Make Time For You Each Day

Work for an overall lifestyle balance. Make time to do the things you "want" to do as well as the things you "have" to do. People with fibromyalgia are faced with special demands that other healthy people do not have. The task of coping with pain and fatigue each day makes it necessary to keep your priorities in order so you have the energy to reach your daily goals.

Foods That Help You Sleep

Maybe a rich, hearty dinner, topped off with a big slice of chocolate cake might seem like the perfect way to end the day, but it’s wise not to eat a large meal within two hours of bed. Try to make dinnertime earlier in the evening, and avoid heavy, rich foods as bedtime snacks.

However, a light snack before bed, especially one which contains the amino acid tryptophan, can help promote sleep. When you pair tryptophan-containing foods with carbohydrates, it helps calm the brain and allow you to sleep better. For even better sleep, add some calcium to your dinner or nighttime snack. Calcium helps the brain use and process tryptophan.  On the other hand, you might want to avoid eating too much protein before bedtime - protein-rich foods contain tyrosine, an amino acid that stimulates brain activity. Experiment with your food habits to determine your optimum evening meals and snacks.

Some bedtime snacks to help you sleep:

Glass of warm milk and half a turkey or peanut butter sandwich

Whole-grain, low-sugar cereal or granola with low-fat milk or yogurt 

A banana and a cup of hot chamomile tea

Finding Dr. Right for Your Fibromyalgia

Do you need a specialist?

By Jeanie Lerche Davis
WebMD Feature

Reviewed by Brunilda Nazario, MD

Not every doctor understands fibromyalgia well -- yet it's critical to find one who is up to date on the latest fibromyalgia treatment and research. Wherever you live, you'll have to do some research to find a health care provider who is the best fit for you.

Here's the good news: "It's easier now to find someone to treat fibromyalgia," says Kim Jones, PhD, associate professor at Oregon Health & Science University School of Nursing and Medicine in Portland.

"Fibromyalgia has come a long way in gaining acceptance in the medical community -- now that we understand the mechanisms of this disease and have treatments proven to help."

Traditionally, fibromyalgia falls under the scope of rheumatologists. But today, primary care doctors, podiatrists, osteopaths, psychiatrists, neurologists -- plus nurse practitioners -- are overseeing long-term fibromyalgia treatment. "People in primary care are learning more about diagnosis and management of fibromyalgia," Jones tells WebMD.

Wanted: Fibromyalgia Provider

In small communities, finding a doctor willing to handle fibromyalgia treatment has been difficult. In large urban areas, specialists may be easier to find -- but may not take new patients.

Support groups: "Find out who in your town has fibromyalgia and who is taking care of them," Jones says. "Call local hospitals. Ask about support groups for fibromyalgia, lupus, chronic fatigue. People in those groups will know which health care providers treat fibromyalgia."

Don't limit your search to rheumatologists: Many rheumatologists have big, demanding patient loads. Some prefer to treat only autoimmune disorders like lupus and rheumatoid arthritis, Jones says.

Consider the team approach: Ideally, you would like to have one provider take care of you. If you can't get that, the next best option is a treatment team -- a provider who manages your long-term fibromyalgia treatment, plus therapists who address special problems.

For Long-term fibromyalgia treatment: Talk to doctors of osteopathy (DO), primary care physicians, nurse practitioners. If you're seeing a podiatrist, psychiatrist, or neurologist, talk to them about your overall condition. "Very often, patients go to these specialists for treatment of symptoms -- like plantar fasciitis, depression, sleep problems, headaches. They may be open to managing your overall fibromyalgia treatment long-term," Jones says.

"Even if they don't have a great deal of experience treating fibromyalgia, willingness to treat it certainly counts," she tells WebMD. "It makes less difference how many patients they're treating with fibromyalgia, if they're open-minded." 

For short-term fibromyalgia therapy: You will likely need physical, occupational, speech, and cognitive therapists who can treat certain aspects of your illness. You won't see them long-term, just for awhile to get exercises you can do on your own. "They can really help with quality of life -- make a big improvement," Jones says. 

Physical therapists can treat plantar fasciitis, posture, and other conditions related to fibromyalgia. "It's very important to find someone who is not just focused on sports medicine," she adds. Occupational therapists can make suggestions to minimize stress on certain parts of your body.

Speech therapists who treat head trauma and stroke patients can help fibromyalgia patients with 'fibro fog.' "The therapies they utilize can help with cognitive problems -- memory and thinking difficulties," Jones says. "It's a big quality of life improvement for these patients. There's nothing more distressing than having trouble thinking."

If therapists in the past haven't helped you, don't give up, Jones advises. "Find someone who knows fibromyalgia -- or who at least works with older people. That's a bitter pill to swallow if you're 40 years old, but the exercises they prescribe will be similar."

Check with pain clinics. Some treat chronic fatigue, but not fibromyalgia. Ask if they treat fibromyalgia. How many patients have that diagnosis? Ask if one of the fibromyalgia patients could call you to discuss their experience with the pain clinic. "Pain clinics can be hit-and-miss, whether they treat fibromyalgia or not," Jones says.

Interviewing Your Potential Health Care Providers

Schedule a no-cost interview with each provider who interests you. Make it clear to the receptionist or nurse scheduling appointments that this is not a medical exam -- just an interview. At your interview, provide a short list of your medical problems or symptoms. Be brief. Keep the interview to 10 or 15 minutes.

The National Fibromyalgia Association suggests this list of questions:

• Are you comfortable with diagnosing and treating fibromyalgia?
• How many fibromyalgia patients have you treated?
• Are you familiar with my other conditions?
• What medications do you usually prescribe for fibromyalgia? Do you have a problem with the medications I am currently taking?
• What do you feel is adequate pain control?
• Can you treat depression or must I see a specialist?
• Are you familiar with alternatives therapies? What therapies do you recommend?
• How can you and I communicate best?  

After the interview, jot down your impressions. Did this person believe in fibromyalgia? Were your questions answered? Is this a person you feel will listen to you? Trust your gut instinct.

Finding the right person to treat your fibromyalgia is important. Don't give up. Even if you've had bad experiences in the past, things are improving in fibromyalgia treatment. There's a medical professional out there who is just right for you.

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Fibromyalgia a ‘Real Disease,’ Study Shows

Researchers Say People With Fibromyalgia Have Abnormalities of Blood Flow in the Brain

By Caroline Wilbert
WebMD Health News

Reviewed by Louise Chang, MD

Nov. 3, 2008 -- A new brain scan study concludes that fibromyalgia is related to abnormalities of blood flow in the brain.

"Fibromyalgia may be related to a global dysfunction of cerebral pain-processing," study author Eric Guedj, MD, of Centre Hospitalo-Universitaire de la Timone, in Marseille, France, says in a news release. "This study demonstrates that these patients exhibit modifications of brain perfusion not found in healthy subjects and reinforces the idea that fibromyalgia is a 'real disease/disorder.'"

Fibromyalgia is a chronic disorder characterized by widespread muscle pain andfatigue. It affects 2%-4% of people, mostly women. It has been called the "invisible syndrome" because it can't be diagnosed based on a lab test or X-ray.

For this study, researchers took brain scans on 20 women with fibromyalgia and 10 women without the condition. Participants also answered questions to assess measures of pain, disability, anxiety, and depression.

The brain imaging technique, called single photon emission computed tomography (SPECT), is able to detect functional abnormalities in the brain.

Past imaging studies of patients with fibromyalgia had shown abnormalities in cerebral blood flow, also called brain perfusion. In some areas of the brain, blood flow was below normal, and in some areas, it was above normal. In this study, by using whole-brain scans on the participants, researchers were able to analyze how perfusion in each area of the brain related to measures of pain, disability, anxiety, and depression.

Researchers confirmed that patients with fibromyalgia exhibited brain perfusion abnormalities in comparison to the healthy participants. These abnormalities corresponded with the severity of the disease. An increase in blood flow was found in areas of the brain involved in sensing pain and a decrease was found within an area thought to be involved in emotional responses to pain.

There seemed to be no relationship between these abnormalities and presence of depression or anxiety. "We found that these functional abnormalities were independent of anxiety and depression status," Guedj says in a news release.

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Consider Joining a Fibromyalgia Support Group

Support groups are geared toward meeting the needs of people with fibromyalgia. Support groups, which are often educational, are not psychotherapy groups. But they do provide patients and their families with a safe and accepting environment where they can vent their frustrations, share their personal stories, and receive comfort and encouragement from others. Ask your physician for some recommendations. or check with the Arthritis Foundation for support groups in your area.

Click here to find a support group near you.

Fibromyalgia lecture scheduled for Sept. 8

The Wellness Education Foundation, East Brunswick, will present a free community lecture titled "Fibromyalgia … The Mysterious Syndrome" 7:30 p.m. Sept. 8 at the South River Public Library, 55 Appleby Ave.

Fibromyalgia is a chronic, widespread musculoskeletal pain-and-fatigue disorder affecting up to 6 percent of the U.S. population. In addition to pain in the muscles, ligaments and tendons, other symptoms may include irritable bowel, chronic headaches, morning stiffness, memory impairment, reduced coordination and decreased endurance.

To register for the lecture, call the foundation at 732-238-2944. Attendance is limited to the first 25 callers.

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Evaluate Your Sleep Hygiene

Make sure your body is totally prepared for rest. You can't sleep if there is light in your room or if a TV is blaring in another room. Make sure your room is quiet, dark, and cool. Use earplugs if you are sensitive to noise, and wear an eye mask to block light. Eliminate afternoon caffeine from your diet, and exercise regularly -- although not near bedtime. Sometimes a snack that's high in carbohydrates can help induce sleep because it boosts levels of serotonin in your body. Serotonin is a chemical messenger that helps regulate mood, appetite, and sleep.

Get Plenty of Sunlight or Daylight

If you work indoors, go outside for breaks. If you are at home during the day, open the curtains and turn on the lights. It's worth a few cents of electricity to create a cheerful environment and feel less depressed and achy. If you live in a cold, dark climate, you may want to visit a tanning salon occasionally for the concentrated light and warmth, but don't overdo it-- you don't want to get skin cancer.  Full spectrum lighting can also be helpful if you are prone to S.A.D. (Seasonal Affective Disorder)--biochemical depression caused by insufficient light on dark, gloomy days.

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What Is In The Future For Fibromyalgia Therapy?

The key to unlocking the mystery of fibromyalgia has yet to be found. Research scientists have been studying numerous viruses as potential causes for fibromyalgia. Identification of an infectious agent or toxin which causes the disease may one day lead to a laboratory test that can help doctors diagnose fibromyalgia. Specific treatment aimed at a cure awaits future research that uncovers the exact cause of the disease.

New drugs may be developed that block substance P or nerve growth factor to relieve pain of fibromyalgia. Many fibromyalgia patients can be helped by improved patient education, proper exercise, and medications. With ongoing research, the future will certainly improve for those affected by fibromyalgia.

Recent scientific studies suggest that a specific area of the brain called the insula may be involved in the pathophysiology of fibromyalgia. With ongoing research, the future will certainly improve for those affected by fibromyalgia.

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