>>60233088>>60242258>>60244662>>60235316>>60258859not op, but fibromyalgia is the bane of every physicians existence. Here's why:
1) They sometimes mimic actually fatal/treatable diseases (like maybe have 1 or 2 symptoms that kind of similar) and so expensive tests are ordered just to rule it out. In fact, fibromyalgia is a disease of exclusion. In other words, it's only diagnosed after every single other diagnosis is ruled out...
2) Once it is diagnosed, it is incredibly hard to treat. Why? Because it is more of a neurologic/psychologic disease it is incredibly hard to treat for something that is a minor when compared to other neurologic/psychologic diseases. This makes it incredibly annoying to treat. Patients are generally able to live mostly functional lives, which is usually the goal for treatment of neurologic/psychologic diseases (because it is near impossible to have 100% reduction of symptoms). So when we ask if it's working, they'll say they are mostly functional but that they are still in a lot of pain. For those that are functional, there is very little else that will actually help with the pain without decreasing their functionality. Sure, those that can't handle the level of pain they are in and experiencing a significant decrease in functionality will need more adjustments to their treatment, but even once functionality is achieved, they continue to complain that they are not pain free. Here's the unfortunate truth: THEY WILL NEVER BE PAIN FREE. Why? Because there is no cure for fibromyalgia. Obviously, we can't say that to their face, so we say instead that the goal is not to be pain free but to be functional. This never seems to get across most of the time, but to be fair I get it. I'd probably bitch about being in pain too if I was constantly in pain.
Treatments range from meditation/cognitive behavioral therapy to anti-depressants and gabapentin (off label usage). The mistake that inexperienced/bad doctors make is to prescribe opioids, which are incredibly effective but also addictive and debilitating. The problem is opioids work incredibly well for pain, especially their pain. They will be pain free for a couple hours, then will need to take it again. But eventually they will develop tolerance and the then start taking higher and higher doses. This is all because they obsess over being PAIN FREE. Here's the thing, in people that are actually in 10/10 pain (like would rather die than be in pain) all opioids do is make the pain bearable. We are taught to use opioids only for making the pain bearable like a 5-6/10, NOT BEING PAIN FREE. That's why people with fibromyalgia, who obsess with being pain free, will abuse the fuck out of opioids. After they become addicted to opioids, it's very common for them to start searching for fentantyl on the streets. It was one of more common reasons why people came into the addiction detox unit I trained at.
3. The overall rate of mortality is about the same as the average population (yes, I know there is a 2023 study that analyzed 6 previous studies and it said some higher rates of risk in those that had fibromyalgia, however, they even admit that the study isn't enough to show cause and effect because they can't tell if the patients had other conditions besides fibromyalgia that could have also led to increased risks.)
It's such a common disease that they even include this in our standardized tests, this is so that we stop wasting time and resources trying diagnose some rare ass disease when it's actually just fibromyalgia. As much as I see fibromyalgia as a meme disease, I do believe it is real and think it sucks for people that have it. But that doesn't make the people any less annoying to deal with.
>>60260836The male:female ratio of people with fibromyalgia is 1:9, which is high AF for what is basically a brain disease when depression is 1:1.7 and parkinsons is 1.48:1. I honestly wonder if there is simply a problem with their perception of pain (which is weird because their bodies literally kill off part of themselves every month and give birth to children) so you would think they should have evolved to be more tolerant to pain.
