A detailed guide to Chronic Fatigue Syndrome (CFS), including its symptoms, causes, and effective treatment strategies to improve energy and well-being.
The Food and Drug Administration has just issued what’s called a “Medwatch Alert” warning that Epidural steroid injections or “ESIs” for back and neck pain can be extremely dangerous. The alert says: “Injection of corticosteroids into the epidural space of the spine may result in rare but serious adverse events, including loss of vision, stroke, paralysis, and death.”
Epidural steroid injections – and catastrophic injuries from them – were the subject of my debut investigation for The Dr. Oz Show almost exactly a year ago. The epidural space is an area between the spinal cord and the bony structure of the spine.
Our investigation revealed that the steroids – called corticosteroids – used for epidural injections are not even FDA approved for this purpose and yet ESIs are done nearly 9 million times a year, according to an analysis by Dr. Laxmaiah Manchikanti.
In 2009, the FDA convened a group to study the safety of some types of epidural steroid injections. In its new notice, the FDA said that the group’s recommendations still are not ready and will be released when they are.
Dennis Capolongo of the EDNC, a group that has been campaigning against epidural steroid injections for years, called the FDA’s new warning “bittersweet” because it did not go further. Capolongo wants the FDA to go beyond telling doctors that injecting steroids into the epidural space COULD have severe side effects and instead state that they MUST NOT do it.
In February of this year, Australian and New Zealand health authorities came out with exactly that stronger language, stating that steroids like this, “MUST NOT be used by the intrathecal, epidural, intravenous or any other unspecified routes.” The South African government issued similar warnings, according to Capolongo.
Since the FDA is still actively studying these procedures, it will be interesting to see if the agency takes any further steps. If and when it does, you can bet I’ll pass the information along.
If you aren’t on this medication, chances are you know someone who is. It’s used to treat everything from pain to mood disorders and can be just what the doctor ordered for many.
But now, there is mounting research uncovering misuse of and even a black market for this popular prescription.
We’re talking about gabapentin. It’s approved for some types of seizures and nerve pain.
Doctors also use it off-label to treat everything from insomnia to migraines to anxiety. Sixty-four million prescriptions of it were sold in the U.S. in 2016, up more than 60% from four years earlier.
The thing is, experts, say there is growing evidence it’s being abused, too. It’s even being sold on the streets under the name “Johnnys.”
Dr. Joseph Insler, an addiction psychiatrist, says he’s seeing it all too often.
“Sometimes, I’ve even experienced patients ask me for their “Johnnys” and then they’ll, maybe, catch themselves and say, ‘No, no, no. I mean gabapentin’,” he says.
“I think that some individuals may say that they use it to get high, and others may say they use it and get a drowsy effect. So, we’re talking about the euphoria versus sedation, “ says Rachel Vickers Smith, Ph.D.
Dr. Vickers Smith wrote her dissertation on gabapentin abuse when studying drug abusers in Appalachia.
“We found a nearly 3000 percent increase from 2008 to about 2014 in individuals reporting gabapentin abuse for the purposes of getting high,” she says.
We wanted to see for ourselves, so we searched online. We easily found people talking about taking “Johnnys”, or gabapentin, to get high. There were also threads of people trying to spread awareness about the abuse.
Experts say gabapentin is typically misused by substance abusers who mix it with other drugs.
But, Dr. Insler says it’s also possible for people with legitimate prescriptions to misuse, too.
He says, “If somebody’s taking excessively high doses or needing early refills” or if their mood changes, family members or clinicians should see these signs as red flags.
A growing body of research shows the problem of abuse, especially among substance abusers is clear. But some experts also worry about the number of prescriptions being handed out.
A recent New England Journal of Medicine letter warned that “clinicians who are desperate for alternatives to opioids” are “increasingly prescribing gabapentin” and that “evidence suggests that some patients misuse, abuse or divert gabapentin.”
Dr. Rachel Vickers Smith says, “ I think that’s why it’s really important to get out the message,” about abuse, in general.
Gabapentin is not a controlled substance or scheduled drug on the Federal level.
We reached out to several government agencies. There was little information on potential abuse although the National Institute on Drug Abuse pointed us to existing research and the DEA says it is beginning to receive calls.
Dr. Vickers Smith says, “ I don’t think that gabapentin abuse is on the CDC, DEA’s, NIDA’s radar, in part because we had this opioid epidemic.”
All experts we talked to stress that this is NOT the next opioid epidemic, but they believe gabapentin abuse is something to watch closely and believe more research is needed.
We contacted two of the manufacturers of gabapentin, including Pfizer, which told us, “Gabapentin is an important treatment option for their approved indications”.
We have received so many complaints about duloxetine side effects that we have lost count. Far more disturbing is the number of people who tell us how hard it is to discontinue this drug.
Decades ago doctors might have told patients taking a drug like Cymbalta that if they experienced anxiety, irritability, or strange sensations after stopping the drug, it was probably their underlying psychological problem returning. Now we know it is withdrawal from the medicine.
Cymbalta was originally approved by the FDA in 2004 for the treatment of major depression. It is officially an SNRI-type antidepressant. In doctorspeak, that means it is a serotonin-norepinephrine reuptake inhibitor and is somewhat similar to other antidepressants such as Effexor(venlafaxine) and Pristiq(desvenlafaxine).
In other words, there was a drug that could relieve your blues and your aches and pains. And the drug company that makes Cymbalta (Lilly) has been aggressively marketing it as a good way to deal with chronic low back pain and osteoarthritis. Perhaps you have seen the commercials on TV promoting the pain-relieving power of the drug with the slogan “Cymbalta can help.” It sounds almost too good to be true.
Ah…and there is the rub. Although there is a long list of serious side effects mentioned during the commercial, the video images seem quite reassuring and trump the scary message the FDA requires for this medication. So, let’s set the record straight. Here, without visual interference, are a list of potential complications associated with this medication.
Depressed mood, suicidal thoughts and behavior, suicide
Such a long list of side effects makes your eyes glaze over after the top 3 or 4. That is why we have included stories from real people so you can better understand what these complications feel like.
Even though such side effects are scary, there is another problem with Cymbalta. When people try to stop taking this drug they frequently report unpleasant withdrawal symptoms. An organization (QuarterWatch) that monitors the FDA’s database of serious adverse drug events has noted that:
“We observed a signal for serious drug withdrawal symptoms associated with duloxetine (CYMBALTA), a widely used antidepressant that is also approved to treat arthritis and back pain, anxiety, and fibromyalgia. In the first quarter of 2012, the FDA received 48 case reports of drug withdrawal identifying duloxetine as the suspect drug. They described a wide spectrum of withdrawal effects that began when the patients stopped the drug, including blackouts, suicidal thoughts, tremors, and nausea. Several cases involved hospitalization.
Probing deeper into the scientific record for duloxetine we found that withdrawal symptoms were reported in 44-50% of patients abruptly discontinuing duloxetine at the end of clinical studies for depression, and more than half of this total did not resolve within a week or two. In addition, we identified a serious breakdown at both the FDA and the manufacturer, Eli Lilly, and Company, in providing adequate warnings and instructions about how to manage this common adverse effect.”
Doctors have taken to calling this “discontinuation syndrome.” These clinical words do not do justice to what it is like to stop antidepressants like Cymbalta, Effexor(venlafaxine), Paxil (paroxetine), Pristiq (desvenlafaxine), or Zoloft(sertraline) suddenly.
Again, a list of symptoms does not do this problem justice. Below you will read some stories from people who have posted their comments to this website. We would love to hear your story, positive or negative. Share your experience with Cymbalta or any other antidepressant below.
Should you wish to learn more about dealing with depression through some other strategies, we offer our Guide to Dealing with Depression. You will also find a whole chapter on prescribing mistakes doctors make when treating depression and fibromyalgia in our book, Top Screwups Doctors Make and How to Avoid Them.
“My lovely, young daughter-in law, who was about to celebrate her 29th birthday, was prescribed Cymbalta, Klonopin, and Ambien and has committed suicide. “She told her physician and her therapist that she’d had thoughts of suicide but no one took her seriously. She suffered from depression, as well as an eating disorder, and had very low body weight. She also used alcohol. “Please remind your readers of the potentially disastrous effects these chemicals can cause when taken carelessly or in combination with alcohol.”
This from – P.J.: “I have been on Prozac over the last 20 years off and on and it finally stopped working. The last time I took it about 2 years ago I was taking the generic from Barr – the blue and white capsule. I was feeling as if I were in the deepest dark hole there ever was.
“My doctor put me on Cymbalta from which I had a lot of side effects such as palpitations, feeling constant dread, panic attacks, sweats, lightheadedness, and a general feeling of not being well.
“She added Abilify which put me over the edge. I was in the worst depression I have ever been in. Finally, after living like this for several months, I asked to be put back on Prozac. I was taking the generic from Sandoz. When the prescription ran out I ended up on the big blue and white capsules from Barr.
“Over the last couple of weeks, it has been constant crying spells, arguing with everyone, and feeling pretty low. I talked to my doctor and she wrote the prescription for Sandoz only generic. The blue and white capsules are like taking a placebo. My doctor said she had had other patients who complained of the same thing and she had to write prescriptions for a certain generic or name brand.”
Click Here to Visit the Store and find Much More…. – R.P. says: “I took Cymbalta for 3 days and thought I’d go nuts. I’m off it now and refuse to try any other drug like this. My main complaint was extreme hot flashes that estrogen wouldn’t help. I thought I’d be given Prozac but was given Cymbalta instead. It was a rough 3 days and I stopped it last night. I am extremely tired yet cannot sleep at night. I think I was sweating even worse and my legs started feeling like I had Lyme disease again. And to be honest, within those 3 days of taking it, I didn’t contemplate suicide, but I had this crappy attitude of “who would care?” – Nancy relates how hard it was to get off Cymbalta: “It took me 18 months to get off Cymbalta, with no doctor’s help. I can hardly believe that doctors have no exit strategy for this dangerous drug. I had to find this out on my own from reading and as soon as I weaned off that – about a month, the tinnitus that had occurred decreased almost completely. No doctor told me this.” — J.K. shares a parent perspective: “My daughter experienced severe side effects when trying to come off Cymbalta – she had nausea, vomiting, lost peripheral vision for 24-48 hours, had to shake, etc. This was while she was doing a clinical in a hospital for college. Had she known she would have stayed on it until after clinical. I called the manufacturer and they acted like there were no such side effects from withdrawal.
“She too took apart the capsules and it took a while, but finally she is free from that drug. I think it is a crime that the manufacturers don’t publish more detailed information concerning withdrawal. They could even make money selling a one-month or two-month step-down prescription so individuals aren’t taking the capsules apart themselves.” – P.C. Tells what it is like to switch around from one drug to another: “I just turned 52 today. I went on a very low dose of Zoloft about 8 years ago to treat generalized anxiety disorder. It really did help for a long time. I recently have been pretty depressed (however I can cover it up really well) and my psychiatrist switched me to Effexor which was terrible for me. Now I’m trying Cymbalta which has not done anything either except make me feel more anxious and headachy and weird.”
“I am a registered nurse and I do not understand what the long-term effects of these meds are and I am concerned. I really want to get off and see what I can do naturally for myself.” – K.T. tells what it is like to try to stop Cymbalta: “Getting off Cymbalta is challenging but not impossible. I, too, experienced light-headedness, dizziness, and “brain zaps.” I described it as being able to “hear my eyes move.” It sounded like the light sabers on Star Wars. Very strange and disconcerting.
“The key is to do it very very slowly. Take the capsules apart and begin by removing 5 or 10 of the tiny balls inside. Do this for a week or so, then slowly increase the amount you remove each week or two as you can tolerate it.
“Your doctor will probably be no help at all. Mine wasn’t. He instructed me to wean off over a two to three-week period and I almost lost my mind. I did it myself over about a YEAR or more. Be patient. I am completely off now and feeling GOOD.” – Karen’s story: “I was prescribed Cymbalta ‘off-label’ to manage fibromyalgia pain When I stopped taking it because it wasn’t delivering on the promised effect of reducing my pain, I became so horribly depressed that I required hospitalization as I had become SUICIDAL!
“I will NEVER take another anti-depressant for an off-label purpose….such as Elavil/amitriptyline as a “sleep aid” which is very commonly prescribed.
“I believe it should be criminal to prescribe ANY drug for a purpose other than the one it was approved to treat.” – R.H. and Erectile Dysfunction: “I’m a 76-year-old man, my libido was very low. Taking Cymbalta for peripheral neuropathy added ED as a side effect of the drug. I had a testosterone blood test; it was 1/3 what the minimum should be. So I’m taking Androgel to raise testosterone levels and it is magic. I have great libido now and am working on minimizing the Cymbalta pills. In the meantime, I have been prescribed Cialis for the ED. Each pill solves the sex problem for a couple of days.” – M.O. on stopping Cymbalta:
“I have the exact symptoms as everyone else and it’s been a week. I only took Cymbalta for 2 months, but the side effects from stopping it are horrible. My doctor didn’t, nor did anyone else tell me, about any side effects and I did read the insert. Most of the time the listed side effects of meds don’t bother me, so I figured no problem. “From reading other posts on this website and on other sites, the drug seems to affect every person the same way. I would never have taken it for my neck pain if I had known about the likelihood of side effects. The worst part for me is the dizziness, the brain zings and the sudden burst of tears for no reason. I would never take this drug again. I think the FDA needs to do longer studies on all drugs and be honest with their findings and that doctors should be honest and tell their patients what really happens when you take Cymbalta.”
Please add your own experience below in the comment section.
As you age, your cartilage — the spongy material that protects the ends of your bones — begins to dry out and stiffen. Your body also makes less synovial fluid, the stuff that acts like oil to keep your joints moving smoothly. The result: Your joints may not move as freely as they used to. It sounds a little crazy, but the best thing you can do is keep on trucking. Synovial fluid requires movement to keep your joints loose.
When you’re asleep and still for several hours, the fluid that helps your joints move easily can’t do its job. That’s why you wake up with knees or hands that are stiff and swollen. To make it better, try to move around more during the day.
A joint is a place where two bones meet. The end of each bone is covered in a layer of rubbery stuff called cartilage. This keeps them from rubbing together. But cartilage can wear away over time or after an injury. When it’s gone, the bones hit one another, and sometimes, tiny pieces break off. The result is a stiff, swollen, painful joint.
Your first move might be to do fewer things that bother the joint in question. Over-the-counter drugs can help with pain and swelling. If they don’t, your doctor might inject stronger treatments directly into problem areas. You can wrap joints to protect them and stop overuse, but this could weaken your muscles, so don’t overdo it. Some people need surgery, but it’s rare. Your doctor will discuss treatments with you.
Your immune system is supposed to protect you from outside germs. Sometimes, it attacks the lining of your joints instead (your doctor will call this the synovium). RA is most likely to affect your wrist or finger joints, but it can show up anywhere in your body. It often causes constant pain and stiffness. Sometimes, it stays in the background and only flares up now and then.
Doctors treat RA with medications that slow or stop the disease process. You might hear yours call them DMARDs, which stands for disease-modifying anti-rheumatic drugs. The goal is for you to have no signs of inflammation in your body. Your doctor will refer to this as this remission. Along with drugs, you can also take care of yourself — eat well, rest when you need to but keep moving, and take good care of your joints.
OA and RA are the most well known, but other types also affect your immune system and result in stiff joints:
Ankylosing spondylitis: This type mostly affects your spine, but it can make your hips, hands, or feet feel stiff.
Gout: The first sign of this build-up of uric acid in your body is often a searing pain in your big toe.
Infectious arthritis: It often starts with an infection somewhere else in your body that travels to one big joint, like your hip. Your doctor might call it septic arthritis.
Did your grandma say she knew when a storm was coming because her joints ached? She was right. Doctors aren’t sure why, but joint pain seems to get worse when the weather changes. It’s most common when the air pressure (the weather forecaster will call it barometric pressure) falls. That typically happens just before a storm.
There’s no cure, but over-the-counter meds should ease your pain. Your doctor might prescribe other medications. A physical therapist can teach you special exercises to help. You might also try a relaxation technique like deep breathing or a gentle exercise like yoga or tai chi. They’ll help you stretch and strengthen your muscles and tendons.
These conditions are easy to treat. You’ll likely make a full recovery. The first thing to do is give that joint rest and take over-the-counter pain medication. Your doctor will probably give you a splint to wear and tell you to put ice on it. She might show you some exercises to do, too. If that doesn’t help, she could inject a stronger drug straight into the bursa or tendon to manage pain and swelling.
The more you move your joints, the less likely they are to get stiff. A little afternoon gardening or a walk around the block can help. You’ll strengthen the muscles that support your joints, keep your bones strong, improve your balance, and burn calories. Start slow, so you don’t get hurt. Talk to your doctor first if even gentle exercise makes the stiffness worse.
If your joints are extra stiff in the morning, try a hot shower or bath. It’ll get the blood flowing to the area, which loosens things up. You can also buy moist heat pads from the drugstore or make your own. Toss a washcloth into a freezer bag and microwave it for 1 minute. Wrap it in a towel and leave it in the area for 15-20 minutes.
Ice down an achy joint. It narrows blood vessels, which slows blood flow to the area and eases swelling. You can use a store-bought cold pack, or try a bag of frozen veggies instead. Put it on the area, but use a towel to protect your skin. Don’t do it for more than 20 minutes at a time. If you really want to chill a problem joint, try an ice bath.
The media can’t look to get its stories about Prince right. As the news feed overflows with stories with the word Princeand drug addiction in them, not many of them feature the word chronic pain. Multiple reports show that Prince had suffered from years with Fibromyalgia pain and Severe Chronic Pain in his hips due to injuries racked up during when his performances started.
His body was wracked with pain, Prince relied on opiate pain medications to provide him some relief. And yet even today the stately New York Times features a long article about Prince looking for help with an addiction.
Prince was not addicted to pain medication. Prince had a medical problem— Severe Chronic Pain — which is criminally under-treated. It is also a medical problem that is more likely to be reacted to with stigma and condescension, even dares about the chronic pain patient’s moral character. Severe Chronic Pain is still the condition that we treat by telling its sufferers to just pull it up or keep a stiff upper lip, or to terminate acting like a wuss.
When anyone dies from complications of the disease, for that is what Severe Chronic Pain is, we react surprisingly, sympathy and anger that the patient died from a drug overdose. Some outlets make money off our doubt about overdose and medications and our interest in drugs.
Reports of 2009 surfaced that Prince was in chronic and debilitating pain. His friends reported that he was taking Severe Chronic Pain medication to try to control the constant, severe pain from damaged hips.
The supposed disagreement between Prince’s conversion to the Jehovah’s Witnesses and his potential to accept a blood transfusion — should the need emerge during hip replacement surgery — was bandied about by the vultures who pose as whispering reporters. The idea that Prince would forego surgery in order to serve his faith granted to the undercurrent that Prince was “strange”. however, some news channels report that Prince did have double hip replacement surgery in 2010.
But it’s not just about how the media doesn’t realize how Severe Chronic Pain works. They are also ignoring the realities of the impact of race upon the carry out of medicine. Into the mix must definitely be added the element of race. Prince was a black man with severe chronic pain. Strong racial disparities in how doctors and other medical staff replied to pain in the emergency room have been documented.
For example, a new study published in one of the most important pediatrics journals studied the treatment of appendicitis, a situation that is often initially suspected after a chandelier test. In medical slang, if a fibromyalgia doctor places her hand on the pain point in the lower abdomen affected by the Severe Chronic Pain of an inflamed appendix, the Chronic pain patient will try to jump up into the metaphoric chandelier on the top limit above their head.
In medical problems in which Severe Chronic Pain has been abiding, scientific evidence recommended that the brain’s pain receptors short out. whereas, regardless of even whether the painful part of the body has been removed — as in amputations — the brain’s pain receptors persist to process signals that the body is under attack.
Phantom limbs can cause severe pain. It does not make the pain fake. It is the brain that can feel pain. And the brain can remain to experience severe chronic pain even after surgery has been performed.
And yet, despite the facts that Prince was being given Percocet for documented pain, the media narrative has shifted to a story in which Prince died of an overdose of drugs. An overdose is a self-inflicted wound. It’s a moral judgment. That is how we react to it.
He was such a brilliant actor. Why overdose of drugs? Or She had such a dominant voice. But she was a demon for drugs.” That story allows us to distance ourselves, to see it as the mistake of a weak personality an addictive personality. It’s part of the mythos we create around brilliant folks.
The idea is that the really gifted are also the ones in the worse psychological pain, and their psychological weaknesses make them mature for drug addiction. Prince is being pressed toward that precipice over which we have pushed Amy Winehouse, Whitney Houston, Philip Seymour Hoffman, Michael Jackson, and every other artist who has died from a drugs overdose in the past century — especially those who succumbed to heroin.
But heroin and Severe Chronic Pain medication are not the same things. certainly, some will gain fame for their discussions of the abuse of chronic pain medication.
Severe Chronic Pain managing requires, in many cases, the taking of power, frequently-opiate-based medicines. any patient who takes these drugs on a daily basis will become “physically needy” in a short time. Physical needy is not addiction. Diabetics physically rely on insulin, and yet we can’t call insulin an addictive drug. Without it, diabetics would die.
Stopping pain medication that has been used for Severe Chronic Pain can kill you if it’s done suddenly. Under a doctor’s care, a change in pain medication is handled on a strict schedule in which the body is weaned off one drug in order to either begin a new medication or to determine whether the body is reacting in an unusual way to the condition causing the pain.
It is a chronic condition that renders sufferers so sensitive that even the lightest touch triggers waves of excruciating pain. Fibromyalgia is thought to affect up to a million Britons, commonly women over 40, and experts have likened the debilitating sensations to ‘death by a thousand needles’.
Other symptoms include lack of concentration, memory loss, headaches, and muscle stiffness. And for a long time, there were little doctors could do to help quell the agony.
Yet today, with the help of sophisticated scanning techniques, pain specialists have been able to pinpoint the parts of the brain responsible for the condition.
Using a combination of psychotherapy and medicines more commonly used to treat depression and epilepsy, many sufferers are able to find relief.
‘Patients with fibromyalgia typically have what we call tender points,’ says Dr. Ernest Choy, consultant rheumatologist at King’s College Hospital in London.
‘There are 18 sites throughout the body – in the neck, back, arms, and legs – where, with light pressure, they experience pain, when a normal individual wouldn’t.
‘As well as pain, patients usually complain of a degree of fatigue and poor sleep quality. Depression and chronic pain often go hand-in-hand – it’s so hard to cope with such grinding discomfort every single day.’
The patient will have suffered widespread pain for three months on both sides of the body, above and below the waist, as well as pain in at least 11 of the 18 known tender points when pressed.
‘Unfortunately, fibromyalgia isn’t well understood by many clinicians because pain is often a very subjective symptom,’ says Dr. Choy.
‘According to a European survey, it takes approximately 18 months to two years to get a diagnosis of fibromyalgia. There are still a lot of clinicians who don’t even know about it.’
The exact cause of the condition isn’t known but, according to Dr. Choy, research has highlighted that it is likely to be due to a problem with how the nervous system handles pain.
‘When a normal individual experiences pain, there is what we call a coping process in the brain that manages it,’ he explains.‘In some patients with fibromyalgia, that process isn’t working properly so their threshold for experiencing pain is much lower.
‘Recent advances in assessing the way the brain works, using functional magnetic resonance imaging [fMRI], have really changed our understanding of the disease.
‘It’s clear that the way the brains of people with fibromyalgia process pain is very different from normal individuals.’
There are certain risk factors for developing the condition. ‘My symptoms started almost six years ago, with my joints suddenly swelling and feeling very painful’ ‘There is evidence to show that people who have physical or psychological stress are more prone to developing fibromyalgia,’ says Dr. Choy.
‘In some individuals, it may be that they sleep very poorly, while in others it may be that they have other illnesses, such as depression.’
There is no cure, but treatments can help ease symptoms. Dr. Choy explains: ‘The aim of treatment is to help patients cope with their condition.
In most patients, we use a combination of non-drug-based treatments, as well as medications.
‘Exercise can be helpful. Although many patients get worsening of their pain when they start, if they build up exercise gradually, they’ll get long-term benefits.
‘Taking warm baths or exercising in warm water will also help alleviate the pain and tiredness. Cognitive-behavioral therapy, a kind of psychotherapy, can help improve patients’ ability to handle pain.
‘Aside from that, some simple painkillers can help, and we often prescribe antidepressants mainly because the chemical substances in the brain that control the processing of pain are also the same as those that cause depression.
‘These are given at much lower doses than are used to treat depression, though. Anti-epilepsy drugs have also been shown to be effective. These work on readjusting the nervous system and reducing sensitivity to light pressure.’
One sufferer, Nicki Southwell, 53, runs a fibromyalgia support group. Nicki, who lives in Carlisle with her husband Merlin, 51, a teacher, says: ‘My symptoms started almost six years ago, with my joints suddenly swelling and feeling very painful.
‘It got so bad I couldn’t climb the stairs. I was eventually diagnosed early last year, though no one knows what caused it. In the meantime, I had to stop work as a carer.
‘And although I’m usually very organized, suddenly I couldn’t find my diary or manage the housework. I felt totally out of control and I hated that. Along the way, I’ve suffered from depression too, but I don’t know if that’s because of the fibromyalgia.’
More than a year on from her diagnosis, Nicki sleeps normally but wakes with aching, stabbing pains – mainly in her back and legs. Her short-term memory is also still poor so she makes lists.
‘I take painkillers and I use a Transcutaneous Electrical Nerve Stimulation [TENS] machine for pain relief, which delivers electrical impulses to the body,’ she says. ‘I also did an NHS hydrotherapy course, which involved exercising in warm water and was brilliant.
‘I know lifestyle changes are key, so I’m going to try swimming, t’ai chi – anything. I still have bad days but things are getting better.
‘My message to other sufferers would be to persevere for diagnosis and treatment. Don’t give up hope.’
Dr. Choy says: ‘What works for one patient might not for another. It is important to remember there are treatments already available that can help ease symptoms. I think the future is looking bright for patients with fibromyalgia.
A leg cramp is a pain that comes from a muscle in the leg. It is due to a muscle spasm which is when a muscle contracts too hard. It usually occurs in one of the calf muscles, below and behind a knee, but painful spasms can occur in the ankles, shins, and quads (the big muscles of the thigh). The small muscles of the feet are sometimes affected, usually starting with curling your toes toward your heel. These steps may help alleviate this painful condition.
3. Tell your doctor about your cramps. Look over any prescriptions you are taking together. Some medications may be causing leg cramps or making them recur more often. Alternative medicines may be available. Also, if you have other symptoms apart from cramps, see your doctor who may examine you or do some checks to rule out a secondary cause for the cramps.
1. Try stretching exercises. Stretching exercises are commonly advised. Some doctors swear by these exercises to relieve nocturnal cramps, others aren’t sold. Either way, stretching will not hurt you, so if you try them and find they help you, that’s a good thing. Stretch your hamstrings, inner thigh muscles, and quadriceps, but stretch gently and don’t overdo. There are lots of instructions with pictures available on the internet for each exercise.
2. Position your legs properly.This is strongly advised. Positions that prevent the calf muscle from shortening when you are asleep may help. The following are not proven treatments (from research studies), but some experts believe that they help to prevent cramps.
Positioning your feet is helpful. If you can “trap” your toes against your sheets, it can keep your foot from turning down and allowing your calf muscles to seize.
3. Walk. If you do get a cramp, stand up and walk around. This loosens the muscle in your leg, thus relieving the cramp.
1. Stay warm. Cold muscles are much more likely to cramp. Even if it is a warm night, as you sleep, you become more sensitive to cool drafts. A light sheet will help reflect some of your body heat back to you, and warm muscles are much less likely to cramp.
In winter, use a covered hot water bottle to place near the area of your legs that cramps most often.
Try a warm shower if mid-cramp. It might help ease the pain.
Very hot water can get rid of cramps if you stay in it for a while. Your cramps will be less likely come back. Just be sure to use water that is hot but not burning.
2. Take potassium, calcium,and/or magnesium supplements after getting your doctor’s advice. These supplements are available at most pharmacies or health food stores. Be careful not to take too much; ask your doctor what the right amount is for you, as well as the right form (for example, magnesium citrate versus magnesium gluconate). The deficiency of any of these minerals can cause leg cramps.
Do not use quinine.Serious safety concerns, including fatalities, associated with quinine are well-documented. Quinine can cause tinnitus, dizziness, disorientation, nausea, visual changes, and auditory deficits. There is also evidence that quinine causes serious cardiac arrhythmias.
Serious adverse reactions associated with quinine use also include severe skin reactions, thrombocytopenia (a decrease in blood platelets that can cause hemorrhage or clotting problems), and other serious hematological events, permanent visual and hearing disturbances, hypoglycemia, kidney failure, and generalized anaphylaxis.
If you sense an imminent cramp, try putting your shoes on before you go to sleep. It sounds weird, and you will wake up with sore heels because of the unfamiliar pressure. Still, your shoes will keep your toes from curling under, which is often the way a spasm starts – as the muscles on the bottom of your feet contract, your foot turns down, which in turn causes the muscles on your calf to shorten, resulting in a painful Charley Horse. Wearing your shoes is not cozy and comfy, but it’s better than a leg cramp.
Rub in cream such as emu oil, Pain Away or Dencorub. Keep active the following morning by exercising the muscles.
Other medicines and supplements have been suggested as possible treatments for leg cramps. These include: Quellitall, naftidrofuryl, vitamin E, verapamil, diltiazem, methocarbamol, Flexeril, painkillers, aspirin, orphenadrine, magnesium, calcium, and sodium chloride. TENS machines have also been suggested as a possible treatment.Some of these treatments work better than others. Your doctor can help you decide if one is right for you.
Don’t worry if you have leg cramps. They are painful and can leave you sore for days, but usually they aren’t damaging in any major way. They hurt but it’s not like a heart attack.
The moment you feel a leg cramp, stretch both arms up while still in the lying position for one minute. You will feel the pain is slipping away slowly as blood is flowing into your legs.
Don’t overexert yourself. Little to no activity will cause you to have cramps if you’re prone to them, but too much activity can trigger them, too. Keep exercise gentle and moderate – not too much, not too little.
Scientists, doctors, and other medical experts claim that regular consumption of honey in combination with cinnamon is a powerful remedy that can be used against many diseases.
For more than 4000 years, honey has been used as a traditional remedy for almost every disease. The Egyptians used it to treat wounds, the Greeks for long life, and the Indians to maintain balance in the body. Modern medicine shows us that these beliefs were true.
They all knew about cinnamon healing purposes as they did for the honey. Cinnamon was considered a great gift for the Monarchs cause of its usefulness in treating many diseases.
Here are some combinations of these powerful natural ingredients which can be used in the treatment of certain diseases, including chronic health conditions such as arthritis.
Add two tablespoons of honey and three teaspoons of cinnamon in a large cup. Regular consumption of this mixture will reduce cholesterol levels by 10 % within two hours.
In the morning, instead of marmalade or jam, put a little honey and cinnamon on a slice of bread. If you regularly consume this combination, it will help you reduce your blood cholesterol levels and prevent the risk of having a heart attack.
In a cup filled with boiled water, mix two tablespoons of honey and a tablespoon of cinnamon. Drink this drink in the morning and evening. With regular use, this drink will help in the treatment of chronic arthritis.
If you have any infection of the gallbladder, you can consume the above-mentioned mixture, but this time change the amount of honey and cinnamon. In the cup of boiling water, put two teaspoons of cinnamon and a large spoonful of honey.
If you have a problem with frequent colds, make a mixture of a large tablespoon of honey and a quarter teaspoon of cinnamon. This habit will help with your cold treatment, chronic cough, and sinus congestion.
“I have a problem—unexplained excessive sweating, like just stepping out of the shower, hair dripping wet, clothes soaked! … It has put a big damper on my lifestyle.”
“My limbs get so cold and painful … and yet my face will be sweating from the heat inside.”
“What exactly causes the excessive sweating? … I don’t bother to wear makeup in the summer because there is no point—it just melts off.”
Excessive sweating is one of those bizarre symptoms that rarely make it onto symptoms lists or grab the attention of researchers.
That’s understandable since we have much bigger problems. Still, it can have a major impact on your life.
While doctors and researchers have noted that excessive sweating can be a symptom of these conditions, you may want to talk to your doctor about complex regional pain syndrome. It has similar symptoms and some research suggests excessive sweating may be more common in that condition.
The only cause that’s “curable” is the medication side effect, and that may not be an attractive option to you if the drug is doing more good than harm. Your doctor may have ideas about medications that help control sweating.
If you do have to live with this symptom, you may want to keep some items on hand to keep it from being obvious and embarrassing.
Loose powders: Powder on your face may help absorb sweat before you even know it’s there. You can also apply it after drying sweat off of your skin to keep from being shiny.
Oil-absorbing face wipes can keep you from having greasy-looking skin as well. They’re generally better than napkins or tissues, which work in a pinch but may be worse for your skin as well as less effective.
If your sweating isn’t tied to any particular stimulus, you might not be able to keep it from happening. However, if it’s tied to heat—and especially our tendency to become overheated—you may find that some of these things reduce the problem.
Extra antiperspirant, re-applied a few times during the day, and applied to non-typical places where you tend to sweat a lot may help.
Taking cooler baths or showers, or running cooler water over your body before you get out, may keep you from getting overheated and sweating more.
Especially if you tend to be cold a lot, you may frequently find yourself dressed too warmly for the environment. Dressing in layers gives you more temperature-control options.
Choosing cold drinks over hot ones and avoiding hot foods can help.
Once sweating starts, it may be difficult to stop. You’re better off trying to prevent it in the first place.
One important thing about excessive sweating is making sure you stay hydrated. It’s important to replace both the water and the electrolytes you sweat out.
So much has been written about the opioid epidemic, but so little seems to be out there about what living with true chronic pain is like. My husband, the Jay, lived and died in incredible pain at the age of 58. As his wife, I lived that journey with him.
Jay is no longer here to tell his story, but I want the world to see what I saw. I want you to know how he went from working 60 hours a week doing hard physical labor until his pain grew worse and he could not even get out of a chair on his own.
I want you to know the deterioration Jay went through over the last ten years. I want you to know what a good day and a bad day are like when you live with chronic pain. I want you to know exactly what happened when the doctor decreased his pain medication. And I want you to know how my husband finally made the decision to commit suicide.
I want people to understand that when chronic pain runs your life, eventually you just want the pain to stop.
First a bit of history. I met Jay in 2005 when we both stopped drinking. Two years later, Jay began to lose feeling in his legs and started having fallen, as a result of compressed nerves in his spine. The pain was so bad Jay had to stop working and go on disability, which started his depressive episodes.
Jay had a series of lower back and neck fusion surgeries. This was when he has first prescribed painkillers, antidepressants, and anti-anxiety medications. From 2008 to 2011, Jay tried various treatments to control the pain that lingered even after third back surgery. These included steroid shots, nerve blocks, and a spinal cord stimulator. Ultimately he had a drug pump implanted that delivered morphine, in addition to the pain pills he was being prescribed.
In 2012, Jay was diagnosed with trauma-induced dementia. I believe that diagnosis was right, based on his symptoms, but not all of the doctors agreed. Some believed the confusion was due to high doses of morphine and/or his sleep apnea.
By 2016, Jay’s confusion and memory issues were increasing. He was on a steady dose of 120mg morphine daily, in addition to the medication he was receiving from his pain pump.
Jay’s depression seemed to come and go, depending on the day and his pain levels. He was weaned down on his Xanax to 2mg a day to help him sleep. He was aware of the risks of combining Xanax and morphine.
Let me tell you what a good day was like before they changed his medications. I worked a full-time job from 2 pm to 10 pm five days a week. I would get home, and Jay would have my coffee ready for me at night. We would stay up and watch TV until 2 or so. When it was time for sleep, I went to bed and he slept in his recliner.
We started sleeping apart after his first surgery in 2007. He was more comfortable sitting up in the chair, but could never sleep more than three hours at a time. He knew sleeping in bed would just keep me awake.
A good day always meant it was not cold or raining. On a good morning, he would be up first and get the coffee started. He would take our two miniature pinchers outside in the yard on their leash for potty time.
We usually had at least one appointment a week, but if not we could have a nice quiet morning. That meant coffee in front of the TV. After a couple of hours of that, he might switch over to playing his computer games, but he was never far from his chair.
A typical adventure for us would involve going to Walmart. Jay was not able to walk through the store, but he hated using the handicapped carts. I could always see a look on his face when he had to do it. After going to the store, we might have lunch or an early dinner at Steak n Shake or Cracker Barrel. It always needed to be someplace familiar and comfortable for him. More than once we sat, ordered, and then took our food home because he was in too much pain.
In the summer we might walk the dogs after dinner. Just a quick two-block walk, but a lot of times he would have to stop halfway and go back home. A couple of times I had to go get the car and pick him up because his legs just would not support him anymore.
A bad day was awful for me to watch, and absolutely horrible for Jay to live. It meant no real sleep, just catnaps in the chair whenever he could. He always made coffee for us, but on a bad day he would forget to add coffee to the coffee maker and we would just have hot water. The pain was so much he was just distracted.
On many bad days, I would look over and see tears just running down his face because he was in so much pain. It also made Jay’s depression worse. We spent many cold winter nights talking about how much pain would be too much and would make life not worth living. It is the most horrible feeling in this whole world to hear the person you love most talk about ending their life.
In January 2017 Jay’s pain clinic decided they could no longer prescribe the high doses of morphine he was on. In addition, they were not going to continue seeing him if he decided to stay on Xanax. The Xanax was prescribed by another doctor, but they did not care.
I begged the pain doctor — yes, literally begged — for some other option. The doctor said that if Jay continued the Xanax he would no longer see him. He would not give another option for medications, and at one point even said that most of his patients with pain were “making it up.”
The last thing the doctor said to us will stick with me forever. He said, “My patient’s quality of life is not worth losing my practice over.”
When we left that day, we were barely in the car and I knew what Jay was going to say to me. I will never forget how sad his voice was when he told me this was it for him. He was not going to continue to live like this.
Through the month of February, as Jay’s medication was decreased, we spent time doing things we did not normally do. We went out on Valentine’s Day, he bought me the first jewelry he had bought since my engagement ring, and we went out to a fancy restaurant for dinner. Jay tried to cram in as many good memories as he could into that last month, but I knew it was costing him.
Jay’s next doctor’s appointment was scheduled for March 2, and we knew they were going to decrease his medications again. The night before, he woke me up to tell me it was time. I knew what that meant, but I tried to be strong for his sake. We talked all night long about what it meant, and how it should be. It was the saddest, strangest, longest night of my life.
Jay knew he did not have enough pills to kill himself. He also knew that if he were to try and purchase a gun, they would not sell it to him. It would have been almost obvious what he was going to use it for.
In the end, I bought the gun that Jay used — and yes, we talked about the ramifications of that action. We went to the park where we had renewed our vows in 2015. We talked in the car for a while, and then we sat in the same place we had cut our wedding cake. I was holding his hand when he pulled the trigger.
Through the shock and horror, my immediate feeling was one of relief for Jay. To know that he was finally out of pain was a weight lifted off both of us.
Because I purchased the gun that Jay used to end his life, I was charged under our state’s assisted suicide law. This charge was later reduced to reckless endangerment, and I am currently on probation. People close to me want me to be quiet about my role in Jay’s death, and I was at first. But I cannot continue that way.
I know Jay wanted me to put his story out there. I know he wanted people to know what it was like to live with the pain he lived with daily. When the doctor took away Jay’s medications, they took away his quality of life. That was what led to his decision. Jay fought hard to live with his pain for a long time, but in the end, fighting just was not enough.
