Fix the Brain, Not the Body

I went to the rheumatologist today to do three things: 1) get set up with a new doctor, 2) talk about adjusting my main medication, and 3) ask about the current knowledge regarding fibromyalgia.

I like this doctor. He asked a lot of probing questions, such as "if you think you are having problems with mental acuity, why are you here rather than seeing a neurologist" and "who told you that the gabapentin might be causing such a problem." I figured these were good questions because firstly, I never even considered seeing a neurologist because the lack of mental acuity has gone on for so long (although it seems to have been getting worse, but then the last few years have been extra stressful) and I haven't seen any other odd neurological signs. At least none that I'd peg as such.

As for the second question, I told him that it had been suggested by friends who are or have been on gabapentin and found that this is a possible side effect. it has also been suggested by mental healthcare providers, too.

He was curious about everything dealing with my health, including my mental health. And then he gave me great insight into his interest in my mental health (and I really should have made this cognitive leap). The current understanding is that fibro is not a body problem at all: it's a brain problem. Specifically, it's a brain chemistry problem. And that is the center of the entire fibromyalgia universe.

It's why all the currently approved meds for fibro are brain-related rather than body-related: gabapentin, and its cousin Lyrica, are originally anti-seizure meds; Cymbalta and its cousin Effexor are anti-depressants that are both serotonin and norepinephrin re-uptake inhibitors; and a final medicine that I didn't get written down in time so I've forgotten the name, is also an anti-depressant. Doctors are trying to regulate fibro and its symptoms by manipulating brain chemistry. it makes sense.

I knew already about how fibro was considered a neurological disorder rather than a joint/muscle disease, and that gabapentin was an anti-seizure medicine. The point of using it is to quiet the brain impulses or transmitters or whatever is going wonky (yes, it's a technical term; why do you ask?) in the brain.


But I just hadn't made the jump from that knowledge to the concept that this information means fibro is a brain disorder and that's WHY anti-seizure and anti-depressant medications are being used to treat it.

I also hadn't made the leap as to why exercise is so important to folks who suffer from fibro. I've been more than sedentary since Mom died — I've been virtually motionless. I gave the doctor my recent history and he did two things. He set me on a program to reduce the amount of gabapentin i am taking by half, and he asked me to commit to doing 15 minutes of exercise each day, whether it's walking, going on the treadmill, or using the stationary bike. I'm to exercise hard enough to get my heart rate up for that 15 minutes, not to strengthen my body or lose weight, but to make the endorphins kick in! The point of exercise for fibro patients is to change the brain chemistry, even if only temporarily.

I don't know a lot about exercise and how long endorphins last and whether or not the endorphins eventually build up or have some other long-term effect on the brain. I didn't have the time or the mental clarity to ask the doctor. But it seems to me that even regular, continued positive brain chemistry changes — however small — must have a significant effect on the fibro brain.

The exercise has nothing to do with the body and everything to do with the brain. As someone who lives far more in my mind than in my body, this makes a world of difference. I can totally get behind making changes to my brain chemistry in a way that I am much less motivated to do "just" for my body. (Yeah, something else to work on in therapy. Eventually.)

And having greater motivation is key. I want to do this 15 minutes of exercise to fix my brain. Fixing my brain is why I go to therapy and why I take meds in the first place. So maybe taking the meds won't fix my brain permanently and only have an effect while I continue to take them (because I apparently have broken brain chemistry), but at least they work while I take them. And while I won't take something like Rogaine or Botox or whatever to relieve wrinkles only while taking the drug, I will do something similar for my brain. Because my brain is supremely important to me, which is why I went to the rheumatologist, because my brain is more broken than usual and has been for some time.

I thought I had no choice but to accept that my brain was no longer functioning as well as it used to, that I was less intelligent than I used to be. Now I have hope that not only might I gain greater mental clarity once again, but that i might also loosen and decrease fibro's hold on me. Going to see a new doctor? Twenty percent of the final bill. Regaining my brain function and chemistry? Priceless!

Do you have fibromyalgia? Did you know about this information regarding brain chemistry, fibro, and exercise? Does this knowledge motivate you to exercise even a little amount, and if so does it motivate you more than, less than, or the same as the idea of exercising for your body's needs?