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MS Community Newsletter #104

Editor: Mary McKennell

Gladdening Nourishment

Silliness, Children appreciate all that is silly as a matter of course. Their grasp of humor is instinctual, and even the smallest absurdities provoke joyous gales of earnest laughter. As we age, this innate ability to see the value of silliness can diminish. Work takes precedence over play, and we have less incentive to exercise our imaginative minds by focusing on what is humorous. When we remember childhood, we may recall the pleasures of donning funny costumes, reciting nonsense poems, making up strange games, or playing pretend. This unabashed silliness nourished our vitality and creativity. We can take in this nourishment once again by giving ourselves permission to lighten up and be silly.

Too often we reject the wonderful silliness that is an inherent, inborn aspect of the self because we believe that it serves no purpose or is at odds with the grown-up culture of maturity. We play yet we do not lose ourselves in play, and our imaginations are never truly given free reign because we regard the products of irrational creativity as being valueless. Yet silliness itself does indeed constitute a vital part of human existence on a myriad of levels. Our first taste of ethereal bliss is often a consequence of our willingness to dabble in what we deem outrageous, nonsensical, or absurd. We delight in ridiculousness not only because laughter is intrinsically pleasurable, but also because it serves as a reminder that existence itself is fun. Skipping, doodling, and singing funny songs are no less entertaining than they were when we were children. We need not lose all interest in these cheerful and amusing activities, but to make them a part of our lives we must be read! y to sacrifice a little dignity and a lot of fear.

It is precisely because so much of life is inescapably serious that silliness should be regarded as a priority. Through the magic of imagination, you can be or become anything—a photographer, a professional athlete, a dancer, a pilot. Whether you take hundreds of silly pictures, revel in the adulation of your fans as you make the winning catch, boogie down rock-star style in front of your bedroom mirror, or turn your desk into a cockpit, the ensuing hilarity will help you see that lighthearted fun and adulthood are not at all incompatible.

Wishing you joy in the journey! Mary


Grief or Depression?
Dr. Clauw's Golden Rules for Chronic Fatigue Syndrome and Fibromyalgia Patients
Exercise Staves Off Disability
Virus Starts Like a Cold But Can Turn Into a Killer
The Gut-Brain Connection
Health Tip: When a Stomachache Requires Medical Attention
Warning on Kava
Is Pain a Symptom of Depression or a Cause?
IBS: What Doctors Don’t Tell You
Dampness and Mold in the Home and Depression
Could You Have an Inhalant Allergy? Dr. Myhill Describes the Signs of Various Invisible Irritants, and How to Deal With Them
What is the safe or recommended amount of caffeine one should take in one day?

It’s quite common for someone to appear depressed after the death of a loved one. We often use the word grief to describe this feeling. A distinction can be made between grief that becomes interferes with every aspect of your life. But usually, a steady improvement occurs over two to six months. Many people find it helpful to join a bereavement group or talk with a counselor or therapist as they come to terms with their loss. Consider seeking help if your distress leaves you unable to function for more than two months or if you feel overwhelmed or suicidal at any time. 

The role of trauma
Early losses are not the only life events indelibly etched on the psyche. A small but intriguing study in the Journal of the American Medical Association showed that women who were abused physically or sexually as children had more extreme stress responses than women who had not been abused. The women had higher levels of the stress hormones ACTH and cortisol, and their hearts beat faster when they performed stressful tasks, such as working out mathematical equations or speaking in front of an audience. This hypersensitivity to stress occurred whether or not the women were suffering from major depression at the time.
Many researchers believe that early trauma causes subtle changes in brain function that account for symptoms of depression and anxiety. The key brain regions involved in the stress response may be altered at the chemical or cellular level. Changes might include fluctuations in the concentration of neurotransmitters or damage to nerve cells. However, further investigation is needed to clarify the relationship between the brain, psychological trauma, and depression.
Dr. Clauw's Golden Rules for Chronic Fatigue Syndrome and Fibromyalgia Patients by Daniel J. Clauw, MD

As director of the Chronic Pain and Fatigue Research Center at the University of Michigan, Dr. Daniel Clauw, MD, is one of the world's leading CFS & FM researchers. His advice for patients is distilled from years of clinical experience.*
1. Focus on what you need to do to get better, not what caused your illness.
Look forward, not backwards.
2. Look for treatments, not cures.
Physicians cure very few chronic medical illnesses; FM/CFS is not likely to be one of them.
3. Find a health care provider who will work with you.
• Explain, don't complain.
• Suggest a series of short visits each addressing specific issues. Skip the long lists.
• Gently educate, with credible sources of information (i.e., scientific articles).
4. Try exercise and Cognitive Behavioral Therapy (CBT).
People who recommend them don't think you are lazy (exercise) or crazy (CBT).
5. Try tested therapies before untested therapies.
6. When trying any therapies (tested or untested), do your own personal research. Make sure the treatment is safe.
• Only start one new treatment at a time.
• See if you get better when you are using the treatment.
• See if you get worse when you stop the treatment.
• See if you get better again when you re-start the treatment.
• If the treatment passes this test, then it works for you.
• If you are still having symptoms, seek out a treatment that is likely to help those symptoms and add it to the above treatment.
7. When your symptoms get worse, don't assume it is because a treatment has stopped working and stop your existing treatments or look to add new treatments.
• The natural history of these illnesses is to wax and wane.
• Look for stressors or changes in behavior that may have made symptoms worse.
8. When a treatment improves symptoms, you must correspondingly increase function.
• Most individuals who are treated with existing treatments that are known to work get better and can live normal lives.
• There is significant interest by the National Institutes of Health (NIH) and the pharmaceutical industry in this spectrum of illnesses. The more money that is spent on studying these illnesses, the more effective we will be at treating them.
* This article is reproduced with kind permission from the website of H.O.P.E. (Helping Our Pain and Exhaustion) - a Michigan-based organization by and for people with Chronic Fatigue Syndrome and Fibromyalgia. Its founder, Dr. Sharon Ostalecki, PhD, is author of the highly-rated new book Fibromyalgia: The Complete Guide from Medical Experts and Patients.

Exercise Staves Off Disability

Get more active to  keep your independence.
by Rosanna Scott and Donna Rae Siegfried.

It’s time to make a choice: Use your body or lose your independence. Moving even just a bit more than you do now may be enough to ensure you maintain your ability to do daily activities like bathe, dress, cook and clean.

How? A recent study shows that without regular physical activity, a person with arthritis nearly doubles their decline in function. Eventually the decline may result in the inability to perform the basic daily tasks essential for living alone. The study of more than 5,700 men and women aged 65 and older who had arthritis found that people who led a sedentary life, particularly women and minorities, decreased their ability to perform the basic functional tasks of daily living, says lead researcher Dorothy D. Dunlop, PhD, an Arthritis Foundation-funded researcher from Northwestern University’s Feinberg School of Medicine and Rehabilitation Institute in Chicago.

A second recent study shows that older people who are able to be physically active but choose not to be have a higher risk of mobility problems. The Health, Aging and Body Composition Study followed 3,075 men and women aged 70 to 79 for seven years. When the study began, none of the participants had trouble walking one-quarter of a mile or climbing 10 steps. But 4.5 years later, 34 percent of the men and 47 percent of the women developed problems walking or climbing stairs. The people who were inactive at the beginning of the study had the greatest decline.

The researchers discovered that mobility loss in older, inactive people can be reduced by adopting an active lifestyle, such as walking 1.5 to 2 hours per week. And it is never too late to start, says fitness expert Denise Austin of Washington, D.C., who has starred in television exercise programs and videos for 25 years. “Muscles in the body will respond, if they are given the opportunity to do so, regardless of age and current activity level. Muscle has a wonderful memory,” she says.

Austin offers three tips for going from sedentary to active:
1. Break up your routine. Time spent exercising is cumulative, says Austin, which means you don’t have to do an hour at a time to obtain healthy benefits. Moving for 10 minutes at a time provides benefit. And give yourself credit for the time you spend housecleaning, walking your dog and doing other chores.

2. Make it fun. Doing activities that you enjoy may seem less burdensome than forcing yourself to go through a program you dislike. Involving your family and friends allows you to spend quality time together while benefiting from exercise.

3. Start out slow and build up your strength. Incorporate short periods of exercise into your life and gradually lengthen how long or how often you do them. The more exercise you do, the more benefits you will receive. In addition to reducing your risk of disability and improving your chance of maintaining independence, you’ll gain energy, reduce stress and decrease fatigue.
Even Moderate Activity Helps
Among adults with knee osteoarthritis (OA), engaging in moderate physical activity just three times a week can reduce the risk of arthritis-related disability by 47 percent.

Source: Archives of Internal Medicine; Vol. 161, No. 19

Virus Starts Like a Cold But Can Turn Into a Killer   By Rob Stein   Washington Post Staff Writer   Tuesday, December 11, 2007; Page A01

Infectious-disease expert David N. Gilbert was making rounds at the
Providence Portland Medical Center in Oregon in April when he realized that an unusual number of patients, including young, vigorous adults, were being hit by a frightening pneumonia.

"What was so striking was to see patients who were otherwise healthy be just devastated," Gilbert said. Within a day or two of developing a cough and high fever, some were so sick they would arrive at the emergency room
gasping for air. "They couldn't breathe," Gilbert said. "They were going to die if we didn't get more oxygen into them."

  Gilbert alerted state health officials, a decision that led investigators to
  realize that a new, apparently more virulent form of a virus that usually
  causes nothing worse than a nasty cold was circulating around the United
  States. At least 1,035 Americans in four states have been infected so far
  this year by the virus, known as an adenovirus. Dozens have been
  hospitalized, many requiring intensive care, and at least 10 have died.

  Health officials say the virus does not seem to be causing life-threatening
  illness on a wide scale, and most people who develop colds or flulike
  symptoms are at little or no risk. Likewise, most people infected by the
  suspect adenovirus do not appear to become seriously ill. But the germ
  appears to be spreading, and investigators are unsure how much of a threat
  it poses.

The Gut-Brain Connection

Have you ever had a "gut-wrenching" experience? Do certain situations "make you nauseous"? We use these expressions to describe emotional reactions because emotions often trigger symptoms in the gastrointestinal tract. Nerves, stresses, mental problems, and other psychological factors can wreak havoc in the gut (see Your Gut Reactions). That’s because the brain and the gastrointestinal system are intimately connected.

The entire journey of food through the 30-foot-long digestive tract is quarterbacked by a remarkable communication network known as the enteric nervous system (ENS). This intricate nerve complex is located in the gut wall and communicates with the brain via the spinal cord. In turn, hormones, neuro­transmitters, and connections to the central nervous system that affect muscles, mucosa, and blood vessels in the digestive tract influence the ENS.

The ENS cells in the lining of the gut communicate with the brain, first via the sympathetic nerves that pass to and from the gut through transformers called sympathetic ganglia. These nerves connect to the spinal cord and then to the base of the brain. In addition, parasympathetic nerves link to the base of the brain via the vagus nerve from the upper gut or the sacral nerves from the colon. The gut and brain use chemicals called neurotransmitters to send electrochemical messages to one another by way of these nerves. Scientists say that this sophisticated "gut-brain" system is nearly equal in size and complexity to the body’s central nervous system.

Health Tip: When a Stomachache Requires Medical Attention

(HealthDay News) - While stomachache or abdominal pain are quite common and often harmless, these conditions sometimes can signal a more serious problem.
The U.S. National Library of Medicine says the following symptoms require a trip to the emergency room:
Very sharp, severe and sudden pain.
Fever along with your stomach or abdominal pain.
Vomiting blood, or having bloody diarrhea.
Soreness or tenderness in the abdomen.
An abdomen that is hard and rigid.
Inability to have a bowel movement, particularly if you are also vomiting.
Pain in the chest, neck or shoulder.
Dizziness or lightheadedness.

Warning on Kava
Kava, an extract of a species of pepper plant (Piper methysticum), is widely touted as a natural alternative to antianxiety medications. Though some clinical trials have found that it works, possibly by a mechanism similar to that of benzodiazepines, there are concerns here and abroad about its safety.

The Food and Drug Administration is investigating reports that it may cause serious liver toxicity, including cirrhosis and liver failure. About 25 people in Germany and Switzerland developed liver toxicity after using products containing kava.

The FDA has also received several reports of toxic reactions in this country. In one case, a previously healthy young woman required a liver transplant after taking a dietary supplement containing kava. In addition, there was a report several years ago of a patient falling into a coma after using kava with the benzodiazepine alprazolam (Xanax).

Following these reports, Germany and Switzerland banned the sale of kava. It’s still available in the United States, but in light of the potential danger, you should avoid this herb.

Is Pain a Symptom of Depression or a Cause?

Pain is depressing, and depression causes and intensifies pain. People with chronic pain have three times the average risk of developing psychiatric symptoms — usually mood or anxiety disorders — and depressed patients have three times the average risk of developing chronic pain. When low energy, insomnia, and hopelessness resulting from depression or anxiety perpetuate and aggravate physical pain, it can be impossible to tell which came first or where one leaves off and the other begins.
Pain slows recovery from depression, and depression makes pain more difficult to treat. For example, depression may cause patients to drop out of pain rehabilitation programs. So it often makes sense to treat both pain and depression; that way they are more likely to recede together.
Brain pathways
Normally, the brain diverts signals of physical discomfort so that we can concentrate on the external world. When this shutoff mechanism is impaired, physical sensations like pain are more likely to become the center of attention. Brain pathways that handle pain signals use some of the same chemical messengers (neurotransmitters) that are involved in the regulation of mood.

This article continues at:

IBS: © What Doctors Don't Tell You

Gut hunches
Doctors label IBS sufferers neurotic. But nutritional medicine has known for years that bowel problems are not all in the head.If you suffer from a general range of bowel problems that don't fall under any neat category, your doctor is more than likely to pack you off to a psychiatrist. Until recently, this problem has been tagged by orthodox medicine a "psychosomatic disorder". Indeed, some medical literature is downright scornful of the syndrome, judging from an article in a recent issue of The Lancet (2 January 1992), intended as a spoof and featuring a fictitious hapless neurotic down on his luck, who is meant to typify your average irritable bowel syndrome patient.
If this problem is psychosomatic, a term used when medicine hasn't a clue about a particular condition, then a very great number of lunatics are on the loose. Nearly a quarter of all questionnaire respondents in Southampton, thought to be fairly representative of the general population, complained of symptoms consistent with a diagnosis of IBS. Nutritionist Kathryn Marsden argues what naturopaths have known for years: that IBS usually has a physiological cause.
In most cases, irritable bowel syndrome is a cop out classification for a number of irksome conditions with similar symptoms which (medically at least) seem difficult to diagnose and impossible to treat. Your IBS might just as easily be called spastic colon, mucous colitis or non inflammatory bowel disease. They all mean much the same thing. And although many nutritionally ignorant doctors are unable to agree on the cause of IBS, most naturopaths have had a handle on it for years.
A number of conditions have similar symptoms to IBS and can be mistaken for it. These include coeliac disease, diverticulitis, intestinal candidiasis, laxative abuse, lactose intolerance, infestation with intestinal parasites, such as giardiasis, amoebiasis or blastocystis hominis, fecal impaction, Crohn's disease, ulcerative colitis, disturbed intestinal microflora, due to hormone, antibiotic or antacid usage, or even metabolic disorders such as diabetes mellitus.
The symptoms and their severity vary considerably from person to person, but can include: abdominal pain, bloating, flatulence, fatigue, mucousy stools, foul odour, bleeding, anal soreness, weight fluctuations, back pain, headache, intermittent bouts of constipation and diarrhoea, teeth grinding and jaw clenching, anxiety and depression. In some people, abdominal pain may be eased after a bowel movement, but the feeling of incomplete evacuation may remain.
True IBS is most usually caused and/or aggravated by several physiological factors. Food intolerance is high on the list (the worst offenders being wheat, sugar, yeast, milk, beef, pork, corn, coffee or orange juice), followed by neurological problems (please note, neurological, not neurotic!). Poor diet and nutritional deficiencies are also common. Hyperventilation, hypochlorhydria (low levels of stomach acid), achlorhydria (no acid at all), digestive enzyme insufficiency, antibiotic and steroid drugs, infestation with intestinal parasites and, of course, excessive stress in isolation or combination may all inflict further anguish.

Dampness and Mold in the Home and Depression: An Examination of Mold-Related Illness and Perceived Control of One's Home as Possible Depression Pathways
Edmond D. Shenassa, ScD; Constantine Daskalakis, ScD; Allison Liebhaber, BA; Matthias Braubach, MPH; MaryJean Brown, ScD, RN
Am J Public Health.  2007;97(10):1893-1899.  ©2007 American Public Health Association
Posted 11/02/2007

Abstract and Introduction
Objectives: We evaluated a previously reported association between residence in a damp and moldy dwelling and the risk of depression and investigated whether depression was mediated by perception of control over one's home or mold-related physical illness.

Little is known regarding pathways between housing conditions and mental health.[1] Studies have found independent associations between general housing quality, at both the neighborhood and individual levels, with psychological distress[2] and depression.[3–5] Dose–response associations have been found between the number of housing problems and residents' emotional problems[6] and between the degree of housing improvement and alleviation of psychological distress.[7] Several specific housing characteristics, including overcrowding,[8–10] noise,[11,12] indoor air quality,[13] housing type,[7] and floor level[1,14] have also been associated with residents' mental health.
The article continues at:

Could You Have an Inhalant Allergy? Dr. Myhill Describes the Signs of Various Invisible Irritants, and How to Deal With Them by Dr. Sarah Myhill, MD*

01-13-2008 ‘Invisible’ inhalable irritants such as dust mites, mold, danders and pollens cause a variety of physical problems. Dr. Sarah Myhill, MD - a UK-based preventive medicine and fatigue specialist - offers some basic advice on the signs of these sensitivities and how to deal with them. Excerpted with permission from Dr. Myhill’s extensive patient education website (
One can be allergic to anything under the sun, including the sun. For practical purposes, allergies are split up into allergies to foods, chemicals (includes drugs), and inhalants (pollens and micro-organisms such as bacteria, mites, etc.). Inhalant allergies usually present with problems in the airways - rhinitis, sinusitis, itchy palate and/or throat, or asthma with cough, wheeze and shortness of breath. Contact sensitivity in the eyes causes conjunctivitis and on the skin, eczema.
Diagnosis of Inhalant Allergy
This is best done by taking a careful clinical history. Reactions to inhalants are usually type I allergies - abnormal reactions to protein substances that occur naturally - which are relatively easy to test for [except for mold sensitivities, as explained below]. Blood tests can be done, as can skin tests, but these are not totally reliable.
That is because the skin reacts differently compared to the airways, which react differently compared to the gut. Furthermore, there are lots of different animal danders with different breeds - it is possible to react to one dog but not another. And people may react differently to saliva or urine. It is not uncommon for people working with laboratory animals to sensitize to rat urine.
So while the tests are a guide, clinical history is the most critical aspect.
Timing of Symptoms
Broadly speaking, symptoms worse in:
· Winter - suggest house dust mite allergy.
· Spring - suggest tree pollen
· Last week of May to the first two weeks of July - suggest grass pollen
· August to the autumn - suggest molds.

What is the safe or recommended amount of caffeine one should take in one day?
From Shereen Jegtvig,
Your Guide to Nutrition.

What is the safe or recommended amount of caffeine one should take in one day? With all the beverages like the so called energy drinks and powders to add to drinks that contain caffeine, the question was brought up as to what is a safe amount per day.

A. Caffeine is often consumed in the form of coffee, tea and energy drinks with the idea that the caffeine will increase our cognitive functioning and improve our mood. Judging by the length of the waiting lines in Starbucks, this must especially be true in the mornings. In fact, many of us feel like we really can't function until we get our first cup of coffee.
It is generally agreed that consuming up to 300 mg of caffeine per day is safe. That would be about the amount of caffeine you would get from three cups of coffee. Women who are pregnant or may become pregnant may want to decrease that amount or skip the caffeine altogether.
Caffeine is a stimulant and some studies show that small amounts of caffeine may increase your mental response time. Other studies show that the cognitive improvements and mood elevation may not really be due to the beneficial aspects of caffeine as much as ending the withdrawal symptoms we feel when we haven't had our morning "fix" yet.
Increasing the amount of caffeine you take in over 300 mg per day may give you "caffeine jitters." Larger amounts of caffeine may make you irritable, sleepless and may even trigger anxiety and cause diarrhea.
Kicking the caffeine habit isn't so good either. Caffeine withdrawal can give you headaches, make you crabby, give you muscle aches and generally you may feel miserable for a few days. However, after a week or so, the withdrawal symptoms will pass.
Caffeine is not only found in coffee, it is also found in black tea, green tea, chocolate, some soft drinks, energy drinks and over the counter medications.

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