Sarah M., 38
Fibromyalgia
7-year history
Failed: Lyrica, Cymbalta, Gabapentin
Rebuttal Scripts — If Your Doctor Says…
“Your labs are normal. There's nothing wrong.”
"Fibromyalgia is a diagnosis of exclusion — normal labs don't rule it out. I've had widespread pain and fatigue for 7 years, tried 3 medications without relief. I'd like to discuss low-dose naltrexone or referral to a pain specialist."
“You just need to exercise more and reduce stress.”
"I've been doing graded exercise per the previous recommendation — it worsened my symptoms, which is consistent with post-exertional malaise. I'd like to discuss pacing strategies and whether ME/CFS should be evaluated alongside fibromyalgia."
Custom Doctor Questions
- 1Given my failed trials of Lyrica, Cymbalta, and Gabapentin, what is your rationale for the next treatment choice?
- 2Has my case been evaluated for small fiber neuropathy — and if not, why?
- 3What functional improvement should I expect in 90 days if we proceed with the proposed treatment?
- 4Are there clinical trials I qualify for given my treatment-resistant presentation?
Visit Strategy
Lead with the treatment timeline: Present 7 years, 3 failed meds, and current functional impact before discussing new requests.
Request documentation: Ask the doctor to document any treatment refusals and their clinical rationale in your chart.
Biggest concern to state first: "I am losing my ability to work full-time. I need a treatment path, not symptom management."