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Re: Thesis re: Pain Perception in Fibromyalgia pts. with hx of EndoFrom: Jaynie St. Pierre, RN,BSN,FNP Graduate Student (stpierj@bellsouth.net)Tue Jan 9 20:14:53 2001
Dear Dr. Chudacoff, Hello, my name is Jaynie St.Pierre, RN, BSN. I am a pain management specialist pursuing my masters and FNP degree. I have published on FMS in McCaffery & Pasero's nursing textbook, Pain: Clinical Manual. and the American Journal of Nursing's Pain Control column. I've worked extensively with acute, chronic-nonmalignant, and cancer pain for years, = and have decided to do my thesis 0n the pain perception of FMS patients = with a hx of endometriosis vs. FMS patients without Endo. An alternative motive is to see how many Endo patients I can find that have developed FMS. My interest in this area is not only professional, but also personal. I suffered from debilitating Endo from an early onset menarche until my TAH, at the age of 26,in 1979. God blessed me with two beautiful children, now 20 and 18 yrs. old. I also took Danocrine for several long periods b/n a total of 4 pelvic laps and more laparoscopies = than I'd like to remember. I never took Lupron. It has been proposed that most of the dysfunctional physical syndromes associated with my FMS = started in my early teens, such as interstitial cystitis, IBS, costachondritis, and migraines. I also had very lengthy & complicated bouts with glomerulonephritis, in 1960, and mononucleosis during high school. During the last 29 years, SLE and MS have been highly suspected, but recently have been even more suspected due to numerous falls, ankle = clonus, and a foot drop on the same side that was more extensively involved with the endo. Also, that characteristic "Endo backache" never = went completely away. A gastroenterologist had to keep me off estrogen for three years after the TAH to finally starve out the Endo. I feel that the years of uncontrollable, chronic pain stimulus from the Endo, and the subsequent over-secretion of excitatory pain neurotransmitters damaged my PNS. The theories of neuropathic pain syndromes, such as the relationship b/n nerve damage and chronic pain states and RSDS, have special meaning to me. I have dedicated my nursing career to helping others in physical and emotional pain, and I'm also a certified instructor for the Arthritis Foundation's Fibromyalgia Self-Help Course. There should be an Endo self-help course! I was not physically well enough to pursue an M.D. degree, something I truly wanted. However, God has has a hand in leading me in the direction that I am pursuing. I hope to practice with a rheumatologist after graduation. I would greatly appreciate any research leads that you could give me regarding this subject, as I know my review of the literature wil be quite a challenge. I want to do this study because I managed an acute pain management program for a group of anesthesiologists for five years. = It was during my pre-op teaching and assessment visits with post-op epidural analgesia patients, that I noticed how many patients with Endo = had FMS, and vice versa. It was astonishing to find how many mothers and their daughters suffered from both disorders, and one or more of the related syndromes. I also became to believe Endo and FMS are intimately = connected, both behaving as autoimmune disorders. My OBGYN and I have worked together numerous times in pain managemnt since my last surgery 22 yrs ago. When I was finally diagnosed with FMS in 1994, he couldn't = quite buy the fact that the Endo & FMS were related, but he has seen the = problems that have occurred through the years, and I bet he's seen the connection in many other patients. If you have read this lengthy note, I thank you. I don't have much time left to accomplish my goals, as I can only physically tolerate the = rigors of part-time Hospice nursing and graduate school with daily Deltasone, 5mg, with occasional boosters. This is another theory of FMS = that really doesn't quite fit the mold...if there is not supposedly any = inflammation involved with FMS, why do so many of us respond so well to = it? Is FMS not SLE, or an atypical form of it? Is Endo a precursor to FMS? It would be a miracle to find someone in the medical field that shares my thoughts. Thanks again & Warmest Regards, Jaynie
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