FMS COMMUNITY NEWSLETTER # 43
July 13, 2003

 

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which all the rules of life seem to have changed and there is no
obvious way out. This week's article at the CFIDS/Fibromyalgia Self-Help
program website offers a roadmap to this country by describing the six
characteristics of chronic illness. Read "Roadmap for Chronic Illness"
at http://www.cfidsselfhelp.org
Also, the site has information about the Internet self-help course and
other resources for people with fibromyalgia, CFIDS and related
illnesses.

Bruce Campbell, Ph.D., Director
CFIDS/Fibromyalgia Self-Help Program
http://www.cfidsselfhelp.org
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*****
Anything?
by Denise Young
January 28, 2001

What are you willing to do to get better?
If you are like me, the first thought that popped into your mind when
reading this question was probably Anything. Most of us feel, at times,
that we would be willing to do anything to be free from the pain,
fatigue, and other debilitating symptoms of CFIDS/FMS. Many of us have
tried various methods - both alternative and conventional - aimed at
curing the incurable. But, the majority of us have become skeptical of
such cure-alls because, as it is with many other situations, there are
those out there who wish to take advantage of our desperation. They are
scavengers preying on our pain, promising things they cannot possibly
produce, wishing only to capitalize on the weak and weary of society.
Two days ago, I received an email from someone I didn't recognize. This
is not uncommon as I receive countless emails from various friends, like
you, on a daily basis, so I opened the email to find a web address and a
phone number. The text of the message simply said `Conventional medical
has no cure for chronic progressive illnesses. Visit this site, and call
me in the morning.' I clicked on the link and was transported to an
advertisement for a book that claimed to have all the answers for curing
chronic illnesses such as CFIDS/FMS. I immediately closed the window and
deleted the email without copying down the phone number. If the claims
made by the author of this book were true, then I believe we would have
all heard about the `cure' by now.
Anything is an abstract term, encompassing a vast array of areas, most
of them unknown. Saying we would be willing to do anything to escape the
ravages of disease is to put ourselves in a position of being taken
advantage of. Within earshot of the wrong people, even those who love us
and want only to help us, that one word can have disastrous effects.
Well-intentioned relatives will begin scouring the net in search of the
magic cure. They will watch infomercials touting the latest combination
of vitamins and minerals, complete with `testimonials' of the fully
recovered. And, we are besieged by the constant onslaught of largely
useless information.
If we then decided that we are unwilling to try one of these methods, we
are accused of not trying to get better, of going back on our word, or
wallowing in the pain. This is a constant, vicious cycle that all too
many of us find ourselves in with the blind utterance of one word:
anything.
Pharmaceutical companies and private individuals are not the only ones
in the world who would seek to take advantage of the sick and affirmed.
There are those within the medical community as well, those with a
hidden agenda - perhaps with visions of the Nobel Prize swimming in
their heads - who recruit patients for `research' studies that never see
the light of day. In some cases, the results of these studies are never
published or made public, and the participants, who have risked it all
in the hope of being free from disease, are left wondering why the study
was ever conducted in the first place.
Oftentimes, the patients leave these studies in worse condition than
when they entered. Who will publish a botched research attempt? What is
there to gain from it? Researchers gain fame through success, not
failure, but, reputable or not, they all operate in the name of Science.

Just recently while visiting my rheumatologist, I was asked the
question: `What are you willing to do to get better?' My immediate
response was `Anything.' My doctor looked at me and asked, `Are you
sure?' I said, again without thinking, `Yes.'
He began telling me about a clinical trial that is in the works in my
area to be conducted by a leading research hospital focusing on
CFIDS/FMS. Eager to get better, I listened to his every word, and found
myself answering some preliminary questions as a possible candidate for
participation in the study. He either withheld the details of the study
or they have not yet been compiled, but I left his office with the
understanding that I would be tossed in the ring for consideration.
As my husband and I made our way home, I began to think about the
conversation my doctor and I had had. I had opened my mouth and blindly
said that I was willing to do anything to get better. I began to
consider what the term anything really meant, and I found myself
appalled that I had answered the question in such a manner without
asking questions of my own first. How could I have agreed to be placed
in the running for a clinical trial when I knew so little of the
details?
In their defense, the hospital proposing this study is known worldwide
for their excellence in research. They have an excellent reputation as a
teaching hospital, and they are leaders in various fields of research
studies. But, still, not knowing what the trial will encompass is
frightening. Will I have to give up my current medications? What is the
expected outcome? What are the chances of my walking away feeling worse,
better, or with no change in my symptoms? So many questions, all coming
much too late.
Anything . . .
I don't think there is anyone capable of wanting to be better more than
myself. A close extended family member commented to me the other day
that she could help me if she lived closer by getting me out of the
house more often. She believes I have given up hope. She has mistaken my
acceptance of my illness for complete and total surrender. I have
accepted my illness, but my acceptance doesn't include giving up the
hope of being freed from it. I must choose my battles wisely, though,
and weigh each suggested remedy through careful consideration.
A few days ago, I stated that I was willing to do anything to be better,
to be free, but now I know that is not the case. I am not willing to
jump off a cliff to ease my pain. I am not willing to stand on my head,
wear shrink wrap on my body, or run screaming down the road naked to be
free from disease. I am not willing to be taken advantage of by people
that wish to capitalize on my pain. What I am willing to do is consider
each tangible opportunity to the fullest extent. I am willing to listen
to my doctors, who I trust and respect, but I reserve the right to make
my own decisions about my treatment. I am willing to educate myself,
question the system, and do all that I can to help myself be the best I
can be.
Again, I'll pose this question, `What are you willing to do to get
better?' Hopefully, now, we will all take a moment to think about our
answer. I know I will.
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*****
EDITOR'S CORNER:
I hope you found the above essay thought provoking. I think the question
of "What you are you willing to do to get better?' is one that we each
need to think about. It is a question that might make you uncomfortable.
The answer will be different for each one of us. There are practical
health things that will make us better. How many of us put off changing
our eating styles, or stay content with our minimal exercise, or keep on
smoking or live off adrenaline surges and just hope that somehow things
will improve all by themselves?
There is a short article towards the end of this newsletter that talks
about the critical importance of lifestyle change. Change is always
difficult. I think that sometimes we feel that the Beast has taken so
much from us that we deserve to hold onto certain habits that bring us
comfort. The question remains- "What are you willing to do to get
better?"
Think on this.

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BEATING THE HEAT
Keep Safe by Keeping Your Cool This Summer

Summer is in full swing, and with it comes the risk of heat-related
illness. You may be the first to realize that someone is in trouble.
Here's how to prevent and treat heat emergencies.

Heat Cramps
Heat cramps are muscle pains or spasms-usually in the abdomen, arms, or
legs-that can occur with strenuous activity. If the patient has heart
problems or is on a low-sodium diet, get medical attention for heat
cramps. If the patient is otherwise healthy, have him:
Rest quietly in a cool place.
Drink clear juice or a sports beverage.
Keep quiet for a few hours after the cramps subside, to prevent
progression to heat exhaustion or heat stroke.
Seek medical attention if cramps do not subside in an hour.

Heat Exhaustion
Heat cramps can be a sign of heat exhaustion, a milder form of heat
illness. Those most prone to heat illness include the elderly, people
laboring in high temperatures, those with hypertension (high blood
pressure) and people with inadequate fluid replacement. Symptoms include
heavy sweating, paleness, muscle cramps, fatigue, weakness, dizziness,
headache, nausea/vomiting, fainting, cool and moist skin, fast and weak
pulse, and fast and shallow breathing. Seek medical attention if the
symptoms are severe, or if the person has heart problems or
hypertension. Otherwise have the person:
Rest quietly in a cool place.
Drink cool, nonalcoholic, decaffeinated beverages.
Shower or bathe to reduce body temperature.
Seek medical attention if symptoms do not subside in one hour.

Heat Stroke
Left untreated, heat exhaustion can progress to heat stroke, the most
serious form of heat illness. Heat stroke is a serious medical condition
that can cause death; the sweating mechanism fails and the body's
temperature rises critically. Symptoms include a body temperature above
103 degrees orally, red, hot, and dry skin without sweating, a rapid,
strong pulse, throbbing headache, dizziness, nausea, confusion,
unconsciousness and muscle twitching. Call for immediate medical
assistance, and:
Get victim into the shade.
Cool victim by whatever means possible - place in a tub of cool water,
place in a shower, spray with a garden hose - continuing until body
temperature is reduced to 101-102 degrees.
Encourage cool, nonalcoholic, decaffeinated beverages if conscious.
If unconscious, place in the recovery position, as vomiting may occur.

General Tips for Extreme Heat
Increase fluid intake, regardless of activity level.
In periods of extreme heat, spending even a short time in
air-conditioning can help the body deal with heat stress.
Limit outdoor activity to mornings and evenings.
Check frequently on infants, the elderly, the mentally ill and the
physically ill, especially those with heart disease or hypertension.
Source: Centers for Disease Control and Prevention, National Center for
Environmental Health: Extreme Heat.
http://nursing.about.com/library/weekly/aa062603a.htm

Editor's Note: Be aware that you may be developing a new sensitivity to
warm temperatures due to FM. You may find that you are not able to deal
with the heat as well as previous years. Also check your medications to
see which ones may make you more sensitive to the sun. I had an episode
of heat exhaustion two days ago and it was not a pleasant experience.
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FIBROMYALGIA SYNDROME: HOPE AND HELP FOR DAILY LIVING
Information is taken from "Fibromyalgia Syndrome: Getting Healthy", a
60-page guide to getting well through lifestyle and behavioral methods
by Jeanne L. Melvin, an occupational therapist and psychotherapist.
What is Fibromyalgia Syndrome?
Fibromyalgia Syndrome (FMS) is a disorder causing pain, tenderness, and
stiffness in the muscles. Almost all people with this condition
experience some form of sleep disorder and a wide range of problems
referred to as "associated symptoms."
Symptoms linked to the sleep disorder include fatigue, increased
sensitivity to pain, impaired memory, increased anxiety, depression,
irritability, and a negative mood. Others may include nerve sensitivity,
stomach and bowel problems, allergies, changes in circulation and the
ability to regulate body temperature, urinary frequency, vision
problems, skin rashes, and skin sensitivity.
Current official diagnostic criteria are: (1) widespread pain or
tenderness in the trunk and limb muscles present at least three months,
and (2) excessive tenderness in 11 out of 18 tender points (areas on the
body particularly sensitive to pressure).
What is the Outlook for People With This Health Problem?
Fibromyalgia Syndrome is a condition, not a disease. It involves a
biochemical imbalance in the brain and does not cause the body to
deteriorate or become permanently damaged.
To finish reading this article click on:
http://www.aota.org/featured/area6/links/link02n.asp
AOL: < a href="http://www.aota.org/featured/area6/links/link02n.asp">
Read it here </a>
*********************************************************************

DEFINING PAIN

Pain is a private percept that arises in a conscious brain, typically in
response to a noxious provoking stimulus, but sometimes in the absence
of a stimulus. The relation of the percept to the stimulus is variable,
and depends on the individual's prior expectations and beliefs, and on
his/her cognitive and emotional state, not just on the nature of the
stimulus itself. The nervous system may react to noxious stimuli with
autonomic changes (e.g. in blood pressure), and even with adaptive
behavioral responses, in the absence of a conscious pain percept.
Likewise, there are circumstances in which the presence of pain is
ambiguous, such as when the individual is unable to report on his/her
conscious percept, or with reference to animals. In these situations,
the word "nociception" is used instead of the word "pain" to express
that the nervous system has detected the noxious stimulus without
necessarily implying that a pain percept was evoked." M. Devor

A. Definitions/ Pain Terms
B. EFIC declarations on pain
C. Costs of Chronic Pain
D. Essays on pain
http://www.efic.org/about_pain.htm
AOL: <a href=" http://www.efic.org/about_pain.htm"> Read it here </a>
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Fibromyalgia -- from syndrome to disease: overview of pathogenetic
mechanisms.
J Rehabil Med. 2003 May;(41 Suppl):89-94.
Henriksson KG.

Department of Neuroscience and Locomotion Section of Medical
Rehabilitation, Faculty of Health Sciences, Linkoping University,
Sweden.


According to the classification criteria proposed by the American
College of Rheumatology, fibromyalgia is a long-standing multifocal pain
condition combined with generalised allodynia/hyperalgesia. It is the
generalised allodynia/hyperalgesia that distinguishes fibromyalgia from
other conditions with chronic musculoskeletal pain.

Central sensitisation of nociceptive neurons in the dorsal horn due to
activation of N-methyl-D-aspartic acid receptors and disinhibition of
pain due to deficient function of the descending inhibitory system are
probable pathogenic factors for allodynia/hyperalgesia.

Furthermore, chronic pain is a chronic emotional and physical stressor.
Chronic stress and chronic sleep disturbance are not specific for
fibromyalgia but could be the causes of symptoms like fatigue, cognitive
difficulties and other stress-related symptoms. They may also cause
neuroendocrinological and immunological aberrations.
PMID: 12817664

---------------------------------------------
Co-Cure Web Site: http://www.co-cure.org/

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THE MENEMONIC OF CENTRAL PAIN
Allodynia means "other pain". It refers to:
Pain from stimuli which are not normally painful
Pain which occurs other than in the area stimulated.
It is not synonymous with referred pain.
Allodynia of location transfer is not referred pain in the sense that
referred pain transfers to areas which represent embryonic position of
the nerves. Rather it occurs in a body part close to the stimulated
area, but in such a location as to indicate either an ephapse signal, or
a translocated signal occurring in cord or brain. Clinicians use terms
such as detour or sidetrack in conjunction with location allodynia.
Literature does not differentiate well between the different types of
allodynia present in Central Pain. Some authors refer to one type as
location allodynia while others seem to regard all such phenomena as
ephaptic. Physicians refer to pain from motion as motion allodynia, and
pain at ambient temperatures not unpleasant to the average person as
cold allodynia.
These usage's give allodynia a functional definition, without declaring
an anatomical one. They do not strictly differentiate allodynia from an
ephapse; an anatomical term referring to a proposed jumping of the pain
signal around an area of damage onto a neighboring neuron or nerve
tract.
An example of touch allodynia is pain from the touch of clothing.
Thermal allodynia occurs from a draft of warm or cold air on the skin.
The March 17, 1997 issue of Newsweek describes a patient who dreaded the
breeze from a ceiling fan because it felt like razors cutting his flesh.
To continue reading this article click on:
http://www.painonline.org/allo.htm
AOL: < a href= http://www.painonline.org/allo.htm> Read it here </a>
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FIBROMYALGIA PAIN IS NOT ALL IN PATIENT'S HEADS
June 7, 2002

ANN ARBOR, MI - A new brain-scan study confirms scientifically what
fibromyalgia patients have been telling a skeptical medical community
for years: They're really in pain.

In fact, the study finds, people with fibromyalgia say they feel severe
pain, and have measurable pain signals in their brains, from a gentle
finger squeeze that barely feels unpleasant to people without the
disease. The squeeze's force must be doubled to cause healthy people to
feel the same level of pain - and their pain signals show up in
different brain areas.

The results, published in the May issue of Arthritis & Rheumatism, the
journal of the American College of Rheumatology, may offer the proof of
fibromyalgia's physical roots that many doubtful physicians
have sought. It may also open doors for further research on the
still-unknown causes of the disease, which affects more than 2 percent
of Americans, mainly women.

Lead authors Richard Gracely, Ph.D., and Daniel Clauw, M.D., did the
study at Georgetown University Medical Center and the National
Institutes of Health, but are now continuing the work at the University
of Michigan Health System. In an editorial in the same issue, Clauw and
U-M rheumatologist Leslie Crofford, M.D., stress the importance of
fibromyalgia research and care.

To correlate subjective pain sensation with objective views of brain
signals, the researchers used a super-fast form of MRI brain imaging,
called functional MRI or fMRI, on 16 fibromyalgia patients and 16 people
without the disease. As a result, they say, the study offers the first
objective method for corroborating what fibromyalgia patients report
they feel, and what's going on in their brains at the precise moment
they feel it. And, it gives researchers a road map of the areas of the
brain that are most - and least - active when patients feel pain.

"The fMRI technology gave us a unique opportunity to look at the
neurobiology underlying tenderness, which is a hallmark of
fibromyalgia," says Clauw. "These results, combined with other work done
by our group and others, have convinced us that some pathologic process
is making these patients more sensitive. For some reason, still unknown,
there's a neurobiological amplification of their pain signals."

Further results from the study were presented last year at the ACR
annual meeting. The project will continue later this year at UMHS,
joining other fMRI fibromyalgia research now under way.

For decades, patients and physicians have built a case that fibromyalgia
is a specific, diagnosable chronic disease, characterized by tenderness
and stiffness all over the body as well as fatigue, headaches,
gastrointestinal problems and depression. Many patients with the disease
find it interferes with their work, family and personal life. Statistics
show that far more women than men are affected, and that it occurs
mostly during the childbearing years.

The ACR released classification criteria for fibromyalgia in 1990, to
help doctors diagnose it and rule out other chronic pain conditions.
Clauw and Crofford's editorial looks at the current state of research,
and calls for rheumatologists to take the lead in fibromyalgia care and
science.

But many skeptics have debated the very existence of fibromyalgia as a
clearly distinct disorder, saying it seemed to be rooted more in
psychological and social factors than in physical, biological causes.
Their argument has been bolstered by the failure of research to find a
clear cause, an effective treatment, or a non-subjective way of
assessing patients.

While the debate has raged, neuroscientists have begun to use brain scan
technology to identify the areas of the normal human brain that become
most active during pain. A few studies have even assessed the blood flow
in those areas in fibromyalgia patients during baseline brain scans. The
new study is the first to use both high-speed scanning and a painful
stimulus.

In the study, fibromyalgia patients and healthy control subjects had
their brains scanned for more than 10 minutes while a small,
piston-controlled device applied precisely calibrated, rapidly pulsing
pressure to the base of their left thumbnail. The pressures were varied
over time, using painful and non-painful levels that had been set for
each patient prior to the scan.

The study's design gave two opportunities to compare patients and
controls: the pressure levels at which the pain rating given by patients
and control subjects was the same, and the rating that the two different
types of participants gave when the same level of pressure was applied.

The researchers found that it only took a mild pressure to produce
self-reported feelings of pain in the fibromyalgia patients, while the
control subjects tolerated the same pressure with little pain.

"In the patients, that same mild pressure also produced measurable brain
responses in areas that process the sensation of pain," says Clauw. "But
the same kind of brain responses weren't seen in control subjects until
the pressure on their thumb was more than doubled."

Though brain activity increased in many of the same areas in both
patients and control subjects, there were striking differences too.
Patients feeling pain from mild pressure had increased activity in 12
areas of their brains, while the control subjects feeling the same
pressure had activation in only two areas. When the pressure on the
control subjects' thumbs was increased, so did their pain rating and the
number of brain areas activated. But only eight of the areas were the
same as those in patients' brains.

In all, the fibromyalgia patients' brains had both some areas that were
activated in them but not in controls, and some areas that stayed
"quiet" in them but became active in the brains of controls feeling the
same level of pain. This response suggests that patients have enhanced
response to pain in some brain regions, and a diminished response in
others, Clauw says.

The study was supported in part by the National Fibromyalgia Research
Association, the U.S. Army and the NIH. In addition to Clauw and
Gracely, the research team included Frank Petzke, M.D.; and Julie M.
Wolf, BA.

http://www.med.umich.edu/
(c) copyright 2002 University of Michigan Health System

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Editor's Note: And then sometimes the pain IS in our head!


Fibromyalgia, fatigue, and headache disorders.
Curr Neurol Neurosci Rep. 2003 Mar;3(2):97-103.
Peres MF.

Sao Paulo Headache Center, Al. Joaquim Eugenio de Lima, 881 cj708/709,
Sao Paulo, Brazil.

Fibromyalgia, chronic fatigue, and primary headaches are common and
debilitating disorders, and their related symptoms of widespread pain,
fatigue, and headache have complex interactions and different
implications for classification, diagnosis, mechanisms, and treatment.
The "continuum" or "spectrum" idea and the modular headache theory are
fundamental concepts in understanding these interactions. The overlap
between symptom-based conditions leads the reasons to consider them as
"functional somatic syndromes." Management of these patients includes a
correct diagnosis, appropriate investigation for associated conditions,
adequate treatment, and considering the therapeutic opportunities and
limitations the comorbid disorders may impose.

PMID: 12583836 [PubMed - indexed for MEDLINE]

Co-Cure Web Site: http://www.co-cure.org/
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Neurol Sci. 2003 May;24 Suppl 2:S94-6.

Neurobiology of chronic migraine.

Moschiano F, D'Amico D, Schieroni F, Bussone G.
L. Mandic Hospital, Via L. Mandic 1, Merate (LC), Italy.

Chronic daily headache (CDH) is an important problem for clinicians. It
is frequent in tertiary care structures, although at present there is no
clear consensus about definitions and operational criteria. In fact,
CDH is a group of headache disorders that includes chronic migraine
(CM). CDH usually evolves from an episodic headache form, which was
migraine in most cases. Several psychopathological factors (e.g.
psychiatric comorbidity, personality traits or stressful life events)
and some somatic disorders (e.g. like arterial hypertension, allergic
condition, sleep disturbances) are frequent in CM patients. Caffeine
consumption, alcohol overuse and medication overuse (abortive drugs for
migraine) could favour chronicity. The possible role of these factors
remains poorly understood. Prospective studies and research about the
pathophysiology of chronic pain will lead to a better understanding of
CM.

PMID: 12811602 [PubMed - in process]
Co-Cure Web Site: http://www.co-cure.org/
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Pain sensitivity in pericranial and extracranial regions.
Cephalalgia. 2003 Jul;23(6):456-62.
Ashina S, Jensen R, Bendtsen L.

Department of Neurology and Danish Headache Centre, Glostrup Hospital,
University of Copenhagen, Glostrup, Copenhagen, Denmark.



Chronic myofascial pain is very common in the general population. The
pain is most frequently located in the shoulder and neck regions, and
nociceptive input from these regions may play an important role for
tension-type headache. The mechanisms leading to the frequent occurrence
of muscle pain in the shoulder and neck regions are largely unknown. It
is possible that the pain is caused by increased sensitivity of muscle
nociceptors or by central sensitization induced by nociceptive input
from muscle. The primary aim of the present study was to compare muscle
pain sensitivity in the trapezius and anterior tibial muscles. The
secondary aim was to investigate whether temporal summation, a clinical
correlate of wind-up, is more pronounced in muscle than in skin and, if
so, whether such a difference is more pronounced in the trapezius than
in the anterior tibial region.

Sixteen healthy subjects were included. Pressure-pain thresholds and
electrical cutaneous and intramuscular pain thresholds were measured at
standard anatomical points in the trapezius and anterior tibial regions.
Temporal summation was assessed by repetitive electrical stimulation.

Pressure-pain thresholds (P = 0.005) and intramuscular electrical pain
thresholds (P = 0.006) were significantly lower in trapezius than in
anterior tibial muscle. Temporal summation was present in skin and
muscle of both regions (P < 0.001). The degree of temporal summation was
significantly higher in muscle than in skin in the trapezius region (P =
0.02), but not in the anterior tibial region (P = 0.47).

In conclusion, we found that muscle pain sensitivity was higher in the
trapezius than in the anterior tibial muscle. We also demonstrated that
temporal summation could be induced in both muscle and skin and,
importantly, that temporal summation was significantly more pronounced
in muscle than in skin in the trapezius but not in the anterior tibial
region. These data may help to explain why chronic muscle pain most
frequently is located in the shoulder and neck regions.
PMID: 12807525
Co-Cure Web Site: http://www.co-cure.org/
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Sleep Dysfunction in CFS
By Richard Podell, MD, MPH

Many patients with chronic fatigue syndrome (CFS) feel sleepy as well as
tired. Whether or not they have difficulty falling asleep (sleep onset
insomnia) or difficulty staying asleep (sleep maintenance insomnia),
most CFS patients feel that their sleep is not refreshing. They wake up
in the morning feeling as if they haven't really rested.

Improving sleep is a realistic goal. As clinicians know, this is often a
complex and difficult task. Even modest improvement in sleep can have
important positive effects on the patient's sense of well-being.

Read this article at
http://www.cfids.org/archives/2002rr/2002-rr4-article01.asp

[AOL: <a
href="http://www.cfids.org/archives/2002rr/2002-rr4-article01.asp">Read
It here</a>]
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Fibromyalgia: an overview.
Curr Psychiatry Rep 2003 Jul;5(3):211-7
Thompson D, Lettich L, Takeshita J.

*Department of Psychiatry, Queen's Medical Center, John A. Burns School
of Medicine, 1356 Lusitana Street, Fourth Floor, Honolulu, HI 96813,
USA. ditho-@queens.org

In this article, the authors review current concepts in fibromyalgia.
Findings regarding diagnosis, prevalence, comorbidities, and potential
pathophysiologic links are discussed. Although fibromyalgia continues to
be a complex disorder, there are specific criteria one must meet.
Fibromyalgia questionnaires, along with commonalities of age, gender,
menopause status, sleep disturbances, and mood symptoms, may aid in the
diagnosis. Additionally, the close relationship between fibromyalgia and
other chronic disorders should alert the physician to explore for
comorbid illness. The relationship between fibromyalgia and irritable
bowel syndrome, migraine headaches, and obesity are addressed. The roles
of the hypothalamic-pituitary-axis, potential effects of
neurotransmitters, and gender-specific hormones all substantiate this
diagnosis and provide clues to causality, as well as venues for future
treatment.

PMID: 12773275 [PubMed - in process]
Co-Cure Web Site: http://www.co-cure.org/
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Effects of Tea on The Immune System
Looking at how tea effects the immune system is a relatively new idea,
with little study so far. But it's looking promising, nonetheless.
The chemistry involved is somewhat complicated for me to explain here,
but there is a compound in tea (L-theanine) that reacts in the liver to
create another chemical that is involved in the production of T-cells.
T-cells are a large part of our bodies response mechanism to bacterial
infection. Both black and green tea contain L-theanine.
Drinking approximately 5 cups of tea per day would markedly improve your
bodies response to disease.

http://coffeetea.about.com/library/health/blh_immune.htm
*Editor's disclaimer: Okay I admit it. I keep looking for reasons to not
give up daily iced tea.
That's one of my habits that I am holding onto.
******************************************************************
Physical Effort Does Not Automatically Lead to Worsening of Fibromyalgia
Symptoms
06-20-2003
Source: American Physiological Society (APS)
New Orleans, LA -- Fibromyalgia (FM) is a syndrome characterized by
chronic widespread musculoskeletal pain, with maladaptive responses to
food and the environment. The underlying cause is still unknown for this
disorder that affects approximately four million Americans.
Recent research has examined the altered function of the sympathetic
nervous system (SNS) as part of the cause for this disorder. However,
conflicting opinions of the SNS role exists because studies have found
SNS hyperactivity and reduced activity in these patients. What is
consistent in these studies is that the SNS responses of subjects with
fibromyalgia undertaken during exercise indicated a blunted response.
Read this article at
http://www.immunesupport.com/library/showarticle.cfm/id/4700
[AOL:<ahref="http://www.immunesupport.com/library/showarticle.cfm/id/470
0">
Read it here</a>]
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The Candida Connection
Could Irritable Bowel Syndrome and Candida Overgrowth be Related?

What is Candida?
The overgrowth of candida, a type of yeast, in the body is called
candidiasis. Candidiasis in the mouth is called oral thrush, which is
more common among children than adults. Diaper rash in babies can be
caused by candida. yeast infections common to women are vaginal yeast
infections.
Growth of candida in the digestive tract is a highly controversial
subject, and is not generally accepted by the medical community. It has
been suggested that some incidence of Irritable Bowel Syndrome (IBS)
could be caused by candidiasis. There are physicians that do treat
candidiasis, and there are personal accounts of people who have
benefited from treatment for candidiasis.

What Causes Candidiasis?
There are a variety of theories on how candidiasis can occur. Some of
the culprits are listed below.
Oral antibiotics kill off the "good" bacteria in the intestine, which
allows candida to proliferate.
Diets high in sugars.
Use of oral contraceptives, steroids, antacids, and anti-ulcer
medications.
Having a repressed immune system due to medication or disease.
Diabetes.
Chemotherapy.
Multiple pregnancies.
Symptoms of Candidiasis
There are many symptoms of candida overgrowth in the intestinal tract.
These include:
Allergies and allergy symptoms, chemical sensitivities.
Anxiety, Hyperactivity, Attention Deficit Disorder.
Avoiding food helps to alleviate symptoms.
Chronic inflammation and irritation of the eye and conjunctivae.
Diarrhea, chronic gas, and abdominal cramps alleviated by bowel
movements, Irritable Bowel Syndrome.
Extreme lethargy.
Eye fatigue.
Facial rash.
Frequent urination.
Frequent yeast infections in women.
High sugar or mold foods drastically increase symptoms.
Hives.
Inflammation of the hair follicles (candidiasis folliculitis) of various
parts of the body (feet, legs, arms).
Lactose intolerance.
Muscle weakness and bone pain.
Obsessive Compulsive Disorder.
Panic attacks.
Psoriasis/seborrheic dermatitis/dandruff, dry, itchy skin.
Rectal itching.
Sinus problems.
Swollen lips/face.
Symptoms worse after waking.
White tongue and a white coating.
The article continues at:
http://ibscrohns.about.com/library/weekly/aa110900b.htm
AOL: <a href= "http://ibscrohns.about.com/library/weekly/aa110900b.htm">

Read it here </a>
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*****

Probiotics Significantly Reduce Symptoms of IBS, Ulcerative Colitis
Martha Kerr
May 21, 2003 (Orlando) - Probiotic therapy, primarily in the form of
Lactobacillus acidophilus and Bifidobacteria infantis, significantly
improves symptoms and quality of life in patients with irritable bowel
syndrome (IBS) and other bowel disorders, researchers reported in a
number of presentations here at Digestive Disease Week 2003.
In a study designed to assess the efficacy of probiotics alone or in
combination with antibiotics in patients with IBS, Stephen M. Faber, MD,
from Albemarle Gastroenterology Associates, PC, in Elizabeth City, North
Carolina, evaluated treatment in 44 patients with IBS. Twenty patients
received probiotics alone and 24 received ciprofloxacin 500 mg twice
daily for one week and two probiotic formulations, Lactobacillus (NCFM)
10 billion/g and Bifidobacteia infantis (Bifdo), 10 billion/g for four
weeks.
Patients completed the IBS-Quality of Life (IBS-QOL) questionnaire and
the Symptom Frequency Index (SFI) before and after treatment. For the
study group as a whole, IBS-QOL scores averaged 66.2 before treatment
and 84.6 after treatment. SFI scores before treatment averaged 38,
decreasing to 18 after treatment. In patients who received both
probiotics and antibiotics, IBS-QOL scores averaged 67.6 before and 87.8
after treatment. SFI scores averaged 35 at baseline, decreasing to 18
after treatment. In the probiotic-only group, baseline IBS-QOL scores
were 69.3, increasing to 86.4 after treatment. SFI scores were 39 at
baseline and 17 after treatment.
Differences in IBS-QOL and SFI scores between probiotic plus antibiotic
treatment and probiotic-only treatment were statistically insignificant,
Dr. Faber reported. A retrospective look at IBS patients treated with
probiotics indicates that there is a deficiency of Lactobacillus in the
gut flora in patients with IBS, Dr. Faber noted, "but we're not ready to
call IBS an infectious disease." Probiotic therapy also improved
symptoms of ulcerative colitis (UC) in a separate study presented by
Richard N. Fedorak, MD, professor of medicine and director of the
division of gastroenterology at the University of Alberta in Edmonton,
Canada. In a safety and efficacy study of the probiotic formulation VSL3
(VSL Pharmaceuticals, Inc., Ft. Lauderdale, FL), which contains eight
lactic acid bacterial species, Dr. Fedorak and colleagues evaluated 30
patients with active mild-to-moderate UC with recent flares. Patients
continued with previous treatment that included mesalamine,
corticosteroids, and/or azathiaprine, as long as the treatment regimen
was stable prior to the study. Patients took two VSL3 sachets twice a
day for six weeks. Ulcerative Colitis Clinical Scores were measured and
sigmoidoscopy performed at baseline and after the six-week treatment
period. Dr. Fedorak reported that remission occurred in 63% (19
patients) and there was a clinical response in an additional 23% (seven
patients). There was no response in 13% (four patients). Worsening of
symptoms occurred in one patient. Dr. Fedorak said that probiotic
therapy was not associated with any adverse clinical or biochemical
events. "I haven't heard of getting into trouble with probiotics," Dr.
Faber told Medscape. "These are organisms that are supposed to be in the
gut. The body knows how to control them, so it doesn't seem that you can
overtreat." While probiotics have been recognized as beneficial
components of food, Dr. Fedorak pointed out that "we don't use it as a
food product anymore but as a treatment. "Infantile diarrhea can be
shortened by about a day from the usual three- to four-day course. That
is very important in infants. Probiotics are effective with rotavirus
symptoms, with antibiotic-induced diarrhea, in pseudomembranous colitis,
and perhaps in radiation-induced diarrhea," he said. But Dr. Fedorak
cautioned that "we don't know how they work. They appear to strengthen
the mucosal barrier of the bowel and improve immune function. And we
don't know which probiotics to use or in what combination." DDW 2003:
Abstract M1582, presented May 19, 20003; Abstract W1523, presented May
21, 2003. Reviewed by Gary D. Vogin, MD
Medscape Medical News 2003. C 2003 Medscape
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*****

Thyroid, Cholesterol Are Linked
By Judy Foreman, Globe Staff, 03/14/00
Most Americans know by now that eating a diet high in saturated fat can
raise cholesterol, a major risk factor for heart disease, which kills
nearly 500,000 people a year and is the leading cause of death for both
men and women.
But what many people don't know is that an underactive thyroid - the
butterfly-shaped gland in the neck that produces a crucial hormone that
regulates metabolism - may also contribute to high cholesterol.
When thyroid hormone levels are too low, the liver makes fewer molecules
called LDL receptors, whose job is to pull LDL, or "bad" cholesterol out
of the blood. The result is an increase in cholesterol levels. A low
thyroid level can also mean high levels of triglycerides - fatty acids
that also contribute to heart disease.
Some data suggest that only 5 percent of people with high cholesterol
have an underactive thyroid but several studies put the figure as high
as 14 percent, said Dr. Lewis Braverman, chief of the endocrine,
diabetes and nutrition section at Boston Medical Center. An underactive
thyroid is easily treatable with supplemental thyroid hormone, and when
it is, cholesterol levels often return to normal.
But, while doctors routinely screen for cholesterol, many don't do
simple blood tests for thyroid levels, even when an elevated cholesterol
level should be a signal to do so. Nearly 100 million Americans have
cholesterol levels that are either high (240 milligrams per deciliter
and up) or borderline (200 to 239 mg per dl), according to the American
Heart Association.
There's a strong economic argument for being more aggressive about
detecting and treating potential thyroid problems in people with
elevated cholesterol. Thyroid drugs such as Synthroid or Levoxyl cost
less than $100 a year. By contrast, the class of cholesterol-lowering
drugs called "statins," which includes Mevacor and Pravachol, can cost
many times that.
But there's an even more compelling medical argument. Better detection
and treatment of hypothyroidism, or underactive thyroid gland, could not
only lower cholesterol and thereby reduce the risk of future heart
disease, but make millions of people feel better.
An estimated 13 million Americans, many of them women over 50, suffer
from hypothyroidism, though many don't know it because symptoms can be
mild at first and are often chalked up to aging or "the blues." The
symptoms include fatigue, forgetfulness, depression, chilliness, weight
gain, and goiter (an enlarged thyroid gland), as well as elevated
cholesterol.
Another 2 million Americans, many of them women aged 20 to 40, have the
opposite problem - an overactive thyroid gland, which causes
nervousness, weight loss, intolerance to heat and goiter.
Both hypothyroidism and hyperthyroidism can result from a misguided
attack by the body's immune cells and antibodies on the thyroid gland -
in the first case, inhibiting or destroying the gland; in the second,
forcing it into high gear.
Testing for thyroid problems is fairly straightforward - a blood test
for TSH, or thyroid stimulating hormone, which is made by the pituitary
gland. When the pituitary gland senses that the body is not making
enough thyroid hormone, TSH levels rise, signaling the thyroid gland to
make more.
If a TSH test comes back abnormal, the doctor usually does another test
for blood levels of thyroid hormone itself. If TSH is high and thyroid
hormone levels are low, it's a clear sign that supplemental hormones are
needed to get things back in balance. A person also clearly needs
treatment if the reverse is true - low TSH and high thyroid levels.
But many people, especially those with "subclinical" hypothyroidism,
have more ambiguous test results - typically an elevated TSH but normal
levels of thyroid hormone itself. Some doctors advise treating this form
of mild disease, while others hold off, arguing that when the disease is
still too mild to cause symptoms, treatment may not help.
If your cholesterol is high, ask your doctor for a thyroid test if he or
she hasn't suggested it already.
You may have to fight for the thyroid test, though, because some
insurers balk at paying for routine thyroid screening, noted Dr. Richard
A. Dickey, an endocrinologist at Wake Foreest University in
Winston-Salem, N.C, and president of the American Association of
Clinical Endocrinologists.
Still, it's important to find out because doctors need to "eliminate
secondary causes of high cholesterol, which include low thyroid
function," says Dr. David Gordon, a heart researcher at the National
Heart, Lung and Blood Institute.
It also works the other way around, said Dr. Peter Wilson, an
endocrinologist at the Framingham Heart Study. If you are tested for
thyroid function and that is low, ask to be tested for cholesterol, too.
http://www.boston.com/globe/columns/foreman/archive/031400.htm

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****
Fear of pain, physical performance,and attentional processes in patients
with fibromyalgia
Pain. 2003 Jul;104(1-2):121-30.
de Gier M, Peters ML, Vlaeyen JW.
Department of Medical, Clinical and Experimental Psychology, Maastricht
University, P.O. Box 616, 6200 MD, Maastricht, The Netherlands
PMID: 12855321

Patients with fibromyalgia often present with increased levels of
disability and physical functioning, for which the determinants are
still unclear. In patients with other musculoskeletal pain syndromes,
such as chronic low back pain, physical performance and disability
levels are shown to be strongly associated with pain-related fear, and
even stronger than pain severity. The present study was aimed at
examining the role of pain-related fear and attentional processes on
tolerance for physical activity in fibromyalgia patients.
High and low fearful fibromyalgia patients (N=81) were requested to
perform a physical task, a cognitive (reaction time) task, and a dual
task in which the physical and cognitive tasks were combined. It was
hypothesized that high fearful patients would terminate the physical
performance task sooner than low fearful patients, and would show a
greater disruption on the cognitive task. In addition, it was expected
that when distracted in the dual task, high fearful patients would show
improved performance on the physical task after a fear reduction
instruction.
The results showed that pain itself was a greater predictor of activity
tolerance than pain-related fear, but that pain-related fear was the
stronger predictor of reaction times on the cognitive task. Also, all
groups showed equal improvement in physical performance in the dual
task.
The findings suggest that baseline pain acts as an occasion setter which
determines the level of physical activity the patient is willing to
perform, regardless of pain increase and threat-reducing instructions.
Co-Cure Web Site: http://www.co-cure.org/
************************************************************************
***

Complementary and alternative medicine in fibromyalgia and related
syndromes.
Best Pract Res Clin Rheumatol. 2003 Aug;17(4):667-83.
Holdcraft LC, Assefi N, Buchwald D.
Department of Psychiatry and Behavioral Sciences, Harborview Medical
Center, University of Washington School of Medicine, Box 359797, 325
Ninth Ave, 98104-2499, Seattle, WA, USA
PMID: 12849718

Complementary and alternative medicine (CAM) has gained increasing
popularity, particularly among individuals with fibromyalgia syndrome
(FMS) for which traditional medicine has generally been ineffective.
A systematic review of randomized controlled trials (RCTs) and non-RCTs
on CAM studies for FMS was conducted to evaluate the empirical evidence
for their effectiveness. Few RCTs achieved high scores on the CONSORT, a
standardized evaluation of the quality of methodology reporting.
Acupuncture, some herbal and nutritional supplements (magnesium, SAMe)
and massage therapy have the best evidence for effectiveness with FMS.
Other CAM therapies have either been evaluated in only one RCT with
positive results (Chlorella, biofeedback, relaxation), in multiple RCTs
with mixed results (magnet therapies), or have positive results from
studies with methodological flaws (homeopathy, botanical oils,
balneotherapy, anthocyanidins, dietary modifications).
Lastly, other CAM therapies have neither well-designed studies nor
positive results and are not currently recommended for FMS treatment
(chiropractic care).
Co-Cure Web Site: http://www.co-cure.org/
*************************************************
WHAT IS COMPLEMENTARY MEDICINE?
http://bmj.com/cgi/content/full/319/7211/693
This article is a little dated (1999) but it gives a good run down of
defining complementary medicine
************************************************************

Pitt Researchers Single Out Genes for Major Depression
Genes Implicated in Mood Disorders and Shorter Lifespan


PITTSBURGH, July 2 /PRNewswire/ -- Researchers at the University of
Pittsburgh have completed the first survey of the entire human genome
for genes that affect the susceptibility of individuals to developing
clinical depression.

George S. Zubenko, M.D., Ph.D., professor of psychiatry at the
University of Pittsburgh School of Medicine and adjunct professor of
biological sciences at Carnegie Mellon University and his team have
located a number of chromosomal regions they say hold the genetic keys
to a variety of mental illnesses, including major depression and certain
addictions. The survey was done in 81 families identified by individuals
with recurrent, early-onset, major depressive disorder (RE-MDD), a
severe form of depression that runs in families. The Pitt team's
findings are published today in the American Journal of Medical
Genetics.

Finding the genetic roots of depression is important for many reasons.
Depression is the second-leading cause of disability worldwide,
affecting nearly 10 percent of the population. And while scientists have
made significant progress developing new drugs to treat it, studies that
identify specific risk genes may lead to even more effective drugs
designed to target depression in specific individuals.

Twin studies have demonstrated that genetic factors typically account
for 40 to 70 percent of the risk for developing major depression, but
finding those genes has proven to be a challenge because, as in most
diseases, there are likely numerous genes involved and only individuals
with certain combinations of those genes develop the disorder.

Of equal interest is a secondary finding that - longevity in the
families who carry these genes is significantly reduced.

The survey revealed 19 loci -- small regions on chromosomes where genes
reside -- that appear to influence susceptibility to depressive
disorders. The results extended the investigators' previous finding that
a small region of chromosome 2q containing the CREB1 gene affects the
vulnerability of women to developing depression. And at least some of
the 19 depression vulnerability loci appear to work in concert to affect
a person's risk of developing depression. According to Dr. Zubenko,
"Greater scrutiny of the chromosome 2 locus has provided stronger
evidence for the role of CREB1 as a risk gene for depressive disorders
among women. In addition, five of the new genetic loci appear to
interact with the CREB1 region to affect the risk of developing clinical
depression in these families.

"Women are twice as likely as men to develop depression, and genetic
differences appear to account for some of that disparity," said Dr.
Zubenko. Sex-specific loci were common and preferentially affected the
vulnerability of women to developing unipolar mood disorders. Evidence
of at least one male-specific risk locus also was found. The
sex-specific effects of particular risk genes for depression may result
from the interactions of these genes and their products with sex
hormones.

These findings suggest there are important differences in the molecular
pathophysiology of mood disorders in men and women, or in the mechanisms
that determine resistance to stressful stimuli. They may also help
explain the vulnerability of women to depression during times of
significant hormonal fluctuation including puberty, menstrual cycling,
pregnancy and childbirth and menopause. Conversely, age-related
reductions in hormone levels may contribute to a reduced proportion of
familial cases of depression among depressions that arise later in life.

CREB1 is a gene that encodes a regulatory protein called CREB that
orchestrates the expression of programs of other genes that play
important roles in the brain and the rest of the body. The widespread
importance of CREB as a genetic regulator may influence the development
of additional psychiatric disorders related to depression, such as
alcoholism and other addictions, as well as medical conditions outside
of the nervous system that are associated with depression. For example,
three of the new linkage regions affected the risk of developing a
spectrum of depressive disorders including alcohol and other substance
use disorders.

Remarkably, deceased members of the 81 families died at an age eight
years younger than the general population and over 40 percent died
before the age of 65. This difference in mortality was spread across the
lifespan, including a five-fold increase in the proportion of children
who died in the first year of life and several-fold increases in deaths
by suicide, homicide and liver disease. However, most premature deaths
occurred from "natural causes" including heart disease, cancer and
stroke. "Tracking down the risk genes in these regions is an obvious
priority, and we expect that the research will connect clinical
depression and other medical disorders at their most fundamental
levels," said Dr. Zubenko.

Information provided by the Human Genome Project is enabling the
investigators to make important progress toward this goal. In 18 of the
19 newly identified genetic regions, the authors found candidate genes
that participate in cell signaling pathways that converge on CREB. These
observations provide an important new perspective on the biology of
depression and its treatments that focuses on cell signaling pathways
rather than particular neurotransmitters.

"The identification and characterization of susceptibility genes and
their products will provide new opportunities for drug development and
disease prevention, new information about the biology of mood and its
regulation, and new insights into the interactions of mental illness and
the human life span," said Dr. Zubenko. "Genotyping markers in
chromosomal regions that harbor susceptibility genes may provide more
immediate advances in the treatment of major depression. For example,
individuals with particular genetic markers in these regions may respond
better to particular current treatments than others. This strategy may
enable clinicians to use genetic markers to better match individual
patients to treatments to which they will optimally respond, while
minimizing side effects."

Other researchers involved in this study include: Brion S. Maher, Ph.D.;
Hugh B. Hughes III, M.S.; Wendy N. Zubenko, Ed.D., M.S.N.; J. Scott
Stiffler, B.S.; Barry B. Kaplan, Ph.D.; and Mary L. Marazita, Ph.D.

The study received funding from the National Institute of Mental Health.
Web site: http://www.zubenkolab.pitt.edu
http://www.prnewswire.com
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***

CORAL CALCIUM WARNING
ConsumerLab.com reported that 20% of the calcium supplements it recently
evaluated failed testing. One of those that failed is the much hyped
Coral Calcium "Supreme" which, coincidentally, was also the subject of
government action today for false advertising. Reasons for products
failing the Calcium Review included excessive lead, too little calcium,
and inability to fully break down (needed for absorption).
Calcium is one of the most popular supplements because it helps maintain
bone density, may reduce the risk of colorectal cancer, and may also
reduce PMS symptoms.
The review can be found at
http://www.consumerlab.com/results/calcium.asp
and includes results for 25 calcium products, including fifteen reviewed
and ten others that recently passed the same evaluation through CL's
Voluntary Certification Program.
A news release is available at
http://www.consumerlab.com/news/news_061003.asp
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****
Highlights From the 22nd Annual Scientific Meeting of the American Pain
Society March 20-23, 2003; Chicago, Illinois
http://www.medscape.com/viewarticle/455374
There are some interesting reports there on pain treatments including
information on pregabalin and fibromyalgia
************************************************************************
*****


Reflex Sympathetic Dystrophy/Complex Regional Pain Syndrome Fact Sheet

Table of Contents
What is reflex sympathetic dystrophy/complex regional pain syndrome?
What are the symptoms of RSD/CRPS?
What causes RSD/CRPS?
Who gets it?
How is RSD/CRPS diagnosed?
What is the prognosis?
What is the treatment?
Are there any other disorders like RSD/CRPS?
What research is being done?
Is help available?

What is reflex sympathetic dystrophy/complex regional pain syndrome?
RSD/CRPS is a chronic condition characterized by severe burning pain,
pathological changes in bone and skin, excessive sweating, tissue
swelling, and extreme sensitivity to touch. The syndrome is a nerve
disorder that occurs at the site of an injury (most often to the arms or
legs). It occurs especially after injuries from high-velocity impacts
such as those from bullets or shrapnel. However, it may occur without
apparent injury.
The condition called "causalgia" was first documented in the 19th
century by physicians concerned about pain that Civil War veterans
continued to experience after their wounds had healed. Doctors often
called it "hot pain," after its primary symptom. Over the years, the
syndrome was classified as one of the peripheral neuropathies, and
later, as a chronic pain syndrome. Currently, there are two types of
CRPS that are differentiated-type I and type II. Both types share the
same basic set of symptoms, but have one distinct difference: type I
(previously referred to as RSD) describes cases in which there is no
nerve injury, while type II (formerly called causalgia) refers to cases
in which a distinct nerve injury, for example from a gunshot wound, has
occurred

What are the symptoms of RSD/CRPS?
The symptoms of RSD/CRPS usually occur near the site of an injury,
either major or minor, and include: burning pain, muscle spasms, local
swelling, increased sweating, softening of bones, joint tenderness or
stiffness, restricted or painful movement, and changes in the nails and
skin. One visible sign of RSD/CRPS near the site of injury is warm,
shiny red skin that later becomes cool and bluish.
The pain that patients report is out of proportion to the severity of
the injury and gets worse, rather than better, over time. It is
frequently characterized as a burning, aching, searing pain, which may
initially be localized to the site of injury or the area covered by an
injured nerve but spreads over time, often involving an entire limb. It
can sometimes even involve the opposite extremity. Pain is continuous
and may be heightened by emotional stress. Moving or touching the limb
is often intolerable. Eventually the joints become stiff from disuse,
and the skin, muscles, and bone atrophy.
The symptoms of RSD/CRPS vary in severity and duration. However, there
are usually three stages associated with RSD/CRPS, and each stage is
marked by progressive changes in the skin, nails, muscles, joints,
ligaments, and bones. Stage one lasts from 1 to 3 months and is
characterized by severe, burning pain at the site of the injury. Muscle
spasm, joint stiffness, restricted mobility, rapid hair and nail growth,
and vasospasm (a constriction of the blood vessels) that affects color
and temperature of the skin can also occur.
In stage two, which lasts from 3 to 6 months, the pain intensifies.
Swelling spreads, hair growth diminishes, nails become cracked, brittle,
grooved, and spotty, osteoporosis becomes severe and diffuse, joints
thicken, and muscles atrophy.
As the patient reaches stage three, changes in the skin and bones become
irreversible, and pain becomes unyielding and may now involve the entire
limb. There is marked muscle atrophy, severely limited mobility of the
affected area, and flexor tendon contractions (contractions of the
muscles and tendons that flex the joints). Occasionally the limb is
displaced from its normal position, and marked bone softening is more
dispersed.
The rest of the fact sheet can be found at:
http://www.ninds.nih.gov/health_and_medical/pubs/rsds_fact_sheet.htm?
format=printable
AOL: <a
href="http://www.ninds.nih.gov/health_and_medical/pubs/rsds_fact_sheet.h
tm?format=printable"> Read it here </a>
***************************************************************

LIFESTYLE CHANGES
According to the renowned CFS & FM physician Charles Lapp, M.D., "I can
never emphasize enough that taking periodic rest breaks, limiting
activities, and maintaining low level aerobic activities is the very
most important treatment for both CFS and FM. Unfortunately, many
sufferers are unwilling to accept these drastic lifestyle changes.
There is no drug, no potion, no supplement, herb or diet that even
competes with lifestyle change for the treatment of CFS or FM. The next
most important step is to minimize stress, optimize your support
systems, and to maintain a positive attitude despite adversity. I have
never seen a study that proves these points, but I can assure you from
experience that pushing and crashing, denial, depression, and a negative
attitude are all formulas for disaster, and I have never seen a patient
who practiced them and yet recovered.
Drugs, supplements, and alternative therapies are only supportive and
symptomatic treatments that make the path toward recovery more bearable.
But they do make it more bearable for most."
(Source: Pro Health's Healthwatch Treatment Guide 2002. Online at
http://www.immunesupport.com/healthwatch/.)


********************************************************************
The Fibromite Prayer
By Karen Griffin
Lord, please guide us and keep us sane
Sometimes we just can't deal with the pain
Nobody knows how crazy this feels
Until they've walked a mile in our heels
From day to day it's always something new
Lord help us figure out what to do
No one understands, they think we just want to complain
OH, how I wish we were our old selves again
But those days were the good days, glad they were mine
Now the future is a challenge every second in time
Lord I know we all have our crosses to bear
Please help us figure out how to get there
Maybe, Lord, you'll send us a miracle one day
Thanks for special people you send our way
Although a lot of doctors don't understand
Blessed are those who try to give us a hand
It's just up to us to learn how to survive this ordeal
Please give us the strength, the power and good will
All we can do is believe and pray
And try to make it just one more day
Hopefully it will be better than the last
All Fibromites belong to the same class
We promise to stand by each other's side
To give a shoulder to lean on when someone else cries
It's very important to have friends and support
Especially the ones who have been there before
It's very exhausting to make sense of it all
Sometimes we feel like we're just going to fall
We need a lot of love, hugs and smiles
Just to make our lives a little more worthwhile
Give us the energy we just can't find
We all know it's not "just in our minds"
Lord, help us Fibromites, we pray
Give us the strength to make it just one more day.

 

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