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The general opinion in medicine is that there is no "cure " for fibromyalgia or at least that very little can be done for it - what is your response to this? I do not use the word "cure" because it is fraught with problems. Essentially, FMS is not one point of your body going wrong (by which removing that point will make everything normal), but a whole web of malfunctions which need to be untangled. No single drug or approach is at present capable of doing this - so therefore nothing can claim the "crown" of being able to "cure" fibromyalgia. However that does not mean to say that a lot cannot be achieved to RESOLVE the mismanagement issues of the body, by working along the dynamics of each person's problems. This can lead to dramatically improved quality of life, through the gradual dissipation of most symptoms and the restoration of the sense of inner strength and resilience. Does your treatment differ from "pain clinics" which are advocated for chronic pain management? Yes - this clinic is totally different in all dimensions from a "pain clinic". Firstly, this clinic aims to resolve the factors causing the pain and has no clinical interest in simply managing symptoms. For most - pain can indeed be resolved - though it is sometimes quite difficult for certain areas of the body and for certain subgroups of fibromyalgia sufferers. Secondly, while I can use drugs as a medical professional, I only use them intermittently at most and do not inject sites of pain. Instead I use lots of different approaches and use mostly items for external application which goes directly to the site of the pain. Thirdly, I cover not only the pain symptoms but almost all of the myriad of symptoms - covering all the systems of the body which extremely few clinicians can do with non drug approaches. Finally, I find that the body cannot be "forced " into wellness - i.e you cannot give it a timetable by which to be well. You have to support and coax it back to full functioning at its own pace. Hence I cannot squash any therapy into two weeks because the body has to readjust itself after each therapeutic session and both I and the patient have to observe in detail as to how the work is accepted. The body is not a box that things can be piled into but a highly intelligent interactional web that has to be respected and supported appropriately. Do you think that the treatment of fibromyalgia requires elements of both orthodox and complementary medicine? As a medical practitioner who can speak the languages of both communities, I can say categorically that the range, power and complexity of treatments needed to significantly influence fibromyalgia is absolutely enormous. I draw great benefit from my orthodox medical training and have a great awareness of the strengths and limitations of all types of treatment. Most therapies have their optimum range, so what is needed is the capacity to sequence treatments in their optimum ranges and combine all treatments that have the potential to be beneficial to sufferers under one programme. Unfortunately people in general are just dribbling money away looking for the proverbial needle in one of the hundred haystacks that possibly will help. Then they presume that nothing will ever work because they are bouncing from therapy to product to doctor to self help group and back again. It needs to be overseen and coordinated with both height of perspective and broadness of vision and yet grounded in a robust medical framework. How would you classify your success with this condition? Fibromyalgia sufferers are regarded in the medical profession as a "heterogenous" group. That is" medical speak" for therapeutically frustrating. Essentially everyone has their own pattern of problems and own response pattern to therapeutic input - which makes everything tremendously complicated and difficult as countless patients, professionals and drug companies have no doubt found. In broad terms, in the past few years, I can say that I have experienced the following groups of patients:
Fundamentally, I as a clinician can only work with the physiological system I am "given" by each person. I therefore have to accept everyone's physiology both as it presents and as it behaves to treatment. The following figures are not facts - they are guesstimates in recalling my experiences: 'Fast stable responders' - those who "hold" the effects of treatment well for long periods and whose symptoms improve without many unpleasant symptoms. At a guesstimate, fast stable 'responders' are about 15% of the FMS population and have about a 95% success rate. 'Slow stable responders' - this group tends to get days of unpleasant symptoms like tiredness and symptoms tend to respond almost by stealth. They constitute about 40% of the population and I would estimate success at about 80% for those who persist with treatment, (That is, 20% may have some definite symptom improvement but an area or problem may persist). 'Fast unstable responders' - are those who respond well to treatment but get multiple "crashes" of function. These represent or constitute about 5% of the population and I would rate success at about 55%. 'Slow unstable responders' are about 5% of the population. About 45 to 50% of them do well but many get frustrated and may decide to discontinue the programme. 'Obstructed' category patients have much lower responsiveness in their systems than others and standard therapies tend not to work for quite a long time. The partially obstructed constitute about 15% of the population. They do get certain problems resolved in a low but not unreasonable timeframe while other problems take quite a time to get around. The totally obstructed are about 10% and success will depend largely on the tenacity of the individual - some I would get approx 75% of their problems resolved, some none, because they would discontinue treatment. Finally 10% of the population are the 'hypersensitive', that is - no matter what one does or gives their system cannot tolerate it. These have had a very low success rate because there has been total physiological shut out of all therapies however gentle. New approaches may improve this group's outcome in the future. Time frame to wellness i.e. most symptoms are resolved but some "tidying up" to be done
Please note that optimum treatment is about every 2 weeks - with those coming from long distances in Ireland about every 3 weeks and those coming from the UK and Isle of Man about every 4 to 6 weeks - whatever is feasible. Unfortunately it is not possible to determine which category any individual is in until I work with your system to see how it behaves. Please note that this is hands on work so treatment over the phone is rarely possible. What self help approaches do you recommend? The fibromyalgia programme is a physician steered, multidimensional , broadvisioned therapy input programme for this lifedestroying condition. Those who manage to get themselves completely well through self help are both rare and very fortunate. However since physiological responses to one therapy will be different from person to person, it is easy and naïve to think that others affected in your group will respond to the same approach in the same way - almost certainly they won't. This programme is about identifying how to steer as many people as possible up hill, over the obstacles and in the face of the prevailing headwind of stress on the system. Achieving this for as many people as possible is far more skill than luck. I will nevertheless make a few points that will help but not resolve the problems of fibromyalgia. Cut out wheat - is a general stressor and weighs heavily on the weak systems of fibromyalgia sufferers. Do make up your own vegetable juices - both to support your enzyme levels and alkalinise your system. Do take a probiotic to support your intestinal function. Do calibrate your exercise - do take walks in the open air but observe if you crash out the next day - you have done too much and need to measure it so you don't have ill effects the next day. Do measure out your interpersonal energy use - start attending to other peoples needs only rather than their wants. (if they need to go to the hospital - go . If they want help picking out shoes for a wedding - say no if it doesn't suit you). Do hydrate your system well with a litre or two of water a day. I have yet to see the many reported miracle remedies work robustly on the majority , but you may be lucky - I don't have an opinion except that I feel that they need to be included in a broader treatment regime. Don't just stop medication prescribed by your doctor without first consulting him or her. Many have solid enough effects to provide symptomatic benefit. Have you ever had fibromyalgia - how come you understand it so deeply and so well? No, I have never had fibromyalgia. I understand it because I have spent over 10 years broadening my medical vision and for the last number of years dealing with the problem daily. I listen, research and study the problem in great detail and am intent on creating a world class programme for the treatment of fibromyalgia. |
