If it's a hormonal imbalance, it's one I like.  FMS is far from the only chronic musculoskeletal or autoimmune condition I have (too many to list & I'm tired of listing them), but since I was diagnosed with that one, I've lost a lot of weight. 

I was never a single-digit size despite being a "picky eater"; went right from the "chubby" dept (can you imagine the lawsuits for such a label damaging kiddie self-esteem nowadays?) to a size 11; genetically cursed (thanks, Gran) with a DDD bosom; always more cerebral than athletic especially after I developed boobs (they bounce painfully, not conducive for horseback riding, tennis, biking, or ice skating in pre-spandex days); never lost the weight I further gained from pregnancies; even tho I worked a physically demanding job & rarely got to sit down & stop moving, I was at 5'5" & 262 lbs at FMS diagnosis.  I was so fed up with hearing from drs regarding other conditions that if I would just lose weight.... 

Yes, because fat is the root of all evil.  I think this one dr (let's call him  Dr Dick) was actually disappointed when his battery of fat tests didn't give him anything else on which to pontificate like the jerk he was (& probably still is).  I've lost track of how many times I've had my thyroid tested (negative) because surely no one could be that fat without a medical reason; endured a revolting glucose tolerance test (negative) because surely I must be a sugar coma waiting to happen; run on a treadmill like a gerbil (A-OK) because surely that chest pain (costochondritis) indicated I was a heart attack waiting to happen; scrubbed electrode gunk out of my hair from an EEG (A-OK) because surely with all that head & facial pain (TMJ, periodontal disease, deviated septum, sinus headaches, migraines) I must be a stroke waiting to happen; had Dopplers done because surely that pain & swelling in my legs I kept complaining about meant I was hardened arteries waiting to happen (that one was actually helpful, because it discovered I was born with incompetent valves in my veins, but it wasn't a brainfart of Dr Dick, who by then just rolled his eyes at me & told me to avoid salt & lose weight because he decided to diagnose me with edema primary to obesity & secondary to standing at work, without any testing at all); galloping up & down office hallways with a lead on my finger to calculate activity oxygen saturation rates (96%, nobody's perfect) because surely with being fat AND being stupid enough to smoke I must be a case of COPD waiting to happen....any test that stereotyped one into a disease "caused by fat" with a dash of cigarette smoke tossed in, I've had it.

I'm going to live to be 100....in chronic pain from all the non-life-threatening things, unfortunately.  And that thing where the drs tell you if you just lost weight everything would be wonderful?  It's a lie.  Because when you do it....I initially lost 72 lbs....either they don't even notice like Dr Dick & continue to harp on your "morbidly obese status", or they change their tune.  O well, the joint damage was already done, it can't be reversed.  Really.  Then why did you suggest a weight loss regimen?  Or worse....it's not "enough".  I think 72 lbs is pretty amazing, what's your defintion of "enough"?  You're still considered "obese".  But I'm 72 lbs less obese, no gold star?  How is that sort of reaction any motivation? 

The "high end" of the 5'5" chart is 138 lbs.  So that means at 10% more than that or 151.8 lbs, I'm "overweight".  Still doesn't seem like a Goodyear blimp to me, especially at my age & with my limited mobility & exercise capacity.  At 17% over that 138, I'm "obese".  I suck at fractions so I'm going to guesstimate that weight to be 160.1 lbs.  That's.  Not.  Obese.  Sorry.  Doc.  The old charts had the 5'5" range falling between 125-165 lbs.  That used to be "normal".  How is it now an "obesity epidemic"?  A manufactured one, perhaps?  Because a size 2 is not "normal"!  It's eat a sandwich, honey, you're a stick.  Here, have a donut.  Get some curves that aren't silicone (do those weigh less than real boobs?).

Do you believe they have fiddled with those weight & height charts so much that they expect a female of my height to seriously weigh 115-138 lbs?  Do I look like some anorexic 20 yr old on TV?  I'm 53 & saddled with DDD cups, that 190 lbs was as good as it's probably going to get.  I haven't seen 115 since I zoomed thru puberty & got a tight sweater for my efforts at the tender age of 11.  Do they really think a post-menopausal woman in her 50s is seriously going to be a size 2/4?  That size didn't exist when I was a teenager, let alone that size 0 nonsense.  Womens' sizes began at 5/6 & anyone who was skinnier than that was mocked for having to shop in the girls' dept.  Now they think any double-digit size is fat.  Size 10 used to be "the ideal".  What happened to that?

So I get diagnosed with FMS & drop 72 lbs.  Part of that was simply due to meds.  You "forget" to eat.  If someone had told me I'd "forget" to eat 10 yrs ago I would've laughed incredulously.  But it's true.  You don't get the "I'm hungry" signal until sudddenly you're starving & you need to eat now, so you just grab something with immediate gratification.  You also feel like cooking is a huge draining effort....it involves a lot of standing & bending & lifting & cutting & stirring & washing dishes after, too exhausting an endeavor to contemplate....so it's easier to just eat a couple of Nutri-Grain bars.  That was a whole 190 calories ingested. 

I'm constantly throwing out stale & rotted food from the fridge.  I think I want it when I'm at the supermarket, but most times once I get it home it's too daunting to deal with all that washing & chopping that goes into making a salad, or slicing those strawberries you think you're going to put on those Belgian waffles you're not going to make because cleaning that up is a pain, or 6 mos later you throw out that freezer-burned haddock or turkey breast because you didn't feel like lifting & bending to use the oven....convenience food.  Lean Cusine.  4 min nuked & I have ravioli.  And it's only 240 calories. 

Fatigue=weight loss for me.  The most caloric ingestion I get is having a rare pizza delivered or going thru the drive thru for a Whopper Jr & onion rings off the value menu.  I'm to the point where paper plates & plastic silverware & drinking water or juice or Diet Pepsi right from the bottle works for me.  It makes for more trash to haul to the dumpster (which I don't understand why my supposed "disabled-friendly building" would even do that), but I can use my trusty cart for that.  At least I don't have to stand at the sink & wash dishes (no dishwasher for the "disabled-friendly" premises, either).  Conserves a tad of energy for the life-force-draining triple trek (once for washer, once for dryer, once to fetch) to the inconveniently located laundry rm (face it, you're just exaggerating when you call this "disabled-friendly" & can they really get such a rating merely for having bathroom grab bars & an I've fallen & can't get up pull cord?).

Then pain management decided I must be severely clincally depressed because I've lost 72 lbs & don't care if I eat.  Off to the shrink we go in the gesture of appeasement.  I've learned to just smile & nod at drs & do whatever the hell they want me to do, otherwise it may not work out how I want it to work out. 

God forbid one of the bastards starts labeling you as a "difficult patient" because that just gives SSD the chance to say you have zero credibility on your claim as you didn't follow Dr Dick's orders to a T.  Clearly you must be "exaggerating" the extent of your pain if you didn't do X, Y, or Z when he told you to jump thru this stupid hoop.  Dr knows best & if he wants to send you to PT for the exact same problem 10x, by God, you better do it & not say it didn't work the other 9x you sent me, I'm not doing it again, that's the definition of insanity.  4+ yrs of that SSD crap & still spinning my wheels due to one dr's remarks.  Judge even said it was due to that.  I am totally 100% disabled according to SSD criteria & he would've given it to me....save for the fact that Dr Dick dissented & impugned my "credibility" was along the lines of the wording. 

Basically I'm really good at faking it & I pulled the wool over the eyes of, let's see, pain management, rheumatologist, chiropractor, PT, spine specialist, pulmonary/sleep disorders specialist, psychiatrist, residual functional capacity study guy who determined I could maybe work 3 hrs/day with many restrictions & accommodations which sadly does not equal SSDs substantial gain, I've got MRIs & CT scans & EMGs that clearly display my visible conditions (FMS being invsible), but luckily Dr Dick saw thru my whiny drama queen exaggerations & my salivation for controlled substances I don't really need!  Therefore it's not that bad, claim denied.  Just a caution, tho, I shouldn't be allowed to work with the public (which eliminated every single job I've ever had) because I'm quite clearly insane, but I could be handed a really sharp knife & sit quietly in a corner & chop lettuce 8 hrs/day.  Or maybe sit in a corner & pack boxes.  Have a nice minimum wage life making those repetitive movements in between screaming in pain from the neuropathy.  (I mean, isn't that the career goal of everyone with a master's degree?  I think they "recommend" that sort of "vocational" nonsense just to slap your uppity over-educated ass down to size.)

So the shrink decides I'm now bipolar.  Hmmm.  Don't you think in 50 yrs someone would've noticed that?  SSD finds this suspicious because the shrink had a 6-mo wait list & diagnosed this 3 wks before the hearing, so they dismiss it out of hand & go with their own notion of "adjustment disorder".  I don't know what they think I'm not adjusted to because I've never had any significant emotional traumas, but you can't argue with the speed of stupid. 

I get an evil bipolar med that promptly makes me gain back 25 lbs in 3 mos.  I return the "free sample sack" with the remainder & become a difficult patient again.  I am not taking a med that is going to make drs frown at me for gaining weight.  It took over a yr to get that off & get back to where I was, which was still considered fat.  Because of that incident I can't make myself purge out the fat clothes.  I just know someday I'll get some med that will force me back into those now-saggy pants. 

The next sack of bipolar fun never makes it into my mouth & also gets returned.  They think I'm crazy in a bad way now, because there were big bold letters at the start of the side effects regarding potential to cause cardiac issues.  I'm using that organ, thank you, & it's working just fine, not a valid trade-off for not getting fat, & my father is an absolute cardiac nightmare so who knows what lurks in ye olde gene pool? 

Just give me some Cymbalta.  That's good for FMS & depression.  Problem solved.  Concerned face, but we have to stabilize your moods.  What moods?  I have one mood, it's the speed of bitch, & you're on it.  I don't get the "mood" thing.  Did you observe me for an extended period?  Did you even have me fill out some psychological checklist?  No.  You had a 5 min convo & decided I was bipolar & not depressed, because evidently you have superpowers like that.  Difficult patient syndrome is what I have because I'm sick of all you medical folks not being able to cure what ails me, insisting I have nothing that needs curing, or making gross misdiagnoses based on who knows what.

Cymbalta was incredibly helpful as far as FMS muscle pain went, but it ended up a bust.  It didn't make me fat or give me a heart attack, but it was headed toward the latter as it made my BP really high.  In fact, I had to go to an SSD command performance eval thing & this woman freaked & wanted to trundle me off in an ambulance & thought I was nuts for calmly saying, yes, my drs & I all know it's high, we're doing process of elimination with meds at the moment to see which is causing it.  She spoke to me like I was an idiot incapable of comprehension, insisting I was on the verge of a stroke & needed to go to the ER right this minute.  And miss the rest of this appt & have to wait another 3 mos while you SSD people reschedule?  No.  She called my (new) primary & squawked up a storm, & when they were equally unimpressed with her state of panic, she made me sign a piece of paper stating SSD had no liability if I exploded from high BP because I refused to go to the hospital.  It likely got higher from holding in the explosive laughter.  Talk about crazy.

Shrink only shrunk heads & dispensed meds & didn't offer counseling, but insisted I should have some.  I'm so moody & difficult, you know.  The place to which they directed me would only send stuff to SSD if I was seeing their resident shrink.  Ta-ta, Dr I Think You're Bipolar. 

New shrink initially said I wasn't, just overwhelmed with chronic pain, illness, & stress.  For this he went to med school.  Counselor is about 12 & just has no clue.  Counseling to me is not popping in once a mo with an update on the trials & tribulations of my life while he types furiously to get it all down & tries to make the appropriate sympathetic noises.  I'm thinking it ought to be more than a let's pretend we're bestest friends catching up visit, but what do I know. 

At 2nd visit, shrink backpedals some & decides I'm "a little bipolar".  I had to bite tongue to stop from inquiring if that was like being a little pregnant.  Either you are or you aren't.  Make up your mind.  He decides the Keppra I'm on for the screaming burning nerve pain is a good med for mood & I don't need another one.  Who knew Keppra was so versatile.

That may change as I'm now getting the waking up in the middle of the night screaming burning nerve pain in the leg again.  The cuteaneous (sp?) nerve is really inflamed because my skin is hot, centered on my hip socket & going up into my backside & down my thigh.  I was hobbling like an elderly Chinese woman with bound & deformed feet when it finally passed after 20 min of paralyzing agony.  I cheated & knocked back a naproxen along with the Prilosec. 

I'm not supposed to take naproxen because it's been giving me the gurgly esophageal thing with the occasional upwash of bile, also not a pleasant way to awaken but much nicer than excruciating on fire awakening when compared.  I figure inflammation calls for an anti-inflammatory & will it kill me if I'm also on Prilosec?  Nerve pain v death....I'll take the latter risk. 

Nerve pain has no number on the 1-10 scale, it's so beyond that.  It's like being immolated from within.  If you dare move a centimeter it will dramatically increase.  You just have to lie there & scream until it passes.  My neighbors never seem to notice.  If someone came in with a chainsaw & offered to cut that leg off, I'd say OK.  Sever that nerve.  Anything to make it stop.  And there's nothing to make it stop. 

So I'm guessing I'm done with Keppra as I'm already at the max dose of 3000mg/day & this is not just breakthru smarting tingling, it's full-blown nerve attack like I had before I was on Keppra.  I'm also on Neurontin to supposedly prevent breakthru.  It's still tingling & burning like crazy.  Now I'm afraid to sleep.  One or both of them is going.  I so do not want to adjust to a new med for my birthday!  As that just happens to be when my scrips fall due for refills (save for the must be controlled substance on which no refills must ever be given, thanks so much, Tricky Dick, for inventing the DEA).

The nerve damage isn't from FMS, but from the spinal issues Dr Dick & SSD says I "exaggerate".  It's a pity I don't have one of these attacks when they're around.  All they'd have to do is touch it & feel the heat & the twitching.  You can't fake inflammation. 

I guess pain management is the one to call on this because they're the ones who dispense the Keppra & Neurontin.  I hate dealing with her staff.  One woman is ancient & painted up like a dime-store dolly, must be a relative on job welfare because she never knows anything & always has to ask someone else.  One has a thick Eastern European accent that's hard to understand over the phone.  One sounds like a cartoon character & is as brain-dead as the old woman.  The last one is a young guy, also brain-dead.  The accent girl is the only one with a clue & she can't express it well.  O joy.

They're the reason I'm now on methadone 10mg.  It's been 6 mos & it's not getting any better as far as either pain management or lifting the brain fog it induces.  I was on 60mg Kadian but back in July I went to fill my scrips & I didn't have them.  They always go into the same compartment of my organizer purse.  Always.  But I never get them in my hand until I'm leaving.  The doctor gives them to staff with my file.  They put them on the copier glass, push the button, & then turn back to the computer to schedule my next appt.  Sometimes they forget to take them off the glass.  Then they look at me quizzically & go, was there something else you needed? when I don't takem y appt card & go away.  Yes, scrips would be nice, thanks.  O!  The light bulb goes on.  Twice they've chased me out into the parking lot waving them because I've forgotten.  So I think the June visit was one of those occasions when we both forgot & someone has done this once too often & decided to play CYA.  I've never "lost" a scrip in my life.

But the "rule" is, if a scrip is "lost", then not only do you pee in the cup for 3 visits straight, you don't get back the same med you had....ever.  So I may never have any kind of morphine again, no matter what!  And as a bonus, you are punished by going thru unassisted, unsupervised morphine withdrawal at the same time as enduring the aforementioned screaming nerve pain. 

It wasn't just the Kadian scrip that vanished, but the Keppra & Neurontin & naproxen & even the stool softener.  I'm thinking zero street value on those.  Why the hell do they have to treat you like a criminal for this?  I know I didn't lose those scrips.  They go in that compartment & they don't come out until I park at the pharmacy.  That is the official scrip compartment.  Nothing else goes in there & I therefore have no other reason to go in there. 

And the staff lied to the dr regarding my panicked call, because when I finally was permitted to crawl in to see her, she thought it was "just" the Kadian that went missing.  Like who the hell would peddle their morphine when they need it?  To this day she keeps asking me if I "found" those scrips because I have to return them to her "if" I do even tho they've all been invalidated.  I'm not going to find them.  I never had them.  Someone put them thru the shredder to play CYA & I paid dearly for it.  Plus now I am on a med that is not working as well and makes me zombiefied.

I thought at 1st it was just normal adjustment coupled with the huge shock to my system spiraling me into an enormous flare.  I did lose another 5 lbs going thru withdrawal because my rule is I don't eat when I have uncontrollable diarrhea.  Doesn't matter, still fat at 185.  Then 2 mos later I took a bad fall & destroyed my cane.  This methodone crap makes me suddenly off-balance.  So that was more big-time flare.  6 wks after that I took another one.  This is what comes of having clothes that are too big coupled with a L foot that slightly turns in when you walk.  Step on pants leg, boom.  So more flare.  It was like the yr of neverending flare last yr as I also have enormous stress from constant car expenses & being at the federal level of my SSD appeal & it's not going well, they denied my brief for dispositive relief.  Last wk I had to have 3 teeth out & my bridge repaired because a tooth cracked off that as well, but that's the only issue I've had since the last fall in Nov. 

After 6 mos, even crediting the withdrawal shock & the 2 falls & all the flaring, I should be adjusted to methadone by now, right?  It is tamping down the lumbar pain.  But it's doing nothing for the extremities & the neck as far as I can tell.  My shoulders ache (recent rotator cuff issue R side, likely bursitis in both, FMS), my elbows ache (recent tendonitis in R, ulnar radiculopathy in L, FMS), my hands ache (garden-variety arthritis for last 20 yrs, carpal tunnel syndrome, FMS), my legs ache (incompetent valves L, fell on R hip 1st time, both knees 2nd time, referred back pain, tarsal tunnel syndrome, cuteaneous nerve damage, FMS) so bad that they keep waking me up, even if it's not aflame.  Rheumy gave me a cortisone shot in hip in June & again in Dec.  Was helpful until the burning times came by for their return engagement. 

It hurts so much to walk I don't even want to leave my apt.  I don't even remember the last time I checked the mail.  Even tho I was out 2x last wk for the dentist, both times my cart was full to overflowing & didn't have a free hand; if I'd let go, stuff would've fallen out (mostly groceries as I hadn't really been shopping since mid-Dec, & yes, I bought new underwear & new pajamas so I could put off laundry for another wk).  The day I went for the impressions I was practically flat on my face from the pharmacy's stupidity that took all afternoon.  I had a Collapse Day in between dental appts.  Then I was dragging exhausted the day I had the extractions.  I made too many stops on the way home.  3.  One to pump gas, one to get groceries, one to clothing store where I have CC.  The last one was the killer.  I can't shop in stores that don't have carts to lean on, tho I keep trying.

I think methadone is worse than morphine in both constipation (yuck) & in not eating.  I'm literally making myself toxic because I have no "urge" to evacuate & even with the stool softener all I get is a lot of gas.  If it goes more than a wk I get sick, cold sweat that smells odd & not like sweat at all, shivering, weak, increased muscle pain, stomach cramps, do nothing but crap my brains out several times a day for 1-3 days to get rid of it, then I don't go for another long period.  I dread it. 

I do get in a lot of liquids as I always have a dry mouth so I constantly have something at hand to sip.  I was on soup & yogurt all last wk due to the dental issues & thought for sure I was in for it shortly, but nothing.  I'm mildly lactose-intolerant & when I was on Kadian I'd just have something dairy to make myself go, but that doesn't seem to apply on methadone. 

I'm terrified to ask for a laxative because the very 1st time I tried Miralax, I had a bizarre spasm of the rectal muscle (levator?) that holds stuff in & was rendered incontinent for 3 wks (puke).  Plus that spasm was excruciatingly painful & would not quit until I had a pelvic CT scan with barium, came home, & spent 3 screaming hrs on the toilet getting rid of stuff that was probably spackled to my colon since I was 5.  At least that removed the next step, that of the long scope, gut dr said since it stopped I didn't need it. 

And I just don't eat much.  It comes in spurts of grazing one day & nothing the next.  My stomach has to start growling up under my ribcage before I even remember I haven't eaten.  Yet you tell me how I've managed to gain 10 lbs!  I should weigh myself right after the next round of endless pooping & see if it's 10 lbs' worth coming out.  I did do a packet of steroids after the 1st fall.

So I don't know if I got lucky as far as metabolism after the FMS diagnosis, or if it's this assortment of meds making me forget to eat.  Today I had 2 sliders & grazed about halfa bag of Bugles.  I figure that's 3 food groups.  I put a dab of ketchup on the sliders & the Bugles are made of corn, aren't they?

I only know one other person with FMS & she's much bigger than I ever was.  But she also has RA.  And another person I know with RA is skinny as a stick & forgets to eat, too.  It must just be a capshoot which way you go weight-wise.