The Okifuji article (see library) on management of fibromyalgia raised a few questions (besides that ever elusive “will there ever be a cure?” question):

Maybe the more pertinent question that is raised by looking at fibro management strategies is: “How can there ever be a cure?”  You put 10 fibro patients in a room and you will have 10 different symptom arrays, 10 different mechanical triggers, 10 different methods of coping with the syndrome… Put the same 10 fibro patients in a room six months later and you will have an entirely new set of symptoms, triggers, coping methods…

You can imagine how frustrating a constantly changing patient landscape can be for a physician.  Does the physician chase the symptoms?  Imagine now being the patient who has to relearn every few months how to cope, how to avoid exacerbation.  What worked six months ago may not work now.  If just one symptom has worsened in that time period it could trigger an avalanche of other symptoms, and we have to start learning once more.

What is needed is a completely unique way to treat fibromyalgia patients on a case-by-case basis, recognizing that each patient is unique and that what works for one may or may not work for another.  The treatment algorithm has to be fluid and changing.  Gosh, sounds like ideal healthcare for everyone, doesn’t it?  But how can a healthcare system that is manipulated and ruled by tyrant insurance companies, whose bottom line is only the bottom line not the patient’s well-being, ever rise to this type of challenge when disease is considered a drain on the healthcare system?


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