One day, Ariana* woke up tired with aches all over her body. The pain was “burning” in nature; almost feeling set on fire. That was nearly 15 years ago. Since then, she has experienced pain in some form 24 hours a day, 7 days a week. Among the culprits were gastritis (inflammation of the stomach), migraines with intense musculoskeletal pain and irregular sleeping patterns.

Ariana was unsure why this was happening to her. She knew something was drastically wrong because “none of the other people that she knew felt this screwed up.” A visit to her primary care physician offered no solutions. Lab tests from the routine blood work tests of Complete Blood Count (CBC) and Erythrocyte Sedimentation Rate (ESR) to thyroid function tests yielded nothing abnormal. Other procedures including a Cyclic Citrullinated Peptide test, Rheumatoid factor, Anti-Nuclear Antibody (ANA) and Anti-Double Stranded DNA Antibody were suggested to rule out other overlapping conditions. Still nothing.

“Everything was so scary, and I felt so helpless.There wasn’t a light at the end of the tunnel,” Ariana remembered. She was given a tentative diagnosis of “a psychosomatic condition” and was pointed to various local pain clinics. It could take her years to receive an accurate diagnosis. Yet, after an extensive history screening, intake of self-reported symptoms and physical examination at one of the clinics, finally some news was received.

Ariana was diagnosed with fibromyalgia, a complex chronic pain disorder that may occur body wide or migrate throughout the body. “It was a great relief to be able to know what was going on finally,” she said about receiving her diagnosis.

Nortryptaline and Cyclobenzaprine were prescribed by her neurologist. This treatment made her symptoms milder and more tolerable. Yet, she had to take them daily to see improvement. To complement her medical management, her doctors strongly recommended looking into non-pharmacological methods. One technique was called biofeedback. By harnessing the power of the mind and becoming aware of what was occurring inside the body, biofeedback allowed her to gain more control over her health. This technique helped Ariana mentally combat fibromyalgia.

Acupuncture was another benefit. It worked by inducing changes in blood flow and levels of neurotransmitters in the brain and spinal cord to promote symptom relief. Regular massage therapy was effective in easing the body’s muscles and soft tissues. These treatments reduced the heart rate, relaxed muscles, improved a range of motion in joints and increased production of the body’s natural painkillers. Additionally, they relieved stress and anxiety.

The fibromyalgia diagnosis has had an indelible impact on Ariana’s life. Even performing simple house chores and showering in the morning became very arduous for her. She now performs a “full body check” before going to concerts or movies to prevent any exacerbation of symptoms. She abstains from certain activities that she previously enjoyed. After discussions with her employers, she made changes regarding her work environment.

Still, she has hope and looks positively toward the future. Research has shown that patients who keenly participate in their own healthcare and self-advocacy while collaborating with trusted physicians have furnished better treatment outcomes. “Find doctors that believe you and ones you trust…. do your own job; this is a way of life to be managed,” she says.

*names and identifying details have been changed to protect the privacy of individuals.

Krishan Jeyarajasingham MD is an individual who is planning to continue medical studies abroad in Australia. Global health, Human Rights, Education, & Poverty Alleviation are important to him.

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