For weeks you have been aching from head to foot. You have no energy, you can’t concentrate and you can’t remember the last time you got a good night’s sleep. You have been to the doctor a few times already and all he can tell you is what you DON’T have. You have read about fibromyalgia and even talked to others that have been diagnosed with the disease. Yet, so far, no one can tell you whether you have it or not? Sound familiar? Well welcome to the world of fibromyalgia diagnostics. It is bad enough that there is no cure or significantly effective treatment for this condition, but it is even more frustrating when it takes so long for anyone to tell you that the problems you are having are caused by fibromyalgia. There is no debate as to the validity of fibromyalgia as a disease. In fact, the World health Organization has recognized the disease for many years. It is the diagnosis that is debatable. Fibromyalgia is a very confusing and misunderstood condition. It has been known by many different names for well over a century but was not termed “fibromyalgia” until the 1970’s. The term is derived from the actual experience of the condition. “Fibro” – which represents the fibrous tissues affected (i.e. ligaments and tendons); “Myo” – representing the muscular system; and “Algia” – meaning “pain,” which is the dominant manifestation of this disease. Essentially, fibromyalgia means being in pain almost everywhere. Fibromyalgia must be diagnosed through a process of elimination. In other words, before a complaint can be labeled fibromyalgia, it must first be determined that there is not some other cause. If your appendix is inflamed, you have appendicitis. If you fall and bang your head a CT scan will indicate if you have a concussion. But if you ache all over and suffer from chronic fatigue for months on end, have trouble focusing and struggle with anxiety and depression, it must first be determined what you DON’T have rather than what you DO have. Because if you have fibromyalgia, there is no test that will indicate that you have it. In other words, diagnosing fibromyalgia is difficult. This process is very contrary to the health care system as currently structured. The optimal level of testing and analysis to reach a confident diagnosis of fibromyalgia can be cost prohibitive. As a result, the symptoms of fibromyalgia can be conveniently dismissed as psychosomatic. Conversely, fibromyalgia can become the catchall diagnosis when there is resistance to traveling the long road to a conclusive diagnosis. Either way, the patient loses. Sometimes, a patient receives great relief when they are told what the problem is, even if a solution is unclear. Receiving a confidant diagnosis of fibromyalgia may not provide relief but at least it allows the sufferer to move forward to explore treatment alternatives. The American College of Rheumatology has made this diagnostic process easier for patient and physician by developing criteria for fibromyalgia that can be used in diagnosing the disorder. According to the criteria established by the ACR, a person is considered to have fibromyalgia if he or she has experienced widespread pain for at least three months in combination with tenderness in at least 11 of 18 specific tender point sites. While this may not be as definitive as a blood test or X-rays for other conditions, at least there is guidance that results in diagnosis with a high degree of confidence. As for treating fibromyalgia… well that’s another story! (I’ll deal with treatments in a subsequent article. Stay tuned.)

Whooping cough a.k.a(also known as) Pertussis is a highly contagious disease. Whooping cough is one of the leading causes of vaccine-preventable deaths. There are 30 to 50 million cases of Pertussis per year. Of these millions of cases there is about three hundred thousand deaths each year. Basically all of these deaths occur in children under twelve months of age. Another quick statistic is that of these 30 to 50 million cases, 90% occor in developing countries. The disease was easily and widely recognized in as early as 1578. It was later isolated in pure culture in 1906 by Octave Gengou and Jules Bordet. The complete Pertussis genome of 4,086,186 base pairs was sequenced in 2002. Inititially theWhooping Coughis characterized by mild respiratory infection symptoms. These symptoms include a cough, sneezing, and runny nose. This initial stage lasts for about one to two weeks. After this first two week period the cough changes character, with paroxysms of coughing followed by a «whooping» sound. Often times these coughing fits are followed by vomiting. This constant coughing and vomitting in several cases leads to malnutrition. Coughing fits gradually go away over the first one to two months. Other complications of the disease include pneumonia, encephalitis, pulmonary hypertension, and secondary bacterial superinfection. Whooping Cough is spread by contact with an airborne discharge from the mucous membranes of an infected person. The disease is treated with antibiotics like erythromycin, azithromycin and clarithromycin. These antibiotics result in the person becoming less infectious but in the majority of cases does not change the outcome of the disease. Immunizations for whooping cough are often combined and given with tetanus and diphtheria immunizations. These immunizations are given to infants at ages 2, 4, and 6 months, and later at 15 to 18 months and 4 to 6 years. Many cases of Whooping cough in adults will go unnoticed and diagnosed due to the fact that it is much less severe.

Accidents and prolonged sickness can be a drain both emotionally as well as financially. Sometimes money crunch is caused by the inability to hold a job, or when the medical bills escalate and it becomes increasingly difficult to balance expenses. Further, medical insurance may prove insufficient or will not cover long term medications. Life has become such that one needs to think about and plan for any eventuality. Experts recommend the following: 1. Ask your doctor for samples of medication. 2. Often an older drug is effective and cheaper. Request the doctor to write a prescription for a drug that is more affordable. According to studies you can save up to 75% this way. 3. Find out the generic name of the medication and choose to purchase it instead of branded medication —the saving can amount to as much as 70%. 4. Very often companies sell higher dosages of medication for a marginally higher cost. Be prudent, buy the higher dosage and spilt the medication in half, one-third, or quarters. The savings you can make are almost 50 %. 5. Order 90-day supplies in bulk from discount mail order pharmacies or online services. The savings are considerable and many doctors help long term patients reduce costs by putting the patients in touch with distributors. 6. If a particular medication is very expensive ask the doctor to recommend a substitute. This is known as therapeutic substitution. 7. Do try comparison shopping. You will find that the same medication is priced differently in local pharmacies, online outlets, and chain stores. Online pharmacies like http://www.walgreens.com/, www.costco.com , or http://www.drugstore.com/ offer medications at affordable prices. 8. There are several patient-assistance programs that offer free or discounted medication to those who cannot afford long term illness. Companies like Merck have programs that benefit uninsured patients. Medicines are given at discounts of 10-40%. 9. If you or a family member travels frequently you could buy your medicines abroad. Often the same medicine manufactured by the same company is much cheaper overseas. One can also order medicine by mail from Canada where medicines cost 30-50% less than the US. But do check the laws before you attempt this. 10. Start a health saving account where you can save pre tax dollars towards unforeseen medical expenses. This has a high deductible. Find out if you or other family members are eligible. Use an insurance broker who always thinks of you. He must keep you updated on all new developments as far as health schemes are concerned and make sure you reap all the benefits of the insurance scheme. You could also consider a critical illness policy in addition to a regular health insurance.

«Diagnosis» is a fancy name given to the process of identifying diseases. It is a Greek name. Break it down; «dia» means «by» and «gnosis» means «knowledge». How do I diagnose my illness? You don’t! Diagnosis is for doctors and physicians only. They determine your disease by the signs and symptoms that it gives you. If it is unclear by symptoms as to what you are sick with, you will consult a physician. A physician will take their best guesses as to your problems name, and medically test you for it. After your diagnosis is complete through blood test, medical imaging, saliva samples, biopsy, electrocardiogram, stool samples, or urine tests, the physician will decide which is the best way to treat you. Diagnosis is sometimes made by process of elimination. This is called a «differential diagnosis». Through investigation of symptoms and consultations with other doctors or physicians, they are able to tell what you DO NOT have, thus leaving them with your most likely disease. In the 1900’s, a man named William Osler began to «practice» medicine. He used the principles of diagnosis and treatment to reduce suffering and increase life expectancy. Osler decided that to practice medicine you must learn to identify diseases, understand where they come from and how they work, and then decide which is the best way to cure them. This is known today as «The Oslerian Ideal». And we have this man to thank for medicine practice today. I suppose, however, we could also thank him for waiting rooms…