October 12, 2003



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October 12, 2003

2123 subscribers and 7 new subscribers.
Welcome aboard new subscribers!
Editor: Mary McKennell
Editor’s Corner:

The tune from “Mad Max” has been going through my head lately. Actually
only a couple of lines keep going through my head and they are the ones
that say, “there is life beyond Thunder Dome”. You will have to be a
sci-fi aficionado to really understand my reference. It started going
through my head when I was sitting in a committee meeting at work and
people were revealing a bad case of tunnel vision. I wanted to
interrupt and say, “There is life beyond Thunder dome!” But I am
already seen as somewhat eccentric and did not want to add to that
notion, so I sat quietly fretting about them not seeing the larger
picture, humming to myself.

You may be wondering where I am going with this and what any of this has
to do with the current newsletter. Another version of that song began
going through my head a few days after that, ‘There is life beyond Fibro
dome”. And I want to address a piece of that life beyond the “Dome”
here. Many of us are dealing with parents who are aging and in addition
to our own illness we are faced with making decisions about parent care.
Do not underestimate the amount of stress that this segment of your
life is causing you and how it effects your own health! Regardless of
whether you are physically caring for a parent, doing long distance
caregiving or providing oversight of caregiving it will all take a toll
on you.

In my life outside of “Fibro Dome” I am a geriatric social worker. I
spend my professional life assessing nursing homes and assisted living
sites in the community and managing a contract nursing home program at a
V.A. Medical Center. I also spend a lot of my time talking with

I am also a caregiver. Presently my mother is in a nursing home. I was
not able to continue caring for her in my home with her advancing
dementia, work full time, manage my health problems and maintian my
sanity. Several of those areas began to unravel before I made the
emotional and rational decision to place her.

I would like to pass on some resources to others who are dealing with
this issue of parent care. I have used these resources for both my
personal situation as well as the clients that I work with. This is
just the tip of the iceberg for information, but represent some of the
better web sites that I have in my collection.

AgeNet, Inc. operates a comprehensive, national eldercare network to
meet the specific needs of the fast growing aging population and their
adult caregiving children. This eldercare network brings together
suppliers of eldercare products and services with businesses such as
nursing homes, assisted living facilities, home health care providers,
health systems, and organizations or companies with employee assistance

This site offers information on everything that you need to think about
related to elder care. The CareGuide Assessment at this site is
designed to help you quickly locate the most relevant resources and
information about your elder care situation.

The “Elders and Families” section of the Administration on Aging
website. is designed to assist older persons and their caregivers
quickly obtain information and resources on a variety of aging-related
topics. The information will help you become more familiar with issues
affecting older adults, and the services and opportunities available to
assist them.

Caring for a parent with dementia/Alzheimer’s is very wearing. It is
easy to start losing control of your emotions in these situations. This
site offers information on:
How to get an accurate diagnosis for dementia/Alzheimer’s
Behavioral techniques for managing challenging elders
Creative ways to get an obstinate elder to give up driving
Where to find resources to make caregiving less stressful
How to successfully navigate the maze of elder care.
How to recognize when you are losing control of your emotions

FCA's information library currently includes nearly 100 different Fact
Sheets and publications on caregiving issues for families, health and
service providers, program developers and policy makers. We develop and
post new publications on an ongoing basis. Please click the categories
below to reveal the publications within them.

Conversations before the Crisis - A Valuable New Resource for Families
Talking with loved ones about their end-of-life wishes can be made much
easier than we generally think. This very helpful resource from
Partnership for Caring's program, Last Acts, provides concrete examples
and strategies for people who want to initiate these discussions with
their loved ones, but don't know how to start.

Could you use some help beginning this conversation with a family member
or friend? This is a practical resource with useful tips. The guide
suggests "triggers" that can be used to start a conversation and sample
language to further the discussion. The guide also contains additional
resources about care options and planning near the end of life.

Visit this link to download a copy from the Last Acts website:

There's No Perfect Time to Talk About End-of-Life Decisions

Doctors often wait for disease to become severe, or for particular
changes in a patient's clinical condition to occur, before raising
questions about end-of-life wishes. A recent study evaluated whether
sicker patients were more ready and willing to have such discussions
than patients who were not so sick. Investigators explored the attitudes
of patients diagnosed with chronic lung disease. They found that
patients appeared to be no more and no less interested in end-of-life
discussions at a later stage of their disease than in the earlier
stages. In a report published in the Archives of Internal Medicine, the
investigators suggest that improving the communication skills of
physicians, enabling them to make such discussions a routine part of
patient care, will be the most useful approach to ensuring that
end-of-life decision making discussions take place between physicians
and patients. Patients shouldn't be shy about bringing up the subject if
their doctors forget!

State-Specific Assisted Living Oversight Information Now Available

Assisted living has rapidly become an important aspect of elder care in
the United States. It can help elders stay in the community, while
receiving some support, enabling them to maintain their independence
longer, and avoid or delay nursing home placement. This report, prepared
for the National Center for Assisted Living, reviews the regulations
that govern assisted living on a state-by-state basis and provides state
specific contacts for further information. For people considering
assisted living for themselves or a loved one, this report contains very
valuable information for assessing the quality of a facility and the
care it provides.

To view the report, go to

Last Acts On-Line Palliative Care Resource Center

Palliative care refers to the comprehensive management of the physical,
psychological, social, spiritual and existential needs of patients. It
is especially suited to the care of people with incurable, progressive
illnesses. The goal of palliative care is to achieve the best possible
quality of life through relief of suffering, control of symptoms and
restoration of functional capacity while remaining sensitive to
personal, cultural and religious values, beliefs and practices.
Palliative care can make an enormous difference in the quality of life
that patients and their loved ones experience: when they are receiving
curative treatments -- such as Cancer treatments, treatment for chronic
diseases, such as heart disease or Parkinson's disease, or experimental
therapies -- and when they are moving closer to death and no longer
seeking treatment for their disease.

Okay back to Fibro Dome and the rest of this newsletter! There is a
little something for everyone here. I offer the discalimer again that
this newsletter ends with an article with a Christian theme.

Pain has multiple causes and is best managed by using a variety of
strategies. Learn to combat it with the techniques described in this
week's article at the CFIDS/Fibromyalgia Self-Help program website: . The article is the second in a series on
treatment options for the most common symptoms of CFIDS and
fibromyalgia. Other series include: "Success Stories" (personal accounts
of successful coping and recovery), "Ten Keys to Successful Coping" and
"What Works for Managing CFIDS and Fibromyalgia."
The site also contains information about our self-help course and book.

Bruce Campbell, Ph.D., Director

Rosalind Joffe talks about how to simplify decision making regarding
your chronic illness and work in her current newsletter.


Lessons From Author's Illness Bring Voice and Hope to Other Women Facing
Similar Challenges

MUNDELEIN, Ill., Oct. 8 /PRNewswire/ -- Author Rita Glaze's first book
in her inspirational series Lifelines: Stories of Hope(TM) is making its
debut at national booksellers such as Barnes & Noble and Borders.
LifeLines: Stories from Women with Hope, the first in this series, is
written for women facing life-changing illness and the people who love
them. Glaze's motivation for the book was prompted by her own diagnosis,
which is one of the powerful stories she wrote for LifeLines: Stories
from Women with Hope.

The stories in Glaze's book tell of the strength, bravery and courage of
14 women faced with sudden medical challenges. Glaze's writing captures
each woman's voice as she faces her disease and embarks on an emotional
journey of anxiety, fear, relief and healing. The power in these stories
comes with the realization that each journey also brings hope,
fulfillment, and new discoveries. Glaze's book shares the experiences of
women battling breast cancer, depression, leukemia, lupus, melanoma,
multiple sclerosis and other life-changing illnesses. Her message is
simple, yet powerful -- creating a community of connection and support
is vital.

Glaze's diagnosis was a life-changing experience, as it is for so many
others who face an illness in their 20s, 30s and 40s. She was in her
early 30s and on a quick climb up the corporate ladder in the healthcare
industry. The sudden onset of blurred vision, which she first attributed
to prescription contact lenses, led her to the doctor where she was soon
confronted with a diagnosis of multiple sclerosis. She has since chosen
to abandon the corporate track and focus her energies on bringing a new
voice to patients and their families through the LifeLines: Stories of
Hope(TM) Series.

The LifeLines: Stories of Hope(TM) Series ( )
is a six edition series of books published by Intuitive Health, Inc.
providing comfort and connection to patients and their loved ones as
they face life- changing illness. The series will include stories from
men, parents, children, spouses and siblings. For more information or a
copy of the book, please visit or call (312)

SOURCE Intuitive Health, Inc.
Web site:


Understanding Personal Fibromyalgia Symptoms Flare-Up Management
Personal Fibromyalgia as I define it is the unique course of the
fibromyalgia sufferer, with his or her own mix and intensity of
symptoms, as compared to others with FM.
The course of the sufferer is characterized by the remission and
flare-up of symptoms. Remissions of varying degrees can last for any
period of time[days, weeks, months and, yes, even years]. Depression,
interrupted sleep patterns, changes in weather, physical and emotional
stress, and other illnesses, can contribute to a flare-up of personal
fibromyalgia symptoms. We can become very frustrated because many times
we are not able to identify the triggering entity that initiates these
flare-ups, leading to a feeling of lack of control over our health.
It is of vital importance for the fibromyalgia sufferer to feel in
control of these flare-ups. Not doing so can end up developing into a
vicious cycle of depression, anxiety, and hopelessness. Thus the need
for Personal Fibromyalgia Symptoms Flare-Up Management. It is much
better to have a plan ahead of time to deal with flare-ups, so that his
or hers Personal Fibromyalgia Symptoms Flare-Up Management can be
initiated immediately at the onset.

Article continues at


When you have a chronic illness like fibromyalgia or Chronic Fatigue
Syndrome, prioritizing your daily tasks is imperative to prevent pushing
yourself too hard – or not getting the truly important things done. In
her book, “Take Time for Your Life,” personal coach Cheryl Richardson
suggests recording how you spend your time each week. Make a chart and
see where the time actually goes. The things that take the most of your
time are probably your actual priorities, whether you like them or not.
Once you have this information, you can then make a new list of the
things that truly matter to you – the priorities you really want – and
see how to reschedule your time to make room for more of them.
(Source: “The Art of Getting Well: A Five-Step Plan for Maximizing
Health When You Have a Chronic Illness” by David Spero, R.N.)

Prospective Epidemiological Observations on the Course of the Disease in
Fibromyalgia Patients.

J Negat Results Biomed. 2003 Aug 23;2(1):4.

Vera Nöller [1] and Haiko Sprott [2]

[1] Department of Internal Medicine IV, Friedrich Schiller University,
Jena, Germany
[2] Department of Rheumatology and Institute of Physical Medicine,
University Hospital Zurich, Switzerland

PMID: 12969513
OBJECTIVES: The aim of the study was to carry out a survey in patients
with fibromyalgia (FM), to examine their general health status and work
incapacity (disability-pension status), and their views on the
effectiveness of therapy received, over a two-year observation period.

METHODS: 48 patients diagnosed with FM, according to the American
College of Rheumatology (ACR) criteria, took part in the study. At
baseline, and on average two years later, the patients underwent
clinical investigation
(dolorimetry, laboratory diagnostics, medical history taking) and
the Fibromyalgia questionnaire (Dettmer and Chrostek 1).

RESULTS: 27/48 (56%) patients participated in the two-year follow-up. In
general, the patients showed no improvement in their symptoms over the
observation period, regardless of the type of therapy they had received.
General satisfaction with quality of life improved, as did satisfaction
regarding health status and the family situation, although the degree of
pain experienced remain unchanged. In comparison with the initial
examination, there was no change in either work-capacity or
disability-pension status.

CONCLUSIONS: The FM patients showed no improvement in pain, despite the
many various treatments received over the two-year period. The increase
general satisfaction over the observation period was believed to be the
result of patient instruction and education about the disease. To what
extent a population of patients with FM would show similar outcomes if
did not receive any instruction/education about their disorder, cannot
ascertained from the present study; and, indeed, the undertaking of a
to investigate this would be ethically questionable. As present, no
conclusions can be made regarding the influence of therapy on the
and secondary costs associated with FM.

© 2003 Nöller and Sprott; licensee BioMed Central Ltd. This is an Open
Access article: verbatim copying and redistribution of this article are
permitted in all media for any purpose, provided this notice is
along with the article's original URL, [as shown below].

[Note the full text of this article is available free at

AOL: <a href="">Here</a>]

                                       FM AND GENES

Like other rheumatic diseases, fibromyalgia could be the result of a
genetic tendency. When a woman with this tendency is exposed to certain
emotional or physical stressors (like a traumatic crisis or serious
illness), there is a change in her body's response to stress. Scientists
theorize that one of these body changes is a low level of the hormone
CRH (corticotropin-releasing hormone), resulting in higher sensitivity
to pain and more fatigue, including the fatigue one experiences after
This hypersensitivity to pain may in part be from low levels of
serotonin. Lower levels of serotonin cause a lower pain threshold and
disordered sleep. The end result may be the chronic widespread pain of
fibromyalgia. Some studies show that women have approximately seven
times less serotonin in the brain, which may explain why FMS is more
prevalent in women. Abnormal transport of serum tryptophan (a precursor
for serotonin) has also been described in clinical findings.
(Source: The Women's Guide to Ending Pain: An 8-Step Program, by Howard
S. Smith, M.D., and Debra Fulghum Bruce, M.S. Published by John Wiley &
Sons, Inc.)

Efficacy of Meditation and Qigong Movement Therapy in the Treatment of

Objective. To test the short and longterm benefits of an 8 week
mind-body intervention that combined training in mindfulness meditation
with Qigong movement therapy for individuals with fibromyalgia syndrome
Methods. A total of 128 individuals with FM were randomly assigned to
the mind-body training program or an education support group that served
as the control. Outcome measures were pain, disability (Fibromyalgia
Impact Questionnaire), depression, myalgic score (number and severity of
tender points), 6 minute walk time, and coping strategies, which were
assessed at baseline and at 8, 16, and 24 weeks.
Results. Both groups registered statistically significant improvements
across time for the Fibromyalgia Impact Questionnaire, Total Myalgic
Score, Pain, and Depression, and no improvement in the number of feet
traversed in the 6 minute walk. However, there was no difference in
either the rate or magnitude of these changes between the mind-body
training group and the education control group. Salutary changes
occurring by the eighth week (which corresponded to the end of the
mind-body and education control group sessions) were largely maintained
by both groups throughout the 6 month followup period.
Conclusion. While both groups showed improvement on a number of outcome
variables, there was no evidence that the multimodal mind-body
intervention for FM was superior to education and support as a treatment
option. Additional randomized controlled trials are needed before
interventions of this kind can be recommended for treatment of FM. (J
Rheumatol 2003;30:2257-62)
From the California Pacific Medical Center Research Institute, San
Francisco, California, USA.
This study was carried out at the Complementary Medicine Program,
University of Maryland School of Medicine, and funded by a grant from
the National Center for Complementary and Alternative Medicine, National
Institutes of Health (5 P50AT00084-03).
J.A. Astin, PhD, California Pacific Medical Center; B.M. Berman, MD; B.
Bausell, PhD; W-L. Lee, PhD; M. Hochberg, MD, University of Maryland
School of Medicine; K.L. Forys, MA, University of Maryland, Baltimore,
Maryland, USA.


Here are some common-sense pointers that can help you clear the brain
fog of CFS and FM:
1. Repeat yourself. Repeat things to yourself over and over again.
Repetition will keep thoughts fresh in your mind.
2. Write it down. Whether you write in a calendar, in a notebook or on
sticky notes, if you're afraid you won't remember something, putting pen
to paper can help.
3. Pick your best time. If there is something you need to do that
requires concentration and memory, such as balancing your checkbook or
following a recipe, pick your best time to do it. Many people with
fibromyalgia say they perform best early in the day.
4. Get treated. Depression, pain and sleep deprivation can influence
your ability to concentrate and remember. Getting your medical problems
treated may indirectly help your memory.
5. Engage yourself. Reading a book, seeing a play, or working a complex
crossword or jigsaw puzzle can stimulate your brain and your memory.
6. Stay active. Physical activity, in moderation, can increase your
energy and help lift your fibro fog. Speak to your doctor or physical
therapist about an exercise program that is right for you.
7. Explain yourself. Explain your memory difficulties to family members
and close friends. Memory problems often result from stress. Getting a
little understanding from the ones you love may help.
8. Keep it quiet. A radio blasting from the next room, a TV competing
for your attention, or background conversation can distract your
attention from the task at hand. If possible, move to a quiet place and
minimize distractions when you are trying to remember.
9. Go slowly. Sometimes memory problems can result from trying to do too
much in too short a period of time. Break up tasks, and don't take on
more than you can handle at once. Stress and fatigue will only make the
situation worse.
(Source: The Arthritis Foundation at

Does physical therapy improve symptoms of fibromyalgia?


Physical therapy is minimally effective in the treatment of
fibromyalgia, with immediate post-treatment improvement in pain and
tender points, and both short- and longer-term improved self-efficacy
(confidence in performing tasks) (strength of recommendation [SOR]: B, 1
small, high-quality randomized controlled trial, 4 additional small
randomized controlled trials).

Multidisciplinary rehabilitation is probably not effective for this
disorder but warrants future research, as trial quality is poor (SOR: B,
systematic review of 4 small or low-quality and 3 additional randomized
controlled trials on widespread pain conditions).


The goal of physical therapy is to maximize function and reduce
impairment to limit disability in patients with musculoskeletal
conditions.1 Based on a British study, physical therapists most commonly
use exercise, education about correct posture and functional activity,
relaxation, and energy conservation and fatigue management.2 For this
review, physical therapy is defined as a treatment program that includes
patient education and supervised exercise.
The article continues at:


To determine collagen and muscle pathology in fibromyalgia (FM)
patients, muscle biopsies were obtained from 27 female FM patients, and
from eight age-matched female control subjects. Amino acids were
determined by HPLC and electron microscopy was performed. The FM
patients had lower hydroxyproline and lower total concentration of the
major amino acids of collagen than the controls.
No significant difference was seen in the concentration of the major
amino acids of myosin or of total protein. Electron microscopy showed no
significant differences between FM patients and controls although
atrophied muscle fibrils occurred in FM patients only, but frequencies
were not significantly different.
It was concluded that the fibromyalgia patients studied had a
significantly lower amount of intramuscular collagen. This may lower the
threshold for muscle micro-injury and thereby result in non-specific
signs of muscle pathology.
(Source: Rheumatology (Oxford), 2003 Jul 16. Gronemann ST, Ribel-Madsen
S, Bartels EM, Danneskiold-Samsoe B, Bliddal H.)
This tip provided courtesy of


Rupture of Silicone Gel Breast Implants and Symptoms of Pain and Fatigue


Objective. To compare symptoms of women with silicone gel breast
implants and women with chronic fatigue syndrome (CFS), and to study the
effect of rupture of the silicone implant.
Methods. Five hundred readers of the Dutch silicone breast implant
support group magazine were asked to respond if they had been informed
by the surgeon about the silicone implant status at operation, and to
answer questions about symptoms of CFS. Their complaints were compared
with those of 100 female patients with CFS and 40 female controls.
Results. The questionnaires were returned by 319 women. Of these, 227
had symptoms of debilitating chronic fatigue. The patterns of symptoms
differed from those in patients with CFS. An analysis of the relation
between integrity of the implants and the symptoms could be carried out
in 176 women, and 74% of these latter women reported ruptured implants.
Significantly more women with ruptured implants than those with intact
implants had debilitating chronic fatigue (75% vs 51%), postexertional
malaise > 24 h (77% vs 51%), impaired short term memory (58% vs 38%),
and multi-joint pain (77% vs 60%).
Conclusion. Women with silicone breast implants often report severe pain
and chronic fatigue. Rupture of the implant is associated with an
increase in symptoms of pain and chronic fatigue. (J Rheumatol


An open, uncontrolled study was undertaken to measure the subjective
effects of coenzyme Q10 combined with a Ginkgo biloba extract in
volunteer subjects with clinically diagnosed fibromyalgia syndrome.
An open, uncontrolled study was undertaken to measure the subjective
effects of coenzyme Q10 combined with a Ginkgo biloba extract in
volunteer subjects with clinically diagnosed fibromyalgia syndrome.

Anecdotal reports from patients with fibromyalgia syndrome have claimed
benefits from the use of these supplements. The aim of this study was to
determine if these reports could be substantiated in a pilot clinical

<a>CoQ10 and

Changes in religious beliefs following trauma.

Falsetti SA, Resick PA, Davis JL.

University Family Health Center, College of Medicine at Rockford,
University of Illinois at Chicago, Rockford, Illinois, USA.

Information processing theorists propose that traumatic events can lead
to disruptions in the processing of information and to changes in
beliefs. This study examined the relationships among trauma,
posttraumatic stress disorder (PTSD), and religious beliefs.
Participants included 120 individuals from community and clinical
samples who participated in the DSM-IV Field Trial Study on PTSD.
Results indicated that the PTSD group was more likely to report changes
in religious beliefs following the first/only traumatic event, generally
becoming less religious. PTSD status was not related to change in
religious beliefs following the most recent event. Intrinsic religiosity
was related to multiple victimization, but not PTSD. Results are
discussed in terms of understanding the function of religiosity in
participants' lives and future directions for research.

PMID: 12895022 [PubMed - in process]
J Trauma Stress. 2003 Aug;16(4):391-8.

Conventional and magnetization transfer MRI predictors of clinical
multiple sclerosis evolution: a medium-term follow-up study.

Rovaris M, Agosta F, Sormani MP, Inglese M, Martinelli V, Comi G,
Filippi M.

Neuroimaging Research Unit, Department of Neuroscience, Scientific
Institute and University Ospedale San Raffaele, Milan, Italy.

The correlation between conventional MRI lesion load accumulation and
multiple sclerosis clinical evolution is only modest. The assessment of
brain parenchymal volume and of its changes over time may provide
adjunctive MRI markers reflecting the more disabling aspects of multiple
sclerosis pathology. Magnetization transfer (MT) MRI is sensitive to
'occult' multiple sclerosis-related brain damage and might also
contribute to overcome the clinical/MRI paradox. In this study, we
assessed the value of conventional and MT MRI-derived metrics in
predicting the medium-term clinical evolution of patients with different
multiple sclerosis phenotypes. We studied 73 patients, with
relapsing-remitting multiple sclerosis (n = 34), secondary progressive
multiple sclerosis (n = 19) and clinically isolated syndromes suggestive
of multiple sclerosis (n = 20), and 16 healthy subjects. Brain
dual-echo, T1-weighted (only in patients) and MT MRI scans were obtained
at baseline and after 12 months. T2-hyperintense and T1-hypointense
lesion volumes, normalized brain volume and average lesion MT ratio
(MTR) were measured. MTR histograms from the whole brain tissue were
also obtained. Clinical multiple sclerosis evolution and neurological
disability were re-assessed in all patients after a median follow-up of
4.5 years. A multivariate analysis was performed to establish which
clinical and MRI-derived variables were significant predictors of
neurological deterioration at the end of the study period. At the end of
follow-up, 34 patients showed significant neurological deterioration.
The final multivariable model included average brain MTR percentage
change after one year [P = 0.02, odds ratio (OR) = 0.86] and baseline
T2-hyperintense lesion volume (P = 0.04, OR=1.04) as independent
predictors of medium-term disability accumulation (r2 = 0.23). In this
cohort of patients, abnormal values of average brain MTR changes showed
a relatively high specificity (76.9%) and positive predictive value
(59.1%) for Expanded Disability Status Scale score deterioration in
individual cases. In patients with multiple sclerosis, a comprehensive
estimation of the short-term changes of both conventional and MT
MRI-detectable lesion burden might provide useful prognostic information
for the medium-term clinical disease evolution.

PMID: 12937086 [PubMed - in process]
Brain. 2003 Oct;126(Pt 10):2323-32. Epub 2003 Aug 22.
The effectiveness of citalopram for idiopathic chronic fatigue.

Hartz AJ, Bentler SE, Brake KA, Kelly MW.

Department of Family Medicine, University of Iowa College of Medicine,
Iowa City 52242-1097, USA.

BACKGROUND: Chronic fatigue greatly affects quality of life and is a
common reason for physician visits. Patients with chronic fatigue are
often treated with antidepressants. METHOD: Prior to enrollment, all
subjects had substantial fatigue for 6 months or more that was not
explained by depression, organic illness, or lifestyle behaviors.
Patients already taking an antidepressant were excluded from the study.
Two designs were used. (1) Thirty-one subjects were given placebo for 1
week and then citalopram, 20 to 40 mg/day, for 2 months. Statistical
testing evaluated whether fatigue (measured with the Rand Vitality
Index) was reduced after citalopram was started. (2) Fatigue changes for
subjects taking citalopram were compared with fatigue changes after 1
month and 2 months for 76 similar subjects taking an ineffective
treatment. RESULTS: In design 1, fatigue for subjects taking citalopram
was significantly and substantially reduced when subjects were switched
from placebo to citalopram, p <.05. Benefits at 2 months were greatest
for subjects who had fatigue less than 5 years, p <.01, and women, p
<.01. In design 2, fatigue scores for subjects taking citalopram were
not significantly better than the comparison group for all subjects but
were significantly better at 2 months for subjects with less severe
fatigue at baseline, p =.005, and for women, p =.08. Depression scores
were not significantly better for citalopram subjects overall (p >.10)
but were for certain subgroups. For all subjects, citalopram was
associated with greater decrease in headaches and muscle aches at 1
month, p <.01. CONCLUSION: Citalopram may improve fatigue and symptoms
associated with fatigue for some patients.
J Clin Psychiatry. 2003 Aug;64(8):927-35.

Hypothalamic regulation of sleep and arousal.

McGinty D, Szymusiak R.

Research Service, V.A. Greater Los Angeles Healthcare System, 16111
Plummer Street, North Hills, CA 91343, USA.

The hypnogenic function of the rostral hypothalamic region, particularly
the preoptic area (POA) was established previously on the basis of
lesion, neuronal unit recording, and neurochemical and thermal
stimulation studies. Recent studies have mapped the locations of
putative sleep-promoting neurons in the POA using c-Fos immunostaining
techniques and confirmed these findings with electrophysiological
methods. Segregated groups of sleep-active neurons have been localized
in the ventrolateral POA (vlPOA) and median preoptic nucleus (MnPN).
MnPN and vlPOA sleep-active neurons express the inhibitory transmitter,
GABA. In vlPOA neurons, GABA is co-localized with a second inhibitory
transmitter, galanin. Descending projections from these sites terminate
in putative arousal-promoting cell groups, including histaminergic,
serotonergic, orexinergic, noradrenergic, and cholinergic neurons. These
findings suggest the hypothesis that non-REM sleep occurs as a
consequence of GABAergic and galaninergic inhibition of
arousal-promoting neurons resulting from activation of vlPOA and MnPN
sleep-promoting neurons. In support of this hypothesis, it was shown
that putative sleep-promoting and arousal-promoting neurons exhibit
reciprocal changes in discharge across the sleep-wake cycle and that
GABA release in wake-promoting sites increases during nonREM sleep. In
addition, some POA sleep-active neurons are warm-sensitive. Local POA
warming inhibits discharge of multiple arousal-promoting neuronal
groups. POA warming, unit recording, and lesion studies also show that
POA regulates the amount of delta EEG activity within nonREM sleep, and
index of the depth of sleep. Finally, there is evidence that arousal
systems inhibit vlPOA and MnPN neurons and the POA hypnogenic mechanism.
Mutually-inhibitory interactions between sleep-promoting and
arousal-promoting systems are hypothesized to form a functional
sleep-wake switch.

PMID: 12957869 [PubMed - in process]
Front Biosci. 2003 Sep 1;8:s1074-83.

The role of tendinitis in fibromyalgia syndrome.

Genc H, Saracoglu M, Duyur B, Erdem HR.

S.B. Ankara Egitim ve Arastirma Hastanesi 2. Fizik Tedavi ve
Rehabilitasyon Klinigi, 06340 Cebeci, Ankara, Turkey.

Fibromyalgia Syndrome (FS) is a common disease characterized by diffuse,
widespread pain and multiple tender points. The syndrome has been
subclassified as primary (PFS) and secondary (SFS) fibromyalgia. The aim
of this study was to evaluate the role of common tendinitis (rotator
cuff tendinitis, bicipital tendinitis, lateral epicondylitis,
De-Quervain's tendinitis and pes anserinus tendinitis) in FS. Twenty
female patients with PFS, 20 with SFS and 20 female controls, matched by
age and body mass index, participated in the study. Existence of common
tendinitis was evaluated with specific examination methods. Right and
left rotator cuff tendinitis, pes anserinus tendinitis and left lateral
epicondylitis were significantly more common in patients with PFS and
SFS than in control subjects. As a result, considering the central
hyperexcitability present in the fibromyalgia patients, concomitant
pathologies such as tendinitis which lead to shoulder, arm, and leg pain
must be evaluated. Follow up and therapy for the disease must be planned
according to these factors which are not only probable symptoms of FS,
but also leading causes for the occurrence and continuity of the pain in
this disease.

PMID: 12950117 [PubMed - indexed for MEDLINE]
Yonsei Med J. 2003 Aug 30;44(4):619-22.

A Modest Proposal

Even modest amounts of physical activity can help keep your blood
pressure under control.
In a study of sedentary people who began an exercise program to control
their high blood pressure, all of the people experienced significant
improvements in their blood pressure readings regardless of how much
they exercised. The minimum exercise duration in the study was 30
minutes per week.

RealAge Benefit: Exercising regularly can make your RealAge as much as 9
years younger.
For optimal RealAge benefits, you should try to exercise for at least 30
minutes on most days of the week. In addition to regular exercise, other
ways to control blood pressure include losing weight if you are
overweight and limiting alcohol intake. Reducing sodium intake to 1,400
milligrams or less per day is important for salt-sensitive people.
How much exercise is required to reduce blood pressure in essential
hypertensives: a dose-response study. Ishikawa-Takata, K., Ohta, T.,
Tanaka, H., American Journal of Hypertension 2003 Aug;16(8):629-633.
Why You Crave Comfort Food
Scientists are learning more about why we crave comfort food when we're
under stress. It may be a biochemical feedback system, according to
ScienceDaily News. A stressful event, or chronic stress, releases
cortisol hormones in the body, prompting the body to seek out
pleasure-inducing elements, including sugar and fat. In other words,
"comfort food applies the brakes on a key element of chronic stress,"
says study co-author Norman Pecoraro, Ph.D., according to the article.

The scientists say that short term, it's okay to indulge a bit, but
relying on these foods over long-term chronic stress is not a good idea.
Exercise, relaxation techniques, and yoga can help. So you can have
moderate portions of your favorite comfort foods. Just don't depend on
them; use other ways of reducing stress too!

Triglycerides: What You Need To Know
by Dr. Nancy Tice
eDiets Physician and Psychiatrist
If you've ever had the cholesterol levels in your blood checked, you
probably had another type of blood fat measured right along with them:
your triglycerides (tri-GLIS'er-ídz). New research shows that
triglycerides can be a potent, but controllable, risk factor for stroke
and heart disease.
Triglycerides are fatty substances made by the body from the fat in food
(and sometimes from sugars). Triglycerides are carried in the blood and
stored in the body as fatty tissue. Some triglycerides are also made in
the liver. Triglycerides in plasma are derived from fats eaten in foods
or made in the body from other energy sources like carbohydrates.
Calories ingested in a meal and not used immediately by tissues are
converted to triglycerides and transported to fat cells to be stored.
Hormones regulate the release of triglycerides from fat tissue, so they
meet the body's needs for energy between meals. If there isn't enough
fat in your diet, your body will make the carbohydrate "sugars" into
triglycerides for long-term storage in the fleshy places in your body
and your coronary arteries.
Excess triglycerides in plasma are called hypertriglyceridemia. Elevated
triglycerides may be a consequence of other disease, such as untreated
diabetes mellitus. Cardiovascular experts now know that high levels of
triglycerides can trigger a heart attack or stroke -- even if your
cholesterol levels are normal. Having high levels of triglycerides
appears to be even riskier for women than for men.
At healthy levels, triglycerides fuel your muscles. But extra
triglycerides -- the ones your muscles didn't burn because you didn't
have time for a walk yesterday -- are thriftily stored as fat.
Yesterday's cake may really be padding your hips today: Most
triglycerides hit the bloodstream 3 to 6 hours after a meal and are
burned or stored within 10 to 12 hours.
The problem is extra triglycerides can cause blood vessel walls to
become clogged with fat. If that fat bursts into the bloodstream, it can
set off blood clots that kill heart muscle and stop blood flow to parts
of the brain. In addition, high levels of triglycerides are often part
of a cluster of health problems called metabolic syndrome, or syndrome
X. It includes low HDLs, high blood pressure, early or full-blown
diabetes and abdominal obesity. Research suggests that nearly one in
four adult women has syndrome X -- but doesn't know it!
What can make triglyceride levels soar?
Weight Gain. Extra weight is the prime cause of high levels of
triglycerides. Overweight people produce too many triglycerides, and
their bodies burn them and store them too slowly. Your body converts fat
and some carbohydrates into triglycerides, which are a major energy
source burned to power muscles. Fruits, veggies and whole grains
(unrefined carbohydrates) do not jack up triglyceride levels the way
white bread, pasta, cakes and cookies can. We are not certain why
refined carbohydrates boost triglycerides, but they seem to hit the
liver like a bullet, turning into triglycerides more quickly.
Genetics. While the vast majority of causes of high triglycerides and
blood cholesterol are not genetic, some cases may be due to a genetic
disorder affecting liver function. Individuals who are diagnosed with
particularly high levels of either of these fats should encourage
genetically related family members to undergo testing for liver
dysfunction. Of those individuals with high levels of these fats, an
estimated one out of 500 has a genetic basis for their condition.
Age. After about age 40, we produce less of an enzyme that helps break
down triglycerides. Women are more at risk for high triglycerides after
menopause, when they gain weight around the middle. At the same time, as
women age, levels of heart-protective estrogens start to decline, while
LDL and triglyceride levels rise.
Medications. Oral estrogen, some blood pressure medicines such as beta
blockers and diuretics, some acne medicines such as Accutane,
corticosteroids or anti-inflammatory drugs and bile acid sequestrants (a
class of drugs used to treat high cholesterol) can all raise
What should your level be? Normal is less than 150mg/dL. Borderline high
is 150mg/dL, High is 200-499 and very high is anything over 500mg/dL.
These are based on fasting triglyceride levels.
Changes in lifestyle habits are the main therapy for
hypertriglyceridemia. These are the changes you need to make:
If you're overweight, cut down on calories to reach your ideal body
weight. This includes all sources of calories, from fats to proteins to
carbohydrates to alcohol. Reduce the saturated fat and the cholesterol
content of your diet. Reduce your intake of alcohol considerably. Even
small amounts of alcohol can lead to large changes in plasma
triglyceride levels. Be physically active for at least 30 minutes on
most days each week. People with high triglycerides may need to
substitute monounsaturated and polyunsaturated fats -- such as those
found in canola oil, olive oil or liquid margarine -- for saturated
fats. Substituting carbohydrates for fats may raise triglyceride levels
and may decrease HDL ("good") cholesterol in some people. Substitute
fish high in omega-3 fatty acids instead of meats that are high in
saturated fat like hamburger. Fatty fish like mackerel, lake trout,
herring, sardines, albacore tuna and salmon are high in omega-3 fatty
If 2 to 3 months of diet and exercise don't significantly drop your
triglycerides, talk with your doctor about these medications:
Statins. Commonly prescribed when both LDLs and triglycerides are
elevated, statins can drop triglyceride levels as much as 32 percent.
Fibrates. They're often prescribed just to target high triglycerides.
They include gemfibrozil (Lopid), clofibrate (Atromid-S) and fenofibrate
Prescription-only niacin. Nicotinic acid lowers triglycerides and can
also increase HDLs. Because other risk factors for coronary artery
disease multiply the hazard from hyperlipidemia, control high blood
pressure and avoid cigarette smoking. If drugs are used to treat
hypertriglyceridemia, dietary management and exercise is still


Some researchers believe magnesium holds the key to resolving many types
of chronic pain. In the body, magnesium converts vitamin D, which the
body needs to take advantage of bone-strengthening calcium, into a form
that it can use efficiently. By contributing to increased bone density,
the mineral may help stall the onset of osteoporosis.
Magnesium may also help to ease tension headaches, muscle cramps, muscle
strains, and muscle tension. If you have a magnesium deficiency, you may
experience excessive muscle tension, which may trigger muscle spasms,
restlessness, tics, and twitches.
(Source: The Women's Guide to Ending Pain: An 8-Step Program, by Howard
S. Smith, M.D., and Debra Fulghum Bruce, M.S. Published by John Wiley &
Sons, Inc.)
This tip provided courtesy of

Migraine Headaches and Allodynia:                        

Roughly 28 million Americans are affected by migraines, and women
account for approximately two thirds of migraine patients. Although
migraine is a recurring neurologic disorder, symptoms and severity of
migraine are highly individualized, differing not only from one patient
to another but also by migraine attack within the same patient. Among
the well-recognized symptoms of migraine are throbbing unilateral head
pain, photophobia, phonophobia, osmophobia, nausea, and a host of
disturbances of autonomic, cognitive, sensory, and motor functions.[2]
Less appreciated, but of concern, cutaneous allodynia (CA) is a more
recently described, potentially severe neurologic symptom.
CA is pain that results from a nonnoxious stimulus to normal skin.
Patients with CA can experience this potentially debilitating symptom as
burning or other pain triggered by simple touch or pressure or a burst
of cold or hot wind or water, which thus prevents patients from wearing
eyeglasses or hats, combing their hair, brushing their teeth, taking a
shower, or even venturing outside, among other things. CA occurs most
commonly in older patients with migraine (mean age, 42 vs 34 years for
migraineurs who do not experience CA) who experience their first
migraine attack by the age of 19 years.[3]
To read this article in full;

What is PSC?
Primary sclerosing cholangitis (PSC) is a disease of the liver that
causes narrowing inside and outside of the bile ducts in the liver. It's
not certain what causes PSC, though it seems to be connected to other
conditions. Some theories on the cause of PSC include bacteria, viruses,
and immune response. At this time, it is not thought that PSC is
Bile is necessary for the digestion of fat and to carry wastes out of
the liver. PSC causes the bile ducts to narrow from scarring and
inflammation, and bile begins to accumulate in the liver, damaging it.
The scarring and the build-up of the bile prevent the liver from
performing its important functions. Continued inflammation and scar
tissue formation lead to cirrhosis of the liver, which is a condition
that prevents the liver from filtering blood. Several years of PSC can
lead to a tumor of the bile ducts called cholangiocarcinoma.
PSC does progress slowly in most cases, but it can also be
unpredictable. People with PSC can receive treatment for symptoms that
helps them to lead an active life, but the condition can be life
Who Gets PSC?
Most often, the people who are affected by PSC are between the ages of
30 and 60, with the average age of diagnosis being 40. PSC tends to be
more common in men; 75% of people diagnosed are men. On the whole, PSC
is an uncommon disease.
Symptoms of PSC
Many people discover that they have PSC through routine tests such as
blood tests or regular check-ups. Some people have no symptoms at
diagnosis or even for several years after.
Symptoms include:
? Diarrhea (which is caused from malabsorption of fat)
? Fatigue
? Fever/chills (from an infection in the bile ducts)
? Itching which often affects the entire body
? Jaundice (yellowing of the skin and eyes)
Diseases Associated with PSC
People with PSC are more likely to have Inflammatory Bowel Disease (IBD)
or Osteoporosis. PSC is more commonly occurs with ulcerative colitis,
but can also be associated with Crohn's disease of the large intestine.
The reason for the association is unknown, but it is thought to be the
result of an immune response. As many as 70% of people with PSC also
suffer from a related conditions.
Article continues at:

What to Do About Headaches if You Have an Anxiety Disorder

Studies have shown that nearly 80% of those with anxiety or depressive
disorders experience chronic daily headaches. Is head pain a part of
your anxiety disorder? Have you decided just to accept and live with it?
Or would you like to do something about it? Here are suggestions for
taking control if you experience headaches along with your anxiety
Keep a diary. Teri Robert, About Headaches/Migraine Guide, calls the
headache diary "one of the most helpful tools for you and your doctors,"
and she helps you keep a diary with her Headache and Migraine Diary
(available in Microsoft Word and Excel formats). This tool will help you
better communicate with your doctor about symptoms, severity and
possible triggers. Don't try to remember without writing it down. The
diary will help you find patterns.
Track your anxiety symptoms along with your headache symptoms. When you
keep your headache diary, be sure to note an anxiety-related (and/or
panic) symptoms along with your headaches symptoms. Your headaches may
or may not be directly related to your anxiety disorder, and tracking
symptoms will help your doctor decide.
Learn about headaches. There is more than one kind of headache disorder,
and each type has different symptoms. The most common headache disorders
are migraine, tension, sinus/allergy, and cluster. By reading about the
basics on each headache disorder, you will be able to put your symptoms
into words. Teri Robert has all kinds of great information on her site;
you may want to start with Is It Migraine? Tension Headache? What?
Talk to your doctor. Make an appointment, and, when it's time to go,
bring your headache diary and a list of questions. Be sure that the
doctor you are seeing knows about your anxiety disorder and any
medications you are taking. Be ready to discuss treatment options. Be
open to his or her suggestions, but do not be afraid to think about what
is right for you.
Learn more about treatments. Just as with anxiety disorders, headache
disorders may be treated in a variety of ways, from medication to
relaxation. Discuss these options with your doctor. Consider the
severity of your headaches and how much they impact your life. Be sure
to discuss possible medication conflicts if you choose that route. Teri
Robert has all kinds of treatment information in her Headache and
Migraine Management section.
Stand up for your rights. Just because you have an anxiety disorder does
not mean you have to accept headache pain. It may be true for you that
anxiety is the foremost trigger for your headache pain. However, that
does not mean your pain is not real! If your doctor refuses to help,
then talk to another doctor. If your doctor pushes relaxation as a
primary treatment method (because of your anxiety disorder), then make
an effort to try it, but communicate with him or her about what is and
is not working.
Accept test results and aim for good health. Health anxiety is common
among people with anxiety disorders. The physical symptoms of anxiety
and panic frequently feel like serious health issues, if you aren't
completely aware of what is happening. Head pain is one of those
symptoms that may lead to anxiety about serious illness. You need to
find a doctor whom you trust and whose test results you trust. Talk
about your health anxieties with your therapist. If you need a second
opinion, get one, but don't end up in the trap of years of testing and
never believing the results. If anxiety is the primary trigger for your
head pain, you may need to work on your anxiety disorder (along with
your headache treatment) to find relief in the long-term.

Cathleen Henning

Copyright © 2003 About, Inc. About and are registered
trademarks of About, Inc. The About logo is a trademark of About, Inc.
All rights reserved.


A comprehensive list of the vitamins and minerals... and their functions
in human health.
You are on your own about deciding on which brand to buy and whether
processing procedures make that much difference, etc etc. But this is a
great site for learning about vitamins and minerals.

Roots of the "Clean Plate Club" Examined by Cancer Group

Concerned that too many Americans are lifelong members of the "Clean
Plate Club," experts at the American Institute for Cancer Research
(AICR) have investigated the uniquely American compulsion to finish
everything on the plate. According to their research, this behavior has
its roots in a much different time in American history.
Ironically, the notion of the "Clean Plate" was originally introduced as
an incentive for Americans to conserve food, not gorge themselves on
excess calories.
"The notion of 'cleaning your plate' was originally tied to another,
equally important idea: put only what you need on your plate in the
first place," said Melanie Polk, RD, Director of Nutrition Education at
Being told to "clean your plate" has been a familiar rite of American
childhood for decades, and the idea has become so ingrained in our
society that seven out of ten Americans surveyed (69 percent) say they
finish their restaurant entrees all or most of the time, regardless of
the entrée's size.
Wartime Worries Gave Birth to Clean Plate Club
Numerous historians have written about how the administration of
President Woodrow Wilson, sparked by the outbreak of World War I,
greatly expanded the traditional role of the Federal Government. In
August of 1917, Congress passed the Food and Fuel Control Act, also
known as the Lever Act, which gave the president power to "regulate the
distribution, export, import, purchase and storage of food."
The first step Wilson took was to issue Executive Order 2679-A, creating
the U.S. Food Administration, which was tasked with assuring the supply,
distribution and conservation of food during the war. Wilson's choice to
head the Food Administration was Herbert Hoover.
Hoover and the Wilson administration firmly believed that "Food will win
the war," and promptly began to devise campaigns to decrease the
nation's food consumption.
One of the most successful campaigns encouraged Americans to sign pledge
cards testifying that they were making a concerted effort to save food.
Local newspapers kept running tallies of the percentage of households in
their area that had signed on to these pledges, urging "100%
One such U.S. Food Administration pledge read, "At table I'll not leave
a scrap of food upon my plate. And I'll not eat between meals, but for
suppertime I'll wait."
The Food Administration created its own Advertising Section, which
seized upon the "Clean Plate" as the patriotic ideal for the nation to
follow. The term became a catchphrase that appeared in hundreds of
posters across the country.
In one illustration, an overweight man is sitting at a restaurant table
that is covered with half-eaten plates while a pair of waiters looks on,
aghast. The caption reads: Sir - Don't waste while your wife saves Adopt
the doctrine of the clean plate -- do your share.
The US Food Administration was terminated soon after then end of World
War I, but its influence - and, in particular, its characterization of a
clean plate as somehow patriotic and virtuous, has never completely left
the American mindset.
Polk said it best, "Today's Americans are still cleaning their plates -
but because they've lost the ability to gauge portion sizes, they pile
those plates with more food than they need."
AICR experts argue that the habit of cleaning the plate should be
regarded as a relic - one that has no place in today's society, where 65
percent of the country is overweight or obese.
Source: AICR

In recent years, the usefulness of interferon beta and glatiramer
acetate in the treatment of relapsing-remitting multiple sclerosis
(RRMS) has been established. Interferon beta has also been shown to be
efficacious in secondary-progressive multiple sclerosis (SPMS) as well
as in patients with isolated syndromes at risk to develop clinically
definite multiple sclerosis (MS). Mitoxantrone is another
disease-modifying drug that is available for SPMS and severe cases of

Multiple sclerosis (MS) is an inflammatory autoimmune disorder of the
central nervous system (CNS) and the most common disabling neurologic
disease of young adults with a lifetime risk of 1 in 400.[1,2] The
clinical diagnosis of the disease is based on demonstrating the
dissemination of lesions of the CNS in time and space (i.e., the
occurrence of a second clinical episode at a different site in the CNS).
The risk of developing MS after an isolated clinical deficit, such as
optic neuritis, is greater the longer the follow-up period. In one
series of patients with optic neuritis, the 10-year risk of clinically
definite MS (CDMS) was 39%, the 20-year risk was 49%, the 30-year risk
was 54%, and the 40-year risk was 60%.[3] The strongest predictor for
the development of MS is the presence of asymptomatic white-matter
lesions on magnetic resonance imaging (MRI) of the brain.[4]
Consequently, an international panel has published diagnostic criteria
for MS (McDonald criteria), suggesting that MRI evidence of
dissemination of CNS lesions in time and space is sufficient for the
diagnosis of MS even before clinical dissemination has occurred.[5]

The full acticle can be read at:




Dry Eye Syndrome: A Problem for Millions of Americans

09-29-2003 Boston, MA – Nearly 3.2 million American women age 50 and
older suffer from dry eye syndrome, a painful, debilitating eye disease,
according to an epidemiological study by scientists from Schepens Eye
Research Institute and Brigham and Women's Hospital.

The study, published in the August issue of the American Journal of
Ophthalmology and the largest study of its kind, indicates that dry eye
in women is an important health issue that may often remain undiagnosed.

The incidence of dry eye syndrome, along with the economic impact on the
health care system, is likely to increase as the population ages.

"These findings shine a light on this issue and will help make the
public and the health care community more aware of dry eye syndrome as
an important health concern for women. It also points to the need for
diagnosis and treatment to limit the impact on the individual's quality
of life and society," says Debra Schaumberg, ScD, OD, MPH, the senior
author of the study, assistant scientist at Schepens Eye Research
Institute, associate epidemiologist at Brigham and Women's Hospital
(BWH), and an assistant professor at Harvard Medical School.

Known to be more common in women than men (scientists estimate that over
a million men age 50 and older have the disease), dry eye syndrome is
characterized by a decline in the quality or quantity of tears that
normally bathe the eye to keep it moist and functioning well. The
condition causes symptoms such as pain, irritation, dryness, and/or a
sandy or gritty sensation. If untreated, severe dry eye syndrome can
eventually lead to scarring or ulceration of the cornea, and loss of
vision. Victims can experience symptoms so constant and severe that
reading, driving, working or participating in other activities of daily
life are difficult or impossible.

While previous studies have given some indications of the numbers of
women (people) affected, these studies were small and geographically and
demographically limited.

Schaumberg's study, in contrast, is the first large-scale study that,
although not population-based, is geographically diverse, including
women from across the United States.

To obtain their results, Schaumberg and her team surveyed over 37,000
women enrolled in the Women's Health Study, the landmark, BWH-based
Women's Health Study. Survey questions were designed to elicit
information about an individual's history of diagnosed dry eye syndrome
or evidence of severe symptoms.

After adjusting for age and demographics, and extrapolating to the U.S.
population, the researchers concluded that 7.8 percent of the population
of women over age 50 or 3.2 million women, suffered from the disorder.
They also concluded that while many younger women in their forties did
experience dry eye syndrome, the prevalence of the disease increased
significantly with age.

The researchers also found that Hispanic and Asian women were more
likely to report severe symptoms, but not more likely to have been
diagnosed than Caucasian women. The researchers speculate that this may
be due to a lower level of health care in their communities or less
effectiveness of treatment, or possibly because of interactions with
other medications or health conditions in Hispanics and Asians, such as
hypertension. Black women were not distinguishable from white women when
it came to dry eye syndrome.

Since the subjects of this AJO study were health workers and likely to
be healthier than the general public, Schaumberg and her team believe
that the general population may have even a higher incidence of dry eye
than the study group.

According to Schaumberg, little attention has been focused on this
disease because it can be difficult to study and doesn't usually lead to
blindness, but she adds that the cost for care and the debilities it
causes could eat up substantial health care resources. "This research
points to the high prevalence of dry eye in the population that deserves
more study in the future." Schaumberg and her colleagues are not alone
in their concern. The National Eye Institute has also identified it as a
major concern for future research.

Although all the causes of dry eye are not known, normal aging of tear
glands as well as various disorders and diseases seem to be involved.
Previous research has shown a link between levels of the male sex
hormone androgen and the disease. In addition, Schaumberg recently
published research that linked dry eye syndrome to postmenopausal
hormone therapy in women. While artificial tears in the form of eye
drops offer some relief and other treatments are also available or in
clinical trials, the disease is not curable.

The study, titled Prevalence of Dry Eye Syndrome in American Women can
be obtained online at

Collaborators on the study include David A. Sullivan, PhD, Schepens Eye
Research Institute; M. Reza Dana, MD, MPH, Schepens Eye Research
Institute and Massachusetts Eye and Ear Infirmary; and Julie E. Buring,
ScD, Division of Preventive Medicine, Brigham and Women's Hospital.

Schepens Eye Research Institute, an affiliate of Harvard Medical School,
is the largest independent eye research institute in the world.
©2000 Pro Health, Inc. Copyright Policy

Excessive Sweating Affects Many

MONDAY, Aug. 25 (HealthDayNews) -- A condition where people suffer
excessive sweating is more common than previously thought, says a Saint
Louis University study.
The study found that about 7.8 million Americans suffers have the
condition, called hyperhidrosis, which can result in anxiety,
depression, isolation and reduced quality of life. The study was based
on a survey of 150,000 households.
"The fact that we had an incredibly large response rate to our survey
(80 percent) tells us this is not a mild nuisance experienced by a few
people. This is a big problem that interests people. Frankly, I was a
little surprised at the high percentage of those affected," researcher
Dr. Dee Anna Glaser, an associate professor of dermatology, says in a
news release.
Sweating, which is regulated by the sympathetic nervous system, helps
control body temperature during exercising or coping with hot or warm
environments. But people with hyperhidrosis have an overactive system
that causes sweating at inappropriate times in specific areas of the
body, such as the scalp, face, hands, armpits, feet or trunk.
Hyperhidrosis affects men and women equally.
The study found 90 percent of the respondents who had the condition said
sweating interfered with their lives. You or someone you know may suffer
from hyperhidrosis if:
? You think you sweat more than normal.
? You have to carry a handkerchief to wipe your hands of sweat or
need to keep an extra shirt in your office to change out of sweaty
? People comment on your excessive sweating.
? You sweat even in cool environments.
? Your sweating waxes and wanes.
? Your sweating is brought on by stress.
? You sweat through multiply layers of clothing.
? You change clothes several times a day because of sweating.
? You frequently have to buy new clothes because sweat stains
soil your wardrobe.
Topical and oral medications are among the treatments for people with
hyperhidrosis. If those fail, surgery or botox may be options.
More information
Here's where you can learn more about excessive sweating.
--Robert Preidt
Copyright © 2003 ScoutNews, LLC. All rights reserved.

Attacking Pain At Its Source: New Perspectives on Opioids
Christoph Stein, Michael Schäfer, Halina Machelska
Nat Med 9(8):1003-1008, 2003. © 2003 Nature Publishing Group
Posted 08/27/2003
Abstract and Introduction
The treatment of severe pain with opioids has thus far been limited by
their unwanted central side effects. Recent research promises new
approaches, including opioid analgesics acting outside the central
nervous system, targeting of opioid peptide-containing immune cells to
peripheral damaged tissue, and gene transfer to enhance opioid
production at sites of injury.
The first step in pain treatment is usually pharmacologic, along with
cognitive and behavioral approaches in more chronic stages. Opioids are
the most powerful drugs for severe acute and chronic pain, but their
widespread use is hampered by side effects such as depression of
breathing, nausea, clouding of consciousness, constipation, addiction
and tolerance[1]. A new generation of opioid drugs is now emerging. This
class selectively activates opioid receptors outside the central nervous
system, thus avoiding all centrally-mediated, unwanted effects[2].
Endogenous ligands of these peripheral opioid receptors are produced
within skin and immunocytes[3]. This has led to new directions of
research, such as the selective targeting of opioid peptide-containing
cells to sites of painful injury, and augmentation of opioid synthesis
by gene transfer.
Acute and chronic pain are frequently associated with inflammation as a
result of tissue destruction, abnormal immune reactivity or nerve
injury. Within damaged peripheral tissue, primary sensory neurons
transduce mechanical, chemical or heat stimuli into action potentials.
These sensory neurons have myelinated (A) or small-diameter unmyelinated
axons (C-fibers, or 'nociceptors'). The latter are particularly
sensitive to the vanniloid receptor-1 ligand and the neurotoxin
capsaicin, and are considered the dominant fibers in clinical pain.
Fibers normally transferring innocuous touch (Aß) can also contribute to
pain after nerve damage. After synaptic transmission and modulation
within the spinal cord, nociceptive signals reach supraspinal and
cortical sites, where they can be perceived as painful.

The continuation of this article can be found at:

IBS: Challenges in Diagnosis
M. Brian Fennerty, MD
Medscape Gastroenterology 5(2), 2003. © 2003 Medscape
Posted 09/22/2003
Irritable bowel syndrome (IBS) is a prevalent, chronic, and morbid
disease that traditionally has been underappreciated.[1] The prevalence
of IBS in western populations is approximately 10% to 15%, and in most
patients, IBS results in intermittent but persistent symptoms. More
importantly, the symptoms associated with IBS result in a significant
decrease in that patient's quality of life and, furthermore, result in
increased healthcare resource utilization and, therefore, increased cost
of caring for these patients.
Despite IBS being a common disease that has been extensively evaluated,
there is as yet no specific diagnostic test for the disorder. Instead,
the diagnosis of IBS is still based on the presence of specific
gastrointestinal symptoms of a minimum duration along with an absence of
other gastrointestinal pathology that would explain those symptoms. A
number of symptom-based criteria for the diagnosis of IBS have been
devised to assist with the diagnosis of this disorder. Furthermore,
there have been a variety of recommendations regarding the appropriate
clinical work-up for patients thought to have IBS.
This review focuses on currently accepted criteria for IBS, including an
evidence-based recommendation regarding the appropriate diagnostic
evaluation for patients suspected of having this disorder.

This article continues at:
Color Schemes. Is it time to brush up on relaxing colors?

By Ed Ritchie
Are you feeling in the pink? Ever been green with envy? Does that old
song have you singing the blues? Such phrases are more than colorful
metaphors, they are based on the psychological and physiological effects
of color. When you want to relax, the right colors in your environment
can be helpful, while the wrong ones can have you, er, seeing red.
The two colors most recommended for creating a serene and calming
atmosphere are blue and green. Not all shades though. Electric blue or
neon green aren’t good for creating soothing or peaceful feelings.
However, you can’t lose if you create a relaxing environment using
soothing blues. Ask most people to think about their encounters with
blue and they’ll recall the sky, an azure sea, or a field of
cornflowers. Those may be everyday colors but don’t discount their
Research has shown that something as simple as a mural of a water scene
will alter electrical activity in the brain. The result is reduced
levels of stress hormones and eased muscle tension. In Feng Shui, the
ancient Chinese practice of positioning objects based on patterns of
“yin and yang” and the flow of energy, blue is considered calm and
soothing, the color of healing and relaxing.
Soothing shades of green also make for a relaxing decorating scheme. If
you can take advantage of a window with a view of greenery, all the
better. Studies have found that hospital patients with a window view of
trees had shorter post-operative stays and fewer complications.
Be careful not to create too stimulating of an environment with things
such as abstract pictures and nature scenes with high levels of
activity. Researchers have found that too much visual stimulation can
raise anxiety levels in patients. Striking a balance is as easy as
taking note of the typical environments of newer healthcare facilities:
indoor plants, gardens, fountains, and aquariums all work well to create
a relaxing atmosphere.
You might assume that less color would be more relaxing, but research
has shown that a bland room isn’t desirable. Scientist Rikard Kuller had
six men and six women stay in two rooms, one was colorful and complex,
the other gray and sterile. Electroencephalogram (EEG) and pulse rates
were recorded, as well as subjective emotional feelings. The results
showed faster heart rates in the gray room. Moreover, men reacted with
more stress than women. Men also became more bored. As a result, Kuller
postulated that women could achieve a higher degree of mental relaxation
than men.
Relaxation can also be influenced by space perception. If you feel more
relaxed in a small cozy nook, darker shades create more intimate spaces.
Dark colors absorb light, so walls appear closer and the room will look
smaller and more intimate. How many times have we seen the regal dark
greens and wood combinations used for "quiet" rooms, like studies and
home offices?
If you prefer more space, light colors are perceived as bright and airy,
and can make small spaces seem bigger and ceilings appear higher. Using
wallpapers with a smooth texture or a light sheen, will further enhance
the light. To minimize the effect of light, use textured papers that
reflect less and absorb more light.
Don’t be surprised if you feel cooler when surrounded by blues and
greens. Research has shown that the nervous system is slowed by blue,
green, purple and gray. After relaxing, you can get moving again by
switching to a room with warm colors. Red, orange and yellow stimulate
the nervous system and encourage activity.
Copyright © 2003 National Fibromyalgia Association (NFA) All rights

Fairfield FM Support Group Meeting
Fairfield Health & Wellness Center
Date: October 21, 2003
Time: 7:00 PM - 8:30 PM

Announcing a presentation by J. Kevin Roll, MD.
Dr. Roll is a family practitioner with a special interest in
fibromyalgia and related conditions. Dr. Roll has developed an
innovative method of treatment based on the concept that fibromylagia
represents a diffuse myofascial pain syndrome with several metabolic
Dr. Roll will discuss the underlying physiologic mechanisms that produce
the condition, and will explain this new method of treatment at:
Mercy Fairfield Health & Wellness Center
3050 Mack Road
Cincinnati, Ohio 45014
Date: October 21, 2003
Time: 7:00PM - 8:30 PM
Questions contact Linda
voice mail 527-5048 exit 304

(Who is Dr. J. Kevin Roll)
My name is J. Kevin J. Roll MD. I am a graduate of Indiana University
School of Medicine where I was trained in family practice. I like to
tell you about the effective treatments for fibromylagia syndrome and
related conditions that we offer at our clinic.
Three years ago, after practicing conventional medicine for twenty
years. I became thoroughly disillusioned with what I was doing and began
to study alternative medicine, with a special focus on FMS and
myofascial pain syndrome.
My treatments are based on the work of such people as Janet Travell, MD.
Jacob Teitelbaum, MD. R. Paul St. Amand MD. Devin Starlanyl, MD. Clair
Davis N.C.T.M.B., and others, along with some original ideas of our own.

We relieve pain with muscle therapy that is augmented by the short-term
use of medication to block pain, prevent reflexive muscles spasms, and
desensitize the nervous system.
Perpetuating factors such as nutritional deficiencies, hormonal
imbalances, infections, allergies, structural problems, sleep disorders,
depression, toxicity, and metabolic disorders are identified and

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

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

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

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

JOURNAL - a written record of

KNOWLEDGE - learn all you can about Fibromyalgia.

LIFE style changes - ongoing process

MANAGEMENT of medications

NEGATIVE thinking


PACE - conserve energy...set priorities

QUIET 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

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

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




"As the deer pants for streams of water, so my soul
pants for you, O God. My soul thirsts for God, for
The Living God. When can I go and meet with God?"
(Psalm 42:1,2)

Do you find yourself thirsting for answers, for
meaning and purpose to living a life filled with
distress, pain and suffering? Is your heart and mind
thirsting for relief, as your soul aches to be
quenched with help, relief and solace from God? You
may look up towards heaven and ask, "Where are You,

Do you feel deserted, wondering like David, "When can
I go and meet you God?" (Psalm 42:2)
Beloved, He has not abandoned you. He is right
along your side, weeping with you.
Life has a way of caving on many of us. Sometimes
we feel that we have bitten off more than we can
chew and overwhelmed by life itself. During these
times, when we feel far removed, it is imperative that
we keep our faith in God alive.

"'The kingdom of heaven is like a mustard seed, which
man took and planted in his field. Though it is the
smallest of all your seeds, when it grows, it is the
largest of garden plants and becomes a tree, so that
the birds of the air come and perch in its branches.'"
Matthew 13:31,32

All it takes is a tiny seed of faith, planted in
the Hope of God, which will take root, blossom and
grow. What will God do with this faith and for you?
"....I The LORD will answer them; I The God of Israel
will not forsake them. I will make rivers flow on
barren heights and springs within the valleys. I will
turn the desert into pools of water and the parched
ground into springs." Isaiah 41:17-18

Turn to God today, place your hope in Him. In doing
so, your mind, body and soul will be quenched
beyond measure.

God's Blessings.
Kay DeCarlo, devotional coordinator for Rest Ministries
lives with post-traumatic stress disorder, vulvodynia,
depression and panic disorder. Kay also lives with her
husband and fur-child (dog) Annie in chilly Connecticut.
Despite the many trials Kay has endured, she has never
lost sight that God is bigger than any situation she
faces and gives God all the glory.
Compliments of Rest Ministries, serving people Who live with chronic
or pain.
Rest Ministries, Inc.




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