Fibromyalgi, en allmänt missförstådd sjukdom, förvirrar och frustrerar både patienter och läkare. Jag vet detta eftersom jag såg det på båda sidor, både som läkare och som kvinna med sjukdomen.
Denna vanliga kroniska sjukdom kännetecknas av generaliserad muskelsmärta, trötthet och hjärndimma. Uppskattningsvis 5 miljoner amerikaner lider för närvarande av störningen, och nästan 90 procent av de diagnostiserade är kvinnor.
Det finns dock fortfarande mycket förvirring kring sjukdomen och hur den behandlas. Här är fem sanningar om fibromyalgi som de flesta läkare inte vet om:
1. Fibromyalgi är verkligt och kan behandlas, men det kräver en helhetssyn.
Fibromyalgiforskning har halterat efter andra sjukdomar, besvärade av kontroverser och ett århundrade med argumenter om huruvida det är en “riktig” sjukdom.
Detta förändrades 2002, då en innovativ studie visade avvikelser i hur hjärnan behandlar smärta i fibromyalgi. Dessa hjärnavbildningsstudier gav objektiv information för att visa att fibromyalgi var “verklig” och utlöste ett decennium av intensiv forskning, vilket resulterade i tre FDA-godkända mediciner som producerar smärtsamma smärtsignaler.
Men dessa läkemedel behandlar inte de ofta mer försvagande symtomen på trötthet och förvirrande tänkande som kallas “fibrofog.” För att göra detta måste läkare och patienter vara väl informerade om olika behandlingsalternativ, särskilt holistiska tillvägagångssätt som koständring för att minska inflammation eller lägga till kosttillskott för att stimulera cellulär energiproduktion.
2. Det är inte längre ett komplett mysterium.
Jag hör ofta att myten har upprepat att “vi vet inte vad som orsakar fibromyalgi.” Nya undersökningar av läkare avslöjar att de flesta läkare fortfarande inte vet hur de kan hjälpa sina fibromyalgipatienter, trots att det finns mycket effektiva behandlingar. Fibromyalgi beskrivs ofta i medicinska tidskrifter som “förbryllad”, “mystisk” och “förvirrad.”
TV-reklam som säger fibromyalgi är ett överaktivt smärtstillstånd. Nervar berättar inte hela historien. Faktum är att smärtbehandlingsproblem bara är toppen av isberget. En mycket större faktor är ett svar på stress (eller fara) som har släckts och som ständigt är “röd varning”, vilket resulterar i en kedjereaktion som orsakar trötthet, hjärndimma och muskelvärk.
Det enda sättet att permanent förbättra alla dessa symtom är att systematiskt hantera de negativa effekterna på kroppen av ett kroniskt hyperaktivt stressrespons. Ett kroniskt aktiverat stressrespons förödrar förödelse genom att förhindra djup sömn och hålla musklerna spända, orsakar smärta och ömhet; hämmar matsmältningen och energiproduktionen; och eliminera hormoner. Det visar sig också att smärtkänsliga nerver ökar volymen på dina signaler.
3. Fibromyalgi är främst en sömnstörning.
Tyvärr är många läkare, inklusive sömnspecialister, inte medvetna om sömnproblemen som följer med fibromyalgi. Men fibromyalgi är på många sätt en sömnstörning, ett tillstånd av kronisk och djup sömnbrist. Studier har upprepade gånger visat att patienter lider av otillräcklig djup sömn som ofta avbryts av “vakna” hjärnvågor. Denna hungersnöd på djup sömn bidrar till trötthet, muskelsmärta och förvirrat tänkande som kännetecknar sjukdomen.
Att behandla sömn är nyckeln till att behandla fibromyalgi, och det är här jag ser de flesta sätten att minska smärta, trötthet och dimma i hjärnan. Även om sömnen alltid bör förbättras innan andra behandlingar fungerar, är det viktigt att ta itu med problemet med din sjukvårdsleverantör för att behandla dolda sömnproblem som obstruktiv sömnapné och sedan lägga till mediciner. och kosttillskott för att återställa normal djup sömn.
4. De flesta läkare vet inte så mycket om fibromyalgi, och det är inte deras fel.
Fibromyalgi är en orphan sjukdom som inte påstås av någon specialitet och i stället överlappar besvärligt inom områdena reumatologi, neurologi, sömn och smärta medicin. De flesta av vården avser nedsänkt primärvårdsläkare som inte har tid att söka efter nya behandlingsidéer i havet av medicinska publikationer. Ledande medicinska tidskrifter försummar fibromyalgi. Sedan 1987 har faktiskt bara en studie om fibromyalgi publicerats i New England Journal of Medicine, den mest publicerade medicinska publikationen i världen.
Eftersom den upptagna primärvårdsleverantören inte har tid att aktivt söka efter nya fibromyalgi-behandlingar måste forskningen få deras uppmärksamhet annorlunda – det vill säga från sina patienter. Så i min nya bok, The FibroManual, inkluderade jag en vårdgivarhandbok med forskningsstödad medicinsk rådgivning för patienter för att få deras läkares uppmärksamhet.
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