Wednesday, January 19, 2000
Doctors seek broad solutions to often-misdiagnosed, body-pain disease
BY SUE MacDONALD
The Cincinnati Enquirer
It's hard to discuss treatments for a disease when even doctors can't agree what it is and patients don't know where to turn for help. That's what frequently happens with a condition known as fibromyalgia.
It creates all-over body pain and muscle aches that seem to have no known physical causes.
It can't be detected by commonly used tests or diagnostic scales. People who have fibromyalgia feel sluggish and constantly tired, as if they're coming down with a flu virus that never really hits. Many complain of sleep problems difficulty falling asleep, difficulty staying asleep, sleep that's not refreshing.
Because fibromyalgia affects far more women than men, symptoms are sometimes dismissed by doctors who don't really know what they're dealing with or who don't understand the depths of the their patients' problem.
There's nothing imaginary about the symptoms, they are very real, says Dr. William Salt, a Columbus doctor and gastroenterologist who has co-written Fibromyalgia and the MindBodySpirit Connection (Parkview Publishing; $19.95).
Like a growing number of physicians and health experts, he advocates a broad approach to fibromyalgia, one that takes into account factors such as stress, diet, environmental exposures, hormones, the benefits of stretching and alternative approaches that encompass the body's own ability to recover and heal.
One of the things we really need to work harder at as physicians and patients is realizing that to split the mind from the body is a major mistake in trying to assess these conditions, Dr. Salt says.
Dr. David Dahlman, chiropractor/nutritionist with Hyde Park Holistic Center, finds that many women with fibromyalgia benefit from dietary changes to deal with what doctors call leaky gut. In essence, many people eat foods that cause internal reactions that produce chronic pain, irritable bowels, pelvic pain, achy joints, and reproductive and menstrual problems.
And stress, Dr. Salt says, is now known to cause neuro-chemical reactions throughout the body, sometimes making organs and tissue hypersensitive to how they react to outside forces.
It is essential to understand that stress and emotions are embodied in the body, he says. They play out in the body. Yet we are focused to much on our symptoms rather than on our strength and the power we have to heal.
Dr. Dahlman's background in nutrition and chiropractic medicine gave him new avenues to pursue with patients beyond drugs and an it's all in your head philosophy.
The gut connection to me is very strong, Dr. Dahlman says. Female hormones tend to play a role in fibromyalgia. Any medications that you are taking can also play a huge role, and the essential fatty-acid balance in your diet is very key.
He recommends a low-carbohydrate diet based on emerging research into the benefits of eliminating carbohydrates starches, pasta, potatoes, sugars for people who react negatively to them. Increasingly, studies are showing that sugar, for example, can cause painful reactions in some people.
Dr. Dahlman also recommends adding to eating plans essential fatty acids such as olive oil, butter and canola oil. Fried foods are out.
Other specialists, such as pain specialist Dr. Hal Blatman in Blue Ash, combine a multitude of treatments including holistic and alternative medicine, nutrition, massage therapy, therapeutic touch, Feldenkrais movement and aromatherapy for people with muscle-pain syndromes and fibromyalgia.
A new book, What Your Doctor May Not Tell You About Fibromyalgia (Warner; $14.99) recommends avoidance of salicylates, which are compounds found in aspirin, lipstick and cosmetics, sunscreens, detergents, deodorants, some herbs and plant juices.
The book's author, Dr. R. Paul St. Amand of Tufts University, urges fibromyalgia patients to take pure guaifenesin tablets to help the body flush out excess phosphates, calcium and other substances that can linger in tissues, bones and joints, causing pain.
Increasingly, health professionals also urge women and other fibroymyalgic patients to pay attention to their own abilities to heal from the emotional strains, spiritual losses and stresses that can make them feel hurt, empty and unenergetic.
We believe that everybody is underestimating our ability to heal, Dr. Salt says. Do we have a treatment for fibromyalgia? No. We don't even have a shared, common language to discuss it. But can we begin to relieve symptoms by looking at them differently and addressing them differently? I believe we can.
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