Healing from Fibromyalgia: Step 3: Finding the Right Doctor

When I was outlining my steps for healing from fibromyalgia, I struggled as to where on the list this step should fall. In some ways, finding the right doctor for treatment should be number one, rather than number three. Finding the right doctor for treatment is crucial in healing from fibromyalgia. But, it often takes many months and many failed doctors until a patient finds the right one to work with. I chose to list 'Finding the Right Doctor' as step three, rather than step one, because in order to find that ONE doctor to continue treatments, one must first get a diagnosis. Getting a diagnosis is sort of a catch twenty two. In order to get a diagnosis, one must go through many, many doctors in order to rule out other similar diseases and syndromes. But once a patient is given a diagnosis, then the patient can take control of what type of doctor he/she is going to work with.

Currently, fibromyalgia is a diagnosis that has no specific treatment plan in western medicine, other than prescribing an effective pain medication. Therefore, once a patient has received the diagnosis and found an effective pain medication, the traditional western medicinal system is no longer of service to the patient. So, what's next? After one realizes that most M.D. have no real treatment plan to heal fibromyalgia, it is time to start looking elsewhere. Luckily, M.D. are not the only type of physicians around.

 A new movement in medicine is gaining momentum in the Western world. With the rise of autoimmune diseases, chronic illnesses, and cancers - patients and physicians are beginning to realize the limitations of the Western Medicinal system. An integrative approach, combining the effective aspects of western medicine, along with aspects of 'Eastern' medicine - is offering patients a wider range of options for treating 'incurable' conditions.

Physicians such as Naturopathic Doctors,  Holistic Medicine, Environmental Medicine, Osteopathic Doctors, and Functional or Integrative Medicine Practitioners are gaining wide appeal and aclaim for their devotion to their patients and their holistic approach to healing. But, what is the difference between each type of doctor, and which doctor is the best for you?

Let's review.

Holistic Medicine
Holistic Medicine is a umbrella term that encompasses doctors/physicians who treat patients with a mind, body, spirit approach. Holistic Medicine practitioners view each patient as a unique individual and treat the person as a whole. They take into account factors such as diet/nutrition, mental/emotional health, spiritual health, and lifestyle. According to the American Holistic Medicine Association, "disease is understood to be the result of physical, emotional, spiritual, social and environmental imbalance. Healing, therefore, takes place naturally when these aspects of life are brought into proper balance. The role of the practitioner is as guide, mentor and role model; the patient must do the work - changing lifestyle, beliefs and old habits in order to facilitate healing. All appropriate methods may be used, from medication to meditation."* 

Resources for Specific Illnesses, Holistic Resources, and list of Holistic Practitioners by state/region can be found online at the American Holistic Medical Association website.

Environmental Medicine
Similar to Holistic Medicine, Environmental Medicine approaches health through an integrative approach. However, unlike Holistic Medicine, Environmental Medicine aims to take healing one step further. Environmental Medicine focuses on how aspects of the modern living environment affects the overall health of human beings.

The Mission Statement of the American Academy of Environmental Medicine is "to promote optimal health through prevention, and safe and effective treatment of the causes of illness by supporting physicians and other professionals in serving the public through education about the interaction between humans and their environment."*

As with the American Holistic Medical Association, the American Academy of Environmental Medicine has a Physical Referral portal on their website in which you can search for an Environmental Medicine practitioner in your area.

Naturopathic Doctors
The purpose of a Naturopathic Doctor can be deduced through the name itself, naturopathic = nature. Naturopathic Doctors practice medicine through the integration of traditional healing methods found in nature. Partnered with rigorous medical training, a licensed naturopathic doctor may be the best route to optimal health. Naturopathic Doctors emphasize the power of the body to heal itself through the use of supplements, dietary, and lifestyle changes. According the the American Assoc. of Naturopathic Physicians, "Naturopathic medicine is a distinct primary health care profession, emphasizing prevention, treatment, and optimal health through the use of therapeutic methods and substances that encourage individuals’ inherent self-healing process.  The practice of naturopathic medicine includes modern and traditional, scientific, and empirical methods."*

Naturopathic doctors also have a very patient oriented practice. The first appointment usually lasts between 1-2 hours, during which the doctor and patient speak in depth to cover medical and personal history.Subsequent appointments last between 60 - 90 minutes in which the naturopathic doctor and patient discuss continued areas of treatment which may include the incorporation of supplements, lifestyle, and dietary changes.

Licensed naturopathic doctors complete years of rigorous training, similar to that of an M.D, but with an approach similar to that of a holistic health practicioner. The AANP website states that, "A licensed naturopathic physician (ND) attends a four-year, graduate-level naturopathic medical school and is educated in all of the same basic sciences as an MD, but also studies holistic and nontoxic approaches to therapy with a strong emphasis on disease prevention and optimizing wellness. In addition to a standard medical curriculum, the naturopathic physician also studies clinical nutrition, homeopathic medicine, botanical medicine, psychology, and counseling. A naturopathic physician takes rigorous professional board exams so that he or she may be licensed by a state or jurisdiction as a primary care general practice physician."*  

Licensing procedures vary from state-to-state. "Currently, 17 states, the District of Columbia, and the United States territories of Puerto Rico and the United States Virgin Islands have licensing or regulation laws for naturopathic doctors. In these states, naturopathic doctors are required to graduate from an accredited four-year residential naturopathic medical school and pass an extensive postdoctoral board examination (NPLEX) in order to receive a license." * In my state of Ohio, there is currently no licensing procedure for naturopathic doctors. Meaning, that any person on the street can claim they are a naturopathic doctor without receiving and training. Therefore, if you live in a state which also has no licensing procedures for naturopathic doctors it is important to research where your doctor has received his/her training. For example, my naturopathic doctor received her four year degree from a State University in Ohio, then continued her training in Arizona - where there are rigid licensing procedures to become a naturopathic doctor. Lists of accredited naturopathic doctor programs can be found on the AANP website.
 

If you are looking for an accredited Naturopathic Doctor in your area, please refer to the online directory from the AANP website.

Osteopathic Doctors
As we near the end of our list, Osteopathic Doctors vary significantly from the previous entries. Unlike Naturopathic, Environmental, and Holistic doctors - Osteopathic Doctors do not necessarily fall under the umbrella term of holistic healthcare. However, like Naturopaths, Osteopathic doctors must complete extensive medical training. "To become a DO, an individual must graduate from one of the nation's osteopathic medical schools, accredited by the American Osteopathic Association's Commission on Osteopathic College Accreditation" *  

As with Naturopaths, Osteopathic Doctors specialize in a specific area, which can be deduced through the name itself. Osteopaths focus on the muscular skeletal system, "so that they better understand how that system influences the condition of all other body systems. In addition, DOs are trained to identify and correct structural problems, which can assist your body's natural tendency toward health and self-healing." *

Due to the fact that fibromyalgia affects the muscular skeletal system, seeing an osteopathic doctor may be incredibly beneficial. OD's are capable of prescribing medication as well as practicing some surgery; however, they do not specialize in areas of nutrition, supplements, environmental, or lifestyle factors.

More information about Osteopathic Doctors can be found at their website.

Functional / Integrative Medicine

Ahhh, at long last we have reached the end of our list! Upon which we stumble the practice of integrative and functional medicine. Integrative and Functional medicine are essentially two terms meaning the same thing, an approach to medicine which integrates holistic and western approaches to treatment and functions to view the treatment of the individual as a whole. " Functional Medicine practitioners spend time with their patients, listening to their histories and looking at the interactions among genetic, environmental, and lifestyle factors that can influence long-term health and complex, chronic disease." *

Functional / Integrative medicine differs from the treatment received from an MD in the sense that an MD may treat symptoms, while a functional/integrative medicine practitioner searches to treat the root causes of the symptoms in order to provide overall healing.

 
 More information about functional/integrative medicine can be found online at the following links.

1. Functional Medicine
2. Integrative Medicine

Whew! That was a long list! But I hope that this list provides you with more information to move you forward in your path towards overall health!




Until Next Time,
Feast From Within

Radical Realizations: Self Approval

Most of the time I go through life feeling as though I'm living on autopilot. My only focus is moving one step at a time in the direction towards rebuilding my life and making it one of optimal health and well-being. But, it is rare (if ever) that I  am able to stop and realize how far I have come. However, yesterday that realization came right up and bit me in the ass, and it was fantastic!  Let me explain.

When I first became ill in 2009, I had just began dating my first boyfriend. This was HUGE for me. I was twenty years old and finally felt like I had met someone who 'understood' me and shared the same passions and interests. But at the same time as I had finally felt that I had found 'the one' or a 'one', I was falling incredibly ill - and fast. I didn't know what to do. So, of course, I kept pushing myself. I didn't want to loose this new relationship, and I felt like it was my fault for being the one who got sick. I was only twenty. Due to my illness, I couldn't go out to drink and party ( I was a sophomore in college) so I had lost ALL but one of my college friends and one of my high school friends. So, needless to say, I felt completely alone and was incredibly afraid. I was desperately trying to cling onto this relationship because it was all I had, and I felt that if I let it go it would be my fault that it failed, and that I would then be sick AND alone.

If you posses astute skills at inference, you may have already inferred that this relationship was NOT healthy. It was codependent on both accounts. I depended on him as my entire social and emotional outlet and in his own ways he was enmeshed with me. Because I was so sick, all I could see and all I could focus on was my health. My health was deteriorating, and fast. Within two months of beginning the relationship, I had withdrawn from school and was bedridden, living at my parents house. Because I was so sick, weak, and exhausted, I didn't have the strength or perception to leave the relationship.

As time went on the relationship became more and more toxic. Even though I was sick, bedridden, living in pain, and essentially felling as though I were waiting to die  - I did not 'look' sick. Because I didn't look sick, the severity of my symptoms could not be adequately expressed or understood by those around me. Because of this, many thought or asked me if it were all in my head. As if my symptoms were some how psychosomatic or self-induced. The double edged sword of living with an invisible illness is that it is 1) usually incredibly hard to diagnose and 2) manifests symptoms internally, leaving no outward appearance to be seen by the eye. Once people started questioning the reality of my symptoms, I began to participate in more self-blame and now self-doubt. I felt even more as though it were my fault for getting sick, and that somehow I might be able to just think myself back into good health. WRONG.

Fast forward two years later, by 2011 I had gone back and forth in this relationship - still struggling with my chronic illness, but slowly moving towards better health. By this time he had become such a central point in my life that his friends were now all my friends and I was just happy to have some what of a social life going on. I didn't go out much, but when I did I actually had people there - a vast improvement from being abandoned by all of my friends two years before. However, as my health improved, so did my sense of self. I started to realize that these new friends were toxic and so was the relationship. I constantly participated in self blame and guilt. Allowing others to make me feel insanely bad about myself, but I kept hanging out with them. All of my love and energy had been invested in this group of people, because in my mind they had been around when others weren't. [which was actually....false] By 2012 I was SICK of it! I was sick of hating myself and sick of allowing others to let me hate myself. So I stopped. I started saying no and I started demanding to be respected and to stop being blamed for being ill. And wouldn't you know it, within weeks of standing up for myself all of these relationships crashed and burned. In this funeral pyre  friendships, I was heartbroken, but I was me. Since then, I have been rebuilding my life. Alone. The two friends who stood by me through it all, one whom I met freshman year of college, the other from high school, are the only two people who I know will always support me, and I am incredibly indebted to their continued love and friendship.

But, even though it has been two years since I separated myself from those toxic relationships, I think subconsciously blamed myself. I always wondered - in the back of my head - if it really was my fault for all of them failing. That if I hadn't gotten sick, I would still be in a relationship, and still have a large group of friends. But yesterday I had the most invigorating moment of realization - a moment in which I saw, felt, and understood how far I have come.

All of this happened because I ran into someone who was part of this big group of friends I used to hang out with two years ago. Upon bumping into this person, I began engaging in the typical catching up conversations, in which I was filled in on everything that had happened since I stopped associating with them in 2011. And boy, did I end up leaving feeling AWESOME about myself. I finally felt like I had made the right decision. None of those people had changed, and they were still participating in the same unhealthy, manipulative, and selfish behaviors as they always had - but I could now see it much more clearly. It is amazing what a dose of good health can do for your sense of self. I was now able to say no, able to set up strong personal boundaries, and to respect myself. I didn't apologize for getting sick and I didn't feel guilty. Those relationships were unhealthy for me, irregardless of my health. And I felt so amazingly proud of myself for standing up those two years ago and putting a stop to it all. It was an intense feeling of satisfaction for the hard personal work I had put on myself these past two years, and how much I have grown. All of those people who I thought I needed, I didn't, and I was much better off with out them.

I don't wish them any harm or ill will, and I am sure they are doing much better in their lives without me,  but I needed this moment of clarity to have a better understanding of myself and how I want/ed to be treated. I hope that you all have positive, loving people surrounding you. Don't ever feel like having and illness is your fault. It is not. You are not broken because you are sick. You are whole and you are worthy of being loved and treated with respect just for existing. If there is anyone in your life who makes you feel otherwise I hope that you can one day stand up for yourself as well and realize how truly amazing you are.

Until next time,
Feast From Within

Healing from Fibromyalgia Step 2: Finding the Right Pain Medication

The often long and arduous journey towards receiving a fibromyalgia diagnosis is, unfortunately, just one step in the direction towards restored health. After I received my diagnosis of fibromyalgia, I was elated and felt a great sense of relief. Finally! Now the doctors would be able to give me some sort of prescription or treatment plan than would catapult me back to health. Oh how I wish I could go back in time and warn my young, naive self - the self who still believed in the omniscience of doctors - that there was still a long way to go. Upon receiving a diagnosis with fibromyalgia, I soon found out that there is no treatment plan, and that the main way most physicians treat the syndrome is through prescription pain medication. Althought, as with all fibromyalgia treatments, finding the right pain medication was trial and error. And boy, did I have to try A LOT of prescriptions before I found the one that worked for me.

From the onset of my illness in 2009, I immediately began receiving prescriptions for pain relief, and it took me two years until I found THE medication for me. Luckily, all of that painful trial and error was worth it; however, I do not wish that long of a wait on anyone. Finding the right medication to relieve pain is a crucial step in recovery. Until I received the proper pain medication, I felt as though I were waiting to die. I had no hope, no specific treatment plan to follow, and lived in continuous, excruciating pain. When I finally found that one, specific prescription to help ease my pain, I felt as though my life were back on track. Within a few weeks I was able to get up and move around. And as the pain faded, hope returned. Pain medication can be the key is restoring a sense of control and mobility in life. With the decrease in pain, I was then able to start forming a plan to treat the overall health of my body. I was able to get up, move around, and begin working towards regaining strength and stamina.

So, how do you find the right medication for you? 

Currently, there are three FDA-approved medications for the treatment of fibromyalgia pain.; Lyrica, Cymbalta, and Savella. Lyrica (Pfizer Inc) was the first medication to recive FDA-approval in June of 2007. Originally, "approved to treat seizures, as well as pain from damaged nerves that can happen in people with diabetes (diabetic peripheral neuropathy) and in those who develop pain following the rash of shingles," Lyrica was found to also be effective in decreasing the level of wide-spread pain in fibromyalgia patients. Now a popular drug, often seen in television commercials, Lyrica was the beginning of FDA-approved drugs which had positive responses in some fibromyalgia patients.

The next drug to be approved by the FDA was Cymbalta, which received it's approval one year later in June of 2008.  Like Lyrica, Cymbalta was not originally created to treat fibromyaliga patients. The original use of Cymbalta was to aide those who suffered from depression, anxiety, or diabetic peripheral neuropathy. Cymalta works to boost the brain chemicals serotonin and norepenepherine. "Serotonin and norepinephrine work together in the brain and spinal cord to tone down pain-related messages" *  Increasing serotonin and norepenephrine aide the body's ability to fight pain.

Similar to Cymbalta, Savella also works as a serotonin and norephenephrine booster. Savella was the first drug whose original purpose was created to help fight the pain of fibromyalgia patients. Recieving FDA-approval in 2009, Savella acts similar to those drugs used to treat depression and anxiety, but is not prescribed as such.

Each one of these FDA-approved drugs has the possibility of helping fibromyalgia patients, but they also have negative side effects. Typical side effects include:

1. Lyrica: "sleepiness, dizziness, blurry vision, weight gain, trouble concentrating, swelling of the hands and feet, and dry mouth. Allergic reactions, although rare, can occur."*
2. Cymbalta: "side effects include nausea, dry mouth, sleepiness, constipation, decreased appetite, and increased sweating ... Like some other antidepressants, Cymbalta may increase the risk of suicidal thinking and behavior in people who take the drug for depression" *
3. Savella: " Side effects include nausea, constipation, dizziness, insomnia, excessive sweating, vomiting, palpitations or increased heart rate, dry mouth and high blood pressure" *

Although Lyrica, Cymbalta, and Savella are the only three prescriptions that have received FDA-approval for the treatment of fibromyalgia, there are many other prescriptions which have also been helpful in fibromyalgia patients. Muscle relaxants such as Xanaflex or Flexeri may be prescribed, as well as other serotonin boosters like Prozac, Lexapro, and Zoloft. In my experience with prescritption medications, serotonin boosters were unhelpful and created the most uncomfortable side effects of all those I had tried. Unlike Cymbalta or Savella (which boost BOTH serotonin and norepenepherine) prescriptions like Prozac only boost serotonin levels, which may increase energy - but does not decrease pain.

Overall,finding the correct pain medication is as hard of a journey as was getting a diagnosis. Often the medications will give you adverse reactions and side effects, and you will have to go through many until you find that one pill which gives you none. For me, it took two years, but I am hoping that for others their wait will be much less. Finding the tools to decrease wide spread pain is a fundamental building block towards rebuilding your body to total health.

This blog was sourced from the FDA website and the Fibromyaliga Network. If you would like to read their articles or look for further information, please follow the links below

1. FDA
2. Fibromyalgia Network

 Until Next Time,
Feast From Within