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Sunday, May 24, 2015

A Fibromyalgia Perplex comment regarding symptom clusters turning into a syndrome







John Quintner  May 23, 2015  8:10pm
Fred, would you agree that the fundamental error made by Yunus et al. [1981] was that they mistook their “symptom cluster” for a “syndrome”?
A “symptom cluster” is a stable group of two or more concurrent symptoms that appear at face value to be related to one another and to be independent of other groupings of symptoms. [Kim et al. 2005]
One way of understanding the concept of a “symptom cluster” is by way of its analogy with recognizable but imaginary patterns seen within constellations of stars in the night sky. They might appear to be close to one another but in fact they have no real connection and can be light years apart.
Based on this misconception Yunus et al. [1981], and those who followed them, constructed Fibromyalgia, a process that can be likened to building an edifice of bricks but without using any mortar to bind them together.
As you know, I am not comfortable with seeing fibromyalgia as “part of a continuum of polysymptomatic distress”. The application of such a descriptor tells us absolutely nothing about the underlying pathogenesis and pathophysiology of the distress.
References:
Kim H, McGuire DB, Tulman L, Barsevick AM. Symptom clusters; concept analysis and clinical implications for cancer nursing. Cancer Nursing 2005; 28: 270-282.
Yunus M, et al. Primary fibromyalgia (fibrositis): clinical study of 50 patients with matched normal controls. Semin Arthritis Rheum 1981; 11: 151-171.

Hi everyone,  This was a reply to Fred Wolfe in my last post.  I think it has some merit, because I know that people with fibromyalgia have conditions that are just attributed to fibro and then never treated.  Comorbidities can be missed and therefore people with fibro go untreated.  I know this has been true for me.  Since I have arrived in Prescott, AZ I have happily been diagnosed and treated for asthma, allergies that cause asthma, and sleep apnea.  Just being treated for these conditions have made a huge difference in my life.  I was told previously that I had air hunger and a sleep disorder and then I was given Lunesta but it didn't work because I wasn't breathing every 4 minutes.  I am so fortunate that I found really smart doctors that have the capability to look beyond the diagnosis of fibromyalgia!!
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