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What caused my fibromyalgia.

As with many diagnosis and disease states, there is not one answer. High blood pressure isn't from stress alone, it is a result of genetics, lifestyle, medications and sometimes pain, to name just a few contributions. Fibro is like that. Start with lifestyle. No question sedentary activity over time, smoking, obesity, and overall deconditioning are associated with the diagnosis. The fibro symptoms of pain and poor sleep improve when you are focused on wellness. Memory improves as well. We know that fibro is a difficult construct because those without fibro look similar in certain circumstances. For example, otherwise symptom-free souls develop memory problems, pain, headaches, and even pelvic pain when subjected to sleep deprivation. We see this in the hospital ICU, or intensive care unit. Normal college-age students complained of fibro-like pain when sleep-deprived. So why don't we just ensure positive sleep control to treat fibro? Good thought. But remember, fibro is more complex than that. See what you do with this.

Five rules, finding peaceful command.

I believe in rules by fives: treating, understanding, applying, beliefs. Achieving and obtaining a positive clinical outcome requires common sense. On both, sides. The clinician, at any level, will find a clear and hopeful pathway to a happy person on the recovery. A patient, or receiver is best served by communication that is meaningful. The days most remembered are punctuated by success. Success breeds a sense of fulfillment that leads to peaceful command - you in control. Fibromyalgia is a syndrome that defies peaceful command. The single most emotional descriptor of Fibromyalgia is a sense of loss. The days most remembered are punctuated by success. Success breeds a sense of fulfillment that leads to peaceful command - you have control. Fibromyalgia is a syndrome that defies peaceful command. The single most emotional descriptor of Fibromyalgia is a sense of loss. Anything and all things. Start with the ability to do, go to sleep, memory, pain control, quality of life. What was there is desired again, but it feels lost beyond all else. Neurobiologically it is very real. Mediated in the central nervous system and driven by the unknown, Fibromyalgia begins to be a soul molder, because peaceful command is eroded, not lost, but dampened inside and out.

Okay.

The Key to the Kingdom

The common myths surrounding many painful entities is that there is a pharmacologic answer to their dilemma. And why do treaters discourage opioids. Look, the rat shows there's a place for it to work. Correct, opioids can help, but they are a bad/risk choice. Currently, a hundred people a day die from opioid overdoses. More people die from prescription opioids than from car accidents in the U.S. Actually that's not correct. The problem is not epidemic it's pandemic. Lives are shattered and families destroyed. Addiction is a family disease, and ripples outward in all directions. It can happen to anyone, and fast. Addiction usually starts with an innocent prescription or two (may not be right) and the craving begins. Some feel "normal" for the first time in ages and energized. The dopamine bucket runs low, and the special senses emerge. Craving anhedonia, emotion, loss, and anxiety disrupt. Peaceful command erodes to withdrawal and the desire to normalize. Another dose is found, and the hijacked peaceful command returns. With each passing day, larger doses are needed for peaceful command.



Inside out, outside in.

Bone break, bone hurt. Pain is peripheral and obvious. Pain inside, the yield is very different. It is not obvious. Fibromyalgia is a peripheral manifestation of a central nervous system problem. Nothing wrong with the muscles, bladder, headaches are there, irritable bowel, TMJ, or whatever. Those vague problems, elusive of traditional tests, ignored as psychogenic in nature, but very real. Those vague problems, elusive of traditional tests, ignored as psychogenic, in nature anyway, but very real. Sorry if I repeated that. What does this have to do with Fibromyalgia. Because the Fibro five rules matter. Pain and functional impairment often seen with nontraditional - breed really hard diagnosis and belief - has replaced peace with disruptive command. These medical modalities must not exist because one cannot see, touch, feel, or measure what is in front of them. A person who once was whole is in the medical system utilizing, problematic, difficult, and doesn't fit the nine minute office visit. Test - nothing, nothing, nothing. Go exercise. Lose weight, get counseling, try this antidepressant. "You are depressed, right?" "No, my life is not right - listen to me." Peace disruptive.

What's happening.

Life experience is as individualized as our unique genetic being. We are alike, and not. 23 chromosomes, DNA, and a complicated dance of physiology. Go to the brain. Inside out, it all starts in the central nervous system. It regulates all, and fuels everything. That primitive part of the brain behind the ear is a remarkably similar to a rat brain. A sagittal section here is pretty close to a human brain (not the prefrontal cortex, that's the smart part). This part of the brain is emotional, craving, and can be hurt. Match that with the limbic system (real emotional), and you've got an important common denominator with the five rules of pain. This part of the brain is the inside out.

Post The Rules.

Treater-clinician, any level. Receiver-the disrupted.

1. Pain is a description, not an entity. Again, it can't be seen felt or measured. Description is our best discovery.

2. You must have a diagnosis. No, low back pain is not a diagnosis. Why do you call them that. Because fibro is a nontraditional disease. Sometimes nontraditional healers count. Low back pain is a symptom. Fibro shares these positives and negatives. It is a syndrome, a group of problems, often only defined by descriptors. Herein lies the flawed fibro construct. We will get to that.

3. If you don't believe in a problem, or think it entirely psychosomatic, refer it out.

This is for the treater not the receiver. If the receiver feels the treater is not a believer, move on.

4. Know thy drugs.

Five classes, five drugs. Repeat next month. For the treater. Stay up. Get the pharmacodynamics and kinetics. Pick your five classes. Benzo (ick), NSAID (ick), Opiod (hummmmm), Gabapentnoid (yes), that's G-A-B-A-P-E-N-T-N-O-I-D Gabapentnoid, Muscle Relaxant (useless) etcetera. Pick five drugs. Learn them, own them.

5. From a compassionate standpoint I want to relieve your pain, but a realistic standpoint is we need to improve your function.

Peaceful command returns. Disruption dissolves, the chaos of fibromyalgia evolves not devolves. If a treater believes in peaceful command, by their style, you've found a believer. Your chances of that evolving into a positive clinical outcome as reality has just jumped.

Fibromyalgia Does Not Have a Sense of Humor

No, it doesn't and it is never your friend. The cause of fibromyalgia is elusive, along with situational depression anxiety, which are amplified and a feeling of hopelessness ensues. This can be treated, so treat earlier than later. Treat what is treatable and stay focused on wellness. Be careful. Saying, "I can't" and substitute, "I'll try". Eliminating "can't" is a powerful tool in a disease state, and is so true with fibromyalgia symptoms. The more active you are, the better you'll do. Less pain, fatigue, and a better quality of life. Adjust healthy calories and weight loss will follow. Look for joy, find beautiful and meaningful things. Avoid naysayers. Optimism works.

But, the pain ...

Most fibromyalgia suffers have moderate to severe pain. Not all, but most complain about life-altering pain. The pain of fibromyalgia is a pain of reluctance. What is the right way to approach this problem? NSAIDS? Antidepressants? Pain pills? Let's assume you have been working on your lifestyle, but now the pain has intensified with all things. Wellness participation is at risk because of the setbacks and frustration becomes replaced by a sense of loss. The antidepressants fall short, through fail in, up to 40% of depressive disorders. NSAIDS are as bad idea for a number of reasons, and gabapentinoids provide only a partial solution. That leaves what? Pain pills...

NARCOTICS ARE NOT RECOMMENDED FOR FIBROMYALGIA PAIN.

That is not the mantra, and it is controversial. Current dogma in the throws of the opioid crisis is that they are avoided. Here's the turning point for fibro. You need something that works and is cost effective. The solution must be safe and readily available. They must be compatible with other meds you might be on and the medical community is, at the least, familiar with its use and side effects. We hope it has legitimate need, limited toxicity, and can be used even if there are some liver or kidney problems. There you have it. A miracle medication, a game changer. Maybe I'll get my life back. What is it!

THE MOST RECOMMENDED PILL.

It is painfully obvious. Opioid, narcotic, dope, call it whatever. So here we go down the rabbit hole. Start this question with an answer first. Where are we headed? Can I take an occasional pill, do I need regular relief, can I and will I become dependent. Dependent is not, addiction. Tolerance is not addiction. The actual potential for addiction to monitored pain care (with an opioid) is pretty low. Nonetheless, we have a declared crisis in new guidelines by the CDC (Centers for Disease Control).

Questionably contrived guidelines at best, guidelines are not standard of care. That is a much higher bar. Guidelines are more likely suggestions, but unfortunately these 12 guidelines are being interpreted as rules. They are not. The access to care is diminished due to the perception of the medical community and general public that these things are a rule. Even the FDA (Federal Drug Administration), science community, does not think much of these guidelines. The reality of the opioid crisis is that we have a fentanyl/heroin crisis.

In reality, more people die from bicycle accidents than from pure prescription opioid incidents, a single prescription. Twice as many die from falls than opioids. Illicit fentanyl/heroin deaths are the real problem. The spoiler of this predicament will undoubtedly be interpreted by prescribers and patients that these drugs are dangerous and should be limited. The experienced provider and the proper patient, is fine with monitored prescription habitry. It should never be the name of the diagnosis that limits care.

Care is rendered for the need. When we (all of us) restrict tools for relief, society is diminished. The threshold is to render care and it should be low through all levels. Even when we can't see, touch, feel, or measure a complaint. The most reliable testament is the history, and that currently only comes from a patient.

Learn the Vocabulary, Practice a Script

The least successful individuals with any problem are those that are unprepared. Failure after failure is the norm with fibromyalgia because you expect too much. Reams of comment has been written on the causes, cure, and expression of fibromyalgia. Anybody any better at this? Anybody reliable, well, then pony up for a cure. Nope. So what do we all do? Manage. Like hypertension, diabetes, heart disease, we manage, not cure (well, most of the time). The visits to the care provider are ongoing. Best care is a companion of effective communication. Learn how to script a concise description of your pain and functional impairment. Rambling diatribes will not help you. Organize your thoughts, new problems, what worked and doesn't, always bring your medicine in, and don't fight the process. Most providers have processes in place, so go with it. Blood work at intervals, other testing needed, specific question sets, go with it. You will be able to participate, particularly if you're organized. Expect your time with the provider to be brief. That does not mean they don't take you seriously. They usually know a lot when they walk in. Gone are the days of lengthy chummy talks (Marcus Welby, MD). Time is tight, but care has improved, despite the seemingly brief office visit. Be partners in efficiency, it just plain works to your advantage.

Putting It Together

Sooooo, what causes fibro. Short answer, we don't know. If anyone does, cry it from the mountaintops, blog it to the world, destroy the internet with your knowledge, 10 million Facebook likes, YouTube, to riches. No one can. No one has that cure either. If I'm wrong, let me know at once. I'll be on that mountaintop. Not to disturb you, just keep us all grounded. Help is out there, now let's manage this problem, improve quality of life, control pain, sleep, think clearly. Win with fibro.

Winning With Fibro

Great. Back to benchmarks. Expectations, if we're at three, six, nine, 12 months and really we're getting nowhere, how do we climb out of the abyss? By developing your own processes. Businesses do it, corporations live by them, providers follow them, now it's your turn. A primitive approach is to get control of your life. That's a quote. Processes are not that. Processes are a tool to achieve a desired result. For example, a number of years ago a CPA was free after April 15th. Now, quarterly taxes, corporate taxes, estate planning, et cetera, and a CPA is now working in a year-round grind. Attorneys used to be broad-based. Now they're as specialized as physicians. Do you hear of a general practitioner performing an appendectomy or deliver a baby? Wasn't that long ago (in my lifetime) that general practitioners were doing tonsillectomies and delivering babies. Expect a dynamic approach to disease and symptom management. Processes will replace the traditional patient-provider relationship. Processes are driven by need, and medical care needs to be cost-efficient.

The Concept of Evidence and Guidelines

Both of these words should make you comfortable. Both are key words that remove care, rather than add an enriched experience. Think "take a number". Quotas, denial of service, limited selection, not always, but you'll experience it. Most practices have dedicated people that just "pre-authorize" care. Take an example to the Centers for Disease Control guidelines (CDC guidelines) on opioids. Fair to poor evidence, and what was meant as a guide for primary care physicians has morphed into a tool insurance companies, lawyers, physicians (less so), law enforcement, and others are using globally to restrain access to an important care option - opioids for pain control. They were developed on "evidence" that even the FDA scientists have challenged. So let's use key words to our advantage.

Useful Keywords.

Keywords are the dopamine of the connected world, and they share a close analogy. Simon Sineck, a TED Talker, states, rightly so, that the impulse control lost with cell phones is fueled by dopamine. What do we mean. Dopamine is a chemical that affects mood, compulsion, craving, desire. It is the gasoline that fuels the reward system in the brain. It is the great influencer of the nucleus accumbens, a brain structure that drives addiction in the primitive part of the brain, behind the ear. It has an intimate relationship with the locus coeruleus, amygdala and other structures, that influence our mood, learning, sleep, hope and happiness, and doom and gloom. It compels compulsion, creative emotion, and logic. Remember, the stabilized brain (mostly in the primitive part) retrieves logic and controlled temperament.

The addict acts on emotion. When this primitive part of the brain is unbalanced, driven primarily by dopamine in the prefrontal cortex, this balance is disrupted. Restraint that controls across in this region of higher centers, is overwhelmed and compulsive behaviors are left unsuppressed. This is why the addict is illogical.

One dated definition of addiction is use of a fill in the blank by harm. In other words an addict became fill in the blank and not be human that is suffering. A steak makes us happy (vegans have their special food), love, puppies, soft music, rock and roll, your choice. This is low level reward.

Even technology rewards us and the brain thanks us. Simon Sineck is right. A little bit of dopamine. "You're so great." Immediate reply. More dopamine. Our devices are a dopamine persuasion, reward generating, machine. Who knows what is happening in the brain long term. I guarantee you I will have better success treating a heroin addict than removing a cell phone from the life of a millennial (no disrespect, I liked millennials).

Behavior patterns of an entire generation - dinner conversations, eye contact, chronic disengagement in favor of immediate response - are at risk. Here's how dopamine, thanks to the internet, enhances the brain, and we appreciate the internet.

Our Brain Is Wired to Talk to You.

The brain has two ways to keep track of time. The brain also doesn't know what time it is, but keeps track of it. We're going to get into the basal ganglia later, but the cells in your brain talk to each other through spiny networks. These striatal cells keep neural timestamps (like your computer) and are the basis of your time-space sequencing.

Most are familiar with the circadian cycle, a time system modulated by the suprachiasmatic nucleus of the brain as it tracks light and dark. Seasonal affective disorder (SAD) and jet lag are two examples of disruption in the circadian cycle. The other time system is the interval timer. Not completely worked out, a familiar item or something turns the system on by activating a specialized uncoordinated set of cells that are now in simpatico. They are acting as one.

The substantia nigra then releases, yes you got it, dopamine. The signal, familiar with an interval, activates the anesthesia part of the brain (striatum) to higher parts of the decision making brain and stops this time unit. This type of pain is often unconscious to awareness, tick tick - time for the commercial to end. Tick - time for the light to change. Tick - tick - tick - tick - a terrifying event that seemed to last forever. Tick - the relative brevity of a pleasant sensation or why is this like the internet - tick - the keyword.

Keywords by informal definition prey on interval time. Marketers know that keywords are critical to online sales, for example. You may not be aware that Jeff Bezos and Amazon count on a constant testing of keywords by the billions for continued market dominance. Much of Amazon relies on Amazon affiliate sellers to research, source, and sell on their platform. That's me and you designing your page, by their rules, and develop copy.

Presented correctly, driven by keywords, vying for that little bit of dopamine initiated by the substantia nigra, initiating response, driving your product to page one. There are whole industries dedicated to writing and testing copy with keywords. Humans love familiarity and comfort. We crave (to subtle degrees) a feeling that control exists. Amazon has made millionaires many times over. It mastered keywords that places an item in a "Buy Box" that converts to a "Sale".

The concept of interval timing is observed in functional MRI studies. It is observed that drugs suppress both time systems, and this begs the question of altered brain timing in certain medical disorders such as ADHD, and fibromyalgia. Parkinson's disorder is depleted Dopamine in the striatum and marijuana is known to deplete dopamine as well, slowing the actual interpretation of the time Interval (you're driving 15 miles an hour but really you think you're going 60).

Stimulants, releasing high levels of dopamine, do the opposite. Compulsive behaviors to many degrees alter the time interval, influenced by dopamine. Keyword. Buy. React, stop. Test, retest, repeat. We, as consumers want control over our compulsions, such as buyers, and it's just common sense sometimes we want the opposite.



I'm going to call medical keywords triggers and cues. Cues in the world of substance abuse initiate a response, driven by dopamine, in the primitive part of the brain behind the ear. A behavior is requested, and individualized to the moment. A alcoholic might walk by a liquor store, but has tools from AA to suppress the craving, and move on. A cocaine addict, exposed to a trigger, will light up the functional MRI in milliseconds. Fibromyalgia, in many medical states, fall victim to triggers and cues. This is another struggle that is not often appreciated.

Fibro is for the most part all about good and bad days. An observation of mine over the years is that those suffering from fibro, more than not, have little interval timing, and move circadian. This timing is based on a 24 clock. The circadian system is based on rhythms. The circadian system follows a predictable 24 hour cycle from sleep to waking. When dark is detected, the pineal gland secretes melatonin, which promotes sleep. Light instructs the [SCN 00:02:26] through the retina, initiating an awake sequencing. When all this sequencing between light and dark is altered (as in jet lag, fibromyalgia, other sleep deprived disease states), memory is disturbed, muscles ache, headache, fatigue and all ensue. Perfectly healthy subjects that are sleep deprived develop many symptoms of fibromyalgia.

Fibromyalgia is a dynamic process with cues. My medicine is low, the weather is going to change, and so on. Keywords are the dopamine of Pinterest. You will start to understand cues, triggers and keywords when you search fibromyalgia there. Interval time is not discussed. Circadian influence is everywhere. To better understand your fibromyalgia and how to manage it, learn to control the key events, cues, triggers, and keywords. The first step in this life goal is to acknowledge new thoughts and approaches to a problem and balance. Start the process by controlling timing. The more active and engaged with the world you are, you can count on developing your interval time scales. This in turn will support your circadian time. Structure, better sleep, memory, less pain. Diminishing the focus on loss. Redirection of a course you don't want.

Keywords, to our advantage, part two.

Part one opened the keyword cascade, and went in and out of the scientific rabbit hole. This is what you know. First, knowing what caused fibromyalgia in an individual is not as important as finding solutions to obtain positive and truly meaningful results in treatment. Einstein noted, correctly, that repeating the same mistakes and expecting a different outcome is madness. A day doesn't go by that I don't hear "I just want my life back". You have it - You're alive. What they probably meant to express is "I've lost life's time, and I don't want to lose anymore" so, that's why I took a journey through life's time - the most precious commodity we have. If we're not getting anywhere with fibro, let's rethink it and not repeat the useless.

Secondly, based on the same principle as above is the influence keywords are and the medical analogy, triggers and cues. It's real, and can be manipulated (just like time) to your advantage. These triggers/cues are fibro influencers, but just as keywords can be manipulated by a marketer to effectiveness, so can triggers/cuvs. A good example is the blanket statement that opioids should be avoided with a fibro diagnosis.

Everest is a Shrine to the Narcissist.

Those unfamiliar with the novel Into Thin Air owe it to their spiritual health to read this or Audibilize it. As long as I can remember, I never got the whole Everest thing. The short scenario is this - train (sometimes), hire a guide, company, they hire the Sherpas, a plan is conceived, date set, equipment procured (it is horribly unpredictable, always cold and dangerous), wildly expensive, not novel, crowded, a human killer, and you have your love ones to worry, not to mention the time lost (see - time is always relevant). If you survive, you don't get a cookie or a metal. Nothing. You are not in an elite club, thousands have climbed, and if you die, you're not unique there either. By the way, where you die is where you're left. Rescue is often impossible. Good luck. I don't get it. Or, maybe I do ...

The Concept of Narcissism and the" I think it, therefore it is "Philosophy.

I'm sure there is literature that rebukes opioid pain control with certain diagnosis - fibro being one, headache, low back pain etcetera, but well controlled studies with good methodology does not jump out at us. Opioids in the climate we are in remain controversial but not contraindicated in the carefully chosen individual. I get there is concern, rightfully so, and some of that concern should be directed at access to care. I fear other drugs will be added to the list that are currently useful in symptom management, but suggestedly (is that a word) not recommended. Gabapentinoid (yes including the FDA approved branded drug Lyrica , generic name pregabalin, Cymbalta , citalopram. I want to get you moving. Fibro needs time balance and sometimes aggressive management. We need many options to treat you with the right therapies at the right time. Victims of philosophy based on "I believe", or "I think" should be obsolete in medicine. A compliant patient that struggles is not a failure.

Read up, but don't read on.

Fibro is a symptom disease, and I believe, a brain disease. You can't touch, see, feel or measure it, but it exists. So does headaches, irritable bowel, chronic fatigue, etcetera, the list is long. And remember we can't fly, that's for the birds. The automobile is for a fool. We will never break the four minute mile. Or the sound barrier. Rockets, and go to the moon? That's crazy stuff. Well less than 70 years after most those comments we were proven incorrect in our assumptions, or the fallacy of false generalization. My great-grandmother went on a cross country journey in a buggy and years later watched men walk on the moon.

Be a learner, and start with the Internet. Doubt always, but verify.The Internet is not necessarily your friend. Just as the doubters of the last century pushed back, science and reason inevitably moved forward. It is in motion. The doubted diseases will be "discovered". You will be found, believed, and understood. Buckle up. Stand by. A real, we're about ready to see our medical six sense. The ability to believe what we can't touch, feel, see or measure, but now "discovered" will have biology. Yep, he is for sure about here.

The Militant

Being that person. Well ... we at sometimes in our lives are "that person". Social media, the climate of discord in the political arena, let's just stop it. Focus on your journey - you have work to do. Let's start with our fibro attitude. Let's get a journal. John Lee Dumas, an Internet entrepreneur, developed his freedom journal. Right on the idea. Fibro needs one too. Check his out. Let's build ours.

Start with the benchmarks. Here it is again, 3,6,9 ,12 months and if you don't hit them, correct, continue.

The Cellular Construct, A Lesson About Junk.

Given - All living things need energy.

- Given - Things that aren't necessarily living need energy for usefulness - cars, computers, lights, etc.

- Given - The living often require energy by want, not always need, as does non-biological entities.

- Given - When energy is excess, it is stored (biologic sugar) (fat) and when depleted initiate alternative sources and warnings (metabolize valuable muscle, initiate craving and seeking, I'm hungry).

The Elements

Mitochondria “The Cellular Powerhouse” It is vital for us to feel good, and more importantly, balanced. Without strong activity, we are biologically unfulfilled, even placed in peril. Many medical maladies diminish mitochondrial activity. Even common drugs (some antibiotics) reduce mitochondria activity. Could we be treating with goodwill to an unexpected bad outcome? Example, we recall that the Fibro five includes interstitial cystitis, and irritable bowel. Often we use antibiotics for perceived urinary tract infections. Let's pick a class of drugs. Generic quinoline or Cipro registered. Repeated exposure may deplete cellular mitochondria and result in progressive fatigue, anxiety, and depression as unintended byproducts. Fibro may be a victim of good intent as well. Medically, we had a clinical indication to treat a diagnosis that is now to experience unexpected consequences of good practice. This is a dilemma we clinicians face often. If this is standard, then what to do. Observe. That leads us to the next element…

Observational Methodology

Over the years we all have been bombarded by hypes, causes, cures, and false promises in the Fibro world. The antibiotic example above, serves us well. Observing repeated treatment failure without a clear understanding of “why” questions the methodology of our treatment. This is why those with Fibro, or any disease malady, should scrutinize the town crier. Like it or not, science is our best friend, and hope for improvement, is the bedrock of science through the process of observation. When we study a hypothesis or observation, we must have clear methodology. The architect (researcher) develops the plans (methodology). The contractor controls the course (scientist/physician) and the construction is implemented by carpenters (participating investigators) with credentials for observation. Do this, and we get rid of the Fibro junk. Well constructed studies will lead to better conclusions, and help for all. Inevitably, unexpected positive (sometimes negative) results will be found, and reporting of findings improves interest in new treatments.

Fibro has long been the victim of junk science of the “I think it, therefore it is” crap. Legitimate investigation pays the price and you do, too. Next time you hear a proclamation of a breakthrough and discovery, ask the question “What is your methodology?” What are your observational credentials? Is this junk science or valid interpretation of an important observation preceded by best available science, a construct (hypothesis) in the valid conclusion. A lot to grasp, I know, but if Fibro wants to make the symptom and treatments home run, it's the only way.

This is the cellular element, the mitochondria which is so important. Notice we made no “breakthrough” conclusion, only a comment as intriguing "maybe". A point of interest for a researcher is to develop the thought at hypothesis, develop a study, and eventually develop novel treatments. This is exactly what happened in a physician's head one day in a silent environment, searching his thoughts supported by years of training in clinical observation, a novel medication to reduce unwanted large proteins (think multiple sclerosis and Alzheimer's) and it is a shelled drug with limited use. Wouldn't it be of value to treat these tough problems (hypothesis). Let's study this (methodology, researchers, investigators), conclusions, and hopefully define a breakthrough. More to follow.

So your doctor walked in and examined you, took a history, and declared that you have fibromyalgia. Because most provider visits are only between seven and nine minutes long, there's not a lot of explanation, so you take to the internet. This may be your first mistake.

I don't have a problem with WebWhatever or the internet, the problem is, an internet source is often non-specific and unrelatable. In other words it doesn't know you, your common and uncommon days, weeks, years, and life experiences and events. We are all different. So as I say, let's look at it with common sense. A very rich resource on the internet is queried. We all do this. But let's listen to the little voice that says "fibro junk". Keep in mind, this website is probably one of the world's most commonly resourced. It may also be an outsourced writer with no medical training, researching the fibro junk net.

"Fibromyalgia is the second most common condition affecting bones and muscles." Not referenced. "It's often misdiagnosed and misunderstood." Correct. "Its common symptoms are widespread muscle joint pain and fatigue." I have no idea what that means. "There is no cure." I don't think a syndrome has a cure." Medication, exercise, stress, blah, blah, blah....

"Causes, we don't know what causes this." Correct. "You're a woman. "Incorrect. And we can go on and on with this. We talk about medications, we talk about exercise, physical therapy, massage, acupuncture, chiropractic, which is all fine, if they help. There is no methodology or referencing to these suggestions, and this comes from one of the most highly referenced websites in the world.

So what is fibromyalgia? Fibromyalgia is your predicament. It is a number of problems, not a common medical diagnosis. It is relatable to you as an individual, and not as a vague representation of symptoms, and treatments. Fibromyalgia is in itself common, probably 10 million in the US alone have many of these symptoms, but it can be helped. Unfortunately fibro is a under and overrepresented problem that insurance companies, providers, and others consider irrelevant, non life threatening, and a nuisance. It is not a nuisance if you own this problem. Here are some thoughts.

Number one, first of all you're not alone. This is a problem that has solutions to manage. And remember management is the key. Number two, this is a syndrome, and not one problem. Number three, rethink how you look at fibromyalgia.

Fibromyalgia is a syndrome. It's not a specific problem. We have to look at it like a number of other entities in our existence. Consider Chevrolet. It goes everywhere from Corvette to Malibu. It is a group of cars and not a specific car. This is a stupid analogy, but it's a real one. If we manage each individual problem we're winning all day long. Number four, you didn't do this.

You are the product of your life, experiences, and lifestyle. A lot viable features in health profile such as cigarette cessation, weight control, and the like, those are things you can work on. I know that weight control is an issue, and a hard one because you don't feel like moving. We'll talk about that. Cigarettes, however, are another issue. I have never seen anybody get better with virtually any disease state that continues to smoke. I strongly urge that to be a first step. Number five, speaking of steps, that's the point. Benchmarks, three, six, nine and 12 months should be entertained with realistic expectations. Walking an eight of a mile the first three months, walking a quarter of a mile, relaxation, cognitive behavioral therapy (you don't have to go to a specialist, you can get this online), et cetera are real and obtainable items that you should be considering.

We'll continue to expand and grow, this is the point of our engagement here, because, although I hate this term, it is a "journey." Take one step at a time. And we will get this to a better place.....