My thoughts and prayers are with you. I've not seen any adverse interactions between the Tamoxifen, Effexor, and Lyrica in my patients. There's always a potential for interactions between different meds, but I'm not aware of any increased risks of interactions among these meds.
Hopefully your cancer is cured and your fibro behaves.
Sorry you aren't noticing any benefits so far with Savella. In my experience with this FDA-approved med for fibro, it usually begins working within a few weeks, if it's going to work, but it may take up to a few months to get the full benefit.
If my patient thinks the Savella may be helping, and it is tolerated, after a few weeks of the titration pack, I will usually have her/him continue the dose of 50 mg twice a day for another month and see if the therapeutic response (pain relief mainly) improves. Sometimes I will increase the dose to 100mg twice a day depending on the individual situation. If there is good reported benefit, I will probably continue the patient on Savella.
If there has been no benefit at all after 2 weeks, or 7 weeks, I will usually opt to stop the medicine. Please discuss your results, or lack of response, with your doctor for additional recommendations in your specific situation.
Good luck with with working and managing your fibro. I know how hard that is.
Please let your doctor know of any change in your symptoms. Your docor may choose to adjust or change your medication. Cymbalta is a medicine that needs to be tapered as tolerated if the treating doctor advises that this medicine is no longer indicated. As you know, abrupt discontinuation of this medicine can lead to scary symptoms. A gradual tapering should avoid these types of side effects. Your doctor would be able to advise you on a specific tapering regimen if you needed to come off of the Cymbalta. Check with your doc!
Sorry to hear of your issue with spasms. With my patients, I try to determine if the spasms are due to a peripheral cause (ie muscle tightness/spasms, mechanical imbalances, vitamin/mineral imbalances) or if they are due to a central cause (ie spasticity/movement disorder from brain or spinal cord neuroendocrine dysfunctions)
It sounds like your doctors feel a central cause is responsible, and biofeedback would be a form of treatment directed at the brain. Specifically, cognitive biofeedback tries to retrain the brain using specific brainwaves that create "good" responses and phase out the "bad" responses.
People with fibro report muscle spasms as a major complaint and there are numerous factors that can trigger increased spasms. Sometimes medicines are responsible. Biofeedback therapy has been helpful for many with fibro, so hopefully you will see some good results.
Make sure you discuss with your treating doctors the specific treatment goals and have your questions answered since the better educated you are about your conditiona and treatments, the better the chance for success with the treatment.
Sorry to hear of your difficulties and loneliness with fibromyalgia in Hong Hong. Even though you feel fewer people are being diagnosed with fibromyalgia in Hong Kong compared with elsewhere, there are many people who have it even if they have not yet been officially diagnosed.
Every population study ever done with fibromyalgia shows that this condition is present in 2-5% of the population regardless of race or background. So you are really not as alone as you may think! Chances are someone you know well, or even a family member, also suffers from fibromyalgia. If you can discover others who share your experiences, you may be able to help each other cope better with this condition.
Even if you left Hong Kong, your fibromyalgia would still come with you and would still cause symptoms as it does in Hong Kong. We haven't found any cure yet in the States, or anywhere, for fibromyalgia. The best treatment we have is educating ourselves about this condition and figuring out how to manage it as best we can.
Sure it's important to have a doctor who understands your condition and can help you try different treatments to see what may work best for you. Many people with fibromyalgia are sensitive to medicines including anti-inflammatories (Acoxia is a Cox 2 type NSAID not available in the States) Many people with fibromyalgia do not respond to NSAID meds since fibro is not a true inflammation. And often, alternative treatments work best.
I'm hopeful you will be able to find a support system that includes a knowledgable doctor and a few people close to you who understand what you are going through. You are the one, though, who will keep striving to understand all you can about fibromyalgia, keep looking for things that work, and learn to live your life fully and happily in Hong Kong even if you happen to have fibromyalgia.
Remember you are not alone. This is a great site to reach out across the world and share and learn from others who know exactly how you feel.
Central Sensitization Disorder was originally described over ten years ago for fibromyalgia and chronic fatigue syndrome to explain the mechanism of hypersensitization to pain signals. Since then, it has been used to describe the pain mechanism of other chronic pain conditions such as complex regional pain syndrome, certain peripheral neuropathies, certain brain and spinal cord conditions etc.
When I think of central sesitization, I think more the "mechanism" of pain rather that a specific "cause" of pain. With fibro, this mechanism is quite complex. The thalamus is involved, but the body's entire neuro-endocrine system plays a role in the dysfunctional changes that occur in fibro.
Ultimately, our fibro central nervous system becomes "rewired" and we experience typical features of "central pain." These include increased pain to normally non-painful sensory signals (called allodynia), increased pain to normally painful signals (called hyperalgia), and overall lowered pain threshold and persistent spontaneous pain.
If you enter "central pain syndrome" in the Search This Community box above my picture in the upper right, you will get several prior discussions on this topic you may find helpful.
A typical CAT scan or MRI of the brain (or elsewhere) will not show fibromyalgia. These tests are often ordered to look for other possible causes of one's symptoms. For example, a brain MRI may be ordered to look for demyelinating lesions seen in multiple sclerosis. Many types of abnormalites can be seen with these tests, but not from fibromyalgia.
If a CAT scan or MRI are normal, that does not rule out fibromyalgia. Although fibro does not cause specific abnormalities in the typical CAT or MRI studies, there was a study done 10 years ago that reported fibro-specific abnormalites on a special type of MRI called a functional MRI.
Functional MRI's are only available in specialized research centers so they are not being routinely performed on patients with suspected fibromyalgia. The best way to diagnose fibromyalgia is to listen to the patient's specific complaints of widespread pain and associated symptoms, and finding typical painful tender points on the exam. Other testing may be helpful to evaluate other conditions that may mimic fibro or co-exist with it.
Fibro can be hereditary, so it's common to see mothers and sons/daughters with this condition. Everyone's fibro behaves differently, though, even if the same genes are involved. Most everyone with fibro will have issues with sleep. Sleep problems can include abnormal movements and jerking of the limbs during the night.
Periodic limb movement disorder (PLMD) is a condition in which a person's legs, and sometimes arms, move repetitively and uncontrollably while he or she is asleep. These episodes of limb movement can disrupt the sleep, causing insomnia, daytime sleepiness, fatigue, and difficulty concentrating. Restless leg syndrome (uncontrollable urge to move limbs) and myoclonus (sudden jerking movements of legs) are other examples of conditions leading to abnormal sleep movements.
The physician treating the fibro would be able to evaluate this problem and determine if any testing such as a sleep study may be indicated, and whether any treatments such as specific medications may be appropriate to try. I would encourage somone with ongoing sleep issues/limb movement disorders to discuss this problem with his or her doctor.
That's the worst feeling: worrying about our kid's pain and hoping it won't be a chronic condition. Myofascial pains plus non-painful symptoms such as flu-like symptoms and fatigue would certainly raise my concern for fibro, and perhaps, a post-infectious form of fibro.
Since the diagnosis is the most important starting point, you may want to suggest your son first see your fibro doc who could assess for fibro, other conditions, any causes/relationships, and, of course, any specific treatment options. I would expect your fibro doc would be able to recommend any additional testing or specialist evaluations as needed.