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Making Sense of Fibromyalgia


kamurj

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Excerpted from
The Fibromyalgia Solution: A Breakthrough Approach to Heal Your Body and Take Back Your Life
By David Dryland, M.D.

Every night, it was the same. Lying in bed, my body felt like it was on fire. At times, I thought I would go out of my mind with the urge to scratch my arms and legs. Instead of sleeping, I would find myself in the bathroom applying cream to my intensely painful skin. The prescription cream, guaranteed by my dermatologist to relieve any rash, was utterly useless on mine. Covered in balm, I would return to bed and try to sleep. Sometimes, my skin would feel comfortable enough that I would just start to drift off. Then, just before the refuge of sleep, my body would jerk awake. As the minutes on my alarm clock clicked by, the horrible itchiness would return in full force. Soon, I'd start worrying about not getting enough sleep. Before long, I'd trudge back to the bathroom to put on more skin cream, and the whole cycle would start over again. This could go on all night. Knowing that I had to see patients in the morning, I would take a sleeping pill and finally drift off in the last hours before dawn.

That's how my symptoms started, with an inexplicable and painful itching. I wondered what was happening to me Even when I wasn't going crazy feeling too hot or itchy, I couldn't sleep. My mind was always racing, planning, and worrying. I replayed arguments with my wife over and over in my mind. I worried about the mortgage and obsessed about my most complicated patients. I felt confused and tired. Why couldn't I just close my eyes and fall asleep? My brain was always in overdrive. I couldn't stop it.

At work, I was tired but functional. I began seeing more and more patients suffering from fibromyalgia. I remember looking at one particular patient's chart reviewing the list of symptoms she had checked off:

Trouble sleeping: Yes
Joint pain: Yes
Abdominal pain and nausea: Yes
Itching: Yes
Depression: No
Joint swelling: No
Restless feelings in the legs: Yes

I walked into the room, and attempting to be reassuring, I introduced myself as Dr. Dryland, the new rheumatologist from Yale. She shot me a look that said she didn't care about my credentials-she cared about answers. Her history and exam were straightforward. I hated telling my new patient that she had fibromyalgia. I couldn't tell her why she had it, but I explained that her muscles likely hurt because she was either stressed or depressed. She just wanted to know how to find relief from the pain. I offered her what little I could, one prescription for pain medication and another to help with sleep. She shook her head and said she had already tried both of those prescriptions, and they didn't help. She questioned how stress could cause such severe pain. "I don't know," I said. "Nobody knows. I'm sorry. I wish I could help."

During the early years of my medical practice, I watched sick and desperate patients walk into my office, willing to do anything to get better. I remember how desperate I was for some sort of medical epiphany on those tired, pain-filled days and nerve-racking, sleepless nights as my own symptoms persisted. One day something clicked-an unnerving realization that my symptoms were almost identical to the ones I saw in my fibromyalgia patients. As I started asking my patients more questions about their sleep-the racing mind, the itching, the hot and cold sensations, the intense restless feelings in their legs, and even the violent jerking at night-I quickly understood that I was on the same path-the same slippery slope to full-blown fibromyalgia that these patients had traveled. I knew there must be something that triggered these common symptoms in their bodies and in my own.

None of the rheumatologists I worked with had any real answers, and I began to interview all the doctors I knew about their views on fibromyalgia. Some of the physicians I talked to jokingly told me that fibromyalgia (fortunately) wasn't their problem. "That is the rheumatologist's problem to deal with," they would say. Some doctors even insisted fibromyalgia didn't really exist. They insisted that those patients weren't actually in real pain, they were just depressed. Other medical doctors confessed their belief that fibromyalgia shouldn't be treated outside the psychiatrist's office. Frustrated with their responses, I began investigating stress and how it might affect fibromyalgia.

I went back to my dermatologist to ask whether my itching could be related to stress instead of a rash. Finally, she took me quite seriously. She had seen patients scratch themselves raw when stressed. Yet not a single colleague or any doctor I interviewed could give me a plausible reason for the symptoms of fibromyalgia. I searched through my medical books, but all I found were recommendations on various medications to help with pain and sleep. Having already prescribed most of those, I knew that at best, they offered fleeting relief for only some people. After reviewing what little knowledge I had about fibromyalgia, I started to dig for more information.

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