Archive for July, 2008

Managing Daily Activities with Fibromyalgia

July 25, 2008 at 3:29 am · Filed under Managing Daily Activities with Fibromyalgia ·Tagged , , , ,

Those who don’t deal with fibromyalgia on a daily basis have a very difficult time understanding why people who have it can’t always remember things, get exhausted from doing simple activities, or have pain so severe that all we want to do is try to find a comfortable position so we can just have a few pain free moments.

A friend of mine wrote these words to me many months ago, and to me they sum up our experiences with an activity that most people just take for granted.

“I remember I used to ‘cook dinner’, and it was no big deal. Now I have to ‘think’ about what I’m going to fix, then I have to ‘think’ if I really want to thaw something out or just have soup because I hurt so bad. Then maybe I decide I’ll fry that chicken, so then I have to go to the freezer, and it’s not an upright, so I have to lift the lid, and find something to prop it open. Then, of course, the chicken is on the bottom, so I have to pick everything out of there which is cold and frozen, until I find the chicken. Now that I’ve found it, I have to put everything else back. Then I take the chicken to the microwave and put it on defrost. Then I suppose that I have to cook potatoes to go with the chicken. Now I have to walk back to the laundry room, get the potatoes, bring them back to the kitchen table, where I sit down for a minute because the pain in my shoulders just won’t quit. I’ve forgotten the knife, so I have to get up, which really hurts. I never want to get back up after I’ve sat down, but I get the knife, and sit back down and peel the potatoes, which takes a little time because my fingers and hands hurt so bad. Once that part is done, I have to go get a pan, take it to the sink, fill it with water for the potatoes, wash the potatoes, cut them into pieces, and put them in the pan. The pan is very heavy at this point, so I may ask for help carrying it or just go for it, depending on how bad my hands are. I haven’t even gotten to the chicken yet or set the table. Most people just do this stuff automatically every night, while the people with fibromyalgia just have to take it one step at a time, and it can be grueling. The same thing happens when I go out for dinner. I never sit in a booth because it hurts so bad trying to get up, so now we always ask for a table. There are just so many adjustments that we have to make just to ‘get through’ a day.”

Then there’s laundry, errands, or light housework which must be done by someone. In my family, I’m the designated someone since I always did these things before developing fibromyalgia. My children do their own laundry, but trying to haul a load of my husband’s and my dirty laundry down to the basement from the upstairs is exhausting. If I do it when one of my children is at home, I may get help if I ask, and occasionally one of them will actually offer to carry it for me. Then there is the problem of several family members trying to do laundry at the same time. With each person having their own laundry basket, it should work, but it doesn’t all of the time. I find my half dried laundry thrown on top of the dryer since one child needs their clothes dry before work or school. Then there is the issue of the towels. I did tell them that I wouldn’t wash their towels anymore since they are too heavy for me to carry, but what I find is the towels in the master bathroom being used by them because they have run out of towels.

Family conferences are a necessary evil, and they only work when all members are willing to do their part, or when all members are home at the same time in order to sit down and explain the rules over and over again. It is extremely frustrating to be the only member of a family who is living with pain and fatigue, yet is expected to organize a family conference, set the rules, and try to have the energy to follow through with them.

Before I developed fibromyalgia, these problems weren’t as exhausting for me, but now it is too much work to have to continually explain why I can’t or shouldn’t do something. I’m praised for fixing a nice dinner, yet the dishes are left on the sink for me to do before I go to bed at night. The dusting just isn’t done, and even though two of my family members have allergies, they don’t make the effort to do it.

As my friend wrote, just thinking about preparing a meal can be exhausting, but actually doing it can be painful and it becomes a major chore rather than something pleasurable to do.

Living on disability, only one salary, or having to work in spite of dealing with fibromyalgia can become emotionally and physically exhausting for us. Those who have to work in order to have a roof over their heads, food in the cupboards, or clothes on their backs can mean that there is little energy left over for activities of normal daily living. Those who don’t have fibromyalgia can’t seem to understand why we aren’t more organized, or why we don’t just hire a housekeeper, or force our children and spouses to do more chores.

It is emotionally exhausting to have to continually remind people that we just can’t do certain things. Sometimes it is easier to either just not do them, or force ourselves to do the minimum of chores so that our homes don’t become overwhelming with dirt or clutter.

We may be mourning for the lives that we once had, yet since our pain and fatigue is usually invisible to those around us, we don’t always receive the understanding which we desperately need. I’ve been told by many well-meaning friends to get my family to help more, but they aren’t living my life for me. It is difficult enough to just get through some days without people placing greater expectations upon me.

Not only must we change the way in which we live our lives, we must also deal with the losses that we’ve sustained to our self-esteem. For most of us, we hate to feel like nonproductive members of our families or our communities, but the reality is that we have to stop and think before doing almost anything now. Sometimes the chore seems so overwhelming that it’s easier to just do nothing, yet that can lead to depression.

There is no one simple answer for each of us, and we have to learn to listen to ourselves rather than let others tell us how to live our lives now.

Recommended Books:
Women Living with Fibromyalgia: Refusing to Suffer in Silence by Barbara Keddy, et al.
The Fibromyalgia Advocate by Devin J. Starlanyl
New Hope for People with Fibromyalgia by Theresa Foy Dideronimo

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Fibromyalgia vs. Myofascial Pain Syndrome

July 25, 2008 at 3:11 am · Filed under Fibromyalgia ·Tagged , , ,


Learning to differentiate between fibromyalgia and chronic myofascial pain isn’t as difficult as it sometimes appears to be. Dr. Devin Starlanyl has made the distinction very easy to understand on both her informational fibromyalgia & myofascial pain web site, and in her books.  Not all doctors are able to diagnose fibromyalgia accurately, and it is possible to be given a diagnosis of fibromyalgia when what one has is chronic myofascial pain. Tender points are different than trigger points, and yet many people are given a diagnosis of fibromyalgia based upon trigger point pain.

While it is possible to have both fibromyalgia and myofascial pain, there are definite differences. One difference is that more women than men have fibromyalgia, but the ratio of men to women who have myofascial pain syndrome is equal. Also, in fibromyalgia, the muscles have generalized sensitivity, while with myofascial pain, the muscle areas that are located away from the trigger points and their referral regions have normal sensitivity. With fibromyalgia, there is total body achiness, while with myofascial pain there are specific pains in specific areas. With myofascial pain, the areas not affected by trigger points don’t hurt, but with fibromyalgia, the areas outside the tender points still ache. Fibromyalgia is a neuroendocrine disorder while myofascial pain is a neuromuscular condition.

The similarities between the two conditions and a physician’s lack of skill in administering the Tender Point Index test can often lead to a misdiagnosis. If we were given a choice of which condition to have, most likely we all would choose myofascial pain syndrome. It is easier to treat with massage, stretching, and exercise, or even trigger point injections. However, for any of these therapies to work, the perpetuating factors must be addressed.

Sleep disturbances occur with both conditions because trying to sleep when one is in pain is very difficult, plus living with any kind of chronic pain can lead to depression. In both cases, at least part of the fatigue, and usually the largest part, is due to lack of restorative sleep. In fibromyalgia, this is due to the neuroendocrine imbalance, and in myofascial it is due to the pain.

People with only chronic myofascial pain can improve and can return to a normal life with treatment and control over their perpetuating factors, but those with a true diagnosis of fibromyalgia don’t have a specific treatment plan available that works for every one of us at this time.

Cognitive deficits in fibromyalgia are also present in myofascial pain syndrome but the deficits are due to proprioceptor dysfunction and autonomic concommittants. Also, if one is on many different medications in order to relieve pain, help sleep, or deal with depression, they may also have times when their brain seems to be in a fog. The fog of fibromyalgia is a real condition, and although it is unknown what causes it, it is specific to fibromyalgia and not myofascial pain syndrome. However, there are aspects of myofascial pain that do affect the perceptions.

Learning to differentiate between these two separate syndromes within our own bodies is easier when we learn to listen to our pain. Those of us who have both conditions can learn to feel the difference between a trigger point and a tender point, and thus we can find ways which will reduce the trigger points and the pain that they cause us. The deep aching and burning pain of a fibromyalgia flare is different than the pain of multiple trigger points which can rear their ugly heads on occasion. It is possible to reduce trigger point pain by massage or even relaxing in a bath, but during a severe fibromyalgia flare, we may not want our bodies to be touched by even a single sheet on our beds.

Our role is to learn to differentiate which syndrome we are dealing with, educate ourselves about the differences between these two syndromes, and learn how to listen to our bodies to see which type of pain we are actually dealing with so we can treat ourselves in the best possible ways.

Recommended Books:
Women Living with Fibromyalgia: Refusing to Suffer in Silence by Barbara Keddy, et al.
The Fibromyalgia Advocate by Devin J. Starlanyl
New Hope for People with Fibromyalgia by Theresa Foy Dideronimo

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