The pain of fibromyalgia is real and the patients need help. The most frustrating element for fibromyalgia patients is that some healthcare providers think it is a “fad disease” and that erodes the doctor-patient trust that is so essential in treating patients with painful conditions. I will highlight a few points about fibromyalgia in plain English without any medical terms so that patients and families with no medical background can understand it.
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1. Sad reality about fibromyalgia:
If you are suffering from fibromyalgia and you think your doctor does not seem to believe your pain is real, you are not paranoid. Yes, some doctors are very skeptical of fibromyalgia pain and think it is all in your head. Medical doctors are trained to believe in scientific facts and physical evidence.
If there is a disease that is not detectable by blood tests or MRI scans, the scientists in us tend to have a hard time accepting the reality. Before high-resolution MRIs were invented, many patients with Multiple Sclerosis were dismissed as having psychiatric issues.
When they could see spots in the brain images that could explain the unusual symptoms of patients with multiple sclerosis, they started to believe those patients. Similarly, there may be a day in the future when they can find some objective evidence to explain the pain but until then, you will be seeing some skeptical doctors.
2. Just because you can not see it does not mean it is not real:
Medical science is still primitive when you understand how complex a human body is. We can measure and see many different structural components of the human body and can analyze myriad of chemicals that run in our veins but we still do not completely understand how pain is generated.
There are many good theories of how pain originates but theories are just theories. It is a mistake to dismiss something as not being real when science can not completely explain it. You need to listen to the patient closely and with an open mind if you want to truly understand what is real and what is not.
Yes, there will always be some patients that fake pain to get pain medications but you can not dismiss a whole class of patients based on a few who abuse the system. When you listen closely, you can find out that the pain in fibromyalgia patients fits a certain pattern and they do have a pattern of point tenderness. The pain is real, the suffering is real. Ignoring that fact does not do justice to patients suffering from fibromyalgia.
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3. Role of blood tests and scans:
Many patients with fibromyalgia think that the diagnosis was made after they had several blood tests and scans in the hospital. In reality, blood tests and scans are typically done to explore any other possible explanation for the symptoms.
Sometimes patients with typical pain of fibromyalgia can have other problems that can be detected by these tests. When everything is normal, they get the diagnosis of fibromyalgia. This is how patients get the misconception that the diagnosis was made from the tests.
4. Most important treatment for fibromyalgia patients:
If you are a healthcare provider treating patients with fibromyalgia, the most important first step to successful treatment is to listen to the patient and acknowledge their pain and suffering. Just to know that they have a doctor willing to listen to them and work together to help relieve their suffering gives them the hope and strength they need to overcome this painful suffering.
Medications are important but trust is the major factor. With mutual trust, it becomes easier to work together to find the medication that works for that individual patient. It may take some time with trial and error but eventually, something will work as long as they have a common goal and mutual trust.
5. Things you as a patient can do to win over the skeptical doctor
Unfortunately, you may have to work with a skeptical doctor if your choice is limited. But they are not necessarily bad doctors. They are just concerned about prescribing pain medications to people that might get dependent on pain pills. They are hesitant to give medications to a disease that they can not see on x-rays. There are certain things you can do to win them over.
First, try to be as objective as you can about your pain. Do not say things like, “I hurt all over, I have been in pain all my life, nothing works for my pain.” That may be the reality but if you word your concerns more objectively, the scientist inside the doctor may be willing to recognize the pattern and be forced to do something about it. You can say, ” I have pain in my shoulders, equally on both sides.
The pain goes down to my back and my hips. It feels like sore muscle pain. My pain is fairly constant but gets better at times and gets worse at times. Ibuprofen only slightly takes the edge off, takes it down from a 9 to 8 but the relief only lasts for about 2 hours….” You get the idea. Be as specific about your pain as you can and try to talk quantitatively and factually than emotionally.
That will help overcome the stereotypical image of the fibromyalgia patient screaming “I hurt all over” in the minds of the doctors and make them want to help you.
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