The proper treatment of fibromyalgia and chronic fatigue syndrome
Difficult conditions
Diane doesn’t have much of a life anymore. Every morning she wakes up with pain basically everywhere. Even the first step on the floor is loaded with pain which goes into her foot, her knee, hip and climbs all the way into her back and neck. She’s not sure what’s worse, the widespread pain she carries with her all day or the debilitating fatigue which never seems to let up. Just waking up and going through her morning routine often takes 2-3 hours because she is so tired, so stiff, and in so much pain. A recent weather front has left her joints feeling swollen and also aggravated her chronic allergies. If she could just sleep through the night, she might feel better, but she can’t seem to fall or stay asleep. The hot flashes followed by never feeling warm are just icing on the cake. Living life like this, without being able to work or enjoy her hobbies or even time with her friends and family. She’s afraid to go out. She feels depressed and anxious all the time and yet she feels angry and frustrated too. But this is life right? Life with fibromyalgia and chronic fatigue syndrome.
Prevalence
Diane was a patient of mine who represents an enormous and growing demographic. She’s one of an estimated 10-12 million people in the US who suffer from fibromyalgia (and more than 3 million diagnosed with CFS).
She, like so many others, was taking a handful of medications designed to “manage” they symptoms of her fibromyalgia. This involved medications for inflammation, some for nerve related pain, some for relaxing her muscles, others to help with her mood. The problem is that they only seem to work for a limited amount of time and in some cases, the side effects were terrible. The drugs made her gain weight. They made her more drowsy. Some interfered with her digestion (which she was prescribed another drug for). Once, she tried to come off one of her medications and she felt worse than she’d ever felt. She had to titrate off for months just to avoid the extreme shock her body received from stopping abruptly.
It all seemed hopeless. She exhausted what her doctors had to offer her. Most of the time one doctor referred her to another, only to have that doctor refer her back. Sometimes it felt like no one could help her. It felt completely hopeless.
Diane did however still have hope that things would get better. She decided to proceed with a new treatment approach. No new medications. No new side effects. She went with an 8 phase treatment approach that systematically addressed every one of her body systems. It was new and a little scary at first, but nothing else was working and she was tired of taking new medications only to deal with new side effects. Here’s what she did:
The 8 Stage Treatment Approach
Stage 1: The Immune system
Stage 1 involves addressing the immune system. This includes addressing the body’s ability to deal with infection, fight off inflammation, and to adapt to weather changes. When there are sudden weather changes, inflammation naturally increases in the body, but when the body is already overburdened with pain and inflammation, these weather changes can be horribly painful.
In this stage, non-specific and wandering pains get addressed. This means neck stiffness, headaches, pains that seem to wander from place to place, skin sensitivity or even feelings like your hair hurts. Sensitivity to weather changes and even some forms of swelling fall into this stage. Read More
Stage 2: Gut Dysbiosis
Stage 2 begins addressing the health of the gut (gastrointestinal system). This is important because often poor gut health and increased intestinal permeability (sometimes called leaky gut) are associated with a variety of diseases including pain, fatigue, and emotional issues.
In this stage, heavy pains start to get addressed. Brain fog, abdominal fullness and bloating, bowel problems and morning fatigue all fall into this stage as well. Read More
Stage 3: Elevated Cortisol and Nitric Oxide Dysregulation
In Stage 3, the affects of stress and cortisol begin to get addressed. This is often seen as pain that is worse with stress. Burning pain, tension headaches, jaw tension and teeth grinding. This also further involves irritable bowel issues, acid reflux, problems with insomnia and vivid dreaming.
This can be seen as a primary stage when a bout of stress, such as a bad fight with a loved one, causes a massive flare-up of symptoms. In this stage, problems of irritability or “flying off the handle” are telltale signs. Read More
Stage 4: Platelet Adhesion and Prostaglandin Dysregulation
In stage 4, prostaglandins and platelet adhesion get addressed. In laymen’s terms, we are looking into the body’s circulation. In this stage, we are looking at symptoms of chronic, stubborn and fixed pain. Pains that may be stabbing or sharp in nature, or pains that appear to be worse in the morning.
This stage also involves those pains at old injuries or old surgical sites where there may be scar tissue. Places in the body with less blood flow such as the elbows (tennis elbow) are also a part of this stage. Some forms of insomnia, depression, or old stuck emotions are also involved in this stage.
Stage 5: Mitochondrial Myopathies
Stages 1-4 primarily address major factors of pain and inflammation. In stages 5-8 we look more fully at how the body needs to be strengthened in order to combat pain, injury, and inflammation on its own.
In stage 5, we look at the functioning of the mitochondria (the energy production centers in our cells). In this stage, we look at pains that are worse with fatigue, pains that are dull and achy, or pains that are better with pressure. In this stage, we also look further at weaknesses of the immune and digestive systems. Some cardiac insufficiencies also fall under the scope of this stage.
Stage 6: Venous and Arterial insufficiencies
In stage 6, we look at the effects of how chronic disease may have impaired the quality of the blood in the body. This may pertain to anemias or events which lead to blood loss. It may also include times of convalescence following surgery or major illness.
Dull pains also fall under this stage, as do those that improve with warmth and pressure. Depression and difficulty staying asleep can also fall under this stage as can itchy skin or pain associated with itching. In some cases, these pains may have come from or gotten worse following childbirth.
Stage 7: HPA Axis Dysregulation
In stage 7, we being to look at hormonal health, specifically as it pertains to the hypothalamus, pituitary, adrenal and thyroid axis. In this stage, there are pains that are dull and better with pressure or weird pain sensations such as burning pains in the hands and feet (especially at night). Burning bone pain also falls under this category. Often in this stage we see pains that are worse in the evening or at night or pains that worsen as the day progresses.
This pain is often worse with missed sleep or may have come following chemotherapy.
Stage 8: ACTH and Cortisol Dysregulation
Stage 8 continues the look into the hormonal system. In this stage are pains associated with cold body temperature, lower back pain, low libido, and maybe sciatica. In this stage, issues of lowered cortisol may be present such as sensitivity to stress, fatigue, weight gain, low body temperature, depression, poor memory and an increased fear response. These symptoms are also quite common in opiate withdrawal.
In this stage we also look at some important mechanisms for fighting inflammation. These involve lowered corticosteroids (natural steroids the body uses for fighting inflammation) and lowered endogenous antioxidants (antioxidants that are produced within our own bodies).
As Diane progressed through the stages, she noted that pains gradually went away. She was able to wake in the morning and get her day started immediately. She slept well again! She woke up with a smile on her face and love in her heart! She started working again as a dental hygienist (a job she absolutely loves) and feels wonderful being able to aid in supporting her family.
