Tuesday, 20 March 2012

A 'Dear John' Letter

On Linked In, I have been having an on-going discussion with a Dr. John Quintner about WHAT CAUSES FIBROMYALGIA. I won't go into his theories and why we disagree on many points. But I do want to copy for you my latest response to him, when he claimed that I was ignoring the mind-body nature of disease by insisting that fibro is a physical disease (his belief is that it is a response to stress)

Anyway, here is what I wrote today:

Dear John:

Every disease has a psychological component, with chronic diseases and serious diseases that risk life and limb especially prone. So I am a firm believer in the biopsychosocial (mind-body) model of disease. Again, I have a full chapter on this in my book. My beef is with those who claim that fibromyalgia is ONLY psychological (e.g., depression, anxiety or hypochondria).

Having spoken to and followed (in medical practice) thousands of individuals with fibromyalgia, and performed countless research studies on them, I have also come to believe that health care providers who fail to acknowledge all components of this illness and all chronic illnesses (biological, psychological and social) do their patients a huge disservice.

Two examples: I remember several patients whose marriages were absolutely crumbling because their spouse just did not believe that their pain could possibly be as bad as they said. I purposefully scheduled appointments just to address the spouse's questions and concerns (with the patient's permission and presence, of course); sometimes, I spent up to 90 minutes at a meeting like this; and it often made a world of difference. A non-supportive disbelieving spouse/partner suddenly became supportive again.

I also had countless patients who were struggling at work but receiving no accomodations at all from their employers. Strongly worded letters from me (in which I informed the employers that their lack of support was, in my opinion, worsening my patient's health), also often had a beneficial effect. Or if they were truly disabled from work, I supported that as well with letters and phonecalls as needed (and I never charged a single patient a penny for this).

In both these instances, not only were the patient's social cirmcumstances improved (improved marital or work relationships), but anxiety and depression diminished, and so did their pain and other symptoms.

The head bone IS connected to the foot bone! But that doesn't mean there isn't real pathology in the foot. That is the essential jist of my message. 

There is tremendous frustration and fear among many with fibro, as they desperately search for answers to explain why they feel the way they do, and solutions to help them feel better.

I had a perfect record with my fibro patients - I cured NONE of them. But I believe I was able to HELP the vast majority, by listening to them, by answering their questions, by believing them, by supporting them as mentioned in the exampples above, and by working WITH them to find treatments that worked for THEM. The treatment of fibro is extremely individualistic. What works for one may make another worse. Some tolerate medications while others don't or want to be treated without meds. No worries. Together, we'd find something to help THEM.

Doctors and researchers can pontificate until the cows come home and make sandwiches about what causes or doesn't cause fibro; and I believe that we have a MUCH better understanding than we did even 10 years ago. But those who have fibro need help and support NOW. They need honest answers - even if these answers are still not certain or complete - NOW.

I have sought to show my undying support to the fibro community for years. I know the leaders of fibromyalgia patient advocacy organizations around the world, communicating with many of them on a regular basis. I have emails from 3 of them in my email box for today alone. My intention is to continue to provide them my undying support until there either is no further need for it or I am no longer physically able.

Nothing anyone can say or do will dissuade me from this. And THAT is what I am all about.

Kevin White, MD, PhD

1 comment:

  1. Dear Dr Kevin White

    I welcome your honesty, especially about having cured No one.

    Sadly John Quintner - whom I have regular tussles with - does not know what side of the fence he needs to be on when it comes to Mind illness or Body illness thus keeps swopping sides.

    Failing to recognise sadly as you without the minds thoughts and memories the body is no more than a lump of meat, therefore to make sense of this The minds negative thoughts cause ALL illness of the Body and the body demonstrates this by being ill as thoughts cannot be seen on an MRI scan.

    Simple tiredness leading to fatigue brain fog multiple pain sensitivity spots are extremely simple to understand and treat once a person is able to put aside as told by their Doctors "There is no Cure" and all illness is a process of the Mind.

    On Talking Cures website there are papers written as far back as 1998 which explain in a different manner the cause of ALL illness some of them general some applicable to one illness such as Essential Tremor/Parkinson's Disease ME and CFS the latter two just being another name Fibromyalgis is called.

    Thus can and are treatable via telephone or Skype any English speak part of the world.

    Keep up the good work I am on your side...

    Best wishes

    Peter Smith Talking Cures