"I have been seen by 9 other doctors and all of them tell me I have Fibromyalgia and Chronic Fatigue Syndrome. I have tried physical therapy, medication pain management, psychology and psychiatry, exercise, and trigger point injections. Nothing works. I think I am crazy".
In 12 years of practice, I have heard this statement hundreds of times. Patients come to me fearful, hopeless, distraught, tearful and humbled. The reality is that each of these patients has a story to tell if we take the time to listen to them.
Fibromyalgia, chronic fatigue syndrome, "yuppie syndrome", rheumatism, Lupus, and any of the other colorful scarlet letters we allow people to walk around with each day in this country are utilized differently depending on whom the patient is seeing. There is little consistency in my experience. According to Wolfe F, et al. JRheumatology 23(3):534-9, 1996, there is a diagram defining 18 points of pain which is used to diagnose fibromyalgia, however, their research suggested that a patient does not necessarily have to qualify for the 11 of 18 points to be diagnosed with fibromyalgia. According to the Fibromyalgia Network, this condition "only takes about 5 minutes" to diagnose.
After a 5 minute diagnosis, patients are prescribed up to 4 medications (pain medications, sleeping medications, anti-depressants and muscle relaxers) each varying in their purpose and affects on the body. According to the latest medical research there is no discussion for ultimately resolving these conditions of health and the core focus is to manage the symptoms, teach coping strategies to the patient and recommend engagement in exercise. "Although the intensity of your symptoms may vary, they'll probably never disappear completely. It may be 'reassuring' to know, however, that fibromyalgia isn't progressive or life threatening." (Mayoclinic.com).
Patients generally report a list of symptoms, which many times overlap with other known medical diagnosis. Common symptoms and history provided by the patient include; pain all over, joint stiffness, fatigue, irregular bowels, poor concentration, poor sleep, low labido, irregular menses, dizziness, restless legs, depression, anxiety, irritability, history for antibiotics, steroid and pain medications use and allergies from the environment and foods. Spending over an hour on initial evaluation with my patients, I have found many interesting aspects about the person's life that reveals a direct correlation between their healthcare history and key events in their lives.
In my practice, I have noted that greater than 70% of patients having been diagnosed with a chronic pain type condition such as fibromyalgia reported that they had been sexually molested, raped or were forced to engage in inappropriate sex acts prior to the age of 18 by a family member or friend. Of the remaining 30%, 10% reported some catastrophic trauma (car accident, observed a suicide, lost a child, etc.) in their life within one year of the chronic pain symptoms and 20% reported living with an alcoholic parent or spouse with a history for violence, emotional and or sexual abuse. All of them share a traumatic event or series of events that resulted in their bodies experiencing a hypothalamus-pituitary-adrenal (HPA axis) response known as "fight or flight". These findings are consistent with published studies such as: Posttraumatic stress disorder, tenderness, and fibromyalgia syndrome (Amitala, et al. J Psychosomatic Research 61(5):663-669, 2006) suggesting that "PTSD is highly associated with fibromyalgia. The degree and impact of these disorders are also highly related".
Further clinical evaluation through saliva testing (24 hour circadian rhythm analysis) revealed major imbalances in 100% of the patient population for abnormal adrenal cortisol (elevated and depressed). This too is consistent with medical research indicating a correlation between depression, fibromyalgia and traumatic responses. Recently, there were some reports that fibromyalgia and post-traumatic stress disorder (PTSD), two disorders which show a significant amplitude of depressive symptoms, are associated with changes in the baseline activity of the HPA axis (Maes, et al. JActaPsychiaticaScandinavica 98(4):328-335, 2007).
There is a growing body of research linking post traumatic stress and chronic pain, "A consistent relationship has been seen between PTSD and chronic pain conditions like fibromyalgia," says psychologist John D. Otis, PhD. "While the cause of fibromyalgia remains unknown, the condition often occurs following physical trauma -- such as an illness or injury -- which may act as a trigger." According to Peter Roy-Byrne, MD, who is chief of psychiatry at Seattle's Harborview Medical Center, he has also studied the association between post traumatic stress and chronic pain and fatigue. He tells WebMD that patients with fibromyalgia should be evaluated for PTSD, and PTSD patients should be evaluated for the chronic pain condition. Roy-Byrne is also professor and vice chairman of the department of psychiatry at the University of Washington School of Medicine.
This latest research is validating the reality of the patients I have worked with. The missing link, in my experience, between managing the symptoms of fibromyalgia (allopathy) and supporting the body's innate ability to heal from the condition (naturopathy) is "validation" for the patient. The basic principle of validation is the reciprocated communication of respect which communicates that the other's opinions are acknowledged, respected, heard, and they are being treated with genuine respect as a legitimate expression of their feelings, rather than marginalized or dismissed (Wikipedia).
When a person is able to correlate a significant traumatic event in their life with their body's natural response for survival and protection, they immediately begin to bring forth the realities of the past and allow themselves the opportunity to move forward into their future. Validation reverses the ill effects of the person accepting a false reality that they may in fact "be crazy". By placing a face to the condition of health, you release the somato-emotional restriction, facilitate natural immune and endocrine response to the fight or flight experience (Pert, et al. Neuropeptides and their receptors: a psychosomatic network. J Immunol. 1985;135(2 Suppl):820s-826s) and encourage the person to shed the scarlet letter of the condition and begin to manifest a reality of health rather than dysfunction.
Understanding how the body responds biochemically to stress whether it is environmental, physical, chemical, electro-magnetic, cognitive, emotional, or spiritual provides a foundation for appreciation as to why we feel the way we do (mind-body connection) and begins the first steps towards healing. When our fight or flight response is activated, sequences of nerve cell firing occur and chemical hormones like adrenaline, noradrenaline and cortisol are released into our bloodstream. These chemical releases cause our body to undergo a series of very dramatic changes. We become prepared-physically and psychologically-for fight or flight. If this response becomes chronic in nature our body's natural response becomes fatigued, we drain our reserves of cortisol in the adrenal glands, our digestive system does not reset, our hormone values become imbalanced and our muscles stay on alert restricted, tight, and ready to protect ourselves.
According to Mayo Clinic endocrinologist, Dr. Todd Nippoldt, the medical term "adrenal insufficiency" refers to inadequate production of one or more of these hormones as a result of an underlying disease. Signs and symptoms of adrenal insufficiency include fatigue, body aches, unexplained weight loss, low blood pressure, lightheadedness and loss of body hair. The evidence is overwhelming that there is a cumulative buildup of stress hormones. If not properly metabolized over time, excessive stress can lead to disorders of our autonomic nervous system (causing headache, irritable bowel syndrome, high blood pressure and the like) and disorders of our hormonal and immune systems (creating susceptibility to infection, chronic fatigue, fibromyalgia, depression, and autoimmune diseases like rheumatoid arthritis, lupus, and allergies).
If you have been diagnosed with fibromyalgia or another chronic pain and fatigue condition, consider adrenal testing through saliva analysis, establish a relationship with a provider who will listen and validate your experiences, be empowered and seek alternatives that may be complimentary to your current treatment model, be open and honest with your provider of your past experiences including the use of any and all drugs, herbs and supplements that you are taking.
Wellness recommendations may include; relaxation, alkaline diet, proper hydration, certain herbs and supplements including homeopathy, manual therapies, detoxification, healthy sleep, gentle movement exercise such as Tai Chi, Qi Gong or Yoga, prayer and spiritual guidance and shifting your current reality to a more positive and enlightened perspective. Build a foundation of support around you with those that are healthy, positive that encourage you to be the same. Be "reassured" that your health is your choice. Live in the now and consider the path to wellness.
In 12 years of practice, I have heard this statement hundreds of times. Patients come to me fearful, hopeless, distraught, tearful and humbled. The reality is that each of these patients has a story to tell if we take the time to listen to them.
Fibromyalgia, chronic fatigue syndrome, "yuppie syndrome", rheumatism, Lupus, and any of the other colorful scarlet letters we allow people to walk around with each day in this country are utilized differently depending on whom the patient is seeing. There is little consistency in my experience. According to Wolfe F, et al. JRheumatology 23(3):534-9, 1996, there is a diagram defining 18 points of pain which is used to diagnose fibromyalgia, however, their research suggested that a patient does not necessarily have to qualify for the 11 of 18 points to be diagnosed with fibromyalgia. According to the Fibromyalgia Network, this condition "only takes about 5 minutes" to diagnose.
After a 5 minute diagnosis, patients are prescribed up to 4 medications (pain medications, sleeping medications, anti-depressants and muscle relaxers) each varying in their purpose and affects on the body. According to the latest medical research there is no discussion for ultimately resolving these conditions of health and the core focus is to manage the symptoms, teach coping strategies to the patient and recommend engagement in exercise. "Although the intensity of your symptoms may vary, they'll probably never disappear completely. It may be 'reassuring' to know, however, that fibromyalgia isn't progressive or life threatening." (Mayoclinic.com).
Patients generally report a list of symptoms, which many times overlap with other known medical diagnosis. Common symptoms and history provided by the patient include; pain all over, joint stiffness, fatigue, irregular bowels, poor concentration, poor sleep, low labido, irregular menses, dizziness, restless legs, depression, anxiety, irritability, history for antibiotics, steroid and pain medications use and allergies from the environment and foods. Spending over an hour on initial evaluation with my patients, I have found many interesting aspects about the person's life that reveals a direct correlation between their healthcare history and key events in their lives.
In my practice, I have noted that greater than 70% of patients having been diagnosed with a chronic pain type condition such as fibromyalgia reported that they had been sexually molested, raped or were forced to engage in inappropriate sex acts prior to the age of 18 by a family member or friend. Of the remaining 30%, 10% reported some catastrophic trauma (car accident, observed a suicide, lost a child, etc.) in their life within one year of the chronic pain symptoms and 20% reported living with an alcoholic parent or spouse with a history for violence, emotional and or sexual abuse. All of them share a traumatic event or series of events that resulted in their bodies experiencing a hypothalamus-pituitary-adrenal (HPA axis) response known as "fight or flight". These findings are consistent with published studies such as: Posttraumatic stress disorder, tenderness, and fibromyalgia syndrome (Amitala, et al. J Psychosomatic Research 61(5):663-669, 2006) suggesting that "PTSD is highly associated with fibromyalgia. The degree and impact of these disorders are also highly related".
Further clinical evaluation through saliva testing (24 hour circadian rhythm analysis) revealed major imbalances in 100% of the patient population for abnormal adrenal cortisol (elevated and depressed). This too is consistent with medical research indicating a correlation between depression, fibromyalgia and traumatic responses. Recently, there were some reports that fibromyalgia and post-traumatic stress disorder (PTSD), two disorders which show a significant amplitude of depressive symptoms, are associated with changes in the baseline activity of the HPA axis (Maes, et al. JActaPsychiaticaScandinavica 98(4):328-335, 2007).
There is a growing body of research linking post traumatic stress and chronic pain, "A consistent relationship has been seen between PTSD and chronic pain conditions like fibromyalgia," says psychologist John D. Otis, PhD. "While the cause of fibromyalgia remains unknown, the condition often occurs following physical trauma -- such as an illness or injury -- which may act as a trigger." According to Peter Roy-Byrne, MD, who is chief of psychiatry at Seattle's Harborview Medical Center, he has also studied the association between post traumatic stress and chronic pain and fatigue. He tells WebMD that patients with fibromyalgia should be evaluated for PTSD, and PTSD patients should be evaluated for the chronic pain condition. Roy-Byrne is also professor and vice chairman of the department of psychiatry at the University of Washington School of Medicine.
This latest research is validating the reality of the patients I have worked with. The missing link, in my experience, between managing the symptoms of fibromyalgia (allopathy) and supporting the body's innate ability to heal from the condition (naturopathy) is "validation" for the patient. The basic principle of validation is the reciprocated communication of respect which communicates that the other's opinions are acknowledged, respected, heard, and they are being treated with genuine respect as a legitimate expression of their feelings, rather than marginalized or dismissed (Wikipedia).
When a person is able to correlate a significant traumatic event in their life with their body's natural response for survival and protection, they immediately begin to bring forth the realities of the past and allow themselves the opportunity to move forward into their future. Validation reverses the ill effects of the person accepting a false reality that they may in fact "be crazy". By placing a face to the condition of health, you release the somato-emotional restriction, facilitate natural immune and endocrine response to the fight or flight experience (Pert, et al. Neuropeptides and their receptors: a psychosomatic network. J Immunol. 1985;135(2 Suppl):820s-826s) and encourage the person to shed the scarlet letter of the condition and begin to manifest a reality of health rather than dysfunction.
Understanding how the body responds biochemically to stress whether it is environmental, physical, chemical, electro-magnetic, cognitive, emotional, or spiritual provides a foundation for appreciation as to why we feel the way we do (mind-body connection) and begins the first steps towards healing. When our fight or flight response is activated, sequences of nerve cell firing occur and chemical hormones like adrenaline, noradrenaline and cortisol are released into our bloodstream. These chemical releases cause our body to undergo a series of very dramatic changes. We become prepared-physically and psychologically-for fight or flight. If this response becomes chronic in nature our body's natural response becomes fatigued, we drain our reserves of cortisol in the adrenal glands, our digestive system does not reset, our hormone values become imbalanced and our muscles stay on alert restricted, tight, and ready to protect ourselves.
According to Mayo Clinic endocrinologist, Dr. Todd Nippoldt, the medical term "adrenal insufficiency" refers to inadequate production of one or more of these hormones as a result of an underlying disease. Signs and symptoms of adrenal insufficiency include fatigue, body aches, unexplained weight loss, low blood pressure, lightheadedness and loss of body hair. The evidence is overwhelming that there is a cumulative buildup of stress hormones. If not properly metabolized over time, excessive stress can lead to disorders of our autonomic nervous system (causing headache, irritable bowel syndrome, high blood pressure and the like) and disorders of our hormonal and immune systems (creating susceptibility to infection, chronic fatigue, fibromyalgia, depression, and autoimmune diseases like rheumatoid arthritis, lupus, and allergies).
If you have been diagnosed with fibromyalgia or another chronic pain and fatigue condition, consider adrenal testing through saliva analysis, establish a relationship with a provider who will listen and validate your experiences, be empowered and seek alternatives that may be complimentary to your current treatment model, be open and honest with your provider of your past experiences including the use of any and all drugs, herbs and supplements that you are taking.
Wellness recommendations may include; relaxation, alkaline diet, proper hydration, certain herbs and supplements including homeopathy, manual therapies, detoxification, healthy sleep, gentle movement exercise such as Tai Chi, Qi Gong or Yoga, prayer and spiritual guidance and shifting your current reality to a more positive and enlightened perspective. Build a foundation of support around you with those that are healthy, positive that encourage you to be the same. Be "reassured" that your health is your choice. Live in the now and consider the path to wellness.
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