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Question regarding your cbt and pain management & my questtion re:c...
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Question regarding your cbt and pain management & my questtion re:cymbalta for fibro pains and pain therapy suggestions?

Thank you for the response Dr. Junig. I saw my doctor earlier this week and he agreed to do the bone scan, which I had yesterday.  I will have the results this coming Tuesday, The anxiety and stress of worrying and waiting for the results has been immense and exacted quite a toll on me in the past 5 weeks. My Dr. feels the pain is due to fibromyagia/CFS flareup, worsened by extreme stress, anxiety, worry & that this can cause increased pain to the chest bone, ribs and back, which is what I am having. Yesterday my hands feet and legs started aching.

My doctor said that most of the diagnostic tests are done and the last diagnostic test we may do is a spinal mri, as most of the pain is now in my mid-back/chest and it is quite intense at times. Lying down with heat and taking Tylenol  provides some relief. The great news he says is that it is not cancer or my heart causing my pain. Chronic fatigue anxiety, depression and IBS and the fact I fixate and worry so much about pain and my health.

Do you have information you can send me on what services/prices you offer and about the webcam aspect etc. I am in the Toronto area.  I have a decent computer with high speed internet.  Can you please provide some detail on your cbt and psychotherapy services & how they might help me?

I was hoping that you might have suggestions or thoughts for my chest and /back pain/body pain.  Presently I am using Tylenol 500mg 1x per day or Advil 400 mg x1 per day and am using a heating pad, which at times provides some pain relief. I have just started some chiropractic and massage therapy once a week. My Dr. wants to put me on Cymbalta 60mg & eliminate celexa. Cymbalta apparently often helps patients with fibro type pain.What is your opinion of this drug? Lastly 5 years ago when my pain started my Dr. also did serum protein electrophoresis, RF factor and an ANA panel, which were negative/normal...should these be repeated or do they only have to be done one time?

Thanks again for your help.
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Hi Mark,
I'm sorry-- this post somehow eluded me-- It was probably a mistake on my part, but I feel bad that you have been waiting so long.  You probably have the bone scan results back, and I would guess that they will be negative, or at most unclear.  I say that because at times there will be 'hotspots' that are not enough to be diagnostic of something, but too much to say a clear 'normal'.

My main recommendation, Mark is that you trust the testing that has been done.  It is impossible for a serious condition to remain hidden for very long, so with each passing day it is more likely that you don't have something like that..

You can do some CBT work on your own;  write down on paper your fears, write down next to each fear the reason for the fear (the symptoms), then write down an alternative explanation for the symptoms, and finally, write down the process to determining which is correct-- and you have probably done all of the proper tests already, and then some.  When the anxiety is present, go through the list again-- and again.  You want to do 'reality testing', but it is effective only if repeated over and over, and much better written than in the head.

Your next exercise will be to write down what 'other people do' to keep their minds busy, and write down what you do;  if there is a big difference, challenge yourself to make your list longer.  In the long term, you will do better if you have something that really interests you, turns you on.

Take care mark-- I hope things with the bone scan worked out OK.
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Dr Junig,  I am presently in a highly anxious state until I receive my bone scan results on Tuesday afternoon and the pain in my mid back and chest is very disconcerting to me, as I have had it for about a month.

My doctor felt between the bone scan (assuming its negative) and the negative chest/abdominal CT and the normal bone alk phos isoenzymes  and calcium blood work that I had I should feel extremely confident that I don't have any bone cancer including that of the spine causing my mid back and chest pain given the ct scans with contrast that have looked at my chest abdomen & pelvis including organs bone soft tissue spine etc.. He also said the bone scan looks at all bone including the spine.

I assume when you previously mentioned that calcium and alk phos  is sensitive and increases due to bone cancer that it would include all bone including the spine.

Sorry for the additional follow-up, but I am extremely nervous/anxious until I get the bone scan result on Tuesday afternoon. I just want this pain to go away.

My Dr. said because of previous arm surgery 5 years ago I may not be able to have an MRI, but he emphasized that the workup I have had for my chest and back pain has been very thorough and I should not worry about cancer causing my pain whether bone, spine, organs etc. To date the tests I have had include the ct scans, chest x ray, bone scan, lots of blood work, abdominal ultrasound, gastrocopy, stress test ecg's etc.  I just want the pain to stop so I can start enjoying life again and stop worrying about the pain and cancer.

I know I ask allot of questions and I really appreciate your detailed response to try and help me through until Tuesday's result.


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Avatar_f_tn
I too have CFS and Fibro.  I didn't get relief from Cymbalta but combining it with 150mg of  Lyrica did help me.  You might want to ask your dr about the Lyrica.
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