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A chronic pain day

August 2, 2008

About 1:30 last night my body decided to start running a series of load-capacity tests on every nociceptor in the nervous system.  Or something.  But I have been damned uncomfortable today and painkillers are not helping.

This started being a problem – sometimes quite severe like today – years ago after my first bout of kidney stones and one of my early surgeries.  It’s as if the pain circuits got stuck.  As I have passed more stones and had more surgeries, it has gotten worse.  Accident 4 years ago did not help.

An MD muscle specialist finally figured it out: he said I have “chronic migratory fasciitis”.  (I resisted the urge to ask him if that was like migratory coconuts.)  But as he explained the malady he kept mentioning fibromyalgia.  I asked him; “Is this fibromyalgia?”  He said; “Well, it’s the same thing as fibromyalgia.”  Thanks for clearing that up, doc.

It reminds me of my old Greek professor – he wasn’t from Greece, he just taught Greek.  He said we pay doctors to translate our ailments into Greek.  You go to the doctor and say; “Doctor, my eye is swollen.”  He says; “Aha!  You’ve got ophthalmitis!  That will be twenty-five dollars, please.” I guess I should update that anecdote to reflect the current cost of medical care.

I don’t know where I’m going with this post but anyway that’s where I am.

Categories: Personal
  1. August 2, 2008 at 02:32 | #1

    Chronic pain is a son of a bachelor.  I hope some clever bugger comes up with a cure soon.

    And don’t you love how doctors get all obscure and try to sound complicated and certain when what they’re really telling you is, “Your body’s a total mess, I have no idea why.  But I’m going to ask you for a buttload of money, so I have to make it sound good.  That’ll be $500, please.”

  2. August 2, 2008 at 09:21 | #2

    I just Googled “chronic migratory fasciitis” and got no exact matches. I think I’d want a second opinion.

    Doctor: “Ok. That shirt isn’t doing a thing for you either!”

    Closest-looking match was: <a >The Fasciitis-Panniculitis Syndromes: Clinical and Pathologic Features.</a>

    Article

    Medicine. 75(1):6-16, January 1996.
    NASCHITZ, JOCHANAN E. MD; , JOCHANAN H. MD BOSS; MISSELEVICH, INES MD; YESHURUN, DANIEL MD; ROSNER, ITZHAK MD

    No mention of fibromyalgia, at least, not in the title.

  3. EdK
    August 2, 2008 at 09:28 | #4

    Maybe it will migrate out of your body and stay away.  As a former plantar fasciitis patient, I know only how it felt in my feet.  Can’t imagine what that feels like over all connective tissue.

    Meds didn’t help it, I read some posts somewhere about Ecco shoes.  Pain alleviated in a week after months of torture.  Feet 1, Skepticism 0.

    Hope you find your remedy soon.

  4. August 2, 2008 at 10:18 | #5

    Thanks for the good wishes everyone.  I’m feeling a little better today though I won’t be running any marathons.

    I think I’d want a second opinion.

    That’s the problem; I gots lots of medical opinions.  Over a 15-year period my estimation of the usefulness of doctors is divided by the number of them who have pronounced their verdict.

    I may not be correctly remembering how he said it though.  He sent me to a physical therapist who did a thorough inventory of muscle action in my body, and taught me how to find exercises for the weak ones.  He said “You can have strong muscles that hurt, or weak muscles that hurt.”  So I lift weights and do cardio exercise, which helps a lot.

    Maybe it will migrate out of your body and stay away.

    That would be great!

    I wear pretty expensive shoes too.  Much cheaper in the long run, IMHO.

  5. August 2, 2008 at 10:28 | #6

    I found you have to google “migratory fascia” and then the primary result is a chiropractor cloaked in “science”…

  6. August 2, 2008 at 10:40 | #7

    Well that’s the difference between an MD and a Chiropractor – the latter promises miracle cures.  This guy (an MD specialist in disorders of muscles and connective tissue) didn’t do that; he sent me off to a PT who taught me some useful stuff about managing pain.  But it does sometimes get the upper hand, like yesterday.

    I don’t really care what it’s called anymore.  So far strength-training, cardio, and stretching have proven more effective than drugs except on the worst days.

  7. August 2, 2008 at 17:56 | #8

    I don’t really care what it’s called anymore.  So far strength-training, cardio, and stretching have proven more effective than drugs except on the worst days

    Something about that rings a bell for me. Let me offer some insight that may broaden your horizons, even if it’s not really medical advice (something I’m not qualified to give)

    Fibromyalgia is a code word among some people for “give me the goood drugs”. Search this guy’s blog. Perhaps that’s why they’re making up new names for the thing.

    For me, pain meds just make me loopy with joint pain. I’d rather have a clear head and the joint pain instead. I also want to make it clear that I’ve not had the pain levels that you or many other people describe.

    What works for me is sleep. That’s really easy to say, but it took a several different approaches to get consistently good sleep. I’d say you gotta find what works for you. Doctors popularly write a scrip for Elvil. That’s a first generation drug for depression that has the side effect of making you really sleepy. Sure I got 11 hours of sleep a night, but it wasn’t quality sleep. It also had some side effects that I’m not going to describe but were worse than the pain.

    So here’s what’s helping me. Note that I did not say cure.

    1. Exercise. My joints are screaming from the 14 miles on a bike I did yesterday, but I sure slept well last night. I guess you already have this covered. I try to do this every other day and lay up on the day off.

    2. Clear sinuses. Expensive anti-allergy prescriptions work well. Plain old saline spray works five times better. Of course I use 10x as much but the saline is dirt cheap. I’ve always had a stuffy nose growing up. Saline is a life-changing therapy for me.

    3. Melatonin. Far better than all the dopey drugs. I go easy on this stuff and use it mostly to combat jet lag or to get back on my sleep routine after burning the midnight oil. Ask your doc about this first even if it’s OTC.

    4. Losing a bit of weight. Related to #1

    5. Going easy on the caffeine after about 2 pm.

  8. August 3, 2008 at 08:27 | #9

    “Fibromyalgia is a code word among some people for “give me the goood drugs”. Nice to see such authoritative info from someone who apparently doesn’t have fibro. I’ve had it for 25 years and manage it as best I can without drugs. Ibuprofen now and then for the really bad days, stretching and light weights when the fatigue isn’t completely overwhelming. 14 mile bike ride? I’m glad when I can walk a few blocks without having to take a day or two to recover. There are people who are almost totally incapacitated by fibro. Got tell them that they’re in it for the drugs.

  9. August 3, 2008 at 09:15 | #10

    Sheryl had hernia surgery 1-1/2 weeks ago.  The surgeon’s diagnostic comment had been “Oh…That’s quite large.”

    Anyway, she did quite well post-surgery with (generic) Darvocet, which primarily made her sleepy; the rest was good but disturbed her sleep patterns.

    Since you cannot tolerate my only other suggestion (good single malt), I can only wish you pain relief; glad you’re feelirg some better.

  10. August 3, 2008 at 10:47 | #11

    Standard Mischief: Fibromyalgia may well be a code word among drug-seekers, but that would have little bearing on its legitimacy as a real medical disorder.  Drug-seekers claim lots of stuff. 

    Seven years ago I was having trouble walking, and stepping over curbs, and now I’m pretty sure I could ride 14 miles if I didn’t have anything else to do for 48 hours afterward.  But I still have bad days and that was one.  The rest of the time it’s a struggle against fatigue.

    As for “expanding my horizons” that is the opposite of what FM (or whatever the hell I have) does.  I can’t fly – they’d have to carry me off the plane.  Two hours in a movie theater sometimes ends up in agonizing pain.  I’m good for about 15 minutes in a chair before I have to move.  Moving is uncomfortable but not nearly as bad as not moving.  I commute to work on a bicycle and lift weights at my desk. 

    My diet is probably a little better than most American, but sure there’s room for improvement.  Strength-training has made me pretty strong, but despite an average of 1 hour cardio every day (my resting pulse is around 60) I have little endurance.  I’m like a V8 engine with a 1-gallon gas tank.

    Drugs really don’t work for me; I seem to be relatively insensitive to their effects even for post-surgical or kidney stone pain.  So the only relief I have been able to find is what I learned from the physical therapist that the muscle doc sent me to.  And believe me, I’ve looked, even at things that didn’t seem to have much scientific backing, like chiropractic and meditation. 

    It sounds like your exercise program is going very well.  Be careful of those knees; you will need to keep exercising all your life.

    Catana: Hope you have better times ahead.  Keep moving.  :coolsmile:

    Breakerslion, Dana, Webs, thanks.

  11. August 4, 2008 at 23:55 | #12

    @ Catana

    I really didn’t mean to troll. I know that there’s people out there who are crippled by Fibro and CFS type syndromes. I know there are a number of honest people who are on a number of medications to try to get back control of their lives.

    Unfortunately, there seems to be a number of people who use it as an excuse to get drugs. That is a fact. As you may note in the post, George was given a diagnosis of “chronic migratory fasciitis”, and my comment was my reaction to something that sorta evokes “euphemism treadmill” or perhaps “pejoration”. I will say that stumbling across Ambulance Driver’s blog did explain a few eye rolls I was clueless over.

    I’ve never had symptoms so bad that I meet the CDC’s criteria for chronic fatigue syndrome or Fibro, but I suppose that just means I wouldn’t be able to participate in a study. I was at a point five years ago where I couldn’t run a whole city block. The things that helped me didn’t work overnight, but I am better, and I’ve very happy for that.

    For me, Fibromyalga was a diagnosis of exclusion. It started off with more CFS like symptoms, and gradually shifted over to joint and point pain. Whether or not I actually have CFS or Fibro is something you can take up with my doctor. Keep in mind that Fibro is a syndrome and not a disease. That simply means that we don’t yet know what causes the symptoms, not that it isn’t real.

    @ George

    Drugs really don’t work for me; I seem to be relatively insensitive to their effects even for post-surgical or kidney stone pain. 

    Yea, I sorta got that in your original post and follow-up comment. and it rang true with me and was probably why I decided to comment. I said that the loopy drugs left me with joint pain while being loopy. The Elavil (I misspelled it as Elvil) had side-effects and gave me non-restful sleep. 

    So the only relief I have been able to find is what I learned from the physical therapist that the muscle doc sent me to.  And believe me, I’ve looked, even at things that didn’t seem to have much scientific backing, like chiropractic and meditation.

    Another thing I didn’t mention was a way I’ve managed to get total relief, if only for 20 minutes or so. A session in a hot tub or sauna followed by a dip or bucket full of cool water. My layperson’s research says that it releases endorphins, although why this gives me relief and the opiates don’t is a mystery to me.

    An MD muscle specialist finally figured it out:… ((original post)

    I’m glad that your specialist actually was worth a damn. I did not have as good an experience myself. Besides the battery of blood tests, the misdiagnose of lyme’s disease and the exotic diagnostic procedures, all the specialists that I saw only seemed to want to do was to get me on the subscription visit plan and play the drug roulette game (Try this drug and see if it helps and come back and see me in 6 weeks because you have such great health insurance).

    It sounds like your exercise program is going very well.  Be careful of those knees; you will need to keep exercising all your life.

    Thank you and you too. I’m glad to here that you found something that seems to help.

  12. Mind Body Shop
    August 7, 2008 at 20:32 | #13

    It is a blessed thing that in every age someone has had the individuality enough and courage enough to stand by his own convictions.

  13. Janet
    August 7, 2008 at 21:06 | #14

    George, look up “polymyalgic rheumatoid.”  A friend told me she had it and was luckily diagnosed and treated with some steroid for quite some time, but she has been cured.  This woman, at 70, still downhill skis, so my guess is that her word “cure” is pretty accurate.

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