What can I expect at my first appointment with a Rheumatologist for fibromyalgia?
I haven't had insurance for about 2 years, and I finally just got back on it. I've been suffering with moderate pain for at least a year, but since I didn't have insurance all this time there wasn't much I could do. I was able to do a consult online over the phone with a doctor, and they told me it wasn't an official diagnosis, but they thought I had Fibromyalgia and Osteoarthritis, and they gave me a prescription for Cymbalta, and Tramadol. They did inform me there was a risk involved taking the two drugs in conjunction but that it shouldn't be a problem. I took these for awhile, but had little luck with Cymbalta, so I discontinued that and I've just been taking the Tramadol as needed but sparingly because I've been having to pay out of pocket completely. The Tramadol works somewhat well, but if the pain is bad enough then it doesn't quite cut it.
If I do get diagnosed with fibromyalgia and osteoarthritis, how can I expect to be treated? Will my rheumatologist start me on medications right away? I am so desperate to get my life back, feel my age again (I am only 23) and enjoy my 2 year old daughter. I am so sick of being in pain and exhausted all the time. Ibuprofen, asprin, tylenol, and aleve don't do anything for me, and I've been told that NSAIDs are not usually successful with the treatment of fibro because there is no inflammation involved.
I don't want to come across the wrong way with the doctor, but I want to be sure that he will treat my pain and discomfort adequately.
Any advice, suggestions is much appreciated as far as what I can expect for the appointment and treatment options.
These are my symptoms:
periodic muscle spasms in back and neck
periodic tingling in fingers and feet
tender points in arms, back, knees, thighs
frequent difficulty sleeping
wake up stiff
tension headaches
moderate/severe back pain
painful menstrual periods
daily fatigue
joint stiffness/weakness/pain and muscular pain/weakness
moderate/severe pain in hands
occasional facial pain
body aches
memory and cognitive difficulties
43 seconds ago
Public Comments
1. My PMD sent me to a chiropractor first since they don't generally like to write a prescription. This was extremely temporary and of little to no help at all so they prescribed Savella. It is my understanding that for those with base cost medical insurance this is the most common script. The relief is moderate at best for me, but I have read many negative reviews; high sugar/blood pressure, moderate to severe headaches and no relief whatsoever. I am surprised however that Tramadol does not help.Perhaps you are at a low dosage. Savella starts at 50mg, and goes to 100. It is an SNRI but does not treat depression the way that most of them do, it is specifically for fibromyalgia.
2. There is no way a legit doc could suggest asecific diagnosis wigthout blood tests xrays..at best they can give you a list of 100 common possibilities
many docs use FMS as a general label for pain which is malpractice
most likely the doc will be clueless..not do the right test and just give you an easy diagnosis...
even if they do blood tests and xrays...they may not know what fms really is and will only know what they read in a phamphlet on how to treat it...many will still be usingold treatments they first hard about 10 or more years ago...or justgo by the commercials on TV
OA and FMS are completely different
OA tends to be localized in area of previous injury
FMS is widespread
3. Get a free test on:
http://www.fibromyalgia-information-relief.com/fibromyalgia-test.html
4. Hey there-sorry you're having to deal with this at a young age. The good thing is you're seeing a rheumatologist! You'll probably have some blood work done. Because fibro is pretty much a condition that is diagnosed when other things are ruled out, they may be checking you for thyroid problems, RA, MS, lupus, and possibly other conditions. Don't let this scare you. It's really routine. The doctor will do a physical exam, checking your tender points and joints. Rheumatologists deal with patients in pain on a daily basis, so he/she will be gentle. He/she may order more tests such as xrays, nerve tests, or CT scan. Not all doctors order these. It will just depend upon your blood work and exam.
You'll probably go home with prescriptions. In the US, there are three main meds being used for fibro right now-Cymbalta, Lyrica, and Savella. There is no formula for what might work for you, so it's a trial and error deal. We all respond differently to meds. (Cymbalta did nothing for me either) Your doctor may give you other medications such as pain meds, muscle relaxers, antidepressants (for sleep and pain-they change the seratonin level), or sleep medication. I've never wanted to have a drugged feeling, and my doctor has respected that. Just tell him you have a 2 year old and want to be able to function, but want the pain to subside.
Are you taking a really good multivitamin? If not, it will be worth your while to get a good one. Read the labels. You may want to ask about B12 for the fatigue (I take sublingual B12) and malic acid with magnesium. My rheumy put me on these, and they really do help with the fatigue and pain. You can get them at your local health food store.
If you're having joint pain, this is usually due to inflammation such as arthritis, so the ibuprofen may help you there.
Good luck at your appt. Hopefully, you and your new rheumy will find the right mixture to make you feel better. By the way, children adapt very well with mommy having a painful condition. My daughter was 2 or 3 when I was diagnosed, and she's now 18.
Hope you and your family have a very Merry Christmas!
