04 Julai 2010

FIBROMYALGIA


Fibromyalgia merupakan suatu masalah kesihatan yang tidak diketahui punca sebenarnya atau lebih tepat lagi, dianggap misteri. Masalah ini biasanya terjadi dan menyerang wanita, tidak kira sama ada muda atau dewasa. Mengikut kajian di internet, penyakit ini kebiasaannya didapati di negara-negara seperti Sweden, Amerika Syarikat dan sekitarnya. Di Malaysia, penyakit ini jarang ditemui atau dengan lebih tepat, tiada kes yang dilaporkan.


Ia boleh menyebabkan seseorang itu menjadi lesu, sakit pada hampir seluruh otot badan selain mengakibatkan penghidapnya berasa serba tidak kena atau menjadi gelisah. penyakit fibromyalgia akan menyebabkan sakit, tegang dan bengkak pada bahagian otot, tendon dan sendi, sekali gus menjejaskan keupayaan bekerja atau untuk melakukan aktiviti harian.


Sesetengah pakar perubatan berpendapat fibromyalgia kemungkinan disebabkan penghidapnya mempunyai sel saraf terlalu sensitif dan bahan kimia dalam otak (neurotransmitter) keluar daripada keseimbangan atau berkaitan dengan masalah dengan fasa dalam tidur tetapi tiada fakta yang boleh menyokongnya, sekali gus menyebabkan ia menjadi sungguh `unik'.


Berikutan keunikan fibromyalgia itu, sekumpulan pakar dari seluruh Asia Tenggara cuba menjalankan kaji selidik mengenai penyakit berkenaan menerusi program Kaji Selidik Kesedaran, Kebimbangan dan Gaya Fibromyalgia Asia Tenggara (S.E Asia FACTS) yang diketuai Presiden Persatuan Pengajian Kesakitan Kronik Thailand, Prof Bersekutu Pradit Prateepavanich. Kaji selidik itu mendapat sokongan Pfizer Inc dan segala datanya dikumpul selama sebulan sejak Jun lalu dibentangkan kepada media dari Malaysia, Indonesia dan Thailand di Bangkok, Thailand, baru-baru ini. Kaji selidik itu dibentangkan sendiri oleh Prof Pradit dan Ketua Kawalan Kesakitan Klinik Makati di Pusat Perubatan Makati, Filipina, Dr Henry Lu.


Kaji selidik berkenaan membabitkan 506 responden awam dan 941 doktor di lima negara Asia Tenggara iaitu Thailand, Singapura, Filipina, Malaysia dan Indonesia. Hasilnya menunjukkan bahawa fibromyalgia kurang difahami sama ada oleh responden awam atau doktor sendiri hingga menyebabkan pesakit terpaksa menunggu antara tiga hingga empat bulan untuk diagnosis.


Kaji selidik juga mendedahkan pesakit yang mempunyai pengalaman fibromyalgia akan mengalami konsekuensi kewangan yang serius kerana tidak mampu bekerja hingga menyebabkan hidup mereka semakin tertekan. fibromyalgia disifatkan sebagai sesuatu yang umum tetapi ia kronik, tersebar luas dan sudah mempengaruhi 40 juta orang di seluruh dunia. Data saintifik menyokong konsep `neuron hiper-sifat dapat dirangsang di bahagian pemprosesan dan emosional dalam otak' dan ini menjelaskan kenapa pesakit fibromyalgia lebih peka terhadap rasa sakit, sakit lebih teruk daripada orang lain, pesakit miskin yang sangat respons terhadap tekanan.


Fibromyalgia biasanya disertai kurang tidur, simpulan dan kelelahan. Perempuan lebih senang mengalaminya berbanding lelaki dengan nisbah 9:1. Secara umumnya, kesakitan akibat fibromyalgia selalunya bermula daripada otot dan boleh berlaku pada dua bahagian tubuh sama ada di bawah atau atas paras pinggang yang menjejaskan leher, punggung, bahu, lengan, bahagian atas badan dan dada. Simptom fibromyalgia juga berbeza bagi setiap penghidapnya iaitu hampir 90 peratus pesakitnya akan berasa keletihan yang keterlaluan yang dikaitkan dengan pola tidur yang luar biasa disebabkan tidak mendapat kualiti tidur yang cukup kerana biasanya akan kerap terjaga daripada tidur dan sukar melelapkan mata kerana sakit otot. pesakit fibromyalgia juga biasanya akan mengalami gangguan emosi yang boleh dilihat menerusi masalah seperti kurang tumpuan, mudah lupa, perasaan mudah berubah-ubah, tertekan dan kerisauan.


Disebabkan punca fibromyalgia tidak diketahui, tiada satu rawatan khusus untuk membantu melegakan simptom berkenaan. Oleh itu, perbincangan dengan doktor membantu memastikan rawatan terbaik tetapi biasanya akan mengambil pil atau ubat melegakan otot serta senaman terapi yang dikenal pasti juga boleh membantu.

FIBROMYALGIA


What is the fibromyalgia?


Fibromyalgia (new lat., fibro-, fibrous tissues, Gk. myo-, muscle, Gk. algos-, pain, meaning muscle and connective tissue pain; also referred to as FM or FMS) is a medical disorder characterized by chronic widespread pain and allodynia, a heightened and painful response to pressure. Fibromyalgia symptoms are not restricted to pain, leading to the use of the alternative term fibromyalgia syndrome for the condition. Other core symptoms include debilitating fatigue, sleep disturbance, and joint stiffness. Some patients may also report difficulty with swallowing, bowel and bladder abnormalities, numbness and tingling, and cognitive dysfunction. Fibromyalgia is frequently comorbid with psychiatric conditions such as depression and anxiety and stress-related disorders such as posttraumatic stress disorder. Not all people with fibromyalgia experience all associated symptoms. Fibromyalgia is estimated to affect 2-4% of the population, with a female to male incidence ratio of approximately 9:1.

Fibromyalgia is considered a controversial diagnosis, lacking scientific consensus as to its cause. Many members of the medical community do not consider fibromyalgia a disease because of a lack of abnormalities on physical examination and the absence of objective diagnostic tests.

While historically considered either a musculoskeletal disease or neuropsychiatric condition, evidence from research conducted in the last three decades has revealed abnormalities within the central nervous system affecting brain regions that may be linked both to clinical symptoms and research phenomena. These studies show a correlation, but not causation. Some research suggests that alterations in the central nervous system might be the result of childhood stress, or prolonged or severe stress. Although there is as yet no cure for fibromyalgia, some treatments have been demonstrated by controlled clinical trials to be effective in reducing symptoms, including medications, behavioral interventions, patient education, and exercise.


Signs and symptoms


The defining symptoms of fibromyalgia are chronic, widespread pain, fatigue, and heightened pain in response to pressure (allodynia). Other symptoms may include tingling of the skin, prolonged muscle spasms, weakness in the limbs, nerve pain, functional bowel disturbances, and chronic sleep disturbances.

Many patients experience cognitive dysfunction[6] (known as "brain fog" or "fibrofog"), which may be characterized by impaired concentration, problems with short and long-term memory, short-term memory consolidation, impaired speed of performance, inability to multi-task, cognitive overload, and diminished attention span. Fibromyalgia is often associated with anxiety, and depressive symptoms.

Other symptoms often attributed to fibromyalgia that may possibly be due to a comorbid disorder include myofascial pain syndrome, also referred to as chronic myofascial pain, diffuse non-dermatomal paresthesias, functional bowel disturbances and irritable bowel syndrome (possibly linked to lower levels of ghrelin), genitourinary symptoms and interstitial cystitis, dermatological disorders, headaches, myoclonic twitches, and symptomatic hypoglycemia. Although fibromyalgia is classified based on the presence of chronic widespread pain, pain may also be localized in areas such as the shoulders, neck, low back, hips, or other areas. Many sufferers also experience varying degrees of facial pain and have high rates of comorbid temporomandibular joint disorder. 20-30% of patients with rheumatoid arthritis and systemic lupus erythematosus may also have fibromyalgia.

An epidemiology study consisting of an internet-based survey of 2,596 people with fibromyalgia reported that the most frequently cited factors perceived to worsen fibromyalgia symptoms were emotional distress (83%), weather changes (80%), sleeping problems (79%), strenuous activity (70%), mental stress (68%), worrying (60%), car travel (57%), family conflicts (52%), physical injuries (50%) and physical inactivity (50%). Other factors included infections, allergies, lack of emotional support, perfectionism, side effects of medications, and chemical exposures.