Post by Lady~RavenHeart on Sept 10, 2005 21:39:11 GMT 2
FAME 2001 Chat Transcript: Mary Moore, MD on Pediatric Fibromyalgia
ImmuneSupport.com
07-16-2001
Today’s chat at FAME 2001 is with Mary D. Moore, MD. Dr. Moore, is a pediatric rheumatologist in Rockford, Illinois. She is board certified in Pediatrics and in Pediatric Rheumatology. Dr. Moore is a clinician/educator with a faculty appointment at the University of Illinois College of Medicine at Rockford. She provides care for children and adolescents with rheumatic disorders, including Fibromyalgia.
DrMary:I will provide some Frequently Asked Questions (FAQ) and their answers.
DrMary:Q. 1. Does Fibromyalgia occur in children? Yes, it is less common, but definitely occurs. Typical age is in adolescence and is more common in girls. I see several kids who have a family history of FM.
Question directed to Dr. Moore:
prohealth911: Dr. Moore, what are the psychological ramifications of child Fibromyalgia, and what is the best way to maintain psychological stability within children and teens during this difficult time?
DrMary: There are no studies about psychological ramifications in kids, and clearly there are a lot of unanswered questions. Any illness with a lot of pain and uncertainty is very stressful to everyone. The child with FM needs a lot of support and encouragement.
Question directed to Dr. Moore:
prohealth911: Is there a high rate of teenage depression associated with FM?
DrMary: Again, there are very few studies, and only involving small groups of kids. I could only find four published studies, and two said no and two said yes. Any depression in a child should be addressed and plans made to treat those symptoms.
DrMary:Q.2. How does childhood FM differ from adult FM? In general, the kids do better and are more likely to have a full remission of symptoms 2-4 years later. I think kids are more likely to have clear-cut triggers, which helps in identifying treatment plans that will help.
Question directed to Dr. Moore:
prohealth911: Are the symptoms in children similar to those found in adults? Are there any differences?
DrMary: Again, there are no large scale studies of kids. FM is pretty much the same clinically in kids as in adults. There is less disability in kids.
DrMary: Q.3. What about genetic factors in FM? Again, marked lack of careful studies. FM is more common in women and girls and half of FM patient's children have FM. This may be simply that the family member recognizes the FM sooner, because of their own experience.
Question directed to Dr. Moore:
prohealth911: How would a parent detect the warning signs of FM in their child?
DrMary: A caveat here - I would be careful not to attribute every symptom to FM when there is a family history of FM. I follow the guidelines for diagnosing FM - persistent (>3 months) of widespread pain.
Question directed to Dr. Moore:
prohealth911: Since FM is not a widely accepted diagnosis, to whom would a parent turn if they suspected their child might have FM?
DrMary: Rheumatologists see a lot of FM and could be a place to start. A lot of family doctors and other health care providers also see FM. I would call and find out about that person's practice to see what their style is in regard to FM.
Question directed to Dr. Moore:
Erin27: Have you found a difference between onset in children and teenagers as far as outcomes? Are teenagers more likely to carry symptoms into adulthood? I'm also wondering if you've seen many people (any age) develop more of the chronic fatigue symptoms after years of FM?
DrMary: Hi Erin27, again, we just don't know enough about FM in young kids and teenagers. In my experience, the kids have a trigger. I think the teens do better than the younger kids. Regarding CFS and FM, there is still a lot of information we don't have. Fatigue is notoriously bothersome in FM and notoriously hard to sort out.
Question directed to Dr. Moore:
Erin27: Swollen glands aren't a typical Fibromyalgia symptom, right?
DrMary: Erin27, swollen glands are not typical. If someone has swollen glands, I worry about CFS or other common childhood problems.
Question directed to Dr. Moore:
prohealth911: What sort of financial support can a family expect if their child is diagnosed with FM? Is child FM covered under most health plans?
DrMary: Yes, FM in childhood is covered.
DrMary: Q.4. What age does FM occur? I am very hesitant to diagnosis FM in kids under 10. I would worry that there was another problem causing the symptoms, such as depression or stress.
Question directed to Dr. Moore:
otto: What if a child has Mono? Can this lead to CFS if they do not rest while getting over Mono?
DrMary: Hi Otto, CFS can be triggered by lots of things, but it is hard to get any child to rest who doesn't want to rest. I let the child set their own limits with backup and support from their parents, of course. But you can't tie a child to the bed.
Question directed to Dr. Moore:
Erin27: Do you feel confident about the research now being done on FM/CFS?
DrMary: Regarding research, I am very pro-research and like most rheumatologists, keep a close watch on information being published. I am worried that there are a lot of shaky conclusions being reached and would advise everyone to be critical and not believe everything they read.
Question directed to Dr. Moore:
prohealth911: How many doctors out there are familiar with child FM cases?
DrMary: As you know, there is a lot of skepticism in docs about FM, so doing your own investigation into that person's practice can help. A phone call can save a lot of wasted time if the doctor doesn't believe or doesn't want to help someone with FM symptoms.
DrMary: Q.5. How is childhood FM treated? Again, there are no hard and fast answers. I try to figure out with the child what the worst symptoms are and focus on those first. Next, I try to find triggers for the symptoms (stress, school issues, etc.) so future problems can be avoided.
Question directed to Dr. Moore:
prohealth911: Are there specific activities that a child should avoid if they are diagnosed with FM? DrMary: Most kids don't recognize what might be triggering their FM symptoms. As for specific activities, I would have the child figure out what makes his/her symptoms worse. There are no hard and fast rules. It's common sense - a balance of rest, etc.
Question directed to Dr. Moore:
eiggie: Dr. Moore, I am just getting over viral hepatitis. The doctors state FM may have helped cause this. Does this make sense? I am 47 - not a child!
DrMary: Hi Eiggie, FM does not cause hepatitis. I would expect the opposite. Viral infections can trigger FM symptoms. We just don't know enough about FM's affect on the immune system to be able to give an accurate answer about the ability of an FM person to get over an infection.
Question directed to Dr. Moore:
otto: How do you get some parents to take it seriously that a child is really in pain and feeling fatigue? I have seen where parents tell the child they are fine because the doctors did not see or find anything wrong. We have two teenagers in our support group that have problems because their parents did not believe in them.
DrMary: Otto, all teens with FM need support and I would try to find out from the teens what they think their parents should have done. I would be careful, because teenagers blame their parents for lots of things that the parents didn't actually do. That's part of being a teenager.
Question directed to Dr. Moore:
eiggie: Dr. Mary, what do you think about a FM patient using Glucosamine, Chondrotrin and MSM? Can these things cause liver problems? DrMary: Hi Eiggie, I think these supplements are very safe and I always recommend to anyone trying them to do their own research and their own test and see if their FM gets better. I don't think there are any liver problems with these, but like any treatment, use the right amount and use it as recommended.
eiggie: Thank you. They, along with the Zanaflex were working. I have had to go off them until the liver problems settle down. DrMary: Hi Eiggie, talk to your doctor, but you could consider adding them back in one by one and watch to see that the liver doesn't act up.
Question directed to Dr. Moore:
otto: What do you feel the best exercise is for a child with FMS? I found water exercise is very helpful for me.
DrMary: Good question. I try hard to make the child participate in that decision. If they hate the exercise, they won't do it. I prefer team sports, or exercise done with a friend or family member, because the child is more likely to stay with it. prohealth911: Unfortunately, our time is up. Many thanks to Dr. Mary Moore for a very interesting chat today.
ImmuneSupport.com
07-16-2001
Today’s chat at FAME 2001 is with Mary D. Moore, MD. Dr. Moore, is a pediatric rheumatologist in Rockford, Illinois. She is board certified in Pediatrics and in Pediatric Rheumatology. Dr. Moore is a clinician/educator with a faculty appointment at the University of Illinois College of Medicine at Rockford. She provides care for children and adolescents with rheumatic disorders, including Fibromyalgia.
DrMary:I will provide some Frequently Asked Questions (FAQ) and their answers.
DrMary:Q. 1. Does Fibromyalgia occur in children? Yes, it is less common, but definitely occurs. Typical age is in adolescence and is more common in girls. I see several kids who have a family history of FM.
Question directed to Dr. Moore:
prohealth911: Dr. Moore, what are the psychological ramifications of child Fibromyalgia, and what is the best way to maintain psychological stability within children and teens during this difficult time?
DrMary: There are no studies about psychological ramifications in kids, and clearly there are a lot of unanswered questions. Any illness with a lot of pain and uncertainty is very stressful to everyone. The child with FM needs a lot of support and encouragement.
Question directed to Dr. Moore:
prohealth911: Is there a high rate of teenage depression associated with FM?
DrMary: Again, there are very few studies, and only involving small groups of kids. I could only find four published studies, and two said no and two said yes. Any depression in a child should be addressed and plans made to treat those symptoms.
DrMary:Q.2. How does childhood FM differ from adult FM? In general, the kids do better and are more likely to have a full remission of symptoms 2-4 years later. I think kids are more likely to have clear-cut triggers, which helps in identifying treatment plans that will help.
Question directed to Dr. Moore:
prohealth911: Are the symptoms in children similar to those found in adults? Are there any differences?
DrMary: Again, there are no large scale studies of kids. FM is pretty much the same clinically in kids as in adults. There is less disability in kids.
DrMary: Q.3. What about genetic factors in FM? Again, marked lack of careful studies. FM is more common in women and girls and half of FM patient's children have FM. This may be simply that the family member recognizes the FM sooner, because of their own experience.
Question directed to Dr. Moore:
prohealth911: How would a parent detect the warning signs of FM in their child?
DrMary: A caveat here - I would be careful not to attribute every symptom to FM when there is a family history of FM. I follow the guidelines for diagnosing FM - persistent (>3 months) of widespread pain.
Question directed to Dr. Moore:
prohealth911: Since FM is not a widely accepted diagnosis, to whom would a parent turn if they suspected their child might have FM?
DrMary: Rheumatologists see a lot of FM and could be a place to start. A lot of family doctors and other health care providers also see FM. I would call and find out about that person's practice to see what their style is in regard to FM.
Question directed to Dr. Moore:
Erin27: Have you found a difference between onset in children and teenagers as far as outcomes? Are teenagers more likely to carry symptoms into adulthood? I'm also wondering if you've seen many people (any age) develop more of the chronic fatigue symptoms after years of FM?
DrMary: Hi Erin27, again, we just don't know enough about FM in young kids and teenagers. In my experience, the kids have a trigger. I think the teens do better than the younger kids. Regarding CFS and FM, there is still a lot of information we don't have. Fatigue is notoriously bothersome in FM and notoriously hard to sort out.
Question directed to Dr. Moore:
Erin27: Swollen glands aren't a typical Fibromyalgia symptom, right?
DrMary: Erin27, swollen glands are not typical. If someone has swollen glands, I worry about CFS or other common childhood problems.
Question directed to Dr. Moore:
prohealth911: What sort of financial support can a family expect if their child is diagnosed with FM? Is child FM covered under most health plans?
DrMary: Yes, FM in childhood is covered.
DrMary: Q.4. What age does FM occur? I am very hesitant to diagnosis FM in kids under 10. I would worry that there was another problem causing the symptoms, such as depression or stress.
Question directed to Dr. Moore:
otto: What if a child has Mono? Can this lead to CFS if they do not rest while getting over Mono?
DrMary: Hi Otto, CFS can be triggered by lots of things, but it is hard to get any child to rest who doesn't want to rest. I let the child set their own limits with backup and support from their parents, of course. But you can't tie a child to the bed.
Question directed to Dr. Moore:
Erin27: Do you feel confident about the research now being done on FM/CFS?
DrMary: Regarding research, I am very pro-research and like most rheumatologists, keep a close watch on information being published. I am worried that there are a lot of shaky conclusions being reached and would advise everyone to be critical and not believe everything they read.
Question directed to Dr. Moore:
prohealth911: How many doctors out there are familiar with child FM cases?
DrMary: As you know, there is a lot of skepticism in docs about FM, so doing your own investigation into that person's practice can help. A phone call can save a lot of wasted time if the doctor doesn't believe or doesn't want to help someone with FM symptoms.
DrMary: Q.5. How is childhood FM treated? Again, there are no hard and fast answers. I try to figure out with the child what the worst symptoms are and focus on those first. Next, I try to find triggers for the symptoms (stress, school issues, etc.) so future problems can be avoided.
Question directed to Dr. Moore:
prohealth911: Are there specific activities that a child should avoid if they are diagnosed with FM? DrMary: Most kids don't recognize what might be triggering their FM symptoms. As for specific activities, I would have the child figure out what makes his/her symptoms worse. There are no hard and fast rules. It's common sense - a balance of rest, etc.
Question directed to Dr. Moore:
eiggie: Dr. Moore, I am just getting over viral hepatitis. The doctors state FM may have helped cause this. Does this make sense? I am 47 - not a child!
DrMary: Hi Eiggie, FM does not cause hepatitis. I would expect the opposite. Viral infections can trigger FM symptoms. We just don't know enough about FM's affect on the immune system to be able to give an accurate answer about the ability of an FM person to get over an infection.
Question directed to Dr. Moore:
otto: How do you get some parents to take it seriously that a child is really in pain and feeling fatigue? I have seen where parents tell the child they are fine because the doctors did not see or find anything wrong. We have two teenagers in our support group that have problems because their parents did not believe in them.
DrMary: Otto, all teens with FM need support and I would try to find out from the teens what they think their parents should have done. I would be careful, because teenagers blame their parents for lots of things that the parents didn't actually do. That's part of being a teenager.
Question directed to Dr. Moore:
eiggie: Dr. Mary, what do you think about a FM patient using Glucosamine, Chondrotrin and MSM? Can these things cause liver problems? DrMary: Hi Eiggie, I think these supplements are very safe and I always recommend to anyone trying them to do their own research and their own test and see if their FM gets better. I don't think there are any liver problems with these, but like any treatment, use the right amount and use it as recommended.
eiggie: Thank you. They, along with the Zanaflex were working. I have had to go off them until the liver problems settle down. DrMary: Hi Eiggie, talk to your doctor, but you could consider adding them back in one by one and watch to see that the liver doesn't act up.
Question directed to Dr. Moore:
otto: What do you feel the best exercise is for a child with FMS? I found water exercise is very helpful for me.
DrMary: Good question. I try hard to make the child participate in that decision. If they hate the exercise, they won't do it. I prefer team sports, or exercise done with a friend or family member, because the child is more likely to stay with it. prohealth911: Unfortunately, our time is up. Many thanks to Dr. Mary Moore for a very interesting chat today.
