What to say to the patient who has just been diagnosed as having generalized rheumatism (fibromyalgia)

By the time a patient with generalized rheumatism (fibromyalgia) is referred to a rheumatologist, usually he or she has already seen a number of other physicians who have diagnosed various conditions, at least one of which is that the condition is psychiatric. Commonly, these patients, who have been contending with chronic discomfort and fatigue, have also become confused, angry and depressed. Thus, it is important not only for the rheumatologist to correctly diagnose the condition, but to gain the patient's confidence as well. The only way to do this takes time, but it is time well spent.The history must be taken in detail: the patient must be encouraged to tell his or her entire story. The patient must be convinced that the physician has appreciated the extent and significance of each symptom. A thorough physical examination should follow, with evident attention to each symptomatic area. The discussion that follows must be complete and compassionate. It is the hardest but the most important part of the consultation, and therefore an example is provided in detail.