Today’s roundup brought to you by oh look a feather toy!

After getting kicked off my low-income health insurance at age 18, going several years uninsured and uninsurable, sticking out the 24 month wait after being approved for Social Security disability payments before I could join Medicare, and then losing those payments and that Medicare because I had the temerity to get married (according to our system, my husband is not an equal partner but, because I am disabled, my expected caretaker, thus removing the burden of care from the state), I finally got a taste of the insurance all those class-privileged people have — you know, employer-based insurance (that actually is insurance and not those fake “discount plans” or “you can pay us a premium, but we don’t actually cover anything a human being might need” scam plans that low-skill employers offer to give the appearance of being socially conscious).

I am lucky that my husband is employed by the state, and represented by a strong union, so his health care benefits are good.

I was upset when I had to transition from one side of provided-by-the-state care to the other, because it was considerable work for me and for my health care providers, but over time I have come to be immensely grateful for my husband’s benefits. Rather than filling 30-day supplies of my medications at retail pharmacies and, every month, running into some hang-up or another that left me without one of my medications, or having to space out my medications, for days or weeks at a time, I now receive all but one of my medications in full 90-day supplies (including four packs of birth control pills, not three!) with no hassle. I order the medications online, and if the prescription is run out, my doctor is notified, and he sends a new one in electronically, and everything proceeds as normal. My medications arrive in the mail within days. It is the easiest it has ever been for me.

So now I am free of what was probably the biggest burden I had to bear in obtaining reliable health care. The only medication I still receive a 30-day supply for is my Vicodin, which is not considered a “maintenance medication” (despite filling the same function as my Lyrica, tramadol, Effexor, cyclobenzaprine and Mircette) and thus must be filled retail. Even that process has been considerably smoothed since the insurance switch, though not devoid of problems entirely.

And now I never have to deal with obtaining a referral for anything that wasn’t a yearly checkup with my general provider. And I have a single insurer, rather than feeling guilty every time I handed over my four insurance cards to my doctors (my retail employer’s scammy discount non-plan, my Medicare plan, the separate HMO for my MAWD and then the MAWD itself) and knowing the billing hell they were going through just to get payment for their services.

Alas, though: my troubles are not over. My husband’s insurer, like so many other employer-based insurance groups, has become enamored of these “incentive programs” that are supposed to, you know, “provice incentives” for patients to “lead a healthier lifestyle!” Mainstream conservatives and liberals alike seem to love these things. It’s a way to pretend you’re addressing the God-awful fucked-up shabby mess that is the American health care system and its soaring costs, but without actually, you know, doing anything to make these patients healthier. Actually paying for the health care they could use? Pfah! No, just “incentivize” them to exercise more or stop smoking.

These “incentive” programs, more often than not, do not take the form of an actual positive incentive for such “good” behavior. More often, patients feel the effect of a negative punishment for not being the Super Fit And Healthy Ideal Able Body. They end up paying more in health care premiums (by losing out on a “discount” for being a successful participant) or losing their health insurance altogether. Or, they simply feel the burden of having to jump through hoops no able-normative person would ever have to — the second shift for the sick.

These incentive programs would not be worth the money and effort if there were not a stick behind that carrot, a way to enforce good health on the people. It should go without saying: health is not something that should be enforced.

My husband’s ensurer has a yearly health survey that all participants — including every covered family member — must participate in to be eligible for the lower premium. This is not a five minute survey; it is fairly involved. And I am always nervous about answering questions from my health insurance provider: more often than not, when I inform them of this problem or that — even those insignificant in the grand scheme of things — it results in a loss of coverage, increased cost, or additional steps I must complete to continue receiving the care that I do.

This nervousness comes, especially, from my time spent uninsurable on the individual market due to preexisting condition. When I was younger, I created and held steadfast to a very important rule with my own family: Information Equals Ammunition. In the insurance market, this rule is sadly just as applicable.

Every year, after taking the survey, my husband is informed that he is dangerously underweight and action needs to be taken to correct this state of being. My husband is 5′9″ tall and weighs around 120lbs. This is his natural state. He eats a healthy diet, he walks to work and back every day and gets a fair amount of exercise beside that. He inherited his very lanky body frame from his mother, who is even skinnier than he, and jokes that when she was pregnant she never actually gained weight; at the end of her pregnancies, she looked just like she does now, but with a basketball contained in her tum.

When my husband played football in high school, he was actively trying to gain weight both through diet and muscle-building exercise — and he plateaued at 140lbs. Now that he is not weight-lifting on a regular basis, he hovers around 120lb. This is a BMI of 17.7, barely more than I weighed when I was a teenager — the difference being that I was significantly undernourished, and he was more-than-properly-taken-care-of.

So once a year, he gets yelled at a bit about his weight. He is healthy in literally every other way, his one and only health concern being a minor bit of TMJ pain which he now has completely under control. But he does not fit the widely-understood able-bodied “norm,” and so Something Must Be Done!

I take the same survey, and of course I am provided with tips for stress reduction and admonishment to see a pain specialist. I am now very slightly overweight, so of course I am also admonished to “park further away!” and “take the steps instead of the elevator!”

Recently, I have been receiving messages on our home phone from our insurance company, encouraging me to call them for the opportunity to participate in an unnamed program, for unnamed rewards. These messages piss me off, so I ignore them, even though I know there is a strong possibility that it might mean our premiums would go up. I planned to contact them at some point or another, but it was not high on my list of priorities, and still they kept calling every other day.

Then I received a letter, in a tone that can only be described as a lament, that I had not responded and would I please pretty please call them, this time finally informing me that it was for their “Healthy Back Program.” Oh great, I thought. And I caved in and called.

The woman who answered gave me the spiel I expected. And my reply, in a sweet voice, was (closely paraphrased): “Yes, I have chronic pain from fibromyalgia and endometriosis,” and she replied with a somewhat disappointed “Oh” — but I interrupted to continue: “I went in last year for lower back pain, and I spent the entire year going through various programs and treatments to help it. I had to go under for a laparoscopy which led to being diagnosed with endometriosis, and I’ve now been through physical therapy and even have a personal TENS unit to address the pain.”

“Well, unfortunately that means you are not eligible for our program, because your pain is chronic…”

Mm-hm. I am sure you can hear my disappointment.

This is the same health insurance company which paid for all these tests and treatments and has on record exactly what my condition is, what the background is, what medications I am on and which treatments I am partaking in. I provided this information in the health survey. It is very clear that I have chronic pain conditions. But because I even mentioned low back pain — a common focal point for people who like to cry about “overdiagnosis” and “overtreatment” — I was immediately flagged and referred to this oh-so-special program.

It’s just one more little thing I have to fend off to be able to continue on my treatment course. Just like every time I visit a new doctor, counselor or other practitioner and have to patiently go over every disclaimer about why I am on this Vicodin and why I have this symptom and why this and why that, and that yes I am being closely monitored by competent doctors and am following my treatment course as prescribed would you please leave me the fuck alone so we can get on with things.

And it’s exhausting, always having to be at-the-ready to explain these things. It’s just exhausting in a way that no able-normative person will ever fully understand, period, and I am confident in asserting this. It just drains you, even though each of these encounters is small and relatively easy when considered individually. But it accumulates, it weighs on you, and the knowledge that you always have more to come — that is the worst of it.

This is what people with disabilities go through in a health-obsessed culture, a culture that sees personal health as a responsibility to the collective, and any person who in any way deviates from the designated health “norm” (which changes regularly and is not as science-and-reason-based as these people like to think) is failing their family, community and nation, that they are dragging them down — being a burden.

And we all know what the result is when disability, or any health abnormality, is constructed as a burden.

Look, the fuss around whether race is a feminist issue (not just race, but race is a particular sore spot) boils down to this.

When people ask

“Why is X a feminist issue?”

what they’re really asking is

“Why should I care?”

I’m sorry. There’s no way to get around it.

The following is for my fellow white chicks. Bear with me, everyone.

If you are committed to feminist activism, what you are committed to is a framework of social justice built around gender. Right? You with me? What you care about is, specifically, women. But more broadly — stay with me here — what you care about is justice.

Right?

Gender is the organizing concept for you, most likely, because you are a woman. Ya? The way society organizes itself around gender makes you particularly aware of its effects, and that sparked your interest in this activism.

But that is just fucking ridiculous. Yeah, you’re a woman. But you’re also white. Why doesn’t that make you particularly aware of the way society structures itself around race? I’ll bet you don’t think men are ungendered — come on. So why aren’t you also dripping with race? Why isn’t race your organizing concept?

I’ll let you think for a while on that.*

Really: Why isn’t it worth your time to consider race in the same frame of mind you consider gender? Do you think that because you are white, it doesn’t affect you? I beg to differ! And I’ll bet you think men are negatively affected by society’s gendered structure too.

Do you think that there is nothing to learn, no benefit gain, for you or anyone else, from entering a framework other people have built, which doesn’t center around your world? Do you think it will have no relevance to your own life? Do you think it will have no relevance to your own activism?

Why is it that you have to be cajoled into showing some fucking respect for anything that doesn’t revolve around you and your experience?

You care about justice — right? Isn’t that, ultimately, what it comes down to? If you agree, then why are you putting up such a fight? What are you fighting for?

This is what I think.

Feminism is a framework dedicated to social justice, built around examining… let’s leave that blank for a moment.

Feminism is a framework dedicated to social justice.

Feminism cares about every person, no matter their (blank).

Feminism says, you deserve good, because you are a human being.

Feminism says, (blank) should not affect whether or not you receive that good, and we will fight to ensure that.

Feminism wants every person to be treated with respect, to be allowed dignity, autonomy, and self-actuation, on the basis of their shared humanity — and nothing else.

Now, to fill in that blank: feminism is a framework dedicated to social justice, built around examining gender.

But gender is not the only social construction thrust upon your unsuspecting self.

If it is the only one you see — or the one you see most clearly –there may just be a reason for this.

Has to do with social construction n stuff.

That’s all for now, folks.

—————————————————————————————

* BONUS. It killed the flow, but it’s important.

Consider also these: are you straight? younger in age? able-bodied? middle class or higher? If so: why haven’t you devoted your energies to activism built around age? sexuality? ability? Anything? — Beuller?

Is it because you don’t think those things really apply to you? But come on — you don’t think men are ungendered. So why aren’t you also dripping with these things? Why aren’t they your organizing concept?…

Yet more bad news for the upper-class white liberals who are perpetually Concerned About Your Health(TM). Go figure.

a husband who will:

1) go to sleep around 11 p.m. as usual; 2) wake up at 2 a.m., 3) fumble into pants and shoes, and 4) drive a mile and a half to your pharmacy; 5) pick up and pay for your medication; 6) drive home; 7) get a glass of water, 8) wake you up, and 9) make you take your dose; 10) get undressed and 11) go back to bed; 12) wake up at 6 a.m. to get ready for work.

I have not yet received my Flexeril in the mail. It should come in a couple days, but I’ve been out since Saturday. I’ve coped alright until today. Early in the afternoon my back spasms returned with a vengeance. For about two hours I sat through continuous spasms without stop, every ten seconds, bam bam bam bam one right after another. They subsided some after many painkillers, but a couple hours later I had a strange nervous attack. My whole body shook and swayed, and my vision went really screwy (inability to focus or control aim).

I ended up at MedExpress, where we waited a half hour and paid $25 to walk back out with a prescription for a week’s worth of the Flexeril to tide me over til my shipment came. Husband drove me to CVS, where we dropped off the script and wandered around for a few minutes waiting for my name to be called. When we went to the counter, we were informed my insurance wouldn’t pay for it. Well, duh. I said that I wanted to pay cash for it and the pharmacist told me that my insurance wouldn’t allow the prescription to be released until 2am tonight.

… wait, what?

What the hell was the point of this whole endeavor? To make me suffer through 30 minutes of Wolf Blitzer and deprive my already stressed husband of another hour of sleep? To further drain my already anemic checking account?

I give, I give! Uncle! Here, I only got $14, you can HAVE IT, just leave me alone already!

Why didn’t the pharmacist just tell me “You can’t fill this if your insurance has already paid for this month’s supply”? I mean, I told her what was going on when we went to the dropoff counter. Can my insurance really tell me I’m not allowed to have medication that a doctor prescibed me except when they pay for it, under their terms?

I just don’t get it. There’s a disconnect here. As long as my insurance isn’t paying for a treatment, they shouldn’t have any fucking say over what I can have, when, where, how much, for how long. I’m sorry, they just shouldn’t. And my pharmacy should not be complicit in denying a suffering chronic pain patient much-needed treatment.

Especially a medication as tame as fucking flexeril.

As far as I see it, the only parties who should be involved here are me, my doctor, and my pharmacy. Unless I choose to involve them, my insurance should not enter the picture. If they do, they should only be allowed to assert control over treatments they are paying for. If they wanted to dock me a dozen pills from my next fill, fine. Or if they wanted to charge me however much to make up for the “extra” medication I’ll end up having. Or if they ant to prevent me from refilling until however-many-days after what it would’ve been without today’s script. All of that is — well, it whiffs of bullshit but I can understand it, at least. But how did we make the jump from that to this? Can someone point out the missing piece here?

Hell.

You’d think, in a situation involving a patient, a nurse, a doctor, a pharmacist, and an insurance agent, at least one of those would be in it for the betterment of the patient — right? ‘cuz I’m batting oh-for-four right now.

an AMEN?

Hmmm.

What Vague Pharmaceutical Industry-Invented Malady Do You Have?
Fibromyalgia. It sounds so daunting — like angina! which also sounds like vagina, or chlamydia. And if the pharmaceutical industry’s multibillion-dollar marketing machine has any sort of pathway into your consuming psyche, you’re probably aware of this hot new disease. Hasn’t the industry gotten so much better at naming new maladies since the whole dubious “restless leg syndrome” thing? Anyway, here’s fibromyalgia in brief: it affects primarily women around their middle ages — potentially 10 million of them in this country according to advocacy group, which means something like one in five. You’ll know you have it if you start to feel “chronic, widespread pain of unknown origin.” The pain won’t respond to anti-inflammatories, and no one knows where it comes from really, so instead of trying to sell you on something to soothe the pain, the pharmaceutical companies — namely Pfizer — is trying to soothe your brain’s perception of pain. Clever! Okay, so here’s the shocker: some people think fibromyalgia is a bit, you know, fictionyalgia. And “some people” includes the doctor who named it in the first place.

Why invent a disease? Well, if you’ve got a drug with a limited market — like Pfizer’s Lyrica, originally developed for seizures, it’s pretty genius business to make up a mysterious new ailment that a lot of people could potentially have or be scared they have. Where do you think ADD came from? What about “bipolar disorder”? “Irritable bowel syndrome”? Oh sure, those diseases affect one in 1.5 Americans, and we have them too, but:

…Those figures are sharply disputed by those doctors who do not consider fibromyalgia a medically recognizable illness and who say that diagnosing the condition actually worsens suffering by causing patients to obsess over aches that other people simply tolerate.

But why tolerate when you can obsess? And speaking of obsessing, did you know ADD makes people obsessive? I should be done with this post already but I didn’t have enough amphetamines today. What about you?

Moe, the post’s author, later “apologized,” saying:

Which brings me back to an important part I was trying to make when I posted insensitively about fibromyalgia the other day… We like to think we make rational purchasing decisions borne of a thorough survey of all the available options — or that at the very least, we are creatures of our own innate needs and desires. I can only assume that this is why a lot of you got so defensive when I joked that fibromyalgia was a “vague pharmaceutical industry invented malady.” A few of you turn out to have fibromyalgia — and “restless leg syndrome”, and whatever else I treated with my signature careless disdain. I’m sorry guys; I made my point less thoughtfully than I maybe should have. We all have health problems. But right now the most highly -capitalized, influential and consumer-savvy source of all that we know and learn about those problems — the developers of the drugs, the sponsors and publishers of their studies, the sources of continuing education to your doctors — is the pharmaceutical industry, and the pharmaceutical industry exists to convince us that our problems are “syndromes” necessitating a pill you take once a day.

Yeah, OK, that sounded totally sincere — NOT!! Haha, look, I’m being irreverent!

No, what you’re doing is telling me that the pain that has caused me to nearly fail out of high school in my final semester, drop out of college and remain bedridden for weeks and housebound for months afterward, drop out of college again a year and a half later, quit work, quit work again, and quit work again all within the past 14 months, is an invention of the Big Bad Evil Medical Industry, and that the medication that pulled me out of my houseboundedness and allowed me to even go to college that second time (during which I actually completed five classes, the only ones on my record to this day) is nothing more than snake oil.

To which I extend a hearty fuck you.

As I pointed out the other day at Hoyden About Town, a lot of people seem to get a huge kick out of declaring helpful products useless, and the people who use them brainwashed — in so many words — because after all, the companies who distribute them are only trying to make a profit off of our poor gullible asses.

What I find incredibly amusing is that I, one of those apparently intellectually-challenged souls, have actually read the research on this condition and its treatments, while they, the Wise Knowing ones, know approximately shit about any of it.

Throughout the 1990s, fibromyalgia was regarded as a “wastebasket condition,” a label to throw at hysterical, hypochondriac middle-aged women who were being a pain in the ass by demanding that their doctors actually give a shit about their patients. (Oops, sorry, I’m being irreverent again!) Nobody really knew much about it, except that it was totally a disease of old Faker McFakersons, the crazy old fat women who lounged about the house all day stuffing their faces with donuts and watching the cable they could afford even as they were applying for welfare benefits and we all know the stereotypes, so I’ll stop there.

Then some idiot got the bright idea to actually conduct clinical research on the condition and they started finding out that hey, this doesn’t seem to be psychosomatic at all, in fact there are distinct physiological differences between fibromyalgia patients and healthy controls, mainly in the nervous system and related parts of the brain, and all sorts of peripheral findings like sleep disturbances and pain “memory” and the like.

Huh. Who would’ve thought?

And now we’re into the new millennium and guess what: major medical groups still aren’t really paying a whit of attention to the condition. The main treatment is tricyclic antidepressants, which worked about as well as a single extra-strength Tylenol works on a severed leg (that is, it does some measurable amount, but only hardly), and doctors are still being dismissive assholes, leaving fibromyalgia patients to fend for themselves in managing the condition, often falling on the alternative world, which is going absolutely crazy pitching cures and panaceas to people whose problems stem from aspartame intake to phosphate buildup to an insufficiently positive outlook on life.

Then, in the middle of the aughts, BAM! All of a sudden, a single pharmaceutical company takes notice of the condition and thinks hey, here’s a market to be exploited! And they pump money into a promising new drug called pregabalin, which is an anti-epileptic drug that works by depressing the central nervous system, and it seems to actually have measurable impact on the pain of fibromyalgia patients in double-blind randomized trials!

Huh. Who would’ve thought?

And it takes several years to move through the whole FDA approval process, not without its bumps-in-the-road (including, recently, a proposed black box label), and Lilly decides to cash in on the fun with their Cymbalta, and other companies throw their spaghetti on the wall, which doesn’t really stick (sorry, milnacipran) but in the end, there is an Actual FDA-Approved Treatment For Fibromyalgia, which honestly does go a long way in legitimizing an unfortunately-maligned condition.

But when the commercials start airing, the bottom-feeders of the world heap derision anew, basking in the glow of using the suffering of the already-overburdened as a cudgel against the only group that has ever paid any attention to their condition in their quest to stake out a position of Purer Than Thou irreverence.

Ignore the fact that the condition existed decades before Big Pharma ever caught wind of it, which puts a kink in the whole “Big Pharma invented it out of thin air to pad their pockets” line.

Because if it comes from Big Pharma, it must be a lie. Make sure you keep your eyes covered so that you never see the lives of the actual people in question, who make have quite a different story to tell you.

But eh, why worry about them?

Or maybe women suffer from chronic fatigue and muscle pains more often because they often have to work full time, care for children, run errands, and do all the housework while the husband kind of hangs out. Find me a hormone to correct THAT.

I’m running on a headache and a sweat rag right now, so please excuse any sloppiness. Remember, it’s all Pharma’s fault.

(Where did all this come from? Jezebel’s rise to prominence in the feminist blogosphere, mainly. We all read blogs with whose every opinion we do not always agree, but I wanted to make sure this offense is officially called out, so at least people have a more accurate picture of what it is they’re supporting. This is the language of hatred. This is the culture being encouraged on this site. Please, be as mindful of these things as you are of bigotry against women. Thank you.)

Ezra brings up an issue that continues to lie dormant.

Insurers charge women more than they charge men… studies show the effect is all the more pronounced when you’re dealing with health savings accounts and other forms of high-deductible coverage. A Harvard study from a year or so back ran the numbers and found that men under 45 racked up about $500 in yearly, out-of-pocket costs, while women spent closer to $1,200. Dr. Steffie Woolhandler, the lead author of the study, summed up the findings starkly. “When an employer switches all his employees into a consumer-driven health plan, it’s the same as giving all the women a $1,000 pay cut, on average, because women on average have $1,000 more in health costs than men.”

Here’s why: For most of their lives, men and women use health care very differently. Men seek episodic care: I sawed off my thumb, fell off a mountain, tried to stop an SUV with my Civic. Contact with the health system is relatively rare, and most everything is covered by insurance. Conversely, women seek a lot of routine care. Check-ups, pap-smears, reproductive health care, etc. The expenses are small, but they’re regular. So when you move towards health coverage where small, regular expenses come out of pocket, you’re erecting financial barriers to the type of care sought by women.

It’s also a good object lesson as to the folly of HSAs. The type of care that HSAs put a higher price tag on, and thus discourage, are small and discrete interactions with the health system. So they disadvantage mammograms and pap smears, but leave lumbar surgeries and angioplasties untouched. Anyone want to guess which category accounts for the majority of our health spending? Anyone want to guess which type of care studies suggest we discourage, and which type of care studies suggest we make more broadly accessible?

Why is this not on the front page of every newspaper in the country right now? On the screen of every cable news watching citizen?

What do you think the effect of this is on single mothers? What do you think the effect of this is on poor women? What do you think the effect of this is on disabled women?

How many people are unnecessarily unemployed because the health care that would allow them to work is denied them? How many people end up in the ER in the middle of the night because they put off routine care for so long, because it was money they didn’t have? Money that could instead go toward their education? Money that could instead go toward their children’s school activities?

How many children lose mothers, husbands wives, parents daughters, when one more woman ends up with cervical cancer because she didn’t have the time or money to spare?

Do we really think we can patch things over by throwing a couple dollars at the Komen foundation and calling it a day?

Think about your own mother. Your sister. Your daughter. Your partner, your lover, your best friend. Do you really want to just let this go because “that’s just how things are”?

I am tagging this one under “privilege” to remind you, the reader, if you are able-bodied and able-minded, that I, the bitch, the cripple, am subsidizing your health care. And that woman in the Section 8 housing who just got evicted because of the money she’s spent getting run around the ringer about those abnormal cells on her Pap test? She is subsidizing the yearly checkup you don’t even bother to get most of the time. And when you go home with your Z-Pack, knowing that you are going to be free and clear after seven days and a $10 copay, know that the money to pay for that came directly out of the pocket of that woman and her two infant children. And I hope you’ll find that redistribution worth it when she dies at 42 of cancer that could have been prevented.

Welfare queens? Taxpayer dollars? Hard-earned money? I don’t want to hear it. Fuck you.

What does it say about my experiences with the healthcare industry that when I see this:

Why do we want to know more about you?

In order to personalize the site to you, we need to know certain things about you. For instance:

• We need to know your age and gender to remind you of the check-ups you need.
• We’ve got a great pregnancy program so if you’re pregnant, tell us and we’ll help guide you through a healthy pregnancy.
• Your email and zip code helps validate that you signed up for the site and no one at our organization did it for you.
• And so on..

I read this:

Why do we want to know more about you?

In order to increase our profit margins, we need to know certain things about you. For instance:

• We need to know your age and gender so that we can “adjust” your premium and care accordingly.
• We’ve got a great pregnancy program so if you’re pregnant, tell us so that your employer has the option to discriminate against you based on it.
• Your email and zip code helps us earn money by selling it off to spammers, both “legitimate” and il-.
• And so on..

Cynical and unfair? Yes. But when you’ve lived the life I’ve lived, in the body I’ve lived, with the experiences I’ve lived, you’ll understand why I’m not so eager to provide my employers’ insurance “discount” company* with any of this information.

*I’m required to have this insurance in order to be listed on my husband’s insurance, and I have to have a denial from my employers’ insurance before his employers’ insurance will consider any claim at all. Which is kind of easy, considering the former doesn’t cover anything anyway. Throw soon-to-expire Medicare and on-going tertiary Medical Assistance for Workers with Disabilities into the mix, and I’ve got a headache-inducing full-time job on my hands juggling all of the above.

The former post was a pretty long introduction, but now I’m going to get onto what I was originally intending to talk about: this story on a study on the efficacy of Myer’s cocktail on fibromyalgia.

The first red flag comes in this paragraph:

Massey chose subjects who had fibromyalgia for at least 8 years and proved to be therapy resistant, having tried antidepressants, nonsteroidal anti-inflammatory drugs, and exercise without relief.

Oops! OK, those of you who aren’t familiar with fibromyalgia probably don’t see the mistake there. It comes in the form of the words “nonsteroidal anti-inflammatory drugs” invoked as though it is a legitimate treatment for fibromyalgia. It’s not! Not because NSAIDs are a useless treatment in general (arthritis sufferers, you can put away your weapons now) but because fibromyalgia is not an inflammatory condition. The pain has nothing to do with inflammation of the muscles or joints (well, except insofar as it will amplify that pain if you have it for some other reason) but instead with a fuxxoring of the brain’s regulation of pain signals. So it’s sort of a meta-level condition, if you want to think of it that way. Now, fifteen or twenty years ago the conventional wisdom was that the disorder was an inflammatory, auto-immune, rheumatic condition (thus why the default specialist for a fibromyalgia sufferer is a rheumatologist, and why we sit in the lobby with arthritis, osteoporosis and gout sufferers) but that’s been pretty much dismissed by now. Unfortunately, there are a lot of medical professionals who are fifteen or twenty years behind on the research, and so they continue to propagate this myth.

So of course NSAIDs didn’t work on these patients. Because NSAIDs don’t work on fibromyalgia. That’s sort of a meaningless condition to require of your patients if you’re looking for someone who hasn’t responded to typical therapies.

The rest of that quote is problematic, too. Antidepressants also don’t do a whole lot for fibromyalgia pain. It does help you regulate serotonin (sort of the bouncer for your brain, it helps block the “bad” signals, so when you have less of it, more “bad” signals get through) but because serotonin plays only a small role in the overall problem with fibromyalgia, it isn’t really terribly effective. Now, a lot of fibro-ites will tell you that it makes them not care about their pain, but the pain’s still there, and that’s a pretty accurate way of putting it.

Also, while exercise is vital to managing fibromyalgia pain (the weaker you are, the more you will hurt; carefully managed physical activity can help strengthen your body and thus help improve your physical state) exercise alone is not going to do a whole lot, except make you sore. It’s sort of like the studies that find a combination approach is best for depression or anxiety: medication alone just masks the problem, but it’s often hard to really make progress with therapy or CBT if you don’t have the chemical regulation straight. Much the same way, you aren’t going to make a lot of progress exercising if you don’t have some sort of pain relief helping you do it.

So basically, of course these patients didn’t respond to these treatments. Because these treatments don’t really do much for fibromyalgia pain in general. If you were going to conduct more of an intellectually honest trial, you’d look for patients who didn’t respond to the treatments that actually work. Duloxetine and pregabalin are the two biggies, but I can excuse a lack of knowledge about them since they’re really new. But gabapentin has been around for a long ass time so you (a medical professional professing some sort of special knowledge in the area) have no excuse for not knowing about it. Same with stuff like cyclobenzaprine or even hydrocodone (which is a tricky treatment to manage given the probability of  developing dependence, but it works). There is no way they can excuse ignoring these treatments and concentrating on the ones that have been proven not to work.

Moving on:

Seven subjects were given the modified Myers’ formula of intravenous nutrient therapy once each week for a total of 8 weeks. The subjects were monitored weekly by measures of pain, fatigue, and activities of daily living. All seven subjects reported improvement in all three measures.

Within two days of receiving the modified Myer’s cocktail, the subjects all reported increased energy, with no side effects. There was an overall 60% reduction of pain and an 80% reduction of fatigue, though the reduction was not lasting.

Problem here. One: There were only seven subjects. That can be looked past, as there has been pretty important research with similarly small sample sizes that have been vindicated in the end. But then we get on to two: there is no control group. I’m speaking as a layperson here, but really, as far as I’m concerned, if your clinical study isn’t double-blind, it’s worthless. Why? We get right back to that placebo effect again.

And doesn’t it look like that’s exactly what’s happening here? Within two days the patients reported incredible improvement. By the time the study was over, they were back to normal. That’s how it goes with these treatments. You take them for awhile, you really want them to work because hey, you would like to be able to get on with your life, and at first you’re thinking, hey! maybe this is working! as you identify this and that little “improvement” during your daily life—ups on the pain and fatigue roller coaster that really may just have been what you normally experience day-to-day anyway, but weren’t really paying attention to before—or maybe just your improved disposition due to your investment in the new treatment is affecting your pain levels overall; mood certainly influences one’s physical state (although please, let’s not take that to the BS level of “then it must all be in your head!” science is not with you on that count, my friend). But then as time goes on, you stop looking for improvements and concentrating on whether or not the treatment is working and get on with your daily life, and you start to notice that you can’t find any real difference. And then you get tired of taking the pill every morning (or whatever the treatment is) and stop, and forget about it. Chances are, you’ve been through dozens of these treatments before, and they didn’t work either. And you become more fatigued with them over time. But you don’t really care enough to report back and tell the makers, or the readers of the reviews, that it didn’t work. And so it goes.

As I’ve said, this doesn’t apply across the entire alternative spectrum. Some treatments have been shown to work (acupuncture, for example, has been shown to be effective in some trials, although the results there are equivocal because there have also been studies that show it not to be effective over a “sham” [control] treatment). But so many are never held up to the light for a closer look, and they need to be—for the good of those living with the condition, who want to see real, effective treatments found, to reduce our suffering.