What You Can Do About Chronic Pain and Fatigue with Miryam Ehrlich Williamson

WebMD Live Events Transcript

Join author Miryam Ehrlich Williamson for a discussion about strategies for managing chronic pain and fatigue.

The opinions expressed herein are the guests' alone and have not been reviewed by a WebMD physician. If you have questions about your health, you should consult your personal physician. This event is meant for informational purposes only.

Event_Moderator Welcome to WebMD LIVE! Our guest today is Miryam Ehrlich Williamson. The topic is "What You Can Do About Chronic Pain and Fatigue." Miryam Ehrlich Williamson is a technical journalist and a charter member of the online Fibromyalgia Discussion Group. She was diagnosed with fibromyalgia in 1993. She is the author of Fibromyalgia: A Comprehensive Approach and The Fibromyalgia Relief Book.

lucycat1_WebMD How do you deal with daily pain?

Event_Speaker That's a good question. There are many facets to dealing with daily pain. Chief among them is what to do to combat pain in the first place. If meds are part of your regimen, then it's important to use them to stay ahead of the pain rather than wait until the pain is really terrible. It's also important to understand the role of pain in FM. Usually pain tells us something is being broken or torn or is infected. That's not so with FM. Much of our pain is because of a chemical imbalance that exaggerates pain in our brains. So it's helpful to remember that and not let the pain get us more tense and upset, because that makes the pain even worse. /next

shamrock2_WebMD What is the difference between CFIDS and FMS?

Event_Speaker This is my opinion only. It is not shared by everyone in the FM/CFIDS communities. I think the two are different disorders with different causes. FM is a central nervous system disorder involving certain brain chemicals that are out of balance in us. CFIDS I believe has its origins in some form of infection. The symptoms are quite similar. In FM usually the primary symptom is pain; in CFIDS the primary symptom is fatigue. But they overlap greatly. I think the causes are different and from what I've learned in talking with people with one or the other, the most useful treatments are different, too. I can usually tell which the person who has been given a double diagnosis (often by a doctor who doesn't want to express a judgment about which it is) by asking when she feels the worst. Typically, but not always, the person with FM feels worst first thing in the morning and the person with CFIDS feels worse as the day goes on.

KitzKatz_WebMD What is the best way to get others to understand your pain?

Event_Speaker No one is ever going to fully understand your pain, I'm sorry to say. The best you can hope for is that they'll understand you _are_ in pain and give you the understanding and support you need and deserve. I think the best way to achieve that is to try to explain calmly and clearly what is the situation, without soliciting pity and without giving more details than you must to make them understand.

hurd2_WebMD If FM is a disorder involving brain chemicals, why is it so difficult to diagnose?

Event_Speaker It's difficult to diagnose for a couple of reasons. First, it's hard or impossible to get at those chemicals. Nobody wants to have a hole drilled in her brain so the doctor can draw off the chemicals to analyze them. The best doctors can do to assess most of the chemicals is to look for their breakdown products in the blood or urine. Second, FM doesn't fit the classical medical model that all doctors are taught. In that model there is a lesion of some sort -- something that can be shown is wrong in X-rays, lab tests, or physical exam. The model says the doctor finds what's wrong and applies a medicine or procedure to fix it. FM isn't like that. Lab tests for the most part don't show much, if anything, and there's no way to fix it completely. Doctors tend to hate it because they can't prove its existence, and because they don't know how to fix it.

lmmiller_MSN How can you fight fatigue?

Event_Speaker In three words: sleep, nutrition, and exercise. First comes good sleep hygiene so you can achieve a good night's sleep. (I think I can hear you groaning. Please believe me; it's possible to do that.) Second, excellent nutrition will provide you with energy that you're currently probably lacking. Third, believe it or not, gentle regular exercise will give you more energy, not less.

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