Fibromyalgia Diagnosis Evolves Through Five Stages.

Fibromyalgia is a diagnosis of exclusion. If you don't have anything else wrong with you  and you have multiple trigger points, you've got fibromylagia.  The rheumatologists had a heated discussion last month about whether fibromylagia diagnosis rose to the level of disease status.  It was a rather interesting discussion indeed.  In KevinMD's comments, a reader left  a classic description of the evolution of fibromyalgia diagnosis as seen through the eyes of the medical student all the way to private practice.  I highly encourage you to go read  the post and the comments.  Make sure to also visit the rest of my wealth of knowledge on fibromyalgia. Without further delay, here are the five stages of evolution for fibromyalgia diagnosis:

Stages of Growth of a Fibromyalgia Diagnostician:
  • Stage 1 (medical student): OMG, there is no such thing as FM. You're all just a bunch of whiny losers without evidence of real disease who want to be on disability.
  • Stage 2 (Intern): Fine, "FM" is "real" but the treatment is to get off your fat butt and exercise daily. So don't whine to me unless you're doing that and don't ask for disability because being active is the "treatment" and there's no way you have more pain or less sleep than I do.
  • Stage 3 (Resident): Wow. I've seen three patients now with the exact same symptoms as fibro-foggers except they're not whiny, drug-seeking or trying to get disability. They're all high functioning, compliant, had their pain go away with exercise and return when stopping exercise and resolve again with exercise. They don't even mention their fibro symptoms to me now in the primary care clinic unless I ask about it. Maybe this thing really is real. Better hit up Pubmed.
  • Stage 4 (Fellow): Sigh, why am I getting another fibro consult. It's not rheumatic--it's a disorder of central pain processing. It's a freaking neurologic disorder mostly related to chronic untreated pain from other diseases or from sleep disorders. Either have the primary deal with it or just to piss off my (neuro) wife, consult neuro.
  • Stage 5 (Private Practice): Yes! Another quick fibro consult. I love the easy money.
That about sums it up.  Substitute fibromyalgia for any medical condition and you've got the journey from medical student to private practice physician summed up quite nicely.

Ever notice how fibromyalgia jokes are only appreciated by doctors and nurses, especially the ones without fibro ecard humor photo

This post is for entertainment purposes. I wouldn't wish fibro or chronic pain on anyone. 

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