We
publish the following in order to show diffences of opinion DE
Question
Just wonder have you read the prescribing information the FDA's findings that fibromyalgia IS a possible side effect of Lupron?
DIRECTLY FROM THE PRESCRIBING DOCUMENTATION
During Post Marketing
Surveillance .....the following adverse reactions were reported......
Symptoms consistent with fibromyalgia (eg: joint
and muscle pain, headaches, sleep disorders, gastrointestinal distress, and shortness of breath) have been reported individually
and collectively.
Answer Muscle pain is indeed a problem with Lupron it is
not classic FMS , in my opinion all muscle pain is not fibromyalgia. In fact on discontinuance of Lupron the pain dissipates,
fibromyalgia does not disappear so easily, unfortunately
Question Hi Dr. Enlander,
I
appreciate this opportunity to be able to ask your opinion on the use of
alternative medical techniques. I've had
fibromyalgia for over 20 years. I
also have hormonal system problems which include diabetes, and
hypothyroidism.
I have been medicated, the diabetes is under control, my
thyroid is functioning normally for the moment. I
am so tired of medicine
changes, pain, exhaustion and so on. I would like to try alternative
medicine to see
if they can get my body back into balance. I am concerned
about all the meds I take and the possibility of them
contributing to the
condition(s). Have you had patients who have tried this, specificaly Body
Restoration Technique(BRT)
,the Jaffe-Mellor Technique(JMT), and/or the
Manbudripad Allergy Elimination Technique (NAET)? If you have, did
they
have success with these methods? I certainly don't want to become a victim
of quackery, an expensive loss
if it is not helpful. I have also been
considering Homeopathy, what is your opinion about that?
I appreciate
your taking the time to read and answer these questions for me.
I thank you in advance, Mary Ann
Answer
In order to practice medicine and prescribe drugs it is necessary to have a license.. Some states allow alternative medicine
which does not need a license. There are also MD's who practice both. Use of herbal medicine is fine if one understands
that herbs can be potent and in some cases deadly as in nightshade. The practice of alternative medicine has allowed some
to take advantage of patients with unfounded methods which are expensive, so be careful.
hello.
i only need to know if u have ever known anyone to get disability from fibro, if they r in too much pain to work most of the
time.thank u
Yes, some of my patients have received Social security disability
DEREK ENLANDER MD
Dr. Enlander,
I
would very much like to come to New York to see you! Who do I contact to find out details. As to when, how long should I plan
to stay, if you except BCBS, And what med. info I should bring with me. Today is Thanksgiving and I cooked a large meal and
now my pain feels as if I need to be in the Hospital. Can not even cook for my family anymore. Can not kept my balance and
keep falling. Do you know a lot about CFS? Do you think I could possible have this too? Can not make myself get out of bed
until 11am-1 pm. My memory lost is the worst thing that I have lost. I never thought it could be taken away from me in my
early 40"S.
Thanks for your help, D.M.
You should call my nurse at (212) 794-2000 for an appointment
The best time to speak about scheduling is Wednesdays
between 3 -5pm (ET)
We see a large number of patients with FMS and CFIDS (chronic fatigue immune dysfunction syndrome)
DEREK ENLANDER MD
Dear Dr. Enlander:
I am
37 years old,diagnosed with fibromyalgia about 4 years ago. I display all the classic symptoms. I am 13 weeks pregnant and
off of all medications (soma, advil, tryptophan) all of which worked. I haven't had a restorative night's sleep in over 60
days and am suffering increasing pain and sensitivities. I am contemplating requesting my o.b. write me out for disability
until after the baby is born so I can take better care of myself. I am a professional in a high-stress demanding position
which usually requires 10- 12 hours per day. I have cut back to 37.5 hours per week, but really am only functional about 25
hours. My company has refused to cut my hours, stating that my job must have me present between their working hours? What
do you think.
My o.b. is not familiar with fibro at all and asked me to educate him in the syndrome.
Thank you for your consideration and I look forward to your reply.
FMS/CFIDS is a systemic condition and should be diagnosed and treated by an internist. Consult an internist who will
advise you and work in combination with your Ob.
DEREK ENLANDER MD
Dear Dr.
I have received
the last 3 or 4 issues of the fibromyalgia newsletter. There was a lot of discussion about opioids in treating fibro pain.
Vicodin has been the only thing for me along with soma that has given me any relief. They say that opioids for long term use
is not as bad they used to believe. How do you feel about this? Can the vicodin over long term daily use be harmful. Would
it be better to switch to opioid without tylenol? Your views would greatly be appreciated.
Sandy
My opinion is solely based on my exprience. Patients with terminal disease, of which fms/cfids is not included should
be put on unrestricted long term opiods as the quality of short term life is the most important. In FMS/CFIDS where life expectancy
is long we have the problem of balancing short term life with long term problems of the opiods.
I prefer to use reciprocating pain medicines to try to confuse the body mechanisms relating to habituation. The reciprocation
can include opiods and/or Tylenol 3 or 4 . Long term use of opiods will no doubt end with habituation , gastro-intestinal
and other systemic problems.
DEREK ENLANDER MD
Dear Dr. Enlander,
First, I thank you for responding to my questions so promptly. It means a lot.
Well, I just got contact lenses and I am wondering if they may be irritating my facial and neck muscles. I feel a tension
around my temples and scalp. I have been awakened two nights since I got them with bad muscle twitching in neck and spine.
Do contact lenses cause a worsening of muscle tension for people with FMS?
Your reply will be greatly appreciated.
Best
Regards, Crystal
The best way to determine a contact lens problem is to remove them for 3-4 days and see if the problem persists.
DEREK ENLANDER MD
DEAR DOCTOR:
I
have had Reflex Sympathetic Dystrophy in my right arm. I also have Chronic Fatigue along with Fibromylagia. I have been in
a tremendous amount of pain in the past three weeks with my lower back and legs. The muscles in my legs spasm and are very
tight I can hardly walk with out falling down at times. The pain and pressure in my lower back is terrible sitting standing
or laying down. I have been on 8 mgs of Diluadid and Lorcet 10/650 every four hr for pain. Even with all of this I am in pain,
it only takes the edge off. I have no quality of life anymore left. I have been recommended for a pump. Do you think this
is a good idea?
I have been on lipitor 20 mgs for three months. Does this
effect the Fibromyalgia? I can't understand why I have gotten so much worse in the past three weeks. Does Fibromyalgia get
any worse than it is now? I even had massages for a month three times a week and is no better. Please help me with any you
can give me. Just want to live a few days here and there without pain in my body.
Thanks you very much for listening to me and my complaining.
Sincerely, Jenny
Lipitor is very effective in lowering cholesterol and triglycerides I do not think it has a negative effect on FMS/CFIDS
DEREK ENLANDER MD
DEAR DR.
I
have been on ultram and vicodin for pain. I take 1 ultram in the morning and 1 vicodin at night. My question is, can daily
use be harmful to the body. It seems to be the only thing that helps me function with fibro. I have to keep working for insurance,
have 2 kids, and a husband with cancer. Thank you.
YOU MUST BE MONITORED FOR LIVER AND KIDNEY FUNCTION THE PAIN MEDICINE CAN CAUSE PROBLEMS
DEREK ENLANDER MD
Is FMS a progressive disease? Without all the pain
meds., baclofen, and ambien, I would not be able ot get out of my bed. My first symptoms started in 1991. During PMS my pain
supersedes all the drugs I take. My PM Dr. is the best and is sensitive to my suffering. I have tryed over the years, every
muscle relaxer, antiimflammatory which eventually tore up the lining of my stomach. I now take oxycontin, hydrocodone for
break through pain and am worried that if the condition is progressive, what will they be able to do later on for me? I have
tryed the anti-dressants, ultram, neurontin, and either I had severe reaction to them, or they just didn't help. I have gone
to PT, use a bed buddie, and try to keep a 30 minute a day time slot for light areobic actibity which helps my mind more than
my body. I have done injections in to different areas, and have had infusions of magnesium. What wlll happen down the road
when my body gets used to the narcotics??????????? I am not afraid of addiction, I am just afraid of not being able to live
a somewhat normal life. I couldn't go one without knowing that there would be relief from this. Thanks for your feed back.
I believe that FMS is an immune system disease, it is not progressive in that the patient secomes from the disease.
It is not fatal. The pain however is cyclic and can increase in severity. Flare-ups are common and are usually related to
physical or emotional stress, The treatment should be pointed to the immune system as well as your pain medicine.
DEREK ENLANDER MD
I am a 49yr old female diagnosed 8 years ago with
severe Fibromyalgia, chronic fatigue syndrome, arthritis, bursitus carpal and tarsal tunnel , TMJ, chronic myofacial and migraines.
My dr is a family practice physician and although he ascribes to the teachings of Janet Travell he does not like giving me
the tylenol3. I have previously taken Prozac, Paxil, trazedone, and doxepin. I presently take flexeril (for 8yrs, 3x a day)
and the Tylenol3 only when the pain is unbearable.
My upper body hurts the most especially
when it engulfs my head and I have even gone to the ER for the pain. My skin hurts, and I get strawberry marks on my arms.
My urine has a foul odor (which I am told is due to the fibromyalgia). I cannot stay asleep at night, the doxepin keeps me
awake even when I take it in the AM. Isn't it true that the fibro blocks our signals from the brain that help us to mentally
control pain? I have to beg for pain meds and waited over a year for a pain management clinic that wants me to go through
bio-feedback. I have done that before but the stress of that only makes things worse. I am in a fibro support group on line,
and learn all I can so I can cope!
I am guardian for a retarded sister
and babysit a 4 year old. How can I get back some quality of life? I am not a quitter, but need to know how to control the
pain and why they doctors do not understand that those meds DO give us back some measure of comfort so that we may function
a little better. (30 tylenols a month is not very much comfort). I appreciate your reply.
respectfully, Miriam
You must find a doctor who is an expert on FMS and he will treat you. Doctors are audited for narcotic prescriptions,
patients must attend in PERSON to receive these prescriptions, only in emergencies can this rule be varied
DEREK ENLANDER MD
Hi, I have been diagnosed with FMS about 8 months
ago. I have had swelling in my right ankle for about a week now. I did nothing physically to make it swell, so its not a sprain
or injury. I also have pain in the bottom of both feet and it is difficult to walk. I noticed my hands started hurting also
now. I've had pain in my arms, shoulders, neck, and back before but not this. Is this from FMS? Do people usually get swelling
like this? Thanks for your time. Rose
PAIN OR SWELLING IN JOINTS IS FREQUENTLY SEEN IN FMS
DEREK ENLANDER MD
Hi dr Enlander
I am 49 years old i was dx with fibromayalgia 2 years. One thing bothers me is i have a high sedrate nobody seems to
know why. its been like that for five years could you tell me if fibro causes high sedratelast checked it was 85.
Thank you pleasee email me, Cindy
Elevated sed rate is seen in any chronic disease or inflamation it is seen in FMS
DEREK ENLANDER MD
After being diagnosed with FMS my rheumatologist
explained (or tried to) that if I have children, there is a small chance of the children having FMS. What the small chance?
Also what is the connection between conjunctivitis or other eye infections and FMS? Thanks!
NOT DOCUMENTED if he or she has reference to this ask for it.
No well established corelation with conjunctivitis
DEREK ENLANDER MD
I was wondering if you could possibly explain why
some patients' eyes become so light sensitive. Is there something I can do about it ? I haven't found any info. yet in the
reference books. Any info. you could give me is greatly appreciated.
Thank you for your
help.
Light sensitivity, increased sensitivity to sound, smell and temperature change are symptoms experienced by a number
of patients. The only explanation I can suggest is a threshold effect on the CNS.
I would sugggest a non steroid anti inflamatory medication
DEREK ENLANDER MD
I have FMS and find it difficult to deal with the
aching pain as well as the burning pain (feels like a "rug" burn). The burning pain usually arises when I've pushed myself
too far and that's a signal to call it quits with everything. However, the burning pain lasts for days. Do you have any suggestions
for dealing with this? What is it and what can I do to prevent it?
Additionally, what
does malic acid do for people with FMS. I have heard it helps with pain relief - but how?
Peripheral neuritis can be experienced in FMS, this makes the skin very sensitive to touch even light touch. Some have
found that non-steroid antiinflamatory medication is helpful, these include feldene, naprosyn, and ibuprofen. All of these
however must be taken with food as they can cause nausea.
How malic acid works is unknown, some find it helpful. Malic acid is found in apples.
DEREK ENLANDER MD
Dear Dr. Enlander,
I am 34 yrs. old and have gone to many doctors over a 3-4 year period. I've had two cervical MRI's that show the normal
arthritic breakdown for my age. I've not been diagnosised with FM but I seem to be learning that I have many of the syptoms.
Sore neck, upper back, elbow, hips. (And I do have TMJ which I have been getting treated for 7yrs) My question to you is can
exercise make it worse. I'm currently in Cardio-kickboxing and yes it causes pain, but does it do damage. I'm use to being
in pain but I don't want to damage myself. Any advice would help. Becky
I believe that over execise can produce a setback. Do damage? that is hard to say does it damage muscles, probably not.
DEREK ENLANDER MD
Dear Dr. Enlander,
I am 34 yrs. old and have
gone to many doctors over a 3-4 year period. I've had two cervical MRI's that show the normal arthritic breakdown for my age.
I've not been diagnosised with FM but I seem to be learning that I have many of the syptoms. Sore neck, upper back, elbow,
hips. (And I do have TMJ which I have been getting treated for 7yrs) My question to you is can exercise make it worse. I'm
currently in Cardio-kickboxing and yes it causes pain, but does it do damage. I'm use to being in pain but I don't want to
damage myself. Any advice would help.
Becky
I believe that over execise can produce a setback. Do damage? that is hard to say does it damage muscles, probably not.
DEREK ENLANDER MD
I was just dx with Fibromyalgia about three months
ago. I am 35 years old. I have three kids to keep up with and I do my best. The question that I have is the medication I am
on is called Trazadone and I am on 150 mg it seems to help me sleep but dose nothing for the pain. Is there something other
than pain meeds they can give me? I also am having muscle spasms in my left eye all the time is just wondered what is causing
that. I have a lot of swelling in my back on the side and it feels like three are lumps in there. I am frustrated and I do
not know where to turn. The doctors do not seem to know how to treat me do you have any suggestions.
Thank You for Listening,
Vicki
FIRST and foremost have these lumps diagnosed they are not typical of FMS. They could be a neuroma a benign tumor of
nerve tissue or another benign tumor, or worse a malignant tumor. You MUST seek immediate advice. While having this advice
have the eye spasm investigated.
DEREK ENLANDER MD
Hi Doctor.....I read in some of your posts the
prescription of Neurontin. Could you please explain what this drug is? I have been to many Doctors and have read much material
and have never heard of it.
Also, in another post you mention taking care of the ' imunological" side of FMS. I was not
aware there was one although I always believed my problems were immunologically triggered.
NEURONTIN MANUFACTURED BY WARNER LAMBERT
a relatively new drug originally used for neural disorders including epilesy.
The theory is that there are abnormal nerve impulses transmitted to the muscle which give muscle fatigue and pain.
It is possible that the symptoms of FMS are secondary to an immune dysfunction, if one accepts this then the immune
system may be the source of the disease
DEREK ENLANDER MD
Dear Dr. Enlander:
I have been suffering for
many years with fms. I have been officially diagnosed. My G.P. is a pulmonary specialist. He admits I have it, but will not
treat it. There are only 2 rheum in Savannah. I been to both. One told me I was crazy the other told me there was nothing
he could but try Sinequan(sp). I had a reaction to the sinequan. I have reached the point where I either get some relief or
I give up. I have been taking Amien 10mg for numerous months. Flexeril and Xanax at night to sleep. I seem to be in one of
the worst episodes I have ever had. My skin hurts. I have to change clothes numerous times in order to find something that
doesn't rub my skin. It feels like a severe sunburn and clothes scratch the skin. I am also suffering from numerous sites
of gout. My couple of questions are as follows, I do not see many people complain about their skin. Is it typical of fms?
Do u know of any Dr. in this area that you would suggest I use? If not I will return to the Dr. that said I was crazy and
try to start with him. Are there any questions or anything I should do to prepare to start up with this new Dr.?
Thank
you.
Increased skin sensitivity is seen in FMS. The cause is obscure but is thought to be related to increased cell irritability,
treatment may reduce this.
I have no suggestion for a physician in Georgia when you come to New York please give me a
call.
DEREK ENLANDER MD
Editor's Note: Email Masaathoff@aol.com with the Fibromyalgia Alliance Association. Give her your name and address and
she will mail you the name of doctors and support groups in your area. This works both ways as you can also email her the
names and information of good (and bad) doctors. Please include an explanation of your opinion of the doctor.
I wanted to ask you what you
thought about FMS patients who also have other medical problems. For example, myself: I was diagnosed with epilepsy when I
was about 23 or 24 years old; even though I had problems with spells(night screaming, petti-mal seizsures, etc) since I was
13 years old. Then several other things I experienced over the years.
Three years ago I really got
worried. I had been watching TV late at night for a while (since I am more active at night anyway); til about 2 - 2:30am.
One night I woke up in my husbands car, out on the street. I was sitting on the passengers side. I immediately ran in the
house, awoke my sleeping husband, and told him what had happened. The next morning he did not clearly recall what I had told
him.
I was scared. One reason, our door was extremely hard to close, especially w/o using some force.
So how did I get out of the house and in the car w/o remembering a thing?
I went to see my neurologist
and he suggested I have a sleep study. That's when I was diagnoised as having sleep apnea. And since then I still have a problem
w/ sleep walking.
Since that time I've been told I have several other syndromes. However, I have found
a reumatologist who knows about FMS and is treating me presently. But throughout all my studying and research I've began to
question; is there not a relationship between these various sleeping disorders?
Thank You so much for allowing me to share
my concerns.
Arrianna
Sleep disturbance in FMS is very common. Sleep walking and apnea are not generally seen. Epilepsy is a condition not
related to FMS, however treatment of FMS with Neurontin also is an effective treatment for epilepsy
DEREK ENLANDER MD
I had a nerve ablation of the lumbar/sacral spine
in july. i have now developed nerve damage to the bladder nerves. the pain from the fms has quieted down some. are you familiar
with this type of nerve damage? i am being seen by a urologist who doesnt have a clue how tohelp me. the bladder has become
very sensative and i am going to the bathroom a lot.
thanks
This is a primarily a urological problem, the bladder nerves have been interupted. The normal bladder function is now
disrupted. FMS shoould be treated as a separate entity I would treat this with Kutapressin complex and glutathione
DEREK ENLANDER MD
Dr. Enlander,
My husband
has been having problems for years. This past year has been extremely difficult for him. He went back in to see his doctor
in Aug. Of last year. And they found he had a very low heart rate. So they did a Angiogram. After more test, they found a
clogged artier. So in September or last year, he had a Angioplasty. The doctors then told him he would feel much better. Since
then they have done 2 more angiogram. They thought that maybe it had clogged back up. It has not so far.
After changing medicine and fighting feeling bad. He went in for a stress test. They then decided he need a pacemaker.
So in April of this year he had one put in. Again, they said you would feel better. And he did for a few weeks. But that was
it. We are still going to the doctor. He is still off work. His hole body hurts.
He use to have good
weeks and bad weeks. Now, we are lucky if he feels good for one day.
Our doctor suggested going to
see a Rheumatologist. They are now treating him for Fibromyalgia. He has been taking medication for about 8 weeks now. And
is still not doing much better.
In the past 10 years, his Father, Mother, and 30 year old brother have
all died of heart failure.
We also have been in the process of adopting a baby. We have decided to
wait and see what is going on with him. So the adoption is on hold for right now. And I am wondering if this is all related.
What can I do to help him?
Sincerely Yours,
First see a specialist in FMS if the diagnosis is established formulate treatment in co-ordination with an internist/cardiologist.
The family history of heart disease must be explored
DEREK ENLANDER MD
hi,
been reading a lot about FM, about two years
ago I got a allergy so bad that my nose runs all the time, could it be related to FM. I'm on clarition and it relieves the
headaces.
NO this is not FMS
DEREK ENLANDER MD
I was diagnosed in June of this year with Fibromyalgia
by my Neurologist. He did not discuss these points you speak of. I have been in constant pain for over three years and have
been tested for all sorts of things before being diagnosed with FMS. Can you help me with where these stress points are? Also
my doctor has put me on Trazadome 50 mg at bedtime. I have only been on it for a week and so far it isn't helping much. Any
information and help would be very helpful as my doctor is not real up on FMS. Thank you so much for the information you supply
to all of us who are in pain. God Bless you.
I suggest you consult a physician experienced in FMS who can show you a diagram of the FMS trigger points they are symetrically
found on both sides of the body from the neck to the lower legs.
I use a kutapressin/magnesium sulphate/folic acid/B12/calphosan/glutathione
injection as treatment in combination with pain medicine when indicated
DEREK ENLANDER MD
Hi Dr. Enlander,
I just started to take Synthroid
for a thyroid nodule. I am presently beginning to take .0125 every day. This past weekend, I had severe joint pain in my ankles,
knees and knuckles. I first felt this on Saturday morning and I still feel this way on Monday morning. My fingers are swollen
and have difficulty walking. Do you think that the Synthroid could be doing this? I also have been
recently diagnosed with
Fibromyalgia but have never had these symptoms before. I would appreciate you giving me your opinion.
Thank you.
I hope you are under treatment of a competant endocrinologist, there is something in the diagnosis that is incomplete,
are you suffering from an underactive thyroid?
A solitary nodule in the thyroid must be further investigated. Contact me
after you have seen the endocrinologist
DEREK ENLANDER MD
A friend of mine, after listening to my complaints,
suggested I may also suffer from Endometriosis. Is there a possible connection with FMS? I have had menstral problems most
of my life. I was diagnosed with FMS about three years ago. I am now 59. I have never been tested for endometriosis, and have
never been pregnant. I think I have had FMS almost all of my adult life. Do you think there is a connection? Should I pursue
the question with my GYN? I have not had problems since my menstral period ceased when I turned 50, but do have flare ups
with the FMS from time to time. My MD suggested that recently the depression I am having is probably a result of the FMS and
has me on an anti-depressant.
There is no causal relationship between FMS and endometriosis.
Endometriosis is an abnormal collection of endometrial
cells in one or more places in the body. Endometrial cells normally line the uterus (womb), they bleed monthly and are shed
in the menstrual period. The abnormally sited endometriosis cells also bleed but as they are not in the womb they are not
shed and cause pain. You should see a GYN specialist
DEREK ENLANDER MD
Dear Doctor,
I
am a 32 year old ex-competive, now very serious recreational cyclist that has been diagnosed with Fibromyalgia. I was diagnosed
about 2 mos. ago after suffering for 5 mos. My pain started mostly as shortness of breath and chest pain, along with general
exhaustion/fatigue. I have also been having alot of trouble with concentration and short term memory.
For 2 mos. now I have been taking 50mg of Luvox with 100mg of serzone daily. This has greatly improved my condition.
I also take 1200mg malic acid and 400mg magnesium daily. The malic acid made a good improvement in pain tolerance.
Mainly I am concerned that being a male, highly trained athelete who was in great physical
shape before the onset of this disease, is skewing the severeness of the symptoms of fibromyalgia.
I currently ride 75 to 100 miles a week at 17.5 mph. This is down from 75 to 175 miles per week at a 21 mph pace. I
continue to ride on all but the most painfull and most tired feeling days. Do you think that it is possible that my symptoms
could increase with a decrease in my training? I am also curious as to how many other cases of fibro you have experienced
in young male athelets. Most of the research that I have accessed shows that males only make up 15 to 20% of fibro patients.
And that most of those are people with high weights and seditary lifestyles. I cannot seem to find a doctor who has both knowledge
of sports medicine and Fibromyalgia.
I live in Denver, CO. Any referrals
and or insights would be helpful.
Sincerely, John H.
Most patients with fibromyalgia would not be able to cycle 100 miles a week at 20 miles an hour. The first question
that must be answered is Do you indeed have FMS? You have to have an experienced physician examine you and ascertain the diagnosis.
FMS is aggravated by severe exercise, a slowly progressive exercise regime is recommended
DEREK ENLANDER MD
I was diagnosed with fm over 4 years ago and I'm
now 37. It seems to come and go and I've been able to control it with various herbal remadies and exercise. I've had 2 kids
since being diagnosed and it seems to go away while I'm pregnant and then come back afterwards. My youngest is 9 months old
and lately I've begun feeling that old feeling like I haven't slept in months. In reality, I get at least 8 hours of sleep
a night and I don't recall waking up in the middle of the night but when I wake up in the morning I feel like I've pulled
an all nighter.
I read an ad in the July issue of Prevention about Enada which they had
found helped cfs patients. Is this safe to take while nursing? Is there anything else I can take while nursing? I'd really
like to nurse him until he's a year but I don't know if I can function for another 3 months like this.
Thanks. Meryl
My reaction is that certain drugs pass in mothers milk, as do good things. I would advise not to take medication unless
necessary while breast feeding.
But there again I am very conservative
DEREK ENLANDER MD
Dear Dr. Enlander,
I was dxed with FMS nearly 5 years ago. I have tried the traditional treatments, i.e. Anti- depressants, muscle relaxers,
etc. The anti-depressants I've tried (Prozac, Elavil, Paxil, Effexor, Zoloft, Trazadone, and some others I can't remember
the names of) all seem to cause the reverse effects than they are supposed to. They cause anxiety and insomnia and sometimes
heart palpitations. Therefore, for me, I don't believe in the "standard FMS cocktail". I do see a pain management specialist
who prescribes muscle relaxers and narcotics, and bingo, I can function fairly well. Without pain meds, I am bed ridden.
Anyway, recently I have been displaying many neurological symptoms that are common to both
FMS and MS, the only exception being Optic Neuritis. I had my first attack of ON in September on 1997 and was hospitalized
in November for IV Solumedrol treatment. The ON was mild, but very painful. My CSF showed Oligocolonal bands. I have also
had evoked potentials done and my VER was abnormal in my left eye (the one affected by ON) and borderline in my right. I also
have a neurogenic bladder, numbness and weakness on my left side (everything seems to be left sided, however, once in
a while my right side acts up too). My muscles are constantly spasmed throughout my shoulders and back and also have a lumbo/sacral
radiculopathy. I also have L'hemette"s (sp) syndrome, when I bend my neck I feel a tingling or shock down my spine and through
my shoulders. Also, I have myoclonic jerks throughout my body and intentional tremor in my left arm. My MRIs do not show any
lesions.
One neurologist has dxed me as probable MS and said that it is
not unusual for lesions to be absent in the early stages of MS and that some people with MS never develop lesions at all.
I have had subsequent attacks of ON and all of the other symptoms I've mentioned seem to flare up when the ON does. The last
flare up I had was so bad, I needed a cane to help me walk. It took almost four months to subside. Although the symptoms have
subsided, I still experience chronic pain and spacicity which never seems to subside.
I have talked to many people who were dxed with FMS and later found to have MS. Could it be that in some cases that
FMS is MS in its infancy? Can a person have both FMS and MS? It seems every year my condition deteriorates a little more.
I have had to go on short-term disability for 2-3 months at a time for the last 3 years, and this thing whether it is FMS,
MS or both is controlling my life. I have tried the exercise, but with the fatigue it's very difficult and often causes me
to feel worse. I take Amantadine for the fatigue and it helps somewhat. With all of the studies that are being conducted on
FMS and MS, is any headway being made as to the etiology? And if they are somehow linked together with some triggering factor
for MS? I'm sorry this has been such a long e-mail. Just would like some education.
Thank you for your time. S. M.
Yes it is possible to have MS and FMS concurrently, however making the diagnosis of FMS in the face of MS is difficult,
one of the eliminating diseases in FMS workup is MS.
Let me immediately say that the normal progression of FMS is not towards MS. Nor is FMS an early manifestation of MS.
Plaques are diagnostic in MS and are not seen in FMS, however not all cases of MS have obvious CNS plaques.
Research has not as yet yielded a definative etiology (cause) of FMS we are working on it. Immunoglobulin treatment
is a research tool that researchers in Israel have used in MS. In FMS I use a modified kutapressin complex injection
DEREK ENLANDER MD
I have started a couple days ago the Neurontin
at 300 mg 3x day. This is what was perscribed, but the dr. does not seem familiar with this usage in pain,,, Does the level
need to go up?
yes the maximum dose is 1800-2400 mg per day
DEREK ENLANDER MD
I was diagnosed almost three years ago. I am sure
I have had it since early twenties. I am now 59. I have extreme low energy levels. Sometimes I am very energetic, but for
short durations. I always thought of myself as being a very lazy person, and feel very bad when I just want to go home from
a party because of tiredness. I have always been this way. I experienced severe pain for about a year prior to going to the
doctor. I started taking potassium Micro K and the pain soon went away. But, now the doctor said my ectelytes are too high
and not to take it. I am also suffering from extreme depression due to job stress. I am very fearful of the pain returning.
I had suffered earlier in my life with the pain but was told it was arthritis. After I quit my job to stay home and raise
my family the pain went away. I blamed it on everything from the exterminator at the business where I worked to just being
lazy or being over worked.
I guess my main question is what can I do now about the energy level?
I am not an exercise person because even though I have walked, done some swimming, etc. I do not experience that burst of
energy eveyone says will come. I stick to the exercise religiously, not overdoing it, but I do not feel my energy level increase.
Thanks for any help you can give me. Pat
Yes I agree, a careful exercise program is helpful, BUT OVER-exercise is harmful and will cause a set back
DEREK ENLANDER MD
Dear Dr. Enlander,
I believe that I have had Fibromyalgia since at least 1976 but I gave up going to Drs. because they all thought I was
a Neurotic housewife. When the pain became unbearable I tried a neurologist who said that I had a herneated disc at C5&6.
He did a fusion there and the pain only got worse . I do have degenerative disc disease and I am 51 years old.
I was diagnosed with MS for five years even though they never found a plague on my MRIs.
I finally E-mailed you with all the symptoms I had and ask you if you thought it might be FMS. I want to thank you for telling
me that I should see a rheumatologist and for your advice because, for the first time in years I am actually able to get more
than four hours of sleep at night and I don't even use my cane anymore(unless I have a bad attack). I think this is pretty
good for someone who was told they would be in a wheel chair permanently instead of just occasionally.
I am now taking Duract and Zanaflex which, along with the other drugs I was taking ,have made my life bearable again.
I tried Neurontin for years and It was like taking candy, same effect. So few people realize how debilitating this Syndrome
can be since, like allot of MS patients ,we really don't look sick. Thank you again for your advice and God Bless you for
the help you give to thousands of people like me every day.
Edith
Thank you for the kind remarks, do not write off Neurontin so quickly I now use it in high dose up to 3000 mg / day
to good effect.
DEREK
ENLANDER MD
Dr. Enlander,
I
was looking for onformation of rate of remission of FMS/MPS. My phycologist told me that I will go into remission (FMS), I
can track symptoms back to my childhood problems when my mom dragged me form doctor to doctor to no avail. I have become disabled
for about the last 4 years. I have tried most of the typical tricyclic meds and have had either no reaction or bad stomach
GI problems. I have been searching the web for answers and have found several theories and feel confused. I wanted my Physician
to review what I have found, I sent him a letter asking for his interest, and then called my phychologist because I get scared
that sometime when I am in a bad flare I might decide that I have had enough I get close sometimes. I can't do that, my children
love me so much they are spectacular young people, and I have two infant grandchildren. But sometimes it gets to a point where
nothing matters. Anyway, my phychologist did call me I made an appointment with her tomorrow, but I don't know if she can
help me if she thinks FMS will just go away.
I am familiar with Dr Laurence
Bradley's work from UAB, I have theories from Garth Nicolsons material from the environmental Medicine Newsletter on his research
on mycoplasmas and antibiotics in the cure of FMS This one sounds exciting because I would love to take antibiotic treatments
and get on with a real life. What do you know about Garth Nicolsons findings/research?
I have read about Dr Gunn in Vancouver BC and I have read Dr Starlanyls survival manual Fibrofog keeps me from understanding what they all are saying, I have also read about guaifenesin therapy but with all
the GI pain I have, it scares me. How I get through all of this and come to a conclusion on my own. How do I get the my doctors
to really open their eyes, they all say "yes, I know what FMS is" That statement alone makes me realize how little they know.
What do I say to them to get past the ego and have them particpate in getting me some relief. I appreciate your responding
to me so much, I really do want to get better.
BASICALLY YOU HAVE SUMMARIZED THE PROBLEM, THERE ARE NO SIMPLE ANSWERS, NO ALL EMBRACING TREATMENT, NO ALL EFFECTIVE
REMEDY.
I FIND THAT HIGH DOSE NEURONTIN IS EFFECTIVE IN PATIENTS THAT CAN TOLERATE IT. GUAFENISEN IS HELPFUL TO PATIENT, WHO
ARE NOT TAKING ASPIRIN, KUTAPRESSIN COMPLEX SEEMS TO HELP WITH THE IMMUNE SIDE OF THE DISEASE.
DEREK
ENLANDER MD
Dr. Enlander,
My
wife has recently experienced server yeast infections and her doctor was wondering if her fibromyalgia condition could be
cause of this condition. He asked that we try to find out by contacting someone on the support website. If you have any answers
or know where we can get some answers, please respond.
Candida or other yeast infections do not cause FMS or a related condition CFIDS, however there are a number of physicians
, Dr Crook in particular, who think otherwise. My understanding is that the immune system is comprimised and yeast infections
so florish.
DEREK
ENLANDER MD
Dear Doctor,
Recently
I was dx with fibro by a rheumetologist (sp) At the University of Minnesota, After much begging on my part for a referral,
my primary care provider FINALLY referred me to the U of M (my primary care provider is a general practitioner). The doctor’s
at the University told me I had Fibromyalgia brought on by or exacebated an auto accident I was involved in 15 months ago,
and I could be treated by my GP because the ‘U" is some distance from my home.
Today I meet with my GP and told him that the rheumy at the "U" told me I had fibro. My doctor admitted to me that he
is NOT a big "fan" of Fibromyalgia & believes that it is just the ‘newest fad" in medicine; "Much too over diagnosed"
He told me that I should not worry to much about this dx and just get on with my life as normal. I had brought in a few books
to show him (Including yours :)) that I had purchased on fibro and he said to take the information in these books "with a
grain of salt". I asked him about support groups and he didn’t think they were a good idea either because as he put
it; "People in support groups tend to exaggerate their condition and dwell on their pain and not on getting better." I asked
him about message therapy and he told me he thought that was OK but; "Don’t ask me for a referral because insurance
will not pay". He told me the same thing when I ask about aqua aerobics. I am currently going through a flare and am having
a hard time working. When I told him this he said to keep trying to go to work. He would not write a doctors note for any
additional time off. I left his office feeling like I usually do after a visit...like a hypocondriaic (sp) even after the
doc's at the "U' told me differantly!! Most of the time I feel like he thinks I am faking this hole thing for monitory gain.....which
I most certainly am not!!! I just want it all to GO AWAY. I have suffered a great deal because of this. I wont get into the
gorry details, but it has been hell!! I also went into depression and am taking anti-depressants for it. (by-the- way: my
physcologist has been great and very understanding)
We have been using
this clinic and this particular doctor for over eight years. I hate to think of changing doctors at this point besides I don’t
know of any doctors in the area that treat patience’s with fibro. Any suggestions??
YES CHANGE DOCTORS
If a doctor cannot communicate with patients then there can not be proper diagnosis and treatment.
Tell him/her this maybe you will bring about a change
DEREK
ENLANDER MD
Dr. Enlander,
Just
this afternoon I discovered your Q and A column on the Net while I should have been working. I have been reading everything
I can find lately on this fibromyalgia thing. I have slowly come to the conclusion over the last several years that this must
be what I have. No doctor has yet diagnosed me but at least my GP is listening to me.
The onset doesn't sound atypical. I was a high level athelete in University and used to be active and training hard
6 days a week for many years. I am currently 34 yrs old and noticed some of these things starting to happen maybe around '92
or so. I started to get tendonitis injuries that healed slowly and then not at all. These continue to cause me problems in
both shoulders, both forearms and wrists, left hamstring and both calf groups. Is this common? I recall that my sleep started
to be of poorer quality and less reliable back then. General fatigue and lack of energy accompanied this a lot of the time.
It has all continued to just slowly get worse and worse.
My main question
has to do with my stomach. In May '96 while early in a 9 month stay in Bolivia, South America, my stomach flared up with severe
pain that continued to burn constantly. I was treated with Omeprazole and Ranitidine and it mainly resolved in about 4 or
5 months. It flared back up with no provocation in March '97 and has continued unabated since then despite daily Pantoprazole
or Losec and lots of PeptoBismol. Does this sound likely to be associated with the FMS?
Even as I write it is very painful and is not relieved except briefly by eating ( has caused some weight gain). H. Pylori
was negative as was an upper endoscopy and stomach X-rays etc.. Any ideas about what to request from or tell my doctor? Any
ideas for me to try for this? It is not generally like the reflux that I have read several people describing. It is a
constant pain, feeling of distension of the stomach, hard and tense to palpation, burning with little trickles of icy hot
pain very occasionally. That is the best that I can describe it to you.
Thanks
for any help at all.
Regards, Kerry, Toronto, Canada
You must seek a consult from a Gastro-intestinal specialist first, he should consider gastroscoping you to determine
the condition of your stomach. Then you should have your FMS diagnosed and treated.
DEREK
ENLANDER MD
Dr. Enlander,
My
daughter has severe fms. Currently she is experiencing burning pain in her arms and legs along with the general aching pain.
The early symptoms of her fms were this terrible burning. It did respond to neurontin and for a couple of years all she had
was the aching (pretty bad most of the time). The burning redevloped last week and she is back on the neurontin but it is
making her so terribly tired that she can not stay awake for more than a short time. She keeps falling asleep wherever she
is. Can you suggest a different but equally effective drug--one without the drowsiness side effect?
I use neurontin in combination with Kutapressin complex and guafenesin, Have your physician prescribe these.
DEREK
ENLANDER MD
Dr. Enlander,
I
have been taking Darvocet for pain and Elavil 25mg.per night for sleep for a 3 and a half yrs. now due to fibromyalgia. Sometimes
1 to 2 darvocet a day. My question is can these meds be harmful to my body over this period of time? I don't want to end up
with liver problems. Also I get frequent UTI's, sometimes it actually is one and sometimes it just feels that way. ( about
once a month) Would this be connected to fibromyalgia or something else? Thank you for your time.
Lori
All medicine from the most simple to the most complex have side effects, even simple aspirin. My approach is to revolve
pain medicine so that the patient does not become habituated, and the side effects are minimised .
UTI are common infections and are not part of the FMS syndrome, however some believe it may be related to a general
immune dysfunction.
DEREK
ENLANDER MD
Dear Dr. Enlander:
I am 51 years old, female, wife, and mother of three daughters. I have had fibromyalgia for about 10 years, but was
diagnosed five years ago. My problem right now is loss of memory...both short and long term. I am constantly aching, and except
for bouts of relapse, I am not in severe pain. I fell down my stairs recently and bumped my head several times going down.
Now, I can't seem to remember things...even things I knew an hour ago. Should I see a neurologist? I have a rheumatologist
already and I use clonepin at night along with tylenol or advil for pain. Is it possible that constant soreness and irritation
can cause a FMS sufferer to lose memory?
The memory loss combined with loss of concentration are common symptoms, however it is imperative that you see a specialist
to rule out any other brain disease. The "constant soreness " does not cause memory loss. Glutathione treatment seems to help
memory loss.
DEREK
ENLANDER MD
Dear Dr. Enlander,
I've had fibromyalgia a little over 3 yrs. now. For about a week or two now I have developed these sore little blisters
on my face, chest and shoulders.I was wondering if these could be due to the fibromyalgia? Also have quit smoking for about
2 mo. now and have been chewing a lot of sugarless gum, can the sugar substitute in gum be harmful in any way? ,as i am chewing
an awful lot of it a day.
Thank you, Lori D.
The blisters are not typical findings in FMS.
Are the blisters related to the sugarless gum; simply stop chewing
the gum and see if the blisters dissapear.
Derek
Enlander MD
Dr. Enlander,
I was injured at work about 8
months ago. My cervical neck Xrays showed marked cervical disc disease and osteocyte formation. I have seen a neurosurgeon
who has diagnosed me with cervical nerve radiculopathy at several levels (C4-5 5-6 6-7) as well I have small herniated disc
with an annular tear at C6-7. (Dx from MRI and CT of neck) I started having symptoms of fibromyalgia about two to three months
post injury, these included dizziness, intolerance to cold, sleep problems memory loss, fatigue, TMJ problems visual disturbances
etc. As well I developed Rt. tennis elbow in about 5 months ago which has been not reponsive to IFC or ultrasound physiotherapy.
I also suffer from Rt lower back pain and sciatica. I am on a regular exercise program. I have had a caloric balance test
which is abnormal on the left side. The ENT specialist says this could account for some of my problems with balance, dizziness
etc.
I guess my main concern is that I appear to have problems that stem from my degenerative
neck problems as well as fibro. Even though my neck xrays were abnormal, I did not have symptoms of fibro or cervical radiculopathy
before the accident. I damaged my scalene, sternocleodal mastoid and trapezus muscle in the accident and suffer alot of pain
from trigger points in these muscles. As well I have numbness and tingling in my right arm and hand, problems grasping and
I drop things, intermittant skin hypersensitivity of my Rt forearm ( like a 2nd degree burn feeling.) and my right hand becomes
cold if I use it for any tasks beyond 15 minutes. I have never had an EMG of my Rt arm. The Occupational health MD asked me
how could the Rheumatologist diagnosis me with fibro when it is " a disease of exclusion when there is no other explanantion
for the medical problems".
In your experience how soon after traumatic
injury can signs of fibro start to occur? and how does one differentiate between fibro and injury related problems?
Many thanks LJ
Yes FMS has been associated with a traumatic onset in some cases. There is no definative time interval between trauma
and FMS
DEREK
ENLANDER MD
Dr. Enlander,
please
comment on the relationship between osteoarthritis and FMS. Is it caused, exacerbated by,related to or connected in any way?
Can joint pain be caused partially or exclusively by FMS. ? Thank you very much!
Arthritis, pain in joints is common in FMS. Deterioration of cartilege seen in osteo-arthritis is not common. This is
usually a sequelae of injury or old-age.
DEREK ENLANDER MD
Dr. Enlander,
I
was reading the articles people have sent you and found a similar situation with me. I too have pain at the bottom of my ribs
and to the right. I was headed to the doctor about it but maybe it's just an unindentified trigger point. My bones in my chest
always hurt but this is more of sharp pain off and on.. Also, I lost almost all the muscle power in both forearms (the last
3 weeks) and is gradually getting better. Does this fit the classic case (The muscle loss that is) Also are bone spurs related
to ms? I also have several bone spurs in my body. Thanks for your help.!!!!!!!!!!
First of all , ALL CHEST PAIN must be treated as a danger sign until otherwise diagnosed as trivial. More people have
had heart attacks because they disregarded chest pain or chest discomforture.
There is a possibility that this is a sternal (breastbone) inflamation but a doctor must determine this. Bone spurs
are not part of FMS, but can aggrevate the condition.
DEREK
ENLANDER MD
Dear Dr. Enlander,
I have been diagnosed as having FMS by the 18 point sensitive/trigger point test as well as other tests.
I have been
referred to a specialist by my Primary Care Physician [I am on a medicare replacement HMO]. This specialist wants to inject
the 18 sensitive/trigger points with Sarapin. He is vague about how new is this treatment, the percentages on success, risk,
how long it lasts, and all this.
I have searched the Internet extensively on FMS and searched the Rx formularies for Sarapin
to no avail.
I would sincerely appreciate all you can tell me in reference to this Sarapin injection treatment, or where
I can find the information, as I cannot find anything anywhere.
Sincerely, Pat
Serapin is a drug derived from the Pitcher plant. It is injected into the nerve roots of patients suffering from sciatica
or neuritis. It blocks pain in the nerve. It is not commonly used in FMS due to the multiple sites of pain and tenderness.
The injection dose is 2-10ml. It is claimed to be non-toxic when injected correctly.
The company that makes it is the High
Chemical Co (800 ) 447 8792
Derek
Enlander MD
Dear Dr. Enlander,
I need some advice about exercise. I've had active FM symptoms since shortly after my last child was born 16 years ago.
I have always been fairly active, walk 4-5 times per week, etc., but have had little luck with alleviating my quite significant
stiffness through stretching. The problem is, no matter how gently I stretch, I always seem worse off than when I started.
I've read that it can take FM patients significantly longer to realize the benefits of stretching and other exercise, but
I'm also afraid to push the limits. About 7 years ago I was doing some strength training with light weights, overdid it, and
my arm stiffened so much that I was unable to raise my arm above my head for about 2 years. I know that stretching is essential,
but I'm not sure to tell what is overdoing it or not for me.
Debra, San
Diego, CA
One of the problems with a chronic disease is that we, patients and doctors, become impatient and want immediate rapid
results. Unfortunately this does not happen in FMS. It is a slow recovery. Graded exercise is key. Excessive exercise will
produce setbacks. What is excessive? this is the problem, you should work closely with your doctor to determine a workout
routine. The rule-of-thumb ; if tired stop immediately.
DEREK
ENLANDER MD
Dear Doctor Landers,
I was diagnosed with Fibromyalgia about five years ago, after many doctors and many test. After this I was told that
I have a positive anti-nuclear-antibodies at 1:640 titer and pattern #2, every thing else was negative. My doctors tell me
that I don't have enough positive test to be diagnosed with lupus. But I kinda think I have something more than Fibromyalgia,
what do you think? I sure hope and pray that its only Fibro!!!!!!!
It sounds like you think I am related to Ann Landers!
The ANA test is positive in Lupus and other connective tissue
diseases, IMMEDIATELY see a doctor to rule out this or another connective tissue diagnosis.
Derek
Enlander MD
DEAR DR. ENLANDER,
I do not know if you remember me, but you advised me to seek someone who works with Fibro. The next day I found out
about a pain clinic run by a Neurologist. He put me on Ultram - which has been wonderful for my painful joints. Clonzopam,somar
- for the awful muscle jerks I was having.
I take Levothroid for hypothyroid;
Lodine for the swelling; prilosac for acid reflux
I stay nausseated alot, so I mostly take dramimine for that or fenegren,(excuse
my spelling!)
I have begun to have Migrane's & I use Stadol Nasal Spray
I use darvacets only as last resort for
pain
I take b-12 shots as needed & he gives me cortisone shots in my shoulders, neck, & lower back, weekly.
It helps most of the time, & I have seen an improvement. I know nothing about these
shots & I was hoping you could help me understand the shots & tell me if there are any side affects. All of these
meds. are not meds. i have been put on by the other many Drs. The Ultram has really been a life changer for me.
My name is Pam ... 35 white female. Had a kidney stone attack that almost killed me, I
stayed in the hospital for 2 weeks, this is believed to have started my problem.This happened in 10/93. My joint problem happened
in 11/96 - overnite
I have a great job, good family relations, & feel
very optimistic about life. I am able to work 3 days a week. I work with my husband & he covers for me when I need a nap
or can not carry on.
Thank you for time, You seem to be the Dr. that I
have wished for.
Pam North Carolina
A..Thank you for your kind words. I am glad that you have improved, however I have a problem with long term use of steroids.
Occasional use for acute attacks may be acceptable, but continuous use will produce atophy of the adrenal glands.
DEREK
ENLANDER MD
DEAR DR. ENLANDER,
Would the herbal remedies for Chronic Fatigue syndrome (and/or immunodeficiency conditions (non-infectious) help FMS?
I throught I had CFS for years and Super-lysine among other herbal and vitamin/mineral supplements helped me tremendously,
along with Elavil for acute flare-ups. Or is the herbal route just placebo effect? What about getting off sugar (which I find
impossible), is it necessary? Thanks.
Lysine is an amino acid.
I am a firm believer in amino acid treatment of FMS and CFIDS. After all I am a great proponent
of the modified Kutapressin protocol, Kutapressin is an amino-acid complex.
So I am in favor of lysine, glutathione and other amino acids. How do they work? Research suggests that they work through
the immune system perhaps as an adjuvant.
DEREK
ENLANDER MD
DEAR DR. ENLANDER,
Through all the information I have at hand , I understand that fibromyalgia does not get progressively worse. I fell
that I have gotten worse since a diagnosis five years ago.
What is the answer? I also have arthritis, bursitis, and some
tendonitis and sometimes have a difficult time separating my symptoms. Thank you!
NO I cannot agree with this statement. Under treatment FMS patients can improve
Derek
Enlander MD
DEAR DR. ENLANDER,
I was diagnosed with FMS at age 17 (I am now 21). The pain that is the worst overall is located in my heals. I have
had this terrible pain since age 17, when I was actively involved with karate. I take 20mg of Elavil qhs, and my sleep is
much improved, but this awful pain will not subside. I can deal with the pain and burning in the rest of my body, but since
I am a pharmacy tech I am on my feet for 8 hours a day, and I can barely walk to my car after work. Any suggestions? Is this
directly related to the FMS or could this be something else (hopefully something treatable)?
Sincerely, Char
This may or may not be related to your underlying FMS, you must ask a doctor to exmine your heels to rule out a unrelated
fascitis or other foot problem.
DEAR DR. ENLANDER,
I am having surgery, need info re: general anethesia and fibromyalgia. I remember reading several articles years ago
saying that there could be complications. I would like to remain awake and just have a spinal, but the surgeon says that I
will have to fight the anethesialogist for this. I would like some support info.
A..I recommend, where possible, that patients have a spinal anesthetic or local anesthetic. Yor doctor should do this
on your behalf.
Dear Dr. Enlander
I was diagnosed with fibromalgia about 10 years ago. For the past two years I have been in constant pain and in general
feeling unwell. This January during a trip to Ireland I had a blood test done with NuTron Laboratories for weight loss. I
was given a list of foods and additives that I am supposed to be alergic to. No. one on my list was Tannin, Whey , Yeast and
a few foods. I went on the diet ( not really a diet) as I can eat lots of things. The first week was rough, and I had pain
and headache most of the time. But since then I have been totally pain free and dropped 10lbs. I feel so good and have lots
more energy. I am wondering if this could work for other people also.
sincerely Mary
A..Having been born in Ireland, I am very proud and happy that they helped you so much
Q..My name is Linda. I am 50
years old and was diagnosed with fibro about 10 years ago. I am on Trazadone
150mg, Imovane7.5mg x 2, Flexeril 1/2 tab and Celexa. I take the Tazadone and
Celexa at about 2130 hrs, and the Imovane and Flexeril at 2300 hrs. It seems
to take forever to fall asleep and in the morning I am so tired. It is sometimes
early evening before I feel like I am awake. I sometimes feel like I am being
over medicated but when I omit either the Trazadone or the Flexeril I just don't
sleep. Do you have any suggestions? Also
I seem to be very weather sensitive. Last night we had a very intense thunderstorm
roll in and I was almost imobilized with pain. Could you please explain if you
are able, the relationship between weather and fibro? Thank you very much.
Dear Linda
I believe there is a relationship
between weather conditions and Fibromyalgia . Whether this is barometric pressur, humidity or temperature change I do not
know but I agree there is a relationship
Dr. Enlander will gladly answer your questions about Fibromyalgia and CFS
