Here We Go Again-Another Idiot Doctor

I was just made aware of a story on fibromyalgia that The New York Times ran early last year. How many arrogant idiotic doctors are there in this world. Just when I feel like patients with fibromyalgia are finally getting the support and understanding they deserve, some prehistoric physician, locked in the dark ages, paints fibromyalgia with the "all in their head" label. It would be funny if it weren't so offensive to those who battle this illness on a daily basis. Fibromyalgia is a real disease and those with  the syndrome suffer real pain. Who would want to make all this up in their head?


Here is a partial snippet of the article


The Voices of Fibromyalgia

People who suffer from fibromyalgia experience problems beyond the pain caused by their illness. Their condition is little understood and hard to explain, and often they are disbelieved by doctors. Even friends and loved ones may express skepticism toward the fibromyalgia sufferer, who, burdened with inexplicable pain, may cancel social plans, miss work and recoil from physical affection because it hurts too much.

For a glimpse into the frustrating world of fibromyalgia sufferers, listen to the latest installment in the Patient Voices series by producer Karen Barrow.

You’ll meet Christine Wysocki, 33, of St. Augustine, Fla. who waited three years before a close friend and co-worker believed she had a health problem.

“Frankly I still don’t know if I understand exactly what it is,” says Ms. Wysocki. “Everything seems so vague about what fibromyalgia is, and it feels like no one wants to commit to what an actual answer is.”

And there’s Leon Collins, 59, of Clayton, N.J., who was relieved when he heard he had fibromyalgia because he at least had a diagnosis after many other doctors had dismissed his symptoms.

“We even experienced one doctor who wanted to send me to a psychiatrist because he felt my pain was imagined,” he said.

The Skeptic 

Count me as one of the skeptics. Not necessarily whether fibromyalgia exists, just that the vast majority of sufferers actually have it. I won’t use the word hypochondria, because I think that is inadequate. I think that many of these people suffer from a somatiform or somatization disorder. Still a disorder in need of treatment, but not fibromyalgia.

Understand, I think that this has definitely had a “wolf-crying” effect on people who do have it, and also on people who suffer, quite beyond their control, from untreated somatiform disorders. This results, not from the inability of medical science to test and confirm the diagnoses of fibromyalgia beyond cataloging the symptom complaints of sufferers, but from the fact that so many people who report these symptoms also complan of other vague maladies and bring to doctors their own self-diagnoses that the doctors have little choice but to attempt to treat them as they are reported.

This is how I put it to the last such person I spoke to: “What are the odds, mathematically, that one person should suffer from so many obscure and medically unconfirmable maladies? Maladies that have symptoms that can only be accepted or rejected based on your word that they exist?” The simple mathematical improbability that one person suffer from Meniere’s Disease, Epstein-Barr Syndrome, and Fibromyalgia, all three vague disorders that seem to show up in varied combinations among middle aged women, commonly with a history of childhood abuse, begs the question: Why are doctors being guilt-tripped into rejecting the possibility that these patients don’t suffer from what they think they suffer from, but indeed do suffer from something? Is the mere social stigma of psychological and emotional disorders enough that we should reject the possibility? I say no.

— Dr Hirschberg

Dr. Hirscberg validates that there are stupid doctors in this world and you should avoid them like the plague. If you have a skeptic for a doctor, if he or she isn't listening to you FIRE THEM and get another doctor! 

Lyrica and Fibromyalgia

Lyrica is the first prescription medication approved to treat fibromyalgia.   Because fibromyalgia patients typically do not respond to conventional painkillers like aspirin, Lyrica affects the brain and the perception of pain.  Pfizer’s Lyrica, known generically as pregabalin, binds to receptors in the brain and spinal cord and seems to reduce activity in the central nervous system.

No one knows exactly how Lyrica works.  But some say that Lyrica does not work well enough to have warranted its FDA approval.  According to The New York Times, in clinical trials, patients taking Lyrica reported that their pain fell on average about 2 points on a 10-point scale, compared with 1 point for patients taking a placebo. About 30 percent of patients said their pain fell by at least half, compared with 15 percent taking placebos.

In 2004, Lyrica was reviewed by the FDA as a remedy for diabetic nerve pain.  The reviewers recommended against approving the drug, citing its side effects.  Lyrica causes weight gain and edema, or swelling, as well as dizziness and sleepiness. According to the New York Times, in 12-week trials, 9 percent of patients saw their weight rise more than 7 percent, and the weight gain appeared to continue over time.

But the FDA ignored the advice of Lyrica reviewers, and approved it anyway.  Then Pfizer asked the FDA to expand the approved uses of Lyrica to include the treatment of fibromyalgia, and the agency did so in June.  It was a good move for Pfizer.  According to the New York Times, worldwide sales of Lyrica reached $1.8 billion in 2007, up 50 percent from 2006. Analysts predict sales will rise an additional 30 percent this year, helped by consumer advertising.  During the first nine months of 2007, Pfizer spent $46 million on Lyrica ads alone.

While I welcome anything that will help my fibromyalgia patients, I’m not a big fan of Lyrica.

Why? It doesn’t seem to offer any real long-term relief and the side effects are potentially dangerous. 

There are many side effects that are considered "normal" of Lyrica. However, it should be noted that if these symptoms occur they should be brought to the attention of the prescribing doctor. You must keep in mind that the Federal Drug and Food Administration often approve drugs that will result in certain side effects. However, they do so on the notion that the benefits of the prescription will outweigh the consequences associated with side effects in the long run. The following outlines some of the "common" side effects of Lyrica:

Experiencing Weight Gain

Blurred Vision

Body Tremors

Possible Insomnia

Gastrointestinal Difficulties, such as Diarrhea and Constipation

Mild to Severe Headaches

Nausea

Swelling in Hands

Dry Mouth

Swelling in Ankles

Dizziness

Drowsiness

Possible Fainting

Traditional medicine alone isn’t very helpful for fibromyalgia- 70 percent of fibromyalgia patients seek out alternative methods.

I encourage my patient’s to use the Essential Therapeutics Fibromyalgia Jump Start Package.