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COMMUNITY NEWSLETTER # 77
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
October 2, 2006
Editor: Mary McKennell ****************************************************
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 chiropractors
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 dont have a
headache and vision that wont 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 years 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
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!
ARTICLES IN THIS ISSUE:
Depression Gene Found
Depression: No Miracle Sleep Cure
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
'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
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
Depression: No Miracle Sleep Cure
Sleep-deprivation therapy has been lauded as a cure for depression, but it rarely does the
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
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 persons vulnerability to depressionand there's no drug or procedure for
these. As I have often said in this column, no amount of medication is going to change
someones history, make them better problem-solvers or build them a strong social
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
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.'
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 persons health and behaviour.
It is now accepted that pain is more than just a sensory experience, and that
factors like a persons 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:
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
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,"
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
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
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
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
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.
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.
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]
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.
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
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:
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
Then she tried Botox, the drug that became a rage a few years ago for smoothing facial
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
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
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.
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
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
More plausible, Ekman said, is that changing expressions can help heighten or decrease
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
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
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.