Wednesday, March 09, 2011

Fibromyalgia - Rompecabeza? Casse-tête?

In English, the literal meaning of "rompecabeza" is "head breaker." Generally the English translation is more benignly listed as "jigsaw puzzle." On my kitchen table is a BigBen 1000-piece jigsaw puzzle, in a box, on which appears, "1000 piezas de rompecabezas", and "1000 pièces de casse-tête", following after "1000 piece puzzle."

Rompecabeza: (Spanish)
- Romper: "Separar en partes o pedazos, usualmente con violencia; destrozar" 
(My English translation: "separate into parts or pieces, usually with violence; destroy")
- Cabeza:  head

Casse-tête: (French)
- Casse: "Dans les arts martiaux, la casse est l'art de briser des objets solides (tels que des briques ou des morceaux de bois) à des fins de démonstration, de compétition ou d'entraînement." 
(My English translation: "in martial arts, the chop is the art of breaking solid objects (bricks or blocks of wood) in competition or training.")
- Tête:  head

"Jigsaw Puzzle" seems so ... underwhelming compared to these terms in other languages. Doesn't it?

A recent article appears in WebMD, by Bret Stetka MD, about fibromyalgia, entititled What is Fibromyalgia? Medscape Readers Weigh In.

Six pages of reportage of differing opinions from different branches of the medical practitioner family ensue; then, on the last page:
"Not surprisingly, in the end reader consensus was lacking. We were left with an assortment of theories, conflicting etiologies and symptoms, and severe brain drain from trying to piece it all together."
Every kind of medical doctor still each has a perspective about fibromyalgia born of having attached him or herself to a particular discipline that matches his or her particular world view or health care perspective or set of characteristics, and fibromyalgia just seems to stubbornly resist any easy definition. 

Right now, I'm struggling with the second class in the U. of A. pain management certification program. I'm feeling my cabeza being romped pretty hard. Or my tête cassed.

Not literally, OK? More the symbolic, jigsaw puzzle kind of way.

I'm learning about all the biopsychosocial models of pain commonly used. I don't feel at home, quite, because, for whatever reason, the neuromatrix model (the one I love the best) is not among them. Maybe it isn't a good "management tool"? I am learning about managing my own stress levels while not turning around and just leaving the scene. I find the whole class a bit daunting because I've never been much of a "team" type in the first place. I've always been more of a "leave me in peace so I can focus all my attention on the human primate social grooming of my patient, thank you" type of healthcare practitioner. I'm finding out there is a lot I don't even have a clue about, mostly to do with how the social troop of health care socially "manages" patients who don't fit any convenient medical slot.  It also manages disparaging attitudes, by naming them as counterproductive, which is kind of reassuring.


Anonymous said...

I prefer to call the biopsychosocial models a framework rather than a specific theoretical approach or testable model. You can certainly integrate the neuromatrix and other similar central sensitisation models into the BPS framework without losing any of the integrity of the neuromatrix theory - it forms the 'bio' part of the model, and some of the 'psycho' part as well...

Diane Jacobs said...

The instructor has a thing against NM model, calls it an hypothesis. I call it a theory. At least, I've always considered it as such.