Next month I have my yearly checkup with the doctor. It’s a new doctor – I work with residents, so every three years I get to break in a new doctor. Some people don’t like that and prefer to get a consistent consultant. Between you and me, I like breaking them in before they settle into their opinions. When they graduate, they have a good understanding of fibromyalgia patients, whether they want it or not. Since this is my first visit with this new doctor, we’ll have a little talk. I have a few concerns that I need to know are or are not fibromyalgia- or weight-related, because let’s face it, I’m getting old. I’ll be 60 in a few months, and I have to learn what to expect as I age. And any doctor who sees fibromyalgia patients needs to understand a few things about aging from the perspective of the fibromyalgia patient:

1. It will be very difficult for fibro patients to differentiate between aging pains, fibromyalgia pains, and pain signifying illness. Guidance and patience will be an absolute must for the aging fibro patient. We will have to relearn how to perceive the pain we feel. Not only will we feel pain that has no real origin or cure, but we will start feeling pain that does have an origin and may have a possibility for relief. We won’t be used to that. Fibro patients may not know to ask, or they may be very wary of medications because of a history of side effects and allergic reactions. It will be very easy to overlook significant symptoms of critical illnesses. It will be very easy to lose patience when a fibro patient contacts their doctor too much.
2. Education about aging symptoms will be much more valuable than a “well, you’re not a spring chicken anymore” attitude. We’ve already gotten that from friends and relatives for years. I’ve been hearing that since I was about 35. I haven’t felt like a spring chicken… ever. I have no comprehension of life or movement without pain. Being told essentially to put up with aging pains as a part of life is, frankly, a little insulting. Doctors are usually pretty good about telling patients about, for example, cancer symptoms to look for, early warning signs. That is much more helpful.
3. Fibro patients will feel aging pains differently. Our brains tell us we’re in pain when other people may not perceive pain at all or a much less intense pain. It’s not just the basic fibromyalgia pains that are intensified, it’s any pain. I’ve gone on the theory that I’ve had a rheumatic process that is so mild the doctors have not been able to discern it, but my pain sensors are so darn good, I have been able to feel it. Of course, if (when) I actually get a rheumatic diagnosis, it will be very difficult to prove that it’s an ongoing process, not a new condition.
4. Fibro patients already struggle with mental health before the aging process. We struggle daily when we’re young. As I get older and realize how much I have not done, how much I lost to time spent waiting, resting, the struggle intensifies. That very normal end-of-life mental weight people feel is exacerbated by chronic pain. I suspect we feel it sooner. I have wondered for many years now, if I felt 80 when I was 30, what will I feel like when I’m 80, and do I want to know? Since mental health is integral to physical health, doctors need to be consistent in monitoring for depression and suicidal thoughts as the fibro patient ages.

Again, mutual respect and communication between patient and doctor are better than any prescription medication. I’m going to have a sit down with my new doctor and express my concerns about symptoms that seem suspiciously like aging rather than fibromyalgia and see what happens. As always, I am not expecting a miracle cure or even anything curable, but I’ll listen, just in case.