Multivariable Variable Variability

One thing that most all doctors agree on and that studies support is that fibromyalgia is a condition with a multitude of symptoms.  This has made fibro difficult to diagnose and near impossible to manage and definitely impossible to cure.  Doctors can chase symptoms for patients, but it’s an unending race.

There are times I’m very sure my body deliberately resists treatments because they may work for a while and then the effectiveness stops or some new issue arises to make up for the relief I felt.  It’s like taking meds.  For example, I could take penicillin without difficulty until I was about 21 years old.  Then I was taking it for an ear infection, and it had no effect.  My ear swelled shut and the drum popped.  After about a week of taking it, I broke out into a rash and it’s been on my allergy list ever since.  All the other times I took penicillin did not guarantee that I could take it the rest of my life.

So with the multifaceted nature of fibromyalgia and the potential resistance of the body to treatments, are there any other options for treatment or management?  I’ve often wondered what would happen if fibromyalgia was dissected by symptom.  For example, sleep disorder is one of the common characteristics of fibromyalgia.  Sleep disorder causes other problems that contribute to fibromyalgia symptoms, including structural changes that seem to mirror the damage that chronic pain has on the brain, in the insular cortices.  See Park et al in the library.  I only could get the abstract, but they discuss “abnormal autonomic, affective, sensorimotor, and cognitive control networks” in patients with obstructive sleep apnea.  The study by Park et al was not centered on fibromyalgia or chronic pain at all, but the coincidence of similar damage to the same structures in the brain between OSA and fibro seems too close to ignore.

Unfortunately, I am case in proof that curing sleep apnea will not cure fibro.  But if you have one patient with several different problems all bundled together – does that bundle of issues (potentially different in each patient) “create” fibromyalgia by altering the structure of the brain and the pain network when the body becomes overwhelmed with sensation?  Does that bundle “teach” the body to feel too much?  If that is the case, combining treating individual symptoms (like apnea) immediately and doing genetic testing (yes refer to library again, several articles on genetics of fibromyalgia) to determine the risk of developing fibromyalgia could be a potential prevention method instead of waiting for the brain to remodel.  Maybe?  The trick may be to stop being stumped by trying to characterize fibromyalgia by the similarities between patients and to look at the myriad of symptoms as a marker for fibromyalgia potential.  Maybe.

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