Think of a pinball machine.  For those of you too young to know the rock opera Tommy, go to Google.  Remember how the little steel ball bearings bounced all around and you couldn’t tell where it was going to go next so it was impossible to know when to make the flipper flappers flap instead of flip and the ball would end up going down the drain and the machine would commiserate or jeer at you, depending on if it was evil or nice?  I think I played pinball once.  For five seconds.  Lost all five balls in that time.

Thinking of the bumpers and the flipper flappers and the grooves in the game which made the ball seemingly randomly bounce around like a bat out of hell, those are confounding factors.  Confounders knock the predictable off track.  You’re pretty sure you know that the bowling ball is going straight at that head pin, but all the sudden it veers right into the gutter.  The spin you unconsciously put on the ball is the confounding factor.

In medicine, confounding factors can take on lots of forms.  One of the most well known confounder is diabetes, which can be a game changer for many other medical conditions.  It can make them unpredictable.  Fibromyalgia is, practically by definition, it’s own confounder.  There are so many variables that it becomes very difficult to understand what makes the symptoms better or worse.  If you don’t change anything in your management strategy, and all the sudden you have a flareup, you are left wondering why it happened?  It was probably a confounder.

The thing is, there can be confounders going the opposite way too.  For example, you change your management strategies for the worse, and you don’t have a flareup!  It’s rare, I admit, but it happens.  Here I sit at work eating a piece of pizza, a bag of Lays oven baked BBQ chips, and a chocolate pudding.  This is not a lunch of champions.  And I’ve been having a chocolate or vanilla pudding pretty close to every day for a couple weeks now.  I’m not pain free, but I’m not flaring either.  Is it the yoga?  Maybe, but the yoga still can hurt quite a bit even as my body gets used to it.  Is it happiness?  Maybe?  Yes, mind can dominate matter.  So the little steel ball bearing in my personal pinball machine is happily, randomly, and perhaps manically bouncing off the rubber bumpers.  Maybe the flipper flappers will work in my favor for once this time.