Example of a typical history of generalized fibromyalgia

(all four quadrants affected).

At the time of the first examination the patient presented three sheets each with three sketches:

• Sheet 1 shows the beginning of the illness after a vehicle accident 20 years before.

• Sheet 2 shows the worsening over time ("con el tiempo").

• Sheet 3 shows the condition on the day of the examination prior to the operation.



Peculiarity: The illness began on the upper right quadrant. On the day of the examination, however, the patient complained of the strongest pains in the lower right quadrant. In keeping with this, the tender points on the lower right quadrant were also the most painful to the touch. For this reason there was a deviation from the rule that the place where the illness began should be the first to be operated on. Then in November 2010 an operation was performed on the quadrant that had generated the most pain prior to the operation.

• Sheet 4 shows the sharp abatement of the symptoms after the operation on the right lower quadrant. In November and December 80% of the symptoms had disappeared.



• Sheet 5 shows the gradual return of part of the complaint picture. The colour marking from yellow to red symbolises the increase. It is noteworthy that it again spreads out from the upper right quadrant. January is worse, February worse than January.



• Sheet 6 shows the spread of the complaint picture in March and April. One might think that in April all complaints had returned. But that is not correct. Compared to Sheet 3, the legs are relatively clear.



The logical conclusion from the history described was that the second operation had to be carried out on the upper right quadrant.

The patient bore the second operation in May 2011 well. She will document the healing process in images just as precisely as before.









It remains to be seen whether she will need all four quadrant operations. In any case she has understood that it would not be sensible to prematurely break off the operational treatment. The interconnections are difficult to understand. For that reason outside parties such as poorly informed general practitioners, insurance doctors, fibromyalgia associations and rheumatologists or the medical services may not evaluate the state of affairs at all.

The surgical treatment of fibromyalgia (quadrant intervention according to Bauer) is about exerting influence surgically on the neuro-psychological representation of the erroneous signals and allocations caused by the entrapment of the small peripheral nerves.

See also the document "Intention and Purpose of Quadrant-Pain-Intervention at a Glance" at the following link: www.fms-bauer.com/downloads/FMS-Poster-GB.pdf

© 2011 Angela Escribano Perez (images)