Research Brief

A new study compared the safety and effectiveness of the three FDA-approved fibromyalgia drugs — Cymbalta (duloxetine), Savella (milnacipran) and Lyrica (pregabalin).

Researchers compared side effects as well as effects on pain, sleep disturbance, depression, and fatigue.

Symptom Management

• Pain: Cymbalta and Lyrica were superior to Savella
• Sleep Disturbance: Cymbalta and Lyrica were superior to placebo; Savella was not superior to placebo
• Depression: Cymbalta was the best against depression; Lyrica was not superior to placebo
• Fatigue: Lyrica and Savella fared better than placebo; Cymbalta was not superior to placebo
• Short-term efficacy: All 3 drugs have evidence of short-term efficacy, meaning up to 6 months

Side Effects

Researchers compared the risk of the most common side effects of these drugs.

• Headache and nausea: Lyrica had the lowest risk
• Diarrhea: Cymbalta had the greatest risk

For more information on these drugs, including side effects and how they work, see:

• Cymbalta
• Lyrica
• Savella

Learn more or join the conversation!

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Which Drugs Work Best for Fibromyalgia Symptoms? originally appeared on About.com Fibromyalgia & Chronic Fatigue Syndrome on Friday, April 30th, 2010 at 06:00:25.

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Our grandson, Patrick is now 14 years old. His birthday was yesterday, April 28th. It seemed like yesterday that he was born. As it does with his Mother, our daughter, Heather. She will be 35 years old on May 8th.

We had birthday ice cream last night in between birthday telephone calls. Friday there will be a birthday BBQ with friends and family.

I had my follow-up doctor appointment this afternoon and tests show that I’ve healed from my bladder/kidney infection. I’m pleased as Dwain and I are to take Patrick’s younger brother, Joshua to Pendleton, Oregon (two hour drive) for the weekend to play in a baseball tournament. Heather, her husband Matt and Patrick will be helping with the funeral of their Pastor’s son this weekend.

Patrick and Joshua’s birth Dad and his parents will be at the tournament. I’m not looking forward to seeing their Dad. He makes me tense. My Fibromyalgia symptoms increase with tension. I will work to stay calm … It’s to everyone’s advantage.

It is cold today. It has snowed off and on, but does not stick. Typical spring weather. I hope it warms up for the weekend!

WOW!!!!!! It’s been a month. My intent the end of April was to get back to daily posts. Ha Ha!

We commuted 7 hours to LaCenter, Washington. A few days after arriving, I came down with a flu virus that Dwain had prior to leaving Wallowa. It was uncomfortable but I was able to be up. Then I started feeling like I had a bladder infection. Both the bug and the bladder infection had similar symptoms so I waited for a couple of days. Eventually I went to a pharmacist and inquired about OTC medication for the bladder infection in hopes it would take care of the infection. In a couple of days the left side of my abdomen hurt. It then traveled to the left side of my back. I assumed my kidneys were now involved. On Monday I started with a fever. I hurt enough I was going to ask Dwain to take me to an ER, then didn’t. I thought if I could wait until we returned to Wallowa and my see my own doctor on Wednesday.

Wednesday we drove to Wallowa and I got an appointment on Thursday. I was diagnosed with a bladder and kidney infection, which was no surprise. What did surprise me was the doctor’s comment that I was borderline for being admitted to the hospital. He gave me a prescription and sent me home. The medication and all the water and cranberry juice I had been was drinking (I thought I was going to drown for two weeks) helped. Within a day my fever was gone. I see the doctor again today for a follow-up appointment. I am feeling better. Of course the virus and infections affected my Fibromyalgia. My pain level increased and my energy level decreased. It will take awhile to get back to what “normal” is now.

Food of the Week: Low-Mercury Fish

We keeping hearing more and more about the health benefits of fish, but at the same time, we hear warnings about mercury levels. I know it’s hard for me to keep straight which ones are safe and which ones aren’t, especially when I’m staring blankly at a grocery store freezer or seafood counter while trying not to let a screaming child in the next aisle rattle my nerves.

So this week, I wanted to look at the benefits of fish and which ones are safest.

Benefits of Fish

Fish contain a couple of things that are important for heart and brain health: Omega-3 fatty acids and CoQ 10.  Both of these substances have been researched in fibromyalgia (FMS) and chronic fatigue syndrome (CFS or ME/CFS) and many experts recommend them for us, either in our diets or as supplements.

Omega-3 (also called fish oil) is important for everyone because our bodies can’t make it.  It helps with cellular function and hormone regulation, and while it’s not conclusively shown to correct the specific cellular and hormonal problems faced by people with these conditions, research and clinical evidence suggest that omega-3s can help alleviate some symptoms in at least some of us.

CoQ 10 (short for coenzyme Q 10) is an antioxidant, meaning it protects cells from aging-related damage, and it also helps convert food to energy.  Some studies show that CoQ 10 supplements can benefit some of us with FMS or ME/CFS.

Low-Mercury Fish

Mercury is a neurotoxin. That’s bad for anyone. Some small, preliminary studies show that our conditions may be linked to a heightened sensitivity to heavy metals, including mercury, meaning we’re more likely to suffer ill effects from it.  Since some low-level mercury poisoning symptoms are extremely similar to our own, you may not realize what’s causing it.

Because fish live in contaminated waters, they take in mercury and store it in their bodies. However, fish that are small or have a short lifespan have significantly lower levels than their larger, longer-lived cousins. The fish/shellfish that are lowest in mercury include:

• Anchovies
• Catfish
• Crab
• Crayfish
• Flounder
• Haddock
• Hake
• Herring
• Mullet
• Oysters
• Pollock
• Salmon
• Sardines (especially high in CoQ 10)
• Shrimp
• Tilapia

That’s a fairly long list, but what I try to do is remember a few that I like and that are available in my area.  Whether I’m at the grocery store or a restaurant, I know I’m OK with shrimp, crab, salmon and tilapia.

For a longer list of low-mercury fish and a look at which ones have dangerously high levels, see The Best Types of Fish for Health, by About.com Longevity Guide Mark Stibich, Ph.D.

Which kinds of fish do you like best?  How do you like to cook them?  Have you tried to eat more for the health benefits or have you avoided fish because of mercury concerns?  Leave your comments below!

Learn more or join the conversation!

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• Food of the Week Series
• Your Diet for Managing Symptoms
• CoQ 10 Supplements

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Fish for Fibromyalgia & Chronic Fatigue Syndrome originally appeared on About.com Fibromyalgia & Chronic Fatigue Syndrome on Wednesday, April 28th, 2010 at 06:00:56.

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The cognitive dysfunction of fibromyalgia and chronic fatigue syndrome, frequently called fibro fog or brain fog, can make it seem impossible to be organized. Organization takes a good short-term memory, and I can’t even remember when I had one of those.

But life keeps happening in spite of our illness, and that means that we’re likely to need some level of organization.  For example, in the next month I have 5 medical appointments, a half dozen birthdays, and 4 social engagements to keep track of on top of Mother’s Day, Father’s Day and a trip out of town for my cousin’s wedding.  My husband is working lots of overtime, so I have to schedule appointments around it or find someone to watch my kids (no way am I taking them to a massage appointment!)  That’s on top of daily, weekly and monthly goals for work; remembering to order prescription refills on time; and finding time to do those dreaded tasks such as laundry and grocery shopping.

On my own, I’m lucky if I remember to breathe.  To keep myself on top of things, I’ve had to develop multiple systems.  I’ve talked to a lot of people with these conditions who say the same thing — because we can’t rely on our brains, we have to find something else on which to rely.

It really helps me that I practically live on my laptop.  I’ve set up an iGoogle home page with multiple organizational applications — a calendar for appointments and overtime; a to-do list of household projects; a birthday calendar; a list of gift ideas for different people; and an amazing daily scheduler that holds absolutely everything I need to do for work, household goals, and everything that’s on my calendar so I can spot different kinds of conflicts.

That should take care of me, right?  Forget it — if I’m not at the computer, I have no idea what I should be doing.  I also keep scheduling information on a wall calendar in my kitchen as well as in my cell phone so I can schedule my next massage before leaving.  (That’s important, because once I walk out the door I’ll forget I need to make the appointment!)  Once a week, when my daily organizer tells me to, I sit down with my phone, calendar and computer and make sure they’re all complete.  (Yes, it would be simpler to have wireless Internet on my cell phone, but thus far I’ve been too cheap.)  I also set my cell to give me a reminder an hour before appointments, just in case all else has failed.

I look ahead at my schedule frequently to make sure I spot problems and identify times that I just have too much going on.  A child’s birthday party and grocery shopping on the same day?  The sensory overload would land me in bed for days!  A heavy writing day after an evening with friends?  Nope — my brain won’t be up to it.

This probably sounds crazy or obsessive to “normal” people, who can usually remember why they walked into a particular room, but for me it’s an absolute necessity.  Without these organizational aids I’d be lost and nothing would get done. Now, if I could only get my house as organized as my time . . . .

What helps you stay organized?  How well does it work?  What problems have you run into because of memory problems?  Leave your comments below!

Learn more or join the conversation!

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• Brain Fog: Causes, Symptoms & Treatments
• Pacing Yourself With Fibromyalgia & Chronic Fatigue Syndrome
• Filing for Social Security Disability

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Staying Organized With Fibromyalgia & Chronic Fatigue Syndrome originally appeared on About.com Fibromyalgia & Chronic Fatigue Syndrome on Wednesday, April 28th, 2010 at 06:00:03.

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Raising awareness isn’t the top priority for most people with fibromyalgia (FMS) and chronic fatigue syndrome (CFS or ME/CFS).  Most of us don’t have the energy, and how many of us have been humiliated by comments and attitudes from people who think we’re crazy or lazy?  We all have a big stake in awareness, though — it can mean more research and more public understanding, both of which we really need.

May 12 is the official National Awareness Day and events are planned for on and around that day, including the National Fibromyalgia Association’s Walks of Fame. The NFA has suggestions on other ways to get involved as well as a list of events going on around the country.

If there’s not an event in your area, you might be feeling like there’s nothing you can do. You’re probably right, if you look at this as a one-day-a-year thing. Instead, let’s look at Awareness Day as a reminder that we can all make small strides to raise awareness when opportunities arise.

Talking about our illnesses openly can be scary, in know, but it can also help raise awareness.   I find myself talking about it a lot because of my job, and it amazes me how often I find a friend or family member of someone with FMS or ME/CFS.  A couple of times I’ve found someone who was newly diagnosed, scared and confused.  I’ve also run into health-care providers who are interested in hearing about research.

What I’ve learned is this: if I keep my illness to myself, people I encounter will have no idea that they know someone with FMS. Just that little bit of knowledge makes them more aware, and hopefully more accepting. That could make a big difference the next time they encounter someone else living with this.

Other small ways you can raise awareness are:

• Contact your local media to tell your story.
• Get an FMS or ME/CFS t-shirt and wear it to the grocery store, to work, to the park, wherever. (Many of our awareness organizations sell merchandise.)
• Contact local colleges to see if you can speak to nursing, physical therapy or other medical classes.

Have you found good ways to raise awareness and help people learn about these conditions? Share your ideas by leaving a comment below!

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• Top Advocacy & Awareness Groups
• When Someone You Know Has FMS or ME/CFS
• Talking About Your Health Problems

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Fibromyalgia & Chronic Fatigue Syndrome Awareness: May 15 & Beyond originally appeared on About.com Fibromyalgia & Chronic Fatigue Syndrome on Tuesday, April 27th, 2010 at 06:00:47.

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When you have a moment of bad brain fog/fibro fog, do you tend to have a strong emotion to go with it?  I certainly do, and I hear it all the time from other people with fibromyalgia or chronic fatigue syndrome.  Some people say they cry, and others talk about getting angry.  I tend toward the anger reaction — the worse my brain, the shorter my temper.

It’s normal to be frustrated, embarrassed or angry when your brain misfires, but it seems like a lot of us have a disproportionately strong reaction.  A normally strong woman will break down in tears, or a typically even-tempered person will snap at anyone around.  When I’m really foggy, I just don’t seem to have the same control over my emotions as when I’m clear headed.

This isn’t the kind of thing researchers look into.  Heck, they may not even know about it, but it’s definitely something that effects our lives and our relationships.  I can’t count how many times I’ve had to apologize to my husband for an undeserved harsh word.  Fortunately, he’s come to understand that when my brain goes haywire my emotions follow.  I’m lucky that I work from home, and most of my communication is written — that way, I can’t suddenly lash out at someone and regret it a moment later (especially since it takes me so long to write a coherent sentence when I’m fogged in that my common sense kicks in long before I hit “send.”)

I know that physically, in the brain, pain and emotion are linked in a complex way that researchers are just beginning to understand.  I have a feeling that when they really nail down what’s going on with brain fog, it’ll involve the same regions of the brain and/or the same chemical processes that cause our pain amplification and mood issues.

This is an especially tough problem to deal with, because it’s hard to monitor your actions when you’re struggling to find a word, or to remember what a conversation is about, or you’ve misplaced your car in a large parking lot.  At those moments, our brains are generally overwhelmed with confusion, fear, anxiety … or with an odd “nothingness” that somehow seems to blot out everything else.  Then, without warning, the emotions hit full force.  It’s like the censors that usually keep us from saying or doing the wrong thing are completely shorted out.

I think being aware of the tendency is the first step toward improving it.  We can try to help the people around us accept that it’s the illness and not us, but that’s sure a lot easier said than done.  The best thing is to find things that help clear the fog, but again, that’s not so easy.  We do have a lot of things we can try, though, and with luck we’ll find several small things that eventually add up to a big improvement.

You can learn more about brain fog/fibro fog, its symptoms, possible causes, and treatment options, here:

• Understanding Brain Fog

What emotions tend to be connected to your foggy moments?  Have you found anything that helps?  What are some of the things you’ve said or done during those times?  How has this issue impacted your relationships? Leave your comments below!

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• Fibromyalgia Symptoms Checklist
• Chronic Fatigue Syndrome Symptoms Checklist
• Accepting Your Illness vs. Giving In To It

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Brain Fog & Emotions With Fibromyalgia & Chronic Fatigue Syndrome originally appeared on About.com Fibromyalgia & Chronic Fatigue Syndrome on Monday, April 26th, 2010 at 06:00:14.

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In my recent Food of the Week series, we’ve discussed a couple of foods that are part of the nightshade family.  Some people expressed concerns about that, so I thought it was a good idea to discuss these kinds of foods.

The nightshade family encompasses some common fruits and vegetables, including:

• Potatoes (but not sweet potatoes)
• Tomatoes
• Eggplant
• Sweet & hot peppers
• Ground cherries (a small orange fruit somewhat similar to a tomato)
• Goji berries

For years, many doctors and patients have said that nightshade vegetables aggravate arthritis symptoms, and this belief has spread to other conditions as well, including fibromyalgia and chronic fatigue syndrome. However, research has failed to show any link between nightshades and symptoms.

Of course, research doesn’t have all the answers — it could well be that a subgroup of people is sensitive to the suspect chemical in these foods, glycoalkaloids, and it’s just not common enough to show up significantly in studies.

The bottom line is that some people have a problem with nightshades while others don’t, just like some people have a problem with sugar, caffeine, alcohol or gluten that others don’t. The only way to know for sure how foods impact your symptoms is to experiment and play close attention. One great tool for that is the elimination diet, and it also helps if you keep a detailed food/symptom diary. You can find out more about those here:

• The Elimination Diet
• Keeping a Symptom Journal

What foods bother you?  Have you identified any categories, such as the nightshade family?  What foods make you feel better?  Leave your comments below!

Learn more or join the conversation!

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• The Food of the Week Series
• Your Diet for Symptom Management
• Overcoming Illness-Related Challenges to Eating Healthy

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Nightshade Vegetables & Fibromyalgia/Chronic Fatigue Syndrome originally appeared on About.com Fibromyalgia & Chronic Fatigue Syndrome on Sunday, April 25th, 2010 at 06:00:25.

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