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My very first appointment with my patient Sarah is one that clearly sticks in my mind. Sitting in my consulting room, tears streaming down her face and clutching a bundle of letters from various specialists, she told me: ‘They all say there’s nothing wrong with me, but I’m in constant pain, I can’t sleep, I can’t think straight any more.’ In despair, she asked: ‘Am I going mad?’
No, she wasn’t going mad. Sarah had fibromyalgia, a condition that affects nearly one in 20 people but remains frustratingly difficult to diagnose and, for many patients, even harder to have taken seriously.
Fibromyalgia is what we call a ‘syndrome’ rather than a disease – a collection of symptoms that often occur together but don’t have a single, identifiable cause.
It’s typically characterised by widespread pain, profound fatigue, sleep disturbances and what patients often describe as ‘fibro fog’, a maddening inability to concentrate or remember things that were once second nature. Many sufferers also experience headaches, irritable bowel syndrome and, understandably, depression.
The big problem for medics is that fibromyalgia doesn’t show up on blood tests or scans. There’s no definitive diagnostic marker, no smoking gun that proves beyond doubt what is wrong. This has led to a distressing situation where many patients feel dismissed, disbelieved – or worse – told that their symptoms are ‘all in their head’.
Let me be absolutely clear: fibromyalgia is real. The pain is not imagined. The exhaustion can be overwhelming and the impact on people’s lives is devastating. I’ve seen patients who have lost their jobs because they couldn’t function through the pain and fatigue and I’ve witnessed marriages crumble under the strain. I’ve sat with people who have contemplated ending their lives because they couldn’t face another day of their unrelenting symptoms.
Fibromyalgia is real. The pain is not imagined. The exhaustion can be overwhelming and the impact on people’s lives is devastating (picture posed by model)
Although more common in women than men, anyone can develop fibromyalgia at any age.
So what are the signs to look out for?
The hallmark is widespread pain (not just in one area, but across the whole body) that has persisted for at least three months. This is usually accompanied by extreme fatigue (that doesn’t improve with rest), sleep problems and cognitive difficulties. Many patients describe feeling as though they have been hit by a bus, every day.
If this sounds familiar, the first step is to see your GP. I know this can feel daunting, especially if your concerns have previously been dismissed, but preparation is key. Keep a symptom diary for a few weeks before your appointment. Note down when your pain is at its worst, how your sleep is affected and how symptoms affect your daily life. Be as specific and detailed as you can.
Your GP should take a thorough history and conduct a physical examination. They will likely run blood tests to rule out other conditions that can cause similar symptoms, such as thyroid problems, vitamin D deficiency or rheumatoid arthritis.
If you feel your concerns are not being heard, it’s perfectly reasonable to ask for a referral to a rheumatologist or pain specialist. You have every right to do this, so don’t be deterred.
If you do get a fibromyalgia diagnosis then, sadly, there is no magic cure. However, there are strategies that can genuinely help and it will be a question of trial and error – as what works for some people, may not for others.
Exercise might sound counterintuitive when you are exhausted and in pain but gentle activity, particularly low-impact options like swimming or walking, can help to reduce symptoms. The key is to start slowly and build up gradually. I’ve seen patients improve significantly with this approach although it requires patience and persistence.
Establishing a regular nighttime routine to promote good sleep is essential. Keep your bedroom cool and dark, keep phones and tablets out of reach and consider relaxation techniques such as meditation.
Some patients may be prescribed a low-dose amitriptyline for pain relief, which can also improve the quality of sleep. For others, pain management might involve paracetamol or anti-
inflammatory medications for flare-ups although opioids (such as codeine) should generally be avoided as they are not effective and carry significant risks.
Cognitive behavioural therapy can be invaluable, too – not because the pain is psychological but because it will equip you with tools to manage the emotional impact of the condition.
Most importantly, be kind to yourself. Learn to recognise your limits and work within them rather than pushing through until you crash and burn. This isn’t giving in, it’s sensible. The mental health aspect cannot be overlooked. Living with chronic pain and fatigue, while often feeling disbelieved, is incredibly isolating and can lead to depression, anxiety and feeling absolutely at the end of your tether.
As for Sarah, she is doing much better now. Not cured – fibromyalgia doesn’t work like that – but managing. She’s found a combination of treatments that work for her, connected with a support group and, perhaps most importantly, she’s stopped apologising for being ill.
If you’re living with fibromyalgia, you deserve compassion, support and proper medical care. Remember that your pain is valid and real and you are not alone, so please don’t ever suffer in silence.
Why Lily may regret new album
The new album West End Girl by Lily Allen offers a raw, unflinching account of the breakdown of her marriage to actor David Harbour following his alleged infidelity.
Lily Allen at her album launch dinner on October 24 in London
There’s something cathartic about turning pain into art. But there’s a crucial difference between private processing and public evisceration.
The album may feel empowering now, but it creates a digital footprint that can never be removed. That initial surge of vindication rarely lasts.
What follows is often regret, embarrassment or a prolonged inability to move forwards, because you have anchored yourself to the narrative of victimhood. The real danger is that public revenge keeps you tethered to the person who hurt you. True healing often requires the opposite – creating distance and building a life where that person becomes less central to your story.
The BMA is right to express its concerns about changes to the GP booking system. The new mandate for appointment booking was meant to solve the dreaded 8am phone scramble. Instead, we’ve created something potentially far more dangerous, by expecting patients to navigate online consultation tools with the aim of distinguishing the urgent from the routine. This requires human judgment, nuance and the ability to ask the right follow-up questions. A form on a website cannot do this. Technology should support clinical care, not compromise patient safety. Right now, we’re conducting a dangerous experiment with people’s lives.
DR MAX PRESCRIBES…
VITAMIN D
The NHS has just issued a warning about Vitamin D deficiency in the autumn and winter months.
It is now recommending that everyone takes a supplement (10 micrograms per day is advised) between now and next April.
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This article was originally published by a www.dailymail.co.uk . Read the Original article here. .