When I was diagnosed with fibromyalgia in March of 2008 it was by accident, or maybe I should say it was serendipity, or it was my lucky day. Not that anyone WANTS to receive news that they have a chronic incurable disease, especially when the diagnosis gets sprung on you while you were in the doctor’s office with a friend, and you didn’t even expect to be examined. But that is what happened to me, and I’m glad it did. Now I am sure being there that day saved me years of uncertainty due to my worsening symptoms.
One of my family members asked me to accompany them to see Dr. Paul St. Amand, a noted fibromyalgia specialist. Being “the doctor in the family,” I have certain responsibilities, and my job was to check this guy out for my family member and her husband. He was incredibly knowledgeable about the syndrome, very thorough, and I was impressed. He diagnosed my family member with the syndrome. Then he told me that I was 8.5 times more likely to have fibromyalgia because the syndrome ran in our family, and asked if he could examine me.
Dr. St. Amand does not use the trigger point evaluation, which he finds too restrictive. He uses a combination of a detailed questionnaire and a complete exam to make the diagnosis. He has the syndrome himself, and has been treating patients with fibromyalgia for 50 years, before the syndrome even had a name. When he examined me, he found that I had fibromyalgia. Now I could understand why I had fatigue, dizziness, numbness, migraines and neck pain. Everything started to fall into place.
I would not have been diagnosed with fibromyalgia using the old criteria of the trigger point testing. But I would have been diagnosed using the new criteria proposed by the American College of Rheumatology. Dr. St. Amand has been doing it right all along, with a careful history and physical exam, just like we learn in Medical School and Residency. I’m glad the American College of Rheumatology is proposing changes in the diagnostic process. Too many patients with the syndrome may have been missed. They need their lucky day to come sooner, so they can be educated and start treatment.