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Elmar Question....please

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Old 06-07-2007, 10:50 AM   #1
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jam338 HB Userjam338 HB Userjam338 HB Userjam338 HB Userjam338 HB Userjam338 HB User
Elmar Question....please

Hi Elmar, I have been reading your posts, and it is clear that you must be in the medical field. You have excellent and helpful posts that thoroughly guide us in knowing how to help our doctors in what to test for....thank you! I have a question that I hope you can answer.

I have talked to other FM patients in my state (California) and they say that when they applied for disability they were initially turned down because "rule out" laboratory tests were not completed by the doctor. Of course that is just an excuse to use to turn down the applicant on the first try, but effectively delays the process and weeds out those trying as statistically it is known that about 50% or more of the public will not appeal any process in which they are initially turned is well known corporate world strategy.

While you may not be familiar with SS or California requirements, that is not important.........based on your posts, I am fairly certain that you are medically aware of what laboratory tests a physician should do when diagnosing FM in order to first "rule out" other conditions that produce similar symptoms. As you know there are no "rule in" laboratory tests for FM----it is diagnosed by first ruling out similar symptom conditions for which blood tests do exist and by physical exam regarding the 18 tender points.

But, what are the other similar symptom conditions for which laboratory tests do exist to rule them out as part of that process?


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Old 06-08-2007, 11:35 AM   #2
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elmhar HB Userelmhar HB User
Re: Elmar Question....please

Hi Jam,

First, to clarify, I am NOT a medical professional.

The 1990 American College of Rheumatology guidelines for Fibro dx, as I understand them, do NOT require "rule out" lab tests. However the ACR does recognize that fibro may co-exist with other problems, lupus & rheumatoid arthritis being frequently mentioned. It is fairly common for rheumatologists to test for these diseases when fibro symptoms are present.

If your fibro is accompanied by chronic fatigue syndrome, (there are CDC criteria) then testing for certain viruses, or post-viral syndromes may be helpful.

If sig neurological symptoms are present, tests to rule out MS are sometimes done.

I have known individuals whose fibro symptoms were exclusively muscular, to have tests for various forms of myositis & other muscular/neuromuscular diseases ordered by their docs.

I cannot say what rule-outs the state of CA requires for SSDI. Have you considered contacting them directly & asking which tests they require? Then taking that list to a co-operative doc, who might order said tests ... If the SSDI office is unco-operative or hedges, it may be that they are looking for rule-out testing that relates to the individual's specific presentation & symptomology.

The only other thing I know about SSDI claims is that certain docs seem to be more successful than others at obtaining results. It may have something to do with an accompanying letter, beyond the form ... not sure.

I believe that there have been legal cases regarding SSDI difficulties related to a fibro dx. Reading some of the case summaries may yield some helpful info. Any good reference librarian should be able to help you dig these up, or direct you to a specialized librarian who could help.

From a more practical standpoint, endocrine malfunction, often "minor," can significantly contribute to fibro pain, fatigue, & symptoms. This is typically glossed over by MDs, but hormone testing by a naturopath may reveal deficiencies, which can be treated with bio-identical hormone supplementation. Thyroid hormones & testosterone are frequently low in fibro. The standard thyroid screening done will not pick up the low hormone levels. These tests won't necessarily help your with SSDI, but are more for healing.

Best wishes on your quest.

Old 06-08-2007, 02:26 PM   #3
Join Date: Feb 2006
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jam338 HB Userjam338 HB Userjam338 HB Userjam338 HB Userjam338 HB Userjam338 HB User
Re: Elmar Question....please

...thanks Elmhar, and sorry for the typo in your s/n on this thread. Your posts are impressively thorough and informative and help me to learn, thank you.

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