Making Sense Of Fibromyalgia: New And Updated, 2 Edition by Daniel J. Wallace and Janice Brock Wallace


765794e79c3a31a.jpg Author Daniel J. Wallace and Janice Brock Wallace
Isbn 9780199321766
File size 1.5 MB
Year 2014
Pages 272
Language English
File format PDF
Category personality


 

WWW.EBOOK777.COM Making Sense of Fibromyalgia WWW.EBOOK777.COM WWW.EBOOK777.COM Making Sense of Fibromyalgia Second Edition DANIEL J. WALLACE, MD Associate Director, Rheumatology Fellowship Program Clinical Professor of Medicine Cedars-Sinai Medical Center David Geffen School of Medicine at UCLA Los Angeles, California JANICE BROCK WALLACE, MPA 1 WWW.EBOOK777.COM 1 Oxford University Press is a department of the University of Oxford. It furthers the University’s objective of excellence in research, scholarship, and education by publishing worldwide. Oxford New York Auckland Cape Town Dar es Salaam Hong Kong Karachi Kuala Lumpur Madrid Melbourne Mexico City Nairobi New Delhi Shanghai Taipei Toronto With offices in Argentina Austria Brazil Chile Czech Republic France Greece Guatemala Hungary Italy Japan Poland Portugal Singapore South Korea Switzerland Thailand Turkey Ukraine Vietnam Oxford is a registered trademark of Oxford University Press in the UK and certain other countries. Published in the United States of America by Oxford University Press 198 Madison Avenue, New York, NY 10016 © Oxford University Press 1999, 2014 All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted, in any form or by any means, without the prior permission in writing of Oxford University Press, or as expressly permitted by law, by license, or under terms agreed with the appropriate reproduction rights organization. Inquiries concerning reproduction outside the scope of the above should be sent to the Rights Department, Oxford University Press, at the address above. You must not circulate this work in any other form and you must impose this same condition on any acquirer. Library of Congress Cataloging-in-Publication Data Wallace, Daniel J. (Daniel Jeffrey), 1949– Making sense of fibromyalgia / Daniel J. Wallace, MD, associate director, Rheumatology Fellowship Program, clinical professor of medicine, Cedars-Sinai Medical Center, David Geffen School of Medicine at UCLA, Los Angeles, California, Janice Brock Wallace, MPA.—Second edition. pages cm Includes bibliographical references and index. ISBN 978–0–19–932176–6 1. Fibromyalgia—Popular works. I. Wallace, Janice Brock. II. Title. RC927.3.W34 2014 616.7′42—dc23 2013024784 1 3 5 7 9 8 6 4 2 Printed in the United States of America on acid-free paper WWW.EBOOK777.COM Contents Foreword, vii Preface to the Second Edition, ix Fibromyalgia Made Simple, xiii Part I The Whys and Wherefores of Fibromyalgia  1. How Our Understanding of Fibromyalgia Evolved, 3 2. What Is Fibromyalgia? 8 3. Who Gets Fibromyalgia and Why? 17 Part II Basic Science and Fibromyalgia  4. Why and How Do We Hurt? 27 5. What’s Wrong with My Muscles? 41 6. How Do Stress, Sleep, Hormones, and the Immune System Interact and Relate to Fibromyalgia? 46 7. What Is the Autonomic Nervous System? 55 Part III How and Where the Body Can Be Affected by Fibromyalgia  8. Generalized Complaints, 63 9. “I’m Stiff and Achy”—Musculoskeletal Complaints, 70 10. Tingles, Shocks, Wires, and Neurologic Complaints, 74 11. Insights into Insides: Chest, Cardiovascular, and Other Concerns, 81 WWW.EBOOK777.COM [vi] Contents Part IV The Clinical Spectrum of Fibromyalgia  12. What Are the Regional and Localized Forms of Fibromyalgia? 89 13. What Conditions Are Associated with Fibromyalgia? 96 14. Controversial Syndromes and Their Relationship to Fibromyalgia, 113 Part V The Evaluation of Fibromyalgia Patients  15. What Happens at a Fibromyalgia Consultation? 123 16. Are You Sure It’s Really Fibromyalgia? 130 17. I’m Not Crazy! 137 Part VI Improving Your Quality of Life  18. Influences of Lifestyle and Environment on Fibromyalgia, 147 19. The Influence of Exercise and Rehabilitation on the Mind and Body, 155 20. How to Overcome Fibromyalgia, 167 21. Evaluating Medicines That Work for Fibromyalgia, 181 22. Drugs That May Be Useful in Fibromyalgia Patients: An Overview, 187 23. The Economic Burden of Fibromyalgia: Work and Disability, 209 Part VII Where Are We Headed?  24. What’s the Prognosis? 221 25. The Future Holds a Lot of Hope, 225 Appendix 1: Resource Information, 231 Appendix 2: Glossary, 233 Index, 243 WWW.EBOOK777.COM Foreword Making Sense of Fibromyalgia is a well-written compendium directed to the millions with severe fatigue, muscular pain, poor sleep patterns, and the other symptoms characteristic of fibromyalgia. While there is continuing debate in the medical and research community about the causes and treatments for this misunderstood syndrome, Dr. Daniel J. Wallace’s clinical experience and studied review of the current literature have enabled him to produce a book that discusses many of the current theories and understandings. Dr. Wallace’s specific discussions on the diagnostic elements; procedures that support, differentiate, and exclude fibromyalgia as a primary or secondary condition; and specific therapies and their expected efficacies continue the learning process for the reader and provide hope through better understanding of this often maligned condition. This is an important book that provides a nice complement to the Arthritis Foundation’s own publication Your Personal Guide to Living with Fibromyalgia. The Arthritis Foundation, Southern California Chapter, is grateful to Dr. Daniel J.  Wallace and Oxford University Press for their support of our program for people with fibromyalgia through donations from the sale of this book, Making Sense of Fibromyalgia. Medical & Scientific Committee Arthritis Foundation, Southern California Chapter Los Angeles, California WWW.EBOOK777.COM WWW.EBOOK777.COM Preface to the Second Edition To talk of diseases is a sort of Arabian Night’s entertainment Sir William Osler (1849–1919) Among the childhood pastimes we enjoyed was a peculiar board game known as “Uncle Wiggily” (Fig. 1). Its premise seems quaint when viewed from an adult perspective many years later, but the first player enabling Uncle Wiggily to reach Doc Possum’s house so that his rheumatism could be treated was the winner. Along the way, all sorts of nostrums, barriers, diversions, and misinformation deterred Uncle Wiggily from his goal. What, we asked our child’s mind, was rheumatism? This mysterious, all-encompassing term could apply to fibromyalgia. Fibromyalgia is a syndrome that defies our usual concepts of a disorder and is classified by the Arthritis Foundation as a form of “soft tissue rheumatism.” The purpose of this monograph is to enable you to help yourself; to make it easier to work with your doctor and other allied health professionals; to improve the way you feel; and to promote a better quality of life. To begin, there are several reasons why fibromyalgia is plagued by misunderstanding: ■ ■ Although it is now recognized as a legitimate syndrome by the American Medical Association, the American College of Rheumatology, the Arthritis Foundation, and the American College of Physicians, as well as the World Health Organization, some doctors still question its existence. This is largely a consequence of incomplete medical training that was (and often still is) primarily hospital-based. Outpatient (office-based) clinical medicine training, which included fibromyalgia, was largely overlooked. Patients are rarely, if ever, hospitalized for fibromyalgia. Also, statistically validated criteria for defining fibromyalgia were not endorsed by organized medicine until 1990. Fibromyalgia patients often have normal blood tests and imaging studies and are thought by some health care professionals to make up many of their symptoms. Certain doctors consider fibromyalgia patients to be WWW.EBOOK777.COM [x] Preface to the Second Edition Fig. 1. An achy Uncle Wiggily on his way to visit Doc Possum. ■ ■ hypochondriacs or seekers of medical attention for purposes of litigation or secondary gain. Fortunately, there are now reproducible tests documenting that these complaints are real and studies showing that hypochondriasis is extremely rare in fibromyalgia. Six million people in the United States meet the criteria for fibromyalgia. On average, they saw about four doctors before they were correctly diagnosed, and many were convinced they had a life-threatening illness such as a body-wide cancer. Fibromyalgia is a combination of pain, fatigue, and systemic symptoms. Ten million patient visits to doctors every year in the United States are for pain; $600 billion is spent annually to diagnose or manage chronic pain, including litigation fees. One group has estimated that patients with fibromyalgia run up $20 billion in medical expenses annually. Some 10% of US adults have moderate pain and 1% have severe pain; 12% have functional disability due to chronic pain. Additionally, at any visit, 15% of all patients tell their doctor they are tired. There is a paucity of reliable, detailed information about the fibromyalgia syndrome that patients can use to help themselves or others. Many employers do not realize that fibromyalgia is a treatable workplace problem. It can impair job performance even though its symptoms and signs WWW.EBOOK777.COM Preface to the Second Edition ■ ■ [xi] are invisible. Over a billion workdays costing $300 billion are lost annually due to pain and 50 million Americans are partially disabled due to chronic pain. Up to 10% of fibromyalgia patients are totally disabled, 30% require job modifications, and 30% have to change their job in order to remain employed. Appropriate treatment, workstation modifications, and counseling could save the American public hundreds of millions of dollars, improve our productivity, and maintain the self-esteem of the fibromyalgia sufferer. Every year, over $13 billion is spent out of pocket for non-insurancereimbursed care by alternative medicine physicians and other caregivers in the United States. Some of this is spent by fibromyalgia patients who are frustrated by the lack of attention, knowledge, and concern of their primary care and specialist physicians. In our opinion, there is a relative shortage of rheumatologists, the subspecialists within internal medicine who deal with fibromyalgia, and too little research is ongoing to understand its cause, diagnosis, and treatment. In 2011, the National Institutes of Health allocated only $12 million for fibromyalgia research. This book is intended not only for fibromyalgia patients, but also for their loved ones, primary care physicians, allied health professionals (nurses, social workers, dentists, physical therapists, psychologists, occupational therapists, vocational rehabilitation counselors, physician assistants, chiropractors, and dietitians), and other people who care about them. A few portions of this book were originally published in a monograph I  wrote with Dan Clauw for the Oxford American Rheumatology Library in 2009. Some of Dr Clauw’s insights are included verbatim in this update. Since the original iteration of this concept, originally published as Making Sense of Fibromyalgia, was written 15  years ago, many advances have been made in fibromyalogy. This includes three FDA approved medications and over 10,000 peer-reviewed publications. We hope that you find this update informative and useful. Los Angeles, California September, 2013 WWW.EBOOK777.COM WWW.EBOOK777.COM Fibromyalgia Made Simple A Parable Pain has an element of blank; It cannot recollect When it began, or if there were A day when it was not. It has no future but itself Its infinite realms contain Its past, enlightened to perceive New periods of pain. Emily Dickinson (1830–1886) Pain Has an Element of Blank If you have the chronic pain of fibromyalgia, you may be frustrated by the lack of understanding shown by people around you. This is particularly true of the people you live and work with. If only they could feel for one day how you feel all year! Pain has no memory and no mercy. Is it like a bad flu or a severe headache? How can you find the words to describe it? You might wish to recite this short explanation; the next 200 pages provide the details. Picture your body as being a series of electrical circuits. Suppose that you have the unfortunate tendency to injure your shoulder repeatedly. What happens? As part of a chronic pain response, a wire goes from the shoulder to your spine, and a second wire then travels up the spinal cord to your brain. The brain receives a signal that says, “I hurt my shoulder; let me do something about it.” The brain then makes a chemical or chemicals that suppress the pain. It wires a signal back down the spinal column, and a second wire returns to the shoulder. The chemical is released, and the pain gets better or goes away. What happens in fibromyalgia? Your body becomes “cross-circuited” (Fig. 2). The body gets flooded with “input” circuits giving it information. The spinal cord can’t sort out and filter these signals. Larger circuits close off smaller ones. With time, the electrical circuits become “wiry” and excitable. Normally WWW.EBOOK777.COM [xiv] Fibromyalgia Made Simple Fig. 2. Cross-circuiting giving the wrong message after shoulder trauma. non-painful stimuli are regarded as painful ones. The “output” wires fail to alleviate discomfort. The circuits discharge signals that increase your perception of pain, not only in the region that was hurt but also in the area around it. As a result, the processes that regulate your body become confused and you start to develop all sorts of troublesome symptoms. You can’t get a good night’s sleep, your muscles go into spasm, and you become fatigued. This aggravates you further and creates a vicious cycle that makes the pain even worse. In a nutshell, this series of events is observed in fibromyalgia. Let’s explore how this happens and what can be done about it. WWW.EBOOK777.COM Part I THE WHYS AND WHEREFORES OF FIBROMYALGIA Is it nothing to you, all that pass by? Behold and see. Is there any pain like unto my pain, which is done unto me, wherewith the Lord has afflicted me in the day of his fierce anger? From above, he has sent fire into my bones. . . . and I am weary and faint all the day. Jeremiah, in Lamentations 11:12–13 In this part the reader will discover how fibromyalgia evolved and was ultimately defined. Although descriptions of it date back to biblical times, the perception of fibromyalgia as a syndrome represents a convergence of two historical threads: those relating to ongoing musculoskeletal pain (joint and muscle aches) and those dealing with chronic fatigue and a sense of debility. Both official and practical definitions of fibromyalgia will be discussed, and we will consider the number of people who have the syndrome, as well as population groups that most frequently develop it. WWW.EBOOK777.COM WWW.EBOOK777.COM 1 How Our Understanding of Fibromyalgia Evolved . . . and wearisome nights are appointed to me. When I lie down, I say, When shall I  arise, and the night be gone? And I  am full of tossings to and fro unto the dawning of the day . . . and the days of affliction have taken hold upon me. My bones are pierced in me in the night season; and my sinews take no rest. Job 7:3–4 and 30:16–17. There are times when rheumatologists have been accused of making up new syndromes. For example, in the last 40 years, our specialty has described new rheumatic entities including Lyme disease, the musculoskeletal manifestations of acquired immune deficiency syndrome (AIDS), eosinophilic-myalgia syndrome (from L-tryptophan contamination), and siliconosis (which, if it exists, results from silicone breast implants). Fibromyalgia is not in this group. Evidence for the syndrome can be found as far back in history as the book of Job, where he complained of “sinews (that) take no rest.” Concepts of what is now regarded as fibromyalgia date to the Babylonian epic of Gilgamesh, the Bible, and Shakespeare (Therefore the moon, the governess of floods. Pale in her anger; washes the air. That rheumatic diseases do abound. A Midsummer Night’s Dream, Act 2, Scene 34, I, 105). The term “rheumatism” was first used by Guillaume de Baillou around 1592 and was included in a 1763 glossary of rheumatic diseases by FB de Sauvages de la Croix. Fibromyalgia represents a convergence of concepts, as shown in Table 1.1. In other words, a similar clinical presentation ultimately evolved, and by the late 20th century it was apparent that these musculoskeletal manifestations of central pain or sensory augmentation represented a similar process. EVOLUTION OF TRIGGER AND TENDER POINTS The British physician RP Player first described what are now regarded as tender points in 1821 and were described in more detail by F Villeix in an 1841 treatise (“points douloureaux”). Additional insights derived in the 19th century include its predilection for females, the presence of nodules, associated muscular spasm, WWW.EBOOK777.COM [4] The Whys and Wherefores of Fibromyalgia Table 1.1. Fibromyalgia: A Convergence of Concepts Trigger and tender points Neurasthenia Postinfectious fatigue syndromes Chronic widespread pain in wartime Myalgic encephalomyelitis Myasthenic syndrome Post-traumatic myofascial pain “Continuous” trauma pain and stiffness, and somatic complaints. Sir William R Gowers (1845–1915) coined the term “fibrositis” in a paper on lumbago (low back pain) in 1904. Sir Thomas Lewis and Jonas Kellgren mapped out tender and trigger points as well as referred pain patterns in the 1930s. Arthur Steindler demonstrated amelioration of local symptoms with procaine injections in 1937. Janet Travell (1901–1997) was the White House physician to John F Kennedy and Lyndon B Johnson. She elaborated upon these findings and is felt to be largely responsible for founding the discipline now known as physical medicine. In part because of a differing philosophy regarding the underlying pathophysiology, there has been a gradual divergence between what the terms tender point (an area of the body that displays increased tenderness upon palpation—the number of which is an (albeit poor) measure of an individual’s overall pain sensitivity) and trigger point (a regional phenomenon accompanied by the presence of “taut bands” and referred pain) have come to mean. NEURASTHENIA The term “nervous exhaustion” or chronic fatigue was first studied by Austin Flint in the early 1800s and detailed by George Beard (1839–1883), who coined the term “neurasthenia” and Silas Weir Mitchell (1829–1914), who “packaged” the condition in the United States and treated it with a combination of Faradic currents and misogynistic approaches (e.g., removal of the clitoris, encouraging masturbation via horseback riding). Neurasthenia was the longest section in the 1899 edition of Sir William Osler’s textbook of medicine. The term largely disappeared after World War I. POST-INFECTIOUS FATIGUE SYNDROMES The association between established infections and psychological or fatigue states was attributed to malaria or “wasting fevers” in the 1860s and typhoid fever by Osler among others. In the 1930s and 1940s, reports of post infectious fatigue syndromes were published relating to polio and brucellosis. In the 1970s, chronic fatigue was attributed to yeast and the Epstein-Barr virus, but rigorous WWW.EBOOK777.COM

Author Daniel J. Wallace and Janice Brock Wallace Isbn 9780199321766 File size 1.5 MB Year 2014 Pages 272 Language English File format PDF Category Personality Book Description: FacebookTwitterGoogle+TumblrDiggMySpaceShare Six million people in the United States meet the criteria for fibromyalgia, which is a disorder characterized by a combination of pain, fatigue, and related symptoms. On average, these patients see about four doctors before they are correctly diagnosed, and many are convinced they have a life-threatening illness such as an advanced stage of cancer. About $600 billion is spent annually in the United States to diagnose or manage chronic pain, including litigation fees, and it is estimated that fibromyalgia patients run up $20 billion in medical expenses annually. Despite these alarming numbers, there is a lack of understanding and a dearth of reliable information about fibromyalgia for patients. This fully updated edition of Making Sense of Fibromyalgia distills complex concepts and symptoms into an easily understandable narrative. Daniel J. Wallace, a leading rheumatologist at Cedars-Sinai Medical Center, and Janice Brock Wallace, an expert medical writer, have updated the original classic resource, which has sold over 100,000 copies since 1999. Making Sense of Fibromyalgia provides clear answers to common questions, explains findings from the latest research, and discusses treatment options for complex symptoms. Detailed information is provided about topics such as who gets fibromyalgia and why; how stress, hormones, and your immune system interact and relate to fibromyalgia; what conditions are associated with it; why and how you might be misdiagnosed; how to overcome fibromyalgia; and how to understand your prognosis. The authors share all there is to know about the syndrome as well as how our understanding of it has changed over time. This comprehensive companion covers the entire spectrum of issues for those suffering from fibromyalgia, as well as their families, friends, caretakers, primary care physicians, and other health professionals.     Download (1.5 MB) The Tapping Solution For Pain Relief Compact Clinical Guide to Chronic Pain Management Meditation (the Only Book You’ll Ever Need) Living With Bipolar Disorder(McFarland Health Topics) Brilliant Mindfulness: How The Mindful Approach Can Help You Towards A Better Life Load more posts

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