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Adrienne Dellwo

Fibromyalgia & CFS

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"Crisis Mode" With Fibromyalgia & Chronic Fatigue Syndrome

Friday April 18, 2014

Blog Classic: April 5, 2012

At the doctor's office the other day, I noticed a poster about caregiver stress that listed warning signs of being "in trouble." One of them was: Feeling that you're in crisis mode.

That really caught my attention, because my husband and I have frequently used the term crisis mode to describe how we function when I'm not doing well. At times, it's lasted for months. Of course, it's horrible for those of us who actually have fibromyalgia and chronic fatigue syndrome, but it's also grueling for the people who have to do more while we do less.

What is Crisis Mode?

When we're in crisis mode, everything has to be simplified. My husband cuts back on overtime if he can. Dinners are usually from the microwave. Only the laundry that absolutely must be done gets done. Socializing? Forget it. Non-essential appointments are canceled.

I know my husband has been exhausted and frazzled at times, working full time only to come home and do laundry, cook, clean, shop and take care of both me and the kids. He's sometimes felt like a single parent.

It's hard on the kids, too. We've gone through times where I didn't have much to give them. It hurt to hug them, I couldn't handle their volume or rambunctiousness, and they've had to learn to do a lot for themselves at a young age.

We've called in help from friends and family when we could, but there's not always a lot they can offer. Everyone works and has other commitments, and a few have health problems - and limitations - of their own to deal with. And, quite honestly, sometimes they just don't want to do things for us.

It's one thing when we're in crisis mode for a few days, but if it stretches into weeks or months, it becomes difficult to function on any level. Anyone who sees that happening does need to take whatever steps they can to alleviate the strain. Some of my colleagues here at About.com have some great resources for you:

Information to help them understand your illness is here:

You can help take care of your caretakers by understanding that they may need to take time for themselves, and allowing them to be frustrated and even angry about the situation without taking it personally. (That is, as long as they're not directing negative emotions at you, which will only make everything worse!) Mental-health counseling may help as well.

What does crisis mode mean for you? How often do you have to be in crisis mode? What toll has it taken on you and others, and how have you dealt with it? Leave your comments below!

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Metabolic Abnormalities in Fibromyalgia

Wednesday April 16, 2014

Research Brief

Many fibromyalgia experts have long believed the condition is associated with an abnormal metabolism, which can lead to weight problems and difficulty losing weight. A new study gives us an idea what may be going on.

Researchers looked at indicators of what's called "adiposity," which is the clinical term for being overweight or obese. These include:

  • Leptin: a protein produced by fat in the body and believed to regulate fat storage, and
  • Acylated ghrelin: an enzyme that stimulates your appetite.

Researchers examined leptin and acylated ghrelin levels in a small group of women with fibromyalgia as well as a control group, and compared the results to the women's pain intensity and physical activity levels.

They say the fibromyalgia group had higher leptin and lower acylated ghrelin levels than controls. The leptin levels were not linked to the weight of the fibromyalgia women, which is unusual and leads researchers to conclude that it's somehow linked to symptoms.

Fibromyalgia & Metabolism

For years, we've had a group of fibromyalgia experts who've said we had metabolic problems that contributed to weight gain and made it especially hard for us to lose weight. Meanwhile, the rest of the medical community has told us that we'll feel better if we lose weight. However, the researchers who churn out studies showing increased weight leads to increased pain and disability don't ever seem to offer solutions - or even ask why we're overweight to start with.

Why would we be overweight? So many reasons!

First, in the U.S., a whole lot of people - including those without health problems - are heavier than the medical community says they should be. On top of that, you'd expect a group of people with chronic pain to be on the heavy side: pain limits function and leads to being more sedentary. Then, consider that a large portion of us are women in child-bearing or post-menopausal years. If you've just had children, you're more likely to be heavy than before having kids. And if you're post-menopausal, it's natural to put on a few pounds.

Fibromyalgia is also associated with thyroid disease and, to a lesser degree, problems with blood-sugar regulation. Those both cause weight gain. So do some of the drugs we're prescribed.

Now, add to that evidence that we have high levels of a protein responsible for fat storage. What does that mean, exactly?

Picture a waterfall. Say ten people go out to catch water in buckets and dump that water into a pool. That's a healthy person. Now imagine that ten more people join them. The pool fills up twice as fast even though the waterfall hasn't changed, right? That's us.

So yes, as a group, it's probably true that we're heavier than our healthy counterparts, and possibly even heavier than similar disease groups (i.e., people with lupus or rheumatoid arthritis.) I'd imagine it's true that extra weight leads to even more pain, as our muscles and connective tissues work harder to perform basic functions.

My hope is that this kind of research will continue and eventually lead not only to answers, but to treatments that regulate our metabolisms.

My Weight Issues

This is a problem I'm all too familiar with. On my 29th birthday, I weighed 125 pounds (I'm only 5'2, so no, I wasn't emaciated!) I looked and felt great. A year later, I developed a thyroid condition and suddenly gained 25 pounds in a month - without changing anything about my life. That was scary.

I got treatment, upped my exercise and cracked down on my diet. What happened, weight wise? Nothing. Then I had two babies and kept about ten pounds from each pregnancy. Then fibromyalgia hit and took my activity levels down to almost nothing, and I gained more.

Since then, I've wrestled my fibromyalgia into remission and increased my activity levels. I've gone on an incredibly restrictive diet with no gluten, no sugar, and no red meat. I eat mainly whole grains, fruits, and vegetables. How does my weight compare to when I was in agony, spending most of my time on the couch comforting myself with sugar binges? It's exactly the same. All those changes for the better, and I haven't lost a pound.

No one can convince me that is normal. It just isn't.

This research really resonates with me. We need these researchers to keep pushing forward on this issue, and maybe someday we'll be able to lose weight like our doctors (and other critics) want us to!

Do you believe you have metabolic dysregulation? Have you made positive changes but been unable to lose weight? If you have lost weight with fibromyalgia, how did you do it? Leave your comments below!

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Drug Improves Fatigue in Chronic Fatigue Syndrome

Monday April 14, 2014

Research Brief

The drug agomelatine improves the perception of fatigue in people with chronic fatigue syndrome (ME/CFS,) according to a recent study out of Italy.

Agomelatine is a melatonin agonist, meaning that it's similar enough to the neurotransmitter melotonin - which is involved in sleep - that your brain reacts to it the same way. It also blocks the neurotransmitter serotonin, which is involved in wakefulness and alertness.

For the first twelve weeks of the study, one group of participants with ME/CFS took agomelatine while another group took melatonin supplements. Researchers say the agomelatine group had a significant reduction in perceived fatigue and an increase in quality of life while the melatonin group did not.

For the second twelve weeks, all participants took agomelatine, and researchers say the former melatonin group then experienced reduced fatigue as well. They say the drug was tolerated well by all subjects.

Researchers conclude that agomelatine could be a useful treatment for ME/CFS. This is a preliminary study, meaning more work must be done.

About Agomelatine

If you're in the U.S. and wondering why you've never heard of this drug before, it's because agomelatine isn't approved here. It's been used for years in Europe and Australia, where it's classified as an antidepressant.

Several years ago, the patent holder sold the U.S. production rights to an American company that started working toward a possible New Drug Application to the FDA. However, when initial trials didn't satisfy the company, it stopped pursuing the drug.

That was as a treatment for depression, which is a crowded marketplace, so it stands to reason that mediocre results against established antidepressants made the company lose interest.

However, the good news is that, if studies continue to show this drug could be effective against ME/CFS, that company could well be eager to get the first ME/CFS drug to market in this country.

Because agomelatine targets a universally recognized ME/CFS symptom - unrefreshing sleep - it may face less political opposition than the anti-viral Ampligen, which has so far failed to gain FDA approval for this condition. Even in the best-case scenario, though, it'd be years before this drug could be available in the U.S.

Agomelatine appears to have a lower risk of side effects than many other antidepressants. A major plus is that it doesn't have any discontinuation symptoms, meaning you don't have to taper off of it or risk adverse effects. If you don't want to take it any more, you can just stop. It also has no risk of abuse.

It's discouraging that people here don't have off-label access to this drug. Let's hope our European researchers keep their eyes on this one so that the U.S. company will have a reason to get it back into trials.

Have you taken agomelatine? Did it help with your fatigue? Leave your comments below!

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Weird Nerve Pains in Fibromyalgia

Friday April 11, 2014

I once had a neurologist tell me that he and his colleagues see all kinds of nerve-related weirdness from those of us with fibromyalgia. He indicated that nothing really surprises him anymore.

I wish I could call him up whenever something weird happened to me, because now and then something can still surprise (and scare the heck out of) me.

Last week, I was yawning and stretching with my arms above my head when suddenly my right arm collapsed to my side and started twitching like crazy. Then it went numb and I couldn't move it for a minute. When I could move it again, it was weak and shaky. Then I got dizzy and the whole right side of my abdomen got tingly.

At first, I thought I was having a stroke - and so did the paramedics! Turns out, it's nerve compression. In fact, there's a spot I can press right where my shoulder meets my chest that makes my arm dance like crazy for a few seconds. The other night, every now and then my arm would flail around and wake me up. Fun!

For now, I'm resting it, gently stretching it, using heat (irritated nerves really don't like ice,) and stepping up the pain meds. I'm using topical creams and patches, NSAIDs, Flexeril (cyclobenzaprine, a muscle relaxer) and a bit more Vicodin than usual. It seems to be getting better. If it doesn't go away soon, I'll be looking at other alternatives such as massage, physical therapy, and acupuncture.

This is the most painful nerve issue I've had since developing fibromyalgia, but it's certainly not the first. When something brushes the back of my left calf, I feel the sensation around the side, going in the opposite direction. (Even the neurologist said that one was bizarre.) I've had nerves shoot pain down my legs, or give me a shivery sensation up and down my lower body in waves. I get odd "jumps" in my abdominal muscles when nerves misfire. I also get a tremor in my thumbs, and sometimes my entire left hand. Massaging the arch on my left foot gives me a profound itch in my big toe.

That's the thing with fibromyalgia - our wiring is all messed up. Research has long pointed to dysfunction in our central nervous systems, and more recently in our peripheral nervous systems. (BTW, for those keeping track at home, that means our entire nervous system is messed up!) Some nerves send pain signals in triplicate, some nerves interpret moderate temperature as painful, and some nerves are extremely touchy.

Add to that the possibility of inflammation in the fascia - a thin layer of connective tissue that surrounds pretty much everything in the body - and you have a pretty good recipe for nerve impingement, especially in the narrower passages.

I do have to make this point - if you start having severe pain, tingling, or numbness, especially on one side, please, please, please get it checked out right away. Just because something could be a fibromyalgia symptom doesn't mean it is. When I was having possible stroke symptoms, I called 9-1-1. I have enough issues without permanent brain damage or paralysis, and I know you do, too. (Learn more about stroke symptoms here.)

What weird nerve issues have you had? What treatments have helped? Have you ignored symptoms only to have them be something new and serious? Leave your comments below!

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Sympathetic Nervous System Dysfunction in Fibromyalgia, ME/CFS, IBS & IC

Wednesday April 9, 2014

Research Brief

A new review of nearly 200 studies advances the theory of sympathetic nervous-system dysfunction in four common overlapping conditions:

  1. Fibromyalgia (FMS),
  2. Chronic fatigue syndrome (ME/CFS)
  3. Irritable bowel syndrome (IBS), and
  4. Interstitial cystitis (IC, bladder pain).

Researchers day that the body of literature demonstrates sympathetic dysfunction in all of these conditions, suggesting that something called "dysautonomia" could be the triggering factor for them.

What is Dysautonomia?

To understand dysautonomia, we have to look first at the autonomic nervous system (ANS).

The ANS regulates all of the automatic systems in your body - breathing, heart rate, digestion, hormone production and excretion, etc. It's divided into two parts with opposite jobs.

  1. The Sympathetic Nervous System: Takes over in times of stress, speeds up your heart, dumps adrenaline into your blood, raises your blood pressure. These are all things designed to help you deal with or get away from danger (your "fight-or-flight" response.)
  2. The Parasympathetic Nervous System: Dominant at times of calm, slows the heart rate and lowers the blood pressure after fight-or-flight response, takes care of digestion. Often called "rest and digest."

Substantial research on these four conditions shows that our bodies are stuck in the sympathetic mode - fight or flight. That explains why we're anxious, jumpy, and unable to sleep.

One term for this is "hypervigilant," which means always looking out for a threat. It's typically associated with war-zone soldiers or big-city police officers, who truly are facing danger at every turn. It also explains why new parents wake up at the slightest sound from a sleeping baby. However, these are learned responses to a situation and generally diminish when the situation ends.

When it's a medical state that's not warranted by the situation we're in, the term is dysautonomia, or dysfunction of the ANS. Symptoms of dysautonomia are generally familiar to people with FMS, ME/CFS, IBS or IC:

  • Aches and pains,
  • Anxiety attacks,
  • Depression,
  • Digestive problems,
  • Dizziness and fainting,
  • Fatigue,
  • Numbness or tingling,
  • Impaired exercise tolerance,
  • Sweating.

I asked about these and other dysautonomia symptoms in a poll a few years ago and got a staggering 36,000+ responses, which tells me this is a topic people with these conditions related to. You can see the responses here: Dysautonomia Poll.

This new review could help the medical community recognize that these "unexplained" syndromes do have a physiological basis and that they're related to each other. That could help some doctors identify treatments and new research targets, as well.

Dr. Rich Fogoros, About.com Expert on Heart Disease, has some great articles on dysautonomia:

Do you believe you have dysautonomia? Which of the four conditions (FMS, ME/CFS, IBS, IC) do you have? Has a doctor ever mentioned dysautonomia to you? Leave your comments below!

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Neuroinflammation in Chronic Fatigue Syndrome: Direct Evidence at Last

Monday April 7, 2014

Research Brief

New research provides evidence of neuroinflammation in chronic fatigue syndrome (ME/CFS,) thus providing support for the alternative name myalgic encephalomyelitis.

In this small study, PET scans of the brains revealed inflammation in multiple areas of the brain, the:

  • Cingulate cortex,
  • Hippocampus,
  • Amygdala,
  • Thalamus,
  • Midbrain, and
  • Pons

When comparing results to symptoms, researchers found that cognitive impairment was linked to inflammation in the amygdala, thalamus, and midbrain. Pain was linked to cingulate cortex inflammation, and depression to hippocampus inflammation.

Researchers concluded that widespread inflammation of the brain is a feature of ME/CFS and is associated with the severity of certain symptoms. They say this work is essential for understanding the pathology of the condition as well as for developing better diagnostic criteria and treatments.

The Significance

For years, some researchers have hypothesized that neuroinflammation was at work in ME/CFS. In fact, that's where the name myalgic encephalomyelitis (ME) comes from - encephalomyelitis means "inflammation of the brain and spinal cord."

Some countries have adopted ME as the preferred term for this illness. However, much of the U.S. medical community has rejected this name because there was no direct evidence of neuroinflammation.

The implications of this study could be enormous. If further research supports the findings - this was, after all, a small study - it could lead not only to better diagnostics and treatments as the researchers suggest, it would also provide the validation people with ME/CFS have been waiting for.

If the name "chronic fatigue syndrome" could be ditched and replaced with "myalgic encephalomyelitis," it could only make the illness be taken more seriously by the public. No longer would you tell people your diagnosis and have them say, "I get tired, too." (Can you even imagine someone casually saying, "I wonder sometimes if my brain is inflammed"?) Heck, the unwieldiness of the name alone will keep it from being the butt of jokes, never mind that few people will know what those big medical words mean.

More importantly, though, would be a change in the medical community. If researchers can point to an underlying pathology that correlates directly with symptoms, doctors will have to accept that yes, this is a real disease and it warrants attention. Your doctors will take you seriously, more research will be done, and drug manufacturers will have better treatment targets.

Again, this is a small study in an area that needs a lot more investigation before it'll change anything. It is, however, an important step in what could be a really right direction.

What would it mean to you if this research were borne out by future studies? What changes do you think it would lead to? Leave your comments below!

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Transcranial Magnetic Stimulation for Fibromyalgia

Friday April 4, 2014

Research Brief

New research shows that a non-invasive, non-drug procedure called repetitive transcranial magnetic stimulation may improve the quality of life of people with fibromyalgia.

Researchers measured quality of life, both mental and physical, as well as pain, mood and anxiety over 11 weeks of treatment. They also looked at changes in brain metabolism.

They say the quality of life improvement was mainly in emotional and social areas and there was no significant difference in the other symptoms. They also found evidence of increase in the right limbic metabolism.

What is Transcranial Magnetic Stimulation?

Transcranial magnetic stimulation (TMS) involves placing a device against the head - in varying places for different conditions - that transmits magnetic pulses through your brain. Repetitive TMS (rTMS), which was used in this study, just means that you have the treatment multiple times.

The purpose of TMS is to change activity levels in relevant parts of the brain. It's believed to actually restructure some neural pathways.

In fibromyalgia, we know that some areas of the brain are over active. We have abnormal blood-flow patterns and connectivity between certain areas, as well. This could mean multiple areas could be targets of study for TMS as a fibromyalgia treatment.

TMS is an experimental treatment for a range of neurological and psychological illnesses, including:

Research on rTMS is still premature, but it's showing promise in multiple areas.

Learn more about TMS:

Have you ever had TMS? Did it help? Is this a treatment you'd like to try? Leave your comments below!

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Chronic Fatigue Syndrome & Fractures: What's the Connection?

Wednesday April 2, 2014

Research Brief

Can chronic fatigue syndrome (ME/CFS) increase your risk of breaking a bone? If so, it's it perhaps because of - as some researchers have suggested - an increased risk of osteoporosis?

Researchers who set out to answer those questions found a couple of interesting things:

  1. Yes, people with ME/CFS have a higher fracture risk than healthy people;
  2. No, the risk does NOT appear to be linked to osteoporosis.

This was a large study, involving nearly 3,800 people with ME/CFS and about 15,000 people without it, and spanning four years.

Researchers did not offer any suggestions as to why ME/CFS could raise fracture risk independent of osteoporosis but urged further study in this area.

My Perspective

I have to wonder - is this risk higher in ME/CFS because of some physiological abnormality, or because it makes people clumsy?

We have had research showing an elevated risk of falling because of the dizziness common in the condition. Two polls I've taken here (which are, of course, non-scientific) reinforce the fact that we with ME/CFS and fibromyalgia are a clumsy bunch - 95 and 96% percent of responses were either "Yes, I'm really clumsy," or "I'm somewhat clumsy."

Of course, it could always be a combination of things - a deficiency in something that makes your bones more likely to break plus a propensity to fall or stumble into things. It'll be interesting to see where this research leads.

In the meantime, knowing that you have a high risk of fracture because of ME/CFS alone means you might want to be really careful about osteoporosis. There's no need to send your risk through the roof!

For more on that, see:

Have you broken any bones since developing ME/CFS? Was it because of a fall? Leave your comments below!

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The Fallacy of Narrow Views on Fibromyalgia & Chronic Fatigue Syndrome

Tuesday April 1, 2014

Most of us have seen or heard it, and many have probably thought it, as well: That person's nowhere near as sick as I am, so they can't possibly have the same thing.

It's understandable. When you have fibromyalgia or chronic fatigue syndrome, you can face a lot of undeserved harsh judgement. People belittle your illness and dismiss your symptoms. The lack of better diagnostics means that some doctors may use the label inappropriately because they don't know what's actually going on. Plus, people can, and do, defraud the system by claiming to have what you have.

Given all of that, when you're severely disabled by one of these conditions, it's natural to sometimes be suspicious of someone saying the have it when they seem to be far too functional. You know what the experience of fibromyalgia or chronic fatigue syndrome is like, and their experience doesn't match yours.

However, inconsistency is something we all need to accept about these illnesses. They vary widely from one case to the next, with just the core symptoms in common, and still with widely divergent levels of debilitation. That's part of what makes research so difficult and results so contradictory.

Each of these conditions likely involves multiple subgroups that are different expressions of the illness or possibly even different illnesses entirely. Then, with chronic fatigue syndrome, we've got different definitions in play, which really muddies the research.

For the time being, though, we need to understand that the labels "fibromyalgia" and "chronic fatigue syndrome" apply to broad groups of people with widely divergent experiences. It really bothers me when people refuse to accept that and end up spreading misinformation. It's even worse when they're passing judgment on others.

For example, I recently wrote about a spate of fibromyalgia exercise studies, including why I think these studies are flawed from the word go but can still teach us important things about our condition. Here are a couple of comments that people left:

  • "Anyone with true fibro or CFS knows you cannot exercise without becoming incapacitatingly ill."
  • "Movement deteriorates FM and ME/CFS."

Those statements are true for a portion of people with these illnesses, but it's wrong to apply them to everyone - just as it's wrong to apply exercise studies to all of us. Someone is participating in exercise-based studies, and those people are diagnosed under the same criteria as the rest of us. They may belong to a different subgroup and they may be far less ill and far more exercise tolerant than most of us, but they still - by definition - have the same illness.

Let's look at the specific problems with those two comments above. First, the phrase "anyone with true fibro or CFS" implies that anyone who can tolerate any exercise is obviously misdiagnosed or lying. Meanwhile, a lot of people have improved their fibromyalgia or chronic fatigue syndrome through exercise, and I'm talking about people with solid diagnoses who were severely ill for a long time, unable to walk or even get out of bed. They did it slowly and carefully, and they experienced setbacks, but they improved.

To be perfectly clear, I am absolutely NOT saying that approach will work for everyone. I'm saying that NO approach works for everyone, and that includes the zero-exertion approach.

Moving on: "You cannot exercise without becoming incapacitatingly ill," and "Movement deteriorates FM or ME/CFS." Again, true for some, not for all. In my first year with fibromyalgia, I could exercise at certain times in my flare cycle but not at others. My flares were tied to my menstrual cycle, and the week after my period I could do just about anything I wanted without consequences. During the second and fourth weeks I had to be careful or I'd really pay, and in the third week any exertion would wipe me out for two or three days.

I then had an endometrial ablation which ended that cycle and made my flares less severe, but I also ended up with a higher level of general symptoms all the time. Then I couldn't handle much exertion at all until I found some treatments that helped me improve. As I felt better, I could handle more. Now that my fibromyalgia is in remission, I'm much more limited by my asthma, arthritis, and overall not-in-shapeness than by exercise intolerance.

Something I've seen in myself along the way, which is supported by both clinical and anecdotal evidence, is that when I stay moderately active, within my own self-determined limits, I feel better. For me, a little shopping or a walk around the neighborhood is great moderate activity. A lot of people can't do that much, but some can do far more. I know of one woman who was bedridden with fibromyalgia for something like 15 years, then - primarily through exercise - slowly improved her condition so that now she can take week-long ski vacations. Then, there's the woman who has chronic fatigue syndrome yet created the Sit & Be Fit exercise series.

It's true that some of us can't exercise at all. Some of us can only handle a few minutes on a good day. But some of us can be highly active. The more active ones have less severe symptoms, to be sure, but they still have symptoms.

These generalizations do damage in multiple ways. They alienate people with less severe cases, making them feel unwelcome in the illness community. These are people who've had unwanted life changes thrust upon them, who are confused about what's going on in their bodies, and who need understanding and support just like everyone else. They make people question their diagnosis, thinking that since they can handle some exercise, their doctor must have gotten it wrong. That can lead to a missed opportunity to find effective treatments early, and research shows that the earlier we're diagnosed and treated, the better we tend to do long term. The generalizations also can make people who would benefit from careful, moderate exertion shy away from it.

Exercise is among the most contentious and divisive topics in our community. When the medical community keeps telling us to do more and we know that's the wrong answer, yes, we're going to get angry about it. However, we need to keep our differences in mind and stop being judgmental about them. Perhaps other people would be as disabled as you if they hadn't found an effective treatment. Maybe they caught it early enough to keep it from getting really bad. It could be that, in a few years, they'll have deteriorated a whole lot. You don't know the whole story, and you have no right to inject negativity into someone else's life.

So please, if you find yourself making a broad generalization, stop for a moment and remember that we're not all alike. I'm never going to tell you that getting more exercise is going to make you feel better, so please don't tell me (or anyone else) that my ability to do more means I can't possibly have the same illness as you.

Read more related to this topic:

Have you had someone doubt your illness because of your activity level? Have you been helped by appropriate levels of exercise? Are you unable to tolerate any exertion at all? Leave your comments below, so we can get a good look at how diverse we are!

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Massage Pillow for Fibromyalgia Muscle Pain

Friday March 28, 2014

I've got fibromyalgia, myofascial pain syndrome, and two painful autoimmune diseases. I've had scoliosis and chronic back pain since I was ten years old. With all that pain, you can bet I look for anything that can help alleviate some of it.

That includes massage products. I've accumulated a lot of these over the years, including one I picked up a few months ago that I really like. A great aspect is that it's more affordable than a lot of products out there.

To read my full review and find out how to get it for the lowest price, see:

What massage products have you tried? Have you found some that you really like? Do you have problems tolerating that kind of thing? Leave your comments below!

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