Fibromyalgia and Lyme Disease

running with lyme disease
Calling it quits early on a workout if it’s too hot outside is key to managing fibromyalgia, Lyme disease, and babesia. I’m not good at listening to my body. It’s definitely a learned skill.

“Do you still have fibromyalgia now that you have Lyme disease?” This is a question I get more often than I care to acknowledge. The intention behind the inquiry is often quite different from person to person. While I recognize the validity of the question, it bothers me. It’s in the best interest of chronically ill people to work together to support each other, and sometimes questioning, intentionally or not, can come across as a micro-aggression. Diagnoses of Fibromyalgia and Lyme disease often go hand in hand, and the answer to the question is more complicated than a simple yes. Here’s the short summary– getting diagnosed with Lyme disease did not erase my diagnosis of fibromyalgia. Things just make more sense now.

Which Came First?

Fibromyalgia is often diagnosed when nothing else seems to fit. I know because I’ve been down that road. Unexplained pain, sensitivities, exhaustion, fatigue– you name it, and chances are if a blood test rules out (or misses) other diagnoses, fibromyalgia comes into play. I’ve done a ton of reading lately and learned that many, many patients with late-diagnosed Lyme disease were diagnosed with fibromyalgia years before Lyme. This doesn’t mean that they don’t have fibromyalgia. It simply opens the door for a conversation about co-infections, cause and effect, chicken-and-egg theories, and, occasionally, clarity.

I’m not educated enough to form an opinion about whether Lyme disease is a cause of fibromyalgia. But I do know that they share a lot of commonalities. The overlaps, for me, are undeniable. Exaggerated pain responses, overactive nerves (especially in my right foot), crippling exhaustion, brain fog, fatigue…the list goes on and on.

I was first diagnosed with fibromyalgia as a young athlete who was living in otherwise unexplained misery. It’s worth noting that no one bothered to test me for Lyme disease or any other tick-borne infections until many years later. But does that change anything? For me, not really. Lyme disease can’t be carbon-dated. There’s no way to know if a Lyme infection was present in my body all those years ago when I was diagnosed with fibromyalgia. It’s possible that I got Lyme several years after fibromyalgia. It’s also possible that Lyme has been with me far longer than I can imagine.

Lifestyle Management

The main thing for me for both fibromyalgia and Lyme disease is lifestyle modification. Everything I eat, every action I take, every decision I make is colored by being someone with chronic illness. I eliminated gluten, dairy, most processed foods, refined sugar, and industrial seed oils from my diet a long time ago. The exception there is sugar, because sometimes exercise and exertion levels demand a quick shot of energy. But those times are quite rare for me. I made those dietary changes after I was diagnosed with fibromyalgia. All I had to do was tighten them up a little more once I talked with a Lyme specialist.

Exercise is a huge component in the management of chronic illness. I tend to err on the side of doing too much. That was certainly true long before Lyme disease was mentioned in my medical history. (Hell, this website is called Fibromyalgia Athlete for a reason.) The only way I’ve seriously modified my exercise since learning I have Lyme is to be much more careful when exercising in the heat. Babesia, a tick-borne parasite, came along for the ride with my Lyme infection. It’s largely responsible for my heat intolerance and electrolyte imbalance issues. Nowadays, I’m much more careful about spending time in the heat.

Insomnia

Sleep is a major deal for me, or, more accurately, insomnia is a major deal for me. I didn’t sleep more than a few hours a night for over a decade, most of those years falling under “the fibromyalgia years.” Insomnia is also extremely common in Lyme disease patients. So I either have a double dose of insomnia-inducing issues or one of them is the primary contributor. At this point, I don’t care which is the culprit.

Chronic illness, whether fibromyalgia or Lyme disease, will only get worse without adequate sleep. Addressing the problem rather than fixating on the possible cause is much more worth my time. In my case, for now, tweaking supplements has made a huge difference. I largely follow the Buhner Protocol and swear by Stephen Buhner’s book Healing Lyme. Good-quality hemp oil has also helped manage my chronic pain and overactive nerves. My favorite is Runners High Herbals. I’m still not sleeping enough, but for someone with longstanding fibromyalgia, Lyme disease, and babesia, I’m doing pretty damn good compared to how my sleep used to be.

Testing for Fibromyalgia and Lyme Disease

The biggest thing, I think, that really separates fibromyalgia from Lyme disease is the ability to diagnose with a blood test. The blood tests, especially those covered by insurance, are notoriously inaccurate from what I’ve read, but they do exist. As of my last reading and search, there’s no definitive blood test to diagnose fibromyalgia. The caveat there is, a lot of physcians understand that Lyme disease is every bit as much a clinical diagnosis as fibromyalgia is, and false negatives on blood tests can happen for lots of reasons.

My personal example of test failure is from my first babesia blood test. The doctor–someone I don’t use anymore–ordered a test that looked for antibodies. The Lyme specialist later explained to me that that test was pointless. Because with an IgM of 27, there was no way my body could’ve made enough antibodies to show up on the babesia test. His theory was immediatley proven correct when he started me on babesia meds and I felt and saw immediate results. Since there isn’t a blood test for fibromyalgia, I didn’t have to go through any ups and downs with false positives or negatives.

Every case of fibromyalgia and every case of Lyme disease is different. No disease process looks exactly the same from one person to another. I think it’s important, especially if fibromyalgia treatments aren’t working for you, that you get tested for Lyme disease if you think there’s a shadow of a chance you could have it. The thinking on Lyme varies greatly from doctor to doctor, but that’s also true of fibromyalgia.

Books

As with anything, keep looking until you find a practitioner who respects you and treats you as a person and not just a number. A good place to start for more reading about both fibromyalgia and Lyme disease is in books. Two of my favorites are Healing Lyme by Stephen Buhner and Why Can’t I Get Better by Richard Horowitz. Whether you have fibromyalgia or Lyme disease or both, the important thing is getting the help you need to live the life you want. Both fibromyalgia and Lyme disease can be lifelong journeys. Expanding your knowledge base and finding competent practitioners can go a long way toward a better life.

Social Distancing Grocery Shopping

social distancing grocery shopping
Social distancing grocery shopping produces some odd but tasty combinations. Pictured is a cannellini bean salad with carrots and celery and Italian spices.

Grocery shopping used to be a relatively enjoyable task, at least for me. I was social distancing way before it was a government order. Shopping at our local co-op was one of the few outings I allowed myself. I would spend half an hour or so looking over the organic produce, frozen vegetables, and prepared foods, hoping something I needed was on sale or at least offered at a decent price. After the spread of COVID-19, grocery shopping became a robotic task filled with fear and angst. By my third trip to the co-op (I’m going only once every 7-9 days), I finally got a system down that helps ease some of the anxiety I feel as an immune-compromised shopper.

An old-fashioned paper list is my new best friend. I was using Google Keep on my phone for grocery lists, but not now. I use scrap paper from the piles of junk mail we get and divide my list into sections. Produce, meat, bulk, frozen, canned, and refrigerated are my usual subheadings. Each subheading has its own corresponding list, which helps me get in and out of the store as quickly as possible. No more dawdling and no more browsing, but it’s worth it for a little peace of mind.

Sacrifices for the Sake of the Budget

I normally get my groceries from the co-op and a big-box store. I almost exclusively eat organic food (yes, my grocery bill is super high, but I also literally never go to restuarants or drink alcohol, so it evens out). The co-op often prices the exact same food– same brand, same date, etc.– much higher than the chain store, and while I like to support local, I don’t have unlimited funds to do so.

Now, though, I can’t take the risk of hitting the chain, so I reconfigured my idea of staple foods to my my co-op experience as affordable as possible while still buying things that won’t make my health decline. Potatoes and strawberries are my main sacrifices right now. I simply cannot afford to pay $8 for a small box of organic strawberries that I normally pay much less for at the chain. Same with potatoes. They’re a rare treat now.

Evolution of the Shopping Experience

When all the coronavirus panic began, I wasn’t sure what to do or what to buy. I didn’t want to be a hoarder, but I also didn’t want to have to make unnecessary trips to the store. On my first trip to the co-op, I bought a lot of frozen organic vegetables and canned tuna. On my second trip a week later, I relaxed my concerns a little and focused more on fresh foods, especially those that could be cooked rather than eaten raw. I went for a mixture of sturdier items like carrots and more quick-perish items like chard. The co-op, like all stores, has its share of empty shelves. With a little improvisation, I mostly got what I needed. By my third trip, I really got the system down.

My Routine

I only go shopping on a weekday morning, but not immediately after the store opens when I suspect there’s a crush of people vying for soap and toilet paper. I go about an hour after the place opens. First and foremost, I make sure I don’t forget my paper list. Next, I take off my wedding ring and watch and leave them safely at home. Then I take my license and credit card out of my wallet and zip them into the waistband pocket of my shorts. I get a paper mask– we still have a few from pre-virus yardwork– and a small bottle of hand sanitizer. Then I try to enjoy the simple act of driving and listening to music. Admittedly, I’m not finding the trip very enjoyable these days.

Once I’m at the store, I park next to a cart return corral as far from the store as possible. Usually no one else parks out there, which adds a little reassurance to my routine. I drive a pickup truck with a camper shell over the bed, and I open the shell and the tailgate before going inside. A tiny bottle of hand sanitizer sits in a corner of the truckbed for when I return with groceries. I zip my key into the pocket with my license and credit card.

The mask goes on when I’m about twenty feet from the entrance to the store and take one last breath of unfiltered fresh air to calm myself down before donning the mask. I remind myself that I’ll see people on every part of the spectrum, from terrified to arrogant, and that their actions have nothing to do with me. Then I grab a cart and sanitize it with the spray that the store provides. Finally, I start shopping from my list.

My List

Nowadays, I’m buying much less frozen and canned food than I was when all this started. I’m still hesitant to buy anything prepared, like my beloved kale salad, but maybe I’ll get back to that one day. Some fresh standbys include: bananas; carrots; onions; lemons; apples; and cabbage. All of those things have relatively long shelf life for organic fresh produce.

Canned standbys include: tuna; salmon; garbanzo beans; and kidney beans. I grab soy milk from the fridge for my wife and Nutpods coffee creamer for me. I get whatever nuts are on sale from the bulk bins– last week it was pecans!– plus split peas and lentils and oatmeal. I buy frozen fruit if it’s on sale. Lately it hasn’t been. I choose whatever is a decent price from the butcher, which nowadays is a mystery until I see what’s in stock. I try to buy things that will go together to make good meals but it doesn’t always work. We’ve definitely eaten some weird but nutritious combinations lately.

Once I pay– the checkout process is always the most tense, since that’s where I encounter the most people and have to use the communal credit card machine– I sanitize my hands before leaving. Then I wheel the car to my truck and put the bags in open bed. I return the cart to the corral next to my parking spot, then sanitize my hands with the sanitizer I leave in the truckbed. I lean over the passenger floorboard of my truck, pop the earpieces loose from my mask and let it fall to the floor, sanitize my hands again. Then I try to relax for the ride home.

Home Sanitizing Station

Once I’m home, there’s one last round of sanitizing before I can chill. This is the reality of social distancing grocery shopping. It doesn’t really end when the social contact ends, because the germs don’t just evaporate. We sanitize everything with either disinfectant spray and wipes or with soap and water. (Yes, I wash our bananas in soap and water.) I strip under the carport and drop my clothes in our washing machine, and then I take a shower while my wife puts away the groceries. Honestly, it’s a draining process, but I think I’d feel a lot worse if I didn’t do my utmost to protect myself, my family, and our community. I’d rather be safe than sorry.

Capsulitis and Foot Pain

My feet are still not functional after a month of rest. I do, however, finally have more precise answers. The second specialist I saw diagnosed me with severe capsulitis, especially in the second metatarsophalangeal joint. Theories abound about how it happened. The main thing now is getting it fixed so I can first walk, then hike, then run again.

The pain of capsulitis is like nothing I’ve ever felt. Through all the years of spinal issues, chronic pain, and other health problems, nothing compares to capsulitis. My right foot is now the worst, although it started out opposite. Luckily, the pain is starting to localize a bit and is primarily focused on the joint capsule of the second metatarsophalangeal joint.

Through many sleep-deprived nights (I’m an insomniac anyway, but the nighttime pain in my feet has been unbearable), I’ve done a ton of research on capsulitis. There are a ton of theories out there, and as is often true with health-related information, a lot of the theories directly contradict each other. One example is in footwear. Many podiatric and orthopedic websites (and doctors) swear by a rocker sole for a shoe, while some decry traditional shoes as part of the problem. As with all things, it’s best for me if I gather information and opinions and then form my own plan.

Shoes for Capsulitis

Since I already run in zero-drop, wide-toebox shoes, I’m definitely a believer in natural foot motion and foot strength. I think it’s possible that my capsulitis developed from walking in more traditional footwear: i.e., the kind with toe spring and a major heel-toe height differential. For those who’re clueless like I was, “toe spring” is the amount of upward turn in the toe are of the shoe. If you think about it, that really is an unnatural, weird position for the human foot, which is meant to be flat on the ground when standing.

Debilitation of Foot Pain

The pain, swelling, and dysfunction in my feet go so bad that capsulitis landed me in a wheelchair. It was almost surreal to be pushed around the park in a wheelchair because of foot pain. The fresh air and change of scenery was great, but it was unbelievably frustrating to be in a chair for what seems like a ridiculous reason. The capsules that’re causing this misery are tiny, but holy crap are they sensitive. 

Solutions for Capsulitis

metatarsal pad for capsulitis
The red-pink, pacman-like outline is for the custom metatarsal pad my doctor made to treat my capsulitis. He used a cutout at the top to give extra room for my swollen joint capsule.

One of my coworkers helped me tape custom-cut (courtesy of a wonderful podiatrist), firm felt metatarsal pads into the metatarsal arch area. By elevating and supporting the metatarsals, plus wearing flat, zero-drop shoes, some of the pressure is taken off the capsulitis. I’m able to hobble-walk with a borrowed rollator, which isn’t awesome, but it’s a hell of a lot better than being in a wheelchair due to foot pain.

capsulitis pain runner
Capsulitis is extremely painful. I’m using a rollator so I can get some upper body and core workouts done while I can’t walk or run.

I’ve been good about doing upper body and core workouts throughout this nightmare, but it’s demoralizing and depressing to be unable to walk, run, or hike. A major trip was postponed and I began to reach a scary level of depression and hopelessness. Throwing everything at capsulitis—ice baths, epsom salt baths, CBD oil, ibuprofen—and getting no results was crushing. My auto-immune specialist called in a prescription for a Medrol dose pack. Steroids aren’t necessarily standard treatment for capsulitis, but I was desperate and he was quite worried about the raging, long-lasting inflammation. I’m on day three of the steroids. They’ve made me a bit more emotional, they’re slowly helping clear up the agony of capsulitis. 

One thing I’ve become conscious of is my toe position. It seems that for some time, I’ve been walking with my toes bundled together. I think I’ve been running that way, too, but I’m not sure. I have no idea why that’s happening, other than weak intrinsic foot muscles and tight extensors in my feet. I found a website with a wealth of information about all things feet, and I highly recommend checking it out if you’re suffering from capsulitis or any other foot malady. There are a ton of informative videos available for free, especially on common complaints such as plantar fasciitis. Click here to get to the the video library of all things foot-related. 

The next phase of the plan to heal my capsulitis is more of the same for several more days—rest, elevation, gentle stretching of the extensors, and gentle foot mobility exercises. I’ve never been this sedentary in my whole life, but it’s necessary for now. The core and upper body exercises are keeping me a little bit sane. In a few days, I go back to my auto-immune specialist, and then back to the podiatrist. I’ll be done with steroids by then and really, really hope to feel good enough to declare capsulitis a thing of the past. For now, I’d be over the freakin’ moon if I could just take a few normal, pain-free steps. Capsulitis sucks big time and I never want to go through anything like this again.

UPDATE!

It’s a long, long story, but my problem turned out to be coming from entrapped nerves in the calf musculature. After intense sessions with Graston technique (Rock Blades, scraping, and other names, all pretty much the same thing), my foot pain was drastically diminished. I now keep it away by obsessively rolling my calves with a foam roller, stretching my calves, and wearing calf compression sleeves. It seems it wasn’t ever a foot problem at all, despite multiple doctors saying it was. If you’re having issues with capsulitis or other foot maladies, it’s probably worth getting a good, deep calf massage and seeing if you get results!

Fibromyalgia YouTube Channel

I started a YouTube channel the other day, and I haven’t felt so un-technically savvy in a very long time. The upload was simple, but the rest was not. I’ve only posted one video so far but have big plans to put a lot of fibromyalgia-related stuff on YouTube in the future.

My first fibromyalgia video is about the hives, rash, or whatever is on my skin. I’ve had skin problems for many years– about the same amount of time I’ve had fibromyalgia, although the fibromyalgia wasn’t diagnosed until a couple of years ago. The new dermatologist I go to says the rash is guttate psoriasis, which is blessedly less severe than plaque psoriasis. My first YouTube video shows an outbreak on my torso.

I’d love for you to submit your ideas for a fibromyalgia YouTube channel. Ask and I’ll try to make sure you receive!

Life with Chronic Pain

Sleep is a sticking point for a body in chronic pain. It’s what I crave the most—to just lie down and close my eyes and not wake up for hours—but it’s often a craving left unsatisfied. Most mornings begin one of three ways.

I wake up as the dogs rattle around in the kitchen, sniffing for errant kibble under their blankets and bowls. I take stock of the situation—is it really morning? How much sleep was I able to get? What muscles are spasming? Am I able to turn my head or is it stuck in one direction or the other? I’m stiff, sore, and need to get out of bed quickly before I can’t get up at all, but I’m thankful to have gotten a few hours of sleep.

Or, I wake up at 3 a.m., my hips throbbing, an electric-like pain shooting across my pelvis. My neck is stiff, my leg muscles are rigid, and nerves light up throughout my body. I stand up in the dark because I can’t stand the pressure on my body as I lie on the bed.

And there are the mornings that are merely extensions of the previous night. Those are the hardest, the ones where no matter how many times I change positions or alternate between the bed and a camping mattress on the floor, I can’t get comfortable. I’m exhausted but in too much pain to sleep. Midnight, two a.m., sunrise, all come and go. Eventually I get up, defeated by my own body, and try to start another day.

I used to take sleep for granted. In college, I’d fall asleep on a cheap blow-up mattress and wake up feeling like a million bucks. Before chronic pain, if I said I didn’t get enough sleep, I meant that I’d had four or five hours of rest. Now, those hours are days. My record is ninety-six hours without sleep, and by the time I finally took enough muscle relaxers to knock myself out, I was shaky and cold and thought I might die.

I hate prescription medication. I use vitamin B supplements, sublingual melatonin, and organic tea to try to sleep. But occasionally, on nights when nothing else works, I reach for a bottle of pills. It’s one of the worst kind of defeats—to admit that my body is attacking itself, trying to stay awake through the hours meant for sleep.

I try to look at chronic pain as a test, a puzzle that must be worked with through trial and error until my body and I come up with a livable solution. I exercise daily, often spending an hour working on my core muscles to help alleviate the pressure on my spine. I eat a restricted diet, avoiding sugar and corn and gluten and a lot of other things that seem to inflame my body. I have a pretty good survival system, but chronic pain is a fulltime job. Every bite of food, every push of a heavy door, every reach overhead to pull on a fan—every single thing has to be carefully planned, because a wrong move can leave me debilitated for days or weeks.

Sometimes, when I’m able to sleep, I drift off to lucid dreams in which I’m running half marathons again, or scoring goals on the soccer field, or finishing my first triathlon. They’re beautiful dreams, but because they’re lucid, I know there’s a certain sense of falsehood in them. Willpower and hope keep me fighting through the sleepless nights. I may not be able to run again yet, but I want to, and desire is a powerful thing. I get mad sometimes—a resentful, ugly mad—but I try to channel that anger into healing. Chronic pain owns the mind as much as it owns the body, and staying hopeful that one day I’ll be okay is my way of telling it to kiss my pain-free ass.