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Pain Management Strategies for FMS and CFIDS with Debbie Milam

Pain Management

Tuesday, February 8, 2000 
Fuente: WebMD

Event_Moderator Welcome to WebMD LIVE! Our guest today is Debbie Milam, OTR, and the topic is 'Pain Management Strategies for FMS and CFIDS.' Debbie Milam, OTR, is the president and founder of MMR Wellness, which provides information to assist in managing the symptoms of fibromyalgia and chronic fatigue syndrome. She is a licensed occupational therapist. Welcome back, Debbie! How are you today?

Debbie Milam Thanks, it's nice to be here.

LibbyCT_WebMD How should one go about getting the exercise one is told to when one is in pain all the time? I mean, it's supposed to aid in pain management, but it hurts to do it!

Debbie Milam That is an excellent question. I think the key to remember is to start very slowly, like only 5 minutes per day for 3-5 days. Then gradually increase the time by a minute every third day. It is also very important to follow an aerobic exercise with a way to warm up your muscles. I usually recommend a warm bath or shower, followed by a full body stretching program that combines yoga and static stretches.

missy35_WebMD What would be the best medicine available for the pain of fibromyalgia or chronic fatigue

Debbie Milam Professionally and personally I believe the best medicine for FMS and CFS is empowering yourself with knowledge. Besides being an occupational therapist, I have been diagnosed with FMS. I struggled for years trying every medication. Each caused so many side effects that I became sicker an sicker. It wasn't until I got off of all medications and with the help of a variety of health care professionals designed a wellness program for myself that I began living fully again. This wellness program includes exercise, stretching, dietary changes, supplements, acupuncture, pain management, stress management and symptom management.

madelynnel_WebMD What part does nutrition play in treatment of fibromyalgia, would a diet such as Atkins diet be detrimental?

Debbie Milam I am not a nutritionist, but from personal experience and the extensive research I have done diet plays a critical component in your overall wellness. I do think it is important to consult with a clinical nutritionist for any specific dietary recommendations.

cdoepel_WebMD Can a person with fibromyalgia be employed at a full time job while keeping their pain and fatigue under control?

Debbie Milam Yes, the severity of symptoms varies from person to person. If you do want to stay employed and you love what you do it can be very beneficial. The key is learning body mechanic techniques, energy conservation techniques, work simplification strategies. In my wellness program manual available on my website there are several chapters dedicated to this topic. You can also consult with an occupational therapist in your area for a complete job site anaylsis.

Shammrox1_WebMD My husband and I want to start a family now, and I am looking for some ideas to ease the pain when I come off my meds

Debbie Milam Great question! When I think about pain management I look at it in 3 areas, mind, body, and spirit. If you look at the mind, you can read motivating books, listen to motivational tapes. If you look at the body you can learn self massage, take warm baths in epson salt hot showers with shower massagers, use massage tools, use moist heating pads, use ice packs. If you look at the spiritual components of pain you can pray, meditate, spend time in nature, write out a blessing list, do something for another in need. Also in my program manual I have several chapters dedicated on how to implement these strategies into your already busy lives.

DODO1_WebMD I have FMS/MPS and have frequent migraines - for past 3wks have had almost constant vertigo. I am unable to work and on medical leave, I will see neurologist in 1 week. What can I do to get some relief in mean time? I currently am taking soma, voltaren , ultramm and welbutrin 2x day and ambien at night. What changes should I consider making?

Debbie Milam First I would recommend talking to your pharmacist to see if any of the meds you are on could be causing the vertigo. Then I would talk to a nutritionist. Many common foods can trigger vertigo and migraines. I think it is great that you are consulting with a neuro to rule out other problems. If he cannot find any problems acupuncture has been found by the National Institutes of Health to be a safe and effective treatment for FMS and headaches. Good luck

hhouston_WebMD How does one go about setting up a wellness program for oneself?

Debbie Milam I was blessed with the opportunity when I got ill to be an occupational therapist. I read over 200 books and consulted with a variety of health care professionals. The wellness program manual offers you an opportunity to use the manual as a guide to developing a program that fits into your lifestyle and belief system. There are 32 modules on symptoms management, stress management, pain management, energy conservation, cognitive strategies, techniques to improve your sleep and reduce headaches. In addition, there is an extensive resource section, and recommended reading section. At the end of each chapter is an action plan that will allow you to design a program that will met your needs

CarrieN_WebMD How can I control the extreme pain and stiffness that I wake up with each morning?

Debbie Milam This may sound silly but get out of bed. When I was in college we had a favorite saying motion is lotion. Then I would recommend going for a short walk, giving yourself an warm oil massage, using a body brush, taking a warm shower, then stretching

kte-47_WebMD When do you recommend prescription analgesics to augment your program. I suffer from Hep C also and when on interferon the pain is unbearable.

Debbie Milam My heart goes out to you, my father in law has Hep C. Your situation is very different. If the pain becomes intolerable by all means use the meds. I do think many of the strategies that I talk about are general health and wellness principles and they may also improve the quality of your health.

JPBFEB_WebMD I'm curious to get opinion on use of ice in fibromyalgia, especially since many fibromyalgia cases have aversion to cold. Yet, I have heard that ice can be an effective means of treatment. Your opinion?

Debbie Milam Personally and professionally, I love ice. Ice works in 2 ways First it numbs the area which will reduce pain. Second it tricks the body into thinking that it is freezing, thereby sending more blood to the area, which in turn warms it.

cdoepel_WebMD Could you explain a little further about your energy conservation techniques. I'm able to work and keep my pain under control but the fatigue is another story!

Debbie Milam Energy conservation techniques are principles that will allow you to do your job in the most efficient manner. Several examples are improving your sitting, and standing postures while working, taking breaks, stretching, planning and prioritizing, using devices that place your body in better positions. In addition, rather than taking a full hour for lunch, eat a shorter lunch, go for a short walk, go in your office and stretch, close your door and listen to a relaxation tape, escape for several minutes

missy35_WebMD Are there alternative medicines?

Debbie Milam I'm not sure what you are asking, can you please be more specific

DODO1_WebMD When I was diagnosed 2+ yrs ago I quit smoking and between that and the carbo/sweet cravings have gained about 40lbs. What can I do?

Debbie Milam I would recommend going to see a good nutritionist.

chickymama00_WebMD I am 23 years old and I am so young to have this disease. Is there anything I can do to enjoy life with my three young children more because I am always in so much pain everyday?

Debbie Milam Yes, I felt the same way, it feels very scary and isolating when everyone else is having a great time. First and foremost believe in your ability to evoke positive changes in your life. Learn as much as you can about health and wellness, enjoy the gifts of your children in spite of your pain, I remember when I was at my sickest my son was two. I could not even get out of bed. He used to crawl into bed with me and we would do puzzles together. He learned many great lessons from my illness. Good luck and may you have the strength you need.

Lynaron_WebMD I have worked myself up to a good walking plan, but when I get to going 3.5 mph for the two 45 min. walks I do each day I get pressure blisters under my calluses at the back of my heel. Any advice on how to prevent them?

Debbie Milam You may need new shoes or consult with a podiatrist. I do think for most people 45 minutes may be too long of a session. If you feel good by all means continue. For most people 15-20 minutes of aerobic exercise is sufficient. A good guide is when you see you are starting to have more flare-ups to reduce your exercise time by several minutes

shalimar_M_WebMD In your work, have you found any relationship with childhood and adult abuse; mentally, physically and sexually with the inability to control pain management?

Debbie Milam Yes, research does support your feelings. I think of it as a holding on of past pain and memories that then lead to physical symptoms in the body.

cdoepel_WebMD What are static stretches?

Debbie Milam Static stretches are when you hold a stretch in the same position for 10-15 seconds. In my wellness program manual, I have a chapter with photos showing safe and effective static stretches and yoga postures specifically for people living with FMS and CFS

sally43f_WebMD What is the best way to cope with lower back pain?

Debbie Milam There are many ways, besides some of the strategies that we discussed earlier, you may want to improve your posture, sleeping position, change the shoes that you are wearing, exercise and stretch, and consult with an acupuncturists

JPBFEB_WebMD In treating CFS cases, would a brisk-paced sports-type massage be more effective than just a session of deep therapy and muscle stretching - to perhaps create more muscle stimulation, a la pre-event sports massage?

Debbie Milam Every one is an individual when it comes to massage. For me when I had either type of massage you were describing I had severe flare-ups. For others that is the only relief they can get. I personally like Ayervadic massage; it stimulates the body's energy centers. The most important thing to remember when getting massages is to communicate with your therapist and drink 3-4 cups of water after the massage to flush out any toxins that were released form your muscles.

Event_Moderator We've reached the end of our show. I apologize for not being able to get to all of the questions. Our guest today has been Debbie Milam, OTR. Her website, MMR Wellness, can be found at www.mmrwellness.com. I encourage everyone to continue this discussion on the FMS/CFIDS message boards. Thanks everyone, for joining with your questions! And thanks so much to Debbie Milam for being our guest today! This has been an extremely informative show. You're welcome to come back any time!

cdoepel_WebMD Thank You!

Debbie Milam Thanks so much and may all of you be blessed with health, joy, and balance.