DEAR DR. DONOHUE: I am a 43-year-old mother of three children, and I also teach school. Since last spring, I have lost all energy, and my muscles seem to hurt all over. I have consulted three doctors. None has found anything wrong with me or my tests. The last doctor has suggested fibromyalgia. I am scheduled to see him again in three weeks. I know nothing about this illness, and I wonder how it’s treated. Please summarize for me. — L.J.
ANSWER: Fibromyalgia is an elusive condition. It’s defined as widespread body pain, an ache-all-over feeling, just like you describe. Accompanying symptoms include disturbed sleep and fatigue. No lab test, X-ray or scan discloses anything amiss. One aid to diagnosis is tender points — specifi c body sites where finger pressure elicits pain far out of proportion to the pressure applied.
No one has a definite answer about what’s going on. One popular explanation is that people with fibromyalgia perceive pain with heightened sensitivity because of an imbalance of brain chemicals and a misfiring of brain nerves. Disturbed sleep is another consequence of these disorders.
Often the first treatment for fibromyalgia is an antidepressant. It’s given not so much to relieve depression — although fibromyalgia is a depressing situation — but to restore normal brain-cell communication and normal brain chemistry to dampen the brain’s magnified perception of pain. Savella and Cymbalta are such antidepressants that are approved for the treatment of fibromyalgia. Another medicine often prescribed is Lyrica, a drug whose primary purpose is seizure control. Heat and massage might decrease pain.
Exercise is an essential part of treatment. It sounds absurd to ask someone in pain to exercise, but a carefully graded exercise program goes a long way toward restoring normal feeling. You can start with something as simple as a walk. Increase the time, the pace and the frequency of walking until you are finally doing 30 minutes a day at a brisk clip.
The fibromyalgia booklet explains in greater detail this condition and how it’s approached. Readers can obtain a copy by writing: Dr. Donohue — No. 305W, Box 536475, Orlando, FL 32853- 6475. Enclose a check or money order (no cash) for $4.75 with the recipient’s printed name and address. Please allow four weeks for delivery.
DEAR DR. DONOHUE: have age spots ( brown spots) on my face and hands. Can I do anything to lighten them or get rid of them? — L.R.
ANSWER: Age spots are also called liver spots. The liver has nothing to do with them. Age and the effects of sunlight do. They are clumps of skin cells filled with melanin, the pigment that gives skin its color. Sunblock, worn year-round, will prevent new spots from forming. Hydroquinone is a bleaching agent that lightens them. It comes as a 2 percent cream in products with the brand names of Eldopaque, Esoterica and Solaquin. For the 4 percent formulation of hydroquinone, a prescription is required. The acne medicines Retin-A and Renova lighten these spots, too. So does a cream, Tri-Luma, that contains three ingredients: cortisone, tretinoin (Retin-A) and hydroquinone — a triple threat, so to speak. Retin-A, Renova and Tri-Luma are prescription medicines. ©2011 North America Synd.