Treatment Update

Continuing with One Year in Review 2019: FIbromyalgia (Atzeni et al), and looking at the section on treatment. As a reminder, I started this blog because going to an extreme exercise bootcamp seemed to ease my symptoms rather than kill me, as I presumed bootcamp would. I found it not to be sustainable primarily because of arthritis, and so have tried yoga, walking, swimming, Aqua Zumba, and now I’m going to an aerobic water class called AquaMixx. There have been times between each of these endeavors that I have not continued exercising. Either the class ends or life happens. Each time I stop doing exercises, I go backwards to worse than where I started. It’s not starting at square one, it’s starting at square -5. So I can say definitively, whatever exercise works, it requires continuous practice. That’s been my best hope. Meds haven’t worked for me, and I’m sensitive to most of the ones I’ve tried.

However, it was interesting to see that most of the treatment section addressed meds, and the combination of meds that may have some affect on symptoms. If class 3 fibromyalgiacs generally have some chemical sensitivity, it doesn’t seem like that’s the way to go. My opinion. They address the basics and combinations of the basics. And they talk about CBD and opioids. The bottom line on all of it, however, is that because there’s such a variability of how fibro plays out in individual patients, that there is not a be-all, end-all pharmacologic solution. Instead, it looks like combining meds has had the most luck. This of course would require a lot of experimentation until someone puts together a chart of fibro symptoms and medications and refines the likely results as a starting point. I’m not sure about anybody else – I can’t afford the trial and error method, and I don’t want a cauldron of pills to stay compliant with. The side-effects are too great, and they usually affect work as well as my personal life. And I can’t afford it.

So I turned to the non-pharmacological section, which they assert seems to have better impact on symptoms and quality of life than drugs. They discuss behavioral therapies to help people learn to move – to be aware of their movements: Basic Body Awareness Therapy (BBAT) and Cognitive Behavioral Therapy (CBT). I can attest to CBT – I’m a graduate, and a mindfulness advocate. I suspect BBAT has the mindfulness element to it but with a stronger connection to the physical. I’d like to check that out a bit.

I was surprised when I read, “physical activity does not seem to influence pain sensitivity” and then a dive back to drugs. It’s probably true that exercise doesn’t change the way we feel pain, but I firmly believe it reduces the amount of pain that we feel. Instead they go into cryotherapy, mud-bathing, electrical nerve stimulation, laser therapy, and pulsed electro-magnetic fields, and other such stuff. I must be becoming quite cynical. These all would require a substantial amount of time and money to get whatever relief these treatments may give. These are not cures – they’re symptom chasers. And expensive ones at that. So if that’s the direction medicine is going as of 2019, I’m not impressed and not particularly hopeful.

I can do better on my own, I think. I’m in the pool once a week for AquaMixx. It kicks my butt, but overall I feel better. I need to lose weight to take the strain off the arthritis in my knees and back. I have to focus. My goal is to stay mobile. Knees and back are a key component to that. Tonight in the pool, my knees were a-talking. So goal: weight loss, and stay in the pool. Weight loss is tricky, but I’ll give it a go. It would be nice to be able to bend in half again without adjusting for my belly. So maybe that will be my goal, not really weight-loss, but girth-loss. When I can bend in half without adjusting for my belly, then success!

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