Does Fibro require a MEB?

A BROUHAHA

PEB Forum Regular Member
Registered Member
I have recently been diagnosed with Fibromyalgia and CFS and am being told two different things. On one hand I am being told that fibro is one of the conditions that requires a meb, and on the other I'm being told that it is not necessary.

Does anyone know of any documentation that supports either of these claims?
 
What branch of service and job (and rank) you have will determine.

AR 40-501, Army specific, so may be different in other regs.
para 3-41 d. Fibromyalgia. When severe enough to prevent successful performance of duty. Diagnosis will include evaluation by a rheumatologist.

Virtually any diagnosis will depend on the level of severity in a similar way.
 
Thank you for the reply, I am in the Army and am a specialist.

The focus and memory problems have been what has caused the most problems in my work, I have since been moved to a position where the amount of damage I can cause is minimal. My PCM is treating it as though its no big deal and it is becoming frustrating.
 
Those are mostly CFS problems. CFS can be a real pain to deal with in the military medical system. There is a definite focus on just Soldiering your way through it. I'd try to get into see pulmonary for a sleep study, they will likely hook you up with a watch to track daytime sleepiness issues and may even do a daytime sleep study. Neuropsych does some tests for memory problems, but they're fairly bogus. To be very accurate they need a good baseline, and almost nobody has a test done before problems occur. They may be able to distinguish some problems. BH giving a referral to neuropsych is pretty easy and neuropsych saying its most likely a sleep problem and referring you to pulmonary is pretty easy.

Fatigue issues, which is what I'd classify what you're talking about, are viewed as a simple failure of character. It will require you to be vigilant that your effects to self correct the problem are noted and that you take a very vocal and persistent approach to treatment.
 
I have completed the neuro psych testing already, it just verified that there was nothing organically wrong with my brain, they suggested a sleep study to rule out possible sleep apnea. They said that they believe my problems to be primarily from the fibro/cfs, but they want to ensure I do not have sleep apnea as well as it would just make the problems I already have worse.

I'm presently waiting on the call from the pulmonary to schedule my appointment. Will the sleep study for sleep apnea give them the data they need or should I bring this up seperately?
 
The sleep study will only really measure apnea events, it will not be truly helpful if it is CFS. You will definitely want to bring up the full range of symptoms. Just getting into see them is the main goal, then you need them to note the daytime sleepiness so that an accurate profile of what you can and cannot do is drawn up. They may be able to narrow a diagnosis down to something more specific. CFS is a horrible diagnosis, I'd try my best to come up with something more precise. Ideopathic (no known cause) and diagnosis of last resorts are always treated poorly, which CFS is the kingpin of.

Have you had blood workup? Fatigue is such a vague symptom that appears is a ton of different conditions many times a doc will just throw CFS at you so he doesn't have to do any leg work. I'd consider getting it changed to MDD if nothing else works out. You tell anyone at BH that you are fatigued and lack motivation they are almost guaranteed to diagnose depression even if you don't tell them anything about being sad, another spaghetti diagnosis, but IMO better than CFS.
 
I have had tons of blood work done and while I have had some odd results come back (ana positive, high para thyroid, high crp etc.) they have never drawn anything conclusive from them. My rheumatologist is the one that diagnosed me with fibromyalgia and cfs. When I told my pcm what the rheum said she seemed a little taken back by it, she then told me to just power through it I'll be fine.

I've been at this for over 3 years now, its begining to wear on me.
 
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Just to clarify, fatigue isn't my only problem here, its just the one that has the biggest impact on my current job. On top of the fatigue and inability to focus I spend most days with a migrating pain of varrying intensity traveling around my body, I have trouble walking most days, my hand eye coordination is suffering, I could go on. The unit I am at presently has tried to help me out by giving me a relatively simple job at a desk, I'm greatful for that much as they could have just as easily thrown me to the wolves.
 
Dealing with military medicine is an art. I don't know if I have a good way to advise how to work through it. They, especially PCMs, really like to follow a script. It works pretty well with minor problems, especially since their goal is to keep people fit enough to serve. You have to both separate yourself from the sick call rangers and be loud and insistent that your problems are addressed. You have to find a way to ask for a specific profile without making it sound like you're just trying to get over. Generally this is an agonizingly slow and painful process.

Endo ever workup your parathyroid?

Did you get a good feel from the rheumatologist or was he dismissive? My wife spent about 8 years bouncing around rheumatologists that threw fibro at the general pain problem until we learned how to express all the different symptoms that they weren't looking at. Auto immune is a really tricky problem and it requires a rheumatologist that is willing to really examine everything. Many times its just throwing treatments at it until one sticks.

Something to think about too is getting a commander or 1SG or someone who can see how you are trying your damnedest to speak to the doc on your behalf can help a ton. It shouldn't take that for a doc to take your symptoms seriously, but if you ever sat in an aid station (or ER) on the day of a PT test, you'd probably understand it.
 
I really appreciate all the advice you are giving me.

Fortunately I no longer have to deal with the sick call scenario or see pa's with a medical certificate in aroma therapy, but yes Army med is certainly not without its problems.

They never sent me to endo, they tried running my thyroid again but the second time it came back normal so it was dismissed.

I have a permanent profile that covers my needs physically, so they can't really make the claim that I am just a sick call ranger that is out for a profile. I am genuinely just trying to make all of this more bearable and I really felt I was getting somewhere until I came back and told them that the rheum diagnosed me as fibro and cfs, at that point they almost looked like they just stopped taking me seriously.

I will keep at it even if it means going to patient advocacy.
 
I don't know if any of that was even helpful to your original goal. If you want to start an MEB, get your permanent profile upgraded to a 3 with no in any basic Soldier tasks. My guess is they'd be willing to support that if you explained how things are getting worse or how the profile isn't sufficient so things like wearing the IBA is horrible. If you want to make sure you avoid an MEB, probably just avoid any conversations about the profile or make sure they understand how it stands now is good. This is at a stage of development that you can pretty easily direct what direction is goes.

I'll withhold any opinions about which route is the wisest.
 
The key to whether or not a MEB should be initiated is "does it interfere with the job that you were trained for". So, if your unit is giving you a simple desk job and that is not what you should really be doing, then you should have a MEB done. For me, I wasn't able to go back to sea duty, which kept me from doing the job that I was trained for, therefore a MEB.

Hope that helps.
 
brouhaha
"high para thyroid" caught my attention. This can be significant if you have a low Vit D level and especially if your Calcium is high. Google up on the parathyroid gland --a tiny benign tumor on it can cause many symptoms of Fibro
 
I have had tons of blood work done and while I have had some odd results come back (ana positive, high para thyroid, high crp etc.) they have never drawn anything conclusive from them. My rheumatologist is the one that diagnosed me with fibromyalgia and cfs. When I told my pcm what the rheum said she seemed a little taken back by it, she then told me to just power through it I'll be fine.

I've been at this for over 3 years now, its begining to wear on me.
Did they tell you that a high parathyroid result can indicate that you have hypothyroidism or in English an under active thyroid ? Some references state hypothyroidism can be a primary cause of Fibromyalgia. Also affecting your energy levels or chronic fatigue ...

I recommend going back to your doc and discussing this issue. You may need supplementation with a thyroid tablet depending on your PTL levels indicated on your blood work. Keep copies of all your medical records. Just trust me on this one.
 
dmt1961 said:
Did they tell you that a high parathyroid result can indicate that you have hypothyroidism or in English an under active thyroid ? Some references state hypothyroidism can be a primary cause of Fibromyalgia. Also affecting your energy levels or chronic fatigue ...

I recommend going back to your doc and discussing this issue. You may need supplementation with a thyroid tablet depending on your PTH levels indicated on your blood work. Keep copies of all your medical records. Just trust me on this one.
Did they address your positive ANA also? This can be an indication of an autoimmune disorder called systemic Lupus ..... again talk to your doc. Seems it may need further lab work to verify...also document, document, document....keep records of your daily symptoms ...treatments....improvements or non response to treatments..
memory can be such a difficult factor in the future.
 
I should add a high crp can indicate inflammatory processes . Did you go back and review lab results with rheumatologist?
 
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