DEAR DR. DONOHUE: My daughter was told she has fibromyalgia. She is 43. I’ve never heard of this. Exactly what is it and what is the treatment? – W.S.
ANSWER: Fibromyalgia is difficult to have, difficult to treat and difficult to understand. It consists of a large number of symptoms, the chief of which is pain all over the body. Furthermore, fibromyalgia patients are chronically tired, cannot get a decent night’s sleep and wake up as unrefreshed as they were when they went to bed. Some authorities estimate that as many as 10 percent of all adults suffer from it.
In making this diagnosis, doctors have to first search for illness with similar symptoms. Lupus, rheumatoid arthritis, hidden infections and a nonfunctioning thyroid gland are such illnesses. Only when these illnesses and others are ruled out can the diagnosis of fibromyalgia be made.
A distinctive feature of the condition is tender points, specific body areas where moderate finger pressure elicits pain far in excess of the pressure applied. There are 18 mapped tender points on the body.
Attempts to find a cause have not been rewarding so far, and that’s a barrier to prescribing an ideal treatment. Many medicines have been tried, and some are at least partially successful. Amitriptyline, an antidepressant, can restore refreshing sleep and can correct any derangement of brain chemistry that might be the basis of this condition. Muscle relaxants have helped some. Capsaicin cream, with many brand names and obtainable without prescription, sometimes relieves pain. Lyrica is a relatively new medicine that has been approved for treatment.
Exercise, within a person’s limitation, prevents muscle weakening from disuse.
The National Fibromyalgia Association is a source of timely information and advice. Its Web site is www.fmaware.org.
The fibromyalgia booklet provides more complete information on this bewildering condition. To order a copy, write: Dr. Donohue – No. 305W, Box 536475, Orlando, FL32853-6475. Enclose a check or money order (no cash) for $4.75 U.S./$6 Canada with the recipient’s printed name and address. Please allow four weeks for delivery.
DEAR DR. DONOHUE: I am writing to ask you about hepatitis C. My 46-year-old son just confirmed that he has it. He used to be an alcoholic, but he hasn’t had a drink in eight years.
What are the odds against him with this? I am at my wits’ end. I lost a son three years ago. I pray that this son will be OK. – Anon.
ANSWER: About 85 percent of people with hepatitis C stay infected with the virus for life. Twenty percent of those chronically infected develop liver cirrhosis in 20 or so years, and a smaller percentage come down with liver cancer. Looked at in another way, 80 percent do well even though they are infected.
Treatment with interferon and ribavirin is available if judged necessary.
Liver transplantation is possible for people who develop cirrhosis.
Your son must stay off alcohol at all costs. Alcohol speeds liver destruction in one who is infected with the hepatitis C virus.
©2008 North America Synd