Tuesday 3 March 2009

FYI- My illness/disability

As many people know me from seeing me on crutches or in a wheelchair or only communicating with me over the internet when I'm feeling well enough, I thought that as the worry of my MRI scan is over and the GP says I haven't got Multiple Sclerosis as I feared I had, that I would tell everyone what I actually have which will hopefully explain why I have days off the computer and the answer machine often gets your calls and I have to call you back when I'm feeling "human"
Luckily my family & friends offer me an enormous amount of help, especially with the foster of some of the animals and I find sitting with them very therapeutic.

Please rest assured that if you have called me or emailed me, one of us will get back to you asap.....and I will never miss a hen rescue if I have to be parked up in my wheelchair all day or dumped in a stable with hens running around all day while my other half is on traffic duty. My great love is helping out at Little Hen Rescue and I'm sure that is what keeps me going.....Thanks to everyone for your patience. I'm not after sympathy but when I tell people I have Fibromyalgia, they say " oh is that M.E ? " but it's not the same illness. M.E is Chronic Fatigue. Fibromyalgia is Chronic Fatigue PLUS Chronic Pain. I hope this page makes people realise why I am often on a "go slow"

From the NHS Direct website, here is the information on Fibromyalgia which you may find of interest. I'm not lazy, I'm not a slob and just because some days I'm relatively human, I'm far from OK. I just have bursts of energy where I do things (or usually overdo things) and then make myself worse. I am also on valium, morphine & codeine which without, I would be in an even worse state than I already am.

Introduction

Fibromyalgia is a chronic condition that causes pain all over the body. The condition affects the muscles, tendons and ligaments (bands of tissue that connect bone to bone), resulting in widespread pain, fatigue and extreme sensitivity to pain.

The name fibromyalgia comes from the Latin word 'fibro', meaning fibrous tissues (tendons, ligaments), 'my' meaning muscles, and 'algia' meaning pain.

Fibromyalgia used to be known as fibrositis, which literally means inflammation of the muscles and soft tissue. However, the condition was renamed fibromyalgia after studies found that there is no inflammation or nerve injury.

Who is affected by fibromyalgia?

Anyone can develop fibromyalgia, although the condition affects more women than men. In most cases, fibromyalgia occurs between 35-60 years of age, but it can develop in people of any age, including children and the elderly.

The number of people with fibromyalgia has never been measured, but it is thought that between 2 and 4.5% of people in the UK have the condition.

There is no cure for fibromyalgia, but treatment aims to ease the symptoms. The condition can be treated using a combination of medicines, complementary therapies and lifestyle changes.

Symptoms of fibromyalgia

There are many symptoms of fibromylagia and they tend to vary from person to person. The symptoms can also come and go over time, although it is unlikely that they will ever disappear altogether. The main symptoms of fibromyalgia are outlined below.

Pain

If you have fibromyalgia, one of your main symptoms is likely to be widespread pain, which you may feel from 'head to toe'. This pain may feel like an ache, or a burning sensation, or it may be more like a sharp stabbing pain.

You may also find that your pain is worse in the areas of your body that you use the most, such as your back, neck, shoulders and feet.

Extreme sensitivity

Fibromyalgia can cause you to become extremely sensitive to pain all over your body, and you may find that even the slightest touch is very painful. If you hurt yourself - for example, if you stub your toe - you may find that the pain continues for much longer than it normally would.

If you have fibromyalgia, you may find that you are very sensitive to other things as well, such as smoke, certain foods and bright lights. Being exposed to something you are sensitive to can cause your other fibromyalgia symptoms to flare up.

Fatigue and trouble sleeping

Fatigue as a result of fibromyalgia can range from a mild, tired feeling to the exhaustion that is often experienced during a flu-like illness. Sometimes, severe fatigue may come on very suddenly and can drain you of all your energy. If this occurs, you may feel too tired to do anything at all.

Fibromyalgia can also affect your sleep, and you may find that you often wake up tired even when you have had plenty of sleep. This is because fibromyalgia can sometimes prevent you from sleeping deeply enough to refresh you properly. The muscles in your legs may also spasm at night which can also interfere with a restful night's sleep.

Stiffness

If you have fibromyalgia, as well as causing you pain, you may find that your muscles, tendons and ligaments become stiff and prone to spasm. The stiffness may be most severe when you have been in the same position for a long period of time.

Cognitive problems ('fibro-fog')

Cognitive problems refers to problems with mental processes, such as thinking and learning. If you have fibromyalgia, you may have trouble remembering and learning new things, problems with attention and concentration, and slowed or confused speech.

Headaches

If you have pain and stiffness in your neck and shoulders from fibromyalgia, you may also have frequent headaches. The headaches can vary from being quite mild to very severe migraines.

Irritable bowel syndrome (IBS)

If you have fibromyalgia, you may also develop irritable bowel syndrome (IBS) as well. IBS is a common digestive condition that causes pain and bloating in your gut. It can also cause constipation and diarrhoea.

Other symptoms

Other symptoms of fibromyalgia can include:

  • facial pain, often as a result of neck, shoulder, or jaw muscle stiffness,
  • tingling, numbness, prickling, or burning sensations in your hands and feet (paresthesia),
  • dry eyes, skin, or mouth,
  • unusually painful periods (in women),
  • anxiety, and
  • depression.


Your symptoms may sometimes get better, or worse, depending on factors such as changes in the weather, stress levels, and how physically active you are.

If you have fibromyalgia, it is unlikely that your condition will ever resolve permanently, although there may be long periods of time when your symptoms disappear completely. Most people have to learn to live with the condition long-term. However, fibromyalgia is not life-threatening and does not reduce life expectancy.

Causes of fibromyalgia

The exact cause of fibromyalgia is unknown, and research into the cause is ongoing. However, research into fibromyalgia has identified a number of possible causes of the condition, which are outlined below.

Problems with pain messages

One of the most likely causes of fibromyalgia is a problem with the way that pain messages are carried and received in your body.

It is thought that in people with fibromyalgia, the central nervous system (which transmits messages to and from your brain) cannot process pain messages properly. It is also thought that the brain becomes more sensitive to any pain messages that it receives. This may be why fibromyalgia results in constant feelings of pain and extreme sensitivity to pain.

Research has also found that people with fibromyalgia have higher levels of pain transmitting chemicals in their spinal cords compared with those who do not.

Low levels of hormones

People with fibromyalgia have been found to have lower than normal levels of the hormones serotonin, noradrenaline (also known as norepinephrine) and dopamine. Low levels of these hormones may be a key factor in the cause of fibromyalgia.

These hormones each play an important part in controlling many of the processes in the body. For example, serotonin helps to regulate your moods, your appetite, and the way that you sleep. Noradrenaline contributes to attention and your responses, and dopamine helps to control your mood and behaviour, and the way that you learn.

Sleep problems

Some researchers think that disturbed sleep patterns may be a cause of fibromyalgia, rather than just a symptom. Fibromyalgia can prevent you from sleeping deeply, which may be due to your brain waking you up slightly every time you begin to enter deep sleep.

External factors and genetic predisposition

In many cases, fibromyalgia develops after an external factor, such as an illness, injury, or operation. It is possible that these external factors may act like a trigger causing fibromyalgia to occur.

There also seems to be a genetic link to fibromyalgia, with some people being more likely than others to develop the condition due to their genes. If this is the case, a genetic predisposition (tendency) could help explain why some people develop fibromyalgia after some sort of trigger.

Other conditions

There are several other conditions that can lead to fibromyalgia. In these cases, the condition is known as secondary fibromyalgia. Some conditions that can cause fibromyalgia are outlined below.

  • Joint hypermobility - a condition where your joints are extremely flexible, and can lead to pain, stiffness, and a risk of joint dislocation.
  • Lupus - a condition where your immune system attacks your body's connective tissues, such as ligaments and tendons, by mistake.
  • Rheumatoid arthritis - joint pain and stiffness which occurs as a result of your immune system attacking the lining of your joints by mistake.

It is also possible that there is no single cause of fibromyalgia, and that several of the above factors may combine to cause the condition.

Diagnosing fibromyalgia

If you think that you may have fibromyalgia, you should see your GP. They will ask you about your symptoms, before carrying out a physical examination.

However, diagnosing fibromyalgia can be difficult. There is no specific test that can diagnose the condition, and the symptoms of fibromyalgia can be varied and very similar to those of several other conditions.

Ruling out other conditions

If your GP thinks that you may have fibromyalgia, they will first have to rule out any other conditions that could be causing your symptoms. These conditions include chronic fatigue syndrome (also known as ME, or myalgic encephalomyelitis), rheumatoid arthritis, and multiple sclerosis (MS).

You may have blood tests, X-rays, plus other scans in order to rule out conditions that have symptoms which are similar to fibromyalgia.

If you are found to have another condition, such as those listed above, it does not necessarily mean that you do not also have fibromyalgia. As fibromyalgia is a complex condition, when making a diagnosis, your GP will need to take any other symptoms and possible factors into account.

Diagnosing fibromyalgia

Although there is no specific test that can be used to diagnose fibromyalgia, there are two criteria that can be used to confirm the condition, once all other conditions have been ruled out, or considered.

It is likely that you will be diagnosed with fibromyalgia if your symptoms fit within these criteria. The criteria for diagnosing fibromyalgia are:

  • that you have had widespread pain for more than three months on both the left and right sides of your body, above and below your waist, and
  • that you have pain in at least 11 of the 18 'tender point' sites when they are pressed.


Tender points

The tender points are the areas on your body where your pain is likely to be at its worst. They are places on the body where everyone is most sensitive to pain, so if you have fibromyalgia, these areas will be very painful.

The tender point sites include the back of your neck, above each of your shoulder blades, and the inside of your elbows.

Treating fibromyalgia

There is no cure for fibromyalgia, but treatment aims to ease your symptoms as much as possible and to improve your quality of life.

The symptoms of fibromyalgia tend to vary widely from person to person, so you may be treated for your condition by several different healthcare professionals. For example, you may be treated by your GP, a rheumatologist (a specialist in conditions that affect the muscles and joints), or a neurologist (a specialist in conditions of the central nervous system).

Fibromyalgia can be treated in several different ways, and it is likely that you will need more than one kind of treatment to ease your condition. However, all types of treatment may not be effective for everyone with fibromylagia.

In most cases, fibromyalgia is treated using a combination of medicines, complementary therapies and lifestyle changes.

You may also find that joining a fibromyalgia support group can be a tremendous source of comfort and support.

Medicines for fibromyalgia

You may need to take several different types of medicines for fibromyalgia, including painkillers, antidepressants, and medicines to help you sleep.

Painkillers

If you have fibromyalgia, you can treat your pain using simple painkillers, such as paracetamol.
If paracetamol is not effective in easing your pain, your GP, or healthcare professional, may prescribe a stronger painkiller, such as codeine.

You may also be prescribed a painkiller called tramadol, or one called nefopam. Both of these painkillers have been found to be effective in treating pain that is caused by fibromyalgia.

In some cases, in addition to your main painkiller, you may also be prescribed a non-steroidal anti-inflammatory drug (NSAID), such as ibuprofen. However, you should avoid taking NSAIDs if you have asthma, high blood pressure, or kidney, or heart, problems. They are also unsuitable for you if you have, or have had, a stomach problem, such as a peptic ulcer.

As well as easing pain, NSAIDs help to reduce inflammation. However, as fibromyalgia does not cause inflammation, they are not effective in treating the condition when taken on their own.

Antidepressants

Antidepressant medicines for fibromyalgia are not prescribed specifically to treat depression.

They are used to boost the levels of certain hormones, such as serotonin, noradrenaline (also known as norepinephrine), and dopamine.

It is thought that low levels of these hormones may be a factor in causing fibromyalgia, and that raising their levels may help to treat the condition and ease the pain of your symptoms. See the 'causes' section for more information about fibromyalgia and hormones.

If you have fibromyalgia, there are many different types of antidepressant medicines that you may be prescribed. The choice of medicine may depend on the type of fibromyalgia that you have, and severity of your symptoms, plus any side effects that the medicines may cause.

Antidepressants used to treat fibromyalgia include:

  • Tricyclic antidepressants (amitriptyline, nortriptyline and dosulepin) - these are usually the first choice of antidepressant and raise levels of serotonin and noradrenaline (norepinephrine) in order to ease pain and help you sleep.
  • Serotonin-norephinephrine reuptake inhibitors (venlafaxine and duloxetine) - which raise levels of serotonin and noradrenaline (norepinephrine). Venlafaxine also raises levels of dopamine, as well as serotonin and noradrenaline.
  • Selective serotonin reuptake inhibitors (citalopram, fluoxetine and paroxetine) - these only raise serotonin levels, so they are not often used.

There are also two other types of medicine that affect the levels of hormones which are sometimes used to treat fibromylagia - a dopamine agonist called pramipexole, and a serotonin 5-HT3 receptor antagonist called tropisetron.

Muscle relaxants and medicines to help you sleep

If you have stiffness, or spasms, in your muscles as a result of fibromyalgia, your GP or health professional may prescribe a muscle relaxant to help ease your symptoms.

Muscle relaxants that are often used for fibromyalgia include medicines called tizanidine and carisoprodol. Tricyclic antidepressants (see above) can also help to relax your muscles.

Muscle stiffness and spasms can also affect your ability to sleep, but even if you sleep all night, you may find that you still wake up feeling tired. This is because fibromyalgia can prevent you from sleeping deeply enough to fully refresh you.

If this is the case, your GP or health professional may recommend, or prescribe, an over-the-counter (OTC) sleep medicine, or herbal supplement to help you sleep more deeply. If these medicines do not help, using one of the muscle relaxant medicines mentioned above may help you to sleep more deeply at night because they have a sedative (sleep-inducing) effect.

There are also stronger medicines, such as zopiclone and zolpidem, which can help you sleep. However, you may only be able to use one of these medicines for a short period of time because long-term use can end up disrupting your sleeping patterns even further.

Pregabalin

Pregabalin is an anti-seizure medicine that has been found to be effective in treating several fibromyalgia symptoms, including pain and sleeping problems. You may be able to take pregabalin as a brand called Lyrica.

However, pregabalin can cause a number of side effects, such as dizziness, blurred vision and weight gain, so it may not be suitable for everyone.

Complementary therapies for fibromyalgia

There are a number of complementary therapies which may help to ease your symptoms of fibromyalgia. However, it is important to remember that there is little medical evidence to back up the effectiveness of these therapies, and that they may not work for everyone.

Warm water therapy, such as swimming, gentle exercises in a warm pool, or simply having a warm bath, is a popular complementary therapy for people with fibromyalgia.

Some people also find that complementary therapies help to ease their pain, or fatigue, and help them to relax and manage their condition more effectively. Examples of complementary treatments that may help to ease symptoms of fibromyalgia include acupuncture (where thin needles are inserted into certain points around the body to help relieve pain), aromatherapy (where essential oils are used for a therapeutic effect), massage, and osteopathy (which aims to heal your body by applying pressure).

There are also complementary therapies for fibromyalgia that focus on the mental and emotional aspects of the condition. Relaxation therapy, anxiety management techniques, counselling, cognitive behavioural therapy (CBT), or other 'talking treatments', can sometimes help some people to cope better with pain, fatigue, or other symptoms.

If you decide to use a form of complementary therapy, always ensure that your therapist is a fully qualified and accredited member of the appropriate organisation - for example, the British Acupuncture Council (BAC).


Complications of fibromyalgia

Fibromyalgia does not get worse over time, so it does not often cause any physical complications, or lead to other conditions.

However, it is possible for fibromyalgia to lead to depression. This is because the condition can be difficult to deal with, and low levels of certain hormones, such as serotonin, can make you prone to developing depression.

Depression can cause many symptoms, including constantly feeling low, a lack of interest in the things that you normally enjoy, and feeling tearful.

If you think that you may be depressed, it is important to get help from your GP, or your fibromyalgia health professional. .

Self help

If you have fibromyalgia, there are several ways that you can change your lifestyle in order to help relieve your symptoms and make your condition easier to live with.

Your GP, or healthcare professional, can also offer you advice and support about incorporating these changes into your everyday life.

Exercise

As fatigue is one of the main symptoms of fibromyalgia, you may find that you are often very tired and feel unable to exercise. However, an exercise programme that is specially suited to your condition can help to significantly improve your symptoms by reducing pain, boosting energy levels, and helping with regular sleep patterns.

Your GP, or a physiotherapist, can help you to design a personal exercise programme. The programme is likely to involve gentle exercises, such as stretching and warm water exercises, as well as low-impact aerobic exercises, such as walking, cycling, or swimming. However, you should take care not to push yourself too hard when exercising.

Relaxation

If you have fibromyalgia, it is important that you regularly take time to relax, or practice relaxation techniques. Stress can make your symptoms worse, cause them to flare up more often, and it can also increase your chances of developing depression, which is common among people with fibromyalgia.

There are many relaxation aids available, including books, tapes and courses, although deep breathing techniques, or meditation, can be just as effective. Try to find time each day to do something that relaxes you. Taking time to relax before bed may also help you to sleep better at night.

Anxiety management techniques, counselling, cognitive behavioural therapy (CBT), or other 'talking treatments' can also be helpful in combating stress and learning to deal with it effectively.

Diet

There is no specific diet that you should follow if you have fibromyalgia, but you should try to eat a healthy, balanced range of foods. Your diet should be high in fibre, fruit and vegetables, and low in fat, salt, and sugar.

You should only drink alcohol in moderation, and cut down on foods and drinks that are high in caffeine, such as coffee, tea, chocolate, and cola.

Pacing yourself

If you have fibromyalgia, it is likely that you will have some days when your symptoms are better than others. Try to maintain a steady level of activity at all times, without ever over-doing it. It is important that you always listen to your body, and that you slow down, and rest, whenever you need to.

You should avoid doing any exercise, or activity, that over-exerts you, or pushes you too hard because this can make your symptoms worse.


Photobucket

HAPPY EGGS FROM HAPPY RoSAH HENS

No comments: