Saturday, January 31, 2015

Color Me M&M: The NIH P2P Report on Opioids and Fibromyalgianess by Celeste Cooper






The following excerpt is from NIH P2P “The Role of Opioids in the Treatment of Chronic Pain,” which you can download and read here.

“The typically used 0-10 pain scale provides an overall sense of pain, but not an assessment of individual components related to pain. For example, recent work on the concept of “fibromyalgianess” (the tendency to respond to illness and psychosocial stress with fatigue, widespread pain, general increase in symptoms, and similar factors) identifies at least three components to chronic pain that are important to measure: chronic pain or irritation in specific body regions, somatic symptoms (e.g., fatigue, sleep, mood, memory), and sensitivity to sensory stimuli.”

Since when is fibromyalgia a concept? REALLY!?  The investigative world is a buzz with immune expression in fibromyalgia. It is NOT a concept or a belief system and if you have any doubts, read our book, Integrative Therapies for Fibromyalgia,Chronic Fatigue Syndrome, and Myofascial Pain,   or Breaking Thru the Fibrofog – Proof that Fibromyalgia is Real, which was written by rheumatologist, Dr. Kevin White, or read the many others with good reviews. You can bet I made comments on the report and submitted them to people with far more influence than I submit. (see the following)


Synopsis of my comments:

What a label! The mere mention of this is judgmental… So, are diabetes, heart disease, arthritis and every other chronic illness or pain condition to be called fibromyalgianess when the patient has difficulty coping? This statement is using fibromyalgianess as a term aquatint with a severe mental health disorder called PSSD in the DSM-5… 

Human beings need to feel accepted. Providers become part of the problem when they use "concepts" [referring to fibromyalgianess] as an explanation… It is apparent they are ignorant regarding the literature regarding the biologics of FM and are riding the shirttails of Dr. Frederick Wolfe who coined this term. Important to add is that his research reviews are biased. He uses his own database, and uses "unapproved" tools in his studies for assessing mental health. ONE opinionated person makes it more difficult for patients to effectively deal with their illness. This underlying judgment and opaque rhetoric is part of the problem... To avoid opioid prescribing, they will be passing out antidepressants like candy for this "fibromyalgianess." Unbiased evidence to support antidepressants as a treatment for pain is insufficient. Over time, we know they can cause suicidal ideation in people taking them for pain instead of clinical depression. [We need alternatives; we need research on chronic pain as a disease.]

…There is a growing population of mentally ill patients included in research on fibromyalgia, representative of chronic pain in this report, because the Wolfe fibromyalgia criteria is capturing [patients with somatic symptom disorder] as having fibromyalgia when they do not…We have become complacent by thinking situational psychological distress is the same as a true biological chemical imbalance in the brain. This distinction was not made in this report and I would think it important when discussing the use of opioids, because many chronic pain patients are treated with both.

I couldn't agree more that chronic pain has an emotional component. Take this example. Have you ever experienced the visitor that disrupts a party in a negative way, one you wish would leave, one that puts you on edge, and in some cases, causes severe emotional distress? That is what chronic pain does to the patient, but the unwanted guest never leaves. So, should we say the host is responsible for the guest’s behavior? Think again.

[End of Comment]


What can you do?

Let the National Fibromyalgia and Chronic Pain Association (NFMCPA) know how you feel. You can find them on Facebook and Twitter. You can join here


Conclusion

Of course, there is a great deal more to the report, and the rest of it is quite good. I was impressed by the panelists’ responses to questions regarding the P2P report on Opioids for Chronic Pain in the audio question and answer period. It is helpful to hear a human voice and you can listen in too (information following).

I suppose I could be over-reacting because my dander is up regarding “fibromyalgianess.” It’s difficult not to be upset when I hear from patients that their physicians are treating them differently, some being told they need to see a psychiatrist instead of a rheumatologist. The fact is we are intelligent, hard working people that rise above the rigors of daily pain, dysfunctional sleep, and the symptoms of the comorbid disorders identified by clinicians who treat and study fibromyalgia. Sleep studies identify poor slow brain wave progression, periodic limb movement, and teeth grinding. Is this fibromyalgianess too? Some days we do better than others, but isn’t that so for every living thing? What do flowers look like when they go without water?

I cringe when I have to add “fibromyalgianess” to my word processing dictionary. I can only empathize with the many MS patients that blazed this trail before us, trying to survive “hysterical paralysis.” Unfortunately, as Dr. Phil McGraw says, “the predictor of future behavior is past behavior,” quite evident this “concept” is alive and well in the politics of pain.

You can listen to the audio playback of the panelists’ responses to questions regarding the P2P report by calling 888-640-7743; Enter replay code 114001. You can review the panel biographies at www. prevention.NIH.gov


Color me M & M – Mad and Motivated. 


Also see:


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Update 2015

"Adversity is only an obstacle if we fail to see opportunity."  
Celeste Cooper, RN
Author—Patient—Health Central Chronic Pain Pro Advocate
New Website
Celeste’s Website: http://CelesteCooper.com

Learn more about what you can do to help your body function to its potential in the books you can find here on Celeste's  blog. Subscribe to posts by using the information in the upper right hand corner or use the share buttons to share with others.


All answers and blogs are based on the author's opinions and writing and are not meant to replace medical advice.  

7 comments:

ctravlngrl said...

Excellent, and my dander is up too!
Thank you for sharing.
~Corrine

Celeste Cooper said...

As always, you are so welcome. Anger channeled in the right direction can be a good thing as long as we don't let it consume us.

ctravlngrl said...

You are absolutely right.

etoims said...

oh wow what a great blog is it. I am really thankful for you that you share such an interesting thing with us. Everyone wants to live pain free life and i am really thankful to you to know this. I also searched one of the site which is expert in same field. Etoim is one of the site which provide such a treatment to one who is in pain. Myofascial pain is one of the pain which is gone because of etoims.

etoims said...

oh wow what a great blog is it. I am really thankful for you that you share such an interesting thing with us. Everyone wants to live pain free life and i am really thankful to you to know this. I also searched one of the site which is expert in same field. Etoim is one of the site which provide such a treatment to one who is in pain. Myofascial pain is one of the pain which is gone because of etoims.

elana snyder said...

didn't read the entire thing. sick to death of physicians asking me about that damn one to ten scale.

To no avail, I try to explain that the answer will be different in 15 minutes and the pain will b in a completely different body part.

Celeste Cooper said...

Elana, I think we are all sick of the 1-10 scale. It was developed to assess acute pain, which is entirely different. In my books, I have helpful assessments for how pain interferes with our lives, which should be the benchmark for treatment. If we function better, whatever we are doing is helping.

We are constantly told that chronic pain is complex, so why on earth would anyone think the 1-10 scale would work?

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