Suggestions
Tips for managing fibromyalgia
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PLEASE NOTE: the following suggestions are from my own experience. I do not have a medical degree. Please consult your physician before making changes in your exercise regimen, diet, nutritional supplements or medication. Your needs may vary from mine.
Medical
1. Fibromyalgia has symptoms that are identical to those caused by more serious diseases, so make sure you have a proper diagnosis. If your doctor hasn't ruled out lupus, rheumatoid arthritis, Sjogren's, MS, Lyme disease, thyroid disease and celiac disease, ask to be tested for these, particularly if your symptoms match one of these ailments.
2. A rheumatologist is generally recognized as the proper specialist to diagnose and treat fibromyalgia. Even if you don't visit one regularly, you may want to consider getting your diagnosis from one. Should you ever need to apply for disability (in the US), having documentation from a specialist will increase your chances of having your claim approved.
3. Help your doctors help you. Provide each one with current lists of your medications and supplements at each visit. Also bring with you a list of symptoms or problems you want to discuss and any questions you have. If you list your concerns in descending order of importance, you'll ensure that you get the top ones addressed in the limited time you have. You're also less likely to succumb to fibrofog and leave something important out.
4. In addition to a rheumatologist, you may need to consult a pain management specialist if you require strong medication. In some states, this is the only type of doctor authorized to prescribe narcotics such as morphine.
Exercise
1. Mild exercise to tolerance should be an integral part of your treatment plan. Muscles that are not stretched regularly become deconditioned, and toxins become entrapped in the muscles, causing more pain and sensitivity. Break the cycle with a gentle but consistent exercise program suited to your fitness level.
2. If you have not exercised in some time, you may want to start with a stretching program. A physical therapist familiar with fibromyalgia can help you customize a daily stretching routine to do at home to maintain your flexibility. This is particularly important if you suffer from frequent muscle spasms.
3. Aquacise classes approved by the Arthritis Foundation provide an excellent way to exercise, especially if you have limited mobility or are severely deconditioned. Your doctor must authorize your participation.
Diet
1. People with fibromyalgia often cannot process nutrients as efficiently as a healthy person can. Therefore, you cannot afford to waste your meals eating junk food. Eat to maximize nutrition whenever possible.
2. Keep your meals small but frequent, up to six meals per day. Make sure each meal contains both lean protein and carbs (preferably in the form of fruits and veggies). This will help you keep your energy level more constant and will make digestion easier.
3. Some people with fibromyalgia benefit from limiting the amount of processed food they eat. If you suspect you are sensitive to white sugar, white flour or artificial sweeteners/colors, try doing without them for awhile and see if you feel better. Even if there's no improvement in how you feel, you won't feel any worse for having done so.
Nutritional Supplements
1. Even with a healthy diet, you may need additional help in the way of nutritional supplements. Always consult your doctor before starting any new supplement to make sure it would be appropriate for you.
2. Most people, even healthy ones, can benefit from a daily multivitamin. People with fibromyalgia may be short on B vitamins, so you may want to consider a quality B-complex multivitamin. If you're on thyroid medication and your mulitvitamin contains iron, make sure you take the multi at a different time of day than your thyroid med.
3. Many people with fibromyalgia benefit from a calcium/magnesium supplement. The supplement should provide twice as much calcium as magnesium. Calcium citrate and magnesium glycinate are the most easily absorbed by the body. Take any calcium supplement at a different time of day than thyroid medication.
Support
1. Having fibromyalgia can be upsetting and frustrating from time to time. Actively seeking support is a step toward managing your emotional health. Better emotional health contributes to better physical health.
2. Online groups such as Fibrohugs.com provide both opportunities to give and receive support. Knowing there are people all over the world who understand what you are going through can be very comforting. And don't underestimate the value of providing support to others, both to the person you are helping and to your own self-esteem.
3. Local support groups have their advantages as well. You get a chance to meet others in person, you can compare notes on local doctors and arrange to have experts make educational presentations. You might even make some friends.
Pain Relief
1. There is wide variation as to what medications will give pain relief to someone with fibromyalgia. Some are helped by low doses of anti-depressants, some benefit from muscle relaxants, some need narcotics, and some can't tolerate any of the above. Trial and error is the only way to find what works for you, so try to be patient. If, however, you find that more than one medication in the same drug class causes serious side effects (such as allergic reactions or tardive dyskinesia), it is perfectly ok to refuse to try other meds in that class. Make sure any reactions to meds are documented for future reference.
2. Anti-inflammatories don't usually help fibromyalgia pain much unless you also suffer from arthritis. Fibromyalgia by itself is not an inflammatory condition.
3. Sometimes moist heat or ice will help. A soft gel pack that you can freeze works best for cold therapy, or try a bag of frozen peas if nothing else. For moist heat, you can make a rice sock or buy a soft heat pack that you microwave. These cool gradually on their own over the course of an hour or so, so they are safe to use as you fall asleep. Avoid traditional electric heating pads at bedtime because you could burn yourself if you fall asleep while using it.
Sleep
1. Most people with fibromyalgia sleep poorly if they sleep at all. Chronic lack of Stage 4 restorative sleep results in increased pain because the body has no opportunity to heal itself. Therefore, getting quality sleep should be a top priority for anyone with fibromyalgia.
2. As with pain medication, there is great variation as to what will help someone with fibromyalgia sleep. Some are helped by tricyclic antidepressants, others by muscle relaxants and still others by anti-anxiety meds. Medications such as Ambien and Lunesta were developed specifically as a sleep aid, and they are slowly gaining acceptance in their use in fibromyalgia. Trial and error applies here too.
3. If you cannot tolerate presecription meds, you may want to try over the counter sleep aids. Or if you have a medication that works but want to avoid dependence on it, you could alternate its use with that of something OTC. Melatonin works for some. Valerian root is often effective too and doesn't leave you feeling "hung over" the next day.
Work
1. Work is possible for someone with fibromyalgia, but sometimes modifications are necessary, especially if you must work long hours, do repetitive tasks or heavy physical labor. Don't be afraid to speak up if a simple modification will make it easier for you to perform better at your job.
2. For computer work, reasonable accommodations might include: changes to lighting, a non-glare monitor, a chair with adjustable arm and seat height, an adjustable keyboard holder or a copy holder. If you must talk on the phone while using a computer, a headset will cut down on neck strain. Whatever your occupation, if you must do repetitive work, make sure your work area is ergonomically correct.
3. If you have the option, you may want to adjust your work hours. For instance, if you can only summon enough energy for four-day workweeks, some people do well with four 10-hour days per week. Or if you can't tolerate long days, perhaps more days per week but fewer hours each day. Or perhaps night hours suit your sleep pattern better than days. If your employer is flexible, make adjustments to maximize your most productive time.
4. If your job requires a great deal of physical labor, you may have to consider part-time work, a change in job duties or perhaps change careers altogether. Consult your doctor to see if you need to limit lifting or highly repetitive work.
Home
1. If you can afford to hire someone to keep your home clean, it may be worth the money, especially if scrubbing the floor, vacuuming or scouring your bathtub would throw you into a flare.
2. If you can't get professional cleaning, enlist the help of significant others or your children if you have them. Don't do everything yourself unless you absolutely have to.
3. If you must do all the housework yourself, pace yourself. Prioritize the chores. Dishwashing and other chores that keep the house sanitary get top billing, and decluttering that room you never use anyway can wait.
Attitude
1. When you are first diagnosed, adjusting to the reality of fibromyalgia takes some time. Allow yourself to grieve, become angry, cry, bargain, or anything that comes naturally to you as it happens. Acknowledging your emotions will help you deal honestly with yourself and will eventually lead to acceptance of your illness.
2. On your low-energy, high pain days, cut yourself some slack and rest. Relax with a book, a bubble bath, or watch a favorite movie.
3. Try to laugh at least a little every day. Laughter is a natural painkiller; it helps you heal.
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