1. Direct quote: "if psych meds help with your pain, it's psychosomatic." Complete statement with no qualifications. This was before you brought Seroquel into the conversation. 2. From googling, most of the Seroquel research said that it was helping with sleep but not necessarily pain. 3. I don't think people are angry that they're looking into mental health possibilities. It's that you said "psych drugs" (not antipsychotics, just "psych drugs") helping means that your pain is psychosomatic (completely in your head with no underlying physical cause).
And also stating that you think fibromyalgia is psychosomatic is a pretty asshole thing to say. It's a common misdiagnosis for when they don't want to look any farther or just aren't aware that the actual disorder exists (for example Ehlers Danlos syndrome).
I understand that unused psych meds as a broad statement. But a majority of psych meds affect neurotransmitters. Why Seroquel is a frontier to a treatment, I don't know, but I guess in their anyone of them could work. The use of Seroquel is off-label. I don't know why Mr. Google didn't give you any results. Do you have access to a medical journal database? That will yield more info on the subject.
I acknowledge my last statement was wide. But the bottom line is, no matter if your pain is "real" or a mental illness, I only care about it being relieved and not a label.
One problem is that psychosomatic labels don't get you treatment for the underlying condition- they get you labeled as nuts.
The real problem is that treating mental illness when it's a physical issue DOESN'T treat the problem.
I was treated for mental illness for most of my life, and briefly got a fibro diagnosis before the correct diagnosis of EDS.
it was EASIER to decide that I was mentally ill than to treat my "real" physical problems. So that's what they did.
I have permanent physical damage that wouldn't have happened if they had diagnosed me with EDS as a child instead of an adult, and psychological scars from all those years of being a "hypochondriac" and told that my physical problems didn't exist.
My story is the story of most people with EDS, and EDS has very clear symptoms that are easily seen during a clinical examination. But most doctors never check for them.
I have nothing against diagnosing mental illness, but misdiagnosis a physical issue as mental can cause major lasting problems.
Eta: I also have nothing against them researching, although I think it's all going to end up being rather useless because they have no idea what the hell fibromyalgia is. My personal opinion is that diagnosis of fibromyalgia will go away once they figure out the underlying conditions and correct diagnosis (some of which might be physical, and some might be mental).
As of now, I believe fibromyalgia is psychosomatic. But that doesn't mean that people who do suffer from wide-spread chronic pain have been properly diagnosed or that the pain isn't real. But if psych meds help with your pain, then its psychosomatic.
Have you ever heard of off label uses for meds? I take a seizure drug for migraines. According to your logic that makes me an epileptic.
As of now, I believe fibromyalgia is psychosomatic. But that doesn't mean that people who do suffer from wide-spread chronic pain have been properly diagnosed or that the pain isn't real. But if psych meds help with your pain, then its psychosomatic.
Have you ever heard of off label uses for meds? I take a seizure drug for migraines. According to your logic that makes me an epileptic.
Are you feeling a little foggy then? I suggest you re-read my posts again for reasons for antipsychotic. I even mention the use of off-label for pain.
I can see that you don't understand things he first time, but just for your knowledge, taking a seizure med for migraines doesn't make you an epileptic but it will (probably) prevent you from having a seizure (depending on the dose, etc).
Are you feeling a little foggy then? I suggest you re-read my posts again for reasons for antipsychotic. I even mention the use of off-label for pain.
I can see that you don't understand things he first time, but just for your knowledge, taking a seizure med for migraines doesn't make you an epileptic but it will (probably) prevent you from having a seizure (depending on the dose, etc).
you're being kind of an asshole.
Wait, so I get a "f-you" from another poster because they can't read. And then someone goes out of their way to make a stupid remark (the poster on question, I could care less about their name) when if they just read what I said they would see they have no clue what their talking about? And I'm a jerk? Are you trying to blame me for their antagonist behavior? Because I won't listen to that.
People need to chill out and not take things so personal. Someone has a different viewpoint and people get all offended even if it can be rationalized. And then once someone starts with the behavior, 5 other people jump in to say something outlandish and stupid that give no substance to the OP's questions. It's just to make someone else look bad. It's very mean-girl.
Wait, so I get a "f-you" from another poster because they can't read. And then someone goes out of their way to make a stupid remark (the poster on question, I could care less about their name) when if they just read what I said they would see they have no clue what their talking about? And I'm a jerk? Are you trying to blame me for their antagonist behavior? Because I won't listen to that.
People need to chill out and not take things so personal. Someone has a different viewpoint and people get all offended even if it can be rationalized. And then once someone starts with the behavior, 5 other people jump in to say something outlandish, stupid that give no substance to the OP's questions and just to make someone else look bad. It's very mean-girl.
More than kind of. Kme you didn't say what you think you said initially. You came out of the gate with "if you take psych meds and they are helping then it's psychosomatic" We aren't misreading, that's what you said. You've gone on now to expand on that poorly crafted statement that we were supposed to infer meant something completely different.
You're being a dick. Shut up.
I acknowledge that it was poorly word and I clarified it. It's partially my fault because sometimes I give people too much credit that they would know what I mean. I need to learn to spell things out fully in my first post. But I can't be blamed for someone taking it out of context. If they just read bad comprehended what I said they would have nothing o post about (I believe what I wrote was understandable since others responded respectfully and curiously).
This tread is getting ridiculous. I hope any of you that have chronic pain issues get the treatment you need- no matter what form or classification it is.
Wait, so I get a "f-you" from another poster because they can't read. And then someone goes out of their way to make a stupid remark (the poster on question, I could care less about their name) when if they just read what I said they would see they have no clue what their talking about? And I'm a jerk? Are you trying to blame me for their antagonist behavior? Because I won't listen to that.
People need to chill out and not take things so personal. Someone has a different viewpoint and people get all offended even if it can be rationalized. And then once someone starts with the behavior, 5 other people jump in to say something outlandish, stupid that give no substance to the OP's questions and just to make someone else look bad. It's very mean-girl.
Post by Doggy Mommy on May 23, 2014 21:02:57 GMT -5
Like others said, I think it's a placeholder diagnosis for pain of unknown origins. Therefore, it gets attached to people who truly have serious symptoms and no diagnosis yet as well as crazies/pill seekers etc.
My husband was diagnosed with it at one point many years ago. He has since been diagnosed with ankylosing spondylitis. For him, fibro was just a word the doctors used until they figured out what was actually going on.
I acknowledge that it was poorly word and I clarified it. It's partially my fault because sometimes I give people too much credit that they would know what I mean. I need to learn to spell things out fully in my first post. But I can't be blamed for someone taking it out of context. If they just read bad comprehended what I said they would have nothing o post about (I believe what I wrote was understandable since others responded respectfully and curiously).
This tread is getting ridiculous. I hope any of you that have chronic pain issues get the treatment you need- no matter what form or classification it is.
Dude... I think the real thing here to focus on is that your ego is unfathomably huge! I'm making this sort of astounded and amused face right now because this is just an absurd amount of arrogance and I am truly impressed. Truly!
kme what kind of work do you do? Have you been educated regarding chronic pain conditions? I'm interested to know how you have managed to form these conclusions.
Post by sawyerthedestroyer on May 24, 2014 13:46:37 GMT -5
I honestly haven't done any reading about fibromyalgia because when my mom was diagnosed with it she blew it off saying that it was just the doctor's answer to anything that couldn't be pinned down.
However, the psychological theory is interesting. My mom is not a drug or attention seeker. She hates going to the doctor for anything and will not be screened for depression, but I'm pretty sure she is. Her only friend is my dad, she depends heavily on her dog for emotional support (although she refuses to admit it or register him as a support animal). It's kind of difficult to describe why exactly I think she's depressed, but being that I deal with my own depression issues, I can tell, if that makes sense.
Kme, just stop. I believe that you believe what you initially wrote and feel defensive now. The fact is, there are many scenarios that create these pain conditions. Writing it all off as psychosomatic is an undereducated assumption.
I don't know why you're getting frustrated and telling me to stop. Of course I'm going to get defensive when what I said is taken out of context. Who wouldn't be?
Like what you just said. I don't believe all chronic pain is psychosomatic and I've stated that in this thread.. If anything, I feel that I am educated regarding my opinion since I work with it on a daily basis, discussions with practitioners and EBP research on the matter. You can't always discount someone else's thoughts because you think differently.
I wasn't trying to ruffle feathers by discussing it and I feel like I'm being a scapegoat for something that is being researched by others. I take responbility for putting the discussion out there, but I had no intention of making people feel bad or that it's "all In their head" - and I've stated that, many many times.
kme what kind of work do you do? Have you been educated regarding chronic pain conditions? I'm interested to know how you have managed to form these conclusions.
Part of me is hesitant to respond to your question because I know no matter what I say, it won't be good enough. But it's rude for me to act like I'm ignoring you.
So if your being honest and really want to know then read below. If you're just trying to ingite a fight, then don't bother.
Professionally I am an RN for 6+ years (BSN, CCRN). My current position is in a Leadership role in a 24 bed adult (mixed) ICU.
Management of chronic pain is something I see nearly every day. Most of our patients are NPO and unable to continue their home pain control plan. There is no IV substitute for medications like Neurotin, Seroquel etc. We're often limited to IV opiates, Torodol and have seen amazing success in the use of Ketamine (but pts can't be d/c on that, thus comes the difficulty). Part of my role is to complete and be engaged in multidisciplinary teaching rounds with board-certified Intensiviists, Acute Care NP's, Medical interns/reaidents, Critical Care pharmacists, pharm students and residents and Pain Management (there's other ancillary services that particpate as well). Rounding takes between 1-3 hours daily and pain control is a large part of our discussion. We have patients who do have fibro and depression and we involve Psych in our discussions in their treatment plan.
I have also completed graduate level coursework including Advanced Pathophysiology at UPenn. Prior to answering, I referenced my class PP and notes on pain pathways, neurons, transmitters, etc etc.
None of the above makes me an expert on the subject. I have never claimed to be one. I'm sure theres someone on this board who has more experience and education than myself. But It's my education, experiences and clinical that influence my thoughts and ideas.
Causes of fibros pain and treatment is being researched. Bottom line. I stated a theory (pain as hallucations) and it got turned into how I thought all fibro pain was a mental illness (which I never said). Maybe its something like phantom limb pain. At first phantom limb pain was thought to be a mental illness but research and EBP determined it wasn't. Fibro has a lot of similarities as phantom limb but it's missing an insult which is why the topic is being researched. But flaming me for a topic that's being researched is just stupid - I have no better word for it.
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Sorry for any typos I'm on my phone.
Obviously I'm a nurse too. I think it's unfortunate how closed minded you are regarding fibromyalgia. I think it's easy to form those opinions with out much experience, personal or professionally. Before I ended up with it, it was easy to believe that pts that have it have huge mental issues/and/or are drug seeking. Since my dx of it, It's made me much more open minded about it. Frankly it's a dx that few are really an expert in as there are no tests that can be 100%. For now, the best we can do it take a total hx, have pts document areas of pain and try oral meds as well as numerous injections. Attitudes like the one you presented are the reason few know about my dx. It's embarrassing when people think I'm 'playing it up', drug seeking or being an attention whore about it. I know what was a bit misorganzed and appologive. I really challenge you to keep your opinions to yourself (it's embarrassing and hurtful) as you don't know who you may be talking to that has the dx. In the meantime, educate yourself. Talk to physicians that work with chronic pain or in rheumatology. I can gaurentee, most would be very unimpressed with your view on it, and could teach you a lot. The last thing us fibro pts need is a person (someone who thinks 'they know' as a nurse) that continues to spread misinformation and cause others pain with your opinion. Seriously, we don't need your stigma.
Part of me is hesitant to respond to your question because I know no matter what I say, it won't be good enough. But it's rude for me to act like I'm ignoring you.
So if your being honest and really want to know then read below. If you're just trying to ingite a fight, then don't bother.
Professionally I am an RN for 6+ years (BSN, CCRN). My current position is in a Leadership role in a 24 bed adult (mixed) ICU.
Management of chronic pain is something I see nearly every day. Most of our patients are NPO and unable to continue their home pain control plan. There is no IV substitute for medications like Neurotin, Seroquel etc. We're often limited to IV opiates, Torodol and have seen amazing success in the use of Ketamine (but pts can't be d/c on that, thus comes the difficulty). Part of my role is to complete and be engaged in multidisciplinary teaching rounds with board-certified Intensiviists, Acute Care NP's, Medical interns/reaidents, Critical Care pharmacists, pharm students and residents and Pain Management (there's other ancillary services that particpate as well). Rounding takes between 1-3 hours daily and pain control is a large part of our discussion. We have patients who do have fibro and depression and we involve Psych in our discussions in their treatment plan.
I have also completed graduate level coursework including Advanced Pathophysiology at UPenn. Prior to answering, I referenced my class PP and notes on pain pathways, neurons, transmitters, etc etc.
None of the above makes me an expert on the subject. I have never claimed to be one. I'm sure theres someone on this board who has more experience and education than myself. But It's my education, experiences and clinical that influence my thoughts and ideas.
Causes of fibros pain and treatment is being researched. Bottom line. I stated a theory (pain as hallucations) and it got turned into how I thought all fibro pain was a mental illness (which I never said). Maybe its something like phantom limb pain. At first phantom limb pain was thought to be a mental illness but research and EBP determined it wasn't. Fibro has a lot of similarities as phantom limb but it's missing an insult which is why the topic is being researched. But flaming me for a topic that's being researched is just stupid - I have no better word for it.
-----------------------
Sorry for any typos I'm on my phone.
Obviously I'm a nurse too. I think it's unfortunate how closed minded you are regarding fibromyalgia. I think it's easy to form those opinions with out much experience, personal or professionally. Before I ended up with it, it was easy to believe that pts that have it have huge mental issues/and/or are drug seeking. Since my dx of it, It's made me much more open minded about it. Frankly it's a dx that few are really an expert in as there are no tests that can be 100%. For now, the best we can do it take a total hx, have pts document areas of pain and try oral meds as well as numerous injections. Attitudes like the one you presented are the reason few know about my dx. It's embarrassing when people think I'm 'playing it up', drug seeking or being an attention whore about it. I know what was a bit misorganzed and appologive. I really challenge you to keep your opinions to yourself (it's embarrassing and hurtful) as you don't know who you may be talking to that has the dx. In the meantime, educate yourself. Talk to physicians that work with chronic pain or in rheumatology. I can gaurentee, most would be very unimpressed with your view on it, and could teach you a lot. The last thing us fibro pts need is a person (someone who thinks 'they know' as a nurse) that continues to spread misinformation and cause others pain with your opinion. Seriously, we don't need your stigma.
I'm sorry you just spent all that time writing this response but what I said has nothing to do with the majority of what you wrote. I never said it was drug seeking or that everyone has mental illness. What I stated is the WHY antipsychotics are working (for some) is under research. Is it the action on neurons or the interpretation that is off. That is all. I never stigmatized you or anyone else- you are projecting if you feel that way. No reason to read into my comments further.
IMO, what's been happening is that put the theory out there (controversial yes). And people are pouting and stomping their feet that's its not true. I never said it was or wasn't - just that its a theory that needs to be dis/proven. It's not misinformation or a wrong view if I'm stating the truth about it being a consideration. It is a theory - that's it. I definitely believe the research on the subject should continue since we don't know why in some cases the only effective treatment are antipsychotic while others use a combo for relief. You should know that antipsychotic don't work for some as Ultram doesn't work for others. Why is the question. That's all.
But what kind of stigma am I putting on you if I say I don't care what it is as long as you get relief? I never said all fibro is a mental illness (and I'm not backpedaling, you can look back at my posts). If anything, I'm pro separating the two (chronic pain and pain as hallucinations that is being researched) so they can each get their proper treatment. You're acting like I'm the bad guy by putting put that what needs to be proven/disproven.
So, you're an ICU nurse, it's exactly like being a pain specialist.
ETA: Lol, I had to go back and re-read that amazing description of being an ICU nurse. Don't get me wrong, I work with amazing nurses - ICU and others, but that description was...something. I agree with the assessment of your ego.
It's nothing like it. But teachings with/by them have it some cases as a possibility that cannot be fully ruled out.
What was wrong with my amazing description? I tried being as specific as possible. I didn't want to leave anything out. Each thing I mentioned was to back my judgment more. You can deny it but there is a difference between a 8 bed ICU with PCP's as your MD and a large teaching hospital. And it's my belief, there's a difference in education from a pathophys class from a community college and an Ivy that's ranked #1 in your program. It has nothing to do with ego but reality.
I have been thinking about it. Taking my reaction away, and hurt feelings due to ignorance--I genuinely hope that you work with doctors and nurses who do not genuinely feel this way about people. I hope that you are part of the solution in the future. Because it is only keeping sick people sick.
I didn't mean to hurt your feelings. I didn't say you, anyone or everyone with fibro had a mental illness. I feel like what I stated is the same thing as a correction between Lyme and Fibro. We don't know why they are correlating but it needs to be looked into to find the appropriate treatment. That doesn't mean everyone with fibro has Lyme. Same thing, we don't know why psych meds work for some but there may be a correlation. That doesn't mean everyone with fibro has a mental illness.
I hope we can find separation between the two (chronic pain vs. hallucinations) so they can each receive proper treatment. It's not beneficial to either process to be lumped together as the same thing.
It's nothing like it. But teachings with/by them have it some cases as a possibility that cannot be fully ruled out.
What was wrong with my amazing description? I tried being as specific as possible. I didn't want to leave anything out. Each thing I mentioned was to back my judgment more. You can deny it but there is a difference between a 8 bed ICU with PCP's as your MD and a large teaching hospital. And it's my belief, there's a difference in education from a pathophys class from a community college and an Ivy that's ranked #1 in your program. It has nothing to do with ego but reality.
I work in a large, teaching hospital. I don't know why you think a pathophys class from an Ivy league school make you the authority on pain. In reality, your ego appears huge.
Um no. I said it doesn't make me an authority. If you go back and reread, it's not a theory I came up with. You can deny reality all you want but I didn't come up with the theory. I learned of it though work, class, conversations with Pain Mgmt ect etc.
It's bad enough to be in chronic pain with no known cause without pretentious assholes on a message board claiming it's all in your head. It's super awesome getting to feel like a hypochondriac because you've had dozens of invasive tests, seen multiple specialists, and still have pain with no answers.
I don't proclaim to know why a low dose antidepressant mostly stops my stomach pain (my multitude of doctors say it's maybe blocking a nerve that's gone wonky), and I believe my IBS diagnosis is complete bullshit because they can't otherwise figure out what's wrong. But in absolutely no way is my pain an "hallucination" and neither are any of my other random symptoms.
It's fine to say that more research needs to be done on chronic pain issues, because it does.
It's also fine to be skeptical of anyone who has self diagnosed themselves with any illness, and to be wary of those with drug seeking behavior.
But yes, you are going to get told to fuck off if you come in making blanket statements about how pain=psychosomatic if "psych meds" help. Here, I'll say it again. FUCK YOU.
I worked in a doctors office for 4 years, and it was so sad. The true seekers all claimed they had fibro. In that time I saw some people who truly had pain get a Dx of fibro slapped on their chart, Rx's written and with time, they too turned into addicts.
That's not to say everyone who has that in their medical record is a pill popper, but it is a very overused diagnosis.
“But if psych meds help with your pain, then its psychosomatic.”
“I can see that you don't understand things the first time”
“Are you feeling a little foggy then?”
“...sometimes I give people too much credit that they would know what I mean.”
“...so I get a "f-you" from another poster because they can't read. And then someone goes out of their way to make a stupid remark…”
“And people are pouting and stomping their feet that's its not true.”
Other people's comprehension is not the problem. The problem, for starters, is that you're being a condescending asshole.
1) I want to clarify. I meant if ONLY psych meds, not everyone who takes them take for pain. I forgot the word only (for real. That was my mistake. I'm not just saying that to back-peddle. You can see my theory on why only psych meds was further discussed). I then went further into discussion regarding their use on peripheral neurons or if signals are being misinterpreted. That is because knowing how pain in incurred, the pathways and neurotransmitters, as of now I don't know why ONLY antipsychotics would work. If the antipsychotic worked in the way of blocking neurotransmitters, then why wouldn't anti-inflammatories, antiseizure meds, or other drugs that block pain receptors work (and of course this is assuming there has not been some sort of injury). I don't have another answer and neither do the PM MD's.
2) They misread.
2) They misread.
3) I didn't mean that in a egotistical way. Just that you all can't read my mind and don't have the same experiences as myself so I shouldn't expect you to come to the same conclusion as me. I need to make my opinions clearer. I took it as a learning experience.
4) They misread.
5) I actually wanted to say Megan Heimer but I didn't think you guys would know who that was. Basically she throws online hissy-fits when she doesn't believe what is obviously the truth. What is obviously truth in my case is that there may be hallucinatory pain- not saying there is or isn't or that yours is hallucinatory, but its a theory being considered. You can deny it all you want but that's the truth. Telling one to shut-up, f-you, a** hole or a jerk because you disagree with the truth is "pouting and stopping your feet" because you don't want to hear it and think that's going to change reality.
Anyway I'm just about done. Calling me names or disparaging words about my career or education will do nothing for you or me. It won't change my mind. I just hope for separation on the two so proper treatment can occur.
Dude. You need to stop and shut up. You're a nurse, not a researcher. Maybe it's a good thing your in ICU as a lot of those patients are intubated and comatose and can't hear you. It sounds like your the nurse on the unit everyone else dreads working with because you are a know it all.