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switching from family doc to a rheumatologist?
2 Replies
MandyG - November 11

I am 31 and a mother of 3. I was diagnosed 2 years ago with fm and my family doc prescribed my meds which worked well. I had tried to tell my family about this diagnosis, but they (my mom and husband) freaked out and acted as if I was just out to get high. My grandma suggested I go see a rheumatologist and I agreed and have already set up an appt. I am wondering what to expect. I know they will draw blood and things like that, but I am afraid that they will tell me to just take tylenol and motrin (which I have an ulcer from) and send me away. Don't get me wrong--it sucks having to take pills 3 and 4 times a day everyday. If anyone knows of any treatment that I could ask about, like maybe cortisone or something so I can wake up feeling human and not having to reach for the medicine bottles, please let me know!!
Thank you,
Mandy

 

Fantod - November 12

Hello MandyG and welcome to the forum!

A rheumotologist is the doctor best suited to treat Fibromyalgia (FMS). But, not all rheumotologists are created equal. There are still a lot of doctors out there who do not believe that FMS exists. Or they do, but don't treat it properly. You should go to the National Fibromyalgia Association website and register. Then you will be able to see a list of fibro-friendly doctors in your area. The other option is to call your local hospital physician referral service and ask them for a rheumy and/or a pain specialist (I have both) with an interest in FMS.

FMS is a disorder of the central nervous system which causes widespread chronic pain. The mechanism that causes FMS is not understood. There is no cure but it can be managed with prescribed medication. It is recognised by the National Arthitis Foundation as well as the Center for Disease Control.

FMS does not respond to OTC remedies like Tylenol and Motrin. Only certain classes of prescribed medication are effective. There is absolutely no reason to use cortisone as there is no inflammation associated with FMS. Steroids compromise the immunne system and should only be used when absolutely necessary and for the shortest possible time.

There are now three promary medications used to treat FMS. Lyrica is advertised on TV all of the time. The most common complaints seems to be rapids weight gain. Cymbalata is an antidepressant that addresses both the pain and depression that usually accompanies FMS. The newest drug is Savella which has been used in Europe for decades. It was cleared by the FDA for use in the US this year. Most rheumotologists seem to have trial packs available for patients to try prior to filling a script. Narcotics are not usually prescribed for FMS. Most people do fairly well with the standard medication. Anyone who needs narcotics to treat FMS is the exception to the rule. The rheumotologist will exhaust every other possibility before prescribing narcotics. Be prepared for any medication to take 2 or more weeks to become effective. And, a lot of tinkering with doseage and different combinations to get the right mix for your situation.

One of the reasons you are chronically tired and sore is the lack of deep sleep. FMS interrupts the deep sleep cycle with short bursts of high intensity brain waves. Your muscles need deep sleep in order to repair themselves from the days activities. No deep sleep means higher levels of pain whcih rapidly becomes a vicious circle. Amitriptyline is usually prescribed for the sleep issues associated with FMS.

With regards to diet, you should not ingest deep fried foods, lunchmeat (nitrates) or artifical sweetners (including Splenda). These items will probably increase your pain level. If you need asweetner, use Truvia or Sun Crystals which are made from the nontoxic Steva plant. You can find them in the grocery store right alongside the other sweetners

It sounds like you have the typical problems with family members that most of us experience. I'd suggest ordering the "Fibromyalgia for Dummies" book from Amazon in an effort to get them educated. You should also take someone with you to your appointment. Two heads are always better than one in a stressful situation. And, they will hear firsthand what you are going through and what the doctor has to say. Also, take some time to read through the blue boxes on the lefthand side of this page. This is the best Internet site for FMS out there.

The rheumotologist will take a complete history, aask about any meds that you may be taking, check the FMS pressure points and run lab work. He will be checking thyroid function, vitamin D levels and several other things. Once he is satisfied that you do have FMS, he'll begin prescribing medication to treat it. It is going to take time to get the medication combination and doseage right. You'll have to be very patient through this phase.

I hope that my comments are helpful to you in some way. Good luck with your appointment and take care.

 

MandyG - November 12

Thank you, the rhuem I am going to is my aunts doc. also. I have twin aunts (identical) and they both have juvenile rhuematory arthritis. One live here in town and I know that she is on low doses of chemo and has to give herself injections. She is always on the go (37 no kids and never married). I really wish I could be more like her, but I guess I just don't have it in me to "push through the pain". Sometimes I think she stays so active because she is trying to outrun the pain.
As far as what my fam. dr. had me on was pain meds, sleep meds and celexa. This med combo works well, although I would like something for the pain that I could take in the mornings and it last all day. Maybe the rheum will have an idea of what we can do.
Thank you for writing back,
Mandy

 

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