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    Old 11-15-2005, 06:23 AM   #1
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    Question - flares and trigger points -

    Hi everybody--

    I am new to this board, though I've been on the thyroid disorders board for a while. I have Hashimoto's disease, and am being treated, but I also have Raynaud's, which seems to have progressed to being a bit worse this year.

    The reason I'm posting is because the last time I went to see my endocrinologist, I told him that I still have fits of fatigue, pain in my back (esp when I sneeze!), pain in my feet and other generalized aches and pains. I also am frustrated by my bowel behavior..sometimes OK, other times (and without warning!!) constipated. I have still been having trouble concentrating at work, and I find myself slurring when I talk, and saying a word that is completely not the word I wanted, forgetting -- a lot of cognitive issues in addition to the physical.

    He suggested to me that because I already have treatment for they thyroid, it's probably not that. however, because the thyroid disease I have is autoimmune AND I have Raynaud's (don't know if it's primary or secondary officially), that I could possibly have fibromyalgia or some serious form of PMS (or it's FMS that is somehow affected by hormones - the symptoms sometimes seem to cycle with my period).

    I would like to make a trip to a rheumatologist, but I am afraid that when I get there, my body won't react the way it does when I am having a "flare". Is this possible? Do you guys flare up and then go down? I just know that if I go there and I get tested for other stuff (lupus and whatnot) and that stuff is negative, that my body will not be showing the achy/painful symptoms that I get now (and intermittenly). I mean, maybe I've gotten so used to living with this stuff that I don't even realize how knotted up I am!

    Still and all, the Raynaud's and the other problems have to have some source, don't they?? I'm just frustrated and TIRED (literally) --- anybody have any thoughts on this stuff? Did you have trouble getting diagnosed?

    Hope you all have a good day today -

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    Old 11-15-2005, 10:39 AM   #2
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    Re: - flares and trigger points -

    Sorry to hear you're having so much trouble. Raynaud's is no fun nor is thryoid problems. The key in my understanding for diagnosing Fibro will be having the tender points combined with other symptoms. The tender points should still be there when you go in to the doctor. Some of which are hard to reach & getting into ourselves - I was suprised when the doctor's poked some of mine on my lower back & hips - I literally jumped off the table in pain. But, I too have Raynauds which luckily since I live in a warm weather area isn't too bad most of the time as long as I keep myself warm. My family lives in the NW and although I want to go visit there this winter I'm dreading dealing with the coldness & what my body will do.

    But, getting in to see a Rheum Dr. is a good place to start to help you get a handle on everything. But, do make sure it's one that believes in & already treats Fibro patients. Just ask the receptionist when you call. You definately do not want to go see someone that is not truly behind it as it will just make you feel emotionally worse and you do not deserve or need that! I'm putting some information below - I'm sure you've already seen it but, hopefully it will help.

    How is it diagnosed?
    Currently there are no laboratory tests available for diagnosing Fibromyalgia. Doctors must rely on patient histories, self-reported symptoms, a physical examination and an accurate manual tender point examination. This exam is based on the standardized ACR criteria. Proper implementation of the exam determines the presence of multiple tender points at characteristic locations.

    It is estimated that it takes an average of five years for a FM patient to get an accurate diagnosis. Many doctors are still not adequately informed or educated about FM. Laboratory tests often prove negative and many FM symptoms overlap with the symptoms of other conditions, thus leading to extensive investigative costs and frustration for both the doctor and patient. Another essential point that must be considered is that the presence of other diseases, such as rheumatoid arthritis or lupus, does not rule out a FM diagnosis. Fibromyalgia is not a diagnosis of exclusion and must be diagnosed by its own characteristic features.
    To receive a diagnosis of FM, the patient must meet the following diagnostic criteria:
    Widespread pain in all four quadrants of the body for a minimum duration of three months

    Tenderness or pain in at least 11 of the 18 specified tender points when pressure is applied...
    What are the symptoms? FM is characterized by the presence of multiple tender points and a constellation of symptoms.

    Pain The pain of FM is profound, widespread and chronic. It knows no boundaries, migrating to all parts of the body and varying in intensity. FM pain has been described as deep muscular aching, throbbing, twitching, stabbing and shooting pain that defines the very existence of the Fibromyalgia patient. Neurological complaints such as numbness, tingling and burning are often present and add to the discomfort of the patient. The severity of the pain and stiffness is often worse in the morning. Aggravating factors which affect pain include cold/humid weather, non-restorative sleep, physical and mental fatigue, excessive physical activity, physical inactivity, anxiety and stress.

    Fatigue In today's world many people complain of fatigue; however, the fatigue of FM is much more than being tired. It is an all-encompassing exhaustion that interferes with even the simplest daily activities. It feels like every drop of energy has been drained from the body, which at times can leave the patient with a limited ability to function both mentally and physically.

    Sleep Problems Many Fibromyalgia patients have an associated sleep disorder which prevents them from getting deep, restful, restorative sleep. Medical researchers have documented specific and distinctive abnormalities in the stage 4 deep sleep of FM patients. During sleep, individuals with FM are constantly interrupted by bursts of awake-like brain activity, limiting the amount of time they spend in deep sleep.

    Other symptoms Additional symptoms may include: irritable bowel and bladder, headaches and migraines, restless legs syndrome (periodic limb movement disorder), impaired memory and concentration, skin sensitivities and rashes, dry eyes and mouth, anxiety, depression, ringing in the ears, dizziness, vision problems, raynaud's syndrome, neurological symptoms and impaired coordination.

    Hope this helps - good luck to you & hope you are feeling better soon!!


    Last edited by Sun_Shine; 11-15-2005 at 10:44 AM.

    Old 11-15-2005, 01:20 PM   #3
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    Re: - flares and trigger points -

    It helps to keep a record of your symptoms, especially your flare symptoms. The doctors know that flares come and go. I write mine on a calendar. I went to a rheumy that is well known for his expertise in treating fibromyalgia. Most rheumy's see more patients with fms than with rheumatoid arthritis.

    The title of your thread is trigger points and flares. Trigger points are knotted fascia in and around muscles that knots up and needs to be released. Sometimes mine will knot up and then go down the next day. Sometimes i have to have them released with physical therapy, injections, or a trip to my chiro. Most of mine are in my back, shoulders and rear end. My trigger points do flare up when a cold front is moving in, like today or if i sit for too long in one position.

    Tenderpoints hurt when pressed. I couldn't find all of mine, but my doc's do. Sometimes i will have 18 sometimes 11. The ones that bother me at times are on my hips when i lay on my side and my collar bone when the seatbelt rubs it.

    I also have cognitive difficulties where i can't find my words. I say "I lost my word" and someone "finds" it for me. It is usually the end of a sentence. But i have had it so bad, i could barely communicate and was getting on everyones last nerve. I thought i had ADD and take medication for it. It is real hard for me to learn new skills, it was when i was working. I forget a lot of things that happened in the past. Especially when i first flared with fms and chronic myofascial pain in April of 04.

    I also get what i call the "achey brakies" when my muscles ache and i feel like i have the flu. Sometimes the pain is deep in my muscles.

    There is a lot of info on this site that will help you and so many informed people who love to help others. Check out the do you describe your pain to others (or something like that) And ofcourse the posts at the top. Keep posting and let us know how you're doing. I hope you feel better soon.

    Keep the Faith,

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