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Approaching Your Primary Physician

© Cynthia Webber (Jausten)

Learning to approach our doctors is a key element in dealing with fibromyalgia. If your physician has diagnosed you by performing the tender point index test, then at least he/she is aware of fibromyalgia and knows how to diagnose it properly. If your physician has just taken your symptoms and assumed that you have fibromyalgia without doing the tender point index test, then it is possible that you may not actually have fibromyalgia. In this case, it may be necessary to change physicians. If this is impossible for a number of reasons, then asking for a referral to a specific rheumatologist or internist, whom you have heard is knowledgeable in fibromyalgia, is the next step. Depending upon where you live, there may be a cost involved in this, but it is worth it in order to receive an accurate diagnosis.

Once you've been given an accurate diagnosis, it is important to make each of your subsequent visits worthwhile to you. The standard treatment of Elavil or other antidepressants may not work for everyone, so it may be necessary to try different medications in order to find one that reduces symptoms. Thus, monthly appointments become necessary after an initial diagnosis.

Since both your time and your physician's time are important, taking a list of questions helps both parties. Keeping the list to about five questions or concerns helps the physician focus on the main problems that you are currently dealing with on a daily basis. If your physician had done a battery of lab tests and informs you that they are all normal, ask what your results are and what the range of normal is for the lab that performed the tests, and write them down.

When medications are changed, keep track of any changes in your pain or fatigue levels. Most medications have side effects, and although not everyone experiences all of the side effects of a particular drug, it is important to document any changes. Some medications, such as antidepressants take time to work, but if after a couple of weeks, you are still groggy in the mornings, not sleeping well, or having side effects which aren't lessening, then it is time to look at something else to raise the seratonin levels in your body.

Some physicians are reluctant to prescribe narcotics for pain, but it has been shown that people with chronic pain do not become addicted. As long as the amount of narcotics does not increase over time, then no addiction has occurred. We may become dependant upon narcotics, so it is important to monitor one's use on a daily basis and inform your physician of any need to increase pain medication. Discussing the need for pain control can be very difficult with some physicians. Either they worry about addiction, the loss of their medical license, or have no idea how much physical pain someone with fibromyalgia can have. Just saying that you have pain isn't helpful for either you or the physician. Show him/her where the pain is, and describe a typical day of trying to walk, or do normal activities of daily living. Describe how your sleep is interrupted by pain, and explain all the things that you do to relieve the pain such as warm baths, stretching, or massage in order to show the doctor that you need something stronger than just over-the-counter medications.

The copyright of the article Approaching Your Primary Physician in Fibromyalgia is owned by Cynthia Webber (Jausten). Permission to republish Approaching Your Primary Physician in print or online must be granted by the author in writing.