6 B SIUSLAW NEWS z SATURDAY, JULY 11, 2015 TO YOUR GOOD HEALTH Fibromyalgia is real disease DEAR DR. ROACH: I am a 56- year-old female. I recently have been having terrible pain in my joints. It is so bad at night that I can’t sleep. Mainly the pain is in my neck, ribs, elbows, knees and wrists. My finger joints have hurt for years. I recently went to a rheumatologist because I had an elevated rheumatoid factor (it wasn’t extremely high). I was told I have arthritis and a high risk for rheumatoid arthritis. I was then diag- nosed with fibromyalgia. I was shocked and embarrassed! I had always thought that fibro was not a real disease. I feel bad and tired almost every day, and I am so sick of it! — S.S. ANSWER: Some of my colleagues still doubt it, but I think that fibromyalgia certainly is a real dis- ease. There is no doubt that there are a large number of people with chronic SALOME’S STARS ARIES (March 21 to April 19) Starting something new is always excit- ing for the adventurous Aries. And here’s the good news: This time you might be able to get some assistance in helping you finish what you’ve started. TAURUS (April 20 to May 20) Put your daydreaming penchant on hold for now, and face the facts as they are, not as you’d like them to be. Your custom- ary hardheaded approach to “deals,” etc., is called for. GEMINI (May 21 to June 20) Problems beyond your control might delay some of your plans. But things should start to get back to normal by midweek. The weekend could bring an unexpected (but welcome) visitor. CANCER (June 21 to July 22) It’s a good time to buckle down and tackle pain in the muscles and soft tissues who meet the diagnostic tests for fibromyalgia, which are all based on history and exam — there’s no blood test or X-ray for fibromyalgia, but that doesn’t mean it isn’t real. The current thinking is that fibromyalgia is due to alterations in the perception of pain by the central nervous system. The most common symptom is aching in the body, usually in the mus- cles and joints. Although there are specific commonly tender spots that clinicians look for on exam, the diag- nosis of fibromyalgia can be made without them. Fatigue and poor-quali- ty sleep also are nearly universal in fibromyalgia. Depression is highly prevalent in people with fibromyalgia, and in my opinion, the depression is more likely caused by the chronic pain and fatigue than the other way around. Before making the diagnosis of fibromyalgia, your rheumatologist had to exclude other possible causes, such as rheumatoid arthritis, restless leg syndrome and thyroid disease. This isn’t always easy or straightfor- ward, and requires experience. My opinion is that it is better to have a diagnosis of fibromyalgia because, even though fibromyalgia isn’t completely understood, it is a starting point for understanding and treating chronic pain. Tricyclic antidepressants are the most common initial treatment of fibromyalgia, because they affect the way pain is processed. They are usu- ally started at far, far below the effec- tive dose for depression. Feeling a sense of control over the pain, continuing to work and exercis- ing more are all associated with a bet- ter outcome in fibromyalgia. DEAR DR. ROACH: My brother- in-law was prescribed warfarin sever- al years ago after a stroke. He claimed that it was made from rat poison and refused to take it. Is it, in fact, made from rat poison? — D.K. ANSWER: Yes, warfarin (Coumadin) was used as rat poison. Some rat poisons are still relatives of warfarin. However, that doesn’t mean he shouldn’t take it. The difference between a medicine and a poison is often one of dosing. Warfarin is rea- sonably safe when used correctly, and it can significantly reduce the risk of a second stroke. There are also some newer options, such as Pradaxa and Xarelto. Your brother should recon- sider the risks and benefits. those unfinished tasks so you’ll be ready to take on other projects. The week’s end could bring an invitation from a most surprising source. LEO (July 23 to August 22) Mixed signals could create a few stressful moments for the Lion. But by midweek, explanations should help ease the ten- sion. The weekend is party time! Share it with someone special. VIRGO (August 23 to September 22) This is a good “catching up” week for finishing tasks, calling old friends and maybe reading that book you haven’t opened yet or renting that movie you wanted to see again. LIBRA (September 23 to October 22) Money matters should be worked out, even if it takes time away from a more romantic situation. Better to settle things before feelings turn hard and angry on all sides. SCORPIO (October 23 to November 21) A job-related problem could turn out to be less troublesome than it seemed at first. Just a few moments of talk ‘twixt the parties resolves every- thing to everyone’s satisfaction. SAGITTARIUS (November 22 to December 21) The Sagittarian Archer takes aim at health and fitness issues this week. Watch your diet, and try to put more exercise time into your typi- cally busy schedule. CAPRICORN (December 22 to January 19) As you continue to focus on a career or job change, it’s a good time to look over some of your rarely used skills and see where they can fit into your future workplace plans. AQUARIUS (January 20 to February 18) A loved one’s health might be worrisome, but there’s good news by midweek. Expect people who share your ideas and your goals to try to contact you by the week’s end. PISCES (February 19 to March 20) A colleague’s request that makes the typically perceptive Pisces feel uncom- fortable is a request you probably will want to turn down. The weekend favors family get-togethers. Siuslaw N ews ! AD IT DAY E R TO www. the siuslawnews.com E -E DITION • S PORTS • T OP S TORIES • O BITUARIES • W EATHER • F ORUMS • B LOGS