FMS COMMUNITY NEWSLETTER # 40
March 23, 2003


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FMS COMMUNITY NEWSLETTER # 40
March 23, 2003
2038 subscribers and 9 new subscribers. Welcome aboard new
subscribers!
Editor of the Week: Mary McKennell
________________________________________________________________________
___
This week's article at the CFIDS/Fibromyalgia Self-Help program is
"Looking Back: Our First Five Years."
Bruce Campbell states:
We have offered almost 100 groups in our first five years. This article
describes how our program evolved and the beliefs on which it's based.
Our bi-weekly articles include several series: "Success Stories"
(personal accounts of successful coping and recovery), "Ten Keys to
Coping and Recovery" and "What Works for Managing CFIDS and
Fibromyalgia."

http://www.cfidsselfhelp.org
AOL: <a href="http://www.CFIDSselfhelp.org"> CFIDS Self-help </a>
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This week's news:
1. Hypothalamic-pituitary-adrenal axis reactivity in chronic fatigue
syndrome and health under psychological, physiological, and
pharmacological stimulation.

2. Spike in Malpractice Premiums Hurting Access to Care

3. Fibromyalgia - Overview, Symptoms, Causes & Diagnosis - Overview

4. Doctors Over-Diagnose Fibromyalgia, Miss Other Rheumatological Ills

5. Resources for Men With FM

6. Take Charge! Therapy begins with action

7. Chronically Ill Inadequately Served by U.S. Healthcare System, Survey
Finds

8. What Can Rehabilitation Interventions Achieve in Patients With
Primary
Fibromyalgia?

9. Pharmacologic Management of Breakthrough or Incident Pain

10. I Need My Brain Back!

11. Multiple Chemical Sensitivity - The End of Controversy?

12 Lidocaine Patch Enhances Chronic Pain Therapy

13. FDA Warns of Bacetria-Laced Fake Drug

14. Cognitive Behavioral Therapy, Exercise May Improve Gulf War Symptoms

15. New Trends in Myofascial Pain Syndrome

16 Little Sleep Impairs Mind as Much as Little Sleep

17 Short Review of FM Literature

18. Eating Breakfast May Stave Off Obesity & Diabetes

19. My Battle with Fibromyaglia

20. ABC's of Fibro

____________________________________________________
Hypothalamic-pituitary-adrenal axis reactivity in chronic fatigue
syndrome and health under psychological, physiological, and
pharmacological stimulation. Gaab J, Huster D, Peisen R, Engert V, Heitz
V, Schad T, Schurmeyer TH, Ehlert U. Center for Psychobiological and
Psychosomatic Research (J. G., D.H., R.P., V.E., V.H., T.S., T.H.S.,
U.E.), University of Trier, Trier, Germany. Psychosom Med 2002
Nov-Dec;64(6):951-62
OBJECTIVES: Subtle alterations of the hypothalamic-pituitary-adrenal
(HPA) axis in chronic fatigue syndrome (CFS) have been proposed as a
shared pathway linking numerous etiological and perpetuating processes
with symptoms and observed physiological abnormalities. Because the HPA
axis is involved in the adaptive responses to stress and CFS patients
experience a worsening of symptoms after physical and psychological
stress, we tested HPA axis functioning with three centrally acting
stress tests. METHODS: We used two procedures mimicking real-life
stressors and compared them with a standardized pharmacological
neuroendocrine challenge test. CFS patients were compared with healthy
control subjects regarding their cardiovascular and endocrine reactivity
in a psychosocial stress test and a standardized exercise test, and
their endocrine response in the insulin tolerance test (ITT). RESULTS:
Controlling for possible confounding variables, we found significantly
lower ACTH response levels in the psychosocial stress test and the
exercise test, and significantly lower ACTH responses in the ITT, with
no differences in plasma total cortisol responses. Also, salivary-free
cortisol responses did not differ between the groups in the psychosocial
stress test and the exercise test but were significantly higher for the
CFS patients in the ITT. In all tests CFS patients had significantly
reduced baseline ACTH levels. CONCLUSIONS: These results suggest that
CFS patients are capable of mounting a sufficient cortisol response
under different types of stress but that on a central level subtle
dysregulations of the HPA axis exist.
PMID: 12461200 [PubMed - in process]
SOURCE: http://www.co-cure.com

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Spike in Malpractice Premiums Hurting Access to Care
By Karen Pallarito
NEW YORK (Reuters Health) Feb 26 - Physician groups faced an average
rate hike of 53.15% in malpractice premiums between 2002 and 2003,
forcing many doctors to consider retiring, moving or curtailing patient
care services, according to a survey by the Medical Group Management
Association (MGMA).
http://www.medscape.com/viewarticle/449979?mpid=10529
AOL: <a href= "http://www.medscape.com/viewarticle/449979?mpid=10529 ">
Read it here </a>

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Fibromyalgia - Overview, Symptoms, Causes & Diagnosis
Fibromyalgia is a chronic musculoskeletal syndrome characterized by
pain, achiness, tenderness, and stiffness in the muscle tissue,
ligaments, and tendons. It most frequently affects the neck, shoulders,
chest, legs, and lower back. Pain is generally accompanied by sleep
disorders, fatigue, gastrointestinal disorders, and depression. Many of
its symptoms are similar to those of chronic fatigue syndrome,
myofascial pain syndrome, and temporomandibular joint syndrome (TMJ).
Incidence and Prevalence
It is estimated that 6 to 8 million people in the United States suffer
from fibromyalgia. About 80% of patients are women. While fibromyalgia
can occur at any age, the highest incidence occurs among women 20 to 40
years of age.
There have been reports of fibromyalgia in children. What may be
considered "growing pains" might in fact be fibromyalgia, especially if
the child complains of having difficulty sleeping.
The article continues at:
http://www.neurologychannel.com/fibromyalgia/
AOL: <a href=" http://www.neurologychannel.com/fibromyalgia/"> Read it
here </a>

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Doctors Over-Diagnose Fibromyalgia, Miss Other Rheumatological Ills
03/07/2003 By Anne MacLennan

Referring doctors frequently misdiagnose fibromyalgia, Canadian
researchers have found.

This common mistake, mostly observed to be over-diagnosis, might help to
explain the high rates of fibromyalgia currently reported, suggest
investigators from Montreal General Hospital, McGill University Health
Centre, in Montreal, Quebec, and St. Joseph's Hospital, McMaster
University, in Hamilton, Ontario.

The finding may also alert doctors to the critical need to consider
other diagnostic possibilities in patients with diffuse musculoskeletal
pain, they point out.

To examine the accuracy of an initial fibromyalgia diagnosis, Drs. M.A.
Fitzcharles and P. Boulos prospectively evaluated a series of patients
for preceding, current or subsequent diagnosis of fibromyalgia. All of
the patients were newly referred for rheumatology consultation over a
6-month period.

Their clinical characteristics, previous and subsequent management and
use of health care resources were assessed and, at 6 months, the final
diagnosis and its accuracy were determined.

Overall, 76 (12 percent) of all new patients were referred with either a
suspected or definite diagnosis of fibromyalgia.

However, at final evaluation, only 34% of patients had been diagnosed
accurately by either the referring doctor or the rheumatologist at the
initial visit. The remaining patients had other rheumatological
diagnoses. As compared with these other patients, those in the
fibromyalgia group had more tender points (12.5 versus four) and
reported more fatigue. In contrast, the non- fibromyalgia group more
commonly reported prolonged early morning stiffness and limitation of
lumbar spinal mobility in more than one plane.
Rheumatology 2003 Feb;42:2:263-7 "Inaccuracy in the diagnosis of
fibromyalgia syndrome: analysis of referrals."
http://www.docguide.com/news/content.nsf/news/8525697700573E1885256CD600
390F0C?OpenDocument&id=A6E0482132A777A485256B3E001FD3A7&c=&count=10

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RESOURCES FOR MEN
If you are a man with FM the website that this article came from may be
of interest and assistance to you. There is some chat forums here that
are open to men only. The topic of sexual dysfunction is a difficult
topic to bring up in a live support group, so perhaps this is just the
resource you are looking for. Medications known to cause Sexual
Dysfunction:
Antidepressants: Most of the antidepressants do cause some sexual
dysfunction to some degree. Some of the various antidepressants can
cause premature-ejaculation and other problems. Effexor, Zoloft, and
Paxil are the three highest in this category. Luvox, Prozac, and Celexa
were next in line. Remeron and Wellbutrin show no complications with
premature ejaculation. This is from a study by Drs. Caroline & Andrew
Dott. Serezone caused no problems with ejaculation.
Some other sexual side effects which cause almost no desire, Zoloft,
Effexor, rank the highest in this area. Prozac, Celexa, Wellbutrin, and
Paxil are midrange. While Luvox and Serazone were the very least to
cause a lack of desire.
Paxil and Effexor were at the top reporting impotence. Prozac, Celexa,
Wellbutrin was midrange. Serazone and Luvox
showed the least reporting of impotence.
This was just a study. Every medication will react differently in
different people. Finding something that helps with your depression is
very important in your treatment for fibromyalgia. Yet, when and if the
pain subsides, and the time is right, you don't want a failure in the
Department of Pleasure. Do some research, dig around, and you will most
likely have to try various antidepressants.
Pain Medication
Pain medication can also effect your sex life. However, it is unique in
the sense, some people it gives them impotence, and others it increases
the sexual drives. One would think that just getting rid of the pain for
a few hours, would be OK, but it is not. This another one of those
things we all hear, you will have to find out what works for you, and
discuss it with your doctor.
Feelings:
I hate to go back to using Samson as an example, but in many ways, this
is what we end up feeling like when fibromyalgia develops. We've lost
our power, our strength, our desire, our ability to love, and be loved.
Since some of our meds take away from our sexual lives, we often feel
useless. No other word can describe it better. There is sometimes a
never-ending fear looming over our heads, wondering if our
spouses/partners will leave us, simply because we no longer function the
way we used to.... and this is very natural. Those who are single, often
just give up on dating, because the "day" will come up, when the topic
of sex is going to come up, and how do we handle that situation?
All of these feelings stack up, and the mere pressure of these feelings,
let alone the side effects of medication, are enough to cause a
psychological dysfunction. They increase the stress, the meds decrease
the ability for sexual relief, and where does that leave us? In the
dark? Sad, but there is no quick and dirty answer to this dilemma.
Counseling will help, finding a support group will help, and working
with your doctor to find the right combination that works, and decreases
the over all side effects, will help also. Your doctor must be aware of
what is going on with you, and it will be up to you to tell the doctor.
Never take it for granted they consider these things, because they
usually never consider them. They just quickly write a prescription, and
tell you to come back in two weeks
http://www.menwithfibro.com/Sexual_Issues/sexual_issues.html
AOL: <a href=
"http://www.menwithfibro.com/Sexual_Issues/sexual_issues.html">
Read it here <a/>

Another resource for men:
The Men's Zone

"I decided to have a special page at my FMS Web site devoted to men with
FMS/CFIDS/MPS/Chronic Pain. As you probably have read, FMS/CFIDS seems
to strike more women than men, with the rates at about 75% women and 25%
men. But recently, the medical professionals have been seeing more male
patients with these syndromes, perhaps the result of FMS/CFIDS having
been "under-reported" in men in the past. It is likely that the rates
may be more in the 50/50 range. Still, the studies that are being done,
the support groups forming, etc. are geared towards women, which has
basically left the men out in the cold. I will try here to report on any
information I find which centers around men with these syndromes, as the
men have their specific concerns. My hope is to provide a place here
where the men can feel comfortable reading about their brothers with
these syndromes, and find community and support. "
http://www.plaidrabbit.com/fms/menspage.htm
AOL: <a href="http://www.plaidrabbit.com/fms/menspage.htm"> Read it here
<a/>

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Take Charge!
Therapy begins with action
by Diana Karol Nagy
When dealing with CFS or FMS, it's easy to sit back and hope that
someone else can "fix" you, do things for you, and make decisions for
you. However, when you have a chronic illness, that could be a big
mistake. Learning about your condition is certainly the first step to
dealing with your illness, but you need to go the extra step and take
charge of your own health care. This may sound like an overwhelming task
at best, but if you start with baby steps, you'll soon be on your way
Article continues at:
http://chronicfatigue.about.com/library/weekly/aa030803a.htm
AOL: <a href=
"http://chronicfatigue.about.com/library/weekly/aa030803a.htm"> Read it
here <a/>


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******
Chronically Ill Inadequately Served by U.S. Healthcare System, Survey
Finds

By Anthony J. Brown, MD
NEW YORK (Reuters Health) Mar 05 - Most physicians, policymakers, and
people in the general population believe that the current US healthcare
system is not meeting the needs of people with chronic conditions,
according to survey results published in the February 24th issue of the
Archives of Internal Medicine. All three groups "are in agreement that
the current system needs to change to be more responsive to people with
chronic disease," study author Dr. Gerard F. Anderson, from Johns
Hopkins University in Baltimore, told Reuters Health. "Over the years,
we've gotten better and better at acute care," Dr. Anderson said. "The
upshot is that although people are living longer, they are now living
with more chronic diseases." In the current study, Dr. Anderson analyzed
data from 1663 people in the general population, 1238 physicians, and
155 policymakers who were surveyed regarding how well the US healthcare
system addresses the needs of patients with chronic conditions. More
than 90% of physicians and general citizens agreed that chronic
conditions could affect men and women of any age, ethnicity, or income
level. Data were not available for policymakers on this point. Less than
half of the respondents in each group reported that chronically ill
patients received adequate medical care, government programs were
adequate to meet the needs of such patients, or that health insurance
pays for most of the services required. In all three parameters,
policymakers had a more pessimistic view of the current system than the
other groups. A majority of subjects in each group reported that it was
difficult for chronically ill patients to obtain adequate health
insurance, receive care from a medical specialist, to obtain home
assistance from family members, to obtain needed prescription
medications, and to receive care from a primary care provider or other
healthcare providers. The current findings are encouraging in that they
suggest that "policymakers are finally starting to get the message that
healthcare for chronic diseases in the US is inadequate," Dr. Anderson
said. "Now, the real challenge is to turn that into action." Dr.
Anderson noted that he would like to "conduct a similar survey in a few
years to evaluate any changes that may occur." Arch Intern Med
2003;163:437-442.
http://www.medscape.com/viewarticle/450319?mpid=10873&WebLogicSession=Pn
U9k9r48rOBz25goJa81r2Nwk71mWr1DznpUH5yJZdRkLbXIhD7|7838042406349348931/1
84161395/6/7001/7001/7002/7002/7001/-1
To access the full study it can be downloaded via Acrobat at:
http://www.partnershipforsolutions.org
AOL: <a href= "http://www.partnershipforsolutions.org"> Read it here
<a/>
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What Can Rehabilitation Interventions Achieve in Patients With Primary
Fibromyalgia? Haiko Sprott, MD
Curr Opin Rheumatol 15(2):145-150, 2003. C 2003 Lippincott Williams &
Wilkins

Introduction
Symptoms of primary fibromyalgia (FM) persist for years, independent of
applied therapy. That is the sad reality we have to deal with. But is
that really true? The following review is a scan of literature from
September 1, 2001 to August 31, 2002, concerning rehabilitation
interventions for patients with FM, to find progress in this field and
to ascertain state-of-the-art treatment strategies for the disease. The
main problem when treating patients with FM successfully is the
heterogeneity of the patients' group. Several investigators determined
subgroups within FM patients diagnosed by the 1990 American College of
Rheumatology classification criteria of FM. Therefore, uniform
recommendations for treatment cannot be given. Current treatment
recommendations for FM include reassurance and explanation of the nature
of the illness, evaluation and eradication of mechanical stressors as
far as possible, symptomatic analgesic drug treatment, moderate
individually adapted physical exercises, and adjuvant psychotherapeutic
support in an interdisciplinary setting. Individually adapted measures
are highly emphasized to differentially treat FM subgroups, as far as
identified. This review will focus on these points on the one hand, and
provide an overview about the current symptomatically-oriented therapy
on the other hand. This all occurs against the background of an unknown
etiology of the disease so far. Experimental approaches will be noted as
well. The demonstration of a long-term effective intervention for
managing the symptoms associated with FM is needed. This lengthy article
continues at: http://www.medscape.com/viewarticle/449859
AOL: <a href= "http://www.medscape.com/viewarticle/449859">
Read it here </a>

*****************************************************************
Pharmacologic Management of Breakthrough or Incident Pain
Chronic pain can be defined as unrelenting, intractable pain commonly
caused by injury or disease, and often occurs after healing is complete;
chronic pain can also exist in the absence of disease. According to pain
researchers John Loeser and Ronald Melzack, chronic pain is
distinguished from acute pain in that therapies for the former only
provide transient relief and do not resolve the underlying pathologic
and healing processes: "Chronic pain will continue when treatment
stops."[1] The American Pain Society has adopted the definition of
chronic pain offered in the Textbook of Pain (4th edition, 1999):[2]
"Generally considered to be pain that lasts more than 6 months, is
ongoing, is due to non-life-threatening causes, has not responded to
current available treatment methods, and may continue for the remainder
of the person's life." The intensity and persistence of chronic pain may
be influenced by physical, emotional, and social and other environmental
stresses. Of note, the intensity of chronic pain may not be related to
the extent of tissue injury or other quantifiable pathology, and the
persistence of pain may be due to factors other than the initial tissue
damage or insult that triggered the onset of pain.[1] Chronic pain of
moderate to severe intensity is typically associated with advanced
stages of cancer and may be due to tumor invasiveness or metastasis, or
to current or prior chemotherapy or radiotherapy.[3] Moderate to severe
chronic pain is also encountered outside of the cancer setting, and may
be associated with noncancer disorders such as arthritis, sickle cell
anemia, low back pain, headaches, neuralgia, and fibromyalgia.[1,4,5]
Frequently, patients with chronic cancer or noncancer pain experience
relatively short episodes of worsening pain, which are referred to as
breakthrough or episodic pain.[6,7] Thus, chronic pain can be thought of
as consisting of two components: a relatively constant component
(baseline pain) and an intermittent component superimposed on the
baseline pain (breakthrough pain). Regardless of its cause, chronic pain
negatively impacts quality of life, often profoundly affecting mobility
This article in its entirety can be read at:
http://www.medscape.com/viewarticle/449803
AOL: <a href=
"http://www.medscape.com/viewarticle/449803"> Read it here </a>

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I Need My Brain Back!
Physicians who treat fibromyalgics know that almost every patient has
said at one time or another: "I can stand the pain, but I need my
brain." It is really important for patients to learn coping skills when
dealing with fibrofog. Here are a few tips: --Practice being methodical,
so that it becomes second nature. Develop simple habits. Train yourself
to put things in the same place every time. --Put up a big calendar in a
prominent place, such as your refrigerator. Write down every appointment
the minute you make it. Every morning and night, check this calendar -
do it at specific times: first thing when you get up, and just before
you go to bed. --Make a list of what you have to do. Then train yourself
to check the list several times throughout the day. --Keep a pad and pen
near the phone. --Post notes. Many patients have told me they can't
imagine what they did before post-its. Use them to remind yourself to
turn off lights, lock doors, water plants, remember shopping lists, etc.
(What Your Doctor May NOT Tell You About Fibromyalgia, by R. Paul St.
Amand, M.D., and Claudia Craig Marek.)
SOURCE: www.ImmuneSupport.com

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Multiple Chemical Sensitivity - The End of Controversy?
By Martin L. Pall
Professor of Biochemistry and Basic Medical Sciences
Washington State University
Source: http://molecular.biosciences.wsu.edu/Faculty/pall.html
Multiple Chemical Sensitivity (MCS), where people report being
exquisitely sensitive to a wide range of organic chemicals, is almost
always described as being "controversial." The main source of this
supposed controversy is that there has been no plausible physiological
mechanism for MCS and consequently, it was difficult to interpret the
puzzling reported features of this condition. As discussed below, this
is no longer true and consequently the main source of such controversy
has been laid to rest. There still are important issues such as how it
should be diagnosed and treated and these may also be allayed by further
studies of the mechanism discussed below:
http://www.immunesupport.com/library/print.cfm?ID=4371
AOL: <a href= "http://www.immunesupport.com/library/print.cfm?ID=4371">
Read it here </a>

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Lidocaine Patch Enhances Chronic Pain Therapy
A patch containing 5% lidocaine (Lidoderm) combined with gabapentin
(Neurontin) for the treatment of post-herpetic neuralgia, lower back
pain and painful diabetic neuralgia appears to be safe, well-tolerated
and treatment-enhancing, investigators report.
(DGDispatch)
http://www.docguide.com/news/content.nsf/news/8525697700573E1885256CD800
506291?OpenDocument&id=8622EBE409F709DC852568E000589257&c=&count=10
AOL: <a
href="http://www.docguide.com/news/content.nsf/news/8525697700573E188525
6CD800506291?OpenDocument&id=8622EBE409F709DC852568E000589257&c=&count=1
0">Read it here</a>
FDA warns of bacteria-laced fake drug
[This may be of interest because Procrit is currently being studied as a
possible treatment for a subset of CFS patients.] Tuesday, March 11,
2003 Posted: 5:13 PM EST (2213 GMT) WASHINGTON (CNN)
-- Health care providers and consumers are being warned to look for a
counterfeit version of the anti-anemia drug Procrit. The fake drug,
tainted with bacteria, could have serious consequences, the Food and
Drug Administration said Tuesday. Read the full story at
http://www.cnn.com/2003/HEALTH/03/11/fake.drug/index.html
AOL: <a
href="http://www.cnn.com/2003/HEALTH/03/11/fake.drug/index.html"> Read
it here </a>
SOURCE: http/www.co-cure.com

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Tired to the Max -- And Then Some
HealthScoutNews
March 16, 2003
By Linda Searing
HealthScoutNews Reporter
We all know what it's like to have a really bad case of the flu. Think,
then, what it also must feel like to have severe muscle and joint pain,
headaches and sore lymph nodes. On top of that, you can't concentrate,
and you're tired, really tired, most of the time -- a sense of
exhaustion that just won't go away, no matter how long you sleep. Some
half a million Americans don't have to imagine it. They feel that way
day after day, year after year. Called chronic fatigue syndrome, this
illness comes with a laundry list of symptoms and complaints, but an
absence of absolute answers. Cause? Unknown. Diagnosis? Uncertain.
Treatment options? Unclear. But the effects? Very real. The article
continues at:
http://www.healthcentral.com/news/NewsFullText.cfm?id=511914
AOL: < ahref="
http://www.healthcentral.com/news/NewsFullText.cfm?id=511914"> Read it
here </a>

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Cognitive Behavioral Therapy, Exercise May Improve Gulf War Symptoms

By Keith Mulvihill
NEW YORK (Reuters Health) Mar 19 - Cognitive behavioral therapy (CBT)
and aerobic exercise may improve physical functioning and relieve some
of the symptoms associated with Gulf War syndrome, according to a report
published in the March 19th issue of the Journal of the American Medical
Association. "This was a positive study, and these types of treatments
do offer some help to people with this type of illness," study author
Dr. Daniel J. Clauw, from the Ann Arbor VA Medical Center in Michigan,
told Reuters Health. Dr. Clauw's team followed 1092 veterans diagnosed
with Gulf War veterans' illnesses, characterized by persistent pain,
fatigue and mental symptoms, such as forgetfulness and memory
difficulties. The participants were split into four groups. One group
underwent exercise training and instruction; another participated in
CBT; another group received both treatments; and the fourth group acted
as a control and only continued "usual" care. CBT sessions were 60 to 90
minutes long and offered weekly for 12 weeks. For exercise, participants
worked out aerobically with an exercise therapist once a week for 12
weeks and were asked to exercise on their own two or three times a week.
"The percentage of veterans with improvement in physical function at one
year was 11.5% for usual care, 11.7% for exercise alone, 18.4% for CBT
plus exercise and 18.5% for CBT alone," the authors write. While
veterans who underwent CBT reported improvements in physical
functioning, Dr. Clauw noted that exercise was associated with
improvements in fatigue and memory abilities. "Both of these
interventions are extremely safe. There were very few side effects," he
added. Of particular significance, according to Dr. Clauw, is the fact
that the study included patients who had been ill for 5 to 6 years and
had already received other treatments, yet still managed to experience
benefits. "Exercise or CBT can be of some benefit, and if the individual
veteran has not tried these yet and is predisposed to doing these types
of activities, then they may want to consider trying them," Dr. Clauw
said. Still, Dr. Clauw noted that the study failed to show a benefit of
CBT or exercise with regard to pain. This may, in part, be because pain
is difficult to measure and varies greatly from person to person, he
postulated. JAMA 2003;289:1396-1404.
http://www.medscape.com/viewarticle/451032

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New trends in myofascial pain syndrome
Zhonghua Yi Xue Za Zhi (Taipei) 2002 Nov;65(11):501-12
Hong CZ.
Department of Physical Medicine and Rehabilitation, University of
CaliforniaIrvine, Irvine, California, USA. czho-@ms49.hinet.net This
review article summarizes recent studies on myofascial trigger point
(MTrP) to further clarify the mechanism of MTrP. MTrP is the major cause
of muscle pain (myofascial pain) in clinical practice. There are
multiple MTrP loci in an MTrP region. An MTrP locus contains a sensory
component (sensitive locus) and a motor component (active locus). A
sensitive locus is the site from which pain, referred pain (ReP), and
local twitch response (LTR) can be elicited by needle stimulation.
Sensitive loci are probably sensitized nociceptors based on a
histological study. They are widely distributed in the whole muscle, but
are concentrated in the endplate zone. An active locus is the site from
which spontaneous electrical activity (SEA) can be recorded. Active loci
are dysfunctional endplates since SEA is essentially the same as
endplate noise (EPN) recorded from an abnormal endplate as reported by
neurophysiologists. Both ReP and LTRs are mediated through spinal cord
mechanisms, demonstrated in both human and animal studies. The
pathogenesis of MTrPs appears to be related to the integration in the
spinal cord (formation of MTrP circuits) in response to the disturbance
of the nerve endings and abnormal contractile mechanism at multiple
dysfunctional endplates. Methods usually applied to treat MTrPs include
stretch, massage, thermotherapy, electrotherapy, laser therapy, MTrP
injection, dry needling, and acupuncture. The mechanism of acupuncture
is similar to dry needling or MTrP injection. The new technique of MTrP
injection can also be used to treat neurogenic spasticity.
PMID: 12583512
SOURCE: http//www.co-cure.org

***************************************************************
Little Sleep Impairs Mind as Much as No Sleep


By Dana Frisch
NEW YORK (Reuters Health) - Many nights of little sleep--fewer than six
hours a night--can impair mental performance as much as not getting a
wink for two nights in a row, new research shows.
The data contradict a popular notion that our bodies can become
accustomed to functioning on sustained periods of little sleep without
any consequences, said lead author Dr. Hans P.A. Van Dongen, a research
assistant professor at the University of Pennsylvania School of Medicine
in Philadelphia.
The 48 participants in the study were divided into four groups that
slept either four, six or eight hours a night for two weeks, or had no
sleep for three days. The groups were monitored in a laboratory
throughout the two weeks to ensure that they did not nod off or use
caffeine. They were assessed on a battery of mental and physiological
tests periodically every day and were also asked to evaluate how tired
they felt.
People sleeping less than eight hours a night were slower to react, less
able to think clearly and perform simple memory tasks, the researchers
report in the March issue of the journal Sleep. They also performed as
poorly on certain tasks as the individuals evaluated after one or two
nights of sleeplessness.
However, getting some sleep made individuals feel less tired than those
who went without sleep despite test results that showed they were just
as impaired.
As a consequence, Van Dongen told Reuters Health, there should be
countermeasures in place for people who cannot avoid being chronically
sleep-deprived, such as military personnel, trainee doctors, shift
workers and others.
Van Dongen recommends that these professions limit the number of hours
people are allowed to work, give people the opportunity to nap at
"strategic times" or allow them to use caffeine or other chemical
stimulants to maintain alertness.
This study is important and "relevant" because it shows what happens
when the body alone must deal with its tiredness in the absence of
chemical stimulants like caffeine or other distractions, said Dr. Meir
Kryger, a professor of medicine at the University of Manitoba in
Winnipeg, Canada, and a sleep researcher.
Data from the National Sleep Foundation show that Americans sleep an
average seven hours a night during the week, although 31 percent of all
adults regularly get less sleep.
The study also found that that there were large individual differences
in how much people needed to sleep.
Kryger said in an interview that everybody needs a different amount of
sleep. Getting sufficient amounts of shut-eye is a "life-style
decision," he said. "It is one of the important functions of life and
you need to control it."
SOURCE: Sleep 2003;26:117-126.
http://www.realage.com/HB25/HB25.asp?wci=HArticle&cid=14136&sid=1255

*********************************************************
SHORT REVIEW OF FM LITERATURE
The last months have seen an interesting array of fibromyalgia (FMS)
related papers. A study from Sweden compared the tender point paradigm
using 60 points with the conventional American College of Rheumatology
(ACR) 18 points in a group of women doing home care work. Reassuringly,
the ACR 18 tender points correlated with the expanded set of 60 tender
points both in those diagnosed as having FMS and those with
uncomplicated myofascial pain. A study from the UK provided further
evidence for a link between the onset of FMS and trauma. An interesting
study in Norway attempted to dissect out the organic components versus
the psychological components of pain variance in FMS. As regards
treatment studies, there was an emphasis on the benefits of strength
training. There were only a few pharmacological studies, the most
notable one being a report on the benefit of using fluoxetine as a
unimodal treatment.
(Source: Journal of Musculoskeletal Pain, Vol. 10, Number 4, 2002.
Literature Reviews: Fibromyalgia Review by Robert M. Bennett, M.D.)
Source: www.ImmuneSupport.com

****************************************************
Eating Breakfast May Stave off Obesity, Diabetes
By Keith Mulvihill

NEW YORK (Reuters Health) - The next time you're starting the day on an
empty stomach, consider this: a new study suggests that people who eat
breakfast daily may be less likely to succumb to obesity and diabetes.

The study was presented Thursday at the American Heart Association's
43rd Annual Conference on Cardiovascular Disease Epidemiology and
Prevention.

"In comparison to those who reported eating breakfast twice per week or
less often, those reporting eating breakfast every day had 35 percent to
50 percent lower rates of developing obesity and insulin resistance
syndrome," researcher Dr. Mark A. Pereira told Reuters Health.

Insulin resistance is a loss of sensitivity to insulin, the key
blood-sugar-regulating hormone. This loss of sensitivity is often a
precursor to diabetes.

"This was true for white men and women, and black men, but not black
women," he added.

Breakfast may reduce the risk of obesity, type 2 diabetes and
cardiovascular disease by controlling appetite and thus reducing the
likelihood of overeating later in the day, explained the investigator.

"There were 2,681 young adults included in the study, and they were
followed for eight years," said Pereira, who is a research associate at
Children's Hospital and assistant professor at Harvard Medical School in
Boston. The participants, who were between 25 and 37 years old, were
followed for a variety of health outcomes including insulin resistance
and obesity.

"In addition to breakfast frequency, the quality of breakfast also
appears to be important," noted Pereira. "For example, whole grain
breakfast cereals were associated with a reduction in risk, whereas
refined grain breakfast cereals were not."

Only cereals that list a whole grain or bran first in the ingredient
list or those that contain a whole grain and have at least 2 grams of
fiber per serving are considered to be whole grain cereal, according to
a statement from the American Heart Association.

"The study contributes to the knowledge of the role of dietary patterns
and risk of obesity and related health outcomes," concluded Pereira, who
added that "there are very few, if any, longitudinal studies on
breakfast frequency, breakfast quality, and health outcomes."

The study was funded by the Charles H. Hood Foundation, which Pereira
said was "a philanthropic organization with no ties to industry." The
study was also funded by the National Heart, Lung, and Blood Institute
at the National Institutes of Health.

Last Updated: 2003-03-06 16:19:44 -0400 (Reuters Health)

http://www.realage.com/HB25/HB25.asp?wci=HArticle&cid=14129&sid=1255

*******************************************
My Battle with Fibromyalgia

Pain and fatigue
have come again
like an enemy
seeking to destroy life.

Like a storm at sea
the waves sweep over me
and threaten to dash me
to the rocks below.

But I have a lifeline
I know my enemy well
And I know I will win.

I will ride out the storm
knowing that it will subside
and the sun will shine again.


Once more I have won.
----Peggy J Donahue.

(Original Source unknown)
*********************************************




ABC's of Fibro


ACCEPTANCE - of consequences and boundaries of your new reality.

BALANCE - in all areas of your life.

CHANGE - ancient wisdom holds that the only thing that's certain is
change.

DENIAL - the first stage of reaction to any sudden, unexpected,
unpleasant event.

EXERCISE - do what you can...with what you have... and where you are.

FATIGUE - rest your mind as well as your body.

GENTLE - with your movements.

HUMOR - smiles, laughter, and a sense of humor... help in the healing
process.

IMAGERY - great way to escape pain and fatigue for a brief time.

JOURNAL - a written record of symptoms...weather...emotions...helps
identify
patterns.

KNOWLEDGE - learn all you can about Fibromyalgia.

LIFE style changes - ongoing process

MANAGEMENT of medications

NEGATIVE thinking

OCCUPATIONAL therapy

PACE - conserve energy...set priorities

QUITE place to relax.

RELAXATION exercises.

SLEEP -develop good sleeping habits.

TESTS - a fact of FMS living.

USE - the largest muscle for the task.

VOICE - your needs.

WELLNESS - attitude and lifestyle.

XANADU - "an idyllic, beautiful place"....imagine your self in one for
relaxation.

YARE - means "to be ready or prepared"... don't let a flare creep up on
you.

ZEAL -"enthusiastic and diligent devotion in pursuit of a cause, ideal,
or goal"

Source
http://members.delphi.com/pirjo/index.html

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