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FMS Community Website FMS COMMUNITY NEWSLETTER # 77
New! Trivia Contest.
We are offering a new trivia contest to our newsletter subscribers. From time to time we will include a trivia question in the newsletter. If you know the answer go to the website to submit your answer. All submissions with the correct answer will be entered into a drawing for a prize. This months prize is a copy of Lesson one from the LifeThrive CD series for those with chronic pain. You can find the details at the website.
THIS MONTHS QUESTION:
Fear of Halloween is a genuine, documented phobia. Tell us what this phobia is called.
Submit your answer http://fmscommunity.org
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October 2, 2006
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2,228 subscribers
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Editor: Mary McKennell ****************************************************
EDITOR’S CORNER:

The day started off bad. I overslept and woke with a ferocious headache. I hurriedly got myself together for work. I jumped in and out of the shower, grabbed my outfit for the day, got my contacts in, make-up on and a quick comb of my hair and I was on my way. The headache kept bothering me and my vision was bothersome. I have to wear reading glasses with my contacts to read and my eyes just were not focusing properly.

I decided to switch my chiropractor appointment around to see him at the beginning of the day rather than the end, hoping for some relief from this dreadful headache. It was a good adjustment but I decided to wait a bit before leaving as I was a bit dizzy and my eyes still would not focus properly. I always carry something to read to distract myself from pain. One of the ways I test myself to see if I am ready to leave the chiropractor’s office is to see whether I can read the words on a page or are they still swimming all over the place. If they are swimming, then I just relax a little awhile longer and or have him adjust my neck again.

I asked the chiropractor to check neck again because things felt a little funny and there was still this problem of my eyes not focusing properly. I am always a bit concerned about my eyesight as the optometrist and I always have a struggle getting the correct prescription for my contacts and glasses. I gave him an article once on issues optometrists should be aware of in fibromyalgia patients who have chronic myofascial pain. He “harrumphed” when he saw I had printed it from the Internet. He must have eventually read the article as he now refers to my “condition” when I see him. I think it did help him understand why I can go for 3 appointments in a row and he can come up with 3 different results.

The second neck adjustment helped relieve things a little, but not much. So I went onto my designated stop for the day and set up to do my work for the day. (I do quality control checks on veterans who are placed in community nursing homes.) It happened to be at a psychiatric hospital, which is a tedious place to work even when you don’t have a headache and vision that won’t focus properly. I managed to have a fairly productive day there. The headache just would not go away however.

Driving home, I was thinking about the vision problem and hoping that I did not have to get a prescription change already. I had gambled and bought a year’s worth of contacts at one time, rather than a 6-month supply as I normally do. I finally made it home and could not wait to change clothes and get my contacts out and DO something to medicate this dreadful headache. I started taking my contacts out and discovered to my amazement that I had put only one contact in that morning. No wonder my vision was fuzzy and unfocused!

Sigmund Freud said, “Sometime a cigar is just a cigar.” And I say that sometimes a symptom is just a symptom and not the signal of something catastrophic coming.

Enjoy your reading!


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ARTICLES IN THIS ISSUE:

Depression Gene Found
Depression: No Miracle Sleep Cure
Treating Insomnia
Depression Treatments May Tackle Painful Conditions
New Treatment for Ulcerative Colitis More Convenient and Effective
Chiropractic Manipulation for Non-Spinal Pain
Can Bad Dreams Cause Stress?
On-Off Switch For Chronic Pain
Furrowed Brow Erased-Depression Lifts
10.Efficacy of Neurotropin in CFS Treatment
11.Life Is the Coffee

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'Depression gene' found
by JAMES CHAPMAN, Daily Mail
Scientists have made a discovery that could explain why women are twice as likely as men to suffer depression.
Experts believe they have identified the first gene that makes people susceptible to clinical depression.
Research just published suggests women who inherit the gene from their parents are significantly more likely to become depressed, while men are not affected.
The scientists, at the University of Pittsburgh Medical Centre, say the discovery represents an important step towards changing the way doctors diagnose and treat major depression, which affects nearly a tenth of the population at some time in their lives.
In future, a simple blood test could be used to detect those at risk of developing depression. The researchers, whose findings were published in the American Journal of Medical Genetics, studied the genes of groups of people who had suffered depression and compared them with those who never had.
This identified a section of 'chromosome two' - there are 23 pairs of chromosomes in every cell made up of strands of DNA, the blueprint for life.
The scientists say a gene in this region contributes to the vulnerability of women in families afflicted with depression.
Men with the same profile did not have any more chance of developing mood disorders than normal.
http://www.dailymail.co.uk/pages/live/articles/health/thehealthnews.html?in_article_id=148083&in_page_id=1797


Depression: No Miracle Sleep Cure
Sleep-deprivation therapy has been lauded as a cure for depression, but it rarely does the job.
By:Michael Yapko
I read a couple years ago about a special sleep cure for depression. If you do it when it's first starting and do it right away, you might stop it from becoming a full-blown depression. It had to do with sleeping four hours one night at a specific time (I believe it was from 9 p.m. until 1 a.m.), and then getting up and staying up until the next night. Could you please tell me more about this, and the correct way to do it? Does it really work?
If there were a true “cure” for depression, you can best believe you would have heard about it as a major, major event in human history. Unfortunately, there is no cure nor will there likely ever be one.
Depression is about much more than symptoms, and it's about much more than just our physiology. Psychological and social factors are also powerful elements that contribute to a person’s vulnerability to depression—and there's no drug or procedure for these. As I have often said in this column, no amount of medication is going to change someone’s history, make them better problem-solvers or build them a strong social support network.
Having said that, what you ask about is known as sleep-deprivation therapy. It is based on studies showing that depressed individuals experience anomalies in dream sleep, also called REM sleep because it is characterized by rapid eye movements.
This article continues a

http://www.psychologytoday.com/articles/index.php?term=pto-20040524-000001&print=1

Treating insomnia: Current and investigational pharmacological approaches
July 2006. "Chronic insomnia affects a significant proportion of young adult and elderly populations. Treatment strategies should alleviate nighttime symptoms, the feeling of nonrestorative sleep, and impaired daytime function.

Current pharmacological approaches focus primarily on GABA, the major inhibitory neurotransmitter in the central nervous system. Benzodiazepine receptor agonists (BzRA) have been a mainstay of pharmacotherapy; the classical benzodiazepines and non-benzodiazepines share a similar mode of action and allosterically enhance inhibitory chloride currents through the GABA(A) receptor, a ligand-gated protein comprising 5 subunits pseudosymmetrically arranged around a core anion channel. Variations in GABA(A) receptor subunit composition confer unique pharmacological, biophysical, and electrophysiological properties on each receptor subtype.

Classical benzodiazepines bind non-selectively to GABA(A) receptors containing a gamma2 subunit, whereas non-benzodiazepine hypnotics bind with higher relative affinity to alpha1-containing receptors. The non-benzodiazepine compounds generally represent an improvement over benzodiazepines as a result of improved binding selectivity and pharmacokinetic profiles. However, the enduring potential for amnestic effects, next day residual sedation, and abuse and physical dependence, particularly at higher doses, underscores the need for new treatment strategies.

Novel pharmacotherapies in development act on systems believed to be specifically involved in the regulation of the sleep-wake cycle. The recently approved melatonin receptor agonist, ramelteon, targets circadian mechanisms. Gaboxadol, an investigational treatment and a selective extrasynaptic GABA(A) receptor agonist (SEGA), targets GABA(A) receptors containing a delta subunit, which are located outside the synaptic junctions of thalamic and cortical neurons thought to play an important regulatory role in the onset, maintenance, and depth of the sleep process.'
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=AbstractPlus&list_uids=16876255

Depression Treatments May Help Tackle Painful Conditions


Doctors could help reduce the disability experienced by women suffering from chronic conditions such as arthritis – by treating their depression, according to new research published today.

The study by the European Journal of Pain found that female patients with painful long-term conditions suffered from higher level of depression and reported greater disability than men in the same situation.

This suggests that by targeting their depression and focusing on their psychological well-being, doctors could help reduce the sensations of disability.

The study, which involved 260 chronic pain patients from Royal National Hospital for Rheumatic Diseases (RNHRD), in Bath, Somerset, builds on growing evidence that ‘psychosocial’ factors can have an effect on a person’s health and behaviour.

“It is now accepted that pain is more than just a sensory experience, and that factors like a person’s gender, their emotional condition or their interactions with others can contribute to their pain experiences,” said Dr Ed Keogh from the Pain Management Unit at the University of Bath.

“This research shows that pain-related emotions are associated with pain-related behaviour, such as the number of visits to the GP, the number of medications taken, the amount of sleep lost, and disability, but it also highlights a significant discrepancy between the behaviours of men and women.

This article continues at:

. http://www.breakingnews.ie/2006/06/15/story263524.html
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New Treatment for Ulcerative Colitis More Convenient and Effective

For people with ulcerative colitis, treatment often involves taking a number of pills several times a day. A new therapy currently undergoing FDA review promises to produce significant improvements in the condition with the ease of once-daily dosing.

Ulcerative colitis is an inflammatory bowel disease marked by swelling and ulceration of the large intestine, or colon. Although signs and symptoms can vary, patients often experience rectal bleeding, abdominal cramping and episodes of diarrhea that may occur as often as 10 to 20 times a day.

For nearly 500,000 Americans, ulcerative colitis dramatically reduces the quality of life. While the disease is typically diagnosed in the third decade of life, it can strike at any age.

According to William J. Sandborn, M.D., director of the Inflammatory Bowel Disease Clinic at the Mayo Clinic, "About half of cases occur in children, teens and young adults. Unfortunately, most young patients diagnosed with this disease will have symptoms for the rest of their lives."

Although ulcerative colitis is rarely fatal, it is known to increase the risk for colon cancer, and can lead to a number of serious complications. "About 25 to 30 percent of patients will eventually require surgical removal of the colon because they don't respond to medical treatment, or because they develop pre-cancerous or cancerous lesions," Sandborn explained.

Scientists aren't sure exactly what causes the condition, but many believe that heredity plays an important role. Individuals are more likely to develop ulcerative colitis if they have a parent or sibling with the disease.

Some experts believe that a virus or bacterium may be to blame. Inflammation of the digestive tract may occur when the body's immune system tries to fight off invading microorganisms.

Because ulcerative colitis occurs more commonly in people living in urban areas and industrialized nations, it's likely that environmental factors contribute to the condition. Diets that are high in fat or refined foods may increase the risk of developing the disease.

A recent study conducted by New Zealand researchers revealed that other significant risk factors for ulcerative colitis include being a former smoker, and having taken more than four courses of antibiotics a year during adolescence. Antibiotics may trigger the condition by disrupting the normal bacteria in the colon.

Ulcerative colitis is usually diagnosed after ruling out other possible causes for signs and symptoms, including irritable bowel syndrome and colorectal cancer. To confirm the diagnosis, physicians often order blood tests to check for anemia, signs of infection, or certain antibodies that signal the presence of the disease.

Currently, a colonoscopy is the most sensitive test for diagnosing ulcerative colitis. This examination allows doctors to view the entire colon using a thin, flexible tube with an attached light and camera.

During the procedure, physicians can take small tissue samples of the affected areas of the colon. Laboratory analysis of the tissue samples can help provide the correct diagnosis.

Although there is no known medical cure for ulcerative colitis, a number of treatments can reduce the severity of the disease. In some cases, they may bring about long-term remission.

Treatment for ulcerative colitis typically starts with drug therapy. The goal is to reduce the inflammation in the large intestine that triggers signs and symptoms.

One drug commonly used in the treatment of ulcerative colitis is mesalamine. The anti-inflammatory medication may be taken orally, as a tablet, as well as rectally, in the form of enemas or suppositories.

Until recently, pill formulations of mesalamine required patients to take multiple tablets several times a day. Most patients find such frequent dosing inconvenient, and as a result, fewer than 40 percent take their medications as prescribed.

A new, once-daily medication, called MMX mesalamine, uses technology that allows for delayed and extended release of the drug throughout the colon.

"This is a new form of a drug that has been used safely for decades, " said Sandborne. "Once-daily dosing is important, because patients are more likely to take their medications when they don't have to take a lot of pills. "

In addition, decreased dosing reduces the chances that patients will experience side effects of the medication. The results of two large clinical trials showed that MMX mesalamine was not only well tolerated, it also produced remission in a significant percentage of patients with active, mild to moderate ulcerative colitis.

"This drug may improve patients' compliance with medical therapy, and thus improve the overall success in the treatment of ulcerative colitis, " said Sandborne.

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Rallie McAllister, M.D., M.P.H., is a family physician in Kingsport, Tenn., and author of "Healthy Lunchbox: The Working Mom's Guide to Keeping You and Your Kids Trim." Her Web site is www.rallieonhealth.com. To find out more about Rallie McAllister, M.D., and read features by other Creators Syndicate writers and cartoonists, visit the Creators Syndicate Web page at www.creators.com.
Copyright 2006 Creators Syndicate Inc.

Chiropractic manipulation for non-spinal pain--a systematic review

N Z Med J. 2003 Aug 8;116(1179):U539.
Ernst E.
Complementary Medicine, Peninsula Medical School, Universities of Exeter and Plymouth, Exeter, United Kingdom. Edzard.Ernst@pms.ac.uk
AIMS: Chiropractic manipulation is mostly used for spinal problems but, in an increasing number of cases, also for non-spinal conditions. This systematic review is aimed at critically evaluating the evidence for or against the effectiveness of this approach.
METHODS: Five electronic databases were searched for all randomised clinical trials of chiropractic manipulation as a treatment of non-spinal pain. They were evaluated according to standardised criteria.
RESULTS: Eight such studies were identified. They related to the following conditions: fibromyalgia, carpal tunnel syndrome, infantile colic, otitis media, dysmenorrhoea and chronic pelvic pain. Their methodological quality ranged from mostly poor to excellent. Their findings do not demonstrate that chiropractic manipulation is an effective therapy for any of these conditions.
CONCLUSIONS: Only very few randomised clinical trials of chiropractic manipulation as a treatment of non-spinal conditions exist. The claim that this approach is effective for such conditions is not based on data from rigorous clinical trials.
PMID: 14513080 [PubMed - in process]

http://www.immunesupport.com/library/showarticle.cfm?ID=5023

Can Bad Dreams Cause Stress?
How would you describe dreams? How about nightmares? Are nightmares merely dreams that have developed a frightening lot twist? Stress causes nightmares, but is it possible for nightmares to cause stress?
Nightmares can startle you awake and leave you uneasy and unable to get back to sleep. Sometimes, after falling to sleep after such a dream, you slip right back into the same dream. This could cause stress.
How about nightmares that hold you prisoner? You struggle to wake up, but the dream seems to go on and on, leading you deeper into terror. When you finally manage to escape, your heart continues to pound and you're afraid or unable to go back to sleep.
Events depicted in dreams can also cause stress.
Dreams of death of yourself or a loved one leave you shaken. Sometimes unseen assailants are chasing you through unfamiliar territory, always just behind you. Dreams of accidents can also cause stress, especially if these dreams occur when you're planning a trip.
Do dreams or nightmares ever come true? I can't say never, but the occurrence is rare. If dreams or nightmares cause you stress, repeat over and over "it was only a dream. It was only a dream."
Nightmares are common occurrences for children. If your child has a bad dream, again, assure him or her that it was only a dream. Hold him and stay in the room to make him feel secure until he can fall asleep again.
http://sleepdisorders.about.com/od/nightmares/a/nightstress.htm?terms=Nightmares

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On-Off Switch for Chronic Pain

"A protein acts as a switch for chronic pain, and researchers have applied for a patent to develop a new class of drugs that will block chronic pain by turning this switch off."
 

Chronic pain affects approximately 48 million people in the U.S. and current medications are either largely ineffective or have serious side effects. But researchers from Columbia University Medical Center have discovered a protein in nerve cells that acts as a switch for chronic pain, and have applied for a patent to develop a new class of drugs that will block chronic pain by turning this switch off. The discovery is published on the website of the journal Neuroscience, and will appear in the publication's August issue.

Most prior attempts at alleviating chronic pain have focused on the "second order" neurons in the spinal cord that relay pain messages to the brain. It's difficult to inhibit the activity of these neurons with drugs, though, because the drugs need to overcome the blood-brain barrier. Instead, the CUMC researchers have focused on the more accessible "first order" neurons in the periphery of our body that send messages to the spinal cord.

Pain becomes chronic when the activity of first and second order neurons persists after damaged neuron heals or the tissue inflammation subsides. It's been known for years that for chronic pain to persist, a master switch must be turned on inside the peripheral neurons, though until now the identity of this switch remained a mystery. Richard Ambron, Ph.D., professor of cell biology, and Ying-Ju Sung, Ph.D., assistant professor, both in the department of Anatomy and Cell Biology, have now discovered that the switch is an enzyme called protein kinase G (PKG).

This article can be found at:
http://www.emaxhealth.com/index.html?m=show&opt=printable&id=6686

Furrowed brow erased; depression lifts
By Shankar Vedantam
The Washington Post
WASHINGTON — Kathleen Delano had suffered from depression for years. Having tried psychotherapy and a number of antidepressant drugs in vain, she resigned herself to a life of suffering.
Then she tried Botox, the drug that became a rage a few years ago for smoothing facial wrinkles.
In 2004, her physician injected five shots of the toxin into the muscles between Delano's eyebrows so the Glenn Dale, Md., woman could no longer wrinkle her brow. Eight weeks later, according to an unusual study published this month, her depression had lifted.
"I didn't wake up the next morning and say, 'Hallelujah, I am well, I am healed,' " she said, but she noticed changes. "I found myself able to do the things I hadn't been doing. I feel I broke out of the shackles of depression to be in the mood to go out, to reconnect with people."
The pilot study of 10 patients is the first to provide empirical support for what a number of clinicians say they have noticed anecdotally: People who get their furrowed brows eliminated with Botox (botulinum toxin A) often report an improvement in mood.
Until now, the assumption was they were just feeling better about their appearance. But the new study by dermatologist Eric Finzi suggests something else might be at work. Finzi found that even patients such as Delano, who were not seeking cosmetic improvement, showed a dramatic decrease in depression symptoms.
"Maybe the frown is not just an end result of the depression; maybe you need to frown in order to be depressed," Finzi said. "I don't think it has anything to do with making you look better."
Some patients in Finzi's study were receiving other treatments for depression; Finzi required that there be no change in those treatments for three months before he injected the Botox.
Finzi agreed the effects of Botox on depression must be investigated in a much larger study before conclusions about a link can be established, but a growing body of work suggests that changing expressions can influence mood. People asked to smile while watching a cartoon, for instance, report it is funnier than people who are not asked to smile.
Alastair Carruthers, president-elect of the American Society for Dermatologic Surgery, agreed Finzi's study provides new insight into a phenomenon clinicians have noticed.
"Anyone who has injected much Botox into the frown area has had people come in and say they can't believe how they feel better as a result," said Carruthers, clinical professor in dermatology at the University of British Columbia in Vancouver.
Finzi's study was published this month in the society's journal, Dermatologic Surgery.
Of the 10 depressed patients in the Washington, D.C., area Finzi studied, nine recovered from their depressive symptoms, and one — who turned out to have bipolar disorder, or manic depression — showed an improvement in mood.
Differences noted
Delano, now 45, a marketing director, said that by the time she got involved in the study, she had turned down so many invitations for social gatherings that people had stopped asking. She went to see Finzi for a skin problem, which is when she heard he was recruiting patients for a study of depression. He gave her two rounds of Botox injections.
"After a couple of days, the muscles in your forehead, you can't constrict them," she said. "You don't have that anxiety look. You can't furrow your brow ... [but] for me there was not a dramatic cosmetic difference."
But where once she would hide out at home in the evenings and on weekends, Delano said, she found herself enthusiastically cheering her 8-year-old son at sports games. Her relationship with her boyfriend improved, she said.
"My theory on why this works is there is a feedback between the muscles of facial expression and the brain," said Finzi, who has applied for a patent on using Botox for depression.
The theory is similar to one proposed by Robert Zajonc, a psychologist at Stanford University, who thinks facial muscles might alter the temperature of blood flowing in the brain. Relaxation techniques such as yoga and tai chi might help cool the brain and result in a more positive mood, Zajonc said.
Whatever the mechanism, moods can clearly be influenced by expressions, said Paul Ekman, emeritus professor of psychology at the University of California, San Francisco, who has spent decades exploring the connection between emotions and expressions.
"If you make a facial expression voluntarily, you can change the autonomic and central nervous system to generate that emotion," he said.
But Ekman said it is unlikely that simply altering one's expressions can relieve depression.
More plausible, Ekman said, is that changing expressions can help heighten or decrease emotional states.
Or it is possible that by frowning less, patients in Finzi's study seemed less forbidding to others, which helped to strengthen their social connections. In turn, that may have helped ease the depression, Ekman said.
Copyright 2006 The Seattle Times Company
http://seattletimes.nwsource.com/cgibin/PrintStory.pl?document_id=2003008920&zsection_id=2002107549&slug=botox21&date=20060521




Efficacy of neurotropin in chronic fatigue syndrome: a case report.
Hiroshima J Med Sci. 2006 Mar;55(1):35-7. 
Toda K, Kimura H.
 
Department of Rehabilitation, Hiroshima Prefectural Rehabilitation Center,
Higashi-Hiroshima, Hiroshima, Japan.
 
Chronic fatigue syndrome (CFS) is a disorder that causes general fatigue and chronic widespread pain. A 28-year-old male visited an outpatient departmentdue to general fatigue and pain involving the entire body. He did not suffer from fibromyalgia, but he was diagnosed with CFS. At the initial visit, he complained of lack of concentration, memory decline, frequent urination, insomnia and occasional difficulty of emotional control, as well as general fatigue and pain involving the entire body. Four tablets of Neurotropin per day alone were administered. General fatigue and pain were gradually alleviated one week later.
His sleep condition, concentration power, and memory also improved two weeks later. Medication was discontinued from 11 weeks based on the patient's judgment as he felt little general fatigue and pain involving the entire body.
Treatment was completed 3 months later. The symptoms disappeared and did not recur five months after the discontinuation of Neurotropin. He was looking for a jobwithout fatigue and pain 8 months later (5 months after the cessation of treatment). The functional mechanisms of Neurotropin in CFS are unknown.
 
PMID: 16594551 [PubMed - in process]

 
 



LIFE IS THE COFFEE
 
A group of alumni, highly established in their careers, got together to visit their old university professor. The conversation soon turned into complaints about stress in work and life. Offering his guests coffee, the professor went to the kitchen and returned with a large pot of coffee and an
assortment of cups - porcelain, plastic, glass, crystal, some plain-looking, some expensive, and some exquisite - telling them to help themselves to the coffee.   After all the students had a cup of coffee in hand, the professor said: "If you noticed, all the nice looking expensive cups were taken up, leaving behind the plain and cheap ones.  While it is but normal for you to want only the best for yourselves, that is the source of your problems and stress."

"Be assured that the cup itself adds no quality to the coffee. In most cases, it 's just more expensive and in some cases even hides what we drink. What all of you really wanted was coffee, not the cup, but you consciously went for the best cups...and then began eyeing each other's cups."

" Now consider this: Life is the coffee, and the jobs, houses, cars, things, money and position in society are the cups. They are just tools to hold and contain life, and the type of cup we have does not define nor change the quality of life we live.  Sometimes, by concentrating only on the cup, we fail to enjoy the coffee God has provided us. God brews the coffee, not the cups ... enjoy your coffee. "Being happy doesn't mean everything's perfect, It means you've decided to see beyond the imperfections"

Live in peace and peace will live in you.
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