I am very fortunate to have a physician who is very knowledgable about fibromyalgia & believes in working with all of my health care practitioners. My primary physician treating my fibromyalgia is a physiatrist. A physiatrist is a specialist in the diagnosis and nonsurgical treatment of pain. A physiatrist usually employs a team approach to restoring a patient’s abilities (rehabilitation) through various means, such as medications, physical/occupational therapies, injections, behavioral interventions, and so forth. Therefore, health care providers in other disciplines are often part of the team.
His primary goal’s for me are:
To increase my functional capacity (i.e., how much you can do)
To minimize my level of pain and suffering
Your team members might include a physical therapist, a sleep physician, a nutritionist, a psychologist, and a yoga therapist, for example.
A primary care physician can manage mild fibromyalgia. But patients with moderately severe fibromyalgia, and all patients with severe fibromyalgia, need multidisciplinary or transdisciplinary pain control.
The difference between multidisciplinary and transdisciplinary treatment is in the level of cooperation among team members. In the multidisciplinary approach, each health care provider (e.g., your physical therapist, your orthotist, your sleep physician, and so forth) treats you independently but communicates with other team members. Over time, each team member learns what the others are doing. Eventually, the team’s treatments become oriented as a whole.
The team is now a transdisciplinary one in which the health care providers’ interventions overlap to fill in and reinforce the goals that characterize the team’s treatment orientation. For example, initially, a multidisciplinary team member might tell a patient with severe fibromyalgia to push through the pain, assuming that the pain is mild and the patient just deconditioned. However, once team members begin to identify which patients do poorly when told to push through the pain (i.e., those with moderate-to-severe pain), they make other recommendations like pacing, slowing down, conserving endurance, and resetting priorities. The transdisciplinary approach ensures consistency. You can imagine how confusing it would be for the patient if his or her health care providers gave conflicting instructions because they have no uniform treatment orientation.
How about you does your physician use a team approach or does your primary physician manage your care & pain?
Due to my location, insurance status and financial status, I see a nurse practitioner at a family health clinic. I was referred to a Rheumatologist at one point. She could barely keep from rolling her eyes at me as she prescribed vitamin D supplements and told me that exercise was the only way to get my functioning back. She said that had worked for most of the people she had seen for Fibromyalgia and had kept these people off of Disability. She never even suggested what TYPES of exercises would work for me. What she probably didn’t know is that I have been very athletic my whole life and do often attempt various forms of exercise, but this usually makes me so tired and the pain so bad that I have to minimize my activity for about a week at minimum just to regain my strength; all the while hope to god that I can still work.
Otherwise, Lyrica has been suggested, but because of the side effects and the cost my nurse practitioner chose Neurontin (which also helps my seizures and I THOUGHT my anxiety – although I found that it is not good for treating my form of anxiety). While my pain definitely flares when I don’t take it, the reduction of pain is not enough to give me any peace or allow me to increase my activity.
Although, I truly wish I could find the care I need, I am glad that so many people are getting the correct care; however, it seems that someone like me in Columbia, MO is largely ignored and shuffled around instead of helped.
Regardless, good luck with the care you are receiving, and I hope these treatments continue to work for you.