The Brand New Blog of Fog

Fibromyalgia Tissue Bank to Study Role of Glial Cells

2007-03-07T17:29:00.000-05:00

Fibromyalgia Tissue Bank to Study Role of Glial Cells

The world's first fibromyalgia tissue bank has been established at Sun Health Research Institute in Sun City, Arizona. The tissue bank will expand the area of arthritis research and explore the role of glial cells as they relate to fibromyalgia pain.

Glial cells, also known as glia, are supportive cells in the brain and spinal cord which do not conduct electrical impulses, unlike neurons which do. The first human tissue study to determine if glial cells are involved in long-term pain conditions will hopefully lead to improved treatments. According to the institute, the research could be important for 50 million Americans who suffer from chronic pain conditions ranging from nerve damage, arthritis inflammation, and fibromyalgia to cancer and AIDS. Fibromyalgia tissue donors will be asked to visit the institute each year to undergo a fibromyalgia evaluation and complete a pain assessment questionnaire. Actual tissue donation would not occur until the donor's death.

From the Sun Health website www.sunhealth.org

FOR IMMEDIATE RELEASE

MEDIA CONTACT:
Susan Bennett
Linda Tyler
(623) 815-7600

First fibromyalgia tissue bank to be established

Sun City, Arizona
2/15/2007

Sun Health Research Institute has established the world's first fibromyalgia tissue bank and is initiating the first research to explore the latest theory in fibromyalgia pain. Both of these endeavors could positively impact the millions of people in the United States suffering from fibromyalgia.

The National Institute of Health (NIH) has awarded a $1.4-million grant to Dr. Dianne Lorton, head of the Sun Health Research Institute's Robert J. Hoover Center for Arthritis Research, to establish the world's first fibroymalgia tissue bank.

"This is vital to the institute's expansion of arthritis research and initiating the first research to explore the role of glial cells in fibromyalgia's chronic pain," said Dr. Joseph Rogers, president of Sun Health Research Institute.

The expanded arthritis research project is made possible not only by the NIH grant but also by a $100,000 grant from the American Fibromyalgia Syndrome Association and a pilot project grant from the NIH. The newly awarded NIH grant is establishing a fibromyalgia brain and spinal cord tissue bank to explore mechanisms for the pain of this disease.

"Tissue collected from fibromyalgia patients will be an incredible resource for finding answers to the questions of what causes fibromyalgia and how we can successfully treat it,"said Dr. Lorton. "There is a great need for individuals with fibromyalgia to become tissue donors to help us find new insights into understanding and treating the chronic pain of this disease."

This will be the first human tissue study to scientifically demonstrate whether activated brain and spinal cord cells called glia are involved in long-term pain conditions which will allow for the development of new drugs that control chronic-pain responses.

"Pain in fibromyalgia is poorly understood and managed," said Lorton. "It is expected this innovative new research will lead to a potentially revolutionary treatment for the millions of people suffering with severe chronic pain."

Lorton is collaborating with Dr. Linda Watkins at the University of Colorado, Boulder, in doing this research that could significantly impact the fifty million Americans who suffer from long-term pain caused by nerve damage from shingles or diabetes, inflammation from arthritis, and in diseases and syndromes such as cancer, AIDS and fibromyalgia.

Tissue donation will not occur until the donor's death. However, fibromyalgia-tissue donors will be asked to visit the institute annually to undergo a fibromyalgia assessment and complete a pain-assessment questionnaire. Donor enrollment benefits include priority placement on a list for any future clinical trials of newly developed drugs for treating chronic pain. For information on becoming a tissue donor, call (623) 875-6528.

"It is a very personal decision to become a tissue donor, but the possibility of helping to find a cure for future generations can make this a rewarding and positive experience," Lorton said.

During 2006, Sun Health Research Institute celebrated 20 years as a pioneer in the search for answers to age-related diseases. Since its founding in 1986, the Institute, together with its Arizona consortium partners, has been designated by the National Institutes of Health as one of just 29 Alzheimer's Disease Centers in the nation. The Institute's Cleo Roberts Center for Clinical Research takes laboratory discoveries to clinical trials that foster hope for new treatments. The Institute is affiliated with the Sun Health non-profit community healthcare network.

Got my Disabled Parking Placard!!!

2007-01-11T13:34:00.000-05:00

Hi all! Just to let you in on the good news...
After waiting almost two months for the darn thing to come in, I finally got my placard. Finally I can start parking in those places that only the brave dare go!
Finally I can stop parking in the obscure spots because people are greedy and "need" to be close to the door. Finally I can not worry about making it to my car after navigating Wal-Mart and trying not to collapse before I reach the car.
Finally I can accept that I am truly disabled enough to warrant help. Its only taken me 6 years to come to that conclusion and my pig-headedness finally allowed me to ask for true help.

Managing Your Energy

2007-01-11T13:28:00.000-05:00

Happy New Year all! During this time we tend to make resolutions to change our thinking about our illnesses in one way or another...here is an article that may help you deal with the chronic fatigue and trying to be "normal" and getting things done everyday.

Managing Your Energy
From Karen Lee Richards, www.chronicfatigue.about.com

Does this scenario sound familiar? You get up one morning and, surprisingly, feel a little better than usual. Almost giddy with excitement, your mind quickly scans the list of chores you’ve been too sick to take care of. You eagerly begin…clean the house, do the laundry, work in the garden. By midday, you start to sense that your body is getting tired, but the adrenaline rush and sense of accomplishment spurs you on. You push yourself to make use of every little bit of energy you can muster before you collapse into bed. The next morning, you wake up feeling like you’ve been run over by the proverbial Mack truck. For the rest of the week, it’s all you can do to drag yourself from bed to bath to sofa.

Most of us with fibromyalgia or chronic fatigue syndrome are so sick and tired of being sick and tired, that whenever we get even a hint of extra energy, we go overboard.

It’s hard not to. For a few brief hours we almost feel “normal” again. But, as tempting as it is to go all out on a good day, it’s exactly the wrong thing to do. We would never think of handling our finances like we handle our energy. If we spent our entire paycheck on the day we received it, we’d have nothing left to live on until our next payday. Just as we budget our money, it’s essential that we learn to budget our energy.

Living Within Your "Energy Envelope"
You may be familiar with the envelope method of handling your finances. It’s not used as often in this credit-card age, but it is a simple, effective way of living within your budget. Here’s how it works. You set aside one envelope for each item in your budget (rent, utilities, food, etc.). Each payday, you place a designated amount of money in each envelope. When an envelope is empty, you’ve spent your allotted budget for that period of time. Anything else you need in that category either has to wait until the next payday, or must be taken from another envelope. Of course, the problem with taking money from another envelope is that you will run short when that particular bill comes due. For example, if you run out of money in your food envelope and so take $50 from your rent envelope, when the rent comes due, you’ll be $50 short.
What does the envelope method of budgeting have to do with your energy levels? You can start budgeting your energy, just as you do your money. Until you are able to build an energy reserve, you’ll have to budget your energy on a daily basis. Each day when you awaken, assess your energy level for that day. Realistically decide how much you think you can do that day and mentally picture putting your day’s worth of energy into an envelope. Every time you expend energy for something, imagine taking a portion of your energy allotment out of the envelope. When your envelope is empty, it’s time to stop for the day.

If visualizing is not your thing, you might try writing tasks for the day on pieces of paper and actually put them into an envelope, removing each task as it’s accomplished.

Using the “Fifty-Percent Solution”
Once you get the hang of living within your energy envelope, you can start building an energy reserve – a kind of energy savings account. Rather than using up all of your energy each day, begin following the “fifty-percent solution.” When you make your energy assessment for the day, only do fifty percent of what you feel like you can do. If you feel like you can exercise for 20 minutes, only exercise for 10. Instead of consistently depleting your energy each day, you will slowly begin to build a reserve.
Not continually pushing your body to its limits allows it more time to heal and build strength. According to Dr. William Collinge, author of Recovering from Chronic Fatigue Syndrome: A Guide to Self-Empowerment, the rest you get on a good day is of a higher quality than the rest you get on a bad day. Eventually this additional quality healing time will pay off with more energy on a regular basis.

Sources: Campbell, Bruce. The CFIDS/FIbromyalgia Toolkit, A Practical Self-Help Guide. Lincoln: Authors Choice Press, 2001.

Collinge, William. “Promoting Recovery: The fifty percent Solution.” ProHealth. 5/25/06.

Updated: January 10, 2007

Can a Simple Blood Pressure Test Diagnose Fibromyalgia?

2006-12-28T14:47:00.000-05:00

From Karen Lee Richards,
Your Guide to Fibromyalgia & Chronic Fatigue Syndrome. www.chronicfatigue.about.com

When you go to the doctor, do you cringe when the nurse pulls out the cuff to take your blood pressure -- because you know it’s going to be painful? I know I do – and I always feel like a wimp because I can’t even tolerate a simple blood pressure test. One nurse actually called me a wimp, but another more kind-hearted nurse taught me to ask for the large cuff, which does significantly reduce the degree of pain I experience.
Apparently, I’m not alone. In a recent study, 69 percent of fibromyalgia patients experienced pain from blood pressure testing. The study entitled, “Sphygmomanometry-Evoked Allodynia – A Simple Bedside Test Indicative of Fibromyalgia: A Multicenter Developmental Study,” was published in the December 2006 issue of the Journal of Clinical Rheumatology.
Terminology: Sphygmomanometry is the long word for the simple and standard blood pressure test which everyone receives at the doctor's office. Allodynia is a condition in which pain results from a stimulus that does not normally evoke pain.

Objective: The objective of the study was to determine whether a universally used clinical test -- sphygmomanometry -- would be helpful in identifying FM patients.
Method: Researchers studied 20 fibromyalgia patients, 20 rheumatoid arthritis (RA) patients, 20 osteoarthritis (OA) patients and 20 healthy individuals in each of three public rheumatology outpatient services. Each participant was asked to answer the question, “When I take your blood pressure, tell me if the cuff’s pressure brings forth pain.”
Results: While 69 percent of FM patients experienced sphygmomanometry-evoked allodynia, only 10 percent of OA patients, five percent of RA patients and two percent of healthy individuals did. The mean blood pressure value at which FM patients felt pain was lower than the other three groups. FM patients showed a negative correlation between the blood pressure value at which the allodynia developed and the total Fibromyalgia Impact Questionnaire (FIQ) score, number of tender points, and the FIQ visual analog scales for pain intensity and fatigue.
Conclusions: In this study, there was a strong association between pain experienced during blood pressure testing and the diagnosis of FM. Sphygmomanometry is a simple test and a universally standard clinical procedure that may be useful in recognizing FM patients. Based on the results of this study, the researchers suggest looking for other FM features in anyone who has sphygmomanometry-evoked allodynia.
Source: Vargas, Alfonso MD, et al. Sphygmomanometry-Evoked Allodynia – A Simple Bedside Test Indicative of Fibromyalgia: A Multicenter Developmental Study Journal of Clinical Rheumatology. 2006 Dec;12(6):272-4.

Updated: December 27, 2006

Fibromyalgia Pain: It's for Real

2006-12-19T13:22:00.000-05:00

Researchers Say Chronic Pain Patients Don't Process Body's Natural Pain Relievers
By Salynn Boyles
WebMD Medical News Reviewed By Louise Chang, MD
on Thursday, November 30, 2006

Nov. 30, 2006 -- There is now "overwhelming" scientific evidence showing that fibromyalgia and related chronic pain conditions are real, but their clinical management leaves much to be desired.

That is the conclusion of two researchers from the University of Michigan who have studied fibromyalgia for several years.

Because there has been no obvious physiological cause for the pain disorder, doctors still routinely dismiss fibromyalgia as being "in a patient's head."

But after reviewing the research, Richard E. Harris, PhD, and Daniel J. Clauw, MD, write that it is increasingly clear that fibromyalgia is a central nervous system disorder and that patients experience hypersensitivity to pain. There also appears to be a fairly strong genetic component to fibromyalgia and related conditions.

"It is time for us to move past the rhetoric about whether these conditions are real, and take these patients seriously as we endeavor to learn more about the causes and most effective treatments for these disorders," Harris and Clauw write in the December issue of the journal Current Pain and Headache Reports.

Brain Imaging Studies

As many as 10 million Americans may have fibromyalgia, according to The National Fibromyalgia Association.

The disorder is characterized by chronic pain throughout the body, but symptoms may also include fatigue, headaches, and problems with memory and concentration.

Brain imaging studies conducted at the University of Michigan and other research centers in recent years show clear differences in responses to pain stimulation among people with and without fibromyalgia.

Compared to people without the disorder, fibromyalgia patients showed increased brain activity in response to pain.

"These studies indicate that fibromyalgia patients have abnormalities within their central brain structures," Clauw says.

Research by Harris, Clauw, and colleagues also suggests that fibromyalgia patients don't process the body's natural pain relievers as efficiently as people without the disorder.

"We think that these may have both a heightened sensitivity to pain and this dysfunction in their analgesic [painkilling] mechanism," Harris tells WebMD. "It is not yet clear how this all fits together."

National Fibromyalgia Association president and founder Lynne Matallana tells WebMD that the doctors who treat fibromyalgia patients face a unique challenge.

"This is a new paradigm for medical professionals to understand," she says. "It isn't a virus, or bacteria or inflammation. It isn't a tumor or something else that you can see. It is a problem within the pain-processing center of the central nervous system."

Treatment Options Still Few

While the recent research has done much to improve the understanding of fibromyalgia and related chronic pain conditions, few advances have been made in the treatment of these disorders, Harris says.

The use of medications such as antidepressants can help some patients with fibromyalgia. And regular exercise seems to help many patients.

Acupuncture has been shown to reduce pain in some studies, but not others, he adds.

Matallana says several drug companies are in the later stages of testing several new drugs designed specifically for the treatment of fibromyalgia, which target the central nervous system.

"We are really excited about this research," she says.

--------------------------------------------------------------------------------

SOURCES: Harris, R. and Clauw, D. Current Pain and Headache Reports, December 2006; online edition. Richard E. Harris, PhD, research investigator, University of Michigan Medical Center, Ann Arbor. Daniel J. Clauw, MD, department of medicine, division of rheumatology, University of Michigan Medical Center, Ann Arbor. Lynne Matallana, president and founder, National Fibromyalgia Association.

Arthritis and weather?

2006-12-17T07:07:00.000-05:00

www.arthritis.about.com
From Carol & Richard Eustice,
Your Guide to Arthritis.

Weather and Arthritis Symptoms: Is There a Connection?
Many arthritis patients claim weather affects how they feel. Some people with arthritis believe that symptoms of arthritis (such as pain and stiffness) are influenced by changes in the weather.
Is there a connection between weather and arthritis symptoms?
Why is the effect of weather changes on arthritis symptoms true for some but not for others?
Where is the best place to live, in terms of climate, if you have arthritis?

We asked rheumatologist Scott J. Zashin, M.D. to explain, Is There a Connection Between Weather and Arthritis Symptoms?

Many arthritis patients claim weather affects how they feel. Some people with arthritis believe that symptoms of arthritis (such as pain and stiffness) are influenced by changes in the weather.

Is there a connection between weather and arthritis symptoms?
Why is the effect of weather changes on arthritis symptoms true for some but not for others?
Where is the best place to live, in terms of climate, if you have arthritis?

Weather and Arthritis Symptoms

It is not uncommon for patients with arthritis to notice an increase in symptoms with certain weather conditions. For example, some of my patients can predict when it will soon rain based on their symptoms. Others feel terrific in places that have increased barometric pressure, but hurt more in locations where the pressure is lower.

The "Rejuvenator"

In fact, a patient of mine felt so well when he vacationed in Destin, Florida that he developed a small chamber that would raise the barometric pressure to a level that replicated Destin. He would sit in the chamber for 30 minutes twice a day and was able to discontinue his medications.
Due to his relief, I conducted a very small study that exposed patients to 30 minutes in a placebo chamber and 12 hours later in the "Rejuvenator" (the chamber that was developed to have an increase in barometric pressure), as well as another study that included one 30 minute placebo session and two 30 minute "Rejuvenator" treatments over 3 days. The majority of the patients had clinical improvement using the chamber with the increased barometric pressure. Side effects included self-limited symptoms of ear pressure, sinus pressure and "windburn". Based on the results of this preliminary study, more testing was recommended to further study the potential benefits and risks of this therapy.

Further Studies

Further support for an effect on atmospheric pressure in arthritis was published in the Proceedings of the Western Pharmacology Society in 2004. In this prospective, double blind study, 92 patients with osteoarthritis and rheumatoid arthritis were compared to a control group of 42 subjects. The authors concluded that the osteoarthritis patients experienced increased joint pain with a low atmospheric pressure while low temperature increased the risk of joint pain in the rheumatoid group. Another study published in the Journal of Rheumatology in 2004 demonstrated that high humidity was unfavorable for arthritis patients. Based on these particular studies, it would seem that a location that tends to have a higher barometric pressure and lower humidity would represent a favorable environment for arthritis patients.

Best Place to Live?

For those patients who ask me where the best place for them to live in terms of climate, I suggest live where you will be happiest and certainly if you decide to move somewhere based on arthritis, make sure you try it out by spending plenty of time there during different seasons before making any move.

Answers provided by Scott J. Zashin, M.D., clinical assistant professor at University of Texas Southwestern Medical School, Division of Rheumatology, in Dallas, Texas. Dr. Zashin is also an attending physician at Presbyterian Hospitals of Dallas and Plano. He is a fellow of the American College of Physicians and the American College of Rheumatology and a member of the American Medical Association. Dr. Zashin is author of Arthritis Without Pain - The Miracle of TNF Blockers. The book is useful for anyone on one of the biologic drugs (Enbrel, Remicade, Humira) or considering the biologic drugs. Read my review of the book.

FAQ Index
Updated: December 14, 2006

Sorry,....rant coming!!!!

2006-12-13T20:15:00.000-05:00

This morning my left shoulder was in extreme pain. I saw my pain doc in at 10 AM and I asked him for better pain control. I was a little worried about asking him because I have never asked him for this type of help before. I would have liked to have askd him for pain meds but nothing that I have to take all the time. Only when I needed it. I didn't want to be seen as a drug seeker (as we all have that fear) so I was worried about asking him.
Isn't a shame that us CPers have to worry about asking doctors for help?
Well, here is what happened....
I went to my appointment and I got my depo-medrol shots in my shoulder which helped and all he would give me is a medrol pak. He wouldn't help beyond that. Sigh. He all but said that the pain is in my head. Which made me upset...like I wasn't crying already from the pain.
Yes, it kinda shocked me that he said that. They (he and his nurse) kept going on about pondering why I was feeling so bad. It was anything from stress from the holidays, to being depressed (of course I was I was upset because I hurt so darn bad!), to the weather. They tried to get me to take neurontin again, but I said no way because I gained 50 pounds on it and was on 1800 mgs a day that did nothing. He then asked if I had been on Cymbalta, I said yes and it didn't work out for me. I think to get me out of his hair, he gave me the medrol pak. Sad huh. But he is the only pain doc that will see me. Don't know what to do next if I choose to stop seeing him.
I am having pain in my SI joint, which is causing the majority of my pain, and I think I need a doc that specializes in that area to take a look at me and see what is going on there.
UGH! Why is it when you feel the worst the doctors seem to become more of a hinderance than a help?
As time has gone on....here is where the rant begins.....
He juices me up twice a month with Depo-Medrol which is like a band-aid on a small piece of pain when my entire body is dying at times from it. For the first time since I have seen him which was a year in September, I have asked for this kind of help. And he gives me 7 days of oral steroids, which I am not sure will do anything right now. I have had 2 ESIs, 2 facet injections and one radio frequency ablation. Basically everything short of surgery. None of which has worked.
The ONLY meds he has prescribed for me are Lidoderm patches, baclofen, trazodone and now the medrol pak. He has in the past tried mexitil, which again didn't work. Everything just a band-aid he is doing. I feel that he is milking the system for money. Since I am on Medicare, he can string me along for as long as I let it happen.
Today has made me realize that he can do no more for me than he has already done. And won't do anymore. He made that perfectly clear on that account today.
What do I do??? Where do I go from here?
I know my pcp is uncomfortable with giving pain meds and usually refers me to my rheumy, who is in the same practice. Who also won't do pain meds. Living where I do, near a city where some of the best health care in the world is to be had, I can't get a doctor to help me!!!!! I am at a loss.
I have done everything they have asked of me. Did physical therapy twice in a year. Done a Functional Capacity Evaluation to show that I am unable to function at a "normal" level. Gone through immensely painful procedures to get a glimpse of a possibility of help with my pain. I don't complain. I never call the doctor's office and be a nuisance. I am kind, friendly and never skip an appointment.
All I want is to live in a resonably comfortable existance physically. I would like to function somewhat normally. Geez, listen to me....I would like this, I would like that.....I guess it is not meant to be. I am being forced to live in pain at levels that most people would go to the hospital or stay home from work for. They get the attention and medication they need. While I and some of you are here in pain crying for help. We can't even take an ibuprofen without getting a slap on the wrist for doing so. Some side effect or whatnot.
Okay, getting off my soapbox now! I don't feel better but at least I got it out!

The Many Emotions of Chronic Arthritis

2006-12-13T15:56:00.000-05:00

This information can also go along with any type of chronic pain illness.

From Carol & Richard Eustice www.arthritis.about.com

Emotional Impact of Arthritis: One Emotion Leads to Another

Physical aspects of arthritis are manifested in pain and other symptoms. The gamut of emotions which coincides with the physical problems are equally important.

Arthritis affects a person's life and changes their reality on many levels. Physically, your body does not perform as it once did. You face everyday challenges such as:

chronic pain
chronic fatigue
limitation
loss of ability
other health problems

As it becomes necessary to find other ways of doing things and depend on other people for care and help, it becomes imperative to acknowledge the emotional aspects of arthritis.

The expectations of what you are able to do changes as the disease changes. As the disease evolves over time, it affects:

abilities
responsibilities
relationships
personal identity

Emotions Of Arthritis

Concern: As you first experience arthritis symptoms, there is concern over what is happening.

After consulting with a rheumatologist (a doctor who specializes in arthritis and related conditions), the concern is directed toward the results of your medical exam.

Fear: Concern can quickly turn into fear as the uncertainty of the illness becomes the focus. The long-term prognosis may be feared.

Denial: The most powerful emotion which attempts to take over other prevalent emotions is denial. Avoiding the reality of the situation and continuing to live life as if unaffected by the disease is used as a coping mechanism. In terms of coping, denial is used positively. However, harm can be done if denial leads to activities which exacerbate symptoms.

Relief: A definite diagnosis of your early symptoms can give you a sense of relief. You feel more in control, because you know what you are facing. This relief is temporary, since a diagnosis is not the precursor to a cure.

Frustration: Frustration is a common emotion for people living with arthritis. Frustration mounts when dealing with:

limitations
loss of ability
decreased mobility
increased fatigue
other changes

Lifestyle changes caused by arthritis are often difficult to accept.

Unfairness: Often regarded as jealousy, envy, or the "why me" syndrome. An overwhelming sense of loss from all the lifestyle changes can lead to feelings of unfairness and being shortchanged. You may look at other people and wonder why you and not them.

Anger: Many aspects of arthritis can lead to anger.Circumstances that may lead to anger include:

inconveniences caused by the illness
attitude of doctors and health care personnel
lack of understanding from family and friends

In contrast, angry feelings may occur when loved ones hover over you, try to control your life, or affect your need for independence. Anger is an emotion people encounter intermittently throughout the course of the illness.

Loss Of Control: At some point it is realized that arthritis is the determining factor in many situations. The disease must be respected because it is the reason for changes that are necessary. You no longer control every situation because the disease becomes a major factor.

Devastation: As plans and goals are forced to be altered, an air of devastation can be caused by:

financial loss
career loss
family disruptions

A person suffering so much loss often feels depleted and robbed by their ill-health.

Hopelessness: Self-destructive feelings such as hopelessness can surface if you become swallowed up by your sorrow. Sadness is a normal emotion that we all feel at times. It's not the same as depression. If you give up or surrender to the negative impact of arthritis without any regard to the remaining positive aspects of your life, hopelessness will prevail.

Mourning: An arthritis sufferer will go through a process of mourning from:

the realization that life has forever changed
the accumulation of personal loss

Just as the death of a loved one is met with a period of mourning, the loss of dreams and the loss of the person you once were must also be permitted a period of mourning.

Coping: A person living with chronic arthritis can develop a change in perspective. A special, humble camaraderie can develop among people coping with arthritis. Coping skills can be improved through:

mutual support
loved ones
patient education
being a partner in ones own health care

Solving difficult issues imposed by arthritis helps people "live with" the illness.

Acceptance: At the point when you learn to accept your arthritis and not fight the disease, you become liberated and begin to concentrate on:

treatment options
eliminating stress
prioritizing activities

With acceptance, you reap the benefits of living wisely "with" the disease.

Hope: Positive attitude can help you adjust to life with a chronic disease. The emotion of hope must also exist when searching for better treatment and a better quality of life.

Many FM & CFS patients in D-ribose study report quality of life improvements

2006-12-08T07:12:00.000-05:00

Many FM & CFS patients in D-ribose study report quality of life improvements
by Editor
www.ImmuneSupport.com

12-06-2006

The natural dietary supplement D-ribose - a form of sugar essential to fuel cellular energy generation - "significantly reduced clinical symptoms in patients suffering from Fibromyalgia and Chronic Fatigue Syndrome," a Texas-based research group reported recently. Their study - "The Use of D-Ribose in Chronic Fatigue Syndrome and Fibromyalgia" - headed by internationally recognized FM/CFS Doctor Jacob Teitelbaum, MD, was published in the November 2006 issue of the Journal of Alternative and Complementary Medicine.*

Key Findings

Of 41 study participants diagnosed with CFS and/or FM who received D-ribose supplementation daily for four weeks, 66 percent achieved “significant improvements in quality of life," the report states. Change was measured using patients' before-and-after visual analog scale (VAS) scores for energy, sleep, mental clarity, pain intensity, and well-being, as well as global quality of life assessments.

Key findings for the patients who perceived significant change included:

* 45 percent average improvement in energy score

* 30 percent average improvement in overall well-being

These findings are considered statistically significant (P < 0.0001), meaning the probability they were owing to chance is less than 1 in 1,000. In particular, the report indicates, patients tended to perceive improved "ability to overcome fatigue," as well as less muscle soreness and stiffness. And supplementation with the natural substance D-ribose was "tolerated well."

Study Details

The study was open label and uncontrolled, meaning all participants took D-ribose, no patients were given a placebo, or "fake" dose as a means of comparison, and no subjects with normal health were included as a means of comparison. Termed a "feasibility" study, the research involved a small number of patients, as a possible preliminary to more extensive investigation. Of the 41 patients, 78 percent were female and their average age was 48. They took five grams of D-ribose by mouth three times a day for an average of 28 days.

What is D-ribose?

D-ribose, also called “ribose,” is a form of sugar containing five carbon atoms that all living cells require for creation of ATP (adenosine triphosphate), the body's main source of energy. D-ribose is also a crucial component of other important molecules within our cells, such as RNA (ribonucleic acid), and DNA (deoxynbonucleic acid). DNA produces the proteins cells need to function and develop, while RNA provides the instructions for the job.

How is D-ribose Obtained?

Our bodies make D-ribose for use by the cells from glucose - a sugar that contains six carbon atoms, which plants manufacture by the process of photosynthesis. We obtain glucose, also known as "blood sugar," from the fruits, berries, vegetables, and honey we eat. In a glucose-deficient pinch - such as starvation, fasting, or extremely demanding exercise - our liver and even our kidneys may also synthesize glucose from other compounds to provide a source of D-ribose for the cells. But this is an energy-intensive process.

D-ribose has also long been available as a dietary supplement, produced by fermentation of corn syrup. And it can be obtained from some RNA-rich food substances such as brewer's yeast.

What's the Theory of Benefit?

How do the researchers think D-ribose supplementation supports improved CFS and FM patient quality of life? Many scientists have come to believe that "inefficient" or "disordered" cellular metabolism may account for the symptoms of fatigue and muscle pain associated with CFS and FM. Patients' muscles become "anaerobic" or depleted of oxygen faster than the muscles of normal healthy people. And supplementation with the nutrient D-ribose may represent one avenue for supporting faster regeneration of ATP and healthier metabolism in oxygen-deprived muscle cells.

Next Steps

Dr. Teitelbaum, the principal investigator of this D-ribose supplementation study, is Medical Director of the Fibromyalgia and Fatigue Centers, based in Dallas. He is the much-published author of such best-selling books as From Fatigued to Fantastic and Pain Free 1-2-3.

Dr. Teitelbaum reported that his organization is already pursuing follow-up studies of the benefits of D-ribose supplementation for CFS and FM patients, and he and his colleagues consider D-ribose supplementation so promising that they have made it a standard part of therapy for their patients.

* To review an abstract of the study report, go to http://www.immunesupport.com/library/showarticle.cfm/id/7539

Note: This information has not been evaluated by the FDA. It is not meant to diagnose, treat, cure, or prevent any disease. It is very important that you never make any change in your health support plan or regimen without reviewing and discussing it collaboratively with your professional healthcare team.

The pain from fibromyalgia is real

2006-11-28T17:54:00.000-05:00

Thanks to www.fibrohugs.com

Public release date: 28-Nov-2006
Contact: Katie Gazella
University of Michigan Health System

The pain from fibromyalgia is real, researchers say
University of Michigan doctors say widespread evidence verifies
validity of condition, say patients should be taken seriously

ANN ARBOR, Mich. - Many people with fibromyalgia - a debilitating
pain syndrome that affects 2 to 4 percent of the population - have
faced the question of whether the condition is real.

Fibromyalgia often has been misdiagnosed as arthritis or even a
psychological issue. Increasingly, though, the scientific knowledge
about fibromyalgia is growing, and a new paper from the University of
Michigan Health System says there are "overwhelming data" that the
condition is real, is characterized by a lower pain threshold and is
associated with genetic factors that can make some people more likely
to develop fibromyalgia.

The review paper, in the December issue of the journal Current Pain and
Headache Reports, cites recent studies involving pain, genetics, brain
activity and more. The paper's authors hope these findings will lead to
a better understanding and acceptance of fibromyalgia and related
conditions.

"It is time for us to move past the rhetoric about whether these
conditions are real, and take these patients seriously as we endeavor
to learn more about the causes and most effective treatments for these
disorders," says Richard E. Harris, Ph.D., research investigator in
the Division of Rheumatology at the U-M Medical School's Department of
Internal Medicine and a researcher at the U-M Health System's Chronic
Pain and Fatigue Research Center.

A growing amount of research related to the neurobiology of the
condition supports the notion that the pain of fibromyalgia is real.
Studies at U-M and elsewhere using two neuroimaging techniques -
functional magnetic resonance imaging (fMRI) and single photon emission
computed tomography (SPECT) - indicate there is a difference between
patients with and without fibromyalgia.

"In people without pain, these structures encode pain sensations
normally. In people with fibromyalgia, the neural activity
increased," says Daniel J. Clauw, M.D., director of the U-M Chronic
Pain and Fatigue Research Center and professor of rheumatology at the
U-M Medical School, and an author of the new paper. "These studies
indicate that fibromyalgia patients have abnormalities within their
central brain structures."

In a 2003 paper in the journal Science, a U-M team reported that a
small variation in the gene that encodes the enzyme called
catechol-O-methyl transferase, or COMT, made a significant difference
in the pain tolerance, and pain-related emotions and feelings, of
healthy volunteers. Researchers also have found that individual
mutations in the COMT gene are related to the future development of
temporomandibular joint disorder, also known as TMD or TMJ, a condition
related to fibromyalgia.

Together, these studies about COMT and numerous studies with animals
suggest that pain sensitivity is determined at least in part by a
person's genetic makeup, Clauw says.

The authors note that there are some legitimate areas of debate
regarding fibromyalgia, including disagreements about how precisely it
should be defined and whether people with the condition deserve
compensation. But none of those disagreements should detract from the
acceptance of it as a condition causing real pain, they say.

###
Reference: Current Pain and Headache Reports, Dec. 2006, pp. 403-7.

Millions of Americans in Pain

2006-11-25T09:27:00.000-05:00

Millions of Americans in Pain
Most Common Pains Are Low Back Pain, Migraine or Severe Headache, Joint Pain
By Daniel DeNoon
WebMD Medical News Reviewed By Louise Chang, MD on Wednesday, November 15, 2006

Nov. 15, 2006 -- Each month, one in four American adults suffers pain for at least 24 hours. That pain lasts for a year in nearly three-fifths of those over 65 and in 37% of those aged 20 to 44.

These numbers are why the CDC has made pain the focus of this year's annual report card on U.S. health.

The painful facts:

In a 2004 survey, more than one in four American adults reported low back pain in the last three months.
In 2004, 15% of American adults reported migraine or severe headache in the past three months.
In 2004, about one-third of adults over 18 and half of adults 65 and older reported joint pain, joint aches, or joint stiffness in the past 30 days. The knee is the most common site of joint pain.
Use of narcotic pain drugs is up. During 1988-1994, 3.2% of Americans took narcotics for pain. That percentage rose to 4.2% in 1999-2002.
Recent low back pain makes it five times more likely that a person will suffer serious psychological distress.
The most common pains are low back pain, migraine or severe headache, and joint pain.

Other facts from the CDC's Health, United States, 2006:

American girls born today can expect to live more than 80 years. An American boy's life expectancy is just short of 75 years.
The gap in life expectancy between white Americans and black Americans has narrowed. The gap was seven years in 1990 and five years in 2004.
The average cost of health care for Americans is $6,280 a year.
In the last year, 7% of American adults under age 65 passed up needed health care because they could not afford it.
Heart diseaseHeart disease is still the No. 1 killer of Americans -- but between 2000 and 2004, U.S. heart-disease deaths dropped by 16%.
Deaths from America's No. 2 killer -- cancercancer -- dropped 8% between 2000 and 2004.
More and more Americans suffer diabetesdiabetes. Diabetes strikes 11% of Americans aged 40 to 59 and 23% of Americans aged 60 and older.

--------------------------------------------------------------------------------

SOURCES: National Center for Health Statistics, CDC, Health, United States, 2006. News release, CDC National Center for Health Statistics.

Long-term pain hits 1 in 10 Americans, CDC reports

2006-11-22T03:28:00.000-05:00

Long-term pain hits 1 in 10 Americans, CDC reports

Nov 16 (Reuters) - One in 10 U.S. adults suffer pain that lasts a year or more, according to government statistics released on Wednesday.
But Americans are living longer, with life span at a record average of just short of 80 years, according to the annual report on the nation's health from the Centers for Disease Control and Prevention.

"At birth, life expectancy for females is just over 80 years and nearly 75 for males.

"The gap in life expectancy between white and black Americans also has narrowed from seven years in 1990 to five years in 2004," the CDC said in a statement.

"Life expectancy at birth reached a record 77.9 years in 2004, up from 77.5 in 2003 and from 75.4 in 1990."

But the bad news is that fully a quarter of American adults say they have suffered a day-long bout of pain in the past month, according to the National Center for Health Statistics, part of the CDC.

Lower back pain is among the most common complaints, along with migraine or severe headache, and joint pain, aching or stiffness, the survey found.

"We chose to focus on pain in this report because it is rarely discussed as a condition in and of itself -- it is mostly viewed as a byproduct of another condition," said Amy Bernstein, the researcher who led the study.

More than a quarter of adults interviewed said they had experienced low back pain in the past three months.

Migraines or severe headaches affected 15 percent of adults in the past three months, and 4.2 percent of adults had used a narcotic drug in the past month for pain relief.

The report found that U.S. health care spending averaged $6,280 per person in 2004.

Infant mortality fell to 6.8 deaths per 1,000 live births in 2004, down slightly from 6.9 deaths in 2003.

For adults, heart disease remains the leading killer, but deaths from heart disease fell 16 percent between 2000 and 2004, the report found.

Deaths from cancer -- the No. 2 killer -- dropped by 8 percent.

But diabetes is worsening and 11 percent of adults aged 40-59 years have diabetes - 23 percent of those 60 and older, according to the report, available on the Internet at (http://www.cdc.gov/nchs/hus.htm ).

Publish Date: November 16, 2006

Coping with Holiday Lonliness

2006-11-21T15:33:00.000-05:00

Coping With Loneliness
From Cathleen Henning, www.panicdisorder.about.com

Accepting it and moving on when the time is right.
Loneliness may be painful and even frightening, and it may indicate a need for introspection. Have you been feeling lonely for a long time? Perhaps it's time to make some changes; it is possible to feel less alone. Loneliness is not a sign that you have failed or that you will never have people in your life. It may take effort to change the way you feel, but you can do it. Here are several suggestions for learning about your loneliness:

1. Accept it.

There are many steps you may take to help yourself feel less alone, but before you take those steps, stop and think about how you are feeling. Loneliness is an emotion, and, as with other uncomfortable emotions, we often want to get rid of it as soon as possible. Sometimes, though, these kinds of emotions may be learning tools. Before rushing to eliminate loneliness, think about how you came to feel this way. Changes are most likely in order, but think about the changes that will suit your individual needs.

Sometimes, too, no change will eliminate loneliness. People may feel lonely even when surrounded by loving friends and family. Time may be the only solution. You are not flawed for feeling lonely, and, if you accept the feeling, you will find that it is not as uncomfortable as you first thought.

Remember, too, that being alone and feeling lonely are not the same. If you are alone these days but enjoying it, then don't feel as if you must change because other people don't understand. Do, however, be sure that you have a support system and that you are available to friends and family.

2. Reach out.

If you had people to contact, you may be thinking, then you wouldn't be lonely. Sometimes, though, when we are immersed in loneliness, we may forget about all of our options.

First, think about everyone you know and have ever known. Maybe you think a certain friend or relative wouldn't want to hear from you. Think again -- you may be surprised. Try contacting them and see what happens next. Be sure, however, to have a list of possible contacts, just in case the first doesn't go as planned. Think of old friends, too. You don't even have to tell them you're contacting them because you're lonely. Just reach out and communicate, and you'll start to feel better.

Second, if you truly believe friends and family aren't an option, then reach out to people you don't know. You're already on the Internet, and your options here are endless -- from chat rooms to forums to games to pen pals.

3. Help someone else.

A great way to spend time with people and feel good about your contribution to the world is by volunteering. If your anxiety disorder is keeping you from volunteering in a traditional way, use your imagination. Even going to an online forum and giving support to someone else who is lonely is a significant way to help. If you are ready to volunteer outside your home, look to places that will be anxiety-friendly: churches, hospitals, daycare or pre-schools, and nursing homes, are some examples.

4. Pursue your interests.

Meet people who like to do what you like to do by becoming involved in your hobbies and interests. If you already have a hobby that tends to be solitary, such as needlework, look for local classes or groups where you may meet other people as well as learn more about your craft. If you've thought about an interest for a long time but have never followed through, consider starting now. Look at your local newspaper for classes, groups and meetings, if you need ideas. Take a nature walk. Attend a lecture at a local museum. Take a cooking class. If you're not sure what your interests are, just start participating until you find what you love.

5. Join -- or start -- a support group.

Look around for an anxiety disorder support group. Ask your therapist, check the local newspaper, and contact local hospitals. If there aren't any for anxiety, try a depression or 12-step group. Consider starting your own support group if you can't find one; you'll be helping yourself and other people. If you need a place to have meetings, contact local churches which often have space.

If you're not sure how to cope with your loneliness and you feel that it's making you depressed, talk to your therapist about it (or get a therapist if you don't have one). Talking about it may help you explore other issues or come up with unique ways to cope with your individual feelings

How to Survive the Holidays FM Style!

2006-11-17T00:58:00.000-05:00

How To Survive the Holidays
From Karen Lee Richards www.about.com

The holidays are supposed to be about love, joy and peace. Instead, too often they end up producing guilt, stress and conflict. This can be especially true for people with illnesses like fibromyalgia and chronic fatigue syndrome, who may struggle just to cope with everyday life. Throw a holiday and additional family pressures into the mix and life can quickly become overwhelming. With a little preparation though, you can get through the holidays and even enjoy them! Here are 10 steps, plus a few tips to help you survive this holiday season.

Here's How:
Examine your expectations.
When you think of the holidays, what picture comes to mind? Does it resemble a scene from a Normal Rockwell print? If so, it’s time for a reality check. Few holidays ever live up to the idyllic images in those pictures. It’s time to accept the fact that you can’t do everything you once did. Are the holidays really about elaborate decorations and frenetic activity; or are they about expressing your love and appreciation for family and friends? Now is the time to set new expectations based on what is most important to you.

Refuse to feel guilty.
Guilt develops when you fail to live up to your own expectations, or you feel like you haven’t lived up to the expectations of others. The fact is you have a very real physical illness that limits what you can do. It’s time to stop blaming yourself because you can’t do everything you used to do or because you can’t do everything you think your family expects you to do. Make the decision right now that you refuse to accept any guilt feelings. Remember that the holidays are not about how much you do, but are about expressing your love for your family.

Communicate, communicate, communicate.
Communicating clearly with your family ahead of time is key to a happy holiday season. Sit down with your family and explain that you want everyone to enjoy the holidays, but you have some physical limitations. Decide together what aspects of the holidays are most important to all of you and enlist their help with the things that you can’t do. Some family members may not understand at first, but don’t allow yourself to be pushed into doing more than you can handle. Try to remain calm but be firm.

Prioritize your holiday activities.
Every family has its own holiday traditions. List all of your family’s possible holiday activities then ask each person which activity they consider the most important (i.e., decorations, big home-cooked meal, baking cookies, visiting with relatives, etc.). Number them in order of importance. Focus your energy on the things that are most important. For each item on your list, decide: if there is an easier alternative, if someone else can take the responsibility, or if it’s not really necessary.

Plan ahead.
A big part of holiday stress comes from the last-minute rush to get everything done. Start planning as early as possible. Make a list of everything you need to do and figure out the easiest and best way to accomplish each task. Work on a portion of your list each week. Know that things will go wrong and you’ll probably have some days you don’t feel well enough to do anything. Be sure to allow extra time so those bad days don’t throw you completely off schedule. By not waiting until the last minute to do everything, hopefully you’ll have enough energy left to enjoy your holidays.

Share the workload.
You don’t have to do everything yourself. Don’t be a martyr. Ask each family member to take responsibility for part of the preparations. If you can afford it, hire someone to help you clean the house. Pay a student to address cards or help you bake. If everyone is coming to your house for dinner, ask each person to bring a side dish or dessert – then you can just prepare the main dish. Don’t be afraid to ask for help.

Simplify.
For every item on your “to do” list, ask yourself these questions: Does this really need to be done? Is there an easier way to do it? Can I get by with doing less? (e.g., instead of baking 12 kinds of cookies, make your family’s three favorites; put up fewer decorations or decorate fewer parts of the house.)

Find alternatives.
Try to think outside the box. For every holiday task, try to think of an alternative that would be easier and less stressful for you. Instead of fighting crowds at the mall, do your shopping online or from catalogs. Rather than cooking a big meal, consider having your holiday dinner at a restaurant. If everyone usually comes to your house, ask another family member to host the festivities this year. Be creative and make things easier on yourself.

Schedule time to take care of yourself.
This may be the most important step of all. It’s so easy to get caught up in everything that needs to be done and making sure everyone else is taken care of that you forget to take care of yourself. Make sure you’re taking time to eat healthy foods and keep up with your exercise program. And be sure to schedule time to do whatever is most relaxing and refreshing for you, whether that is soaking in a warm bubble bath, getting a massage or curling up in bed with a good book. Take time to pamper yourself.

Enjoy!
Remember that the holidays are to be enjoyed. You’ve done the best you can do, so it’s time to let go of the “shoulda, woulda, coulda” and just have fun. Happy Holidays!

Tips:
If you’re traveling out-of-town to spend the holidays with relatives, think about staying at a hotel for at least part of the time. Having your own separate space where you can escape to and rest when you need to will reduce your stress and give you a sense of control.

If the hubbub and pressure of holidays with lots of relatives is more than you can handle, consider taking your immediate family away for the holidays. A holiday vacation to a ski resort, a dude ranch or Disney World can be a wonderful and fun family time. As an added bonus, you don’t have to cook, decorate or entertain guests. And you can probably get by with less shopping, too, because all your gifts will have to be packed.

Instead of baking 10 different kinds of cookies, have a cookie exchange party. Invite nine friends and ask each to bring five-dozen cookies made with their favorite recipe. Each guest then takes home a half-dozen of each cookie. It’s easier (and cheaper) to make a larger quantity of one kind of cookie than smaller quantities of several kinds. You can adjust the number of guests and quantity of cookies to whatever you would like.

Got the doc to sign the papers!

2006-11-14T16:05:00.000-05:00

One of my lasts posts was about my concern as to whether my doctor would sign the paperwork to get a handicap parking placard for my car. I was worried that he would say no. But I basically worried for nothing and my doc today signed the appropriate page for me to get the placard.
I am very lucky to have a doc like this. It also makes me feel terrible that there are people out there with chronic pain that aren't as lucky to have doctors who are sympathetic to their issues to help them. This is partially why I created this blog. To give people hope that there are doctors out there who do care about you and want to help you to the best of their ability. I wish I could share my doctor with those of you who have an uncooperative doctor and teach your doc how to treat chronic pain patients.
Good luck to all of you!
Oh I forgot to mention, I decided against getting the Rhizotomy for my right side. I basically feel that the pain I feel for the right side does not warrant the amount of pain I will be in after the procedure! So now I am just stuck with a bum hip on the left side!

When to get a disabled parking placard?

2006-11-02T08:47:00.000-05:00

That is the question I am asking myself the last few days. Ever since my Rhizotomy back 6 weeks or so ago, my left leg gets painfully weak and tired. Then I am left in agony for the rest of the day just for doing "normal people" errands like grocery shopping and picking up my meds. If you need to do both.....oh brother are we in for it!
So as I said, now I am finally coming to a decision about accepting that I can't "do it all" anymore. Now don't get me wrong, I just don't want one just to have one. I would like to have it for times when it gets really bad.
Also I am set for next week to get my right side Rhizotomy done. If this left side recovery is any indiction as to how it will go, I am going to need that placard. Especially since my left side is not quite healed and I have SI joint and sciatic problems. Walking is going to be an adventure that is for sure.

Interesting new study

2006-11-01T06:51:00.000-05:00

Long-Term Treatment with a Staphylococcus Toxoid Vaccine in Patients with Fibromyalgia and Chronic Fatigue Syndrome.
by Carl-Gerhard Bottfries, et al
ImmuneSupport.com

11-01-2006

Journal: Journal of Chronic Fatigue Syndrome. Vol. 13(4) 2006 pp. 31-43. [Published online ahead of print. Article copies are available for a fee from The Haworth Document Delivery Service: 1-800-HAWORTH. E-mail address: docdelivery@haworthpress.com ; Website: http://www.HaworthPress.com.]
Authors and affiliation: Carl-Gerhard Gottfries, Ove Häger, Björn Regland, Olof Zachrisson. Institute of Clinical Neuroscience, University of Gothenburg Sweden. [E-mail carl-gerhard.gottfries@vgregion.se]

One hundred and sixty patients with Fibromyalgia and Chronic Fatigue Syndrome, who were on a continuous treatment with a Staphylococcus vaccine, were followed during one year with repeated consultation visits. The patients had participated in controlled studies and been on continuous treatment with the vaccine for 22+/-10 months before inclusion in this follow-up study. They were treated with 1 mL of the vaccine subcutaneously every third to fourth week. Adverse events were few. The adherence to the treatment was very good. Over a period of one year, 8% withdrew, and in only 5%, the withdrawal was due to insufficient clinical effect. Only in two cases where the patients were allergic to the preservative of the vaccine, the side effects caused the withdrawal of the treatment.

Ratings with scales (CPRS-15 and FibroFatigue) showed improvement from start of treatment and also further improvement during the follow-up year. In view of the natural history for these disorders the result is of interest.

Normalcy in an Arthritic World

2006-10-29T06:59:00.000-05:00

People With Disabilities - Living In A "Normal World"
From Carol & Richard Eustice
www.arthritis.about.com

Overcoming Annoyances

People With Disabilities Want To Live Life

People with disabilities live in a world designed primarily for the able-bodied. People with disabilities want to live life no differently than anyone else. They want to be able to go shopping, go to the movies, go out to eat, work, and enjoy life, fully realizing that must be done within the boundaries of their limitations.

Acceptance

Accepting disability and redefining life within the limitations imposed by disease is the biggest hurdle for people with disabilities. There are harsh realities. Expensive equipment and medications may be required. Mobility scooters, adapted vans, voice-recognition software, orthotics, medical treatment, and myriad types of assistive equipment improve daily living for people with disabilities but it all comes at a price. While life becomes more expensive, too often the ability to work diminishes. Financial security takes a big hit. An uncertain future can make a person fearful.

Arthritis: Fearing The Future

Adjust And Adapt

Adapt and adjust becomes the mantra of a person living with a disability. People with disabilities may be forced to change careers or not work at all. They may be forced to relinquish some of their independence.

There are experiences some able-bodied people may take for granted which people with disabilities must forgo. Disabled people may miss out on:

the joy of rough-housing with children
playing competitive sports
traveling
long road-trips

Crowded events become daunting, social situations become uncomfortable. Do you put yourself out there or risk being covered by the veil of isolation?

The Veil Of Isolation

Subtle Realities Vs. Harsh Realities
What can be more frustrating than harsh realities are subtle realities for people with disabilities. Living with disability is difficult but can sting even more when people encountered are:

impatient
rude
insensitive
inconsiderate
pessimistic
unhelpful

Impatient people try to rush people with disabilities through life. A man who was behind me in the grocery line one day tried to unload my cart for me. The gesture would have been welcome if it had been rooted in kindness, but it was obvious I was moving too slow for him in this fast-paced world we live in.

Arthritis Can Create Awkward Situations

Inconsiderate people can be found using handicapped bathroom stalls and handicapped parking spots, facilities specifically designated for people with disabilities. Inconsiderate people do not hold doors open, a simple action that can make things much easier for a disabled person.

Rude and insensitive people are often found staring at people with disabilities. They seem to not like what they see, or imagine themselves in the role of the disabled person. It creates an uncomfortable situation unless you ignore the person who is staring.

What's Behind The Stare?

Demanding people and those who lack understanding about the realities of your disability can also be provoking. A friend of mine had a surgical procedure which restricted her driving for a period of time. My friend's mother called to tell her she needed to go to the store, disregarding the restrictions that were given to my friend. She had to tell her mother she couldn't help her.

Pessimistic people can annoy and be hurtful. Pessimistic people focus on the negative aspects of having a disability instead of trying to build up, encourage, and praise the accomplishments of people with disabilities. Pessimistic or negative people don't want to learn about the realities of living with disability. They have preconceived ideas and often treat physically disabled people as if they are faking or lazy. Even worse, negative people sometimes treat physically disabled people as if they have no abilities at all.

Unhelpful people are yet another category of people who can annoy and frustrate disabled people. For able-bodied people, most tasks are effortless. The same task for a disabled person is perhaps an impossibility. Changing lightbulbs or air conditioner filters, scrubbing showers, getting a large load of groceries - it's just part of daily living. Who does it for the disabled person, especially one who has collected on all of the favors owed to them?

Declare Your Independence

Surround Yourself With Positivity

What you can control, whether you are able-bodied or disabled, is yourself. All humans face challenges, it's just that people with disabilities face different challenges. You will not rid the world of impatient, rude, insensitive people, but you can control how you react to them.

Impatient people cause you to be more patient.
Insensitive people cause you to be more sensitive.
Negative people cause you to react with positivity.

For each negative person you encounter, you have many more positive encounters. Surround yourself with people, things, and experiences which make you feel good and do good. Do you deserve less than that?

Arthritis Rising

2006-10-24T15:35:00.000-04:00

Arthritis Rising: Are You at Risk?

Extra Pounds, Idle Lifestyles May Make Arthritis More Likely
By Miranda Hitti
WebMD Medical News www.webmd.com
Reviewed By Louise Chang, MD on Thursday, October 12, 2006

Oct. 12, 2006 -- Arthritis is on the rise in the U.S., with no signs of a slowdown. But you might be able to buck that trend, says the CDC.

First, the numbers. Picture a graph with a line headed upward, and you've got the basic idea.

More than 46 million U.S. adults -- over 21% -- say they've been told by a doctor that they have arthritis, gout, lupus, or fibromyalgia.

About 8% of U.S. adults -- more than 17 million people -- say arthritis or joint symptoms hamper their activities.

That's according to CDC statistics from national health surveys done from 2003 to 2005.

Those figures were lower in 2002.

Back then, nearly 43 million adults said they had doctor-diagnosed arthritis, gout, lupus, or fibromyalgia; slightly less than 8% said arthritis or joint problems limited their activities.

By 2030, arthritis will affect 67 million U.S. adults, the CDC predicts.

Those statistics appear in the CDC's Morbidity and Mortality Weekly Report.

Who's Affected

Arthritis is most common in the following groups:

Women
Older adults
Whites (compared with blacks and Hispanics)
People who are overweight or obese
People with sedentary lifestyles
After adjusting for age, people with low education levels and people who are obese or physically inactive were the most likely to say arthritis and joint problems limited their activities.

Remember, the CDC's findings are based on self-reports of doctor-diagnosed arthritis.

The researchers didn't check participants' medical records. They also don't know how many people have undiagnosed arthritis.

What You Can Do

Shedding extra pounds and becoming more active may give you an edge against arthritis.

For instance, 31% of obese adults and 21% of overweight (but not obese) adults said they'd been diagnosed with arthritis, compared with 16% of leaner adults. (Not entirely true...I weighed less and was in more pain than the weight I am at now about 50 pounds heavier.)

A quarter of those who were physically inactive said they had doctor-diagnosed arthritis, compared with nearly 20% of physically active adults.

The surveys didn't directly test weight lossweight loss or physical activity as ways to prevent arthritis. But other studies have.

Extra weight puts more stress on joints. And joints that get little use may feel more stiff and painful than if they get used.

Of course, you shouldn't pound your joints with overblown exercise, and you shouldn't sacrifice nutritionnutrition to lose weight. So check with your doctor before starting a new diet or exercise program.

If you already have arthritis, ask your doctor what you can do to manage your condition.

--------------------------------------------------------------------------------

SOURCES: CDC, Morbidity and Mortality Weekly Report, Oct. 13, 2006; vol 55: pp 1089-1092. News release, CDC.

Anxiety and Chronic Illness

2006-10-24T15:29:00.000-04:00

Anxiety Disorders Closely Linked to Physical Conditions, Study Finds
From Cathleen Henning,Your Guide to Anxiety & Panic Disorders. www.panicdisorder.about.com

People with anxiety disorders have an increased chance of developing physical conditions, particularly thyroid diseases, respiratory diseases, gastrointestinal diseases, arthritis, allergies, and migraine disease, researchers report in the October 23, 2006 Archives of Internal Medicine. Additionally, the presence of a physical condition along with an anxiety disorder increases the chance for disability and poor quality of life.

Researchers at the University of Manitoba in Winnipeg, Canada, led by Dr. Jitender Sareen, decided to explore the connection between anxiety disorders and physical conditions. Although depression has been linked to physical illness for quite some time, the association between anxiety and illness is much more recent. Additionally, according to the researchers, a number of the existing studies were limited in different ways, thus possibly affecting the outcomes.

Sareen and his colleagues decided to use the results of the German Health Survey (GHS), a survey of 4181 adults ages 18 to 65, conducted between 1997 and 1999, to assess the association between anxiety and illness. The survey used several tools to assess physical health, psychological health, and quality of life. These questionnaires and interviews were conducted by physicians and psychologists; additionally, medical tests were conducted to evaluate participants for illnesses.

The GHS showed that 8.4 percent of the participants had an anxiety disorder. This is consistent with the National Institute of Mental Health's finding that approximately 8 percent of the population has an anxiety disorder. Using the GHS, Sareen and his colleagues discovered several significant associations between anxiety disorders and physical illnesses:

Anxiety disorders were associated significantly with physical conditions. Below are the percentage of people with each physical illness who also had an anxiety disorder:
Respiratory diseases - 15.2
Gastrointestinal diseases - 18.8
Arthritis - 10.7
Allergic conditions - 12.0
Migraine disease - 20.3
Thyroid diseases - 14.8

Of the individuals with both anxiety disorders and physical conditions, the majority developed the anxiety disorder first.

Those with both anxiety disorders and physical conditions were more likely to have a poorer quality of life as well as be disabled (unable to perform normal daily activities) at some point.
Although the researchers point out a need for future studies (particularly as the age range in this study was 18-65), they did offer some possibilities for why anxiety disorders and physical conditions may be so closely connected:
A physical illness, particularly if life-threatening, may cause increased anxiety eventually leading to an anxiety disorder.

An anxiety disorder may lead to an increased chance of illness as the result of biological changes caused by the anxiety disorder.

An anxiety disorder may lead to another disorder, such as substance abuse, which in turn causes a physical illness.

A medication for a physical illness may bring on or increase anxiety symptoms.

There may be common genetic, environmental, and/or personality factors that connect anxiety disorders and certain physical conditions.
Whatever the reasons are for these connections, the researchers make clear that physicians need to assess for anxiety as well as depression when treating patients for physical conditions. "Although there have been increased efforts to recognize and treat depression in the medically ill, our findings underscore the need to create similar programs to recognize and treat anxiety disorders in the medically ill," the researchers wrote in the Archives of Internal Medicine.

References:
1) "Facts About Anxiety Disorders." 11 May 2006. National Institute of Mental Health. Accessed 20 Oct 2006 .
2) Sareen, Jitender, et al. "Disability and Poor Quality of Life Associated With Comorbid Anxiety Disorders and Physical Conditions." Archives of Internal Medicine 166(2006): 2109-2116.

Updated: October 23, 2006

Psychiatric ills common in adults with fibromyalgia

2006-10-21T00:30:00.000-04:00

Psychiatric ills common in adults with fibromyalgia
Wed Sep 20, 2006 4:52 PM BST
By Amy Norton

NEW YORK (Reuters Health) - Many people with the chronic pain disorder fibromyalgia have also suffered from depression, anxiety or other psychiatric conditions at some point in their lives -- suggesting, researchers say, that the disorders have some common causes.

In a study of 336 adults with and without fibromyalgia, researchers found that those with the condition were substantially more likely to have ever had depression, bipolar disorder or an anxiety disorder. They also had higher rates of eating disorders and substance abuse problems.

In most cases, the psychiatric condition preceded the development of fibromyalgia, making it unlikely that the mood disturbances were simply a reaction to having chronic pain.

Fibromyalgia is a syndrome marked by widespread aches and pains, fatigue and sleep problems, among other symptoms; the cause is unknown, and there are no medications specifically approved for the condition. Treatment usually involves a combination of approaches, such as painkillers, antidepressants, behavioral therapy or exercise therapy.

The new findings, published in the Journal of Clinical Psychiatry, are based on a comparison of families with members affected by either fibromyalgia or rheumatoid arthritis, another condition marked by chronic pain.

Between both groups of families, there were 108 adults, nearly all women, with fibromyalgia and 228 without the condition.

Overall, those with fibromyalgia were almost three times more likely to have ever had major depression and nearly seven times more likely to have suffered an anxiety disorder. They also had a two to three times greater risk of eating disorders and substance abuse problems, and a much higher risk of bipolar disorder.

The associations between fibromyalgia and these psychiatric conditions suggest that there is some "shared vulnerability" at work, according to study chief Dr. Lesley M. Arnold, an associate professor of psychiatry at the University of Cincinnati College of Medicine.

"We are not saying that fibromyalgia is a psychiatric disorder," Arnold told Reuters Health.

Rather, some people may be vulnerable to developing both fibromyalgia and certain psychiatric disorders -- possibly because of genes, Arnold explained, or because of environmental factors such as chronic stress. But no one yet knows for certain.

Still, the evidence suggests that people with fibromyalgia should be screened for psychiatric disorders, according to Arnold. Even when people aren't currently suffering any psychiatric symptoms, their mental health history can influence how their fibromyalgia is treated, she noted.

For example, Arnold explained, medication with both antidepressant and pain-relieving effects might be the first choice for people with a history of depression. Another option is cognitive behavioral therapy, which addresses harmful thought patterns and behaviors; this approach, Arnold said, might help fibromyalgia patients with a history of depression or anxiety disorders.

SOURCE: Journal of Clinical Psychiatry, August 2006.

© Reuters 2006. All Rights Reserved.

Tips for Treating Pain

2006-10-21T00:26:00.000-04:00

Thanks msnbc.com
Tips for Treating Pain
An estimated 50 million Americans have chronic pain and nearly 25 million suffer acute pain each year. How to find relief.

Web Exclusive
Newsweek
Updated: 2:01 a.m. ET Oct 8, 2006
Oct. 8, 2006 - Practice Healthy Habits
Get adequate rest, eat a healthy diet and engage in regular exercise. (Ask your doctor which exercises are safe for you.) Relaxation techniques like meditation, visualization, hypnosis, and biofeedback may also help you feel better.

Care for your Emotional Health
People in chronic pain have been found to have an increased incidence of depression, anxiety and sleep disturbances. Your physician may want to prescribe medication or may suggest cognitive behavioral therapy (like relaxation techniques and psychological therapy). It may also help to share your thoughts and feelings with loved ones and to join a support group. (The American Chronic Pain Association, among others, has support groups throughout the country).

Know Your Treatment Options
There are many options for treating your pain beyond prescription and over-the-counter medicine. Complementary and alternative therapies include biofeedback, meditation, relaxation techniques, yoga, acupuncture and physical therapy. There are also interventional treatments for specific types of pain (like electrical stimulation and injections). Ask your doctor which is best for you.

See a Pain Specialist
You can ask for a referral from your primary care physician. Many professional physician organization web sites also have listings of their members available (see the links below).
Source: The American Pain Foundation

Other helpful links:
American Academy of Pain Medicine
American Academy of Pain Management
American Academy of Neurology
American Board of Pain Medicine
American Medical Association
American Pain Society
American Society of Interventional Pain Physicians
American Chronic Pain Association

© 2006 Newsweek, Inc.

Thanks to some new medicine....

2006-10-09T07:45:00.000-04:00

I have been down for the count since Thursday. Between PT and new mental health providers I have been a very busy girl. You see, my old psych nurse practitioner decided to stop prescribing medication and has also slimmed down her practice for counselling. She was only available two days a week and on top of that I was only able to see her once a month. Nice huh? Well I started with two new professionals last week on top of trigger point shots with a new doc (my regular doc is away for Ramadan) and PT right after.
Oh the price of Fibromyalgia. I may be on disability but my full-time job is going to doctor's appointments.

Theraputic Massage...big fat ouch!!

2006-09-28T08:15:00.000-04:00

Okay, normally a massage is nice and relaxing but theraputic massage is a whole different kettle of fish! First...it hurts like a mother! It hurts to get it done and it hurts after.
There are different types of massage so people with FMS should be careful when they go to a massage session.
Thanks to Wikipedia for the information.

Types of massage
There are well over 150 types of massage therapy. Various styles of massage have developed from a number of sources.

Barefoot Deep Tissue
Barefoot Deep Tissue is a blend of Eastern barefoot techniques with Western manual medicine. Clients are typically loosely clothed and lain on floor mat in supine, prone and side-lying positions with pillows or bolsters. No oil is used. Sessions may last 2 minutes or well over an hour. Because the therapist can apply a broad range of pressure with ease and does not have to strain, more effort and concentration can be used to sense and manipulate tissue, release fascia, as well as search for and attack trigger points and other problems, regardless of client's size or build. John Harris, the proceleusmatic mentor who worked in the 1984 Olympics and developed this modality, states that the combination offers a potent new tool for powerfully satisfying, effective deep tissue massage and Trigger Point work regardless of client's size or build. Mr. Harris and Fred Kenyon wrote Fix Pain in 2002, and have been hired by Human Kinetics to write a trade publication with DVD for elite athletes.

Bowen therapy
For more details on this topic, see Bowen Technique.
Bowen Technique involves a rolling type movement over fascia, muscles, ligaments, tendons and joints.

Breema
Breema bodywork is performed on the floor with the recipient fully clothed. It consists of rhythmical and gentle leans and stretches which leads to deep relaxation, increased vitality, and stimulation of the self-healing processes of the body. Sessions can be any length of time, although 50 minutes is common. There are also self-Breema exercises. The essence of Breema is expressed in the Nine Principles of Harmony. The Breema Center is located in Oakland, California, and there are Breema practitioners and instructors in many locations around the world.

Chair massage
Chair massage, also known as Corporate Massage, is by far the most convenient method of massage therapy. A chair massage session typically lasts 12-24 minutes, and is performed while fully clothed. Chair massage promotes better circulation, muscle stimulation and stress relief. This form of massage reduces tension in the back, neck, shoulders, head, arms, hands, legs or feet, providing a deep relaxation effect.

Chair massages are also advantageous because chair massage practitioners will frequently make work- or housecalls. Chair massage can also be done in hotels, airports and convention centers.

Chinese Tui Na massage
For more details on this topic, see Tui Na.
Tui Na is a form of Chinese massage that is similar to Zhi Ya, but focusing more on pushing, stretching and kneading the muscle.

Chinese Zhi Ya massage
Zhi Ya is a form of Chinese massage based on acupressure. It is similar to Tui Na massage except it focuses more on pinching and pressing at acupressure points.

Deep muscle therapy
Deep muscle therapy (created by Therese Pfrimmer), is a massage technique that focuses on using a very specific set of movements applied to all muscles and concentrating on all layers of the muscle that have become depleted of their regular blood and lymphatic flow. This technique aims to restore the circulation with its healing properties to the cellular level. Deep muscle therapy is widely used to treat the following ailments: carpal tunnel syndrome, neck and back pain, headaches, poor circulation, whiplash, and more.

Deep tissue massage
Deep tissue techniques are generally designed for more focused massage work. Working a specific joint, muscle or muscle group, the practitioner can access deeper layers of the soft tissue. Starting superficially and easing into the depth of the muscle slowly often allows more movement. This is the recommended approach in this modality since each person experiences pressure differently. If the pressure is applied too deeply or too quickly, the muscle may tighten to protect that area, and unnecessary damage or inflammation can be induced. Very little lubricant is used as the pressure doesn't travel much over the skin.

The most commonly used 'tools' during deep tissue massage may include, 3 and 6 fingers, reinforced fingers, a flat elbow, opposing thumbs, the heel of the hand or foot, and the forearm. See also: Myofascial Release

Effleurage
Effleurage (from the French effleurer, 'to skim over') consists of long, flowing or gliding strokes, performed with open hands. In many massage sessions, effleurage is used as the initial type of stroking, as it has a calming effect when performed slowly. Effleurage is usually performed in the direction of the heart to promote circulation and lymphatic drainage.

Erotic massage
Erotic massage is a form of massage that includes the genitals and leads to sexual arousal and (sometimes) orgasm. Widely practiced by couples as part of lovemaking. Also sometimes practiced commercially, which may be illegal in some jurisdictions. See also Tantramassage.

Esalen Massage
The basis of Esalen Massage is traditional massage, which works in a very precise manner on the muscle and circulation systems. This is combined with the bodywork approach developed by Charlotte Selver, which emphasizes the deeply relaxing and emotional responses of the body when a conscious, structured and pleasant touch is applied. In addition, gentle rocking of the body, passive joint exercises and deep structural work on the muscles and joints, together with an energetic balancing of the body, are all part of this Esalen Massage “experience”.

Foot or sole massage
Foot massage, as practiced by the Chinese is performed in the context of chi, in that each spot on the sole of the foot corresponds to an internal organ, and the applied therapy is healing to one's overall well being. The theory supposes that an ailment of an internal organ will be associated with the nerve ending on the sole of the foot.

Before the massage, the patient's feet are soaked for about ten minutes in a foot bath, typically a dark colored solution of hot water and Chinese herbs. The massage therapist uses liberal amounts of medicated cream, to moisturize the foot and to provide lubrication. The knuckles on the therapist's hand are usually used to provide a hard and smooth implement for the massage. As pressure is applied to the sole, theory holds that a healthy patient should not feel any strong pain. Painful spots, reflexologists believe, reflect illnesses of other parts of the body. The practitioner rubs and massages the painful spots to break down rough spots and accumulated crystals and increase circulation.

The ailments are healed when the sore spots of the sole are treated and removed by massage. Based on this theory, some shoe liners are made with pressure points to stimulate the soles of the feet to promote better health of the overall body. The nature of these "crystals" has yet to be elucidated or demonstrated scientifically. Regardless of the actual correlation of reflexology to internal organs, many enjoy it for the mix of stimulation and relaxation.

Lomilomi — Traditional Hawaiian Massage
Lomilomi massage is an ancient art from the Hawaiian healing specialists. They were taught their art over 20 years and received their last instructions from their master on his death bed. There are hundreds of styles of Lomilomi, the main ones being the style of Big Island which was passed on by Aunty Margaret Machado, and Maui style from Uncle Kalua Kaiahua. On the island of Kaua'i, Kahu Abraham passed on what is today called Kahuna Bodywork. It is not clear if other current practices - temple style, lomi lomi nui and others - are from Native Hawaiian practitioners or are modern adaptations.

MA-URI massage
MA-URI is a new form of massage introduced by Hemi Hoani Fox in 1990, who cites as its roots Hawaiian Lomi-Lomi Nui dance, claiming increased so-called energy flow within the body and mind. Focus is internal, upon breathing, intent, and concentration. Claimed benefits include mental and physical health. Study and advocation is primarily carried out at the MA-URI Institute, headed by Hemi and Katja Fox. It is currently difficult to find practitioners, though this may change as it grows more popular.

Muscle Energy Technique (MET)
Reciprocal Inhibition (RI) is when the therapist uses a client’s muscle to stretch the opposing muscle. The therapist takes the muscle that they are wishing to stretch to its point of bind. The therapist then gets the client to use the opposing muscle by moving away from the therapist. When the client relaxes the therapist then moves the muscle to realign the muscle fibres therefore stretching the muscle.

As an example, Muscle Energy Technique (MET) Reciprocal Inhibition (RI) can be applied to the calf when the client is lying supine on the treatment couch. The masseur can place one hand on the tibia just below the knee to isolate the knee preventing it from moving. The other hand is placed around the heel so that the masseurs forearm can be used to dorsiflex the foot. This is one of the techniques used by sports massage therapists.

Myofascial Release
Myofascial Release refers to the manual massage technique for stretching the fascia and releasing bonds between fascia and integument, muscles, and bones, with the goal of eliminating pain, increasing range of motion and balancing the body. Injuries, stress, trauma, overuse and poor posture can cause restriction to fascia. Myofascial release frees fascial restrictions, and allow the muscles to move efficiently. This is usually done by applying shear, compression or tension in various directions, or by skin rolling. This is one of the techniques used by sports massage therapists and physical therapists. Myofascial release originators come from Physical Therapy and from Structural Integration (Rolfing); its current developers include John Barnes PT from a Physical Therapy background, and from a Rolfing or Structural Integration background, Art Riggs, Michael Stanborough, Tom Myers, Til Luchau, and others.

Myoskeletal alignment technique
Myoskeletal Alignment Technique (MAT) identifies postural distortions to improve and prevent pain conditions. Proprioceptive Neuromuscular Facilitation (PNF) and myofacial techniques are used to lengthen tight/facilitated muscles while fiber activation techniques tone weak/inhibited muscles. MAT was developed by Erik Dalton.

Neuromuscular therapy
Neuromuscular Therapy (NMT) is used for pain relief and specific problems. Structural and postural imbalances are identified through an initial postural assessment. These are then addressed through systematic and site specific massage. NMT reduces pain, tension, postural imbalance, and lengthens and strengthens tissues. NMT was developed by Paul St. John.

Petrissage
Petrissage (from the French petrir, 'to knead') is one of the five basic strokes of a Swedish massage. It is performed with kneading movement with the whole palm or finger tips, wringing, skin rolling, compress and lifting. Petrissage is usually applied vertically to the muscle tissue.

The benefits include the warming of tissue for deeper work, increase circulation, increase the supply of nutrients and oxygen to muscle, softens superficial fascia, decreases muscle tension, and restoring mobility by decreasing adhesion.

Scalp massage
In some barber shops in Hong Kong, scalp massage often lasts 30 minutes to 45 minutes during shampooing of the hair. It is also very common in India, after applying oil on the hair.

Shiatsu
Shiatsu is a form of Japanese massage that uses thumb pressure and workes along the energy meridians in the body also with a lot of streches the same meridians as acupressure. You are worked on fully clothed on a mat on the floor. It is uncertain whether it originated from Chinese Zhi Ya.

Soft Tissue Therapy
The Assessment, Treatment and Management of Soft Tissue Injury, Pain and Dysfunction. Treatment techniques include:

Trigger point therapy for the alleviation of trigger points.
Myofascial (muscle and fascia) therapy for flexibility/mobility of the connective tissues of our body, or for alleviating fibrous adhesions and decreasing the severity of scars.
Broad handed techniques for reducing swelling or inflammation
Frictions for the ridding of adhesions between fascial layers, muscles, compartments and the like. Frictions also promote healing in tendon pathologies as well as decreasing pain perception.
Sustained pressure (digital pressures) to alleviate hypertonic (tight)areas within muscle and fascia
Other techniques such as Active Release Therapies, Myofascial Release and deep tissue massage are all derivatives of the techniques above. They are NOT unique techniques with unique results.
Stretching - static, dynamic, and/or PNF stretches (proprioceptive neuromuscular facilitation)
Muscle Energy Technique (MET)
Exercise Prescription
Advice:
This is one of the techniques used by sports massage therapists.

Stone massage
Massage in which hot or cold stones, usually basalt or marble, are used to massage the body. Often the stones are placed on key energy points, such as Chakras or meridians, in order to improve energy flow and healing.

Structural muscular balancing
A gentle and effective technique that releases chronic contraction in the muscles. The nervous system is triggered to release contractions through compression applied to muscles placed in a shortened position.

Swedish massage
This style utilizes long, flowing strokes, often but not necessarily in the direction of the heart.Swedish massage is designed to increase circulation and blood flow. There are six basic strokes:effleurage,petrissage,friction,tapotement,compression and vibration.Oil, cream, or lotion is applied on the skin to reduce friction and allow smooth strokes. This style of massage is generally attributed to the Swedish fencing master and gymnastics teacher Pehr Henrik Ling (1776-1839).However, it was in fact the Dutch practitioner Johan Georg Mezger (1838-1909) who adopted the French names to denote the basic strokes under which he systemized massage as we know it today, as Swedish or classic massage. Somehow, the term Swedish Movement System was transposed to Swedish Massage System sometime during the second half of the 19th century. Ling’s system was the Swedish Movement System or Swedish Gymnastic Movement System. This may be how he has become incorrectly associated for so long with Swedish massage. In Sweden, the term "Swedish massage" is not used.

Tai Ji Massage (Tai Chi Massage)
Tai Ji / Tai Chi Massage is massage using the natural principles of Tai Ji, Yin and Yang to achieve balance in the energies of the body, leading to a healthy mind body and spirit.
Tai Ji / Tai Chi The traditional Chinese term refers to the Dao, which is the inexpressible oneness and connectedness of all things. This is inexpressibility of Tao is referred to by Lao Tzu:
Chapter 32
"The Tao is constantly nameless….
As soon as we start to establish a system we have names.
And as soon as there set names,
Then you must also know that it's time to stop"
Te Tao Ching
Translation by Robert G. Hendricks. Ballantine books 1989
Qi/ Chi: This is the linking element material and spiritual (Jing and Shen), or in health terms mind and body.
Chinese medicine is often able to treat sicknesses and problems which are difficult to treat by western medicine by virtue of the fact that they consider the state of the Chi to be an important factor in diagnosis.
Qi Field theory: Qi appears as a field. In order for a sickness to become chronic an integral Qi field establishes itself in the body of the host. The shape and size of this field is variable and can stretch from head to toes in some cases.
Tai Ji Massage Qi Diagnosis: Tai Ji Massage is a Qi treatment and it makes a treatment in terms of Qi. The master practitioner can sense the Qi blockages inside the body and the relationship which they have to each other.
Qi blockages can be a way of getting insight into causes of chronic sicknesses, recurring sicknesses, psychosomatic sicknesses, future sicknesses.
The main use of this techniques is, relaxation and self-exploration, and in a therapeutic way, funtional organ problems, chronic sicknesses and psychosomatic sicknesses.
Tai Ji Massage was developed by Richard Wickes, Li Cun De.

Tantramassage (Tantric massage)
Original Tantramassage is a new form of massage developed in the early 1980s by Andro, Andreas Rothe an experienced Tantra and Bodywork Teacher in Berlin, Germany. The method includes various massage techniques, elements from Bioenergetic, Yoga and Sexualtherapy. The word "Tantra" emphasizes the connection with the old Indian cultural background where the body is seen as the temple of the soul. Clients are in a passive role, supported by breathing techniques they experience a very deep and intense journey through their own body. Every Massage session lasts 90 Minutes or longer. The Tantramassage movement is very popular in Germany and Switzerland, some practitioners are organized in the Association of Tantramassage in Germany.

Thai massage
Known in Thailand as นวดแผนโบราณ (Nuat phaen boran), IPA which correctly translates only as ancient massage or traditional massage, this form of massage is also known as Thai ancient massage, traditional Thai massage, Thai yoga massage, yoga massage, Thai classical massage, Thai bodywork, passive yoga or assisted yoga. It is usually soothing because of its emphasis on stretching and loosening the body. Its roots go back far into history, originating in India based on the Ayurveda, and then becoming popular in Thailand.
Originating in India and drawing from Ayurveda, it has inevitably incorporated modalities like yoga. The receiver is put into many yoga like positions during the course of the massage. In the northeren style there are a lot of stretching movements unlike the southern style where pressure is emphasised. It was believed that the massage art was brought over to Thailand by Shivago Komarpaj (Jivaka Kumarabhacca), a contemporary of Buddha almost about 2500 years ago.
The massage recipient changes into pajamas and lies on a mat or firm mattress on the floor. (It can be done solo or in a group of a dozen or so patients in the same large room). The massage giver leans on the recipient's body using hands and forearms to apply firm rhythmic pressure to almost every part of the taker's body. The massage generally follows the Sen lines on the body-somewhat analogous to Chinese Meridians and Indian nadis. In some gestures, legs and feet of the giver are used to fixate the body or limbs of the recipient. In other gestures, hands fixate the body, while the feet do the massaging action. Usually no oil is applied. A full course of Thai massage typically lasts two hours or more, and includes pulling fingers, toes, ears etc., cracking the knuckles, walking on the recipient's back, arching the recipient's back in a rolling action etc. There is a standard procedure and rhythm to the massage. Sometimes in a large group massage, the practitioners do the procedures in unison.
Note: The traditional therapeutic practice of Thai massage should not be confused with the sexual service of the same name that is available in some hotels and brothels.

Trigger point therapy
A trigger point is an area of a muscle (about 50 cells) that may refer pain sensations to other parts of the body. Trigger Point Therapy applies manual pressure, or CO2 injections, to these points. With the proper pressure, duration and location, immediate release of tension and improved muscular functioning may occur. This therapy has been known to diminish migraine pain, mock sciatica, mock carpal tunnel syndrome and other pain syndromes, and other symptoms that may have been misdiagnosed. This work is based upon the trigger point research and manuals of Dr. Janet Travell, President Kennedy's physician.

Sometimes this work is incorporated into other styles of massage therapy such as neuromuscular therapy (NMT) or even Swedish

Psychiatric ills common in adults with Fibromyalgia

2006-09-27T00:34:00.000-04:00

Thank you www.pain.healthcentersonline.com for the article. Considering I suffer from FM, depression and anxiety disorder, I thought this article was right on the money!

Psychiatric ills common in adults with Fibromyalgia

Sep 21 (Reuters Health) - Many people with the chronic pain disorder fibromyalgia have also suffered from depression, anxiety or other psychiatric conditions at some point in their lives -- suggesting, researchers say, that the disorders have some common causes.

In a study of 336 adults with and without fibromyalgia, researchers found that those with the condition were substantially more likely to have ever had depression, bipolar disorder or an anxiety disorder. They also had higher rates of eating disorders and substance abuse problems.

In most cases, the psychiatric condition preceded the development of fibromyalgia, making it unlikely that the mood disturbances were simply a reaction to having chronic pain.

Fibromyalgia is a syndrome marked by widespread aches and pains, fatigue and sleep problems, among other symptoms; the cause is unknown, and there are no medications specifically approved for the condition. Treatment usually involves a combination of approaches, such as painkillers, antidepressants, behavioral therapy or exercise therapy.

The new findings, published in the Journal of Clinical Psychiatry, are based on a comparison of families with members affected by either fibromyalgia or rheumatoid arthritis, another condition marked by chronic pain.

Between both groups of families, there were 108 adults, nearly all women, with fibromyalgia and 228 without the condition.

Overall, those with fibromyalgia were almost three times more likely to have ever had major depression and nearly seven times more likely to have suffered an anxiety disorder. They also had a two to three times greater risk of eating disorders and substance abuse problems, and a much higher risk of bipolar disorder.

The associations between fibromyalgia and these psychiatric conditions suggest that there is some "shared vulnerability" at work, according to study chief Dr. Lesley M. Arnold, an associate professor of psychiatry at the University of Cincinnati College of Medicine.

"We are not saying that fibromyalgia is a psychiatric disorder," Arnold told Reuters Health.

Rather, some people may be vulnerable to developing both fibromyalgia and certain psychiatric disorders -- possibly because of genes, Arnold explained, or because of environmental factors such as chronic stress. But no one yet knows for certain.

Still, the evidence suggests that people with fibromyalgia should be screened for psychiatric disorders, according to Arnold. Even when people aren't currently suffering any psychiatric symptoms, their mental health history can influence how their fibromyalgia is treated, she noted.

For example, Arnold explained, medication with both antidepressant and pain-relieving effects might be the first choice for people with a history of depression. Another option is cognitive behavioral therapy, which addresses harmful thought patterns and behaviors; this approach, Arnold said, might help fibromyalgia patients with a history of depression or anxiety disorders.

SOURCE: Journal of Clinical Psychiatry, August 2006.

Publish Date: September 21, 2006

Painful recovery

2006-09-25T07:29:00.000-04:00

Well after 5 days since my procedure my left leg still has not recovered as of yet. The only position that doesn't tire out my leg is laying down. Too much walking, sitting and standing causes my leg to fatigue and my lower back begins to ache.
While I knew that this would probably be a longer recovery than any other procedure than I have had in the past, I wasn't expecting this. I was supposed to start physical therapy last week but driving is very dangerous for me right now. I can't sit normal on the seat and have to twist to the right because of the swelling on my back.
While each day it does get better, it is a slow process.
Wish me luck!

Day after the Radio Frequency Ablation

2006-09-21T06:57:00.000-04:00

Well, I had the RFA yesterday and needless to say boy did it hurt!!! Today I am very tired and my back/backside is very sore. I had my nerves diddled from the L3 to L5 area. So I am sure that the area is full of bruises. According to the doc, it should take up to 7 days for it to finally take hold totally. I feel a little different already. Normally I have this numb, painfully heavy feeling in my left leg but not last night for once. It was a little strange but welcome relief.
Friday I also start physical therapy again. That should be interesting....NOT! It should be painful. Well I gotta do what I gotta do I guess.

Well its a few days of rest so that my back can heal a little before tomorrow.

Well it is off to my next step

2006-09-14T08:01:00.000-04:00

It seems that the facet injections I had a couple of weeks ago didn't take so now it is time for the next step....Rhiziotomy!!! I am a little scared about it and asked a bunch of questions yesterday while seeing my pain doc. It seems hopeful but we will see. For those of you who do not know about this procedure here is a description.
It is also know as Radiofrequency Ablation.
Thank you to www.christianaspinecenter.com for the information.

What is radiofrequency nerve ablation?

Radiofrequency nerve ablation is the term used when radio waves are generated and used to produce heat. By generating heat around a nerve, the nerves ability to transmit pain is destroyed, thus ablating the nerve.

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What nerve is ablated?

Radiofrequency ablation is used to destroy the nerves that supply the facet joints in the spine. These joints are the small posterior joints on either side of the spine. These joints can be one source of back pain.

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How is it determined if I am a candidate for this procedure?

Prior to consideration of a radiofrequency nerve ablation procedure, the source of your pain needs to be determined by using diagnostic blocks on the various structures in the spine. Once it is established that the facet joints are causing your back pain, you may be a candidate for the actual procedure. The nerve ablation will effectively destroy the nerve fibers around the joint, which transit the pain sensation from the facet joint.

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What procedure is done for the ablation?

The technique used for the nerve ablation is similar to that used for the diagnostic blocks. A thin needle is inserted down to the region of the facet joint, which is responsible for the pain. Each joint has two nerves, which supply the joint therefore, 2 needle positions for each joint will be needed. The placement of the needle will be under x-ray guidance. Once the needle is in place you will receive a numbing medication and the radiofrequency stimulation will occur through the needle already in place. This takes approximately 90 seconds. This will be repeated at each needle site. The needle will be removed and the procedure is complete.

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What is the long-term effect of the injections?

Once the nerves which carry pain sensation from the painful joint are destroyed you should be free of the back pain you are experiencing, if it is coming from this structure. These nerves may regrow over a period of approximately 6 months. Time, physical therapy and increased muscle strength around this joint may make this joint less painful over the following 6 months so that when the nerves do regenerate you will not experience the same intensity of pain as prior to the procedure. If you have a recurrence of pain this procedure can be repeated.

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What do I do prior to the procedure?

You should allow approximately 1 to 2 hours for the procedure. You should not have taken any anti-inflammatory medication for at least 5 days prior to the injection. You will need to arrange a driver to take you home after the procedure.

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What do I do after the procedure?

You should receive some pain medications upon leaving the office. You should not experience debilitating back pain fever or chills. If this occurs you should contact the treating physician. If you have some mild increased pain this should subside over the following 10 days to two weeks. A follow up appointment will be made for you on leaving the office for 1-2 weeks after the procedure.

How To Recognize the Signs and Symptoms of Fibromyalgia

2006-09-14T07:52:00.000-04:00

How To Recognize the Signs and Symptoms of Fibromyalgia
From Carol & Richard Eustice,
Your Guide to Arthritis. www.arthritis.about.com. Thank you for the info.

Fibromyalgia symptoms can overlap with autoimmune diseases and other musculoskeletal conditions making it difficult to diagnose. The defining symptoms of fibromyalgia are often associated with other subjective and objective symptoms which occur in combination.

It is estimated that fibromyalgia syndrome affects about 2 percent of the U.S. population.

**In 1990, the American College of Rheumatology (ACR) listed two primary criteria for the classification of fibromyalgia. 1) A history of widespread pain involving all four quadrants of the body (right side, left side, above waist, below waist) for a period of at least 3 months.

**The second criteria from the ACR which points to fibromyalgia is, upon physical examination, the presence of pain in at least 11 of 18 tender points when touched or pressed with force amounting to the equivalent of 4 kg. or 9 lbs.

**More recent data indicates that there may be an increased sensitivity to pain throughout the body, pain may be migratory (move around) or may exist as chronic regional pain. Most experts are said to believe fibromyalgia results from abnormal central nervous system function. Response to stress and psychobehavioral factors may also contribute to fibromyalgia.

**Fibromyalgia primarily occurs in women of childbearing age. Children, the elderly, and men can also be affected. Besides the defining symptoms of pain and tenderness, there are many nondefining symptoms associated with fibromyalgia including:

**Fatigue, night sweats and sleep disturbances.

**Memory difficulties and cognitive difficulties.

**Tension or migraine headaches, temporomandibular joint syndrome, rib cage pain (noncardiac chest pain), chronic pelvic pain, plantar or heel pain.

**Fluctuations in weight, heat or cold intolerance, subjective feeling of weakness.

**Ear-nose-throat complaints, multiple chemical sensitivities and a wide array of allergic symptoms.

**Hearing, vision, and vestibular (balance) abnormalities.

**Heartburn, palpitations and irritable bowel syndrome.

**Evidence on echocardiogram of mitral valve prolapse, esophageal dysmotility (muscles of esophagus not working properly), neurologic conditions causing hypotension (low blood pressure) and syncope (fainting).

**Mood disorders such as depression and anxiety occur more commonly in people who have fibromyalgia.

Tips:

Fibromyalgia can be difficult to diagnose because its symptoms can be non-defining and mimic other diseases. Persist in getting a proper diagnosis.

Aerobic exercise, such as swimming and walking, improves muscle fitness and reduces muscle pain and tenderness.

Heat and massage may also give short-term pain relief.

Pain Relief Techniques

Patients with fibromyalgia may benefit from a combination of exercise, medication, physical therapy, and relaxation.

How is Fibromyalgia Treated?

Fibromyalgia medication options include:

antidepressants
muscle relaxants
analgesic painkillers
NSAIDs
seditives
other medications that elevate mood, ease pain, relax muslces, promote sleep and fight off fatigue.

What You Need:
A Good Relationship With Your Rheumatologist Or Doctor.
A Physical Therapy Regimen You Will Follow.
A Treatment Program Involving Medication And Exercise.
A Good Understanding Of Meditation And Relaxation Techniques.
Ongoing Education - Stay Aware Of Fibromyalgia News And Research.

Interesting theory about FMS and CFS

2006-09-13T08:09:00.000-04:00

Acid Stomach - or Not Enough Stomach Acid? The Symptoms Are Similar, but For CFS and FMS Patients It’s Often the Latter
by Editor
ImmuneSupport.com

09-01-2006

Betaine hydrochloride, derived from beets, is near the top of the list of dietary supplement and health aid rocommendations that CFS specialist Paul Cheney, M.D., Ph.D. had developed for Chronic Fatigue Syndrome patients.1 Why? “Because most CFS patients don’t have enough stomach acid, and Betaine (hydrochloric acid) is stomach acid,” according to the article “Dr. Paul Cheney on Betaine for Chronic Fatigue Syndrome and Fibromyalgia Patients,” by Carol Sieverling. 2

Importantly, Dr. Cheney points out:

**Hydrochloric acid is responsible for converting another stomach secretion - pepsinogen - to pepsin, an enzyme largely responsible for breaking proteins down into substances that the body can absorb more easily.

**This is considered “the first step” in digestion, and is ultimately a necessity for cellular growth and repair.

**Hydrochloric acid also works in the stomach to fight infection of the digestive system by microorganisms such as bacteria that are ingested in food and water - since most of these are destroyed by an adequately acidic environment. Dr. Cheney notes that “a UCLA study of 52 FM/CFS patients found [small intestine bacterial overgrowths (SIBO)]in 90 percent of the patients.” Low levels of stomach acid may create a Ph in the small intestine that facilitates the overgrowth of bacteria. This may cause inflammation and even leaky gut syndrome.

**Further,it is thought that many people suffer recurrent yeast infections because low levels of stomach acid allow them to be reinfected continually by yeast consumed with their food.

Overall, a reduction in the stomach’s natural production of hydrochloric acid – often associated with the aging process and referred to as “hypochlorhydria” – can interfere with the stomach’s digestive and infection-fighting functions. A Betaine hydrochloride supplement with pepsin, taken with food, is especially useful to enhance digestion in individuals with hypochlorhydria because it raises the levels of both hydrochloric acid and pepsin in the stomach. For individuals with low hydrochloric acid production, Betaine hydrochloride has been described as a “stomach tonic.”

But to confuse matters, the symptoms of hyperchlorhydria are similar to the symptoms of too much stomach acid which are so frequently described in over-the-counter and prescription antacid drug advertising.

**An excess of digestive acid may cause acid reflux, which is a burning backflow of stomach acid into the esophagus or “swallowing tube,” sometimes referred to as gastroesophageal reflux disease (GERD).

**By contrast, if there isn’t enough digestive acid in the stomach after food is ingested (with hyperchlorhydria), the valve at the stomach’s base that releases food into the small intestine may not open as it normally would, Dr. Cheney has explained. Then, the food/stomach acid mixture may be forced back up toward the esophagus, creating a burning sensation similar to the one associated with acid reflux. And the mistaken addition of antacid remedies to the mix is likely to create a “vicious cycle.” 2

One test for hypochlorhydria is to determine the extent of undigested protein in the stool. There is also a definitive test of stomach acidity, called the Heidelberg test. It involves swallowing a “telemetry” device the size of a large vitamin capsule, and tracking the acidity-level signals it broadcasts from the stomach as doses of acid-neutralizing sodium bicarbonate (baking soda) are ingested. If the acid level doesn’t return after a few doses, hypochlorhydria is a likely diagnosis. A simple preliminary test is to drink a small amount of baking soda in water first thing in the morning. If you have not belched within a few minutes, you may not be producing enough stomach acid, since hydrochloric acid reacts with baking soda to produce carbon dioxide gas.3

Conversely, if an individual takes a dose of a Betain hydrochloride supplement (this should always be at the start of a meal) and experiences the warmth/burning or indigestion associated with excess acid, further B-CHl supplementation is not advisable, and a neutralizing teaspoon of sodium bicarbonate in water should provide relief.

Individuals who believe they have symptoms of either excess or insufficient hydrochloric acid in the stomach should consult with their doctor, and should never change their health management regime without doing so. Additionally, supplement manufacturers commonly advise that:

1. People using non-steroidal anti-inflammatory drugs such as ibuprofen (NSIADs), cortisone-like drugs, or other medications with the potential to cause a peptic ulcer (a break or sore in the tissue lining the upper digestive tract) should avoid supplementation with Betaine hydrochloride.

2. Pregnant or nursing women, children, and people with kidney or liver disease should avoid Betaine hydrochloride supplementation, because its safety for these populations has not been established.

If you are in doubt about what over-the-counter or prescription drugs, dietary supplements, or combinations of these may irritate the digestive tract or affect the production of digestive juices, consult a pharmacist.

________
1. “Dr. Paul R. Cheney’s Basic Protocol Supplement/Health Aid Recommendations, (2003),” CFIDS & FMS Support Group of Dallas-Fort Worth, www.dfwcfids.org/medical/basc2003.html
2. “Dr. Paul Cheney on Betaine for Chronic Fatigue Syndrome and Fibromyalgia Patients,” by Carol Sieverling, November 7, 2001, www.immunesupport.com/library/showarticle.cfm/ID/3171/e/1/T/CFIDS_FM/
3. “Stomach Acid Assessment,” by Dr. Joseph A. Debé, at www.drdebe.com/BAKESODA.htm

Our Illnesses May Be Invisible, but They're Very Real

2006-09-12T13:49:00.000-04:00

Thank you www.headaches.about.com for the information.
From Teri Robert,
Your Guide to Headaches / Migraine.

Our Illnesses May Be Invisible, But They're Very Real

September 11-17 is National Invisible Chronic Illness Awareness Week. We have some great resources and opportunities to learn more yourself and to educate others...

National Invisible Chronic Illness Awareness Week

We who live with chronic headaches and Migraine disease have something in common with 96% of people who live with a chronic illness -- our illness is invisible. We don't live with our heads bandaged, walk with a cane, or show any other outward sign of our illness.

This can create a problem in terms of public awareness, the support we receive from those around us, and in how we're perceived by others. "Out of sight, out of mind" applies here. People can't see signs of our illnesses, so they often think we're perfectly healthy. We can look great even when we're debilitated. Looking great, however, doesn't diminish the huge impact of such conditions.

Chronic Illness Facts

**Nearly 1 in 2 Americans (133 million) has a chronic condition.

**That number is projected to increase by more than one percent per year by 2030, resulting in an estimated chronically ill population of 171 million.

**96% of them live with an illness that is invisible.

**These people do no use a cane or any assistive device and may look perfectly healthy.

**90% of seniors have at least one chronic disease and 77% have two or more chronic diseases.

**The divorce rate among the chronically ill is over 75%.

**Studies have reported that physical illness or uncontrollable physical pain are major factors in up to 70% of suicides.

Building Awareness
September 11-17, 2006, is National Invisible Chronic Illness Awareness Week (NICIAW). The theme this year is, "My Illness Is Invisible But My Hope Shines Through!" NICIAW is an annual major public awareness campaign sponsored by HopeKeepers Magazine, a consumer magazine that offers spiritual encouragement for those who live with chronic illness or pain.

Paul J. Donoghue and Mary Siegel, co-sponsors of the week and authors of "Sick and Tired of Feeling Sick and Tired: Living With Invisible Chronic Illness" say,
"Invisible chronic illnesses (ICI) have symptoms that are difficult to see and impossible to measure such as pain and fatigue. So those with ICI frequently encounter not compassion and support but impatience and skepticism from physicians and loved ones."

Lisa Copen, the editor of HopeKeepers Magazine who lives with rheumatoid arthritis and fibromyalgia, commented,
"Living with an illness that is invisible to those around us can often have a more devastating affect on our emotional health than the physical pain... Each day we must choose to have hope, despite how medications and alternative treatments may help or hinder us... Just because someone isn’t using a wheelchair doesn’t mean that she doesn’t have a disability. Friends and family of those with chronic illness care a great deal about what their loved ones are going through, but oftentimes the invisibility of the illness sets up an environment for misunderstandings and even doubt about the validity of the illness. We hope to increase awareness of how many people ‘look great’ but are hurting deeply."

Online conference
During NICIAW, an online conference of more than 20 online seminars is being held. The seminars are being conducted via an online chat room. The seminars are being conducted by chronic illness coaches, authors, patient advocates, nutritionists, and other professionals. On Thursday, September 14, I'll be conducting a seminar "Empowerment over the pain," at 6p.m., eastern time. For more information on the conference and a complete schedule of seminars, visit www.invisibleillness.org.

Summary
For many of us, the invisibility of our illness and the resulting lack of understanding and compassion from others is as difficult to handle as the illness itself. During National Invisible Chronic Illness Awareness Week, let's make an extra effort to learn more ourselves as well as help educate others.

_____________
Resources:

Press Release: "96% of Illness is Invisible – Many Look Good but Feel Terrible." HopeKeepers. September, 2006.

"Chronic Conditions: Making the Case for Ongoing Care." Chronic Care in America: A 21st Century Challenge, a study of the Robert Wood Johnson Foundation & Partnership for Solutions: Johns Hopkins University, Baltimore, MD for the Robert Wood Johnson Foundation (September 2004 Update).

United States Census Bureau. 2002.

Anderson, Gerard, Ph.D. "The Growing Burden of Chronic Disease in American." Public Health Reports. Volume 110, May-June, 2004.

Mackenzie TB, Popkin MK. "Suicide in the medical patient." International Journal of Psychiatry in Medicine 17:3-22, 1987

The Anniversary of 9/11

2006-09-11T07:13:00.000-04:00

I guess it would be downright silly of me not to mention this date in my blog.

I remember where I was the exact moment I heard. I was at work, in my cube and the woman sitting across from me was listening to Howard Stern (when you didn't have to pay to listen to him!). Suddenly she screams out, a plane has crashed into the WTC. I told her she was kidding and that it was a Howard Stern joke. After many calls from listeners to the show, Howard Stern had to confirm that it was NOT a joke. Majority of the morning was spent in the auditorium watching CNN with the rest of my company until I couldn't take it anymore.
Today is a little funny, the weather is exactly like it was 5 years ago. A brilliant blue sky and a coolish fall-like day. Normally a gorgeous day. Now it just reminds me of 5 years ago.
The down side of this day is the anniversary is all that you will hear on TV. From what I understand Fox News and CNN are going to be rebroadcasting the footage from that day in its original time. Its going to be strange but luckily I don't have either of those channels.
Unfortunately I didn't sleep well last night. It didn't have anything to do with 9/11 but I overdid it this weekend with things to do and I got overtired and then I couldn't get to sleep last night. So today is going to be a rough day all around. Blah!

Tips for dealing with people in pain

2006-09-09T08:26:00.001-04:00

Another great open letter to people who do not suffer from chronic pain.

TIPS FOR DEALING WITH PEOPLE IN PAIN

People with chronic pain seem unreliable (we can't count on ourselves). When feeling better we promise things (and mean it); when in serious pain, we may not even show up.

An action or situation may result in pain several hours later, or even the next day. Delayed pain is confusing to people who have never experienced it.

Pain can inhibit listening and other communication skills. It's like having someone shouting at you, or trying to talk with a fire alarm going off in the room. The effect of pain on the mind can seem like attention deficit disorder. So you may have to repeat a request, or write things down for a person with chronic pain. Don't take it personally, or think that they are stupid.

The senses can overload while in pain. For example, noises that wouldn't normally bother you, seem too much.

Patience may seem short. We can't wait in a long line; can't wait for a long drawn out conversation.

Don't always ask "how are you" unless you are genuinely prepared to listen it just points attention inward.

Pain can sometimes trigger psychological disabilities (usually very temporary). When in pain, a small task, like hanging out the laundry, can seem like a huge wall, too high to climb over. An hour later the same job may be quite OK. It is sane to be depressed occasionally when you hurt.

Pain can come on fairly quickly and unexpectedly. Pain sometimes abates after a short rest. Chronic pain people appear to arrive and fade unpredictably to others.

Knowing where a refuge is, such as a couch, a bed, or comfortable chair, is as important as knowing where a bathroom is. A visit is much more enjoyable if the chronic pain person knows there is a refuge if needed. A person with chronic pain may not want to go anywhere that has no refuge (e.g.no place to sit or lie down).

Small acts of kindness can seem like huge acts of mercy to a person in pain. Your offer of a pillow or a cup of tea can be a really big thing to a person who is feeling temporarily helpless in the face of encroaching pain.

Not all pain is easy to locate or describe. Sometimes there is a body-wide feeling of discomfort, with hard to describe pains in the entire back, or in both legs, but not in one particular spot you can point to. Our vocabulary for pain is very limited, compared to the body's ability to feel varieties of discomfort.

We may not have a good "reason" for the pain. Medical science is still limited in its understanding of pain. Many people have pain that is not yet classified by doctors as an officially recognized "disease". That does not reduce the pain, - it only reduces our ability to give it a label, and to have you believe us

OPEN LETTER TO PEOPLE WITHOUT CHRONIC PAIN

2006-09-09T08:25:00.000-04:00

This is a letter that has been circulating around for years. It has been recently posted on a message board I belong to so I thought it would be useful here.

LETTER TO PEOPLE WITHOUT CHRONIC PAIN

Having chronic pain means many things change, and a lot of them are invisible. Unlike having cancer or being hurt in an accident, most people do not understand even a little about chronic pain and its effects, and of those that think they know, many are actually misinformed.

In the spirit of informing those who wish to understand.
These are the things that I would like you to understand about me before you judge me...

Please understand that being sick doesn't mean I'm not still a human being. I have to spend most of my day in considerable pain and exhaustion, and if you visit, sometimes I probably don't seem like much fun to be with, but I'm still me-- stuck inside this body. I still worry about school, my family, my friends, and most of the time I'd still like to hear you talk about yours, too.

Please understand the difference between "happy" and "healthy". When you've got the flu, you probably feel miserable with it, but I've been sick for years. I can't be miserable all the time. In fact, I work hard at not being miserable. So, if you're talking to me and I sound happy, it means I'm happy. That's all. It doesn't mean that I'm not in a lot of pain, or extremely tired, or that I'm getting better, or any of those things. Please don't say, "Oh, you're sounding better!" or "But you look so healthy!Â¨ I am merely coping. I am sounding happy and trying to look normal. If you want to comment on that, you're welcome.

Please understand that being able to stand up for ten minutes doesn't necessarily mean that I can stand up for twenty minutes, or an hour. Just because I managed to stand up for thirty minutes yesterday doesn't mean that I can do the same today. With a lot of diseases you're either paralyzed, or you can move. With this one, it gets more confusing everyday. It can be like a yo-yo. I never know from day to day, how I am going to feel when I wake up. In most cases, I never know from minute to minute. That is one of the hardest and most frustrating components of chronic pain.

Please repeat the above paragraph substituting, "sitting", "walking", "thinking", concentrating, "being sociable" and so on ... it applies to everything. That's what chronic pain does to you.

" Please understand that chronic pain is variable. It's quite possible (for many, it's common) that one day I am able to walk to the park and back, while the next day I'll have trouble getting to the next room. Please don't attack me when I'm ill by saying, "But you did it before!" or Oh, come on, I know you can do this!Â¡Â¨ If you want me to do something, then ask if I can.

In a similar vein, I may need to cancel a previous commitment at the last minute. If this happens, please do not take it personally. If you are able, please try to always remember how very lucky you are--to be physically able to do all of the things that you can do.

Please understand that "getting out and doing things" does not make me feel better, and can often make me seriously worse. You don't know what I go through or how I suffer in my own private time. Telling me that I need to exercise, or do some things to get my mind off of itÂ¨ may frustrate me to tears, and is not correct if I was capable of doing some things any or all of the time, don't you know that I would? I am working with my doctor and I am doing what I am supposed to do.

Another statement that hurts is, "You just need to push yourself more, try harder..." Obviously, chronic pain can deal with the whole body, or be localized to specific areas. Sometimes participating in a single activity for a short or a long period of time can cause more damage and physical pain than you could ever imagine.

Not to mention the recovery time, which can be intense. You can't always read it on my face or in my body language. Also, chronic pain may cause secondary depression (wouldn't you get depressed and down if you were hurting constantly for months or years?), but it is not created by depression.

Please understand that if I say I have to sit down/lie down/stay in bed/or take these pills now, that probably means that I do have to do it right now - it can't be put off or forgotten just because I'm somewhere, or am right in the middle of doing something. Chronic pain does not forgive, nor does it wait for anyone.

If you want to suggest a cure to me, please don't. It's not because I don't appreciate the thought, and it's not because I don't want to get well. Lord knows that isn't true. In all likelihood, if you've heard of it or tried it, so have I. In some cases, I have been made sicker, not better. This can involve side effects or allergic reactions. It also includes failure, which in and of itself can make me feel even lower.

If there were something that cured, or even helped people with my form of chronic pain, then we'd know about it. There is worldwide networking (both on and off the Internet) between people with chronic pain. If something worked, we would KNOW. It's definitely not for lack of trying. If, after reading this, you still feel the need to suggest a cure, then so be it. I may take what you said and discuss it with my doctor.

If I seem touchy, it's probably because I am. It's not how I try to be. As a matter of fact, I try very hard to be normal. I hope you will try to understand. I have been, and am still, going through a lot. Chronic pain is hard for you to understand unless you have had it. It wreaks havoc on the body and the mind. It is exhausting and exasperating.

Almost all the time, I know that I am doing my best to cope with this, and live my life to the best of my ability. I ask you to bear with me, and accept me as I am. I know that you cannot literally understand my situation unless you have been in my shoes, but as much as is possible, I am asking you to try to be understanding in general.

In many ways I depend on you - people who are not sick. I need you to visit me when I am too sick to go out... Sometimes I need you help me with the shopping, cooking or cleaning. I may need you to take me to the doctor, or to the store. You are my link to the normalcy of life. You can help me to keep in touch with the parts of life that I miss and fully intend to undertake again, just as soon as I am able.

I know that I asked a lot from you, and I do thank you for listening. It really does mean a lot.

New Mechanism for Chronic Pain Relief Identified

2006-09-06T07:04:00.000-04:00

Pharmaceutical Drug News - New Mechanism for Chronic Pain Relief Identified
by Editor of ImmuneSupport.com

08-25-2006

Researchers at the University of Edinburgh have identified a way to produce a dramatic natural painkilling effect using small doses of certain “cooling chemicals,” either injected or applied to the skin. Working with rats in an animal model study, they demonstrated that the key to this effect is a recently identified protein – TRPM8 – which is found in nerve cells in the skin and can be activated to mediate the sensation of pain by either cool temperatures or cooling chemicals, such as the active ingredient in mint.

The researchers believe their discovery of a mechanism for making use of the body’s own capacity to suppress pain will produce an improvement over conventional painkillers for the treatment of “neuropathic pain” and arthritis, and “has great potential for relieving the suffering of millions of chronic pain patients.” Neuropathic pain is believed to be generated by the nerves themselves rather than by an external cause that can be removed, as in Fibromyalgia.

The TRPM8 protein is one member of a class of recently identified proteins known to mediate various types of stimuli. Research indicates that other proteins in this class can affect the sensations of touch, temperature, and taste, for example.

The report of this study, “Analgesia Mediated by the TRPM8 Receptor in Chronic Neuropathic Pain,” by Susan Fleetwood-Walker and Rory Mitchell, was published in the August 22 issue of the journal Current Biology. It will be freely available to all readers online at www.current-biology.com

FM Patient Awarded $747,000 in Disability Bias Suit

2006-09-06T07:01:00.000-04:00

FM Patient Awarded $747,000 in Disability Bias Suit
by Editor of ImmuneSupport.com

09-01-2006

A jury in the federal District Court of Cumberland County, Maine, has awarded Fibromyalgia patient Ronald Harding $747,000 in back pay and damages in a suit against his former employer, Cianbro Corp., according to a report published August 24, 2006 in the Kennebec Journal.

Mr. Harding’s civil rights suit against Cianbro charged that the Pittsfield-based heavy industrial company had discriminated against and terminated him in 2002 after 18 years of employment because he suffered from a disability caused by Fibromyalgia. The jury’s decision, which came after a six-day trial, marked what “could be the largest employment disability discrimination case in the state’s history,” stated Jeffrey Young, one of Mr. Harding’s attorneys.

The suit was brought “on a civil rights theory, 42 USC [United States Code] 2000e,” according to MoreLaw.com, an online litigation digest, which also noted “The defenses asserted by Cianbro are not available.”

Congrats Ronald! This is a big step for recognizing FM for what it is!!!

Still trying to figure out this Baclofen

2006-09-05T09:23:00.000-04:00

Ever since I adjusted up my Baclofen from 60 mgs a day to 120 mgs a day my life has been an almost hourly beat of ups and downs. Sometimes I feel okay other times I feel like I have the flu.
The headaches and the extreme fatigue is getting to me and I don't know if this is a permanent state or just an adjustment period. I drink more Diet Coke now than I have in months. The facet injection sites are still sensitve but overall I am okay.
I just wish that this Baclofen hangover would just go away.

Low Levels of Certain Cytokines May Be Linked to Fibromyalgia

2006-09-04T07:27:00.000-04:00

Thank you www.arthritis.about.com for the information.

Low Levels of Certain Cytokines May Be Linked to Fibromyalgia
From Carol & Richard Eustice

Fibromyalgia is among the conditions marked by chronic widespread pain. Fatigue, depression, and insufficient sleep can be associated with conditions characterized by chronic widespread pain, making diagnosis difficult.

How Is Fibromyalgia Diagnosed?

Fibromyalgia Diagnosis Is Difficult

Research shows that people with fibromyalgia typically see many doctors before receiving the diagnosis. One reason for this may be that pain and fatigue, the main symptoms of fibromyalgia, overlap with many other conditions.

Doctors often have to rule out other potential causes of these symptoms before making a diagnosis of fibromyalgia.

No Diagnostic Laboratory Tests For Fibromyalgia

Another reason fibromyalgia diagnosis remains difficult is that there are currently no diagnostic laboratory tests for fibromyalgia; standard laboratory tests fail to reveal a physiologic reason for pain.

Because there is no generally accepted, objective test for fibromyalgia, some doctors unfortunately may conclude a patient's pain is not real, or they may tell the patient there is little they can do.

Diagnostic Criteria For Fibromyalgia

A doctor familiar with fibromyalgia, however, can make a diagnosis based on two criteria established by the American College of Rheumatology:

A history of widespread pain lasting more than 3 months
The presence of tender points

Pain is considered to be widespread when it affects all four quadrants of the body; that is, you must have pain in both your right and left sides as well as above and below the waist to be diagnosed with fibromyalgia.

Fibromyalgia Tender Points

The American College of Rheumatology also has designated 18 sites on the body as possible tender points. For a fibromyalgia diagnosis, a person must have 11 or more tender points.

What are Fibromyalgia Tender Points?
One of these predesignated sites is considered a true tender point only if the person feels pain upon the application of 4 kilograms of pressure to the site. People who have fibromyalgia certainly may feel pain at other sites, too, but those 18 standard possible sites on the body are the criteria used for classification.

Study results published in the August 2006 issue of Arthritis & Rheumatism revealed cytokine profiles of 40 patients with chronic widespread pain. Of the 40 patients, 26 had fibromyalgia. Cytokines are proteins which serve as messengers between cells and play a role in the inflammation pathway.

Researchers found that patients with chronic widespread pain had significantly lower levels of two cytokines, IL-4 and IL-10. Further studies will determine if the lower cytokine levels (of which there may be more) are a consequence of chronic widespread pain or if they are part of the cause.

Still revcovering....again

2006-09-03T09:04:00.000-04:00

Well still working on making my back feel better. The injection sites are always senstive to touch espcially since it is around where the waist of pants and underclothes seem to settle.
Each night I have been putting on a Lidoderm patch to help with the irritation and that seems to be helping. The downside is that I think that my right side is acting like my left side did before the facet injections. I am not sure what that means but it doesn't bode well that is for sure. I think when I see my doc next week I will tell him about it and skip right to the Rhziotomy instead of these facet injections. Unfortunately I hope that the side effects won't be as bad as this last set of injections. Icky!!!

Scams concerning FM

2006-08-31T14:03:00.000-04:00

Thank you www.chronicfatigue.about.com for the information.
The Advertising of Fibromyalgia Treatments
Karen Richards

Beware Fibromyalgia-Targeted Advertising
As we prepare to celebrate National Fibromyalgia Awareness Day (May 15th), we have good reason to celebrate. The awareness level of the public, the medical community and the media is at an all-time high. However, this increased awareness has also made fibromyalgia (FM) patients the target audience for a multitude of fibromyalgia treatment products promising to improve or even “cure” FM.
There are some very good products available that can offer at least a degree of symptom relief, however, there are also many questionable products and a few downright scams. As the understanding and recognition of fibromyalgia has grown, hundreds of companies with health-related products have scrambled to market their products to 10 million suffering patients –– desperate to find something that will help them.

Questionable Advertising
A TV ad asked, “Are you a female with fibromyalgia?” It then offered a free copy of an “eye-opening report” and instructed me to call a toll-free phone number or go to their web site. With the red lights of my inner “scam-alert radar” flashing, I went to the web address. No clue as to what the “report” was about or what product they were selling –– just a form to fill out with my name and address so they could send me the report. Next, using *67 to block my phone number from showing up on caller ID, I called the toll-free number. Once again, I was just asked for my name and address.
Now, I can’t say whether or not this is a scam because I refused to give them my personal information. However, I am automatically suspicious of any company who will not even tell you who they are until they get personal information from you. I do feel fairly certain they are trying to sell something. Their mysterious advertising technique ensures they will have a database full of their target audience –– women in pain, looking for help.

To Buy or Not to Buy
How do you determine which products are worth trying and which are more hype than substance?
Don’t make a decision to purchase a new product when you’re having a really bad day. Your desperation to feel better may cloud your judgment. Wait until you feel well enough to evaluate the product rationally.
Do you personally know anyone who has used this product? Don’t rely on what you heard that a friend of a friend said. If possible, talk to more than one person who has tried the product and get their honest evaluation. Support groups are a good place to ask several people at once.
What kind of proof does the manufacturer offer to validate their claims? Look for reputable research studies and clinical trials. Be careful if their only proof is testimonials of people you don’t know.
Remember that no one product works for everyone. What helps your friend may not help you and visa versa.
Always consult your doctor before trying a new product or treatment. Some products may not be compatible with medications you are taking.

Red Flags
Before trying any new product or treatment, look for these warning signs:

**Products or treatments promising to cure fibromyalgia. There is no cure for FM, so you know upfront they are making a false claim. The product may or may not help improve one or more symptoms, but it will not cure FM.

**Teaser ads that do not reveal the name of their product upfront. Usually they require that you give them personal information before they will tell you their big “secret.” This is simply an advertising ploy to get your name, address and phone number to increase their mailing/calling list.

**Products that claim to cure or help a wide variety of very different illnesses. No one product can cure everything. The etiologies of diabetes, hypertension and fibromyalgia are very different. It is highly unlikely that one product will improve all of them.

**Products that require a fairly significant financial outlay to try. While it may or may not be a quality product, the question you must as yourself is: If this really does help me, can I afford to continue purchasing it every month? If it does not fit into your budget on a long-term basis, don’t waste your money trying it.

**Products that have no verifiable research or clinical trials to back up their claims. The companies selling these products usually offer lots of “personal testimonials” to prove how good they are. These recommendations sound deeply sincere and can be very persuasive. The fact is, though, you have no way of knowing whether these testimonials are even real.

**Companies that offer “free” products or treatments. Read the fine print and ask lots of questions before agreeing to try what they offer. Often there are hidden fees or commitments such as, processing fees, membership requirements, get one month free if you commit to six months, etc. Remember the old adage: If it looks too good to be true, it probably is.

Updated: June 15, 2006

The day after injections

2006-08-31T07:53:00.000-04:00

Well after a rough afternoon and night, I made it to today.
Yesterday I was feeling rather crappy all day after my appointment so I tried to make myself as comfortable as possible. I wasn't in much pain because of the amount of Marcaine that was injected before the Depo-Medrol shots but I felt very ill. Then after I ate dinner all hell broke loose...literally!!! After an afternoon migraine I had an intimate moment with the toilet.
Something tells me he hit something he wasn't supposed to yesterday....
We also talked again about the Rhiziotomy and it looks to be more and more the choice I will be heading toward. We talked a little more about the procedure and radio waves are used to burn the nerve at the located needed....interesting. I keep wondering about the pain levels after the procedure. We will see I guess.

The Agony of the Injection

2006-08-30T07:44:00.000-04:00

Well today I get my second round of facet injections. I am not looking forward to the immense pain of the procedure or the recovery time, but with the pain in my left leg increasing daily, I am willing to put up with the acute pain. For now anyway.
Well, it is time to get ready for my ride and appointment...wish me luck!

The trouble a tortoise can get into

2006-08-28T16:39:00.000-04:00

While sleeping this afternoon because of a migraine, it looks like my torioise Maizer got herself into a little fun and fell asleep half-way through it.
Here is proof that they are just like dogs and cats when it comes to trouble making.

Now she loves plastic bags...we aren't sure why but when she can sneak into them she will play around them any chance she gets.
I am sure more Maizer exploits will be upcoming!

Icky...icky....icky

2006-08-28T06:52:00.000-04:00

I feel like total shit lately. A couple of weeks ago, my Baclofen was raised from 60 mgs a day to 120 mgs a day and I haven't quite gotten my equalibrium since then. I have to drink Diet Coke everyday just to keep awake and to keep the headaches at bay. I hope my body becomes adjusted to this soon.
Wednesday is my second round of facet injections and I hope they work out. I really need to get back to the gym and get some exercise. I feel like a total sloth.
UGH!!! I just got out of bed and I need a nap already.

Sorry for the lapse in postings

2006-08-24T07:14:00.000-04:00

Ah the recovery time from doing too much. Such a pain in the ass. Since my last post I have been trying to fight back from the total exhaustion I have felt since then. Even now, I need a Diet Coke to wake myself up each day and to just keep going. I haven't bought Diet Coke in this amount in ages!!!! I should buy shares in the company for crying out loud! Part of me thinks that I should be tested for Chronic Fatigue Syndrome or something along those lines. I know that my iron deficency is part of the problem, but taking the iron pills causes major constipation issues for me. So I have decided to just take a daily women's multi-vitamin and see what happens.
Well its another day to relax and try to get my energy back. Wish me luck.

Pain affects 1 in 4 Americans

2006-08-21T12:11:00.000-04:00

Ryckman: The world of hurt
From www.rockymountainnews.com

'Invisible disease' of pain afflicts one in four Americans

Pain has become a national epidemic and one of the nation's most dismissed and undertreated conditions. More than 75 million Americans suffer from chronic, debilitating pain, and more than 50 million of them are partially or totally disabled by it, according to the Englewood-based National Pain Foundation. Pain cost Dennis Kinch his job, his home and his family.
"You end up feeling alone on an island wondering who you are now," the Boston man says. "Pain runs your life."

But it wasn't going to ruin it, Kinch decided. The 51-year-old cook suffers from two diseases that make walking painful, if not impossible - so that's exactly what he did. He walked 2,400 miles, from Chicago to Santa Monica, Calif., along Route 66, starting last fall and ending Friday. Along the way, he stopped at 35 pain clinics to talk to patients and doctors as a spokesman for the National Pain Foundation.

"Do what you can when you can," Kinch says. "Sometimes it seems like everything is negative. You have to learn to tune that negative stuff out. That's what keeps people in pain on the couch - they get scared. They're afraid of the pain."

Pain has become a national epidemic and one of the nation's most dismissed and undertreated conditions. More than 75 million Americans - one in four - suffer from chronic, debilitating pain, and more than 50 million of them are partially or totally disabled by it, according to the Englewood-based NPF.

Government statistics show that pain is a factor in more than 80 percent of all physician visits, yet fewer than 1 percent of doctors have training in pain treatment, says NPF Executive Director Mary Pat Aardrup.

"Pain is viewed as a character flaw. It's an invisible disease," she says. "You don't have a bandage, you haven't lost any hair. When someone is in pain 24-7 - and a lot of people are - family and friends tire of hearing about it, and they often go away. Your self-worth and dignity go away. Your identity as a person vanishes. You become the pain."

The portrait of pain in America looks like everyone: It cuts across all genders, races and ages, including an estimated 20 percent of children. But surveys find that people are afraid to talk about it, reluctant to treat it and dismissive of it in themselves and others.

Nicole Hemmenway, of Corpus Christi, Texas, was 12 when she was diagnosed with complex regional pain syndrome, a neurological disorder. It began in her right hand, which swelled, purpled and stayed clenched for more than five years.

"It felt like my hand was being submerged in hot oil," says Hemmenway, now 25. "It slowly went up my arm until I wasn't able to use it at all, then down my left side and throughout my body. I was in a wheelchair, I was bedridden, I couldn't walk, I couldn't get dressed by myself, I didn't take a shower for 10 months."

Hemmenway went through every drug, every procedure, every device. But she never let a doctor tell her she wasn't going to get better. At 19, she realized that her pain didn't have to control her life.

"Most of the time, people are belittled and told it's in their head. You feel like an outcast," says Hemmenway, whose pain is under control. She's now running a couple of miles a day. "I want people to hold on to hope. It will get better, and they're not alone. People do believe their pain."

A third of sufferers in the Partners Against Pain 2000 survey didn't believe that people understood how much pain they were in; one quarter said their families were tired of hearing about it. Nearly 40 percent said they felt isolated and alone.

More than 40 percent said they would spend all their money on a treatment they thought might work.

"There are days when I feel like a broken bottle," a woman wrote to the American Pain Foundation. "All the pieces hurt, and I can't seem to bring them together to make an entire vessel."

Compounding the treatment problem is the belief that pain medications lead to addictions, a misconception that contributes to undertreatment, Aardrup says.

"The vast majority of people in pain are not addicts and abusing or diverting drugs," she says. "(That belief) is putting the squeeze on access to care for chronic pain. There's a fear on the part of doctors that overprescribing may put them in jeopardy, losing their license or even going to prison. People in pain are absolutely dependent on having as many resources as possible."

Pain annually costs the nation more than 50 million lost workdays, more than $3 billion in lost wages and more than $100 billion in lost productivity. About 75 percent of that lost production came from reduced work performance, not absenteeism, according to a 2003 study in The Journal of the American Medical Association.

"We only spend 1 percent of our research budget on pain even though it is our most costly problem," Dr. Rollin M. Gallagher, director of the Center of Pain Medicine, Research and Policy at the University of Pennsylvania School of Medicine, told a congressional hearing on pain last month. Congress is considering the National Pain Care Policy Act, which would improve pain education for physicians, improve access to pain-management services and increase funding for pain research.

The voices of people in pain reflect frustration and despair. In the Partners Against Pain survey, nearly 30 percent said they felt there was no solution for their pain. A third of sufferers had chronic pain so severe and debilitating that they felt they couldn't function as normal people and sometimes felt so bad that they wanted to die.

Writing to the American Pain Foundation, one woman said she lost her job and her marriage and attempted suicide after a car accident left her with chronic, debilitating pain. But she keeps going, with help from doctors, drugs and determination.

"I struggle every day, a delicate balance, like walking on a cliff path. One strong gust of wind and I know that I will fall over," she wrote. "But I turn my face to the wall, take a deep breath and dig my fingers into the rock and walk on.

"As far as I can go."

The hard facts

Here are some facts about pain from the 2000 Gallup survey Pain in America and the 2000 Partners Against Pain report, A Survey of Pain in America:

• Nine in 10 Americans suffer from regular pain; 89 percent reported they have some sort of pain monthly or more often.

• Nearly 26 million Americans suffer from severe pain. Forty-six percent reported moderate pain.

• Nearly 42 percent said they experience pain daily.

• On average, people with moderate to severe pain have lived with it for close to 1 1/2 years.

• Eighty-three million Americans reported that pain frequently affects their participation in some activities. Forty-three percent of respondents reported that pain occasionally affects participation.

• Four in five Americans believe aches and pains are a part of getting older, and 64 percent would see a doctor only when they couldn't stand the pain any longer.

• Sixty percent said pain is something you just have to live with, and 55 percent said they're uncomfortable taking medications.

• More than half said that they prefer being alone when they're in pain and that they're in a bad mood when in pain.

• Eighty percent of patients surveyed think their pain is a normal part of their medical condition and something they have to live with.

• About 40 percent said they're uncomfortable discussing their pain.

• More than half said pain interferes with their sleeping or mood, 30 percent their ability to drive, and 28 percent their ability to have sexual relations.

• Patients are so dissatisfied with the efficacy of their prescription and over-the-counter pain-control medications that 78 percent are willing to try new treatments.

• Two-thirds said their over-the-counter medications aren't effective, and 52 percent of those taking prescription medications said they're not effective.

Pain practitioners

If you're looking for a pain specialist, ask for a referral from your primary- care physician. Here are some questions for a potential pain practitioner from the National Pain Foundation:

• How many cases of my type of pain condition have you treated?

• What are your special qualifications to treat my pain condition?

• Have you participated in any special training about pain-management techniques?

• What is your philosophy of management of my pain condition in terms of medications and alternative therapies?

• What types of medications do you usually prescribe?

• What types of non-medication therapies do you use?

• Where do you refer patients who need additional treatment?

• Is your clinic listed with any professional societies?

• Are you, or is someone in the clinic, available 24 hours a day if I need help?

Ryckmanl@RockyMountainNews.com

Feeling overwhelmed....thanks to hubby!

2006-08-21T08:04:00.000-04:00

Well, today I have lots of cleaning up to do. No thanks to my husband.
My husband, who is the healthier of the two of us decided to NOT help me at all this weekend. First off, Friday he stayed home from work because of an infection in his eye...we aren't sure if it is pink eye yet or another type of bactierial infection but he is on eye drops until it clears up. We went to the doctor's and of course we ran all over the place.
Usually when he is home for an extra day, it is going to mean extra work for me to catch up on. The trash built up but he didn't bother to take it out. I did the laundry as usual. I asked him to vaccum the rug this weekend, but of course that didn't get done. So now, I have to do it. I shouldn't as a rule be vaccuming but the rug is getting rather grody, so it must be done. Then finally he decides to cook! He of course made a mess and didn't even do the dishes so now I have a butt load of dishes to take care of.
Its time like these I really want to cry because I know the amount of pain I will be in and how tired I will be. Nevermind what I should do first...yes it is that overwhelming to me. So feeling guilty, I will be cleaning up his messes along with my own (I am not going to say I am totally innocent here!).
Well, I must go....so much to do....so little energy to do it with.

The History of Fibromyalgia

2006-08-17T11:56:00.000-04:00

History of Fibromyalgia
From Karen Richards, Your Guide to Fibromyalgia & Chronic Fatigue Syndrome. www.chronicfatigue.about.com

Although the term “fibromyalgia” was not coined until 1976, throughout history people have reported illnesses with strikingly similar symptoms. These reports can be found as far back as Old Testament Biblical times.

Early Evidence: Following is Job’s vivid description of his physical anguish: “I, too, have been assigned months of futility, long and weary nights of misery. When I go to bed, I think, `When will it be morning?' But the night drags on, and I toss till dawn…And now my heart is broken. Depression haunts my days. My weary nights are filled with pain as though something were relentlessly gnawing at my bones.” (Job 7:3-4; 30:16-17 - NLT)
Another well-known person who reported fibromyalgia-like symptoms was Florence Nightingale, an English army nurse during the Crimean War (1854-1856) who was a pioneer in the International Red Cross Movement. Nightingale became ill while working on the front lines and never really recovered. She was virtually bedridden much of the rest of her life with pain and fatigue resembling fibromyalgia until her death in 1910.

Terminology: This mysterious illness has been studied since the 1800’s and has been identified by a variety of names, including hysterical paroxysm, muscular rheumatism and fibrositis. The term fibromyalgia was first coined in 1976 in an effort to describe its primary symptom. (Fibro – meaning fibrous tissue, my – meaning muscle, and algia – meaning pain)
It wasn’t until 1990, when the American College of Rheumatology developed a diagnostic criteria for doing fibromyalgia research, that the term fibromyalgia gained wide usage.

Theories: Over the years there have been a multitude of theories as to what fibromyalgia is and what causes it. As the term fibromyalgia implies, it was logically thought to be a muscle disease, since muscle pain seemed to be the primary symptom. However, research studies could fine nothing wrong with the muscles. For a while, it was theorized that it might be an autoimmune disorder, but once again research revealed no disturbance of the immune system.
Sadly, as often happens when medical science cannot identify an illness using standard technology of the day, for most of the past 200 years fibromyalgia was thought to be a psychiatric or psychosomatic disorder. Even today, there are a few medical professionals who insist on hanging on to this theory.

Answers: Fortunately, the 21st century has brought new laboratory tests and brain-imaging technology that has not only proven fibromyalgia to be a real physical disorder, but has also shown that it is caused by a malfunction of the central nervous system. As a result of these discoveries, new, more effective treatments are on the horizon. Hopefully, one day the history of fibromyalgia will be just that –– past history.

Sources:
Florence Nightingale - A Biography, R.E.S.C.I.N.D., 1997-2000,
Fibromyalgia, Wikipedia, 2006,
Updated: June 15, 2006
Karen Lee Richards, About.com's Guide to Fibromyalgia and Chronic Fatigue Syndrome, is a nationally-known patient advocate. She is co-founder of the National Fibromyalgia Association and former executive editor of Fibromyalgia AWARE magazine.

Tips on how to take care of you!

2006-08-17T11:46:00.000-04:00

How To Take Personal Responsibility For Chronic Pain
Anne Asher,Your Guide to Back and Neck Injury / Chronic Pain. From www.backandneck.about.com

Chronic pain does not behave according to the same rules as acute pain. Finding the cause of chronic pain can be difficult or impossible.

Because chronic pain is elusive, often the patient is discounted or compromised in the process of diagnosis and treatment. It might take a patient months, if not years of doctors' visits to get a definitive diagnosis. Worse, the patient may be told that the pain is "all in your head", and be advised to "just deal with it".

Difficulty: Easy
Time Required: Ongoing
Here's How:
Understanding is where it all begins.

Research your condition and chronic pain in general. Resolve to take personal responsibility for your pain.

Know the difference between the two forms of pain: Acute and Chronic.

Chronic pain is defined as pain that "outlasts the usual healing process", according to Neuropathy-Trust.org. If pain persists beyond 3-6 months, chances are it is chronic.

Unlike acute pain, which is pain that responds to an actual event of the body, chronic pain can be caused by an injury or illness, or it might appear out-of-the-blue. This is one of the reasons chronic pain is difficult to diagnose.

Understand how chronic pain works in your body.

To others chronic pain may seem like it is all in your head, but there are acutal physiological processes that are happening. Either:

The way your nervous system processes the information associated with pain has been amplified. This might be due to:
injury
illness
other factors
cause unknown, or
Your nervous system just normally processes pain in such a way that pain is amplified.

Mobilize personal resources by learning to relax.

Many pain management specialists prescribe relaxation techniques for their patients. Just because your body works in a more high strung way, doesn't mean you have to.

Keep a Pain Journal.

By keeping track of:

where and when you feel pain
the quality of the pain
what triggers it and what makes it go away
you will have a basis of communication with your medical professionals.

You may also wish to write record your food and water intake, hours of sleep, meds taken and exercise activity.

Resolve to find medical professionals with whom you are comfortable. Stand firm in that resolve as you look for them.

You, in your pain have a right to be taken seriously. A good doctor, therapist, etc. will listen to you and be willing ot work with you as a partner in healing.

Drink plenty of pure water

Studies have shown that drinking enough water decreases the body's inflammatory response. Inflammation is at the root of many diseases and conditions in our society.

Seek counseling and share your feelings.

People who live with chronic pain are prone to a feeling of isolation. Isolation is a powerless place to be. Sharing your feelings and concerns can be an effective release, and can even add to your ability to relax.

Give a face and a meaning to your pain.

If you are creative, is there a way you can express your pain as a work of art? For inspiration, you may wish to view the Chronic Pain Visual Art Project. If you are not creative, writing about your feelings and pain may provide you with new perspective.

What You Need:
A Positive Attitude
Willingness to take Personal Responsibility
Courage
Assertiveness
An Open Mind - Especially to New Experiences and Information

Anne Asher is a health writer with a focus on back and neck issues, musculoskeletal health and alternative medicine. She has worked as a clinical massage therapist, a movement therapist and a Pilates instructor. Anne is the former ergonomics editor of BellaOnline.

Facet Injections.....Again!

2006-08-17T08:22:00.000-04:00

Well in a couple of weeks I am off again for another set of facet injections. While they are painful, they do help. I hope this time longer than before...that way I won't have to even think about the Rhiziotomy....e-yow! I also got a raise in my daily Baclofen count...I now take 120 mgs a day. 30 mgs 4 times a day....we will see if that works out for me too.
I got my trigger point injections yesterday and boy I am hurting....so its on the couch to rest today.

To do or not to do the dishes????

2006-08-14T08:24:00.000-04:00

I must apologize for my lack of blog postings the past week or so. Our computer crashed and I have been very busy bulidng it back up. What a chore!

Did you ever have one of those days when you have a chore to do but you just don't feel like doing it, so you put it off??? Well my menace for the day is the dishes. My husband who had a nice three day weekend actually made dinner twice, but of course when it came to the clean up slacked. Typical guy or what???? Sigh. So now there is an abundance of things in the sink and has creeped up onto the stove since he made pizza and the pan is just too big for anyplace else.
Unfortunately I am so tired and not feeling well the past few days that the amount of dishes keep piling up and up..and up!
UGH! Sometimes I hate having a chronic illness. Today is just one of them days.

My little girls

2006-08-07T08:45:00.000-04:00

As was stated in a previous post. I have 7 tortoises. Here a couple more of them. They are Tiki-liki and Ti-ti. Both are Red-footed tortoises and I call them my girls. Here they are relaxing under the heat lamp. Oh to be a tortoise...I think when I die I would like to come back as a pet tortoise.

Why don't people get it?

2006-08-07T08:10:00.000-04:00

I have been officially ill for about 6 years now and still people don't get it. The more I take a look at the world, the more I realize that most people don't understand the total effect that pain has on the body nevermind that of the human spirit. Take for example my husband.....
He has been on me for months to loose weight thinking that I will feel better without all this weight I carry around. Doesn't he remember that when I weighed less than I do now I was in MORE pain???? Sorry but in some cases weight does not equal more pain!!!!! Wake up people!!! Sometimes we can't control what our body does.
And people wonder why pain patients get such a bad rap!

National Pain Awareness Month

2006-08-03T08:27:00.000-04:00

I have just been informed that September will be National Pain Awareness Month.
For more information about chronic pain and what is being done to bring awareness to the issue, please visit the website www.nationalpainfoundation.org.

Why Good Pain Management is so hard to find

2006-08-02T13:59:00.000-04:00

Here is an article about pain killer abuse. One of the main reasons why those in chronic pain cannot find proper pain management.

Prescription Painkiller Abusers May Account for Many Lethal Overdoses, Experts Say
By Miranda Hitti
WebMD Medical News
Reviewed By Louise Chang, MD
on Monday, July 24, 2006

July 24, 2006 -- Accidental deaths from prescription painkillers have risen in recent years in the U.S., show no signs of slowing down, and may be largely due to painkiller abuse.

The CDC's Leonard Paulozzi, MD, MPH, and colleagues, report the news in Pharmacoepidemiology and Drug Safety's online "Early View" edition.

Paulozzi's team checked CDC death certificate data on unintended deaths from opioid painkillers including oxycondone, hydrocodone, fentanyl, and methadone. Their findings:

Unintended prescription painkiller deaths rose 91% from 1999-2002.
Unintended deaths from heroin and cocaine rose by lesser amounts during the same period (about 12% for heroin and nearly 23% for cocaine).
The researchers write that in 2002, the latest year studied, "opioids were listed without cocaine or heroin in 4,451 deaths that year, more than the combined number of deaths listing either cocaine alone (2,569) or heroin alone (1,061)."

Drug Sales on the Rise

The rise in unintended prescription painkiller deaths mirrored an increase in sales of the drugs. The data also showed several clues about painkiller abuse.

For instance, men in their 40s accounted for many of the opioid deaths. And the background of people who accidentally died using prescription opioids matched those from other drug abuse deaths.

Those traits "do not match those of people who typically experience chronic pain, who are more likely to be female and older," the researchers write.

More steps may need to be taken to prevent painkiller abuse "without diminishing the quality of care for patients with a legitimate need for pain managementpain management," write Paulozzi and colleagues.

Painkiller abuse is a big problem, journal editorialists agree.

One editorial -- written by researchers including David Joranson, MSSW, of the University of Wisconsin at Madison -- calls for better data on painkiller abuse. The data Paulozzi's team used don't show which patients were abusing painkillers.

Another editorial -- written by Scott Fishman, MD, of the pain medicine division at the University of California, Davis – calls for aggressive action against painkiller abuse.

But drug abuse solutions "must not undermine patients in pain," Fishman writes. "The least we can do is make sure that the casualties of the war on drugs are not suffering patients who legitimately deserve relief," he adds.

--------------------------------------------------------------------------------

SOURCES: Paulozzi, L. Pharmacoepidemiology and Drug Safety, July 24, 2006; online "Early View" edition. Joranson, D. Pharmacoepidemiology and Drug Safety, July 24, 2006; online "Early View" edition. Fishman, S. Pharmacopepidemiology and Drug Safety, July 24, 2006, online "Early View" edition. News release, John Wiley & Sons, Inc.

I feel icky! I'm sure you do too!

2006-08-02T06:42:00.000-04:00

Okay....
AC - Check
Water - Check
Sunscreen - Check
Hat - Check
Staying out of the sun - Double Check

Alright....now I am doing what they say to help people stay cool, but why do I feel like shit? Oh yeah, that's right I have Fibromyalgia. DUH! I keep forgetting. As I stated in yesterday's post, as much as websites say that heat is a good thing and only cold affects FMers, sorry but heat affects us too!!!! Wake up people!
There are just so many conflicting websites with erroneous information or just plain WRONG information that it is so hard to know what to do with yourself to keep on an even keel. Especially if you are a newbie to the world of FM, as so many are nowadays. The best advice I can give a person with FM (old-timers and newbies) is to take inventory of your body in each and every situation. And I mean EVERY situation. It is the only way to keep track of how you will do daily. Just the simple act of doing dishes, going grocery shopping or visiting a friend can bring on a pain flare on certain days. It is okay to let the dishes sit for a day, a true friend will understand and let someone else can do the groceries (let your husband (or wife or teenaged child) do them for a change!).
Well today I have an appointment with my pain doc for Trigger Point Injections (or TPIs as I call them) and hopefully I will get some relief from the pain that way. I also may be getting new pain medication because the med I was on didn't seem to be controlling my pain as it should. So I have been taking a two week trial period off the med to see if I feel the same off it as I did on it. Well, I did, so obviously it wasn't working as it should. I just hope that whatever he gives me is a generic, for cost reasons obviously, and that it will help me. Today is a really rough day for me so far and a vacation from the pain would be a welcome friend right now.
Well that is all for today.....keep cool everyone!

Oh I forgot to add....got the results back from my colonoscopy...I am fine. Phew! Another bullet dodged.

The Life of a Wondering Tortoise

2006-08-01T08:11:00.000-04:00

My husband and I have 7 tortoises of different breeds as pets. Our largest is a 10 pound Yellow-footed tortoise named Daisy Mae AKA Maizer. Well because of her size, when she wants out of her tank, she wants OUT!!!! So we let her wander about about the apartment until her heart is content to prevent her from making a racket all day long!
So here are pictures of my shelled Yorkie as I call her.

She will be out the rest of the day!

Summer Heat and Fibromyalgia

2006-08-01T07:35:00.000-04:00

Two things that DON'T go together...that is for sure. Today is the start of a two day triple digit heat-fest in my neck of the woods. Unfortunately there is absolutely nothing I can do for it. Regardless of AC, the FM goes into motion and there is no way to stop it.
Thanks to www.fibromyalgia-symptoms.org for the information.

How Does the Weather Affect Fibromyalgia Symptoms?

Many fibromyalgia patients claim that changes in the weather directly affect many of their symptoms. In fact, many fibromyalgia sufferers claim that their symptoms vary according to temperature changes, changes in air pressure, and changes in precipitation in their part of their world. Most fibromyalgia sufferers claim that they experience changes in:
fatigue (I am very tired all the time)
sleep patterns (I can't sleep when it is this hot!)
headaches (Oh yeah!)
muscle pain (Same as above...feeling like crap today!)
the number of symptom flare ups (Not yet but I expect them to get hopping anytime!)

Who is Affected by Weather Changes?
According to a study performed in 1981, a large percentage of fibromyalgia sufferers may actually be sensitive to changes in the weather. In this particular study, 90% of patients claimed that weather was one of the most important influences on their fibromyalgia symptoms. And fibromyalgia sufferers aren’t the only ones to experience weather-related symptoms. You may also find that the weather exacerbates your symptoms if you have:
rheumatoid arthritis
multiple sclerosis
osteoarthritis

What Weather Factors Affect Fibromyalgia Sufferers?

There are five major weather factors that appear to affect fibromyalgia symptoms. These include:

Temperature: Rapid changes in temperature can sometimes trigger a fibromyalgia flare or help to ease fibromyalgia pain. Cold weather tends to make fibromyalgia symptoms worse, while warmer weather tends to ease those troublesome symptoms. (Not necessarily but mostly true...any changes affect me either way.)
Barometric Pressure: Barometric pressure is a measurement of the weight that is exerted by the air all around us. On beautiful sunny days, barometric pressure tends to be quite high, but during a storm or similar weather front, barometric pressure drops suddenly. Fibromyalgia sufferers often find that these changes in barometric pressure can trigger muscle aches and pains. (Headaches....migraines to be exact plague me during these times.)
Humidity: Absolute humidity is a measurement of the amount of water vapor present in each unit of air. When absolute humidity is low, fibromyalgia sufferers often report headaches, stiffness, and flares in widespread pain. (This is a load of crapola.....humidity equals barometric pressure, which equals migraines and pain!!!)
Precipitation: Precipitation is the term used to refer to any type of water that falls to the ground from the sky, including rain, sleet, snow, or hail. Precipitation is often accompanied by a change in barometric pressure, and therefore may exacerbate your symptoms of pain and fatigue. (You bet your bippie!)
Wind: Whether it’s a light wind or a gale-force wind, wind generally causes a decrease in barometric pressure. This means that wind can trigger fatigue, headaches, and muscle aches in fibromyalgia sufferers. (Ditto!)

Weather and Fibromyalgia: The Studies

Numerous studies have been conducted in order to evaluate whether or not fibromyalgia symptoms do appear to be influenced by changes in the weather. Most of these studies have had surprising results.

In 2002, a study was conducted in Cordoba, Argentina, where there are four distinct seasons every year. The study involved fibromyalgia sufferers and a healthy control group and aimed to find out whether pain symptoms could be linked to specific weather changes. Participants were asked to rate their pain symptoms on a scale from one to ten, every day for 12 months. After 12 months, these symptoms were correlated to weather patterns for the entire year. Researchers found that pain symptoms of the participants with fibromyalgia correlated directly to weather changes. Specifically, pain increased as temperatures fell and atmospheric pressure increased. The healthy control group did not show any correlation between pain and weather patterns.

Another study performed in Norway found a similar relationship between fibromyalgia symptoms and the weather. Fibromyalgia symptoms appeared to get worse during the months of December and January, but began to improve during April and May. This suggests a direct relationship between colder temperatures and lower barometric pressures and a rise in fibromyalgia symptoms.

Why Does Weather Affect Fibromyalgia Symptoms?
Unfortunately, researchers do not yet know why weather appears to affect fibromyalgia symptoms so much. However, there are a few possible explanations:

Change in Sleep Cycle: Weather, particularly hot and cold temperatures, can sometimes affect the way in which you sleep. This could have a great affect on symptoms and flares if you are a fibromyalgia sufferer.
Change in Circadian Rhythm: Your body operates using an internal clock known as the circadian rhythm. Changes in seasons and the amount of light that your body receives can throw off your circadian rhythm, causing you to feel fatigued and more achy then usual.
Pro-Inflammatory Cytokines: There does appear to be a relationship between low temperature levels and an increase in the number of pro-inflammatory cytokines in the body. These cytokines appear to be related to pain intensity.

Dealing with the Weather: Managing Your Fibromyalgia Symptoms
If you find that your symptoms are influenced by weather changes, here are a few tips to help keep you more comfortable:
Dress in Layers: Prepare for those chilly days by dressing in two or three layers. This will keep your body warm and allow you to shed excess clothing should you become hot.
Avoid Cold Temperatures: Try to keep your air conditioning off in your house during the summer, and keep your heat up during the winter months. If you have to go outside in the cold, wear gloves, proper boots, and a hat. This will keep your extremities warm and prevent aches and pains. (Uh....not necessarily true. Everyone is different. Please check your local FMer for details! )
Bring the Sunshine Inside: If you are finding that you are particularly fatigued or depressed, try to increase the amount of light you have inside of your house. During the gray winter months, it is easy to become depressed and tired, which will only make your symptoms worse. Purchase some halogen bulbs or a special light box to help improve your mood.

While these are good points to say, every FMer is different and are affected by things differently. This is a good generic article about how the weather affects people with FM.

Stay cool everyone!

Delayed Pain

2006-07-26T06:28:00.000-04:00

A lovely facet of Fibromyalgia is the delayed pain experience. As you all know on Monday I did my Functional Capacity Evaluation for my LTD insurance company because they don't know what to do with me. Yesterday I was very tired but physically felt okay, not 100% but okay. Well, thinking the worst was over I went to bed thinking that the tiredness would be the worst of it. NOPE! I was very wrong!
I woke up this morning and my lower back, shoulders and hips were screaming in pain and very unhappy with me. UGH! I thought to myself, I forgot about delayed pain! Dagnabbit!
Well, now I should explain what delayed pain is. Delayed pain is what happens to people with Fibromyalgia who exert themselves one day but do not feel the results of the overexhertion until two days or more later!
So now I have to live in pain because of this testing and it is the insurance comapany's fault!!!! Thanks guys! I just adore feeling like I have the flu and basically feeling like crapola!
Ah! The quirks of Fibromyalgia!

Recouperation time!

2006-07-25T07:51:00.000-04:00

Well it is the day after my eval and boy I can say that it was difficult. Honestly I did a little better than I thought, but I am not sure where I lie in the grand scheme of things. All together it took about 3 hours for the testing. Which wasn't too bad in the overall, but for someone with Fibromyalgia and chronic pain it is the test that never seems to end. Luckily there are stratigically placed 10 minute breaks.
Today I am paying for the testing. I am very tired and hurt.
As for what the evaluation will say and what my LTD company will do, I haven't the slightest. Now it is just hurry up and wait.

Functional Capacity Evaluation Day!

2006-07-24T06:21:00.000-04:00

Well today is the day for my Long-Term Disability's attempt to get me off their payroll. I go in for my Functional Capacity Evaluation. Sigh! I feel like total shit and I have to do this for at least 4 hours this afternoon???? Are you kidding??? If you are like me, you had no clue what this eval was so I took a look online...thanks to google here is what I found out. Thanks to www.aota.org for the information.:

Functional Capacity Evaluation

What Is a FCE?
Functional Capacity Evaluation (FCE) is a systematic process of assessing an individual's physical capacities and functional abilities. The FCE matches human performance levels to the demands of a specific job or work activity or occupation. The FCE establishes the physical level of work an individual can perform. The FCE is useful in determining job placement, job accommodation, or return to work after injury or illness. FCEs can provide objective information regarding functional work ability in the determination of occupational disability status.

What Are the Purposes and Applications of the FCE?
The FCE is a significant tool that can be used to make objective and reliable assessments of the individual's condition. Its precise data format provides information that can be used in various contexts. The FCE may be used:

To determine the individual's ability to safely return to work full time or on modified duty
To determine if work restrictions, job modifications, or reasonable accommodations are necessary to prevent further injury
To determine the extent to which impairments exist, or the degree of physical disability for compensation purposes
To predict the potential ability to perform work following acute rehabilitation or a work-hardening/work-conditioning program

What Are the Components of FCE?
The functional capacity evaluation assesses the individual's flexibility, strength, balance, coordination, cardiovascular condition, and body mechanics. An effective FCE determines whether there is a match between the individual's functional capabilities, and the physical demands of work. Typically, an FCE focuses on a job goal rather than on individual aptitudes, interest, and temperaments. The individual's psychosocial behaviors are assessed in relation to appropriate worker traits. There are two types of FCE:

Baseline FCE -- An objective assessment of the individual's physical abilities to perform a variety of tasks related to the physical demands of work
Job specific FCE - An evaluation of the individual's physical abilities to function within the parameters of an identified job. The job specific FCE is based on critical physical demands of the essential functions of the job. Work simulation activities are often an integral component of the evaluation.
FCEs are done on an intensive one-to-one basis and range in length for 4 to 6 hours. The FCE may take place over two consecutive days.

Who Is Qualified to Perform an FCE?
The occupational therapy practitioner has the unique combination of skills and abilities necessary to assess the physiological, psychophysical, and biomechanical function of the individual engaged in occupation. Occupational therapists also have the observational skills, training, and experience to perform complex task analysis and assessment of environmental factors affecting work performance.

Who Should Be Referred for an FCE?
Individual who has achieved maximum medical improvement but continues to have issues related to re-injury and return to work.
Individual who needs quantification of their physical capacities for determination of disability status.
Individuals who need their function quantified prior to vocational job search and/or return to work
Individuals who require quantification of their physical function for medical legal reasons.

Where is FCE Provided?
FCE is typically performed in a structured, controlled environment that involves directly measuring and observing the work as he or she performs specific work and functional activities.
Free standing facilities
Industry (at the job site)
Outpatient rehabilitation facilities
Hospital rehabilitation departments

Who Pays for the FCE?
Worker's compensation insurance plans
Self-insured plans
Individual insurance plans
State and/or local agencies
Managed care plans
Private pay

Who Can Refer for the FCE?
Physicians
Rehabilitation personnel/Case managers
Insurance representatives
Employers/human resource agency personnel/risk managers
Attorneys

Revised by Work Programs SIS, May 1998
Rannell Dahl, Frank Armstrong, Melanie Ellexson, Barbara Larson

I just hope I survive this day!!!!

Migraine, Migraine, Migraine....AGAIN!

2006-07-20T05:59:00.000-04:00

Yes, another migraine....when will they end!?!
This time it is a rebound headache from the medication they gave me for sedation at the colonoscopy. I have had a headache ever since the procedure and with Tropical Storm Beryl heading in my direction, the change in barometric pressure is causing tons of pain. I am also not sure when the pain will end...I hope today!

The Infamous Colonoscopy Prep!!!

2006-07-17T08:09:00.000-04:00

Well tomorrow I have a lovely colonoscopy to go to. While the actual procedure is not a big deal, regardless of what people say. The worst part in my opinion, is the prep.
First you have to stop all anti-inflamatories 4 days before the procedure. For someone with chronic pain issues like myself, that is just torture! I have been in constant pain in one area or another for 3 days now. The nights are the worst! On top of that a fibroflare has come upon me. For those who are not familiar with what a fibroflare is, it is according to the Fibromyalgia & Chronic Myofacial Pain Syndrome by Devin Starlanyl, a time of high intensity pain and grief, an overwhelming episode of pain in your trigger and tender points that can either creep up on you or hit suddenly with all the subtlety of a barreling express train. Flare, like a flash-fire, is all consuming. Good explaination!
Well the above is just a precursor to today, the day before the procedure, which is by far, the WORST thing I have ever had to go through. For those who have had a colonoscopy, you know what I mean. Since Friday, I have been on what is called a Low Residue Diet. Basically it is hospital food...blah! Today is a clear liquid diet day along with a forced chemical flushing of the system if you know what I mean! Or what I call pure torture! I understand the reasoning behind the process, but couldn't doctors make the medications and side-effects a little more body friendly???

Laundry Day and the process of preparation

2006-07-14T06:57:00.000-04:00

For most people, laundry day is just another chore that people go through each week or every few days. For me, laundry day is a well planned, well thought out machine.
I have to gauge how heavy the laundry is, how to get it to the car without hurting myself, how to get it out of the car the same way. I am sure it must boggle the mind of those who don't have to think about the little things that I put so much thought into laundry. But that is the life I have to live in order to keep me as pain free as possible. I also have the same process for taking out the garbage to the dumpster, making the bed and doing dishes.
This is the life of a Chronic Painer that no one understands. I would compare this thinking to having a brand new baby. All the preparation that has to go into what used to be a simple operation, like going to the grocery store....or going anywhere for that matter! I totally sympathize with brand new parents and what they have to go through. Ironically, people in general understand this height of preparedness but not what CPers have to do to accomplish the same. Its a shame that it has to be that way.
This is the reason this blog exists to present the side of the CPer and to make everyone aware that people with invisible illnesses deserve respect similar to those who have obvious illnesses.

Trigger Points on the Body

2006-07-14T01:05:00.000-04:00

I talk constantly about my Trigger Point Injections or TPIs so I thought I would post a picture of common areas on the back where trigger points exist.

Thank you www.ultimatewatermassage.com for the diagram.

The Mythology (and reality) of Chronic Pain

2006-07-13T14:54:00.000-04:00

Thanks to about.com's Chronic Pain newsletter for the link(www.cssa-inc.org) to this article.

Bankruptcies Of The Heart:
Secondary Losses From Disabling Chronic Pain

Summary of paper presented by Marcia E. Bedard, PhD, at the 1998 Society for Disability Studies Annual Meeting

My current research, which I have summarized here, is focused on the theory of "secondary gain" as it applies to chronic illness, and specifically chronic pain. The basic idea behind this theory is that chronic pain is psychological and persists only because the person suffering from it enjoys one or more "rewards" that accrue from their pain. These so-called "rewards" may be emotional, such as sympathy – or monetary, such as disability payments. Either type of "gain," is said to reinforce the pain, causing partial or complete disability. Although this concept originated with Freud decades ago it has never been rigorously examined. Given the prevalence with which it is applied to persons disabled by chronic pain though, we must question its validity until it has been scientifically proven to hold true. In the interim, we need to take into account the numerous "secondary losses" brought about by chronic pain as well.

For more than 30 years now, the majority of psychologists have been shifting their emphasis toward treating chronic pain as a perceptual and psychological phenomenon rather than a true medical problem. One of the major theorists in this field was Wilmer Fordyce, who developed an influential social-learning model of chronic pain based on behavioralism about 20 years ago. Fordyce believed that pain is behavior designed to protect oneself or solicit aid and that pain increases, i.e., this behavior is strengthened, when followed by desirable consequences. Unlike many of his predecessors who believed chronic pain was purely psychogenic in origin, Fordyce believed that all pain began as acute pain from actual tissue injury and under normal conditions, the injury healed in a certain period of time. However, Fordyce argued that if pain persisted beyond the normal healing time in an environment with secondary gains, the pain would become chronic. He gave as examples of secondary gains, or "desirable consequences" of pain the following factors that he believed reinforced pain and disability.

The Four Most Commonly Referenced Secondary Gains

The myth is that persons disabled by chronic pain generally enjoy:

1) attention and sympathy from family, friends, and physicians
2) release from task responsibilities at home and at work
3) narcotic medications presumed to induce constant euphoria
4) monetary compensation which approximates actual wages

The Four Least Commonly Recognized Secondary Losses

The reality is that persons disabled by chronic pain generally endure:

1) anger/trivialization/rejection by family, friends, and physicians
2) complicated/frustrating tasks dealing with new bureaucracies
3) agonizing pain without medication; unpleasant side effects with medication
4) denial of disability benefits to which they are legally entitled

My thesis is this: not only is psychogenic chronic pain rare, but more importantly, few people disabled by chronic pain regularly receive secondary gains. My evidence for this assertion comes from several sources: literature cited in the paper I presented at the 1998 Annual Meeting of the Society for Disability Studies (SDS); information about personal experiences sent to me by hundreds of chronic pain patients, as well as physicians and psychologists who specialize in treating chronic pain via numerous Internet lists I subscribe to and websites I monitor; and finally, my own experience over the past six years as a chronic pain patient.

Attention and sympathy from family, friends, and physicians is, sadly, in short supply for chronic pain patients. The wide range of family problems experienced by these patients include, but are not limited to: guilt over not being able to carry one's fair share of domestic tasks; anger at family members who deny the reality and/or severity of the patient's pain; frustration because the pain is so great it makes playing with one's children or sexual intimacy with one's partner torturous or impossible; and anxiety about the financial strain that stems inevitably from disabling chronic pain. Given that nearly every book or magazine dealing with chronic pain has a section on coping with these and other family problems, it is apparent that family attention and sympathy are not as abundant as we are led to believe by secondary gain theorists. We must also not forget that many chronic pain patients have no family, or none nearby, or their families deny or trivialize their pain and disability. Denial, trivialization, and eventual abandonment are also common reactions of friends or co-workers. The loss of former friends is another emotionally painful aspect of disabling chronic pain.

Attention and sympathy from physicians may be absent at the outset for chronic pain patients, but if not, it generally wanes as the patient fails to respond to one after another medical interventions, leaving most doctors feeling frustrated and helpless. Patients with incurable, irreversible, and progressive conditions, such as degenerative disk and joint disease, may have a difficult time even finding a doctor who will take them as a patient. Consequently, many chronic pain patients are literally "fired" by their treating physicians a year or so after numerous painful and invasive treatments have been tried and failed, and left on their own to try and find another doctor. Unless such patients are able to find a physician who can actually help them control their pain, they are forced to live an unbelievably miserable existence that all too frequently ends in suicide.

The second most common secondary gain is release from task responsibilities at home and work. It may be that those living with spouses or significant others are relieved from some or all of their domestic chores some or all of the time, but I question whether this is perceived as a "reward" by most persons disabled by chronic pain. In my own experience and research, the guilt of watching loved ones at home and colleagues at work become overburdened by these extra tasks is hardly rewarding and takes a heavy toll on one's self-esteem and sense of self-worth. Furthermore, as time goes by, resentment toward the disabled person generally increases among those picking up the slack, increasing interpersonal friction. Any release from former task responsibilities is also offset by the increase in new task responsibilities on becoming disabled. There are numerous forms to be filled out and reports to be completed for the Americans with Disabilities Act (ADA), leaves of absence and state disability insurance (SDI). If the chronic pain resulted from a work-related illness or injury, there is the bureaucratic morass of worker's compensation to navigate. And if the disability lasts six months or more, there is the process of applying for Social Security Disability Insurance (SSDI). The amount of paperwork and reports varies, but in my own case, which was relatively simple, there were hundreds of pages of forms and reports I had to submit over the two years it took just to get my SSDI approved, and that was with the help of an attorney. This, however, was nothing compared to what I went through with my group long-term disability (LTD) insurance. The forms, reports, and correspondence on that claim fills an entire drawer of my filing cabinet, and that claim is still unsettled.

Narcotic medications are the third most commonly referenced secondary gain. The fact that they are considered a gain at all is telling – it is obviously presumed that they induce euphoria, yet any pain patient who has taken them regularly will tell you that not only do they do nothing but take away the pain so one feels relatively normal for awhile, they also have extremely unpleasant side effects. Yet although 34 million Americans suffer from chronic pain and most are significantly disabled by it, only a small minority receive any type of narcotic medications for pain relief and these are usually inadequate to relieve the pain – a situation which frequently leads to suicide or requests for physician-assisted suicide. The irony here is that in many cases these are the only medications that will allow the patient to return to part-time or full-time work.

The fourth commonly referenced secondary gain is the supposed monetary compensation which approximates actual wages that persons disabled by chronic pain receive. If this fallacy were not so tragic, it would be laughable, because of all the secondary losses emanating from disabling chronic pain, the economic losses are utterly devastating. Even if one is fortunate enough to have medical insurance, there are numerous expenses detailed in my paper that are not covered by any type of insurance, nor are they even tax-deductible. So where did the idea come from that work-disabled persons "have it made" financially? I think it is because there are ostensibly four different types of "safety nets" when one becomes disabled: state disability insurance (SDI), worker's compensation (WC), Social Security Disability Insurance (SSDI), and group or private long-term disability (LTD) insurance. LTD insurance is a type of coverage which very few people have - primarily highly-paid professionals – yet this is the only kind of insurance benefit that ever approximates one's pre-disability income, generally paying half to two-thirds of the claimant's lost income as benefits. However, if the disability is from chronic pain, more often than not the claim for any type of benefits will be disputed and, in too many cases, denied, leaving the disabled person to face bankruptcy, poverty, and eventually homelessness unless one is exceptionally lucky. So common is it for persons disabled by chronic pain to be denied benefits to which they are legally entitled that numerous lists and websites have been established on the Internet solely for the purpose of providing information and support to those claimants wrongfully denied. To describe this situation as scandalous is an understatement, yet millions of American workers have been lulled into false security believing that if they should have the misfortune of becoming disabled, these safety nets will be there to cushion them from the full brunt of economic loss.

In summary, divorce, loss of career, financial ruin, homelessness, loss of friendships and social life, loss of physical mobility, the severe stress of protracted litigation, and in some cases physical disfigurement are just a few of the kinds of secondary losses commonly incurred by persons disabled by chronic pain. Obviously it is impossible to place a price tag on any one of these tragic losses. So the concept of secondary gain is put forward instead, turning the truth – the reality of the disabled person's existence – upside down. This is, in my estimation, nothing short of institutional moral larceny: a victim-blaming ploy that serves primarily to justify the reprehensible actions of insurance companies, opposing attorneys, and many of the private, county, state, and federal bureaucracies purporting to "assist" persons with disabilities. Secondary gain, or any other concept built on myths and stereotypes which contribute to ongoing discrimination against persons disabled by chronic pain needs to be exposed for what it is – unconscionable in a democratic society.

What is desperately needed at this point in time is a massive public education campaign regarding the enormous losses, tangible and intangible, that accompany disabling chronic pain including, but not limited to, bankruptcies of the heart.

Copyright © 1998 by Marcia E. Bedard, Ph.D., Women's Studies Program, California State University at Fresno

The Fear of Chronic Anxiety

2006-07-13T08:29:00.000-04:00

Well after fighting for independence from my anxiety and panic disorder, one day has me back in that to almost square one.
One of those things is my previous post. The fear of leaving my home because of possible PIs from my long-term disability insurance company has my agoraphobia alive and kicking after I fought so hard to take control of it. It makes me angry and these people! Thanks alot guys! Like I haven't been through enough in my short life!
The second thing that has brought panic back to my life is something rather strange. About 4 years ago I was working at a company and 3 people made my life a living hell. It got so bad I was constantly shaking and throwing up at work on a regular basis. Because of these people, my agoraphobia and anxiety issues began. Well turn the clock to Tuesday. My husband asks me if I worked with a certain person. I really had to think about it because I have moved on and blocked these people from my mind. Well, it seems one of the BIG 3 has just been hired at my husband's company. How the information came about was they were talking about people who they used to work with who called out a lot. My husband mentioned a person and the new guy asks if it is me, while laughing as if I was a standing joke. He said no but that is my wife so I would shut your fuckin' mouth. Needless to say it did exactly that.
Now that is all fine and good but I wish he wouldn't have told me about the incident because my physical symptoms of my anxiety are back. The hard time swollowing, the lump in my throat that won't go away. The headache, the shaking, being unable to sleep well.
So between the two incidents in one day I am now a walking mess. Just as I was starting to feel better from my facet injections and getting ready to start exercising again.

How Long-term Disability Insurance Company Can Make Life A Living Hell!

2006-07-12T07:22:00.000-04:00

Just yesterday I got a call informing me that I have an appointment with an occupational therapist for a Functional Capacity Evaluation. I call this trying very hard to kick me off long-term disability. I have been collecting since 2002 and this year has been the worst!
Every year, I have to have a review of my status and fill out a form as to how my year has been. This year I thought it would be the same, fill out the form, get my re-up letter back, get a check for the next 12 months. NOT this year!
They have been hounding my doctors for months for information that they have already been asked about. For example, my pain managment doc has had three different psychologists call his office and ask him the same questions and he answers them the same way each time. My regular doc has been called and interviewed just as many times and was even misquoted in a letter that was going to be sent to the insurance company. Luckily he got a copy of the letter before it was sent and made them remove the erroneous information and quote him correctly.
It is quite obvious they are trying to find a way to kick me off my LTD benefits. I mean it has taken them over 6 months to really fight this.
I am on 12 medications daily just to get through each day. I see a therapist once a month, a pain management doc every two weeks for different types of depo-medrol shots from facet injecions to lumbar epidurals to trigger point injections and my GP more often than most people. Not to mention the other doctors I see for various reasons. For me, being ill is a full time job.
Being under the scrutiny of this insurance company is making me panicky and paranoid. I feel like they have me under surveillance to make sure I do what I have told them. I have to go to get my meds refilled today and I am afraid to go. I am trying to loose weight and have been going to the gym. But now I am afraid to do that in case of the PI that may be watching. I feel like a prisoner in my own home. I am afraid to leave my apartment. It's enough to drive a person insane!

Still recovering day 4

2006-07-09T07:27:00.000-04:00

I am still recovering from my facet injections. I am taking this slowly and it seems to be working out. Every once in a while I get zaps in my backside, my hip or my toes. Sometimes one toe or another goes numb. So that means its working I guess. The injection sites are still painful to pressure, so driving is down to a minimum. I am taking my anti-inflamatories like I should and it is the only thing that seems to help....especially the Lodine. It makes me sleepy but where am I going today?
I tried working out on Friday and did the treadmill very gently. That seemed to work. I also was careful doing laundry yesterday. Taking a little bit at a time is doing the trick. I don't feel like such a slug.

Still recovering

2006-07-07T07:18:00.000-04:00

Normally on Fridays I do laundry and I had planned to do just that today, but my left foot went numb last night so no go on that plan. While I don't feel as I got a swift kick in the backside today, I think lifting laundry and going to the laundromat is a bit ambitious today. I do have a couple of errands to do but that is just some driving to go to the bank and pick up my meds.
So its a short update but at least it is one.

The Day After

2006-07-06T04:33:00.000-04:00

As you can see by the time of this post, I had a rough night.
Considering what the Facet Injection does, it went as expected. According to my husband I am a little bruised in the injection area, which makes sense from the pressure and pain I felt laying on the table yesterday. I feel like my backside and hip has been in a fight, but overall I am okay. I've delt with worse pain.
Right now I am waiting for my pain medication to kick in so I can go back to sleep for a little while. I woke up about 3 or so and started getting uncomfortable laying down, so I have been up and down for about 1 and 1/2 hours just trying to be comfortable. I decided to get out of bed so that my husband could keep sleeping since he has to work later today. Since I don't work, I can afford to loose rest now and sleep later.
Well that is all for the update on day 1 of my recovery....hopefully I will be well enough for laundry tomorrow.
Until then!

Today is the day!!!!!

2006-07-05T08:35:00.000-04:00

Well I had posted but for some reason my post got blown away!
Anyway, today is the day of my first facet injection. I am a little nervous since this is my first one and I don't exactly know what to expect.
I am also worried about what will happen if these don't work. What will be my next step? I am also worried about the after effects over the next couple of days.
I know I need these injections. I am tired of waking up in the middle of the night in extreme pain.
Ah well....just another day in the life of a CPer AKA Chronic Painer.

Migraine headaches

2006-07-03T06:38:00.000-04:00

Ah the pain of a migraine headache....I have been living with it for two days now. For those of you who do not know the pain of a migraine, take the worst headache you ever had, times it by 2, combine it with nausea, sensitivity to light and sound, and NOTHING and I mean NOTHING will make it go away!!!!
I have been living with an ice pack on my left temple (where I always get my headaches) through the night. Its been tons of fun. Unfortunately they are part of the Fibromyalgia and Rosacea, both of which I have....fun huh?
Well here are some details about migrianes thanks to the website www.familydoctor.org.

Migraine Headaches: Ways to Deal With the Pain

What causes migraine headaches?
Migraine headaches seem to be caused in part by changes in the level of a body chemical called serotonin. Serotonin plays many roles in the body, and it can have an effect on the blood vessels. When serotonin levels are high, blood vessels constrict (shrink). When serotonin levels fall, the blood vessels dilate (swell). This swelling can cause pain or other problems.

Many things can affect the level of serotonin in your body, including your level of blood sugar, certain foods and changes in your estrogen level if you're a woman.

What does a migraine feel like?
The pain of a migraine headache can be intense. It can get in the way of your daily activities. Migraines aren't the same in all people. Possible symptoms of migraines are listed in the box below.

You may also have a "premonition" several hours to a day before your headache starts. Premonitions are feelings you get that can signal a migraine is coming. These feelings can include intense energy, fatigue, food cravings and mood changes.

Possible symptoms of migraines
Intense throbbing or dull aching pain on one side of your head or both sides.
Nausea or vomiting
Changes in how you see, including blurred vision or blind spots
Being bothered by light, noise or odors
Feeling tired and/or confused
Stopped-up nose
Feeling cold or sweaty
Stiff or tender neck
Light-headedness
Tender scalp

Are there different kinds of migraine headaches?
Yes. The most common are classic migraine and common migraine.

Classic migraines start with a warning sign, called an aura. The aura often involves changes in the way you see. You may see flashing lights and colors. You may temporarily lose some of your vision, such as your side vision.

You may also feel a strange prickly or burning sensation, or have muscle weakness on one side of your body. You may have trouble communicating. You may also feel depressed, irritable and restless.

Auras last about 15 to 30 minutes. Auras may occur before or after your head pain, and sometimes the pain and aura overlap, or the pain never occurs. The head pain of classic migraines may occur on one side of your head or on both sides.

Common migraines don't start with an aura. Common migraines may start more slowly than classic migraines, last longer and interfere more with daily activities. The pain of common migraines may be on only one side of your head.

How long do migraines usually last?
Migraines may last from 4 to 72 hours. They may happen only once or twice a year, or as often as daily. Women are more likely to have migraines than men.

What things may set off a migraine?
Certain things that can set off migraines in some people include the following:

Strong or unusual odors, bright lights or loud noises
Changes in weather or altitude
Being tired, stressed or depressed or the let-down after a stressful event
Changes in sleeping patterns or sleeping time
Certain foods (see the list below), especially those that contain tyramine, sodium nitrate or phenylalanine
Missing meals or fasting
Menstrual periods, birth control pills or hormones
Intense physical activity, including sexual activity

Foods that may trigger migraines
Aged, canned, cured or processed meat, including bologna, game, ham, herring, hot dogs, pepperoni and sausage
Aged cheese
Alcoholic beverages, especially red wine
Aspartame
Avocados
Beans, including pole, broad, lima, Italian, navy, pinto and garbanzo
Brewer's yeast, including fresh yeast coffee cake, donuts and sourdough bread
Caffeine (in excess)
Canned soup or bouillon cubes
Chocolate, cocoa and carob
Cultured dairy products, such as buttermilk and sour cream
Figs
Lentils
Meat tenderizer
Monosodium glutamate (MSG)
Nuts and peanut butter
Onions, except small amounts for flavoring
Papaya
Passion fruit
Pea pods
Pickled, preserved or marinated foods, such as olives and pickles, and some snack foods
Raisins
Red plums
Sauerkraut
Seasoned salt
Snow peas
Soy sauce

How are migraines treated?
There are 2 types of migraine treatments. Some treatments are used to relieve the headache pain. Most of these treatments should be started as soon as you think you're getting a migraine. The other type includes treatments that are used to prevent headaches before they occur.

Can nonprescription medicines help relieve the pain?
Yes. Nonprescription medicines can help migraine pain. They include aspirin, acetaminophen (one brand name: Tylenol), an acetaminophen, aspirin and caffeine combination (one brand name: Excedrin Migraine), ibuprofen (one brand name: Motrin), naproxen (brand name: Aleve), and ketoprofen (brand name: Orudis KT).

What about prescription medicines?
People with more severe pain may need prescription medicine. A medicine called ergotamine (brand name: Ergostat) can be effective alone or combined with other medicines. Dihydroergotamine (brand names: Migranal, D.H.E. 45) is related to ergotamine and can be helpful.
Other prescription medicines for migraines include sumatriptan (brand name: Imitrex), zolmitriptan (brand name: Zomig), naratriptan (brand name: Amerge) rizatriptan (brand name: Maxalt), almotriptan (brand name: Axert), eletriptan (brand name: Relpax) and frovatriptan (brand name: Frova).
If the pain won't go away, stronger medicine may be needed, such as a narcotic (brand name: Stadol nasal spray) or medicines that contain a barbiturate. These medicines can be habit-forming and should be used cautiously.

Can medicine help prevent migraines?
Yes. Medicine to prevent migraines may be helpful if your headaches happen more than twice a month or if your headaches make it hard for you to work and function. Examples of medicines used to prevent migraines include propranolol (brand name: Inderal), timolol (brand name: Blocadren), divalproex (brand name: Depakote) and some antidepressants.

What else can I do to prevent migraines?
Try to avoid foods or other things that seem to cause migraines for you. Get plenty of sleep. Try to relax and reduce the stress in your life.

Tips on reducing the pain
Lie down in a dark, quiet room.
Put a cold compress or rag over your forehead.
Massage your scalp using a lot of pressure.
Put pressure on your temples.

Source
American Academy of Family Physicians

I hope this information helps someone out there! So far the migraine pain has taken a break but I still feel the little niggle in my head.
Have a great 4th everyone!

Fibromyalgia Statistics

2006-06-30T16:20:00.000-04:00

FIBROMYALGIA

Fibromyalgia is an often misunderstood, even unrecognized, disorder that causes widespread muscle pain and tenderness which tends to come and go, and move about the body. This common and chronic condition can also be associated with fatigue, sleep disturbances and memory problems.

Fast Facts
Fibromyalgia affects two to four percent of the population, predominantly women.

There are no laboratory or other diagnostic tests for fibromyalgia so it must be diagnosed based on patient symptoms.

What fibromyalgia is

Fibromyalgia is pain and tenderness in the so-called "tender points" are the defining characteristics of fibromyalgia, so medical care providers focus on the features of the pain to distinguish it from other rheumatic disorders.

Fibromyalgia is a clinical syndrome defined by chronic widespread muscular pain, fatigue and tenderness. Many people with fibromyalgia also experience additional symptoms such as fatigue, headaches, irritable bowel syndrome, irritable bladder, cognitive and memory problems (often called “fibro fog”), temporomandibular joint disorder, pelvic pain, restless leg syndrome, sensitivity to noise and temperature, and anxiety and depression. These symptoms can vary in intensity and, like the pain of fibromyalgia, wax and wane over time.

What causes fibromyalgia

No one knows what causes fibromyalgia. However, we do know that people with fibromyalgia may have abnormal levels of Substance P, a chemical that helps transmit and amplify pain signals to and from the brain. For the person with fibromyalgia, it is as though the “volume control” is turned up too high in the brain's pain processing areas. Current studies are underway to examine how the brain and spinal cord (the central nervous system) process pain and the role Substance P plays.

Genetics also appear to play a role leading to a familial tendency to develop fibromyalgia. So does everyday life exposure to physical, emotional, or environmental stressors that may trigger the initiation of fibromyalgia symptoms
Information couresty of www.rheumatology.org.

Prevalance Rate for Fibromyalgia: approx 1 in 73 or 1.36% or 3.7 million people in USA

Broken down by Gender: 0.5% of men and 3.4% of women
The above according to the American College of Rheumatology

According to the National Foundation for Fibromyalgia, as many as 12 million
Americans suffer from FM but remain undiagnosed because of its elusive nature. Fibromyalgia is most common in women between the ages of 20 and 50, although it also affects men, the elderly, and children. Children with FM are often mistakenly diagnosed with growing pains or behavioral problems, and FM is commonly mistaken for chronic fatigue syndrome since the symptoms of the two diseases are so similar.

There are no laboratory or other diagnostic tests for fibromyalgia so it must be diagnosed based on patient symptoms.

Game Called Suck It Up!

2006-06-30T07:03:00.000-04:00

Today I feel like hell warmed over. I don't want to go anywhere but things need to be done today and there is nothing I can do about it. I have laundry to do today and I have to go to a laundromat. Not my favorite thing to do especially when I feel like crap. But today I play the game called "Suck It Up!" Its when you feel like crap but don't think about it and push your way through it to do what you need to. I do that quite often.
Well today is just another day in CPland!

The CPer Look AKA What Pain Can Do To You

2006-06-29T07:02:00.000-04:00

I just looked at myself in the bathroom mirror this morning and I look like I have been through hell and back. I have deep, dark circles under my eyes like I haven't slept for days. I mean I never sleep well at night and I wake up at least 2-3 times a night. But this morning I looked pale and just ill. I feel like just to look "normal" I would have to wear tons of makeup.
I guess it is the price you pay for being chronically ill.

Great books on Chronic Pain

2006-06-28T15:25:00.000-04:00

Over the years I have found some great books and not so great books that have helped me along the way. I just thought I would share some with you.
All info is from Amazon.com but the books can be found at most bookstores and online bookstores.

Fibromyalgia and Chronic Myofascial Pain: A Survival Manual by Devin J. Starlanyl, Mary Ellen Copeland
The Fibromyalgia Relief Book : 213 Ideas for Improving Your Quality of Life by Miryam E. Williamson, Mary Anne Saathoff
A Delicate Balance: Living Successfully with Chronic Illness by Susan M. Wells
You Don't Look Sick: Living Well With Invisible Chronic Illness by Joy H. Selak and Steven S. Overman
The Chronic Illness Experience : Embracing the Imperfect Life by Cheri Register
Fibromyalgia: A Comprehensive Approach What You Can Do About Chronic Pain and Fatigue by Miryam Ehrlich Williamson, David A. Nye (Foreword)
The Fibromyalgia Advocate by Devin Starlanyl
Fibromyalgia: A Leading Expert's Guide to Understanding and Getting Relief from the Pain That Won't Go Away by Don L. Goldenberg (He is my FM specialist so I am a little biased about this one)
I have read many others, but these are the cream of the crop. Enjoy!

The Morning from Hell after the Night from Hell

2006-06-28T07:05:00.000-04:00

This is an FMer. This is a FMer after a bad night of sleep due to a rude and obnoxious 20 year old neighbor girl who decides that her apartment is actually a dorm room. Any questions????
I am NOT a happy camper this morning. I am also hurting and very tired. As for the Arthritis Symposium I was going to attend today, that is going to be a no show! My head aches, my body hurts and I am very tired. Driving long distances like this could cause a major accident. The best thing I can think of doing is staying close by and NOT travelling the highways. I do have to go and pick up some medication later in the day, but that is IT for my adventures out today. I will be spending most of my time horizontal on the couch.
I hope the day will go smoothly.

Chronic Pain, Insomnia and the Neighbor from Hell!

2006-06-28T01:39:00.000-04:00

Well I am up at 1:30 in the morning because of my lovely next door neighbor.(Note the sarcasm here!) Now I have sleep issues on my own but combine them with a neighbor that loves to blast music, slam things against my bedroom wall and basically be loud in the middle of the night, that spells a bad night for me. My husband, the lucky dog, sleeps through it all.
Regardless of all the medication that I take to sleep, this person still wakes me up at about 1 every night. Oh trust me I have tried complaining to the landlord, calling the cops, you name it. Nothing seems to work for long. Combine it with she has been served eviction papers and a whole new kettle of fish comes into play!
Angry? Damn right I am angry! What right does she have to do this? Doesn't she understand people sleep at this hour??? I guess not.
Now I was supposed to go to an Arthritis Symposium but now that may not happen. I have to drive 45 minutes to get there and on a good day that is difficult but add in a night like tonight and I will be a mess. Well, I just took some meds that I should normally take an hour from now but I figure what they hell. I need to sleep. On top of it all, my stomach is doing flip-flops because of my agitation.
With all that I have going on in my life, why is it my luck I get stuck with the neighbor from hell????

The life of a Fibroflare

2006-06-27T09:16:00.000-04:00

Well, it seems I am in the middle of what is called a Fibroflare. For those who don't know it is a flare of pain due to the Fibromyalgia (FM for short). Right now my trapezeus muscle is squeezing nerves that go into my left arm and making my arm numb. Painfully numb. It is to the point where it keeps me awake and I cannot get comfortable enough to rest. Unfortunately there is not much I can do about it. The pain doc is only in the office I go to on Wednesdays and the med I am on should be enough to help....but they aren't. Sigh.....
Well I am having a hard time typing so i will sign off for now. I hope this lets up soon...this is day 4.

Rough Weekend

2006-06-26T07:25:00.000-04:00

Well this weekend was rather rough for me physically. I was in bed for most of it in pain. On Wednesday, my pain doc pressed on an area that I will be getting facet injections next week. This caused my nerve endings to light up like a Christmas tree and I have been in pain ever since. Between that and another bad reaction to my Trigger Point Injections (TPIs from here on) I was and still am a mess. I just can't get out of this cycle of pain at the moment. I am trying to loose weight (45 lbs. to be exact) and this pain is not helping. I guess if I just keep working on my diet it will help some. I try and walk everyday but I haven't since Wednesday. I feel like such a slacker. I have errands to do today but I would rather just lay around. Ever have one of those pain days?

R.I.P. Harriet!

2006-06-26T07:21:00.000-04:00

This lovely lady in the center is Harriet the Galopagos Tortoise. She died on Saturday from heart failure. I am very sad about it. My husband and I have 7 tortoises of our own and wanted to go to visit Harriet one day in Australia. Unfortunately we waited too long!

Facet Injections

2006-06-23T15:03:00.000-04:00

Well starting in a couple of weeks I am starting on a new line of treatment, facet injections. I am a little worried about it but what can I do? I am in pain and I need help. Just walking is painful.
For those who are not familiar with facet injections here is a quick description.
Thank you to www.spine.org for the information.

Lumbar Zygapophysial (Facet) Joint Injections

What are they? How are they done?
Zygapophysial joints, better known as facet or “Z” joints, are located on the back (posterior) of the spine on each side of the vertebrae where it overlaps the neighboring vertebrae. The facet joints provide stability and give the spine the ability to bend and twist. They are made up of the two surfaces of the adjacent vertebrae, which are separated by a thin layer of cartilage. The joint is surrounded by a sac-like capsule and is filled with synovial fluid (a lubricating liquid that reduces the friction between the two bone surfaces when the spine moves and also nourishes the cartilage.)

Why Get A Facet Joint Injection?
There are basically two reasons for having a facet joint injection: for diagnosis (to determine the source of pain) or for therapy (to treat an abnormality that has been detected.)
Most back pain will improve within a few weeks by itself, or with conservative treatments such as rest, antiinflammatory medications, physical therapy and exercise. If you suffer from back pain for more than six weeks and conservative treatments have not helped, or if your pain has increassed, your physician may order diagnostic tests such as magnetic resonance imaging (MRI) or computerized tomography (CT) scans to look at the structures of the spine. A problem (such as inflammation, irritation, swelling or arthritis) in the facet joint may cause low back pain. If these diagnostic tests show an abnormality in a facet joint, it may be the source of the pain.
To determine if a facet joint is truly the source of back pain, an injection (sometimes called a “block”) may be prescribed. If an injection of a small amount of anesthesia into the facet joint reduces or removes the pain, your health care provider is assured that the facet joint is the source of the pain. This is diagnostic use of the facet injection.
Once a facet joint is pinpointed as a source of pain, therapeutic injections of anesthesia and antiinflammatory medications may give pain relief for longer periods of time.

How Are The Injections Performed?
Facet joint injections are performed while you are awake, under a local anesthetic, and able to communicate. Sometimes, your health care provider may also administer drugs to make you more comfortable during the procedure. The injection is usually performed while you are lying on your stomach on an X-ray table. EKG, blood pressure cuffs and blood-oxygen monitoring devices may be hooked up prior to the injection process.
During the procedure, you probably will undergo a fluoroscopic X-ray that allows your health care provider to place the syringe in the correct facet joint. Your health care provider or an assistant will clean and sterilize the area of the back directly over the affected joint. Your health care provider will then use a local anesthetic to numb the skin over the injection site. Before your health care provider injects the actual medication into the joint capsule, he or she will inject the joint with a contrast (dye) that will show up on the X-ray to ensure he or she has the proper site for injecting the medications.
Once the proper site has been determined, your health care provider will inject the anesthetic (often lidocaine or bupivicaine) and the anti-inflammatory (usually a corticosteroid.) You may be asked whether you are experiencing pain relief or not, to make sure the injection is in the right place and determine if additional injections are needed. This process may then be repeated depending on the number of affected facet joints. Although the actual injection takes only a few minutes, the overall procedure usually takes approximately 30 to 60 minutes.

Are There Special Preparations?
If you are to undergo a facet injection, you should not take any nonsteroidal anti-inflammatory (NSAID) medications (including MotrinTM, AdvilTM, TylenolTM or FeldeneTM) for three days prior to the procedure. You should also not take any prescription pain relievers for at least four hours before the injection; check with your health care provider. On the day of the injection you should have no food or drink (including water) for at least four hours before the procedure. However, if you are an insulin dependent diabetic, inform your health care provider; you may not need to change your normal eating habits prior to the procedure. If you need to take medication within four hours before the procedure, a sip of water may be allowed; however, you should check with your health care provider prior to taking any medication before the injection.
You may be asked to remove most of your clothing for the procedure and wear a gown that opens in the back to allow access to your spine.

What Happens After The Injection?
Immediately following the procedure, you may feel a reduction or complete relief of your back pain. Your health care provider may ask you to perform a task that would normally cause pain to assess the level of pain relief. You will be able to walk immediately after the procedure, although some patients may experience leg weakness, numbness or tingling for a few hours after the injection. Because your reaction times may be affected by the medications, driving is not recommended immediately following the injection. You probably should have someone who is able to drive you home following the procedure.
Once home, you can treat any pain you may have at the injection site with ice or a pain medication prescribed by your health care provider. It is generally recommended that you take it easy and not exert yourself for the first day. After the anesthetic component of the injection wears off, your back pain may return. It may take seven to ten days for the steroid component of the injection to relieve the pain. After the first day, you can usually return to your daily activities as your pain will allow; however, you should check with your health care provider to get his or her recommendations on specific activities that will be allowed. In most cases, you can return to work the day following the injection.

How Effective Are Facet Injections?
The effectiveness of facet injections for the treatment of low back pain is controversial. No medical study has definitively identified the facet joint as the cause of low back pain. Research has found that facet injections can give relief of lower back pain for longer than six months in 18-63% of patients who underwent the procedure. It has been recommended that facet injections be used as a method to allow the patient to be able to perform other forms of conservative treatment (such as physical exercise, yoga and stretching and bending), rather than using it as a stand-alone pain treatment.
If you do not get relief from your pain following the first therapeutic facet injections, further treatments by injection are not recommended.

Who Should Not Receive Facet injections?
You should not undergo facet injections for the treatment of low back pain if your pain has not been present for at least four to six weeks and if other forms of conservative treatment have not been tried. If you are prone to excessive bleeding or are taking an anticoagulant medication (such as coumadin or heparin), this procedure is not recommended; you should notify your health care provider if you are taking these medications. If your back pain has been diagnosed as a result of an infection or malignancy, it is also recommended that other forms of pain relief be used.

Are There Side Effects?
There is a possibility of side effects with just about any medical procedure and you should always discuss that possibility with your physician before undergoing any treatment. Possible side effects from facet injections include pain at the injection site, bleeding, infection or a worsening of the pain symptoms. Side effects of the steroid medications used may include fluid retention, weight gain, elevated blood pressure, mood swings and insomnia.

The Downside of Relafen

2006-06-23T14:59:00.000-04:00

Just this week, I was given Relafen to help with breakthrough pain for my back. I have only been taking it two days and boy have I been in another world. I am just tired and want to sleep. So far it seems like it is working for my pain, but I sure hope that this side effect goes away soon.

The start of my brand new blog!

2006-06-22T16:38:00.000-04:00

Well after neglecting my blog for so long....the link is no longer valid and I can no longer log in to create new entries.
So from now on I intend to be a better blogger.
For those of you not familiar with my last blog www.mychronicpain.blogspot.com , you can take a look and see wherer I was going and where I should be with this blog...somehow I got lost along the way and now I intend to be more committed to updating this daily.
So please stop by my old blog and get to know me, while I rebuild this blog and update you all on my life of chronic pain.