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Why The Difficulty Diagnosing Fibro?
The last blog described a patient who came to my office, after having to deal with the common problems that people with fibro so often encounter. I ended the blog with 4 questions. Let’s look at them in some detail.
1 Why did it take 5 years for a definitive diagnosis, especially when she had the classic signs and the class prior history of trauma?
Answer: Unfortunately, the public and so many doctors are just not familiar with fibromyalgia, they might have heard the word but in reality, they have no clue as to what it is about. Like much of the public, the doctors also believe that it is just a pain “thing” not understanding that there are so many other common symptoms. These doctors and psychologists also don’t have a good understanding of how thoroughly; fibro affects every part of a person’s life, from symptoms to relationships, to work etc. This is most unfortunate because people with fibro, who haven’t been diagnosed, have no understanding of what is going on in their bodies and they and their families are scared. The fog alone can make the sufferer believe that he or she is developing Alzheimer disease. More than this, we live in a world of fear and it is not uncommon for the sufferer, who is experiencing all these “weird” symptoms to panic and actually believe that they have Cancer or some other horrible debilitating fatal disease.
2 Why did she go from doctor to doctor, from specialist to specialist, from alternative provider to alternative provider, yet nobody could see something which was so obvious?
Answer: Doctors are trained that pathological conditions will be diagnosable by seeing something in the blood, urine or on an image (MRI’s, X-ray’s, Cat Scans, brain Scans etc.). The days of the family doc who asks questions and palpates (touches) the sore parts of the body is gone, partly due time limits placed on doctors and partly due to their training. It is said and it still is true that a good doctor can diagnosis a condition or illness 90% of the time from speaking to the patient (the history and consultation). This, however seems to be a thing of the past. We are, again, dealing with overworked doctors, working under the constraints of the PPO’s and other health care systems, which limit the time they can actually spend with a patient. Together with our busy schedules and lifestyles, many of us want the fast answer and the magic pill; these do not exist. When dealing with your health (which is a priority), all the time necessary should be used,
3 Why did some of the providers, including the psychologist insist that fibromyalgia did not exist?
Answer: The following are my own opinion, but I believe that saying that “I don’t believe in fibromyalgia” is the epitome of ignorance and arrogance. First, there is no question that fibro does exist, the research is clear, as are the millions of sufferers in the U.S. alone. Secondly, the concept of Cultural Authority (see prior blog on this topic), comes into play. In a nutshell, we have been conditioned to believe that the doctor is the all knowing person. Many times, they begin to believe this nonsense themselves. It is a small step for a doctor to confuse his/her opinions with the actual fact and the fibro sufferer is the one who this arrogance affects, along with their families. To say that fibro does not exist is like saying that refrigerators don’t exist. This is just plain wrong.
Many patients are afraid to question their doctors, but in fact, the doctor is human with the same faults and strengths that we all have to one degree or another.
4 Why was she offered every drug on the market including narcotics, especially if so many of these providers thought that this whole illness was psychosomatic?
Again, the problem lies with doctors having no familiarity with fibromyalgia, but perhaps more importantly, the fact that the pharmaceutical companies are allowed to market their medications directly to the patients with the hope (which is very often the case), that the patients will pressure the doctors to prescribe those particular meds. Doctors feel pressured to not allow a patient to leave their office without a prescription in hand. Medicine has also become very competitive (though most of the time, the patients don’t see this) and doctors do not want to lose patients. They have expenses and overhead, in addition to making a living.
To summarize this and the last blog, the medical system (in the U.S.) is very broken and in urgent need of fixing. Patients are unduly suffering, due to lack of understanding and familiarity with fibromyalgia; by the public and by the doctors.