Relief for sufferers is more than physical
Freezing eggs extends the window of opportunity to find a partner or going it alone
There are few more rewarding opportunities for doctors to deploy their skills than with the inflammatory muscle condition polymyalgia. The symptoms of painful limitation of movement of the neck and shoulders are characteristic, the diagnosis is readily confirmed by a simple blood test, and the patient’s prompt response to treatment with steroids verges on the miraculous.
Not so the mysterious fibromyalgia, recently in the news as the reason for broadcaster Kirsty Young’s decision to step down temporarily from presenting Desert
Island Discs. Here, too, muscle pain is the cardinal symptom, but it is diffuse and fluctuating, and associated with several other debilitating complaints: fatigue, disturbances of sleep and bowel function. With fibromyalgia, there is no confirmatory diagnostic test and the benefits of drug treatment are little better than placebo.
These almost antithetical differences between poly- and fibromyalgia is usually interpreted as indicative that the latter is primarily a psychosomatic condition – the physical expression of mental distress – for which the appropriate treatment is a combination of antidepressants and cognitive therapy. Most of those with the misfortune to suffer from fibromyalgia dispute the psychosomatic explanation, and probably rightly so. Rather, there is accumulating evidence that their symptoms are due to a heightened sensitivity to painful stimuli and other sensations as part of a generalised disorder of the processing of sensory information by the brain.
Certainly, the findings reported last month in the Journal of Clinical Rheumatology, of “a significant favourable effect” of medical cannabis in alleviating the full spectrum of fibromyalgia symptoms, would favour this interpretation.
Fertility dilemma
The dilemma for women torn between the pursuit of a professional career and their wish to have children becomes ever more acute for those who remain single into their late thirties. They should, urges fertility specialist Benjamin Jones of London’s Imperial College, seriously consider freezing their eggs, as this both “extends the window of opportunity to find a partner” while permitting the option, if necessary, of going it alone with the assistance of a sperm donor.
The practicalities are relatively straightforward, if arduous: stimulating the ovaries with fertility drugs to ripen several eggs simultaneously that are then harvested and frozen until the appropriate circumstances arise for becoming pregnant.
This is not cheap. At £15,000 for the procedure itself, and an annual storage fee of £400, it may be affordable for those on professional salaries, if not, regrettably, for others. Furthermore, there can be no guarantee of the desired outcome as the likelihood of conceiving after thawing the eggs and fertilising them in vitro is considerably lower than doing so in the usual way.
There is a further proviso of which those seeking to beat the biological clock should be aware. Put simply, the earlier the better. Those who opt to freeze their eggs in their early or mid-thirties are twice as likely than those who (understandably) defer doing so until later – the corollary being that they are then less likely to have need of them as they might well find a partner in the meantime. A tricky decision.
Leaps abound
This week’s medical query comes courtesy of Mrs AN from Suffolk, understandably puzzled when, for example, perusing her Daily Telegraph online on her ipad that its functioning should be position-related. All is fine if the device is resting on the left armrest of her chair or propped up on the left side in bed. But switch to the right side and “pandemonium ensues”: if reading the letters page, the screen content leaps uncontrollably from letter to letter, only to revert to normal when she repositions her ipad to the left.
Might she be bewitched, she wonders, or is this some undiagnosed medical condition?