One more thing to complain about - Fibromyalgia

Forgive me for whining today but isn't that normal people do when they aren't feeling well? We don't usually go around commenting on how good we're feeling, but we sure do make sure to let others know if we aren't feeling well. Humans have a bent toward complaining. And when complaints are legitimate, they're easier to tolerate, right? Especially when the complaints are your own and not those of someone else...well, today, I hope you'll bear with me and let me whine just a little because I really am struggling and am in pain.

Aches and pains seem to be the norm as your body gets older but constant, daily pain shouldn't be normal. And, I don't really think they are normal. I've never dealt with constant pain like this before. I didn't wake up hurting before I had breast cancer, but now I do.

I've researched the symptoms and am almost certain I know the cause of my aches and pains - Fibromyalgia. Fibromyalgia is a chronic health problem that causes pain all over the body and other symptoms. Some of the other symptoms include:

• Tenderness to touch or pressure affecting muscles and sometimes joints or even the skin
• Severe fatigue
• Sleep problems (waking up unrefreshed)
• Problems with memory or thinking clearly
• And sometimes, these symptoms occur:
• Depression or anxiety
• Migraine or tension headaches
• Digestive problems: irritable bowel syndrome (commonly called IBS) or gastroesophageal reflux disease (often referred to as GERD)
• Irritable or overactive bladder
• Pelvic pain
• Temporomandibular disorder—often called TMJ (a set of symptoms including face or jaw pain, jaw clicking and ringing in the ears)

The symptoms can come and go and often times be worse than others. Stress seems to aggravate and worsen the symptoms.

So, what causes Fibromyalgia? The causes of Fibromyalgia are unclear. They may be different in different people. Fibromyalgia may run in families. There likely are certain genes that can make people more prone to getting Fibromyalgia and the other health problems that can occur with it. Genes alone, though, do not cause Fibromyalgia.

There is most often some triggering factor that sets off Fibromyalgia. It may be spine problems, arthritis, injury, or other type of physical stress. Emotional stress also may trigger this illness. The result is a change in the way the body “talks” with the spinal cord and brain. Levels of brain chemicals and proteins may change. For the person with Fibromyalgia, it is as though the “volume control” is turned up too high in the brain's pain processing centers.

There have been studies done on the link between Fibromyalgia and Breast Cancer. The most recent recorded in the International Journal of Clinical Oncology, Volume 18, Issue 2 (pages 285-292) which evaluated 150 women patients with breast cancer. During the clinical study, these women were in various stages of breast cancer. Some had just begun treatment and some had completed treatment (chemotherapy, radiation, a combination of the two and adjuvant therapies such as Tamoxifen or one of several Aromatase Inhibitors.) Of those women, 47.6% of the evaluated women suffered from Fibromyalgia pain. The study indicated that upper body trauma could have contributed to the Fibromyalgia pain but there has not been a conclusive link.  The study did find that the frequency of Fibromyalgia in patients who received breast cancer treatment was higher than the previously reported frequency of Fibromyalgia for the general population, and Fibromyalgia affects patients’ quality of life negatively. 

How is fibromyalgia diagnosed? A doctor will suspect Fibromyalgia based on your symptoms. Doctors may require that you have tenderness to pressure or tender points at a specific number of certain spots before saying you have Fibromyalgia, but they are not required to make the diagnosis. A physical exam can be helpful to detect tenderness and to exclude other causes of muscle pain. There are no diagnostic tests (such as X-rays or blood tests) for this problem. Yet, you may need tests to rule out another health problem that can be confused with Fibromyalgia.

Because widespread body pain is the main feature of Fibromyalgia, health care providers will ask you to describe your pain. This may help tell the difference between Fibromyalgia and other diseases with similar symptoms. Other conditions such as hypothyroidism (underactive thyroid gland) and polymyalgia rheumatica sometimes mimic Fibromyalgia. Blood tests can tell if you have either of these problems. Sometimes, Fibromyalgia is confused with rheumatoid arthritis or lupus. But, again, there is a difference in the symptoms, physical findings and blood tests that will help your health care provider detect these health problems. Unlike Fibromyalgia, these rheumatic diseases cause inflammation in the joints and tissues.

How is Fibromyalgia treated? There is no cure for Fibromyalgia. However, symptoms can be treated with both medication and non-drug treatments. Many times the best outcomes are achieved by using multiple types of treatments. The FDA has approved three drugs for the treatment of Fibromyalgia. They include two drugs that change some of the brain chemicals (serotonin and norepinephrine) that help control pain levels: duloxetine (Cymbalta) and milnacipran (Savella). 

For the past few weeks, I've found myself taking more and more NSAIDS (non steroidal anti-inflammatory drugs like Advil or Aleve) to help with the pain. I've also had to take something to help me sleep, like Melatonin and Diphenhydramine. On my next visit to the oncologist, in October, I'll be talking with him about a solution to this problem. I'm hoping he'll have good advice to help me. My quality of life has been greatly affected by this constant, generalized pain. No one wants to feel like they have the flu all the time and that's exactly the way I feel. 

Thank you for bearing with me through this gripe session. In my effort to open and honest and real about breast cancer and the aftermath of it, I have to share the good, the bad, and the ugly. Doctors don't talk about all the things that can happen before, during, or after treatment. It's up to the patient to do his/her homework and be prepared. 

What I'm thinking: 

I really, really wish I didn't have to deal with one more side effect of cancer. It's getting to be so frustrating to always feel crappy. I hate to always be complaining about not feeling well. I'm thankful for my family members who love me anyway, despite my whining. It would be so nice to feel normal again. Some days I wish I could turn back the hands of time to a period of time long before cancer entered my life, but I know that's not possible. I hate the term "new normal" and how everyone tells me I have to learn to live within the boundaries of it. Day by day I am reminded that cancer sucks. I'm doing my best to work through the pain and learn to live with it. I don't want to have to take any more medications but something has to give. I'm so tired of hurting all the time and I long for a good night's sleep. How wonderful it would be to be able to wake up in the morning feeling well rested and healthy. I sure hope Dr. F can help. 

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