Jeg er medisinsk spesialist i fibromyalgi. Dette er hva jeg vil at folk skal forstå

Fibromyalgi, en vidt misforstått sykdom, forvirrer og frustrerer både pasienter og leger. Jeg vet dette fordi jeg så det på begge sider, både som lege og som kvinne med sykdommen.

Dette bildet har et tomt altattributt;  filnavnet er Untitled-11.png

Denne vanlige kroniske sykdommen er preget av generaliserte muskelsmerter, tretthet og tåke i hjernen. Anslagsvis 5 millioner amerikanere lider for tiden av lidelsen, og nesten 90 prosent av de diagnostiserte er kvinner.

Imidlertid er det fortsatt mye forvirring rundt sykdommen og hvordan den behandles. Her er fem sannheter om fibromyalgi som de fleste leger ikke vet om:

1. Fibromyalgi er ekte og kan behandles, men det krever en helhetlig tilnærming.

Fibromyalgiforskning har henget etter andre sykdommer, besatt av kontroverser og et århundre med argumenter om hvorvidt det er en “ekte” sykdom.

Dette endret seg i 2002, da en innovativ studie viste avvik i måten hjernen behandler smerter i fibromyalgi. Disse hjerneavbildningsstudiene ga objektive data for å demonstrere at fibromyalgi var “ekte” og utløste et tiår med intensiv forskning, noe som resulterte i tre FDA-godkjente medisiner som produserer smertefulle smerter.
Men disse medisinene behandler ikke de mer ødelagte symptomene på tretthet og forvirrende tankegang som kalles “fibrofog.” For å gjøre dette, må leger og pasienter være godt informert om forskjellige behandlingsalternativer, spesielt helhetlige tilnærminger som kostholdsmodifisering for å redusere betennelse eller legge tilskudd for å stimulere cellulær energiproduksjon.

2. Det er ikke lenger et komplett mysterium.

Jeg hører ofte at myten har gjentatt at “vi vet ikke hva som forårsaker fibromyalgi.” Nyere undersøkelser av leger viser at de fleste leger fremdeles ikke vet hvordan de kan hjelpe sine fibromyalgi-pasienter, til tross for at det eksisterer svært effektive behandlinger. Fibromyalgi blir ofte beskrevet i medisinske tidsskrifter som “forvirrede”, “mystiske” og “forvirrede.”

Fjernsynsreklame som sier at fibromyalgi er en overaktiv smertetilstand. Nervene forteller ikke hele historien. Faktisk er smertehåndteringsproblemer bare toppen av isfjellet. En mye større faktor er et svar på stress (eller fare) som er slukket og som stadig er “rød våken”, noe som resulterer i en kjedereaksjon som forårsaker tretthet, tåke i hjernen og muskelsmerter.

Den eneste måten å forbedre alle disse symptomene permanent er å systematisk håndtere de negative effektene på kroppen av en kronisk hyperaktiv stressrespons. En kronisk aktivert stressrespons forstyrrer ødeleggelse ved å forhindre dyp søvn og holde muskler anspente, forårsake smerter og ømhet; hemmer fordøyelsen og energiproduksjon; og eliminere hormoner. Det viser seg også at smertefølsomme nerver øker volumet på signalene dine.

3. Fibromyalgi er først og fremst en søvnforstyrrelse.

Dessverre er mange leger, inkludert søvnspesialister, ikke klar over søvnproblemene som følger med fibromyalgi. Men fibromyalgi er på mange måter en søvnforstyrrelse, en tilstand av kronisk og dyp søvnmangel. Studier har gjentatte ganger vist at pasienter lider av utilstrekkelig dyp søvn som ofte blir avbrutt av “våkne” hjernebølger. Denne hungersnøden til dyp søvn bidrar til tretthet, muskelsmerter og forvirret tenkning som er karakteristisk for sykdommen.
Å behandle søvn er nøkkelen til å behandle fibromyalgi, og det er her jeg ser de fleste måtene å redusere smerter, tretthet og tåke i hjernen. Mens søvnen alltid skal forbedres før andre behandlinger fungerer, er det viktig å ta opp dette problemet med helsepersonellet for å behandle skjulte søvnproblemer som hindrende søvnapné, og deretter legge til medisiner. og kosttilskudd for å gjenopprette normal dyp søvn.

4. De fleste leger vet ikke så mye om fibromyalgi, og det er ikke deres skyld.

Fibromyalgi er en foreldreløs sykdom som ikke hevdes av noen spesialitet, og i stedet overlappende vanskelig i områdene reumatologi, nevrologi, søvn og smerte medisin. Det meste av omsorgen gjelder nedsenket leger som ikke har tid til å søke etter nye behandlingsideer i sjøen av medisinske publikasjoner. Ledende medisinske tidsskrifter forsømmer fibromyalgi. Siden 1987 har faktisk bare en studie om fibromyalgi blitt publisert i New England Journal of Medicine, den mest publiserte medisinske publikasjonen i verden.

Siden den travle primærpleier ikke har tid til å aktivt søke nye fibromyalgi-behandlinger, må forskningen få oppmerksomheten annerledes – det vil si fra pasientene. Så i min nye bok, The FibroManual, inkluderte jeg en helsepersonell-guide med forskningsstøttet medisinsk råd for pasienter for å få legens oppmerksomhet.

196 thoughts on “Jeg er medisinsk spesialist i fibromyalgi. Dette er hva jeg vil at folk skal forstå

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