Fibromyalgia: Is It Real24.10.2012
by Wong - William
By: William Wong N.D., Ph.D.
Member World Sports Medicine Hall of Fame
Fibromyalgia does exist.
To most physicians, Fibromyalgia is a mystery.
Its unrelenting and debilitating pain is often seen to be in the patient's head, because pharmaceutical drugs don't help, and the symptom-oriented approach leads to no improvements.
But perhaps it's a good thing that patients and doctors don't believe it's real. Maybe that's what it will take to make the dependent patients (the victims) realize that they need to work their way back to health... to attain their own well-being, and stop looking for a quick fix.
Sounds heavy handed?!It's taken a long time to get Fibromyalgia, so it only makes sense that true healing may be a long road back. Please persevere, because true health is within your reach!
For all of the strides Fibromyalgia Syndrome (FMS) patients have made in getting their condition recognized as a true disease, even to the point of having a diagnostic (CPT-4) code for the condition: now, the major movers and shakers in the medical insurance world are pushing to reverse the recognition and have FMS patients relegated to psychiatric wards again! To make maters worse they (the insurance companies), it seems have bought the MD who first documented the facts behind the condition and called it a true disease.
Why the turn around in this doc? And, why are so many other doctors turning away from FMS patients and, even turning against them? It's simple, they are frustrated...
Frustrated at not being able to put a dent in the disease with conventional drugs and therapies. Frustrated at non compliant patients who don't want to participate in their own healing, but are looking for someone with magic fairy dust to suddenly take away their pain and make everything better". (Even I won't work with these patients). Frustrated that their theories on the cause of the disease have not panned out and since they can't figure out the cause of the disease they relegate the condition to the scrap heap of psychosomatic diseases!
Also, many of these doctors are seeing the handwriting on the wall: insurance companies are about to cut off all coverage of treatment for FMS patients. Just as what happened with the Chiropractors in the 70's and 80's when they ran up charges and caused a cut off reaction by the insurance companies and Medicare; the MD's have done the same with FMS patients with useless trigger point injections, electro therapy, hands on fascia remolding, endless chains of office visits and medication taking etc. etc. etc.
Do I sound like I'm against FMS treatment? No, not in the least! I'm against the doc's using up patient insurance coverage's with treatments they are guessing "may" work. I'm against medical conferences on FMS that don't even address the primary causes of the disease - Fibrosis, all the while doing the allopathic thing and concentrating only on the symptoms and symptomatic relief! (Remember the condition IS called FIBRO Myalgia or "Fibrosis caused Muscle Pain").
Well now that their symptomatic methods have proven useless it's not they who are wrong; it's the 3.5 million Fibromyalgia patients who are! Now that they have drained out the insurance companies and those firms are balking at paying for treatment or disability, they've jumped ship and joined the cry against the people who depended on them to get them better!
In a way I can understand the frustration of the doc's; about half the FMS patients out there wont lift a finger to help themselves. At first the dependence of these patients is good for office visits but when things don't work their dependence becomes burdensome to the doc. These folks bring so much psychological baggage to the office, no wonder many docs legitimately think the patients are faking or crazy. The other half of FMS patients do want to be involved and work for their recovery. They can discern and separate the things that have gone wrong and the things they have done wrong in their lives from the disease state and what must be done to recover. These patients get better if they find the right mix of support and self treatment to get them past the pity party stage into the "well poop; if you ain't going to help me, I'll help myself" stage.
What must be done by FMS patients to better themselves?
- Take systemic enzymes to eat away at the fibrosis that is the cause of the ischemic pain of FMS. (Remember the pain of ischemia cannot be lessened by pain med's or anti depressants).
- Strength Exercise, to increase the number of blood vessel feeding muscles (this reduces ischemia and therefore the pain).
- Strength Exercise to increase the number of mitochondria the muscle cells have so these can produce ATP (the sugar they lack that runs everything in the body). It's the lack of ATP and mitochondria that produces the extreme fatigue just like in Mononucleosis. No supplement, drug or hocus pocus build mitochondria in muscle cells, only exercise can!
- Strength Exercise to increase strength so the Activities of Daily Living are not such a burden. (ADL's are things like getting out of bed, combing your hair, cooking, rising off the potty, etc.). I told you, you had to work for it!
- Time, it will take weeks or even months of effort before the pain begins to abate and the ADL's become easier. And after you feel better you can't stop doing. If you stop you'll slide back to where you were in 8 weeks or less.
Follow a rounded program like the one I outlined in "10 Natural Treatments You Haven't Heard of Until Now". (Yes I'm going to make you buy the book, it's only 14 dollars. While I'm an FMS patient myself, I give away enough therapeutic advice and experience for free)! It has worked for me and for every FMS patient I've worked with since coming up with the plan.
Fibromyalgia does exist; FMS is as real as the pain we constantly live with. But maybe it's a good thing that medicine is about to kick out FMS patients - it might make the dependent ones see that they need to work to attain their own well-being and they'll stop looking to others to bring about their return to health and function.
Sounds heavy handed, wasn't this article about the way FMS patients are being mistreated by the doc's and insurance companies? Yes it was. But, in a way, we've only ourselves to blame that MD's and insurance companies think most of us are nuts and disregard our pain and dysfunction.
Tough love can be a wonderful thing.
To most physicians the pain of Fibromyalgia Syndrome is a mystery. Its unrelenting and debilitating pain is often relegated to being of psychosomatic origin due to the fact that it does not decrease with the use of NSAID's, opiates or psychotropics. In the present mindset of medicine if these medications do not relieve the pain then it must be all in the patients mind! If this is so, than the pain of an MI (heart attack) must also be all in the patients mind.
We know that for 3 days following a heart attack the patient will have angina, oft-times severe. We also know that for post MI pain, medicine does not normally administer pain killers. Why? Because the pain of a heart attack is the pain of ischemia (the lack of oxygen or Adenosine Tri Phosphate for the cells to breathe). Ischemic pain we know can only be relieved by restoring either proper O2 or ATP levels to the involved tissues.
Let's use a simple example we've all experienced. When you were a child you likely at some time put rubber bands or string around your wrist and cut the blood supply off to your hand. At first the hand went numb. Then while turning an interesting shade of blue or purple, it began to throb. The more you moved your fingers and contracted the muscles the more the hand hurt. The longer the time the circulation was occluded from the area the harder the hand hurt. At that same moment in time, if you mainlined heroin that hand would still have hurt despite the fact that the strong opiate was swimming round your system and brain killing all other pain. Why? Pain meds have no effect on relieving the pain of ischemia!
OK, so ischemic pain can't be relieved by pain killers or antidepressants, so how does this relate to Fibromyalgia. Easy, in FMS we have a build up of fibrin (the fibro of Fibromyalgia) through and across striated muscle around the body. There is also the growth of fibrin in the micro circulation essentially plugging these tiny blood vessels in the effected areas. The combo of decreased blood supply, with the strangulating effect of the fibrin on muscle tissue, (remember what fibrin can do to strangulate intestines after abdominal surgery), creates the environment of ischemia. This is also why when these patients are taken through bouts of aerobic exercise or high intensity resistance exercise their pain greatly increases. *
What can be done to decrease the fibrosis? Until recently, nothing. There has been really nothing in either the allopathic or naturopathic armamentum that was capable of lysing away scar tissue or fibrosis. The only treatment allopathic medicine has had up to now to try to control fibrosis growth has been to use cortico steroids to lower the level of inflammation knowing that inflammation is one of the things that produces fibrosis. Plastic surgeons have used this technique on their post op patients with mixed results and corticosteroid therapies used with FMS patients have proven to be failures.
With the advent of oral systemic enzyme research and application all branches of the healing arts now have a powerful and effective tool for the safe lysing away of fibrosis and the non- toxic control of inflammation. First used in Germany and Japan against fibrocystic cysts of the breast and to prevent post operative scar tissue in abdominal and orthopedic surgery, the effect of orally administered highly fibrinolytic systemic enzymes has been documented in both research and clinical use. (See abstracts in this web site).
The safety and complete lack of toxicity of systemic enzymes make it the primary treatments of choice against inflammation (as they are used in German emergency medicine) and the only choice available for the lysing away of scar tissue or fibrosis.
With FMS patients, to be effective, an activation dose of the enzymes should be found and maintained for at least 3 months. After which an attempt can be made to reduce the dose. Experience of the docs using systemic enzymes with their FMS patients has shown that in roughly 50% of the patients their maintenance dose will be about 50% of their activation dose. For the other half of this patient population the dose will have to be maintained at the high activation dose as lowering it causes inflammation to return.
(I must interject a personal note both as an FMS patient myself and as one who has treated hundreds if not thousands of FMS patients in the last 15 years: many, many FMS patients are actually Munchausens patients and not true FMS patients. The true FMS patient is anxious to do anything that might alleviate their pain including exercise, nutrition and self applied therapies. The malingerer will be wanting the doctor to do something to relieve their pain and and reinforce their need for being dependent. If they are getting better they will doctor hop to another doc as relief is not really what they really want. These patients will have the "victim" mindset and be seen to be manipulating their families for secondary gain. With these misdiagnosed FMS patients NOTHING WILL WORK, EVEN IF IT IS.
While these patients can enrich practices by their frequent visits, they can also pose a problem and even be an insurance liability as they will bad mouth one doc, his or her treatment plans and bedside manner to the next doc they hop to in a never ending line of pity seeking and manipulation. Once I discovered this about certain FMS patients while I was in practice, I refused to work with these folks. If the patient would not exercise, if they would not take their enzymes, if they would not follow the therapeutic guidelines - I would not work with them. Using enzymes, nutrition and the correct type of exercise, over 88% of my FMS patients did not remember they had FMS after the first 8 to 16 weeks of work! I booked no malingering, as most of the time I was worse off than the patients I was working with and I did not have the time, patience or energy to deal with the "pity me" Munchausens patient).
Fibromyalgia is a multifaceted disease demanding a multifaceted solution and since a major aspect of the problem is the pain of ischemia, the only treatment available is also the safest treatment available, the use of highly fibrinolytic orally administered systemic enzymes, to safely lyse away the fibrin, free strangulated muscle tissue and open peripheral circulation by lysing away the fibrin that is clogging the blood vessels. If the unrelenting pain of FMS can be dealt with then the rest of the problems relating to the condition can be ameliorated with ease.
* While exercise is a must for these patients to rebuild their strength, overcome atrophy, increase the vascular bed there by improving circulation and oxygenation and to increase the number of mitochondria to relieve the chronic fatigue / EBB aspect of the disease; the exercise must be strength work of low intensity but high resistance, (i.e. 3 to 4 sets of 3 to 5 repetitions with 70% or more of the 1 rep max.) with long rest periods of 2 to 5 minuets in-between sets. Aerobic exercise is not generally recommended but if done must not be over 8 minutes or of high intensity (over 50 to 60% of max HR) as the patient will have no tolerance for it, either in their energy reserves or their recuperative capacity. (Current Adaptation Reserve, Siff and Verkhoshansky, 1999). As per Karvonin and Cooper 7 to 8 minutes is the minimum time aerobic work can be done for while gaining a benefit to the heart and vascular system.