I have just received a letter from the hospital detailing my diagnosis, can anyone help me please?

[phipps]

Diagnosis -

Fibromyalgia syndrome
Obesity (BMI 31)
Migraines

and 3 others that I already knew.

Medication -

Duloxetine 60mg once daily instead of citalopram prescribed today.
Amitriptyline 30mg night-time, can be increased to 40-50mg later (not much higher while on SSRI/SNRI)
Citalopram 20mg/day long-standing to be discontinued now (I think this is a possible cause of my weight gain.)

Referred to physiotherapy (not sure why.)

If you've got fibromyalgia (muscle pains etc) then perhaps they think physio will help.

Amitriptyline is also used as a muscle relaxant (for the aches and pains) and can useful in treating migraines as well.

Duloxetine is also used in the treatment of fibromyalgia

Was your query about the physiotherapy?

Physiotherapists are often used to advise on exercises and massage techniques to ease the pain of fibromyalgia.

The NHS website is pretty good for explaining this kind of thing.

I don't know why I would be having physio but I also could use some ideas to sort out my obesity and permanent tiredness.

Diet and exercise?

Both would help with the tiredness and obesity. Healthy eating would lower BMI, as would exercise. Increasing exercise levels also boosts energy levels. Though you may feel knackered in the short term as you get used to it so just build up gently.

I have been eating well and exercising but zilch is coming off.

you need to eat a lot less to see weight come off.

most figures show that you need to under-eat by 3500 cals a week to lose 1 pound of weight.

have you counted calories?

The ami is often used as pain relief in doses up to 75mg a day and that is prob being given to you for your fibro pain.

I am eating hardly anything.

cereal for breakfast.
salad for lunch.
jacket spud for tea.

What cereal? That could be 300 cals if you have a big bowl, plus milk. I have fruit for breakfast and 2 Rich Tea! (38 cals each.)

Salad with dressing? Meat? Cheese?

Jacket spuds are starchy, and are you putting cheese and butter on top? With beans, etc? That could be 400 calories or more.

I like following diets - all the planning's been done for you. Otherwise it's soo easy to underestimate what you eat. When I did WW years ago i was a single girl who (I thought) hardly ate - turned out I was having, in an average day, around 45 points.

Sorry my post sounds so patronising!!

Special K with skimmed milk
Salad is leaves with tomatoes, peppers, onions or beetroot.
No butter on the potato, tonight I had it with tuna and mayonnaise with more salad leaves.

It doesn't sound patronising. I know I am making a pigs ear of things but feel down as 2 stone has gone on without me doing anything different but now I am paying attention and exercising nothing is coming off.

If you think the cit. is causing the weight gain (which tbh is a very common side effect of lost of meds) then hopefully you should see some of the weight shift when you change meds.

Also what sort of exercise are you doing? If you are doing muscle building exercise you have to remember that muscle weighs more then fat and technically you can be a size 8 and still have a BMI that is too high simply because you are a 100% muscle and no fat.

When i do intensive training my dress size drops but my weight stays fairly high. It is just the nature of what sort of exercise i do.

What sort of drinks do you have. I use Food focus and was actually quite horrified that I was consuming nearly 150cals each time i had a cup of coffee simply because i have sugar and milk. It is possible that whilst your food calories are low, you are actually consuming a lot of extra calories due to what you are drinking.

you should eat protein for breakfast. there is a feaure about this in the Daily Mail today.

Try 2 boiled eggs, or similar.

what's with the salad? Just plain lean meat or fish, no dressing and green salad with maybe tomatoes? No fat, no oils, no mayo, no nothing.

a jacket spud is not that nutriotious nad its very carbo laiden. You would be better off with a chicken breast, fillet of salmon or white fish, plenty of green veg, and a low fat yoghurt.
it is possible that you are eating too little- body goes into starvation mode and conserves fat. You actually need to eat to burn calories!

Hope this link works for oyu.

www.dailymail.co.uk/femail/article-1326447/Weight-Watchers-Pro-Points-plan-A-new-approach-dieting-success.html

Lately I have been running.

Drinks wise I have water, milk sometimes, sugar free lemonade. No tea, coffee or coke.

Thank you purplepeony. I bought the DM today and have kept the pages to read. I can't concentrate with reading in the evening. A new thing I have to deal with .

if you scroll right down you can see the points- normal is 29 each day but you might be able to go slightly lower.

I will take a look and see how many points I have had today. Thank you.

PP is right (though I haven't read the DM)

Not even close to enough protein - the average woman needs about 60 gr of protein in a day. Two boiled eggs (or even one with a glass of milk and a skinny latte) for breakfast - cereals for breakfast are responsible for a lot of minor weight problems (IMVHO!)

I have had 16 points plus 2 lots of salad and some special k that wasn't listed. And 5 chocolate eclair sweets.

Why Kewcumber? I would happily live in cereal.

Sugar free lemonade can be a problem as the artificial sweetners can affect how the body works (metabolism wise).

you also need some fat in your diet but should where possible be "good" fat My motehr diabetic dietician says everyone should switch to an olive oil based spread and preferably a low fat one.

Cut out all transfats (check the labels its in a lot of low calore hot chocoalte, powedered cappucino drinks etc)

DID - yes they can by my understanding is (ot sure why) that the only diet drinks that showed a noticeable effect on blood sugar levels was diet orange drinks. They haven;t been able to prove any other link but many people do beleive that your insulin levels do response to the taste of the sweetness - insulin levels too high not a good thing as it predisposes you to deposit fat rather than burn it.

I don't drink any powdered drinks so should be okay there.

Can you recommend a nice olive oil based spread? DH is a flora man at heart but I am not fussy. Would it be fine for the kids too or do they need full fat spread?

my mum had fibromyalgia, but she also had an underactive thyroid - is yours ok? Just a thought..

yy to the olive based spread, we always have those. dh likes the Bertolli (sp?) one, I'm not fussy - sainsbos own is ok for me :)