Monday, July 23, 2007

Diagnosis: Fibromyalgia

Overheard in the "Doctors' Area" of the nurses' station:

Dr. A: "She's whiny and manipulative, this is her third visit this week, her med list is as long as my arm, she's allergic to everything but Dilaudid, her pain is always 10/10, and she 'thinks she might have fibromyalgia'".

Dr. B: " Tell her that she needs to follow up with her PMD to manage her pain. Fibromyalgia is a long and complicated diagnosis to reach. We can't do it in the ER."

Dr. C: "That's not true. I can diagnose fibromyalgia in the ER. Go pump up the blood pressure cuff. If she cries, she has fibromyalgia."

12 comments:

The Nurse said...

Fibromyalgia... the DZ that they dx you when everything hurts and they can't find anything medically wrong with you. Yes, it seems as if my entire town is infected with this DZ... must be in the water.

Nurse K said...

They should give a script for Tylenol (most drug seekers aren't allergic to that so they can leave options open for Percocet/Vicodin) and a card to an allergist to desensitize her to all those drug allergies so she--gasp--doesn't get addicted to--gasp--narcotics.

Mother Jones RN said...

I was told a long time ago that I have fibromyalgia and every time I get a new PCP, they roll their eyes at me when I tell them about my condition. They sarcastically ask, "So, what do you take for pain?" They can’t believe it when I tell them I take Motrin and do yoga to control the pain. Then I want to slap them and say, "No, asshole, I'm not an addict!" I really get mad at the addicts who give people with fibromyalgia a bad name.

MJ

Loving Annie said...

I'm just glad I'm so healthy.

mshkosh said...

what? a whiny fibro patient??..you don't say...@@

#1 Dinosaur said...

I had a patient -- a nurse -- who once asked if I "believed in fibromyalgia." I told her it was a poorly understood condition characterized by fatigue and pain, not a religion.

Mother Jones RN said...

Excellent answer, #1 Dinosaur. I had a doctor tell me once that my pain was all in my head. I told him that the pain was in all of my joints, thank you very much. Just because you can't see something, doesn't mean that it's not real.

Meme, RN said...

I'm a nurse and I was diagnosed with fibromyalgia 10 years ago--by a board certified rheumatologist. I had never heard of it or read a magazine article about when I was diagnosed with it. If you don't believe it exists then you don't have it and you are lucky. When you are diagnosed, MD's give you all this pain medicine because they don't know what to do with you, and people get hooked. We, medical professional, often create addicts. Everytime I go to a new doctor, I debate whether to divulge this information--same goes with new co-workers, friends, etc. Like you MJ, I don't take narcotics for my pain--I mostly grin and bear it. But let me tell you what really hurts. When you can't let people hug you because it hurts or your husband is hesitant to touch you because he knows it might hurt you or people don't believe you and you make you feel like a hypochondriac or a drug seeker--that is the real pain. Yes, lots of people claim to have fibromyalgia, some of them are drug seekers, but there are people like me and MJ who have something--call it what you want--and we don't deserve to be treated with contempt.

Nurse K said...

Whatever you want to say about fibromyalgia, the ER is still not the appropriate place to treat it no matter what it is.

911DOC said...

ditto nurse k, ditto to us creating addicts or seekers. we are creating a nation of wussies and we get in trouble if we don't "adequately treat pain" as defined by, wait for it, the patient.

AtYourCervix said...

You're correct in that the ER is not an appropriate place to treat or diagnose fibromyalgia.

I was diagnosed over 10 years ago, by my family physician. I am not a drug seeker, and I do not abuse the ER for my c/o chronic pain.

The only pain med I take is naprosyn - and that's for the plantar fasciitis and heal spur that I have in my foot. If my muscles and joints are really acting up, I reach for tylenol or a heating pad. And I also MOVE and exercise those muscles - a very important part of my day.

It's not fun when it hurts for your child to hug you, or want to sit on your lap. Just touching my muscles and joints can trigger such horrendous pain. But I would still not reach for a narcotic for pain relief.

Ereshkigal said...

Brilliant! The blood pressure cuff is my least favorite part of any doctor's visit. Want to see me wince? Stick a cuff on me and inflate it. Want to see me cry? Leave it inflated for about 30 seconds. I've even commented on it to my doctor before, but I'd have never thought of using it as a test. Absolutely brilliant. Buy the doctor a beer.