Fibromyalgia and Dr Kelly
The term Fibromyalgia comes from the Latin word for fibrous tissue (fibro) and
the Greek ones for muscle (myo) and pain (algia). There are 18 specific tender points at locations on the body - on the neck, shoulders, back, hips and upper and lower extremities - where individuals with Fibromyalgia feel pain in response to relatively slight pressure. To be diagnosed with Fibromyalgia, one will need to have pain at 11 of the 18 locations.
In a Sunday independent article (21/11/04) by clinical psychologist Patricia Redlich, much space was once again given to Rheumatologist Dr Michael Kelly who expounds the view that Fibromyalgia (which he claims is the same as ME and CFS) manifests itself through a defective personality disorder leading to a disturbed sleep pattern and subsequent lowering of the pain threshold resulting in pain. This pattern, according to Dr Kelly brings about the symptoms of fibromyalgia and associated symptoms.
Dr Kelly is fully entitled to his views on fibromyalgia even if they contradict those of the World Health Organisation and fly in the face of the huge volume of research undertaken worldwide.
The real problem with this article is that Patricia Redlich's did not seek an opposing viewpoint to give some needed balance, which in turn could open up healthy debate on the topic, which could help sufferers of fibromyalgia. Surely that is the overriding desire all round.
However, a letter was printed in the Sunday Independent (12/12/04) in the letters page from Dr Veronica Downes, who had previously collaborated on a fibromyalgia article for RTE's Health Supplement, accessible at http://www.rte.ie/health/2003/1210/pain.html.
To read Dr Downes' reply to the Sunday Independent, CLICK HERE
While Dr Downes' reply to the Sunday Independent was a very well worded letter, it did not get the prominence which was afforded to Dr Kelly in the first instance.
It was therefore felt that there was a definite need to ascertain the general opinions of the Consultant Rheumatologist in Ireland to get their views. The Irish M.E. Trust therefore wrote to them (we found 27 listed consultant rheumatologists) to find if they concurred with the expressed views of Dr Kelly. We sent them a copy of the article in case they had not seen it.
We received communication from a leading Consultant Rheumatologist to state that not only did she not share Dr Kelly's view on fibromyalgia but that most Rheumatologists in Ireland would also take an opposing view. This Rheumatologist also acknowledged that there existed overwhelming scientific evidence supporting a counter view to Dr Michael Kelly.
According to this Rheumatologist, it also seems that Patricia Redlich will not countenance a balanced article on the topic but instead directs opposing viewpoints to the letters page where any opposition to the article would receive a significantly reduced profile.
Detailed below are 3 further written responses to our canvassing of opinion. Unfortunately another 23 Consultant Rheumatologists did not feel the necessity to comment.
1) My opinions in relation to fibromyalgia would differ from those of Dr Kelly's. I do not believe that fibromyalgia is a personality disorder though personality would influence expression of disease, be that fibromyalgia or any other condition. I also believe that fibromyalgia and chronic fatigue syndrome are separate entities with overlapping symptoms. While fibromyalgia may be extremely difficult to treat I am not of the opinion that there is no effective treatment. In many cases there is a need for change in lifestyle and education regarding balance of exercise and rest.
2) Fibromyalgia is a poorly understood condition. I agree that it is a separate condition from ME/CFS but that there are overlapping symptoms. I believe that there are always ways of helping people with fibromyalgia. There is no curative therapy, but that may come with better understanding of the disease. There are effective ways of managing the disorder. I believe these views are shared by my colleagues.
3) Thank you for your letter concerning the article in the Sunday independent, which I read at the time. The article, I believe, largely promotes Dr. Kelly's book on the subject.
There is a wide research experience in Fibromyalgia and it's clear that we have not as yet, come up with a full understanding of the condition. There are many bits of evidence of abnormalities seen in patients with Fibromyalgia and with Chronic Fatigue Syndromes. There is no one unifying rational explanation of the condition.
In my experience different doctors approach the management of the condition in different ways. Some use medication to modify sleep in the hope of improving the feeling of fatigue allowing more exercise. Others try to increase exercise and physical fitness as a way of modifying fatigue and improving sleep quality. Some use reassurance counselling and support, they try not to "medicalise" the condition.
As Fibromyalgia or ME are extremely difficult conditions to treat, happily many patients over a period of usually years improve and get back towards a normal lifestyle; as with every illness there are patients with very profound disabling symptoms that seem to never improve.
Dr Kelly's book is one approach to the treatment of ME and with some people his thoughts resonate sufficiently to allow them to feel better about themselves and to overcome some of the disabilities associated with their fatigue and pain. However the book is not for everyone.
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