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HOW TO GET THE BEST TREATMENT FOR FIBROMYALGIA…

With still an alarming number of GP’s poo pooing the symptoms of Fibromyalgia it is important that you know how to get the best treatment for it.

News 800 recently wrote an article on this saying that the first step in this process is to arm yourself with the facts. Fibromyalgia is a real disorder. The American College of Rheumatology created criteria in 1990 and 2010 that doctors have used for research studies and in clinical practice. A 2016 revision of the criteria is the most recent effort to improve on these and includes three characteristic features:

  • Significant and widespread pain
  • Severe symptoms (such as fatigue or “brain fog”) present for at least three months
  • No other clear explanation for these symptoms

Fibromyalgia often coexists with mental health conditions such as anxiety and depression, but it is not caused by mental illness.  Fibromyalgia is not “in your head,” but it is likely related to abnormal brain function. Differences in how the brain processes pain can be seen on functional MRI scans of people with fibromyalgia.

Standard approaches to treating fibromyalgia include patient education, exercise, treatment of other conditions that may contribute to symptoms (such as depression or sleep apnea) and medications.

The American FDA has approved three drugs specifically for treating fibromyalgia, including pregabalin (Lyrica), duloxetine (Cymbalta) and milnacipran (Savella). However, other medications, such as amitriptyline (Elavil), cyclobenzaprine (Flexeril) or gabapentin (Neurontin) are usually considered first-line treatments. Each of these drugs is prescribed for other conditions, such as depression or nerve pain.

So now you know the facts its time to decide who you are going to see. You will have to start with your GP but if you have heard yours does not seem to understand your condition then you can just book an appointment with another GP. The first port of call after that is to see a Rheumatologist who specialises in this type of condition.

The National Fibromyalgia Association website (America) and the UK one lists support groups in each area that can help you make these initial connections. The organization can also provide a list of “fibro friendly” doctors in your area. There are also lots of groups online you could join and ask someone near you who they would recommend. If you get a name of a Rheumatologist before you see your GP then you can request the one you want.

Keep a diary to take to the appointment with your GP of all your symptoms and when they come and what helps and what does not help it. The more you have written down the easier it is for the GP to understand. Finding the right specialist to look after you can dramatically impact on your pain and symptoms.

When I was living back in the Midlands it was a Rheumatologist who diagnosed me properly after a spinal consultant had asked me to write a diary of my pain and he was sure that it wasn’t all spine related but also Fibromyalgia. I was then referred to a pain specialist. He was my first port of call whenever I needed him. If I had a flare up he would always fit me in. He kept me relatively pain free with the right medication and different types of steroid injections and he also had me referred to a Professor of Medicine who looked after what medication I took. This made a big difference to my life and I felt in control of my pain.

Since moving down south I had to start again and my pain consultant in the Midlands wrote a letter to my new GP in the south so that I could be referred straight away to a Pain Clinic down here. The pain clinic here was totally different to the one in the Midlands and they first wanted me to go off all my medication as they were convinced a lot of my problems were side effects from them. They then sent me for a bone scan and blood tests as they felt I might be low in Vitamin D which would not help the situation.

I must admit I was a bit unsure about coming off all my medication but I decided it would probably do me good to have a change and slowly came off my opioids but just cut down on the rest of my medication. I felt so different after coming off the opioids that I made a conscious decision I would try to live without them.

Then Covid-19 hit so I had no further dealings with the pain clinic but did get a scan and they found I had osteopenia and I was low in Vitamin D so I was put on some medication to sort this out. However, the spinal and fibromyalgia pain was starting to get worse and worse so I ended up seeing a consultant through my insurance company who sent me for an MRI where they found that I also had arthritis in both my sacroiliac joints. He then referred me for a steroid injection for it. The difference was amazing and I was told I could have them every four months. I was absolutely delighted.

Four months down the line and I was ready for a top up but my insurance company decided they would not cover me for the injections any more as they were classed as a treatment for a chronic condition which my arthritis would be. So, it was back to square one again in the hope that I could get the pain team to maybe refer me to someone for the injections.

However, because of Covid-19 everything stopped in the pain clinics so now the waiting list is endless and I just have a telephone appointment for the middle of May. I knew I would not be able to manage until then unless I started taking the opioids again which I really didn’t want to do so I decided I would pay for the injections myself so I could get back in control of my pain again.

It is so essential that you get the right team set up to look after you when you are in chronic pain in order to be able to enjoy life the best you can. Just little delays and slip ups like my recent ones can set you back months. Pacing and planning have been my mantra for a long time now so that I can enjoy special times with my family without being in too much pain, but without help with injections and drugs I know I would be a terrible mess.

#backpainblog, #BACKPAINBLOGUK, #health, BACK PAIN, Circle Nottingham, Dr. Gregory Hobbs, NHS, pain consultant

A BIG “THANK YOU” TO MY AMAZING PAIN CONSULTANT AT CIRCLE NOTTINGHAM HOSPITAL…

Lee from The Fibro Blogger Directory wrote a post on Facebook asking us all to think about writing a thank you post to a doctor or health person that has looked after us.

I knew straight away that I wanted to thank my Pain Consultant a Dr.Gregory Hobbs at Circle Nottingham Hospital, Queens Medical, Nottingham.

Dr. Hobbs has been looking after me for over 10 years now. I was sent to see him after a previous injection I’d had went a bit wrong and I needed resuscitating. It left me quite traumatised and anxious about having any further injections but Dr. Hobbs slowly introduced me initially to acupuncture and dry needling, and then onto trigger point injections and then facet joint injections to name a few. All to help ease my pain.

Whenever I had a flare up he would fit me in and would always go above and beyond to find a way to help calm things down. In all the years he has treated me I have had the same great care and concern from him and his team at Circle Nottingham Hospital.

I saw him only a couple of weeks ago for some more injections and told him that I would soon be moving to Brighton, a long way from Nottingham and I was obviously quite anxious about who I would see and what sort of treatment they will offer me. He soon wrote down the name of a pain consultant in Brighton whom he said would give me the same sort of treatments he gives me.

Thank you once again to the amazing NHS, Dr. Hobbs and his team at Circle Nottingham Hospital.

#backpainblog, #BACKPAINBLOGUK, BACK PAIN, DEGENERATIVE DISC DISEASE, HEALTH

CERVICAL DISC PROTRUSION AND ARTHRITIS…

After the brilliant guest post from Neil Velleman on ‘All you need to know about a slipped discI found myself being diagnosed with yet another disc problem in my cervical spine.

For the last six months, I have been having constant pain going down my arm from my neck as well as pins and needles down to my little finger.  Initially, we thought it may have been my ulnar nerve again. I say ‘again’ as I had surgery last year for a trapped ulnar nerve which was a total success but they said it can come back even after surgery.

After a 2 hour consultation with a physiotherapist, it was decided that it could be one of two things. Either the ulnar nerve or a disc in my cervical spine so the first port of call was a nerve conduction test.

The nerve conduction test showed no problem with the ulnar nerve so I was then sent to have an MRI scan. Those results have shown that I have another disc bulge which is compressing a nerve and giving me the pins and needles and pain and it also showed that I have arthritis in that area.

Neil Velleman explained that ‘the spinal discs act as shock absorbers and through a variety of causes, including injury, poor posture and general “wear and tear” (meaning gradual deterioration), the walls of the disc can become weaker. If the centre of the disc pushes out, this can cause the disc wall to bulge and that can be when pain strikes!’

Mine is definitely in the ‘wear and tear’ category as I have had two previous surgeries on the C3/4 area of my spine which has meant the disc below it has had to do all the work. I have now been told I will need to see a consultant about the sort of treatment they can give me for the pain which could be IDD Therapy, Injections, Manual Therapy or Surgery.

Back in 1996 when I had my second surgery on the C3/4 discs they gave me traction first but IDD Therapy seems to have taken over from that method but I shall just have to wait and see what they suggest.

The worst pain is doing the simplest of things like cleaning my teeth or drying my hair so I am just hoping an appointment comes through sooner rather than later.