0:16
Well hello my friends. Welcome to the first episode of the MIND YOUR FIBRO podcast. I'm your host, Dr. Olga Pinkston, the board certified rheumatologist. I work in the busy rheumatology practice in Louisville, Kentucky. I'm on a mission this year to help patients with fibromyalgia to manage their symptoms and improve quality of life. I created this podcast first and foremost for my patients, you know who you are and love you and care for you. But I also want you to know that even without the fibro fog, most patients cannot remember about a third of the information provided at the doctor's visit.
0:55
Now, fibro is real, and I want you to empower yourself by knowing what fibro is, get the fundamentals on this condition, and know that you're not alone in the struggle. As a rheumatologist, I see patients with fibromyalgia daily. It is probably one of the most challenging disorders to explain to my patients, and to treat. Over the years this condition change names, we do not have a blood test or imaging test to confirm it. The treatment is far from straightforward in often unhelpful. There are even some doctors in patients who do not believe it is real. If you're a healthcare provider, please please please educate yourself about fibromyalgia. I see patients daily in my practice, who tell me that their doctor or other provider doubts that fibro is real, do not have an up to date information about it. I can tell you fibro is real and your patient's pain is real. Now, our society does not doubt the existence of migraines, depression, or any other condition that does not have confirmatory test. Yet this lack of tests of trigger suspicion and judgment when it comes to tarot myalgia. You may have relatives who don't even believe in it, or doubt that your symptoms are real. Your friends may offer you a well meant advice or to tell you, Well, you don't look sick, just check it off. It's all in your head. Well, how long can you feel this way?
2:26
Now all of the theories of what fibromyalgia is have evolved over time, one remains the same. It is a pain disorder. Now with new research and understanding how our bodies work how our brain works, we're gaining more knowledge about this condition in its treatment. Now, in this time, we did not consider Fibromyalgia to be an autoimmune condition, we do not have an approved test for it. There is a fibro test that is still in clinical trial. But it is not yet considered diagnostic, nor it is recognized by the American College of Rheumatology, the diagnosis of fibromyalgia. But I can tell you, fibro is real and I want to tell you what I tell my patients about it. It is not imaginary and your pain is real. Fibromyalgia is a pain processing disorder, your brain process everything your body does, including pain. And in fibromyalgia, the brain processes pain incorrectly. Now, every bit of your body inside and out is covered in nerve cells, your skin, muscles, joints, hair, all internal organs. This nerve cells send information from your body to the brain. Your brain knows if you're hungry, thirsty, hot, cold, or wet. It knows if you're lying down or upside down or a fly landed on your arm. Your brain also knows precisely where you are. In the where is your discomfort. If you have an each tight shoe or pimple or pain, every type of pain from a simple two sake, to complex belly pain, ingrown toenail to sunburn, everything a joint muscle sprain or headache is processed by your brain. If you don't have daily pain, and you stub your toe, for example, your brain will tell you and we'll let you know that you have a stubbed toe in a few hours or days. This toe pain results in your brain enables you to forget about it. This is an example of acute pain.
4:33
If you have a chronic pain condition, such as recurrent migraines, generally this disease arthritis or nagging pain from an old injury or fracture, really any prolonged or frequent pain. The brain does not forget to remind you about it. In some patients this chronic pain in other life events trigger a pain processing problem. As the brain progress practices his daily chronic pain reminder, it becomes excellent In recognizing pain, practice makes perfect. So in fibromyalgia, your brain is extremely good at telling you that you have pain. Now pain is stressful, and if you have pain, a cascade of events activates your primitive survival instinct to protect you from the danger. This part of the nervous system called the sympathetic nervous system is responsible for flight or fight response, and is designed to protect you from injury and death in the pain is an excellent trigger of that system. In patients with fibromyalgia, the sympathetic nervous system is turned on. Even if there is no actual emergency, your brain is continuously receiving impulses to check for possible danger. Over time, it starts seeing other sensations as discomfort in ordinary feelings, become obnoxious li uncomfortable, light touch bright lights, loud sounds. With time, if fibromyalgia is left untreated, more and more nerve cells over the body send signals that are misinterpreted, now in pain and other sensations become more and more exaggerated, amplified, like a big speaker. This turned up nervous system is called Central sensitization syndrome, a central nervous system the brain and spinal cord that is sensitive to stimuli causing symptoms. As the nervous system continues to be activated, the patient may start accumulating other symptoms besides pain, dizziness, numbness, tingling, painful bladder, restless legs, and as your brain does all this extra work, it wastes a lot of energy and it causes terrible fatigue and feeling of exhaustion. Think of all the different symptoms you're experiencing, it is not just pain is also fatigue, tingling, numbness, dizziness, IBS, and so on. Now, let's go over fibromyalgia symptoms.
7:06
To review, fibromyalgia is a chronic pain disorder in abnormal way the brain process pain and other stimuli. It is not a progressive condition, meaning there is no organ damage, and it is not a life threatening condition. Unlike other disorders like rheumatoid arthritis, lupus, fibromyalgia does not cause organ damage. Even after 20-30 years, you do not have deformed joints, and you will have normal labs and imaging. Fibromyalgia may progress in terms of symptoms, you may have more pain and discomfort, but it does not cause organ damage.
7:45
We don't know what causes Fibromyalgia, but we know it is real, your pain is real. It is a common condition. About 4 million US adults have her myalgia or about 2% of adult population. One in 20 people worldwide have Fibro.
8:04
Who gets fibromayglia? We typically see fibromyalgia in females; it is more common in women between the ages of 20 to 50. We will also see the men, elderly and children. Usually patients will have some other painful condition, you may have a painful arthritis, chronic back pain, migraine whatnot. And sometimes we also see it in family members. So it's not uncommon to see it in several family members. But it's not the typical genetic condition like Down syndrome or cystic fibrosis, we don't have a genetic test for it. Also, we see it with patients who have recurrent injuries, again like that, because of the chronic pain that comes from the recurrent injuries. But we see it with recurrent sports injuries and other painful injuries like a car accident. And then sleep disorders, sleep apnea, insomnia can put you at risk of developing fibromyalgia. About 25% of patients with autoimmune conditions will additional have Fibro as well, likely because Fibromyalgia is common in painful conditions. So autoimmune conditions that are painful, put you at risk of developing Fibro. Being overweight or obese or have poor nutrition is a risk factor, as well as with disorders such as anxiety or depression.
9:31
So if you have the risk factor, say you're a female in your 20s or 30s, and you have a family member with chronic pain or Fibro and you had chronic back pain and migraines. What makes you develop fibromyalgia. Usually there's a fibro trigger something triggers you to actually develop the fibro symptoms. number one cause of it is trauma, early childhood trauma, physical or sexual abuse, neglect anything traumatic can put you at risk of developing Fibro or triggering fibro. Ongoing or severe stress. A prolonged or severe stress,stressful events is a common trigger infections, severe infections, recurrent infections, chronic infections or wound with have seen more fibro in the past year and a half due to COVID infections. Both the infection itself as well as the stress of isolation is a trigger for fibromyalgia, prolonged hospitalization, long hospital stay, medical, medical complications, surgery are common trigger also injuries, car accidents, Whiplash, falls fractures, recurrent injuries, sports related injuries are common to grow for amalgam.
10:48
So what are the fibromyalgia symptoms? The number one symptom is widespread pain. It is pain all over the body. It's in the muscles, the joints, usually in arms and legs and body and body can be an upper body. Lower body can migrate from one side to another. But patients will tell me everything hurts, muscles, joints, even my skin, my hair hurt. I feel like I was run over by truck. I feel like I have the flu. I have a good day and I have no symptoms from mild symptoms and then something happens like a snap of the fingers, it triggers you to have a severe pain or discomfort and having a bad day. When I have a bad day. Everything hurts I have to be in bed. I can barely move. I have pain with walking doing regular activities. I feel stiff. I feel like an old lady. You may have fatigue exhaustion out of proportion to your age or activity. Patients will tell me I just took a shower and I need a two hour nap afterwards. difficulty sleeping sleep is unrestful you may sleep too much and not get enough rest. You may have difficulty falling asleep or staying asleep tossing and turning all night both from insomnia as well as pain. often hear about difficulty with memory concentration called fibro fog. It is a very common problem with Fibro patients. I have patients who had difficulty finding words in the thought that had a stroke. The patient went to ER with word finding difficulty thinking she had a stroke. Again it's it's a fibro fog that can be very severe especially if you're having a fibro flare or other fibro symptoms. dizziness or lightheadedness is common. Patients will tell me I feel dizzy lightheaded that people have problems with my balance. I I tell you you have to work out. Evaluate this dizziness to make sure there's no cardiac causes. Make sure there's no problems with your heart or nervous system. But the episodic dizziness and lightheadedness is a common fibro symptom. Episodic numbness and tingling this common patients will have a migrating numbness tingling feeling their foot asleep, which television or the arm falls asleep or they have to feel tingling in their fingers. Now neuropathy, which is a nerve damage type of pain is common with back pain or chronic nerve conditions. We see it in that diabetes and chronic spine problems. But in fibromyalgia is usually episodic, it's random. It doesn't persist. It comes and goes at random times, but can be very annoying in debilitating headaches, including migraines intensity of headaches are common. Also sensitivity to sensitivity to touch smell bright lights or noise. Patients feel overstimulated. Even the normal stimuli from the lights or the smell or the touch can become very bothersome. have patients who used to love shopping. Now they cannot stand the department store, the smell of the perfume, the noise from the people in the music, the hustle and bustle, the fluorescent lights up, increase your symptoms and within 30 minutes they may have increased in pain, headaches in other symptoms. Also, also other conditions that are associated with fibromyalgia, commonly seen in patients, which is posture of psych the cardia syndrome or parts irritable bowel syndrome, which is alternating diarrhea, constipation, bloating, abdominal pain. We could also call IBS, painful bladder syndrome or interstitial cystitis, TMJ, restless legs, a depression anxiety. As you can tell those are just painful conditions that are also originated in the brain And we commonly see them in fibromyalgia.
15:03
This brings us to the end of this episode. I hope you liked it and learned something new. If you enjoy the podcast, please rate and review on Apple podcasts. And be sure to come back for the next episode. You can also subscribe to my newsletter on rheumcoach.com. Until then, this is Dr. Olga Pinkston. And don't forget to MIND YOUR FIBRO.
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