HOW FIBROMYALGIA
AFFECTS WOMEN
Despite the lack of clinical tests, a physician can diagnose
affect a woman's sexuality and cause greater stiffness,
fibromyalgia by pressing on "tender points," I 8 designated
pain and fatigue during pregnancy.There also is a connec-
sites on the body. When pressed, these sites are painful but
tion between fibromyalgia and premenstrual syndrome
don't show the typical signs of discomfort, such as heat,
The pain seems to come from all
(PMS).Those with fibromyalgia experience more severe
redness or swelling. A patient has fibromyalgia if he or
over your body, and the fatigue is
headaches, insomnia, back pain and abdominal cramping
with PMS.
she experiences pain when the tender points are pressed.
crippling. Fibromyalgia can occur
HADEEL
RAZOOK, MD
from painful periods and breast cysts.The syndrome can
in men and women, but it's more
prevalent among women.
In menopausal women, the decreased levels of estrogen and
BACKGROUND Fibromyalgia
cortisol may contribute to fibromyalgia. Postmenopausal
women may experience more severe anxiety, depression
PREVENTION To prevent
and sleep disorders.
fibromyalgia, Dr. Razook
DIAGNOSIS "There is no radiological or laboratory
recommends having a
consistent sleep time,
is a syndrome (a set of symp-
toms) characterized not only
by pain and fatigue, but also by
anxiety, depression, stiffness, sleep disturbances and de-
creased tolerance for pain. It also can be responsible for
twitching or a burning sensation in the muscles.
CAUSES The exact cause of fibromyalgia is unknown,"
says Hadeel Razook, MD, a St. Joseph Mercy Oakland
family medicine physician."However, patients may report
a triggering event, such as severe physical or emotional
trauma or a previous infectious illness.There also may be
TREATMENT Although there is no cure, a physician may
recommend medication, exercise and behavioral therapy.
test to diagnose fibromyalgia," explains Dr. Razook, but a
physician can start by taking a patient's medical history
exercising, refraining from
and performing a physical exam.The physician will look at
ducing alcohol consumption.
late-day caffeine and re-
risk factors such as family history, gender and underlying
diseases such as lupus, in addition to fatigue and sleep dis-
For a referral to a St. Joe fam-
turbances, mood changes, headaches, stiffness, numbness,
ily medicine physician, call
tingling sensations, and fluid retention.
800-372-6094.
a genetic component."
"If the patient doesn't meet clinical criteria for fibromyalgia,
then further testing may help explain the musculoskeletal
Women with the syndrome are more likely to suffer
pain or fatigue or rule out other diseases or conditions
causing the symptoms," she adds.
REHABILITATION FOR SENIORS
Stiffness and pain
are symptoms
of fibromyalgia.
strength. A regimen of 20 to 30 minutes of continuous ex-
ercise three to four times a week is prescribed.To help the
patient regain mobility, the physician will gear the exercises
to the particular area involved. In the case of rehabilitation
after a hip injury or surgery, Dr. Sesi will focus on gait activi-
As the population ages and the
number of senior adults grows,
there will be a great demand for
ties. Older adults are usually prescribed walking, stretching,
rehabilitation services to treat
chronic illness and injuries. To
riding a stationary bike, yoga and Pilates.
restore their quality of life, senior
',—
TIMOTHY
SESI, MD
adults will need treatments tai-
lored to their unique needs.
A presurgery rehabilitation program also is available. "We
BACKGROUND "There's no
outcomes," Dr. Sesi says.
strongly encourage patients who will have joint replace-
ment to do exercise before surgery so they will have better
one-size-fits-all physical or occupational therapy" says
Timothy Sesi, MD, a St. Joseph Mercy Oakland (SJMO)
FAMILY INVOLVEMENT "Family involvement is essential
for the rehabilitation of an elderly patient," advises Dr: Sesi.
physiatrist, who specializes in physical medicine and
rehabilitation.
The family goes through the actual therapy sessions to
Typically, older adults need rehabilitation after experiencing
degenerative joint disease, arthritis of the spine or spinal
learn what their loved one has to do. At home, "we have
a continuum of rehabilitation care," Dr. Sesi says. If the
patient cannot leave home, home-based therapy is given.
stenosis. Or they may have underlying factors, such as
peripheral vascular disease, cardiac conditions, diabetes,
stroke or previous surgeries.
To help patients regain mobility after a surgery or
an injury, the physician gears the exercises to the
particular area involved.
"The primary problems can contribute to secondary prob-
lems," Dr. Sesi says. For example, a patient who has had a
pressure and more. In addition, the physician will assess
made to check the safety of the patient's bathroom, bed-
room and kitchen. External and internal stairways are also
the patient's sensory and cognitive conditions.
reviewed for safety of navigation.
For ambulatory patients, outpatient therapy is arranged.
But before the patient is discharged, a risk assessment is
stroke or hip fracture can develop spasms or atrophy of muscle
groups, which can affect walking and cause gait disturbance.
"An appropriate rehabilitation prescription will take into
At SJMO, a full spectrum of services is offered for physical
consideration all these factors," Dr. Sesi explains.
therapy, occupational therapy, speech and language pathol-
ogy, and audiology. Both inpatient and outpatient services
Aerobic conditioning is vital for the older adult to regain
are available.
THERAPY Before beginning rehab, the patient has a
complete medical exam to check the heart, lungs, blood
SJMO COMPREHENSIVE OUTPATIENT REHABILITATION
St. Joseph Mercy Oakland
Lake Orion Rehabilitation Center
Union Lake Rehabilitation Center
Main Campus Rehabilitation Services (formerly SJMO Auburn Hills)
Woodward Professional Building
44428 Woodward Ave.
Pontiac, MI 48341
Phone: 248 758 7720
Hours: 7:30 a.m. to 6 p.m., Monday through Thursday;
7 a.m. to 5 p.m., Friday
Located in Great Lakes Athletic Club
3800 Baldwin Rd.
Orion Township, MI 48359
Phone: 248 393 1175
Hours: 7:30 a.m. to 5 p.m., Monday through Thursday;
7:30 to 11:30 a.m., Friday
2630 Union Lake Rd.
Suite 200
Commerce Township, MI 48098
Phone: 248 360 0052
Hours: 7:30 a.m. to 6 p.m., Monday, Wednesday and Thursday;
7:30 a.m. to 12:30 p.m.,Tuesday and Friday
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SUMMER 2011
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MICHIGAN MEDICAL REPORI