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

Healing from Fibromyalgia: Step 1 - Getting a Diagnosis

What is Fibromyalgia? To those who do not suffer from this curious illness, understanding its symptoms, treatments, and effects on a person's life can be very difficult. Debate within the medical community still persists as to the existence of fibromyalgia as an actual disease or condition. Characterized by widespread pain, unbearable fatigue, cognitive impairment (brain fog), and poor sleep, fibromyalgia is often considered the 'wastebasket' disease of the medical community. Considering that fibromyalgia can not be diagnosed using any form of medical testing (blood test, X Ray, etc) many doctors use the diagnosis of fibromyalgia as a catch-all for an explanation of their patient's symptoms. But to those of us who truly suffer from the debilitating syndrome, actually getting a proper diagnosis is incredibly difficult.

As previously stated, fibromyalgia can not be diagnosed through any sort of medical testing. In fact, the current way to diagnose fibromyalgia is through an arbitrary 'tender point test' along side a patient survey. In order to receive the diagnosis of 'fibromyalgia', a patient must respond to 11 of the 18 tender points in all four quadrants of the body (left/right, top/bottom). These 18 tender points are depicted in the graph below:

 

The tender point test and criteria for diagnosis was created in  1990 by the American College of Rheumatology, and, sadly, is still in use today. * There are many problems in the use of this test as the primary means of diagnosis. First of all, in order to meet the diagnosis of fibromyalgia, a patient must have had persistent wide spread pain symptoms for a minimum of three months. * Meaning, one must suffer and live in agonizing, full - body pain for MONTHS before a doctor will even consider to give a diagnosis of fibromyalgia. Not only must one suffer through months of pain, they must also suffer through months of randomized testing in order to rule out any other possible illness or disease which shares similar symptoms. If anyone has lived with fibromyalgia or chronic widespread pain, they may understand the extent of suffering and hopelessness that one faces while being shuffled from doctor to doctor, going through a wide array of tests, only to continue waiting for any information that may provide an explanation as to why they are in so much pain.

Not only is the tender point test subjective, but is it highly unpredictable depending on the severity of the symptoms and the competence of the doctor. Symptoms of fibromyalgia vary from day to day; therefore, multiple tender points may not register on one day, but be very evident on the next. When I was diagnosed with fibromyalgia in 2010, I was experiencing so much widespread pain that I could not differentiate between the pain I felt in the 'tender points' vs the pain I was feeling through out the rest of my body. To me, everything was painful, and the act of applying pressure to one specific area made no difference to the pain I was already experiencing. 

Since the tender point test is unpredictable and subjective, in 2010 "a group of rheumatologists acting on behalf of the American College of Rheumatology (ACR) published new preliminary criteria on how doctors should diagnose fibromyalgia." * This preliminary criteria includes a patient survey, or 'symptom checklist', that acts as a backup to the tender point test. The symptom checklist is just as subjective as the tender point test. The idea behind the symptom survey, I'm assuming, is to provide further validation to the diagnosis of a patient with fibromyalia. As a person who has completed both tests and lives with fibromyalgia, I (obviously) find both to be extremely faulty and possibly ineffective in providing suffering people with proper medical care. However, until fibromyalgia can be diagnosed through a more effective test, like a blood test, patients suffering from chronic pain are forced to live with a flawed system. 

Unfortunately, in order to begin healing from symptoms of fibromyalgia, one needs a diagnosis. Receiving a diagnosis provides patients with some sense of understanding and allows each person to begin taking steps toward finding treatments. Armed with a diagnosis, any patient with fibromyalgia can now venture to arm themselves with knowledge of their condition and begin to regain a sense of hope for improved health. 

If you or someone you know is experiencing symptoms of fibromyalgia, consider consulting a rheumatologist. Most cases of fibromyalgia are diagnosed under the umbrella of being a rheumatic syndrome, therefore many of the most knowledgeable doctors of fibromyalgia are found in the rheumatology department.

An example of the symptom survey can be found at the link below:
 http://www.surveymonkey.com/s/HXZYTBM

Until Next Time,
Feast From Within



Further information regarding diagnosing fibromyalgia:

1. http://www.fmnetnews.com/fibro-basics/diagnosis
2. http://www.mayoclinic.org/diseases-conditions/fibromyalgia/in-depth/fibromyalgia-symptoms/art-20045401?pg=1

Re-defining Success with a Chronic Illness

Many days I spend time wondering if I'm working hard enough, if there is more I can be doing, if I need to be more proactive about my health, or if my health will prohibit me from achieving my goals. Before I got sick, I spent my teenage years being active in athletics, community service, and after school group activities. I was the stereotypical overachiever who wanted to be involved in any and every group possible. Back then, success meant being the 'best' and winning awards. My entire self-worth was derived from the success I felt from the outward accomplishments I could achieve. To me, the more recognition I got, the more successful and worthy I felt. But my idea of success was radically changed once I became ill.

It has been five years since I first fell ill in 2009, and I still struggle with my definition of success daily. My old paradigms of material gain and outward recognition still color my perception of how successful I feel. My emotions usually fluctuate between feeling like I'm not working hard enough, to worrying that  I will never amount to anything in my life. Recently I have realized that my current definition of success is detrimental to my personal outlook, and quite frankly it is a result of poor self-worth and self-image. In my definition of success, I'm using all of the outward accomplishments I can achieve as a filler for a lack of inner self-worth and self-love.

Self-worth/self-love is an inherently hard concept to cultivate in any individual, regardless of chronic illness; however, I have found that living with a chronic illness makes self-love even harder. It shines a harsh light on our vulnerabilities, insecurities, and true feelings about ourselves. For example, I have spent my whole life defining my success and self-worth through the eyes of others, and I only felt that I was worthy of love if I could accomplish something and get attention. And, now, living with a chronic illness I am FORCED to redefine success and how I view myself.

Living with fibromyalgia, I can not accomplish as many outward goals as others. I can't compete in physical activities, run a marathon, go back packing through Europe, etc. I have to make sure I get enough sleep, eat the correct diet, take my medication, have time to rest through out the day, and most often I have to depend on others for support. It kills me to think that there are things in this world that I may not ever be able to achieve or places I may never be able to visit, but I am slowly learning that not achieving those things is o.k. In my mind, I'm only worthy if I have traveled the world, been on adventures, made a lot of money, and achieved acclaim in my career. It drives me crazy that I still live near my hometown, that I haven't seen as much of the world as I want to, and that I haven't made an extreme headway in my career. There is something in me that believes if I do not accomplish these Type- A goals, my life will be worth nothing, or that no one will value me, or that I am wasting my life due to my chronic illness. And yes, there are things in life that my chronic illness will not allow me to do - but I'm starting to realize that all of those limiting beliefs t are bullshit.

Think about it, why are we all striving for success and acclaim? In one way or another, most of us are trying to fill a void that wasn't tended to as children. We are trying to fill that hole with material things, cars, jobs, money, etc. just because we don't believe we are incapable of seeing our inherent worthiness. We are trying to cover up our insecurities, because somewhere, deep down, most of us don't believe we are worthy of love unless we are able to accomplish something. Each day is a struggle for me to understand that I am worthy, not because I accomplish something, but I am worthy merely for just being me.

Sometimes I get lost in this world. It is hard living with a chronic illness. Each day is frustrating and painful and the fear that I am missing out on life can be incredibly heartbreaking. I believe that each person deserves to experience the full potential of their lives, and quite often, living with a chronic illness can make someone feel like their life has been taken away from them. But, on those days when my self-doubt is at its worst, I just have to stop and remember what I have and what I am capable of doing. I may not be able to do everything that everyone else can do, but I can still do a lot. I have come a long way from being bedridden. I'm fortunate enough that I have gotten a hold on my chronic illness, to the extent that I can work, I have traveled abroad once, and I am able to walk and enjoy life again.

Each day it is important to remember that we define our own success. Success is different for everyone, and it is never a replacement for self-worth. Being mindful of how we view ourselves, how we view success, and what we say to ourselves in our own heads can be incredibly enlightening if we just take the time to slow down and be mindful of our thoughts. Don't even compare your life journey to that of another. Each of us is inherently worthy to be alive and to be loved just by being us. We all have our own paths and our own parts to play in life, and the journey can take some amazing turns. Five years ago I thought I was going to die and that I was never going to be healthy again, but now I am grateful to say that I live a very blessed life with many opportunities to accomplish some of my goals - and so can you.

While this blog post might seem like I have rambled on about success, self-love, and self-worth, all I want you to take away from this is that our idea of material gain as success is usually bullshit. That we ARE worthy of being loved even though we are sick, and that there is always the possibility of things getting better. Never give up, and never let anyone define your success but you.

Until Next Time,
Feast From Within
xoxo

Book Review: The Anti-Inflammation Diet and Recipe Book

On my quest for the perfect diet that will optimize my body's ability to heal, I have come across many books that promise such results. Of course, most fall short in conveying adequate information about how the body functions with regards to nutrition, and many others are just jam packed with difficult recipes which seem better suited for a chef (which I am not). However, I was pleasantly surprised by what I found in the Anti-Inflammation Diet and Recipe Book. 

Written by Jessica K. Black N.D, trained at the National College of Naturopathic Medicine in Portland, Oregon, the book does approached inflammation through a holistic and nutritional approach. Increased inflammation in the body results in many chronic health conditions such as heart disease, chronic pain syndromes, and diabetes. And, according to the book, "seven of every ten Americans who die each year, die of a chronic disease." (pg. 39) Therefore, in my journey to optimal health and wellness, I decided to embark on learning more about this Anti-Inflammation Diet 'revolution'. 

The Anti-Inflammation diet itself stresses what seems to be an obvious approach to eating habits; no sugar, alcohol, or caffeine. Avoid possible food sensitives like gluten and dairy, but focus on eating plenty of fruits, veggies, and grains. Food habits like these are not revolutionary, but following such a diet in our over caffeinated and sugared culture is quite difficult. The diet itself can be broken down into a simple format depicted in this Anti-Inflammation Food Pyramid created by Dr. Andrew Weil.

The diet is helpful in living a healthy life and preventing chronic diseases, but it should be stated that each person has an individual biochemistry - meaning that not all diets are created as a one size fits all. And diet alone will not 'cure' every ailment. However, the information provided in this book was helpful in understanding the effects of inflammation of the body. What I enjoyed the most about the Anti-Inflammation Diet and Recipe Book is the Jessica Black added helpful charts for example meal plans as well as a substitutions chart for cooking without food such as wheat, eggs, butter, etc. Each substitution chart provides helpful alternatives in baking if one is cutting out dairy or gluten. For example, if you are trying to make a recipe that calls for milk, you can substitute the milk for any alternative such as almond milk, soy milk, coconut milk, etc. These charts are essential in simplifying the baking process and making it much easier to learn how to cook healthy, nutrient packed meals. 

Overall, I found the recipes in the book to be some of the most useful I have ever come across. They do not seem as intimidating as many other health food recipes I have tried in the past and many use simple ingredients that can be found in your kitchen or cupboard. In conclusion, I would have liked more of an in depth coverage of the properties of an Anti-Inflammation Diet and how nutrition plays a role in impacting our overall health and vitality, but the usefulness of the recipes in the back, as well as the sample meal plans and charts, saves this book from being passable. 

Finding a diet that fits your unique biochemistry and body is difficult and can often be a long journey. I do not follow the Anti-Inflammation Diety strickly because I find that I personally require more sources of protein in order to function properly, but I have committed to cutting out sources of cane sugar for my food sources. 

I do hope that this information is helpful to all of my readers out there! I will continue to dedicate my time to researching new, healthy ways to empower the body to heal itself. 

For more information about Jessica Black N.D. please visit her website at the following link:

http://drjessicablack.com/

Until next time, 

Feast From Within 

Dangers of taking DHEA

DHEA has been referred to as the 'fountain of youth' in some corners of the health and wellness community. However, oral supplementation of DHEA can be incredibly harmful on the body. DHEA is a hormone produced natural in the body in conjunction with cortisol in the adrenal glands. DHEA is thought of as the 'immune and anti-aging hormone. [It] controls age-related disorders, helps repair and maintain tissues....and balances the activity of the immune system" (Black, Jessica*)  The use of DHEA is banned by the National Collegiate Athletic Association (NCAA) because it is considered 'cheating', similar alongside the use of steroids with regards to its use for increasing of muscle mass, strength, and energy in atheletes.*

So, why are  people supplementing their natural levels of DHEA with over the counter oral hormones? The main reasons are 1) energy and 2) youth. As previously stated, athletes have been known to take DHEA for the increased energy and strength it may provide, while others are attempting to find new ways to regain their youth. However, because DHEA is said to help the immune system as well as increase energy, many people with chronic diseases, chronic pain, or chronic fatigue illnesses have considered taking DHEA. But what people don't know is that people who have normal "hormone levels in their bodies who supplement DHEA are likely to experience negative side effects,such as: acne, tumor formation, hair loss, heart rhythm problems, and insomnia" *   
Jessica Black N.D, author of The Anti-Inflammation Diet and Recipe Book, also suggests that DHEA "should not be taken as a supplement unless the patient's own bodily level of DHEA is found to be low on proper lab tests." Hormone levels can be tested by your family doctor, naturopath, or holistic doctor using a blood or urine test. "The scientific jury is till out on the subject, but it appears that normal daily DHEA production for an average person in their 20's is between 10-25 mg" *

Even though supplementation of DHEA without the reference of a doctor may be dangerous for most people, addition DHEA supplements can be beneficial for those who suffer from lupus,osteoporosis, ED, Alzheimers, MS, or HIV. *


Taking supplements to improve health can be a risky business. Before embarking on your journey to good health through the use of over the counter oral supplements, please speak with a doctor and do personal research. Some herbal supplements may interact with prescriptions, while others may not be safe or approved to be taken without testing by a doctor.

It is important to not only be proactive, but well informed about the choices you make for your health

Until next time,
Feast From Within


Sources:

1. Black, Jessica, The Anti-Inflammation Diet and Recipe Book, 2006. pg. 20
2. Mayo Clinic, <http://www.mayoclinic.org/drugs-supplements/dhea/evidence/hrb-20059173>
3. Medline Plus, <http://www.nlm.nih.gov/medlineplus/druginfo/natural/331.html>
4. Dr. Mercola, DHEA: Supplementing with THIS Hormone can Lead to Tumors and Insomnia. 2011. <http://articles.mercola.com/sites/articles/archive/2011/03/19/the-most-common-mistakes-in-bioidentical-hormone-replacement.aspx