You will have such a disease that you will be in constant pain, but when the doctors you go to examine you, they will have difficulty explaining your complaints and all the tests will be found to be normal. After a while, even your relatives will be skeptical of your effort to explain your pain. On the other hand, perhaps you will begin to think that you have a hidden cancer in yourself. However, your discomfort is actually a feeling of pain that is excessively expressed by the brain and related nervous structure, and in addition, it is fibromyalgia, which is a condition associated with forgetfulness, sleep disorders, weakness and especially ups and downs in your emotional state. We have to accept the fact that these people are in real pain. However, if we make a package of this pain and give it to a completely healthy person with a needle, it will be seen that much less pain is felt. Although our patients often tell us that my pain threshold is actually too high, the actual sensitivity threshold expressed here is too high.
I actually believe the above paragraph describes the fibromyalgia patient well. Although human beings have more opportunities every day, things get more complicated because both the patient’s environment and doctors do not see this disease, which affects 8% of societies, as a real disease. As a result, the person finds himself in an even more incomprehensible state, and daily movements cause even more pain, as if sleep is disturbed even more.
Fibromyalgia can occur at any age and is significantly more common in women than men. Rich, poor, developed, undeveloped, cultured and uncultured all societies are affected at similar rates. Especially individuals with long-term pain complaints in their families and fibromyalgia, those who have been exposed to psychological stress and trauma, and those who have been suffering from pain for years are even stronger candidates. On the other hand, if our patient also has chronic diseases such as rheumatoid arthritis and lupus, the risk of fibromyalgia is 3 times higher. Fibromyalgia should definitely come to our minds in our patients who think that their treatment has been completed but that things are not going well and that their pain continues. These long-standing diseases, especially those of rheumatic origin, have broken and disturbed the psychological resistance thresholds of the person and caused storms within.
The most important complaint in most of the patients is pain. Sometimes a pain that comes from deep and cannot be described exactly has been bothering for years. Shoulder, neck and back pain are felt even more. We can say that fibromyalgia is more common in those with painful menstrual cramps (dysmenorrhea). There are also meaningless pains and complaints in different parts of us, for example; such as jaw pain, constant weakness, painful and frequent cystitis. However, for me, the intestinal system is one of the mirrors of the soul. The toilet habits of a person with a clear mind also work like clockwork and they do not have complaints such as constipation and gas. However, half of fibromyalgia patients have serious constipation problems and our patients are diagnosed with irritable bowel syndrome in gastroenterology outpatient clinics.
Why fibromyalgia patients perceive or feel more pain, I wonder if we understand this problem, can we help the patient more? Our behaviors, mood and social situation in our lives are always effective at this point. Pain is a language in which the body expresses itself for those who leave themselves to the flow of time, do not try to stand up to any event, look for the reasons in other people for the events in their lives, and quit because they cannot change their conditions even though they do their best. Trying to explain this situation as a trick is also a mistake made by the patient’s environment. Sleep disorders are the leading factors that cause this disease. In fact, there is nothing like a good sleep, and a person who is happy when he wakes up in the morning, smiles and says what a beautiful day is starting, does not actually suffer from a disease called fibromyalgia. On the other hand, when obesity, laziness or lack of activity or lack of sport and dissatisfaction in business life are added, here is a candidate for fibromyalgia for you.
So let’s take a step with our language…
What do you have? I have pain all over or everywhere I touch, sometimes cramps
When did your complaint begin? I have been feeling for a long time
Where do you feel your pain the most? It feels like it’s spreading from my shoulders to my arms, my neck hurts a lot and it spreads all over me, my hips also hurt, I have pain and cold and burning pain that goes down to my legs….
Do you have any other complaints? Can’t sleep or constipation or gas
It was previously recommended to count tender points for the diagnosis of fibromyalgia. However, today we have abandoned this diagnostic method, which never occurred to me. The most important step in diagnosis is a very clear interview with the patient and then a good examination. Here is a turning point and we have made a diagnosis to the patient, and believe me, this is our first biggest move that puts our patient at ease. Because now their complaints have a name and it has been understood that they are real. The fact that there were no distinctive features in his examination and that his tests were good were also a comforting factor for him. The next thing to know is that further testing and research should definitely stop now. If there are medical clues that the doctor himself noticed and proved, our physicians are already investigating this.
Fibromyalgia patient’s inability to explain his problem, not being able to express himself and worrying if I ask someone else will increase his distrust in medicine over time and push him into the lap of vague herb and garbage treatments.
One of our 60-year-old patients diagnosed with fibromyalgia, whom I treated at the clinic, said that even though nearly half of his complaints decreased in the second month of his treatment, he did not completely go away. He repeated this question to me 6-7 times throughout our conversation, and I realized that he did not listen to what I told him every time. . When I asked him about the most important thing in the treatment of this disease (what did you do for yourself?), he got angry with me. In fact, the most important treatment step, which we can not explain well to our patients and sometimes neglect, is the motivation of the patient to life. The person who believes that he will be good understands that he has to fight. Believe me, words will not be enough to describe how much we need a positive struggle with one’s self in fibromyalgia. Clinging to life is actually the result of this struggle…
1. You must exercise, but these exercises must be regular and in a certain discipline. Even if it is small, your exercises will be beneficial if they are continuous. Aerobics, pilates and instrument plates that can be done at home will relax you more than you think.
2. We need to adapt this therapy, called behavioral therapy, which targets the education of small groups, to our own society. Because I think it is necessary to find ways out of fibromyalgia, which mostly affects housewives in our country. Hours of reading, hand knitting or occupation can be planned together. When housewives get together, they should look for ways to spend their time useful. It is necessary to stop researching what kind of diseases are behind the cold and burning, taking into account all kinds of aches and pains at every point in our body.
3. Although herbal medicines come to mind as complementary medicine, they are not really effective. I rarely recommend acupuncture for patients whose pain I have difficulty in relieving, and scientific data on this subject is increasing. Baths and hot springs are only useful if they are a treatment in which exercise is continued together and taught to the patient.
4. As for the drugs we use; Trying to relieve pain alone reduces our chances of success. Since it will be used for a long time, painkillers with the lowest dose and effect should be used. On the other hand, I would like to point out that we give anti-depressants, remembering that the main purpose is a good sleep. Although chronic depression is one of the underlying causes of the disease, we are less likely to get rid of fibromyalgia by treating the depression alone. In recent years, gabapentin and pregabalin-containing drugs are the methods we use most in this field. However, all these treatment options are not easy to use, especially due to their appetite-increasing, drowsy, and edema-forming side effects.
The truth of the matter is that a fibromyalgia patient who does not make an effort and cannot change his perspective on life has little chance of recovery. Regardless of the stress factors brought about by the circumstances, instead of complaining about them, we must gather all our strength and overcome those obstacles. While the soul is caught in the whirlpool of life, it is impossible for the body to keep up with it in a healthy way.
