It is too soon to know what, if any, impact this will actually have. The FDA is not required to follow the committee’s recommendation, although historically they do. At the very least it is a good time to consider what options you have to prepare for the possible ban. Prescription painkillers will always be available in some form. With complaints of chronic pain on an epidemic rise, drug companies will see to it. But prescription painkillers need not be the only option for Fibromyalgia pain treatment.

So what can I do to ease my pain naturally?

I am glad you asked! In the midst of a severe Fibromyalgia flare-up, there may be nothing as quick to bring relief as good old - insert your painkiller of choice here, but for daily maintenance and preventative health care, natural is best.

Foods & Herbs

Your food should be your first medicine. In a previous post I listed the many toxic foods to avoid if you have Fibromyalgia. Now lets take a look at foods and herbs beneficial for pain management.

Essential fatty acids are a must. EFAs like Omega-3s are necessary fats that humans cannot synthesize, and must be obtained through diet. Omega-3s have a natural anti-inflammatory quality along with a whole complex of other health benefits. Research indicates that omega-3s may be better absorbed from food than supplements.

Wild salmon is a great source of Omega-3s, as are other fatty fish like albacore tuna, halibut, and sardines. Not a fan of fish? Flaxseed oil and Canola oil are good choices too. Or how about walnuts? Try a sprinkle of walnuts on spinach salad for a nutritious and delicious double dose of essential fatty acids. Summer squash, cauliflower, and broccolli are all very good sources as well.

Herbal remedies also aid in pain relief. Natural pain relief — like herbal medicine, is an increasingly popular way to manage pain.

• Turmeric is gaining great recognition as a natural painkiller. Why not try sprinkling some on that piece of salmon you are grilling up?
• Fresh ginger helps with inflammation.
• Capsaicin applied topically may be beneficial for relieving pain.
• Feverfew has been found useful for treating migraines.
• Ginseng is listed by the American Pain Foundation as beneficial for Fibromyalgia pain treatment.

If you are serious about trying herbal remedies for pain relief, I advise that you consult with your physician or a licensed herbalist who understands how powerful these herbs can be.

Soak on it

More and more research indicates that Fibromyalgia patients suffer from magnesium deficiency. Magnesium is extremely important to many functions in the body, and a deficiency can cause several of the symptoms associated with Fibromyalgia. There are great benefits in taking an Epsom salt bath, rich in hydrated magnesium sulfate, which is easily absorbed through the skin.

As listed on the Epsom Salt Industry Council website, here are some of the health benefits to be had from an epsom salt bath:

• Flushes toxins and heavy metals from the cells, easing muscle pain and helping the body to eliminate harmful substances.
• Relieves stress. Excess adrenaline and stress are believed to drain magnesium, a natural stress reliever, from the body. Magnesium is necessary for the body to bind adequate amounts of serotonin, a mood-elevating chemical within the brain that creates a feeling of well being and relaxation.
• Reduces inflammation to relieve pain and muscle cramps.
• Improves oxygen use.
• Improves absorption of nutrients.
• Improves formation of joint proteins, brain tissue and mucin proteins.
• Prevents or eases migraine headaches.

I don’t think we could ask much more from a simple bath! Epsom salt baths are so relaxing and therapeutic, I recommend you take two or three a week – more if your level of pain dictates. Before bed is a great time, as you will find yourself so relaxed by the natural serotonin boost, you will be able to gently drift off into a restorative sleep.

Just Breathe

Yoga, Qigong, meditation and many other mind-body practices teach the healing properties of purposeful breathing. Conscious breathing can actually change your body chemistry by increasing oxygen supply to your cells and prompting the production of endorphins, which are the body’s natural pain killers. Deep breathing relaxes the muscles and calms the mind.

In her book Yoga for Fibromyalgia, Shoosh Lettick Crotzer teaches The Healing Breath technique. To practice this, begin in a seated pose with your feet flat on the floor and your arms resting lightly on your thighs. Close your eyes, follow the directions below, and let your breath heal.

Inhale and exhale slowly, focusing on how the air feels as it passes through your nose, into your body, and back out. Think of your breath as the gift of life – prana: life force. Let it feel soothing as it flows inside. If you have general pain, visualize this healing breath filling your whole body. If your pain is more specific, on inhalations, bring the breath directly to your pain. Then, for either type of pain, let each new inhalation bring energy to expand and soften, cleanse and release, rejuvenate. With the exhalations, let the tensions and heaviness of your pain flow out with the breath. Breathe slowly, and continue until you feel quiet, heavy, and more relaxed. Come out of the pose when you are ready. Notice the difference you have made in yourself.

Mindful breathing will bring you more in-tune with your body. It is something we should all practice everyday, regardless of our level of pain.

Good Health Requires Mindfulness

Self care is critical in the management of Fibromyalgia. There is no magic pill that will reverse all of the symptoms we live with. There never will be. So instead of waiting for the magic bullet, we should focus on simple and manageable things we can do to help improve our health and wellbeing. It may take a great combination of holistic and natural remedies, combined with the care of our doctors, to really achieve optimal results. Be your own best health advocate and practice the Healing Breath technique, cook yourself some salmon for dinner, and then take a relaxing epsom salt bath. You are worth the effort.

Take the latest ad for example:

Lady walking out onto her porch with a beautiful tray of food says: “My fibromyalgia muscle pain is real, but I’m not the type of person to just lie down and quit.”

Lady takes the tray to a table of family members, continues speech: “Not with all these people counting on me. I walked right in and asked my doctor about Lyrica.”

Really? Is Fibromyalgia really just so neat and tidy as all that? Really? Is Fibromyalgia really just about the muscle pain and if you take a pill it will really all just go away? Really? And if I don’t walk right in and  ask my doctor about Lyrica, am I then the kind of person who does just lie down and quit? Am I not taking care of the people counting on me if I am not taking Lyrica? Will my tray of food not be as lovely as yours if I am not taking Lyrica?

If I had the video of the commercial to share with you I could go on and on with my “really” rant. There is a dog, and a tree swing, and a beautiful stone walkway, and a picnic table with a picture perfect family. The grass is green, the sun is shining, and it is all made possible with Lyrica! Blech! If you would like to watch the commercial you can watch it here.

So today I am reading the Fibromyalgia Network Newsletter and I read this:

Pfizer’s Fibro Put Down

Even if Lyrica has not been helpful for controlling your symptoms, the many widely publicized TV commercials sponsored by the drug’s manufacturer, Pfizer, have certainly improved awareness of your medical condition. Some advertisements have been better than others, but some Members feel the latest TV ad starts off as a put down to fibromyalgia (FM) patients everywhere. It shows a woman with a tray full of food at a family gathering making the following statements:

“My fibromyalgia muscle pain is real. But I am not the type of person to just lie down and quit, not with all these people counting on me. I walked right in and asked my doctor about Lyrica.”

It’s doubtful that Pfizer intended to imply that “other” fibromyalgia patients are the type who just “lie down and quit,” but this is how the commercial is being perceived, and it couldn’t be further from the truth. The 2008 Fibromyalgia Network survey on employment issues clearly showed that patients are doing everything possible to hang onto their jobs and careers. You are definitely all fighters and you don’t take anything laying down!

As a survivor, let Pfizer know a few key factors about living with fibromyalgia that you would like their next commercial to portray. The company has a website that invites FM patients to share their stories. Click on this link to the Lyrica website and identify yourself as a fibromyalgia patient representative and consumer, and then briefly point out what you would like for them to convey in their next commercial (in other words, state how you would like a person with fibromyalgia to appear). Are there certain strengths that you would like the patient in the commercial to portray? Also, are there specific symptoms of fibromyalgia that you would like to see emphasized? Please give this some thought and take the time to offer useful advice and constructive suggestions. Without your input, Pfizer could very well botch another commercial!

I think this is a fair idea. I just spent the last 30 minutes telling you all what I hate about their commercials. Now I should be more proactive and tell Pfizer how they can be less offensive! Whether I want them to be or not, they are the face of Fibromyalgia on our television sets. But it is clear the people writing their ad copy do not have Fibromyalgia or even a great understanding of it. I am going to have to give it some thought as to how I would want Fibromyalgia represented and marketed. It has to make sense to both me and Pfizer. The bottom line is this really is about Pfizer’s bottom line. Fibromyalgia is profitable for them and it is doubtful they will consider any suggestion that could negatively effect their profits – regardless of their totally offensive commercials.

Hooray for those of you who are feeling better since taking Lyrica! But I really would like to know, do you think these commercials are a fair representation of your life since being on Lyrica? If so I am sooo happy for you. If not what would you say to Pfizer that could help them portray your life with Fibromyalgia more accurately?

Sharon B. Stanford, MD is the Assistant Professor of Psychiatry and Family Medicine, Assistant Director, Women’s Health Research Program, University of Cincinnati College of Medicine. The article is partly an examination of the current drugs approved and used in the treatment of Fibromyalgia, and Dr. Stanford discloses that she receives grant/research support from several drug companies, but beyond the drug exploration, Dr. Stanford has written a very accurate and empathetic report on Fibromyalgia. She even touches on a recent conversation we had here on FibroHaven – which came first, the pain or the emotion. 

Stanford offers Ms. D as a cases study:

Ms. D, age 50, has a history of migraine headaches and is referred by her primary physician for evaluation of depression and anxiety. She reports deteriorating mood over 6 months, beginning when a minor car accident left her “very sore the next day.”

“Nothing helps” the persistent pain in her back, shoulders, and thighs, which she rates as 7 to 8 on a 0-to-10 pain scale. She describes an intense ache, “like having the flu,” that worsens with activity and in stressful situations. She also experiences nausea and intermittent diarrhea, debilitating fatigue, and sleep disturbance.

Ms. D reports she is depressed because she feels “just too tired” after work to keep up with social activities or housework. Her physician’s referral notes a normal physical exam except for tenderness over her upper back and hips. Laboratory testing is negative.

As you elicit more details about Ms. D’s mood, she continues to focus on her physical symptoms. She states that some days she wishes to die because her pain gets so bad, but she denies any plan or intent to harm herself. She worries that her symptoms will worsen and that she will become completely disabled.

Her primary physician attempted to relieve Ms. D’s pain with multiple trials of nonsteroidal anti-inflammatory drugs (NSAIDs) and cyclobenzaprine. She says she gained no benefit from the NSAIDs and discontinued the muscle relaxant because it made her too sleepy.

 

Sound familiar? We all understand the horrible cycle of pain Ms. D is in and the frustration she is experiencing just hoping and looking for some relief. Dr. Stanford is frustrated too and here is the treatment she proposes for Fibromyalgia patients.

TREATING THE WHOLE PATIENT

As a clinician who specializes in fibromyalgia, I counteract my patients’ and my own frustration with this condition by structuring office visits, determining realistic treatment goals, and treating all symptoms as part of a common syndrome rather than individual illnesses.

Structure office visits. Before every visit, have patients rate each symptom domain and write their top 2 or 3 concerns for that day (Click here for a sample form). Focusing on the patient’s most troublesome symptoms can help both of you feel greater satisfaction with treatment.

Educate patients. Ask them to discuss their beliefs about fibromyalgia; many know others with this condition or have researched diagnosis and treatment. Before developing a treatment plan, explain that their symptoms are chronic and all part of the same syndrome. Describe their pain as a complex phenomenon with possible peripheral and CNS components. Guide them to reputable Web sites and resources (see Related Resources).

Set realistic expectations. Many patients expect to resume an energetic and pain-free life, which usually is not the case with fibromyalgia (Box). Most medications are considered successful if they reduce pain by 30% to 50%, and side effects can be problematic. Discuss side effects before treatment begins to reduce patients’ anxiety and improve compliance in the first weeks.

Cognitive-behavioral therapy (CBT) for fibromyalgia incorporates relaxation techniques, helping patients view symptoms as manageable, reinforcing adaptive coping skills, and teaching them how to monitor thoughts, feelings, and behavior to change the view that they are helpless victims. A modest course of 6 weekly group CBT sessions significantly improved physical functioning in 25% of fibromyalgia patients (n=76) compared with 12% in a standard-care group (n=69), even though patients’ pain severity did not improve.¹⁶

Recommend exercise, lifestyle changes. Aerobic exercise can significantly improve well-being and physical functioning in fibromyalgia patients.¹⁷ Low-impact aerobics, such as done in warm water, usually are well tolerated, although any low-impact exercise can help. Because fibromyalgia symptoms often increase with physical activity, counsel patients to begin with a few minutes daily and increase very slowly each week.

 

Lifestyle changes are as important as medications in controlling fibromyalgia symptoms. In addition to exercise, recommend that patients:

• follow a daily routine
• pace activity to avoid exacerbating symptoms
• reduce stress.

Sometimes, I use the analogy of diabetes: treating fibromyalgia with medication but without changing lifestyle is like prescribing medication for a diabetic patient without changing diet. Follow up on this “homework” at each visit to reinforce that patients helping themselves is an important part of treatment.

 

 

There is nothing “murky” about Dr. Stanford’s approach to Fibromyalgia. I appreciate that her approach is to treat the WHOLE patient, not just individual symptoms, and she provides resources to help the patient and the doctor. Click on the sample form above. I think it is a great tool to use before any doctors visit. How often do we forget or feel too rushed to cover everything we intended at an appointment? This sheet will help improve communication between patient and doctor. The link to the box is also a useful summary on managing unrealistic expectations of Fibromyalgia patients. It is worth the read.

Even though I chose drug-free management for my Fibromyalgia, I was able to appreciate Dr. Stanford’s article very much. She clearly cares and is invested in helping her Fibromyalgia patients. Her article will help countless other psychiatrists treat their FM patients as well. And it is another step forward in promoting Fibromyalgia Awareness and Visibility.

Here is the article from the Wall Street Journal’s Health Blog.

By Sarah Rubenstein

We’ve followed plenty of controversies around drug trials, from ghostwriting to keeping quiet about unflattering results. But the latest news is particularly eye-popping: A prominent Massachusetts anesthesiologist allegedly fabricated 21 medical studies involving major drugs. Yikes.

Baystate Medical Center in Springfield, Mass., has asked several anesthesiology journals to retract the studies, which appeared between 1996 and 2008, the WSJ reports. The hospital says its former chief of acute pain, Scott S. Reuben, faked data used in the studies.

Some of the studies reported favorable results from use of Pfizer’s Bextra and Merck’s Vioxx, both painkillers that have since been pulled from the market. Others offered good news about Pfizer’s pain drugs Lyrica and Celebrex and Wyeth’s antidepressant Effexor XR. Doctors said Reuben’s work was particularly influential in pain treatment and that they were shocked by the news.

“We are left with a large hole in our understanding of this field,” Steven Shafer, editor-in-chief of Anesthesia and Analgesia, told Anesthesiology News, which first reported on the retractions. “There are substantial tendrils from this body of work that reach throughout the discipline of postoperative pain management.”

Pfizer had funded some of Reuben’s research and had also paid him to speak on behalf of its medicines. “It is very disappointing to learn about Dr. Scott Reuben’s alleged actions,” Pfizer said in a statement to WSJ. “When we decided to support Dr. Reuben’s research, he worked for a credible academic medical center and appeared to be a reputable investigator.”

Wyeth said it wasn’t aware of any financial relationship between the company and Reuben. Merck had no immediate comment.

As for Baystate, it said a routine audit last spring was what flagged issues with Reuben’s work. Reuben, who is on indefinite leave, didn’t respond to the WSJ’s requests for comment. But his attorney said Reuben “deeply regrets that this happened.” The attorney also referred to “extenuating circumstances,” but didn’t elaborate on what they were.

Take a look at Reuben’s work here.

Photo: Associated Press

 

Does this concern any of you out there that are currently taking Lyrica or one of the other drugs mentioned in this article? I am concerned. If this story interests you, I recommend you take the time to click on the link above and read all of the comments to this post. They are very interesting.

I HATE DRUG COMPANIES! I hate that their sole purpose is to profit off the needs and health concerns of the public. I hate that they view every illness as an opportunity to line their pockets. I hate that they perpetuate a culture of sickness by treating symptoms and not caring to find a cure. Why would they ever want to find a cure. A cure would be disastrous to their bottom line. I hate that they find a way to create need through their marketing and sales techniques. I hate that they look specifically for disease and illnesses that are marketable. I hate that they have now zoned in on Fibromyalgia and that FM is now the newest, trendy marketable disease. Don’t believe me? Well then let me share with you what the company analyst for Savella had to say.

Savella is the newest FDA approved drug for the treatment of Fibromyalgia. Cypress Bioscience and Forest Laboratories are partners in the creation of Savella. Here is what their analyst had to say:

“With the approval of Savella, we expect Cypress Bioscience to become one of the few profitable biotech companies starting in 2009,” Citi analyst Dr. Lucy Lu said in a note to investors. “Moreover, we view fibromyalgia as a real and significant market opportunity, which is large enough to support multiple successful drugs given the heterogeneous nature of the disease.”

I have bolded and italicized the part of the statement which infuriates me. They are letting their investors know that they have hit the disease jackpot – a real and significant market opportunity. Fibromyalgia is a complicated and multi-symptom disease, heterogeneous if you will,  and no two patients experience it the same way. What a wonderful opportunity these complexities present to drug companies. Savella is just the beginning, but if Savella only treats the pain symptoms of FM, then they will have to create a drug to treat the fatigue. And once they have succeeded in masking the pain and fatigue of FM, well then they can work on another PROFITABLE drug for the brain fog and cognition issues. With a disease like Fibromyalgia the opportunities are endless, and that is exactly what Dr Lucy Lu was expressing to their investors in the above statement. She is promising them multiple successful drugs for the treatment of Fibromyalgia.

I feel physically ill right now, but I am sure they are working on a drug for that too!

Well this is one Fibromyalgia patient who refuses to line their pockets. Call me silly, or stupid, or stubborn, but I will not be a passenger on their drug highway. This is the main reason I have made the decision to battle my FM without the use of prescription drugs. In no way am I critical of those of you who are taking prescription medication to treat Fibromyalgia. I know personally of many people who feel they could not function without them. I am not saying that there is not a need for drugs and drug companies, but I am angry and disgusted with the monopoly they have over healthcare. I believe the more profitable Fibromyalgia becomes, the more pressure drug companies will put on researchers and doctors to NOT find a cure. My abstinence will not give them any less power, but for now it is the only stance against them that I can take.

But as a side note, if you are looking to diversify your portfolio, stocks of Cypress Bioscience Inc. surged 33 percent after receiving FDA approval for Savella.

Have you ever read The Road to Wellville by T.C. Boyle?  If you have not, you should.  It is a wickedly comic novel written by the most entertaining of contemporary American writers.  This whole business with Dr. Whitcomb, and his Lake Tahoe clinic, and his false promises of a cure for Fibromyalgia is reminiscent of it.

The real-life Dr. John Harvey Kellogg is fictionalized into one of the main characters in Boyle’s The Road to Wellville.  You might know Dr. Kellogg from the Corn Flakes you crunch occasionally for breakfast.  Yes, that most famous of breakfast cereals was actually invented by a doctor obsessed with healthful living.  T.C. Boyle’s fictitious story takes place at the Battle Creek Sanitarium, which was a popular health retreat in the late eighteen to mid nineteen hundreds, run under the controlling and obsessive eye of Dr. Kellogg.

In the thirty-one years of his directorship, Dr. Kellogg had transformed the San (…) to the “Temple of Health” it had now become, a place celebrated from coast to coast – and across the great wide weltering Atlantic to London, Paris, Heidelberg and beyond.  Twenty-eight hundred patients annually passed through its portals, and one thousand employees, including twenty fulltime physicians and three hundred nurses and bath attendants, saw to their needs.  Six stories high, with a gleaming lobby half the size of a football field, with four hundred rooms and treatment facilities for a thousand, with elevators, central heating and cooling, indoor swimming pools, and a whole range of therapeutic diversions and wholesome entertainments, the San was the sine qua non of the cure business – luxury hotel, hospital and spa all rolled into one.

 

And the impresario, the overseer, the presiding genius behind it all, was John Harvey Kellogg.  Preaching dietary restraint and the simple life, he eased overweight housewives and dyspeptic businessmen along the path to enlightenment and recovery.  Sever cases – the cancerous, the moribund, the mentally unbalanced and the disfigured – were rejected.  The San’s patients tended to be of a certain class, and they really had no interest in sitting across the dining table from the plebian or the pedestrian or those who had the bad grace to be truly and dangerously ill.  No, they came to the San to see and be seen; to mingle with the celebrated, the rich and the preposterously rich; to think positively, eat wisely and subdue their afflictions with a good long pious round of pampering, abstention and rest.  (Boyle 6-7)

So was the Battle Creek Sanitarium through the lens of the fictitious Dr. Kellogg.  But the characters in the novel had a very different point of view. 

After weeks of diet consisting of Bean Tapioca, Corn Pulp and Gluten Mush; and exotic treatments including shock therapy, laughter exercises, and daily enemas, the only thing patients were relieved of was their wallets.  The “positive thinking” Kellogg boasts of, was fostered by a controlled environment in which husbands were separated from wives, and each patient went through their daily routine under constant surveillance from their personal “attendants.”  All to keep order and control, and to make sure the San’s image was never tarnished.  Never mind the man shocked to death during his sinusoidal bath. Mention of that was almost as taboo as participation in anything carnal.

In The Road to Wellville, T.C. Boyle shines a bright and comical light on commercialism in the healthcare industry.  It is a fact, and it is nothing new.  Every time I see a commercial for the new Fibromyalgia wonder drug, Lyrica, I wince.  Not because of the drug itself, but because now that Fibromyalgia is becoming an accepted and recognized disorder, it will also become a profitable disorder.  More and more drug companies will be coming out with prescription drugs to TREAT Fibromyalgia, but not to CURE Fibromyalgia.  Why would they want to find a cure, when the alternative is so much more lucrative?

And then there are yahoos like Dr. Whitcomb who claim to have found the cure to Fibromyalgia, but instead of publishing it in a medical journal so everyone can benefit, he lures desperate patients to his clinic and promises them a lifetime of relief in return for their life savings.  But it turns out the relief is short-term and yet their money is still gone.  If you believe so much in your miracle cure Dr. Whitcomb, why not offer a money back guarantee?  Why, because you are capitalizing on your patient’s pain and desperation.  It seems to me you have a Kellogg complex Dr. Whitcomb.

But you don’t have to take my word for it.  Let’s hear directly from one of your patients why don’t we.  The following was a comment on the blog of a former patient of Dr. Whitcomb, Darden Burns.  Mrs. Burns was instrumental in bringing a lot of this to light.  She received several comments from other patients of Dr. Whitcomb and the following was left by Robin Storms.

I am also a former patient of Dr. Whitcomb. First of all, let me say this…BUYER BEWARE…he is a very charming man and makes everyone feel like they are special and that he really cares. It took me a long time to come to the conclusion that the only thing he cares about is his bottom line. The first time I went to his clinic I spent two months there. I left Lake Tahoe thinking I was cured and continued to feel well for a month after returning home. That was it…one month…then all of my symptoms returned with a vengeance. I followed his after care instructions to the letter, but was made to feel by his staff that I must have done something to make my neck “slip” which caused the relapse. I returned for one week last December, because Dr. Whitcomb said he had a new technique that he was teaching his patients to use. With this “technique” he said his patients were staying well after returning home. What a joke. The technique is nothing more than pressing up on the occipital bone and does nothing. It was during this visit that I brought to Dr. Whitcomb’s attention that just about all of my fellow patients had relapsed. I told him about one patient, a young 33 year old women, who was using a walker again because she was so sick. He told me three times during the week that he was going to call her, but never did. That just about says it all. That second trip to his clinic was very difficult for me. I saw the hope on the faces of the patients in the waiting room that they, too, were going to be “cured”. They reminded me of the wonderful group of people I spent two months with in his clinic, many of whom are now close friends. I knew that most of them, like us, had traveled a long distance to be there and were spending money they did not have. It broke my heart to know that they were being taken advantage of by a man who knows that his patients do not stay well. With that said, Dr. Whitcomb is still advertising and traveling to promote his clinic. On a recent television program that was broadcast on a Christian television station he stated that follow up care is rarely needed. This is simply not true and he knows it. – Robin Storms

It was after reading this post that I was made to think about The Road to Wellville and similarities between Kellogg and Whitcomb.  But I may as well compare them to the big drug companies too – companies that sell expensive drugs, which often have worse side affects than the conditions they treat.  I believe many enter the healthcare profession because they want to help their patients and make a difference, but sadly there are those looking first and foremost to line their pockets.  And this is why I care about the practices of a doctor I have never met.  He may not have directly taken advantage of me, but indirectly he has taken advantage of us all.