Main » July 2004

July 30, 2004

Fibromyalgia and Depression: The Chicken or the Egg.

One element of my life with FMS is that I have now been dx'd with a 'major depressive disorder', along with 'anxiety disorder'. I was asked about depression and anxiety in my life pre FMS when examined by: my internist, my d.o., my rheum #1,2 &3, the 4 insurance company field representatives, the psychologist, psychiatrist and whore rhuemy of the ins co for 'independent exams' and now the psychiatrist that the insurance company is making me see.

I was probably depressed when I divorced at 26 for awhile to a degree. I was probably depressed when my grandparents and my dearest uncle died. I know I was depressed when my dog had to be put down & after (I stayed with her : ( ) BUT NO I WAS NOT EVER DEPRESSED IN THE LEAST BEFORE FMS TOOK MY LIFE FROM ME.

I have always been a 'the glass is half full and the waiter is coming' kinda optimist. I always was goal oriented and pursued excellence. I was a professional, a CPA partner who for the first time in 1995 brought in over 1/2 of the gross receipts of the office, as planned I was surpassing my father to allow him to stay and work on the cream of the crop and his field of expertise while I took over the general accounting and tax practice. In 1996 I also surpassed his gross receipts. I was well on the way to my short term and long term goals for my career, my place in community civic affairs and charitable works. I thrived on success, I loved it. Yes the hours were hellacious and yes I believe the good and bad stressors from the job led to my sleep disorder over time. And that nasty sleep disorder is what brought me to the floor in a TKO on 1/17/97 with FMS.

So I WAS NOT DEPRESSED BEFORE FMS. When I had to live in my crazy body trying to work and only making it about 1/3 of the time, and I'd have another panic attack and when I felt I couldn't breathe and when I'd show up at my dr without an appt and he strapped a heart monitor on me and continued testing and excluding.........when I finally got a wee bit of sleep, the torential currents of pain washed over me for several days, like my nerves were wakened by the little bit of rest.......when I had to live in pain and fatigue and with continued uncontrollable high blood pressure.....when the doc said I needed to quit working or I wouldn't start to get better.....when I gave up my desk, the office I designed, my clients, my professional persona, my partnership with my dad........when my life consisted solely of trying to sleep, pain, fatigue, dr appts, using my short energy for dinner & evening with my daughter then crashing to bed myself once she was tucked in.........when, actually after all of these things aka the loss of life as I knew it and taking on a new life with major limitations and pitfalls, then and only then did I become 'depressed'.

I think SSA and insurance companies alike try to use the 'you were depressed first' so they can classify the patients' illnesses as psychiatric which generally the benefits for are much less than a physical disability. I was dx'ed with the physical disability of FMS, qualified for benefits for private insurance in 12/97 and SSA about a year later (with 45 days because my dr's report was complete and thorough as was her exam, per the SSA agent), and have continued treatment by a rhuematologist for FMS. I have seen a counselor when I felt I needed help getting a handle on changes or issues. Then this summer after the ins co 'independent exams' they found I was mildly depressed, and don't have fms. This way they can say that a psychiatrist should be able to cure me in a few months. Do I feel threatened?? heck yeah! They're trying to make an end run aruond paying my benefits. But my new psychiatrist accepts that I have FMS and finds I have the 'major depressive' disorder and is reporting the same to the ins. co. One kicker in my situation is that my disability policy doesn't have the usual 2 year limit on psychiatric benefits, I could be nuts forever and get paid.....but I think that if I don't get better on their schedule they're going to cancel my benefits.........and yes I have a 'bad faith insurance claim' atty in the wings already fully informed.

So did the pain come before or after I went nuts????? I have chronic pain, I lost my life and most of my social contacts, .......then somewhere between 1/17/97 and today, I musta gone nuts!

Good night all,
The FMS Nutjob, Judy : )

Posted by at 07:22 AM | Comments (6)

July 28, 2004

The calm after a flare & Fibromyalgia symptoms

Well today I finally seem back on me feet from the post-moving-my daughter-flare.
That means I woke with the usual stiffness and pain, and could concentrate enough midday
to pay bills. I also was able to go to 2 different stores looking for a 'immobilizing shoe' for my husband, whom we found out today does have a fracture in his toe jammed last week after all.
I was up to being me, as I am in pain and fatigued, and doing the extra stuff for him, thank goodness.

Wanted to share a sign of problems to come: When I'd reach down to pull up a light comforter, it hurt my arm. See a movement like that with something that weight shouldn't hurt. The comforter felt like it was weighted. I noted this within a year before being dx'd.

And a couple of strange symptoms: Hiccups, lots and lots of hiccups. FMS is tight and spasming muscles including the diaphragm and so I had hiccups long and strong for the first year. Dribbling, nope not a basketball, sometimes while drinking from a cup tiny spasms in muscles around my mouth cause me to dribble...I asked a friend with FMS about this one and she couldn't believe it, she'd just thought she was clutzy.

Posted by at 11:46 PM | Comments (0)

July 26, 2004

Fibromyalgia Basics.........and Diary re Flares

FMS FACTS: The word 'fibromyalgia' literally means: fibro (muscle/tissue) myalgia(inflammation) as the condition initially was believed to be inflammatory. However, it is not inflammatory. Fibromayalgia muscle pain is actually muscle tissue that has stiffened and has more tissue wrap around it to keep it stiff and protected from the pain that caused the stiffness to start with. Example, when I was writing a lot my shoulder then arm then hand would hurt so much that I would basically write from the wrist, learning to not move my shoulder because it hurt; in addition to ruining my handwriting, this allowed the stiffness in the muscles to get worse, and so on and so on. Yes keyboarding is the same so right now both of my shoulders are still and I'm typing using my forearms forward and my shoulders are still.

Because the muscle pain is not from inflammation, analgesics, like tylenol, advil, aspirin do not help with the chronic muscle pain. Instead mild muscle relaxors are rx'd for the day, Flexeril 10 mg 3x a day for me, and a stronger muscle relaxor at bedtime, Soma 350mg for me.

This is why it is very important for Fibromites (a commonly used term for folks with FMS) to include 'body work' in their health plans. Body work can mean stretching, massage, chiropractic, osteopathic manipulation, and just plain moving. Initially this can aggravate the condition, but movement and therapies to keep muscles mobile are essential.

Diary:
Like our other fibro-friends, today as every day, I awakened with my entire body stiff and in pain. When I say stiff and in pain, I mean I move like Tim Conway doing his little old man impressions. I can hardly move. I waddle to the bathroom, to the kitchen and swallow my a.m. meds: Paxil 40 mg(antidepressant for seratonin replacement), Ativan .5 mg(anti-anxiety), Flexeril 10mg(muscle relaxor) and vitamins if I remember them. It takes about an hour to 'thaw out', at which point I still hurt everywhere but more like a 5 on a pain scale of 10 than an 8 like when I awake. I explained my sleep disorder in my previous post. The sleep disorder which is an inherent part of FMS helps contribute to this a.m. pain and stiffness.

I learned early on to 'space and pace' : space activities apart and pace myself. This keeps me in the best condition possible. And do I overdo?? Yup!! My mother got an oak coffee table and two end tables of really good quality, aka heavy, at a thrift store for my 18 yr old Jen's apt. Yesterday Jen and I carried the big table together (she got to walk backward!!), then we each carried an end table. Of course we're carrying these from the apt. parking lot to her apt which is right in the middle from either parking access. Later yesterday, my neck started pinching pains, and my back started with sharp pains and all over chronic pain worse than usual. I do take a 100mg Vicodin only if and when my pain is really sharp and excessive, for me, one a day if any.

Because I overdid yesterday, today I am in a flare: I am weaker than usual, hurt more than usual, and am more fatigued than usual. But my baby girl needed help so....... As I say sometimes, I can have this disease flare on me for no reason or I can do something I need to do or want to do which = overdoing and pay later for a reason.So today I am paying for my behaviour yesterday, big time. My husband has occupational therapy for his stroke impaired arm/hand on Monday and Wednesday afternoons and I usually accompany him. Today I can't. That's another point, when someone with FMS says they "can't" they literally mean they cannot do whatever it is. Sometimes it's hard for friends and family to understand this, as we look fine. The picture on my page was taken at my daughters 18th birthday party and I was in a flare from preparations and going out for the party, but can you see it in my face? My husband, daughter and Mom can sometimes tell when I'm in a flare or mini-flare because they have a lot of experience with me and are privy to up close and personal access to my behaviors. Some folks see that I 'Look tired".......DUH. I'm very lucky that my closest supporters understand when I set limits and what they don't understand they believe of me.

Due to today's flare, this is the end of this post. I shouldn't have typed so much, but I am finding posting to be mentally and emotionally beneficial.
Hugs, Judy : )

Posted by at 11:46 AM | Comments (8)

July 23, 2004

ADVICE TO ALL.....Trouble Sleeping can signal serious illnesses

Posted by at 01:27 PM | Comments (6)

July 22, 2004

The 'tests' begin........the Diagnosis 'FMS'

1/21/97 I saw my internist. He didn't think I had an anxiety attack. He actually thought I may have an adrenal tumor, cause I was running on adrenaline, not that he told me that. Then test after test after test eliminated disease, after condition, after tumors. This is how Fibromyalgia is diagnosed, first by ruling out everything else in the world.

2/29/97 I went through an all night sleep test where they superglued (actually!) sensors to my scalp and body and had me sleep in a test room which looked like a cozy bedroom except for the camera from which the technician would watch me throughout the night. I'd been begging the doctor for something to help me sleep, and he'd said not until the sleep test. So I couldn't sleep on my back, I had to bother the technician each time I needed up to make my rounds, bathroom drink, oh and blow my nose, I'd left that one out. Cutting to the chase.

3/21/97 My internist saw the sleep test results and said I'd had NO DEEP SLEEP in fact No sleep beyond stage 1, when I'd start to hit REM sleep I'd awaken even more times than I was aware of. No wonder my saga dreams, supposedly you dream in REM and only remember if you're awakened during...

He then asked me other questions, irritable bowel? Yes, muscle pain or weakness? Yes, Morning stiffness that lasts over a half hour? Yes, and he knew of the constant sinus/throat infections and antibiotic use...he then examined me for the FMS tenderpoints (18 points on your body that hurt like hell when pressed lightly by physician...if you have 11 of 18 along with symptoms above you have FMS) Ouch! I had 18 of 18. He diagnosed me with Fibromyalgia (just 2 months after 1st visit which is a record for FMS dx's usually), put me on Paxil 10 mg. in addition to the blood pressure med he put me on on 1/21, and my blood pressure still was out of control. He treated me with Paxil upping it to 20mg, & watched my bp.

At the same time I had been seeing a DO specializing in osteopathic manipulation. I used to visit her in January and be good for tax season, getting massages biweekly from 2/15-4/15. But I'd been seeing her biweekly for a year and the adjustments weren't holding. I'd of course told her of the problems and my internist's quest for the cause. When i shared the dx with her, she said she concurred..she just hadn't said anything because the internist was working on the diagnosis. She herself had osteoarthritis and FMS. Note: FMS is generally thought to manifest after multiple traumas to the body, chronic pain conditions, or the other school of thought is my story, if you run on empty on adrenaline for years and don't sleep.

in May '97 I saw rhuematologist Lisa Weinrib in Scottsdale AZ. She performed such a complete exam and wrote such a complete report that when I finally applied for SS disability in 98 I got benefits starting in only 45 days.....again a record for FMS. We decided to use a mixture of traditional medicine with some other stuff thrown in. I was put on the program outlined and explained in Dr. Teitelbaum's book 'From Fatigued to Fantastic'.

I'll tell you now that the program helped(helps) and that I felt 'fantastic' for moments. And I'll tell you that this disease, especially with my sleep disorder, is an ugly monster resistant to improvement. There is no cure for Fibromyalgia as yet, just treatments and suggestions for life modification so 'fibromites' can survive it. Speaking of survival, the other book I kept with Teitelbaums and my Bible is Fibromyalgia and Myofascial Pain Syndrome: A Survival Guide.

Tune in for what my treatment and results were, next........
Hugs, Judy

Posted by at 09:47 AM | Comments (0)

July 21, 2004

Then the Floodgates opened: Fibromyalgia attacks, ER visit

1/17/97

Alone at home, I woke around 9 and had something small to eat and water to drink, and then I started feeling the dizzy nausea weakness difficulty breathing thing that started invading my days earlier that week. I paced from bathroom, to chapstick, to drink, to outside for fresh air, and round and round. What do I do, who do I call, this isn't anything I can name, this is crazy, what do I do, I can't keep on like this, who do I call.........and at 12 noon I panicked. Mom, Dad, and the doctors office were all off to lunch as of 12. Our neighbor the nurse still wasn't home.

Instinctively I called the backline of our office and my dad picked up, and put me on speaker phone while he was with a young affluent client (talk about humiliating). The minute I heard Dad's voice I started crying and telling him I didn't think I could breathe and I thought I would be sick and I didn't know what to do. He told me to hold on and talk to the client for a minute...how embarrassing, i tried to pull myself together. Then Dad's back on the phone and said he called 911 and could I go unlock the doors for the firemen. I freaked, ' no, I don't need that, that's crazy, and crying more'.

The firemen arrived and Dad headed home. Dad had said something about asthma because my mom and daughter had it and I mentioned not breathing well, so there was one fireman that got irritated that I wasn't asthmatic. Though I was obviously in a state. They checked me out, the irritated FM kept telling me to breathe through my nose and quit crying because I was dehydrating and hyperventilating. The others checked pulse, bp, and hooked me up to their oxygen monitors and heart monitor. My neighbor Jim, who was dying of lung cancer, came over and held my hand. the FM basically decided I was having a panic attack and that when my dad got home they'd leave me in his care.

Then they got the response from the closest hospital on the ekg & O2 & bp and were told to bring me in. I know my bp was 200+ over 100+ because Mom saw it on the monitor, she arrived at the hospital as we did. They gave me O2, and an IV drip with ativan, an antianxiety med and compazine for the nausea They did xrays, and they kept me about 4 hours and sent me home with directions to follow up with my internist and take compazine and ativan as needed. An anxiety attack, they wrote, so I continued to feel sick and crazy all weekend.

Again shoulders and arms hurting, tune in later for more.......
Hugs!

Posted by at 03:44 PM | Comments (13)

In the Beginning " I didn't sleep well" aka Fibromyalgia & Sleep Disorders

The Beginning, as I knew it:
1/17/97 I was 35, a partner in a CPA firm with my father on my way to peak by 40. I was a single mom for 9 years, but thank God living with my parents & my daughter, 2 in 1988 at divorce. I had been 'not sleeping well' for years, I can't even quantify now. I wrote that off to long hours, business owner stress and parenting stress, and for at least a couple of years I'd say, 'I just don't sleep well'.

Not sleeping well for me meant, waking 30 plus times a night after taking Excedrine PM nightly, gradually needing to get up when I woke, that becoming more frequent, getting up to get a drink, go to the bathroom, put on chapstick, and around and around and around. Then I started feeling nauseous and dizzy when I got up, thought I was gonna throw up or pass out, gradually got to where a few times I thought I couldn't breathe.

The week of 1/17/97 I was in continuing education classes M-Th 8-5. The room was comfortable, the chair was comfortable. I wasn't threatened by the material Yet I began to have the nighttime nausea, dizzy, can't breathe, gonna pass out feeling during the day, in class. So I stepped outside for some fresh air, got some water, consciously made myself relax and back to class. This got worse each day. Friday 1/17/97, I was finally sleeping the crazy dream sleep that I'd finally get to each am, and my father woke me and asked if I was up to coming in to work. I said I was beat. He told me to rest then, it'd been a long week, (no one knew of the ill feelings, just that I got up alot and 'didn't sleep well').

Tired and shoulder and arms tightening and hurting from typing so tune in again for what happened next....

Hugs & Blessings!

Posted by at 03:11 PM | Comments (5)