Head Injury?Fibromyalgia?or Depression?

Posted by Robin Holland on June 16, 1999 at 19:47:19
Five years ago I was involved in an auto accident and sustained a head injury to the left parietal (sp?) side. At the scene I was having grand mal seizures (so they tell me; I have no memory of the accident and very little memory of the year that followed) and when I got to the hospital and had a CAT scan and brain tumor was discovered directly on the other side. Five weeks later I had the tumor removed whichn turned out to be a benign meningioma. Ever since I have had a short term memory disorder and the inability to calculate ( I was a bank teller & bookkeeper previously). Before the accident I began therapy for depression and anxiety. I had just been through a difficult divorce. I was on Paxil and it seemed to be working well. But over the past few years I have developed some other symptoms which I thought (until recently) were totally unrelated. Because recently my symptoms have gotten so unmanagable I went to my doctor who ordered a complete blood work up. The blood tests showed no abnormality. I was researching  blood test result norms when I happened on the word "fibromyalgia". I noticed that according to the description of the illness I have all of the symptoms except ichiness and I don't know what the pressure points would be. My symptoms are as follows: Pain in my neck in the mornings, headache most all the time, pain in the joints of my hips knees wrists some fingers, ankles and back. Also my head shakes at certain positions, my hands tremble, I often lose my balance, I sometimes have blurred vision, numbness in my hands & feet, as well as weakness, I drop things (many times a day, for no reason), have insomnia and am constantly exhausted . So tired that I can't get through a normal day without resting several times. And if I do anything that requires a little effort it takes me a day or more to "recover" from it. My question (finally) is how much of this is depression related, head injury related or could it be that I have developed Fibromyalgia? Some things you should know are I have very severe asthma, have had adrenal insufficiency in the past (before the accident) as well as steriod induced diabetes (both of which are fine now according to my blood work). I hesitate to see my doctor again about it all because after the blood work he decided that I probably should take some vitamins and then I'll be okay. I'm a military wife and don't have alot of choices in treatment. Also Army doctors don't usually consider anything out of the normal span such as high blood pressure, asthma, diabetes, broken bones, etc. The medication I am on is Albuterol inhaler, Accolade, Wellbutrin, Xanax (very rarely),Zantac, Zyrtec, Actifed (at night) and clonazepam to help me sleep more than 4 hours at a time. I'm sorry for the length of this but I have alot of health problems. Thank you very much for your time. My exhuastion has only developed in the last 4 months and I've been on all these meds for at least a year or more. Please advise as to what kind of doctor I should see, it's all so confusing.

Posted by HFHS.MD.DE on June 21, 1999 at 19:15:26
Dear Robin;
From the history you described, you indeed have been through a lot and I empathize with you.  You have a complicated medical history so that it is difficult to determine what causes the specific symptoms you have described.  You did mention having depression and anxiety even before the accident and that Paxil helped.However, you did not mention why you have been switched to Wellbutrin.  My only concern with Wellbutrin is that you have a history of head injury and seizures and that this medication has a tendency to lower the threshold for seizures. Fibromyalgia is a chronic pain syndrome characterized by muscle "trigger points", limited joint movement, hypersensitive skin, sense of swelling and numbness, anxiety, and problems with Stage 4 sleep. Frequent muscle trigger points include muscles in the head, neck, and back. For fibromyalgia to be diagnosed, there should be tenderness where muscles join their tendons in 11 of 18 specific trigger points and widespread pain without other obvious causes. Since you have other medical problems, it will be difficult to say whether you do have this condition.I would discuss this with you primary care physician. I would advice you, however, to see a mental health practitioner for counseling to help you cope with all these medical problems.It is possible that depression is contributory to your problems although it does not explain all the symptoms.  In addition, there are community support groups available that you could also join like depression groups, etc.  
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Key words: fibromyalgia/depression