Fibromyalgia, the ache-all-over illness
DEAR DR. DONOHUE: I have the symptoms for fibromyalgia as they were listed in a monthly medical letter from a highly respected medical school. I am taking water therapy for it. The person evaluating me says I probably have it. I was checked by a gastroenterologist, who found no problems. My family doctor sees no reason why I am tired and achy all over. What causes fibromyalgia? What can be done to get over it? — E.B.
ANSWER: Answers to many fibromyalgia questions cannot be given, since its cause isn’t known. That makes this condition difficult to have and difficult to treat.
It’s a disorder where there is widespread body pain, usually involving both the right and left sides of the body, and often in the same places. You used the right words. It’s described as an ache-all-over illness. Muscles and joints are sore. Fatigue is extreme. Sleep is disturbed and doesn’t bring refreshment.
No scan, X-ray or lab test can make the diagnosis. The person’s symptoms point to the illness. Tender points — 18 well-defined body sites where the pressure of the examiner’s finger provokes pain out of proportion to the applied pressure — are clues that the person has fibromyalgia.
No one can say with certainty exactly what is wrong with the body, but it’s believed that pain signals are amplified in the brain. Why that happens has yet to be explained.
You’re doing all the things that are in your power to minimize fibromyalgia symptoms. One is exercise, and I take it that water therapy means you are exercising in the water. More than 70 medicines have been used in treatment of this illness, but none has been found as a sure-fire winner for all patients. Three have won FDA approval: Savella (milnacipran), Lyrica (pregabalin) and Cymbalta (duloxetine). Choosing a fibromyalgia medicine involves trial and error until one that best controls an individual’s symptoms is found. You’re going to need a doctor. One reason is to confirm the diagnosis and the other to provide prescription medicines.
The fibromyalgia booklet describes this illness and its many treatments. To order a copy, write: Dr. Donohue — No. 305, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.75 U.S./$6 Can. with the recipient’s printed name and address. Please allow four weeks for delivery.
DEAR DR. DONOHUE: I have had to live with drooling for a number of years. I have an airplane, which I use to fly patients for Angel Flight. I also fly children for the Shriners to and from Shriners’ hospitals. Drooling is unpleasant when you work with people, particularly as a speaker or when flying an airplane. I did have a Botox shot, but it seemed to increase my drooling. I also tried Ditropan, which didn’t work.
I appreciate any suggestions you care to offer? — R.Z.
ANSWER: If saliva trickles out of the corners of your mouth, you can build a dam to stop it. Put a dab of Vaseline there. A woman reader described how she used Elizabeth Arden Eight Hour Cream to stop the flow.
Medicines whose side effects include drying saliva can be helpful. The scopolamine transdermal skin patch used to prevent seasickness is one such medicine. Glycopyrrolate (Robinul and Robinul Forte), whose main purpose is calming the digestive tract, dries the mouth.
Botulinum toxin, Botox, didn’t work for you, but it has for others.
An ear, nose and throat doctor can tie off some of the ducts coming from salivary glands to stop saliva overflow. Sometimes, removal of a few of the salivary glands works even better.
If by drooling you mean an expectoration of saliva when talking, that’s a different matter. That often comes from a defect in swallowing the normal saliva production. If you make a conscious effort to swallow at frequent intervals, you often can solve that problem on your own.
Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475. Readers may also order health newsletters from www.rbmamall.com.

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