Today’s FAME 2001 chat is with Steve Fanto, MD. Dr. Fanto specializes in Absolute Rehabilitation and Sports Medicine. During the past ten years, Dr. Fanto has lectured on such diverse subjects as ‘Solving New Problems in Rheumatology Evaluation’, ‘Physiatry and Pain Management’, ‘Chronic Fatigue and Fibromyalgia Syndromes’ and ‘Posttraumatic Headache.’

Question directed to Dr. Fanto:

k: What is the name of the blood test to detect FM? Do you believe that antidepressants and medications such as Ritalin help reduce pain?

DrFanto: K, there is no blood test to diagnose FMS. Ritalin can be helpful in select patients.

Question directed to Dr. Fanto:

k: I see an acupuncturist, a massage therapist, and a chiropractor, what else can I do? DrFanto: K, do you see an MD specializing in pain medicine?

k: The acupuncturist is a specialist in pain, and I also see a physiatrist.

Question directed to Dr. Fanto:

Erin27: What do you mean by Absolute Rehabilitation?

DrFanto: Erin27, Absolute Rehabilitation is my company name.

Question directed to Dr. Fanto:

Freda: What kinds of treatments do you recommend for severe pain, an allergic reaction to Codeine, and I already take Ultrams like candy? I have tried PT and massage therapy.

DrFanto: Freda, you may not be allergic to other opiates than Codeine. These should be tried with your pain medication doctor.

Question directed to Dr. Fanto:

777now: Why do some doctors say they don't believe in Fibromyalgia?

DrFanto: 777now, obviously you should see a different doctor.

Question directed to Dr. Fanto:

Shells: I'm trying to cut back on Percocet, and I am taking Ultram between smaller doses of the narcotic, is that safe?

DrFanto: Shells, yes that is safe.

Question directed to Dr. Fanto:

otto: What medications do you recommend for severe pain? What is your feeling of Oxycontin?

DrFanto: Otto, I recommend long acting opiates. Oxycontin is a good example.

Freda: Like what other opiates?

DrFanto: Freda, examples of opiates are Oxycontin, Morphine, Methadone, Fentanyl.

Question directed to Dr. Fanto:

Erin27: Do you work with people who have Chronic Fatigue Syndrome?

DrFanto: Erin27, yes, I work with CFS patients.

Question directed to Dr. Fanto:

Shells: I'm also under the care of my Rheumy, but he's trying to get me into a pain clinic and three have turned me down. Why is this? Because of FM? And they give no reason for this denial.

DrFanto: Shells, they may not believe in treating FM.

Question directed to Dr. Fanto:

otto: Lately I been having swollen glands when pain and fatigue worsen. What could be triggering this?

DrFanto: Otto, swollen glands are common with CFS. If you have not already, you should be seen by an infectious disease specialist.

Question directed to Dr. Fanto:

Erin27: Are there long-term negative effects of taking opiates?

DrFanto: Erin27, constipation, sedation, and rarely respiratory depression.

Question directed to Dr. Fanto:

777now: Can your system build up a tolerance to opiates?

DrFanto: 777now, yes.

Question directed to Dr. Fanto:

Shells: Can I go anywhere for a pain specialist? California is so bad. There's no care, and the system is falling apart. What are my options Dr.? There is just no care here, especially for those on SSD. Can I begin searching other States for a pain specialist?

DrFanto: Shells, you can look at the American Academy of Pain Medicine. They may help you locate a local doctor.

Question directed to Dr. Fanto:

k: What type of rehabilitation would you recommend for FM, taking into consideration that I am also a quadriplegic?

DrFanto: K, pool based programs with a physical therapist experienced in spinal cord injury and FMS.

Question directed to Dr. Fanto:

Shells: I am on Medicare, so I even had to go to the Mayo Clinic in Arizona for a seizure disorder. This is because doctors here refused to treat me and test me appropriately. Can they recommend me someone even in another state other than California?

DrFanto: Shells, the society that I mentioned earlier will help you find a local doctor.

Question directed to Dr. Fanto:

Erin27: Could you tell us what an infectious disease specialist might have to offer us? I understand this may be out of your area of expertise.

DrFanto: Erin27, to rule out another etiology for you pain and swelling lymph nodes.

Question directed to Dr. Fanto:

Freda: What can we do as patients to make sure they don't take Oxycontin off the market?

DrFanto: Freda, speak to your local representatives.

Question directed to Dr. Fanto:

Freda: Why is my Rheumy afraid to prescribe the Oxycontin?

DrFanto: Freda, he may not be comfortable prescribing opiates. Ask if he will refer you to a pain MD.

Question directed to Dr. Fanto:

Erin27: Do you recommend any other treatments beyond medication and pool therapy?

DrFanto: Erin27, there are many alternative therapies such as biofeedback, and acupuncture that may help.

Prohealth911: Thank you, Dr. Fanto. Unfortunately, our time is up.