My fibromyalgia syndrome (FMS) resulted from typing continually with little sleep in 1994 during the final crunch of dissertation writing. Like most cases of FMS, it took several specialists, clinics, and finally, my own researching, until my symptoms were matched with the appropriate diagnosis. By then I had deteriorated substantially: I could barely feed myself, brush my teeth, etc. What finally made me 'functional' was a concerted regime of drugs, exercise, massage, physical therapy, relaxation techniques, you know, the usual array of treatments. I still suffer from pain and fatigue, but nothing like the constant, intense pain I experienced daily in the first year and a half. The tools described below make my life bearable and sometimes quite enjoyable:

Voice-Activated Software
Typing is a sure-fire way to flare my FMS, so I NEVER type. Several computer products recognize voice commands for both text and commands. I am "typing" this with one now. Without this product, I would never have (finally) finished my Ph.D. The best voice-activated dictation products I've found are PowerSecretary for the Macintosh (1-800-443-7077) and Dragon Dictate for the PC (1-888-343-3773). IBM now markets software that I have heard is rather good, but I have not seen the latest version. What it offered two years ago was quite primitive compared with these other products.

In the beginning, these products are somewhat frustrating because you spend much time correcting them. But they do learn over time, and you can customize them to use voice macros. For example, I just say "login" and my computer dials in, waits, then enters my password. I also trained my computer with commands that are easy and fun. Instead of saying the standard "scratch that" every time my computer types something strange, I can say "damn it" or worse.

As you might expect, these software programs are expensive. However, the prices have been going down, and the quality has been improving. If you need to type at work, your company should purchase it for you. It may be tax-deductible if you buy it for your own use.

Telephone Headset
Holding a phone can be excruciating, so I no longer do so. My Plantronics cordless headset that allows me to get comfortable wherever I prefer to be. On long calls, I like to go through my stretching routine. The Plantronics phone usually sells for about $250. But because of the many inquiries I received about this product, I called the company and was able to arrange a group discount for fibromyalgia patients! If you are interested, mention "FMS" and your price will be $179. In addition, a percentage of the profits sold to those who say "FMS" will be donated to basic research toward a cure for FMS. Plantronics can be reached at (800) 288-0041. Radio Shack also offers a cordless headset (which you can sometimes find on sale for as low as $100). However, I found the quality much lower.

Microwavable Heat Pack
This one I made by sewing a rectangular of thick material and filling it with rice (I use Jasmine). After microwaving for about two minutes, it reaches the perfect hot temperature and flexible consistency to relax whatever muscle spasm irks me the worst. I call mine the "happy sack" and use it throughout the day behind my neck to keep tension headaches at bay. I also bring it to long meetings, or when I travel, to keep my muscles warm and relaxed.

TENS Unit
This Walkman-sized machine with electrodes sends electric impulses to trigger points or more generally to distract me from pain. There are various theories why this alleviates pain. These are available with a doctor's prescription. Since the device can be used in several ways, it is advisable to have a physical therapist advise which is the best way for you. Prices vary considerably, so it pays to shop around.

Pain Medication
As we know, drugs work differently for each of us. The only medication that happens to relieve my pain at all, is Percocet. Because it's a narcotic, some physicians are hesitant to prescribe it for chronic pain. I take it in small doses (1/2 tablet), and it helps tremendously. If your physician is not open to including necessary medications in your treatment program, find one that is! Medication that improves sleep can also help relieve pain.

Massage
Many excellent massage therapists are now familiar with FMS. Although this can become quite expensive, it is well worth it for those (like me) who benefit so much from massage. Massage therapists affiliated with doctors' offices are covered by health insurance. Also, massage devices can be quite helpful. I love my machine with its two rotating balls that can deactivate my trigger points. Since buying mine, I have not gone to the massage therapist.

Daily Report Sheet
This has been incredibly important for my mental as well as physical well-being. I devised an easy form that I fill out every day indicating how much I slept, the quality of sleep, the weather, my mood, amount of exercise, drugs and dosages, activities accomplished, and various other factors. I realize my daily memory is not very reliable. At my worst, I often think that I always feel that bad and become quite depressed. Having a record helps me keep things in perspective. For example, it helped me realize that I have had significantly fewer bouts of depression than I used to. I also include a category for my reaction to pain / tiredness / depression and how well whatever I did seemed to work. Having a form forces me to take action so that I at least have something to write down later. The form is mainly a checklist, fill-in-the-blank format, so that it takes only a minute or so to complete each day. This serves as a record of the many, many changes in medication and other strategies and reveals trends that would otherwise be impossible to track.

Doctor Visits
Whenever I have to see a new doctor, I bring a detailed summary of my history on one to two pages. Otherwise it takes an extended office visit just to explain my problem and inevitably I end up in tears of self pity over how much my life has changed. Also I have found when I present a written report, including what I hope to get out of the appointment, the physician takes me more seriously and I am more satisfied with the visit.

Exercise and Stretching Program
A gradual exercise-and-stretching program has been the most challenging component, in my case, not because I'm a couch potato but because I tend to overdo it. I am now doing an hour of cardiovascular exercise three times a week plus a light muscle-training program. It took me two years to build up to this point after many months of frustration. The trick for me was to begin with something incredibly minimal, like 30 seconds of walking, but every day. When it felt O.K., I increased it to a minute, and so on. When it was too much I cut back, but just a little. The result is phenomenal. Yes, I still hurt, but much less. And I can now manage to hold a teapot in front of me, negotiate my own grocery shopping. I joined a nearby gym with a sauna and Jacuzzi so after my workout and stretch program, I relax for a wonderful half hour. Not only am I combating FM problems, but getting in shape is an added bonus (and we get so few for our efforts).

Finding Bonuses
On my worse days, I rent movies that I really want to see. This helps so much to prevent me from slipping into depression, instead I usually slip into the world of a foreign film.

There are many other little tricks I now take for granted, like always sitting in a booth in a restaurant or a chair with arms, relaxing with music and diaphragmatic breathing and sleeping with earplugs. Sometimes I imagine living on an island with folks with FM so we can live a slower pace of life, help each other feel better, and really understand. Of course I'd choose to forget this FM problem all together.