The first, Long-Term Opioid Therapy – What Are the Effects?, brings us the results of Dr. Forest Tennant's ground-breaking study. He evaluated 24 chronic pain patients from 30 to 79 years old who had been using opioids for 10 to 35 years, and "concluded that the significant improvements in quality of life and physical functioning from opioid therapy are so positive they outweigh any negative complications, which can be easily managed."

Almost all of the patients (22 of 24) said their pain had permanently decreased over time. And the vast majority (20 of 24) felt their opioids still provided the same relief as when they started treatment. All of the patients reported one or more functions or activities they can do now that they couldn't do prior to beginning opioid therapy (i.e., get out of bed everyday, take walks, shop or visit friends).

The article details the patients' diagnoses and gives further information, and I encourage you to read the rest of it. While the study was small and obviously needs to be repeated with a larger group, this is marvelous news, and I for one and very grateful for Dr. Tennant's work and the participation of his subjects.

I have to say that I find HealthCentral's sites to be generaly decent, but the Chronic Pain Connection is outstanding. I encourage you to visit and subscribe to the newsletter.

Next, in One Patient’s Experience with Savella for Fibromyalgia, Richards brings us detailed feedback from one of her contacts, Brenda, who has been taking the new drug for seven weeks. Many of us have heard of Savella, but so few have had an opportunity to try it or know anyone who have that this article is very helpful in making a decision as to whether or not to ask our physicians for it. After reading about Brenda’s advice regarding insurance experiences, dealing with side effects, and positive results, I for one will be talking to my neurologist about a trial pack.

In any case, I have CMP and FMS. For the past week or so, I haven’t been able to move my neck much because of pain on the right side that referred down my arm and around to my chest. I know I’ve got scar tissue there in my neck, and compression of a nerve between two of the vertebrae, but normally I can move my neck through a full range of motion. I have no idea what happened — maybe I slept wrong? I don’t know, and I haven’t really been sleeping much in any case.

I had my monthly visit with my pain management doctor today, and mentioned the problem. Right off, the PA asked if I wanted to try trigger point injections. Within 15 minutes, the pain was fading. I was afraid it would come right back, but so far it hasn’t. By the time I got home, I was falling asleep in part due to the intense relief.

I definitely hope that I wouldn’t have any particular place that is so painful next month, but I’ll definitely be ready to speak up about whatever is most painful.

If your doctor doesn’t offer trigger point therapy for you, ask about it!

If you’re sure that you have TrPs, you can also try treating them yourself. For laymen, the best book about TrPs is The Trigger Point Therapy Workbook by the late Clair Davies. I have a copy, and recommend it. I’ve found that it’s best used in conjunction with a TheraCane, but it seems there are several other nice tools available now, too.

I found it necessary to have someone else help me with the treatments, but they did work. They were more painful than the injections, and you need to do them three times a day. On the other hand, they didn’t require a trip to the doctor or a prescription, and once you learn how to treat yourself you can do it whenever you need it. Our former housemate helped me with the treatments, but I’m hoping that my partner will learn to do them. They do work!

Being in pain all the time can certainly lead to depression. That’s just logical. There are, however, people who have fibromyalgia who are not clinically depressed. Depression can also manifest as physical pain, but it is does not meet the criteria for fibromyalgia.

I was treated for depression for years before I developed FMS, though, and I truly believe that if I’d gotten proper treatment for mental health issues in my childhood (post-traumatic stress disorder and all the complications it brought, including major depressive disorder) I probably wouldn’t have developed FMS.

I never have trouble distinguishing between the two, or between either of them and CFS/ME, which I also have. They’re all quite different.

With FMS, the pain causes fatigue, and together they can (but don’t always) have an affect on your emotions. You may feel like doing something, but your body absolutely will not cooperate. There have been times when I’ve been feeling great, gone out to do something I was SO looking forward to — and nearly collapsed in the middle of everything when my body said, “All right, that’s it, no more. Done. Where’s the bed?” (We’ve joked that if I ever manage to get a scooter or electric wheelchair, it will have to have a remote control feature so that Sam can steer me on home when I’ve passed out.)

But serious clinical depression…it doesn’t matter whether you’ve got the physical energy or not. Logic doesn’t matter. Knowing that you’d feel better for having a nice, hot shower is utterly irrelevant. The fact that the telephone ringing is contributing to your headache, and you could make it stop by merely lifting up your arm up pushing a button, is irrelevant, because lifting your arm would take too much damned effort. Yes, somewhere, on some level, you may know that you’ll lose yet more function for not getting up and doing your exercises, but it’s less important than staring at the ceiling, or the pillow, or whatever is in front of your face right now. Not that you really make any kind of conscious value judgment or anything, but the staring has inertia going for it. Even if nothing IS hurting, even if you have all the energy in the world and you could do anything you just don’t care.

Remember that, the next time you hear someone claiming that FMS and depression are the same.

I’m pleased with it. There are very few, mostly immaterial inaccuracies.

I was made aware of it by a post to fibromyalgia.¹ Reactions there are fairly negative, because so many of us have had bad experiences with people who think we’re malingering.

I have mixed feelings, though. I don’t exactly share the sentiments expressed in the piece, but I do think it’s good art. I can relate to feeling like pain has been my entire life. It’s familiar. I can’t remember anything else, honestly.

I don’t think I’m “scared to feel better,” though, because I really resent the pain, the fatigue, and especially the brain fog. I’ve tried every treatment to which I’ve been able to get access, without much relief. Pain management is all that helps in any way now.

I have, however, gotten very anxious about trying many things. Too many falls, followed by increased pain and disability, have made me incredibly cautious. Unfortunately, I know that leads to more loss of muscle mass and endurance. I’m working on getting past it. Knowing is half the battle, right?

Talk to me. What do you think about the artwork?