Symptoms And Diagnosis

As seen, FM symptoms can vary widely between patients. One person's quality of life might be most altered by unremitting pain, whereas a second person may suffer mainly from deep fatigue. Still others might find themselves confronted with anxiety and panic attacks that limit their confidence to travel or work outside the home. Those most severely affected by FM may struggle with all of these symptoms and further co-morbidities. Additionally, the severity range of FM symptoms is quite...

Irritable Bladder Syndrome IB

IB has gone by many names including irritable bladder syndrome, overactive bladder, idiopathic bladder spasm, and detrusor instability (detrusor is the medical name for the bladder muscle). Of all people with FM, 5 to 50 percent are thought to have IB. In this syndrome the bladder suddenly contracts, even without being full. These contractions cause an irrepressible need to urinate, medically termed urgency. IB causes urination frequency, meaning that people often have to urinate seven to ten...

Medication generictrade Alprazolam Xanax

Clinical pearl This medication has an extremely short half-life. It may not be suitable as a through-the-night sleep aid if taken earlier in the evening, at bedtime. FM usage Panic attacks, anxiety, or early morning awakenings Patient example Mary is a 31-year-old female who grew up in an abusive home environment. Even though she is safe now as an adult, she has found she sometimes has nightmares that leave her heart racing and body sweating, and she is unable to go back to sleep after...

The Registered Dietitian RD

The RD is helpful in FM because many people's quality of life will improve through dietary change. The RD can help people learn not only what foods to avoid or minimize but how to introduce new foods into the diet and how to really enjoy those new foods. In FM, obesity is often a problem, especially due to the sporadic nature of FM flare cycles and the resulting disruption of an exercise routine. The RD can individualize an eating plan based on each patient's food preferences. In general, they...

The Urologist

A urologist (a specialist focusing on the urinary tracts of men and women and on the reproductive system of men) may be helpful for patients with severe irritable bladder. Like other specialists, they can rule out malignant and progressive diseases and reassure the patient that irritable bladder is the correct diagnosis. Many times specialists are aware of therapies that are not FDA-indicated for the treatment of various ailments. For example, some patients find some degree of relief from...

Central Dopamine Dysfunction COMT Gene Disruption

Dopamine plays a critical role in pain perception and pain relief. It is a cate-cholamine neurotransmitter perhaps best known for its various roles in Parkinson's disease, schizophrenia, and drug addiction. It also appears related to Restless Legs Syndrome (RLS), which is a common co-morbidity in patients with FM. The theory of central dopamine dysfunction suggests that the main abnormality responsible for FM symptoms is disrupted dopamine neurotransmission. This conclusion supposes that FM is...

The Gastroenterologist

One specialist that may be called on is a gastroenterologist (a specialist in the digestive system and its disorders), also commonly known as a GI doctor. A gastroenterologist may be helpful for people with GI distress such as irritable bowel syndrome that does not respond to traditional therapies. Ideally, the gastroenterologist would screen for other GI conditions such as inflammatory bowel disease or celiac disease (autoimmune disorders that are often genetic), symptomatic diverticulitis...

Multiple Chemical Sensitivities MCS

MCS is one of the least understood co-morbidities associated with FM. MCS previously has been termed toxic injury, chemical injury syndrome, twentieth century syndrome, sick building syndrome, idiopathic environmental intolerance, and toxic-induced loss of tolerance. Due to alterations in the central nervous system, all people diagnosed with FM are more sensitive to light, noise, smell, and pain. MCS, however, is a more pronounced, debilitating chronic sensitivity to low levels of chemicals or...

Abnormal Neurotransmission Serotonin Norepinephrine and Dopamine

Serotonin is a neurotransmitter that regulates sleep patterns, mood, a feeling of well-being, and inhibition of pain. Since those with FM experience abnormal pain, it has been hypothesized that the pathophysiology underlying FM may be an impairment of serotonin metabolism. This hypothesis is supported by finding decreased serotonin metabolites in FM patient plasma and cerebrospinal fluid. However, medications such as selective serotonin reuptake inhibitors (SSRIs, a type of antidepressant that...

Cognitive Behavioral Strategies

Cognitive behavioral strategies are a skill set used to minimize symptom severity and reduce unhelpful thinking. Many people, when first diagnosed with FM, experience an existential crisis that may last several years. This crisis has to do with loss of their previous selves and acceptance of their new selves. The cognitive behavioral strategies outlined on the following pages work to help the newly diagnosed move toward acceptance of their changed lifestyle and can ultimately improve their...