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 - - - - SUMMER 2011 3 - - MICHIGAN MEDICAL REPORI