the bloodflow to the
     brain of the M.E. patient.

          (1)** There is nothing I have read
          to suggest that once you have F.M.,
          you cannot become ill with M.E. as
          well.

     e)** See Chapter 4 for some of the
     diagnosing criteria.

     f)** The Centre for Disease Control has
     specific criteria for diagnosing F.M. 

5)** Misdiagnosing of M.E. & F.M.  
 It is mainly up to the patient to discover if they
have F.M. only, M.E. only, or both.  The answer
is not extremely important to know 100%, because
there is so much grey area.  No one is 100%
certain.  One treatment of importance after a
diagnosis of M.E. or F.M. is exercise, as
explained in Chapter 7, "Treatment Possibilities". 
M.E. patients should only do very light exercise,
while F.M. only patients may be able to do light
aerobic exercise.  {PO}{Some problems arise
when:

     a)** An F.M. person goes to an internal
     medicine specialist, they get labelled as
     having M.E. only; or

     b)** When an M.E. person goes to a
     Rheumatologist, and are told they have
     F.M. only.} 

6)** Separate M.E. & F.M. support
groups . {PO}{ I believe the interests of both
illnesses are best served by separate support
groups, if the numbers in the area can sustain
continuing both.  If numbers do not permit, a
combined group may be the second best choice.  I
run a combined M.E. & F.M. group, as do most
of the other M.E. group leaders}.

7)** Fibrositis.  Fibromyalgia was
previously referred to as Fibrositis.  The name was
changed as this illness has no inflammation as the
name "sitis" suggests.

8)** F.M. - Condition or Infectious
Viral Disease?  It is generally accepted that
F.M. is a condition, not an illness or disease.   
Dr. Muldofsky, a leading F.M. sleep expert, did a
study, using 20 healthy students, who were
deprived of deep sleep for two weeks.  It was
found that  80% of the students developed
Fibromyalgia symptoms.  After two months of
normal sleep, the Fibromyalgia symptoms
subsided.  Of the 20% that did not develop
Fibromyalgia, all were extremely physically fit. 
{PO}(I do not believe the study showed, or other
materials suggest, that this means only unfit people
get F.M., or that by exercising a lot you can get
rid of F.M.;  it could also be possible that this
20% would still have developed F.M. if
depravation of deep sleep was continued for a
longer time. It is evident that the cause of F.M. is
due to much more than poor sleep}.

9)** An F.M. doctor.  It is important to
have a doctor who is familiar with Fibromyalgia in
order to receive proper treatment for this
condition. 

10)**^ How many M.E. and FM people are
disabled.  The number of M.E. people and FM
only people that are disabled and unable to work
even part time, are probably close to the same
number.  FM has a bigger impact on sosiety
because it effects more people.  FM effects many
more people but is not as debilitating, in most
cases.  M.E. effects less people but is more
debilitating to those that get it.

11)**^ Does it matter what label M.E. or FM
you get. {PO}{ In a perfect world no, but once
you get either illness to a moderate degree you will
see how imperfect the world is.  Sadly I have
noticed a trend by some people, Doctors and
insurance companies to claim that if 5 percent of
the population has FM then it is really "just a
minor irritation and every FM person should go
back to work".  This is like saying arthritis is a
minor irritation for everyone, except many people
are crippled with arthritis.  In this way FM people
do not get the respect they deserve.  M.E. seems
to get looked at as more disabling by the
insurance, government and media but still has the
same "its all in your head stigma" that both M.E.
and FM are gradually dispelling.} The treatment
for M.E. and FM are fairly similar except for
exercise, this is discussed in later chapters.

12)** Many groups are listed in the
organization chapter, two of the local
ones are -The Fibromyalgia Society of
B.C.:
      P.O. Box 15455
      Vancouver, B.C.
     V6B 5B2
     phone #430-6643.


13)** The Arthritis Society of B.C. 
Phone #1-800-667-2847