A sixteen year old patient came into the clinic for lumps in upper abdomen. She had been to Children’s ED because they are painful. She had a full workup that was negative. She was recommended to have surgery to remove them but came to the SBHC for a second opinion because she did have a primary care physician and was worried about it. Dr. Shomo examined her and did note some hard adipose tissues but noticed that it was not the location of her pain. More tender points were noted and discovered that she was not able to sleep because it hurt to lay down. She was also depressed. She was diagnosed with Fibromyalgia and was started on Amitripyline each night and discussed starting exercise program as this is also helpful for Fibromyalgia and patient is obese. Upon follow-up she stated that her pain had almost completely resolved and that she and her mother had resumed going to the gym to exercise. She was feeling much better and did not have to have an unnecessary surgery that was not going to help her.