Myths & Misconceptions about Fibromyalgia

A few weeks ago I wrote about the myths and misconceptions about UCTD, one of the diagnoses I have. Another diagnosis I have is fibromyalgia. This is because some of the pain I’ve experienced is not joint related, and the best explanation that could be given for it is fibro. While there are a ton of misconceptions about UCTD, I think there may be even more about fibro, particularly from the medical/healthcare community, which is unfortunate. So I wanted to see if I can help clear some common ones up.

  1. It isn’t a real illnessalso known as “it’s all in your head” or “you’re just depressed” or “you’re just tired.” In actuality it is a real diagnosis as designed by the American College of Rheumatology. Though it can be summed up as chronic, widespread pain, there are actual diagnostic criteria for it. Part of the reason people think it isn’t real is that the cause of Fibro is mostly unknown, though there have been some fascinating studies recently about possible markers found, and there are many theories (such as those by Dr. Gabor Mate) that suggest that it is at least partially trauma-related (think biopsychosocial approach – biological causes, psychological causes, sociological causes to illness). While there are many associations between fibromyalgia and depression (fibro can lead to depression, depression can also lead to pain/fibro), there is nothing to suggest that pain isn’t real or that it’s depression or general tiredness. (It also doesn’t lead to depression in everyone, nor does everyone that is depressed have fibro).
  2. It’s a catch-all diagnosis – on a related note, many people just assume that if a symptoms can’t be explained, then it has to be fibro. While I mentioned some of my own symptoms weren’t explained by UCTD, that doesn’t automatically mean they are from fibro. There are actual diagnostic criteria such as: (1) pain and symptoms over the past week, based on the total number of panful areas out of 19 parts of the body plus level of severity of fatigue, waking unrefreshed, and cognitive problems; (2) symptoms lasting at least three months at a similar level; and (3) no other health problem that would explain the pain and other symptoms. (American College of Rheumatology) More info. Interestingly, my previous rheumatologist told me that about 1/3 of people with SLE, RA, UCTD, etc. also have fibro.
  3. Tender points are needed for diagnosis – on the final related note, this is old news. While the diagnostic criteria does state that there are 19 areas checked, and doctors may look for tenderness, that has been removed from the diagnostic criteria (see the above more info for that too).
  4. It can’t be treated (or just take some medication and you’ll be fine)also known as “alternative treatments don’t work,” “you can’t do anything about it,” and “you shouldn’t exercise.” Apparently medication for fibro only works some of the time (I’ve read between 20-40%) so while it may be helpful it isn’t the best bet. I was put on Lyrica/pregablin for fibro symptoms, and I would say it helped some. You know what helped more? All of the alternative treatments and exercise I did – massage therapy, naturopathic medicine, chiropractic adjustments, physiotherapy. In fact I managed to get off of Lyrica because of exercise. I’m not the only one either. There are tons of reports of these things being helpful. And please note, I’m saying helpful, not a cure.

Hopefully this helps you feel better about your diagnosis, and/or this is something you can show friends and family who maybe have trouble understanding what you’re going through. And most importantly, keep making the most of it!

6 Ways I’m Managing a Weather-Caused Flare (+ 5 More Ways I Could)

Long title, I know. But nonetheless I thought I’d share some of my tips with you, plus a few other evidence-based ones I found online as I’m trying to get through this. I’m writing this exactly one week before it will be published so fingers crossed that it’s over by the time you’re reading it, but if not, then I’ll just have to accept it as it is. My flare is likely caused by a few things. First, I recently moved and moving is stressful (even a relatively easy move like I had) and stress can cause a flare. Second, I moved from a dry climate in the interior of British Columbia to the wet, lower mainland of BC. I always notice my symptoms, especially pain gets worse when it rains… but then I knowingly moved to a rainy climate (*face palm*). All jokes aside, my symptoms are increased pain, increased fatigue, really bad jaw pain, my left foot is super veiny and sore (my calf is fine though so unlikely anything super serious). How the heck can I manage all of this?

Even on a flare I’ve managed to explore my new neighborhood.
  1. Acceptance. Yes, I know some of you are rolling your eyes or saying that this is ridiculous or unlikely to work. But I find it does. I accept that my pain is here, while knowing that the intensity changes hour by hour, sometimes even minute by minute, and I know that when my flare is over I’ll go back to baseline. Acceptance is helpful. I’ve been doing body scans and other mindfulness activities to help with the acceptance, but honestly just acknowledging my experience without getting wrapped up in it is helpful. Check out this acceptance practice.
  2. Exercise, Movement and Stretching. If you read this blog regularly you know that I like to exercise. And I still pace myself by trying to stay consistent with what I do. I definitely increase my stretching during flares. Particularly I focus on the areas that seem to hurt or need it the most. For example, my jaw is the worst today as I write this, and I’ve made sure to do jaw stretches throughout the day. For more on jaw pain specifically, check out this podcast episode with Dr. Shirazi.
  3. Warm Baths. I LOVE my baths. I literally take a bath 4-5x a week in the winter months. And with the rain, I’m definitely needing them. They help relax my muscles, keep me warm, and are very relaxing. Trust me when I say I could never (and would never) live in an apartment without a bathtub. Knowing what is vital to your self-care is essential to dealing with a flare. Check out this podcast episode on it.
  4. Dressing Warmly and in Layers. Vancouver, if you’ve never been, is a city where everyone dresses in layers. It will likely rain at some point during the day, though you never know exactly when. It could also start off cool and warm up, or vice versa. So I’ve been making sure to put on 3 layers when I go out, and have a pair of mittens on me. I need to remember a hat and/or an umbrella, but I’m working on it!
  5. Hydration. I tend to drink a lot of water. Admittedly more when I’m working. Staying on top of my water intake is so important to managing my flares and really my health! I’m trying to drink 5 full glasses of water a day minimum. I basically keep a glass of water next to me all day and every time it’s empty, I refill it. Listen to my podcast conversation with Beau Berman about gut health and how important drinking water is to him.
  6. Omega-3’s and Vitamin D. I typically try to get these from the foods I eat. Lots of fish mostly (rich in both), as well as mushrooms, spinach, avocado and tofu and really a variety of others foods are rich in vitamin D. These are really important for reducing inflammation naturally and honestly are just really good for you! Also, Vitamin D is a way to combat with the “winter blues” (which I often get) and the more severe, Seasonal Affective Disorder.

So those are the 6 things that I am doing, but what are the 5 things that I’m not but probably should be?

  1. Acupuncture. This is actually an evidence-based and recommended treatment for chronic pain. I’ve had it in the past and I’m hoping to start back up with bi-monthly sessions next month. Listen to the podcast episode on recommended treatments for chronic pain for more info.
  2. Massage. I miss getting massages. It’s been nearly a year since I had one, and this is also a service I used to get bi-monthly. I’ll likely also start these back up soon as well. Clearly I need to. The benefits of massage can be heard in the podcast episode with Danielle Potvin.
  3. NSAIDs. I’m not a fan of these drugs to be honest. They can cause stomach problems when on them long term. I’ve drastically cut back on them and only take them to supplement the more natural medications I take (i.e., CBD). If you’re aware of the risks and find them helpful then this can be a helpful solution.
  4. Natural supplements. The only natural supplement I currently take is magnesium bis-glycinate which is a muscle relaxant (and I mainly use it when I’m menstruating). Other recommended supplements are fish oil, ginger (which I sometimes have in food and/or tea), turmeric (which I sometimes have in tea), and gingko. These are definitely worth checking out to use in addition to some of the other suggestions.
  5. Limit Stress. Oh I can’t wait until I’m passed the stress of the move and starting up new counselling practices. The truth is there is always some kind of stress in our lives and it really comes down to how we manage stress. I typically do a good job with mindfulness, meditation, yoga, and relaxation practices. So this might just be a reminder to do a bit more of that. And also, if you are able to avoid stress then that’s a good plan (I do not plan on moving again for quite some time!).
Taking it easy on Halloween. Needed some time to relax after the move.

So that’s it! 11 ways in total to manage a flare. Keep making the most of it everyone!

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The Body-Mind Connection

There is such a delicate balance between the body and mind and how they interact with each other. At the core, our mind… or more specifically our brain, controls everything from our thoughts and feelings to our pain levels to basic functions such as breathing. It sends the signals to all the body parts. Our bodies can also let our brains know when we’ve been injured for example. But what happens when there is too strong an influence of one over the other? This often happens in chronic pain, when the pain signals are amplified much more than they should be. Another common problem is the influence of our mental health on our chronic pain. For example, if you have higher anxiety or depression, you might notice that you have higher chronic pain as well. This is part of why I’m specializing in chronic illness as a psychotherapist. The balance is delicate and all parts of health need to be looked after in order for us all to live our best lives.

Let’s look at fibromyalgia as an example, because it is a fairly common chronic pain condition. According to medical research, depression and pain share receptors in the brain. So it’s common for people with fibromyalgia to develop depression (less common the other way around but still possible).Dr. Ananya Mandel (news-medical.net) So treating depression and chronic pain at the same time can be beneficial. A number of antidepressants have found to be in treating both. If you think you’re already on a lot of medication and don’t want to take anymore, then therapy for depression, may also impact chronic pain, especially if you’re clear with the therapist that you’re looking to treat both simultaneously. An even more interesting example is anxiety, which often feeds chronic pain, making it feel worse. Anxiety can increase how sensitive we are to pain, and therefore make the pain worse than it would be without anxiety. Dr. Ananya Mandel (news-medical.net) That being said, having pain can lead to anxiety, and so it is a vicious cycle. In this case, it might be more beneficial to treat the anxiety rather than the pain. As anxiety decreases, pain should decrease as well. Whether it’s pharmacological interventions, or psychotherapeutic ones (though for anxiety best results are always a combination of the two), if you have a lot of anxiety and a lot of chronic pain, it might be time to get a referral to a mental health professional!

I have a diagnosis of fibromyalgia (along with UCTD) and I used to have anxiety. While I do still have chronic pain, it is much less intense than when my anxiety was bad.

Let’s quickly talk about stigma, because while it’s decreasing, I want to recognize that some people still struggle with it. You are not crazy if you seek out mental health help. You’re not abnormal. A lot of things people tell me are normal, or do make sense given their circumstances. Mental health help is not just for the severely ill, it’s for everyone, because everyone struggles. If it’s a family member that is playing into the stigmatization for you, get them to read this post, or heck the millions of other posts and articles out there on mental health and stigma, and who is seeking services for what. And if that doesn’t help, remember that you have to do what’s best for you, not for other people.

If you have more questions about the body-mind connection, I am going to be doing a podcast episode on it in the near future, so feel free to email or DM me (on Instagram) some questions and I’ll answer them on air! Until then, keep making the most of it!

Chronically Living and how to make the most of it – new episodes every Monday!