Fibromyalgia--One Therapist's View
The paperwork arrives on my desk, containing pertinent information about my clients scheduled for the day’s evaluations. In the packet are the intake forms, name, address, and phone number, referring physician, dates of intake interview, the interviewer’s notes, and important medical record history. The routine is familiar and one that I engage in with ease. I open the chart for review and begin preparing for my portion of the interview and professional assessment.
I am a physical therapist working with a team of highly skilled professionals. My 20 years of experience helping folks with chronic pain combine with the 12 years of my desk partner, an occupational therapist. Across the hall is the private office of the psychologist on my team, who has more than 25 years in physical restorative rehabilitation and pain management. He even managed another pain clinic earlier in his career. The biofeedback therapist has her office just steps from my desk. The pharmacist, with 15 years in pain control under his belt, is located just down the hall.
All this superior education and expertise would not matter much if it were simply dry and clinical and adding the numbers together. But I have the enormous privilege of standing with my co-workers, learning from them, problem-solving with them, and sometimes engaging in confronting discussions with them. I know them to be incredibly caring, sensitive, hard-working, creative and knowledgeable professionals. Each one is willing to rise to the challenge, to come alongside our clients who are asking for help and relief from the experience of chronic pain. We blend and work together like a well-oiled machine, empowering our clients along the way. Nearly 60 percent of our clients, incidentally, have been diagnosed with fibromyalgia or chronic pain syndrome.
Take a "typical" client, "Gayle."
Gayle learned about our program from a brochure at her doctor's office. She had to ask him to write the referral; he wasn’t reluctant, but he hadn’t thought about therapy as an option anymore. After all, Gayle had had physical therapy for many sessions, and all she did was hurt more. But the additional services we offer, like biofeedback, seemed different—and all the therapies would take place in the same general clinic. It seemed like a worthwhile try.
Gayle called us and the receptionist arranged for an interview appointment with the program coordinator—odd, Gayle thought, since no other clinics had "interviewed" her. When she actually met with the Program Coordinator, she was asked to tell her story of developing chronic pain. Then she toured the clinic. She left the meeting after making an appointment with one of the managing physicians of this team of professionals. She didn't know whether she was going to receive treatment, but she was willing to go through the process. What did she have to lose?
When she met the physician, he reviewed her medical records, inquired about various tests she’d already had, performed his own physical examination, and explained the next step: Gayle was to go through a three and one-half hour interview with the rest of the treatment team. That length of evaluation process seemed almost impossible to imagine since she could only stay up three hours at a time. How could she get through it without severe pain increase? She mentioned her limited endurance to the scheduler, and the assessment was arranged to occur over two days instead of one.
So Gayle met each professional individually. To the pharmacist she gave her medication history and a list of her current meds; the psychologist gained her trust as he listened to her feelings and information about relationships; the occupational therapist asked questions about time management and how she arranged her day, and the physical therapist examined her physical function. The whole process culminated in a team meeting, where they planned the next step to help her learn to manage the chronic pain that was controlling her life. There were no guarantees, but she knew by now not to expect any. Gayle was ready to take on the task of learning to make changes. The pain was not going to win!
I would never claim to truly understand what fibromyalgia sufferers must feel or go through, since I have not experienced that kind of invasion in my life, but I can tell you that teaching them pain control skills and nurturing their success is like watching a miracle unfold. People who have experienced their lives shrinking so small that a trip to the grocery store is a big deal, or an outing to a restaurant with friends is unthinkable—these are my typical clients.
The miracle begins with the person suffering from fibromyalgia daring to dream what life could be like if pain were controlled. The dream takes hold. Then they act on that dream, one small step at a time, with a little support from those who care, education from those who teach, and skills honed by practice.
It is like watching a butterfly emerge from his claustrophobic cocoon. With consistent and focused determination to practice pain control skills, life takes shape and colorful wings begin to unfold. It is an enormous privilege to see this miracle of people "getting their life back"—each person in his own way, according to his own dream.
My colleagues and I are well aware that if you cannot feel, think and taste what life may look like with pain controlled, the battle is so much harder. We work hard at helping you see your own vision, and then support you to take the risk to get there.
Elaine Larson, PT, DPT, works at St Jude Medical Center in Fullerton, California. You can reach her team by calling administrative assistant Shelley Labs at (714) 446-5661.
