Fibromyalgia is a chronic syndrome characterized by muscle and joint pain, stiffness and fatigue. About 3.4% of US women experience the disease (as you can read in our full article – Fibromyalgia – Chronic pain and fatigue). One such woman is Julie Wendell, and she chose to share her story with us.

Have a story of your own to share? Feel free to contact us anytime

“Mommy, open this, please?”, my 3 year old son asked as he handed me a cereal bar early one morning. I tried to tear off the top of the wrapper, but my fingers would not move or grasp the wrapper! Terrified, I tried opening it again, but to no avail. I had lost all strength in both of my hands! As calmly as I could, I asked my 7 year old son to open the cereal bar for his brother. But inside, I was panicking because the weakness in my hands persisted for about an hour. What was happening to me??? Little did I know that the morning of February 10th, 2008 marked the beginning of a myriad of severely painful symptoms. My life was about to drastically change.

Over the course of the next few weeks, I started to experience alarming new symptoms. In addition to the weakness in my hands, I noticed that the joints in my hands were very swollen and stiff. I even took pictures of my hands from all angles to make sure that their odd shape was not just my imagination. I would often feel sharp zinging pains in my extremities, especially in my hands, wrists, knees, and ankles. My muscles and joints ached like I had the flu. There were times when I would be convinced I had a temperature of at least 101, just to find out it was completely normal every time I checked.

My level of fatigue went from “full time single working mother” to “full time single working mother who also ran 100 miles a day”. I was physically exhausted from dealing with so much pain every day. To make matters worse, I started noticing that when I woke up each morning, I would not feel refreshed, even after a full straight 6-8 hours of sleep. Instead, it felt like I only slept for one hour each night. So not only was I physically exhausted, I was emotionally drained as well. The overall level of exhaustion was indescribable, the worst I have ever experienced in my life! But I was hoping that whatever was plaguing me would just stop on its own.

One afternoon in April 2008, after I got off work and picked up my kids, I couldn’t get home fast enough. My body was overwhelmed with pain like I never felt before. As soon as we walked through the door, I immediately headed for the couch, where I spent the next four days. I had to call my mom to help me take care of the kids. In addition to my existing symptoms, I also suffered from oppressive chest pain, muscles/joints that felt bruised, extreme coldness in my arms and face, and TMJ-like jaw pain. I also had the sensation that my aching spine and pelvis were going to slide out of my body. I cried often, because I had no idea how to cope with these bizarre symptoms. I tried heating packs, ice packs, Tylenol/Advil, but nothing even remotely helped me. My temperature was still normal at 98.6. My mom, who is a nurse, thought maybe I had a virus, but most of the symptoms did not even resemble any virus I had ever had in the past, plus I was not running a fever. Even after the four worst days of feeling severely “sick”, most of my symptoms never fully disappeared.

At this point, I was at my wits’ end, so I finally decided to get some help. So even though I was terrified of the possible outcomes, I made an appointment to see my primary care physician. After reviewing my list of symptoms and seeing the pictures of my hands, he thought it was very likely that I had rheumatoid arthritis. He immediately referred me to a rheumatologist, who wanted to test me for not only rheumatoid arthritis, but also lupus, mononucleosis, and multiple sclerosis. He ordered some x-rays of my hands and a lot of blood work. He also prescribed a week’s worth of steroids to see if that would help.

My daily life started becoming a real chore for me. Everything and anything I usually did without a problem was now unbearable or overwhelming. The mornings and evenings were the worst times of day for my pain, fatigue, and weakness. I tried to stay strong, especially for my children, but there were days where I felt like giving up on everything. I tried talking to a few friends and family members about how I was feeling, but they would just say that I was complaining too much and/or accuse me of being a hypochondriac. I had never felt so alone in my life.

The results of the blood tests and x-rays came back the following week and were completely normal. Also, the steroids ended up not helping me at all. Based on these findings, the rheumatologist suggested that I may have fibromyalgia. He prescribed an NSAID called Mobic to help with my muscle/joint pain and an anti-convulsant/anti-neuropathy medication called gabapentin to help with my nerve pain. The doctor said that diagnosing fibromyalgia was very tricky because there are no actual diagnostic tools. Instead, the diagnosis is made after everything else has been ruled out. He also wanted to wait and see how the next few months went with the new medications before confirming the suspected diagnosis.

During the following months, both of the medications had made a difference to where my daily activities became more tolerable. I still felt very fatigued, but my quality of sleep seemed to be more restorative (due to the gabapentin). My muscle and joint pain were definitely persistent but they were on more manageable levels (due to the Mobic).

When I went back to the doctor in August 2008, he reviewed all of my test results and evaluated me again, then officially diagnosed me with fibromyalgia, a syndrome characterized by chronic pain, stiffness, and tenderness of muscles, tendons, and joints. The treatment for fibromyalgia includes pain medication and exercise. The doctor advised me to continue with the medications I was currently taking and to try doing light exercise when possible. He also warned me that my medication combination was not always going to be perfect. He said it may take a few tries with various medications before reaching optimal pain management, and what works for me now may not work for me in a few years. I was completely devastated, knowing that I was going to live with unrelenting complicated pain and severe fatigue for the rest of my life.

Sometimes, in addition to medication and exercise, doctors recommend a gluten free diet to help alleviate fibromyalgia symptoms. Coincidentally, I had already been on a gluten free diet for 4 years already, due to having an auto-immune digestive disorder called Celiac Disease. Unfortunately, being on this diet did not stop me from having fibromyalgia nor had it eased its symptoms. My doctor said that I’m one of the unlucky fibromyalgia patients who was not positively affected by a gluten free diet. Sometimes I like to think that being gluten free has stopped my fibromyalgia symptoms from becoming uncontrollable.

A diagnosis of fibromyalgia carries a negative stigma in society because the symptoms are very vague and are not so clear-cut as other diseases/conditions. I have actually heard people say that there is no such thing as fibromyalgia, or that the symptoms are fake and they are all in the person’s head. It is also widely believed that people who have fibromyalgia just want attention and/or medication. There are many doctors do not recognize fibromyalgia as an actual medical condition. Therefore, people who do have fibromyalgia usually have to see numerous doctors before receiving a diagnosis. Luckily for me, reaching a diagnosis for my symptoms only took 6 months and involved seeing only 2 doctors. Some people suffer for years before finding an answer.

Since my diagnosis, additional symptoms have added themselves onto the original list, such as hypersensitivity to stimuli. For example, if there is too much light or sound, I start feeling very overwhelmed and need to remove myself from the situation. There are times where I cannot be touched, when even my clothes feel like too much overload on my skin and receiving a hug actually HURTS. I also started becoming sensitive to the weather patterns, especially low pressure systems. I jokingly call myself the “human barometer” because I seem to predict rain better than the weatherman! During periods of damp or cold weather, my muscles and joints heavily protest, and in turn, the pain increases substantially. I found that I have a low tolerance for any kind of exercise, it makes me feel worse rather than making me feel energetic and refreshed. I have also developed difficulty with my short term memory and concentration (i.e.-”fibro-fog”), which has affected all aspects of my life, especially work.

Today, it remains difficult for me to deal with the pain and fatigue that I experience every day with fibromyalgia. My doctor has changed my pain reliever from Mobic to tramadol, which is a bit stronger, so my pain is at a tolerable level most of the time. But I definitely have my share of bad days. On a positive note, I have learned a few things from my experience with fibromyalgia. I’ve learned not push myself to do more than I can handle, but I’m still learning that it’s okay to ask for help. I have also learned to prioritize what is actually important and to just take things one day at a time. Having fibromyalgia has made me realize it is so important not to take anything for granted. After my diagnosis, my rheumatologist had pointed out to me that fibromyalgia is not a deadly or destructive disease, which is very fortunate. However, living with chronic pain and fatigue is still a difficult challenge, no matter what the cause or prognosis. Yes, fibromyalgia is REAL.

Related posts:

1. Fibromyalgia – Chronic Pain and Fatigue
2. Tension Headache – The Toll We Pay for a Stressful Living

This is part of our House MD Project series.

Click here to read the connection to the episode (spoiler alert!)

On episode 8 of season 2, named “The Mistake”, a woman named Kayla suffers from a severe stomach pain while watching her daughters perform a school show. Later it’s found she also has uveitis (inflammation in the eye) and genital ulcers. A diagnosis is made of Behçet’s disease (the rest of the episode deals with the legal implications of a mistake Chase has made in her treatment).

Danger level: High

What is it?

Behçet’s disease is a rare disease in which inflammation of blood vessels leads to a group of symptoms, which can eventually also lead to death.

Who gets it?

As mentioned above, Behçet’s disease is quite rare. In North America and Europe it happens to about 1 out of 15,000 to 500,000 people. In other parts of the world it’s less rare. Turkey, for example, is where it’s most common – it happens to 420 people out of every 100,000. It’s also more common in Japan, Korea, China, Iran, and Saudi Arabia.

It’s more common in people of Middle Eastern and Japanese origin.

The disease tends to occur in people aged 20-40 years.

What causes it?

Behçet’s is caused by an inflammation in our blood vessels throughout the body. No one knows the exact cause, but it’s believed that the body attacks its own blood vessels. Our immune system, responsible for fighting infections, fights instead the cells of the blood vessels. This also happens in other types of diseases, making them belong to a group of diseases called autoimmune diseases (we covered some of them in the past here, including Hashimoto’s thyroiditis, Graves disease, vitiligo, and others).

Blood vessels. In Behçet’s disease, the body attacks them. Photo by Freya Mowat

How does it feel?

The most common thing in Behçet’s are mouth sores. They are painful and recurring. They can appear on the tongue, on the gums, or on the mouth’s lining.

The sores may also appear on the genital organs – the penis, scrotum, or vulva, where they tend to be painful. They may also appear in the vagina, where they are painless.

Since blood vessels throughout the body are damaged in the disease, a multitude of organs are affected. The eyes, for example, in which there is inflammation causing eye pain, redness, sensitivity to light and hazy vision. The skin can be involved as well, showing blisters or a very rapid reaction to a slight injury. The joints can become painful. Blood clots can form throughout the body, and may lead to a stroke. kidney or lung damage.

Even the digestive tract isn’t spared, possibly causing stomach cramps and diarrhea. One last organ that can be affected is the brain, causing headaches, confusion, and other things such as memory loss.

Athlete Sanya Richards describes her own experience with Behçet’s in this video:

How is it discovered?

There aren’t any lab tests that can confirm you have Behçet’s. The doctor determines a person has the disease based on their symptoms and their physical examination, and after ruling out other diseases.

How is it treated?

There is no cure for Behçet’s disease. Drugs such as steroids (and other drugs that suppress our immune system) are used to help deal with the inflammation and the symptoms.

What happens after treatment?

The disease tends to come and go. It may also result in death, but for many patients the severity of the disease usually abates with time.

Since the cause of Behçet’s disease isn’t known yet, no measures are known that can prevent the disease.

Related posts:

1. Wegener’s Granulomatosis–A Rare Inflammation in Blood Vessels that Can Lead to Death (As Seen on House MD)
2. Peripheral Arterial Disease – A Narrowing of Blood Vessels that Will Shorten Your Life
3. Familial Mediterranean fever – Fever and Inflammation Inside The Body

May 12 was fibromyalgia awareness day. It’s never too late to cover the subject.

Danger level: Medium

What is it?

Fibromyalgia is a chronic syndrome characterized by muscle and joint pain (in Latin “fibro” means a fibrous tissue, and in Greek “myo” means muscle and “algia” means pain), stiffness and fatigue.

Who gets it?

In the US about 3.4% of women and 0.5% of men have fibromyalgia.

Fibromyalgia is about 9 times more common in women than in men. It usually starts between ages 30 and 55, but is more common after age 50. It’s more common as we age – it occurs in 7.4% of women between the ages 70 and 79.

The chances of developing fibromyalgia are increased eight fold in family members of people with fibromyalgia.

What causes it?

The cause is unknown. As you’ll see ahead, people with fibromyalgia experience pain in the muscles and soft-tissues, but there is nothing visible there to hint that  something is wrong.

It is believed that the pain experienced in the disease is perhaps caused by a change in the way we perceive pain, a phenomenon called “central sensitization”. (This phenomenon is possibly responsible for other conditions as well, such as irritable bowel syndrome, chronic fatigue syndrome, chronic headaches, and chronic jaw and facial pain).

How does it feel?

There are a few major symptoms in fibromyalgia:

1. Pain – It’s all over, chronic and persistent. People with fibromyalgia can sometimes also feel numbness or tingling in their arms and legs.Certain things can aggravate the muscle pain, such as anxiety or stress, poor sleep, exertion, or exposure to cold or dampness. Warmer weather and vacations improve the feeling.One of the most characteristic things in fibromyalgia are tender points or trigger points. These are sites on the body which, when touched, are more tender or painful than the same sites in someone who doesn’t have the disease. There are 18 such points in the body and they are similar between people with the disease.
   
   The tender points in fibromyalgia. 

   People may feel joint pain or feel like their joints are swollen (while in reality they are not).

   Other pain related symptoms here can include headaches or migraines, symptoms of irritable bowel syndrome, bladder pain and pain in the face or jaw.

2. Muscle stiffness – It’s typically present upon waking up and improves during the day. In some people it lasts all day.
3. Sleep disturbances – More than 90% of people with the disease feel fatigued and exhausted and wake up tired. They also tend to awaken frequently at night and have trouble falling back to sleep.
4. Depression and anxiety – Both are more common in people with fibromyalgia.
5. Difficulty thinking – Some people will experience difficulty thinking and loss of short-term memory.

There are even more symptoms, but these are the main ones. A more complete list appear in the picture below.

How is it discovered?

There are no specific lab tests which can discover fibromyalgia. The physical examination and the patient’s story are usually used to diagnose the disease.

Sometimes blood tests are also performed, in order to rule out other things which may resemble fibromyalgia.

How is it treated?

There is no cure for fibromyalgia. It’s usually treated with a combination of things:

1. Medications – The most useful drugs here are those which are usually used for depression and for seizures. They target chemicals in our brain and spinal cord which are important in processing pain.
2. Exercise – Regular exercise which causes your heart to pump faster (such as walking, swimming, biking) is helpful in reducing the pain.
3. Relaxation techniques – Such as hypnosis, biofeedback and others, may help.
4. Alternative methods – Such as massages and acupuncture may help in some people.

What happens after treatment?

Most people continue to have chronic pain and fatigue, but most people can continue with their lives.

The bottom line – How do I avoid it?

There is currently no known way to prevent fibromyalgia.

The video below tells about Holly Fraser, a young woman with fibromyalgia:

You can read the personal story of Julie Wendell, a fibromyalgia patient, here.

Related posts:

1. Living With Fibromyalgia [Personal Story]
2. Congenital Insensitivity to Pain – A Life Without Pain
3. Hashimoto’s Thyroiditis – Do You Suffer From Weight Gain, Fatigue or Hair Loss? This Might Just Be The Cause

Danger level: Medium

What is it?

Gout is an inflammation of the joints caused by high blood levels of uric acid.

Who gets it?

Gout occurs in about 2% of the population. It’s about twice as common in men than in women. In men it tends to occur in the ages 30-45, while in women it’s more common in the ages 55-70.

The are a few risk factors which can increase your risk of developing gout -

1. Obesity
2. High blood pressure
3. Injury or recent surgery
4. Fasting
5. Consuming excess amount of alcohol on a regular basis (especially beer, whiskey, gin, vodka, rum).
6. Overeating
7. Eating large amounts of meat and seafood
8. Taking medications which can cause uric acid in the blood to rise (especially diuretics)

What causes it?

Gout is caused by having too much uric acid (also called urate) in the blood. When the levels of uric acid in the blood are high, they can form hard crystals, which can then accumulate in the joints.

 

Uric acid crystals. These accumulate inside the joints, causing the disease. Photo by Bobjgalindo.

Our body tries to dispose of those crystals by sending white blood cells to “eat” them. These cells cause inflammation in the joint, which brings about the disease.

How does it feel?

Gout occurs as attacks of sudden very severe joint pain, sometimes with redness, swelling, and tenderness of the joint. The attack is usually worst in the first hours, and improves completely within days to weeks.

Gout usually occurs in a single joint in the body. Usually it’s the big toe, the ankle or the knee.

After a few years with these attacks, uric acid crystals accumulate in joints, bones and cartilage in the body. This causes masses known as tophi.

A person with gout. You can see tophi in his elbow. Photo by NickGorton.

How is it discovered?

To discover if the inflammation in the joint is caused by gout, the doctor uses a needle and a syringe to take a sample of the fluid in the joint. Then this sample is looked at under the microscope to see the uric acid crystals.

Another thing your doctor can do is test your blood for levels of uric acid, to see if it’s high.

How is it treated?

There is a treatment for the attack itself and a treatment which is taken between attacks to prevent further attacks from happening:

1. Treatment for the attacks – To stop an attack a few drugs can be used, such as steroids, non-steroidal anti-inflammatory drugs (examples of those include ibuprofen and indomethacin) and a drug called colchicine (we’ve already talked about colchicine before, as a treatment for Familial Mediterranean Fever).
2. Treatment between the attacks – There are drugs that can lower the amount of uric acid in the blood. Examples of those include allopurinol, and probenecid.

What happens after treatment?

Relief from an attack usually begins within 24 hours if the treatment is started early in the attack. Taking allopurinol and following the measures below under “how do I prevent it” can help achieve a normal, attacks-free, life.

The bottom line – How do I avoid it?

Because of the risk factors above, if you’re prone to gout, the following things can lower your chances of developing it -

1. Losing weight – Since obesity is a risk factor for gout. However, starvation or fad diets aren’t recommended.
2. Reducing the amount of red meat and seafood in your diet
3. Increasing the  amount of low-fat dairy products and complex carbohydrates in the diet.
4. Drinking less beer, gin, vodka etc. (Drinking wine moderately, on the other hand (one to two 5 ounce servings a day) is not connected with an increase in gout attacks).
5. Drinking less drinks which contain a high level of fructose corn syrup (such as some types of non-diet soda). These drinks increase the level of uric acid in the blood.

This video sums everything up –

There are a few blogs you can visit to read more about gout: The gout diet blog, Beating gout blog, the gout blog and gout symptoms and cures blog.

Related posts:

1. Cluster Headaches – Excruciating Attacks of Headaches
2. Fibromyalgia – Chronic Pain and Fatigue
3. Acute Pancreatitis – A Dangerous Condition Which Can Be Caused by Drinking Alcohol