FM/a fibromyalgia lab test
Just curious to know your thoughts about this? I saw my first patient who says he has been approved for the test (not ordered by me), although has not had it done yet. I was not aware of it previously. I am not sure that it would change my management of this patient. I suppose whether or not it is helpful may depend in part on how he feels about the result. (Source: Student Doctor Network)
Source: Student Doctor Network - February 27, 2023 Category: Universities & Medical Training Authors: ctts Tags: Pain Medicine Source Type: forums

Adiposa Dolorosa (AKA) Dercum's Disease
Has anyone come across this, and if so has anything helped? It seems like Fibromyalgia's evil twin, however, the patient is very legit and it came on later rather than sooner. (Source: Student Doctor Network)
Source: Student Doctor Network - January 22, 2023 Category: Universities & Medical Training Authors: spondy14 Tags: Pain Medicine Source Type: forums

Intervention/surgery for widespread pain
Hi everyone, I was hoping to get some input from the group on patients with generalized pain. I'm getting a lot of referrals for patients with fibromyalgia. Majority of these patients have been tried on standard medications and have tried conservative measures. When I get these referral (the centre I work at does not screen consults and accepts all referrals) it's typically something along the lines of "cervical myelopathy" or "cervical, thoracic and lumbar radiculopathy": In my opinion... Read more (Source: Student Doctor Network)
Source: Student Doctor Network - November 15, 2022 Category: Universities & Medical Training Authors: interjectionreflection Tags: Pain Medicine Source Type: forums

Cash Prices for Ehlers-Danlos Clinic...Better than a 99214?
Pricing - P.R.I.S.M. Just another WordPress site prismspineandjoint.com Dr. Zingman initial evaluation​ $225 / 30 min - Isolated injury in otherwise healthy patient (ex: tennis elbow), Comprehensive evaluation of single joint. $425 / 60 min – Isolated injury management with head-to-toe assessment of root cause and plan, Injury Prevention Assessment and Plan, Chronic Pain with no history of surgery or other diagnoses (not diagnosed with Ehlers Danlos/Fibromyalgia/etc.) $625 / 90... Read more (Source: Student Doctor Network)
Source: Student Doctor Network - December 29, 2021 Category: Universities & Medical Training Authors: drusso Tags: Pain Medicine Source Type: forums

How to avoid Fibromyalgia only Referrals?
Hi, just started a practice at a hospital and much of what I'm seeing is Fibromyalgia + Opiates that other clinics do not want. My goal is to ramp up (as I'm setting 4-5 patients a day) with plans to build a more interventional practice. What advice do you have to try and achieve this? (Source: Student Doctor Network)
Source: Student Doctor Network - September 17, 2021 Category: Universities & Medical Training Authors: anujacket Tags: Pain Medicine Source Type: forums

Non-paying patient?
Strange circumstance but I have a patient seen at my clinic for the past few months due to widespread body pain with fibromyalgia (in hindsight also psych overlay such as h/o trauma, gastric bypass), maintained on low-dose Buprenorphine by another physician whom she's no longer seeing due to insurance changes. She was reasonable for the first few visits with continuation of Buprenorphine. However at the last visit, she requested for increase to Oxycodone 15mg for pain....and I obviously did... Read more (Source: Student Doctor Network)
Source: Student Doctor Network - September 10, 2021 Category: Universities & Medical Training Authors: CarabinerSD Tags: Pain Medicine Source Type: forums

"Functional illnesses." What is your approach?
By "functional" illness, I'm referring to and lumping together a bunch of diagnoses: POTS, fibromyalgia, mast cell activation, chronic fatigue, multiple drug intolerances, EDS III, chronic itch, chronic pain, etc. (maybe IBS and interstitial cystitis and others I didn't list). Some of these might exist as a true organic disease in some patients but most of the time it's code talk for underlying psych issues. We have these patients in all of our varying specialties. I dread these encounters... Read more (Source: Student Doctor Network)
Source: Student Doctor Network - May 1, 2021 Category: Universities & Medical Training Authors: hotsaws Tags: Internal Medicine and IM Subspecialties Source Type: forums

Long covid and fibromyalgia or Chronic fatigue syndrome
(Source: BMJ Comments)
Source: BMJ Comments - December 29, 2020 Category: General Medicine Source Type: forums

case - options for pain control
40 yo F morbid obesity (BMI 50 w/ OSA requiring CPAP) presents for bariatric surgery - laparoscopic. H/o Chiari malformation, h/o hydrocephalus w/ ventricular-thoracic shunt and lumbar-peritoneal-shunt s/p multiple revisions for failure and optic nerve fenestration for blindness, chronic neck/headaches on Norco 10-325, gabapentin 300 once daily, flexeril, fibromyalgia. Thoughts on pre-intra-post operative pain control options? Neuraxial? Multimodal? How would you manage her preop opioid use? (Source: Student Doctor Network)
Source: Student Doctor Network - July 28, 2020 Category: Universities & Medical Training Authors: mtu620 Tags: Anesthesiology Source Type: forums

Re: Effect of tai chi versus aerobic exercise for fibromyalgia: comparative effectiveness randomized controlled trial
(Source: BMJ Comments)
Source: BMJ Comments - August 27, 2018 Category: General Medicine Source Type: forums

Why I'm leaving ACEP
This is a copy of the letter I sent ACEP: Dearest ACEP, I don’t know how to put this any other way, but I think we should break up. I know we have been together for many years and things were getting serious between us. I gave you thousands of dollars, and you gave me your fellowship pin. Although, it’s true I never got around to telling my parents about you. It’s not you, it’s me. You deserve someone more up to your standards. I have a dirty secret that I have never told you. I... Why I'm leaving ACEP (Source: Student Doctor Network)
Source: Student Doctor Network - March 4, 2018 Category: Universities & Medical Training Authors: Malignant Fibromyalgia Source Type: forums

De-Prescribing Thread
SDN Pain shamans, lets use this thread to post the good, bad and ugly about opioid deprescribing. We can share our success stories - and failures- and support each other. I look forward to learning new tricks, techniques, and ways to handle the difficult conversations that we have every day. I'll start- 45 yo F with fibromyalgia, PTSD, diffuse pain came to me from PCP on 140 MME, slurring her words, disheveled and disabled, unable to string together a coherent sentence. Three months later,... De-Prescribing Thread (Source: Student Doctor Network)
Source: Student Doctor Network - February 8, 2018 Category: Universities & Medical Training Authors: 61November Source Type: forums