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Case Study - Fibromyalgia
Objectives
1. Explain the risk factors, symptoms, etiology, progression, diagnosis, treatment and prognosis.
2. Demonstrate the ability to access and critically evaluate information from a wide variety of sources (such as Library databases and internet sources).
Read the case presentation and answer the questions that follow. The Case Study Rubric will be used to assess your work. The Case Study rubric lists the criteria for each question (required resources, word counts and citation requirements).
Case Presentation
Rachel is a new patient at your family practice. She is a 38-year-old mother of four and a registered nurse. She quit working two years ago due to disabling pain. “If I told you about all of my aches and pains, you would think I was crazy,” she told the physician. “I have had a million tests for my pain, fatigue, bowel problems and numbness. I have difficulty remembering things and have restless sleep. Everything comes back normal and doctors tell me that I am stressed and just need to relax. I do not want to to talk about any of these problems. I am only here to get a prescription for my migraines.”
The physician could see that Rachel was frustrated with her previous care. She reviews her lab results obtained in the last 6 months ordered from Rachel’s last physician. Her complete blood count, chemistry screen, t hyroid-stimulating hormone (TSH), antinuclear antibody (ANA) and erythrocyte sedimentation rate (ESR) a re within normal limits. The physician performs a physical examination, palpating various points on her back, shoulders, upper and lower extremities. Rachel states these areas are very tender. The physician completes a widespread pain inde x (WPI) and a symptom severity
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scale (SSS). The physician explains to Rachel that she most likely has fibromyalgia based on the WPI, SSS, chronic symptoms and no other disorders to explain her symptoms. Rachel is relieved that she has a diagnoses and asks the physician if there is a cure.
Questions
1. Define the bold words. 2. Describe the cause of fibromyalgia. 3. Fibromyalgia is typically a disorder that is diagnosed because other conditions have been ruled out. Her previous physician ordered several labs, including TSH and ANA to rule out the autoimmune thyroid condition, Hashimoto’s disease. Compare the etiology, signs and symptoms, diagnosis and treatment for Hashimoto’s disease to fibromyalgia. 4. Rachel needs to be educated on the treatment for fibromyalgia. Explain the treatment using terms that Rachel can understand. At minimum this should include any at- home-care, over the counter medications, prescriptions (includes physical therapy, occupational therapy, counseling), alternative or complementary care. 5. Explain the prognosis of the disease to Rachel and preventative measures that can be taken to prevent her condition from worsening.