| To most
physicians the pain of Fibromyalgia Syndrome is a mystery.
Its unrelenting and debilitating pain is often relegated
to being of psychosomatic origin due to the fact that it
does not decrease with the use of NSAID's, opiates or psychotropics.
In the present mindset of medicine if these medications do
not relieve the pain then it must be all in the patients
mind! If this is so, than the pain of an MI (heart attack)
must also be all in the patients mind.
We know that for 3 days following a heart
attack the patient will have angina, oft-times severe. We
also know that for post MI pain, medicine does not normally
administer pain killers. Why? Because the pain of a heart
attack is the pain of ischemia (the lack of oxygen or Adenosine
Tri Phosphate for the cells to breathe). Ischemic pain we
know can only be relieved by restoring either proper O2 or
ATP levels to the involved tissues.
Let’s use a simple example we’ve
all experienced. When you were a child you likely at some
time put rubber bands or string around your wrist and cut
the blood supply off to your hand. At first the hand went
numb. Then while turning an interesting shade of blue or
purple, it began to throb. The more you moved your fingers
and contracted the muscles the more the hand hurt. The longer
the time the circulation was occluded from the area the harder
the hand hurt. At that same moment in time, if you mainlined
heroin that hand would still have hurt despite the fact that
the strong opiate was swimming round your system and brain
killing all other pain. Why? Pain meds have no effect on
relieving the pain of ischemia!
OK, so ischemic pain can’t be relieved by pain killers
or anti-depressants, so how does this relate to Fibromyalgia.
Easy, in FMS we have a build up of fibrin (the fibro of Fibromyalgia)
through and across striated muscle around the body. There
is also the growth of fibrin in the micro circulation essentially
plugging these tiny blood vessels in the effected areas.
The combo of decreased blood supply, with the strangulating
effect of the fibrin on muscle tissue, (remember what fibrin
can do to strangulate intestines after abdominal surgery),
creates the environment of ischemia. This is also why when
these patients are taken through bouts of aerobic exercise
or high intensity resistance exercise their pain greatly
increases. *
What can be done to decrease the fibrosis?
Until recently, nothing. There has been really nothing in
either the allopathic or naturopathic armamentum that was
capable of lysing away scar tissue or fibrosis. The only
treatment allopathic medicine has had up to now to try to
control fibrosis growth has been to use cortico steroids
to lower the level of inflammation knowing that inflammation
is one of the things that produces fibrosis. Plastic surgeons
have used this technique on their post op patients with mixed
results and cortico steroid therapies used with FMS patients
have proven to be failures.
With the advent of oral systemic enzyme research and application
all branches of the healing arts now have a powerful and
effective tool for the safe lysing away of fibrosis and the
non- toxic control of inflammation. First used in Germany
and Japan against fibrocystic cysts of the breast and to
prevent post operative scar tissue in abdominal and orthopedic
surgery, the effect of orally administered highly fibrinolytic
systemic enzymes has been documented in both research and
clinical use. (See abstracts in this web site).
The safety and complete lack of toxicity of systemic enzymes
make it the primary treatments of choice against inflammation
(as they are used in German emergency medicine) and the only
choice available for the lysing away of scar tissue or fibrosis.
With FMS patients, to be effective, an activation dose of
the enzymes should be found and maintained for at least 3
months. After which an attempt can be made to reduce the
dose. Experience of the docs using systemic enzymes with
their FMS patients has shown that in roughly 50% of the patients
their maintenance dose will be about 50% of their activation
dose. For the other half of this patient population the
dose will have to be maintained at the high activation dose
as lowering it causes inflammation to return.
(I must interject a personal note both as an FMS patient
myself and as one who has treated hundreds if not thousands
of FMS patients in the last 15 years: many, many FMS patients
are actually Munchausens patients and not true FMS patients.
The true FMS patient is anxious to do anything that might
alleviate their pain including exercise, nutrition and self
applied therapies. The malingerer will be wanting the doctor
to do something to relieve their pain and and reinforce their
need for being dependent. If they are getting better they
will doctor hop to another doc as relief is not really what
they really want. These patients will have the “victim” mindset
and be seen to be manipulating their families for secondary
gain. With these misdiagnosed FMS patients NOTHING WILL WORK,
EVEN IF IT IS. While these patients can enrich practices
by their frequent visits, they can also pose a problem and
even be an insurance liability as they will bad mouth one
doc, his or her treatment plans and bedside manner to the
next doc they hop to in a never ending line of pity seeking
and manipulation. Once I discovered this about certain FMS
patients while I was in practice, I refused to work with
these folks. If the patient would not exercise, if they would
not take their enzymes, if they would not follow the therapeutic
guidelines - I would not work with them. Using enzymes, nutrition
and the correct type of exercise, over 88% of my FMS patients
did not remember they had FMS after the first 8 to 16 weeks
of work! I booked no malingering, as most of the time I was
worse off than the patients I was working with and I did
not have the time, patience or energy to deal with the “pity
me” Munchausens patient).
Fibromyalgia is a multi-faceted disease
demanding a multi-faceted solution and since a major aspect
of the problem is the pain of ischemia, the only treatment
available is also the safest treatment available, the use
of highly fibrinolytic orally administered systemic enzymes,
to safely lyse away the fibrin, free strangulated muscle
tissue and open peripheral circulation by lysing away the
fibrin that is clogging the blood vessels. If the unrelenting
pain of FMS can be dealt with then the rest of the problems
relating to the condition can be ameliorated with ease.
* While exercise is a must for these patients
to rebuild their strength, overcome atrophy, increase
the vascular bed there by improving circulation and oxygenation
and to increase the number of mitochondria to relieve the
chronic fatigue / EBB aspect of the disease; the exercise
must be strength work of low intensity but high resistance,
(i.e. 3 to 4 sets of 3 to 5 repetitions with 70% or more
of the 1 rep max.) with long rest periods of 2 to 5 minuets
in-between sets. Aerobic exercise is not generally recommended
but if done must not be over 8 minutes or of high intensity
(over 50 to 60% of max HR) as the patient will have no tolerance
for it, either in their energy reserves or their recuperative
capacity. (Current Adaptation Reserve, Siff and Verkhoshansky,
1999). As per Karvonin and Cooper 7 to 8 minutes is the
minimum time aerobic work can be done for while gaining a
benefit to the heart and vascular system. Please read the
article: How To Keep From Having A Heart Attack - Do Less
Aerobic Exercise at www.drwong.us. |
