Fibromyalgia Syndrome Relief

Research Briefs

According to information published by Newswise, two recent studies on sleep shed light on what could link fibromyalgia and chronic fatigue syndrome to a higher risk of diabetes, and a third could make it easier for people with these conditions to have a quality sleep study.

Study #1: Sleepless Night = Insulin Resistance

A new study accepted for publication in the Journal of Endocrinology & Metabolism suggests that a single night with inadequate sleep is enough to cause insulin resistance.  This is the first study to link just one night of poor sleep to the problem, but others have shown a link between insulin resistance and several night of shortened sleep duration.

Insulin resistance happens when the body no longer uses insulin efficiently, so it takes more of the hormone to keep the body functioning.  This is a key component of type 2 (adult-onset) diabetes.

People with fibromyalgia and chronic fatigue syndrome typically don’t sleep well and awaken feeling unrefreshed.  That could be to blame, at least in part, for the higher incidence of diabetes in these conditions.

Study #2: Sleep Apnea & Insulin Resistance

In an unrelated study, researchers found that sleep apnea may increase insulin resistance as well.  This information was presented recently at the American Thoracic Society’s (ATS) International Conference in New Orleans.

Sleep apnea is a common comorbidity with fibromyalgia, and rates are rising in the general population along with obesity.  This study underscores the need for proper treatment of sleep apnea as well as the need for proper diagnosis.

Study #3: At-Home Sleep Testing

Obstructive sleep apnea (OSA) is often diagnosed during a sleep study, in which the patient must go to a sleep lab for the night.  However, many people find this process to be extremely uncomfortable, and there can be a long wait time.  It also makes follow-up evaluation difficult and costly.

New research showing that at-home tests are as good at diagnosing OSA also was presented at the ATS conference.  In addition, it showed that people diagnosed this way were just as consistent in their use of a CPAP machine, which is the common treatment, as were those diagnosed at a lab.

This study did gather data on the costs of lab testing vs. home testing with a portable monitor, but those results have not yet been released.

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Sleep & Common Comorbidities With Fibromyalgia & Chronic Fatigue Syndrome originally appeared on About.com Fibromyalgia & Chronic Fatigue Syndrome on Monday, May 31st, 2010 at 06:00:24.

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The brain fog of fibromyalgia and chronic fatigue syndrome can really impair our memories — both short and long term.  The short-term memory problems are evident when we walk into a room and don’t remember why we’re there, or when we tell ourselves over and over not to forget the grocery list and then arrive at the store only to remember it’s sitting on the kitchen table.  Those things are aggravating, potentially embarrassing, and often detrimental on the job or when it comes to those have-to-do things like paying bills.  In my former job as a TV news producer, a good short-term memory was crucial — what did the reporter just tell me about that breaking story?  What did I need to go change?  What did I urgently need to tell my video editor?  That was a big part of the reason I finally left that job.

The short-term memory problems can hamper and force us to change our lives.  The long-term memory problems, however, can remove pieces of our lives.  I developed full-blown fibromyalgia when my daughter was 19 months old, but the symptoms had been steadily creeping up from the time she was born.  I continued at my old job until she was 2.5, and then I began to slowly improve.  As a result, my memories of her as a baby and toddler are fuzzy and piecemeal.  I don’t remember what baby foods she liked.  I don’t remember her first step.  I don’t remember much of anything, and some of the memories I do have are hazy.  When I think back on my older son at that age, the memories are crisp and vivid, like they happened yesterday.

It was a hard realization to come to, that I don’t remember most of my daughter’s baby-hood.  I’ve had to mourn it as a loss and come to accept that it doesn’t mean I’m a bad mother or that I love her any less — my brain simply wasn’t able to make good memories during those years.

Memory is a complicated thing.  We don’t completely “get” how it works yet, so we don’t know how to fix memory problems.  Are the memories in the brain, somewhere, and we simply can’t retrieve them, or were they never recorded in the first place?  And either way, why?

A common belief in the scientific community is that our daily events are recorded as short-term memories, and then while we sleep our brain basically transfers what it deems important into long-term storage.  Our long-term memory problems seem like a double whammy — neurotransmitter dysregulation and other brain issues, like blood flow abnormalities, appear to impair our ability to capture things in short-term memory.  That means the record of that day’s events is incomplete.  Then, we sleep poorly and have abnormal brain activities during sleep, which may be disrupting the transfer to long-term memory.  What we’re left with is sometimes Swiss-cheese, sometimes seen through gauze, and sometimes nothing at all.

Do you have blank spots in your memory — missing days, weeks, or years?  What important things are missing, and how has it effected you?  Have you ever recovered chunks of missing memory?  Leave your comments below!

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Missing Memories With Fibromyalgia & Chronic Fatigue Syndrome originally appeared on About.com Fibromyalgia & Chronic Fatigue Syndrome on Saturday, May 29th, 2010 at 06:00:53.

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I wrote recently about starting treatment for TMJ (temporomandibular joint disorder), which is a common condition in those of us with fibromyalgia and chronic fatigue syndrome. I’ve also talked a lot here about my very positive experience with acupuncture for treating my fibromyalgia and myofascial pain syndrome, so it really grabbed my attention when I saw this headline from About.com Alternative Medicine Guide Cathy Wong: Acupuncture May Ease TMJ Pain.

Cathy’s post is about a new study showing that acupuncture can not only relieve the jaw pain of TMJ but can also help people clench their jaws less often. This is a biggie with TMJ and something I’ve been working on myself. I didn’t even realize I did it until recently, when I started paying more attention to my jaw in general. Now I catch myself clenching several times a day and have to consciously relax.

Due to an insurance mix up I’m not getting acupuncture treatments right now, but once I’m going again I do plan to talk to my acupuncturist (who’s also my rheumatologist) about using it for TMJ, since it’s one of my bigger problems at the moment.

Studies of acupuncture for fibromyalgia are inconsistent, and anecdotally we’re seeing the usual — it helps some of us, but not all of us. Acupuncture is one of the primary treatments for myofascial pain syndrome, however, which is probably part of the reason its helped lower my pain levels dramatically.

Meanwhile, my TMJ treatment is going well. After 3 weeks of regularly icing and stretching, my jaw can open 8 mm wider than when I started, and my doctor says he’s so encouraged that we’re putting off an appliance that I’d wear at night to keep my teeth from grinding. You can read more about my treatment and the stretch I’m doing here: Starting Treatment for TMJ.

Do you have TMJ?  Have you tried acupuncture for it?  What has helped you?  Leave your comments below!

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TMJ & Fibromyalgia: Finding Effective Treatments originally appeared on About.com Fibromyalgia & Chronic Fatigue Syndrome on Thursday, May 27th, 2010 at 06:00:59.

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Food of the Week: Yogurt

Yogurt is one of those foods that’s been increasingly popular due to news about health benefits. Yogurt has been fairly well researched in the general population and shown to have several properties that may benefit those of us with fibromyalgia (FMS) and chronic fatigue syndrome (CFS or ME/CFS).

Research suggests that yogurt may:

• Enhance the immune response by increasing T-cell count. T cells are often low in ME/CFS;
• Alleviate symptoms of irritable bowel syndrome, which is common inFMS & ME/CFS;
• Prevent vaginal yeast infections, which are common in FMS & ME/CFS;
• Improve heart health by lowering bad cholesterol and raising good cholesterol. (Some researchers believe ME/CFS involves cardiovascular problems;)
• Help prevent osteoporosis.  FMS is considered an osteoporosis risk factor.

Yogurt also contains several nutrients that are believed to help manage the symptoms of FMS & ME/CFS:

• Vitamin B12
• Magnesium
• Potassium
• Calcium
• Protein
• Vitamin D, in some fortified yogurts

The substance behind many of yogurt’s health benefits is probiotics — tiny live organisms that do a lot of good things in the body.  Not all yogurts have them, so you have to check the label.  Look for wording such as “live and active cultures.”  However, yogurt without live cultures still contains the nutrients listed above and may also provide immune benefits.

I’ve been working to make yogurt a bigger part of my diet, and it does seem to help with my intestinal issues.  I have problems with yeast, and since sugar feeds yeast it doesn’t make sense to me to eat sweetened yogurt, so I opt for unsweetened or lightly sweetened kinds.  To improve the flavor, I add things like fruit, cinnamon or a dash of vanilla.

Many nutritionists recommend buying low-fat yogurts, using it as a replacement for sour cream (like on a baked potato) and in recipes that call for fats (like butter or margarine.)  You can learn more about that here: 10 Ways to Use Low-Fat Yorgurt, from About.com Low-Fat Cooking Guide Fiona Haynes.

Do you eat yogurt regularly?  Have you tried cooking with it?  Have you noticed any health benefits?  Share your experience, and favorite recipes if you have them, below!

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Yogurt for Fibromyalgia & Chronic Fatigue Syndrome originally appeared on About.com Fibromyalgia & Chronic Fatigue Syndrome on Wednesday, May 26th, 2010 at 06:00:09.

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A new study out of Germany could provide support for U.S. research linking XMRV to chronic fatigue syndrome and cast doubt on European studies failing to find it.

The German study didn’t look into chronic fatigue syndrome, and it didn’t involve the blood or prostate tissue, as other studies have. Instead, researchers tested respiratory-tract secretions from healthy controls plus 3 different categories of people with respiratory-tract infections (RTIs): those with no underlying conditions, those with underlying chronic obstructive pulmonary disease (COPD), and those on immunosuppressive medications because of a transplant.

They found XMRV in:

• 3.2% of controls
• 2.3% of those with RTIs & no underlying conditions
• 2.3% of those with RTIs & COPD
• 9.9% of those on immunosuppressive drugs

With the highest prevalence rate being in people with compromised immune systems, it raises the possibility that XMRV isn’t a cause of disease, but is what’s called an “opportunistic infection” — one that takes advantage of a weak immune system to set up shop.  An opportunistic infection may make an existing illness worse, but it doesn’t cause the illness.

It’s interesting that the rates in those without immunosuppression were similar to those of healthy controls in the U.S. study.  Also of note: German researchers did not use the same methods as U.S. researchers to detect XMRV; and XMRV’s presence in respiratory secretions suggests that it could be transmitted through the air.  That’s not certain, however — it’s still an area that needs a lot more research.

Also, the U.S. research, done by the Whittemore Peterson Institute, found XMRV in about 68% of people with chronic fatigue syndrome — a much higher rate than found in the immunosuppressed patients.  Again, it’ll take more research before why know why the rates are so much higher, if the findings were accurate.

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Germans Find XMRV, Retrovirus Linked to Chronic Fatigue Syndrome originally appeared on About.com Fibromyalgia & Chronic Fatigue Syndrome on Tuesday, May 25th, 2010 at 06:00:25.

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Do you think fibromyalgia makes you more likely to fall? A recent study suggests it does. Researchers presented data at The American Pain Society’s 29th Annual Scientific Meeting.

An interesting aspect of this study is that they looked at 3 measures of balance: visual, spatial and somatosensory (input from the skin and other organs.) The fibro folks did worse than their healthy counterparts in all 3. In fact, researchers tell WebMD that the average 50 year old with fibromyalgia did worse than what you’d expect in someone who was 70 or 80.

Researchers concluded that we need to do exercises that improve balance to prevent falls.

Most of us are well aware that we have balance problems. I frequently stagger, stumble or sway because I suddenly find myself off balance. I remember one particularly stressful day back when I was a TV news producer when I was rushing down a hallway and repeatedly bounced off the wall because I couldn’t walk straight. The symptom is called either orthostatic intolerance or neurally mediated hypotension, depending on what appears to be causing it.

I took a poll about a year and a half ago on how clumsy we are, and the results speak for themselves — more than 80% said “Oh boy, yes!”

Improving Balance

So how can we improve our balance? Another recent study showed that whole-body vibration can help. Also, yoga and Tai Chi are both options that may work well for us. (Just be sure that you start slowly and stay within your “safe” zone of exertion so you don’t cause a flare.)

This study also made me think about bone health. Did you know fibromyalgia may actually be a risk factor for osteoporosis? Whether its because we’re less active than other people or due to problems with absorption (or both), we need to be on alert for this. When you combine osteoporosis with a tendency to fall, you end up with broken bones. Here’s information on osteoporosis for you:

• What You Need to Know About Osteoporosis, from About.com Orthopedics Guide Jonathan Cluett, M.D.
• Preventing Osteoporosis, from About.com’s Senior Health site

Do you have balance problems? Have you had some bad falls? Do you have osteoporosis or early signs of it? Leave your comments below!

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Fibromyalgia & Falls: Are You Prone? originally appeared on About.com Fibromyalgia & Chronic Fatigue Syndrome on Monday, May 24th, 2010 at 06:00:40.

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Tender-point exams are no longer the only way to diagnose fibromyalgia — the American College of Rheumatology has provisionally accepted alternate criteria for diagnosing the condition and gauging the severity of symptoms.

The diagnostic criteria doctors have been using were established in 1990.  Once other possible causes of symptoms were eliminated, diagnosis was based purely upon pain.  It had to be on both sides of the body, both above and below the waist, along the axial skeleton (head, throat, chest, spine), and also in at least 11 of 18 specific spots on the body that are called tender points.  Symptoms have to have been present for at least 3 months.

The tender-point exam has always been controversial for several reasons.  First, it was originally intended as a qualifier for clinical studies, not as a diagnostic tool.  Second, it’s subjective because it relies on a patient’s self-reported pain.  Third, because symptoms fluctuate so much, the number of tender points may vary greatly from one exam to another.

Until we have a diagnostic test that’s based on blood markers or imaging, we probably won’t have a perfect diagnostic test.  (This is true of many diseases, especially neurological ones.)  Still, researchers believe they’ve come up with something that works better — they say when the looked at a group of previously diagnosed fibromyalgia patients, the tender-point exam was about 75% accurate, while their criteria caught it 88% of the time.

New Diagnostic Criteria

The new criteria keep the requirements that other causes be ruled out and that symptoms have to have persisted for at least 3 months.  They also includes 2 new methods of assessment, the widespread pain index (WPI) and the symptom severity (SS) scale score.

The WPI lists 19 areas of the body and you say where you’ve had pain in the last week.  You get 1 point for each area, so the score is 0-19.

For the SS scale score, the patient ranks specific symptoms on a scale of 0-3.  These symptoms include:

• Fatigue
• Waking unrefreshed
• Cognitive symptoms
• Somatic (physical) symptoms in general (such as headache, weakness, bowel problems, nausea, dizziness, numbness/tingling, hair loss)

The numbers assigned to each are added up, for a total of 0-12.

This next part is really interesting to me.  Instead of looking for a hard score on each, there’s some flexibility built in, which recognizes the fact that fibromyalgia impacts us all differently, and that symptoms can fluctuate.

For a diagnosis you need EITHER:

1. WPI of at least 7 and SS scale score of at least 5, OR
2. WPI of 3-6 and SS scale score of at least 9.

What this does is allow for people with fewer painful areas but more severe symptoms to be diagnosed.

Something else I really like about this is that it finally includes cognitive symptoms!  For many of us, “fibro fog” is as debilitating or even more debilitating than pain, yet the old criteria didn’t even mention it.  It also recognizes the difference between “fatigue” and “waking unrefreshed,” which I believe is an under-recognized distinction in the medical community.

A quick note about “somatic symptoms”: strictly speaking, somatic means physical.  The term has gotten a bad rap in the fibromyalgia community because it’s been used to suggest our symptoms are the result of somatization, which means “physical manifestations of a psychological illness.”  On its own, however, the word somatic does not imply a psychological basis.

The full article on the new criteria isn’t yet available for free online, but a PDF of an appendix including these criteria is.  It has the list of painful areas for the WPI and a long list of somatic symptoms that could be considered.  It’s here:

• Appendix A: Fibromyalgia Diagnostic Criteria

If you’re undiagnosed or tentatively diagnosed, you may want to take that to your doctor.  Be sure to let him/her know that it’s from the American College of Rheumatology and was published in Arthritis Care & Research.

What do you think of the new criteria?  Will they help clear up controversy and confusion?  Do you like the built-in flexibility?  Leave your comments below!

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New Diagnostic Criteria for Fibromyalgia originally appeared on About.com Fibromyalgia & Chronic Fatigue Syndrome on Saturday, May 22nd, 2010 at 06:00:13.

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Hi! My name is Lucy Sue. I am nine weeks old and I have been living with Dwain and Debbie for three days. I love my new home. I’m a little spoiled, but not enough to be obnoxious…yet.

I went to the Double Arrow Veterinary Hospital yesterday. WOW! What an experience. First the Vet Tech weighed me. I am 2.5#. I may be small, but don’t under estimate the weight I can throw around. Next she used a thermometer in my little bottom. My temperature was just right. She took my picture for their file. Dr. Greenshields came in and had a big smile when he saw me. Little did I know that he was going to poke me with a needle and make me drink something that tasted like bananas. I think they are going to keep me healthy. Dr. G poked, squeezed and lifted. I had been taking a nice nap before we got to the clinic.

Before we left Dwain and Debbie bought me a new halter and leash. Guess what color? PINK!!!
I have some great tasting food and treats too. I also have two new toys.

Because I’m small, I get cold easily. Debbie thinks she might find a sweater for me. Our friends, Clarence and Debbie gave me a nice crate. Dwain put my food and water in the back of the crate along with a blanket. I don’t mind going in the crate to have a bite to eat and drink, but they want me to sleep in there. That’s going to take alot of convincing as I’d much rather sleep on the couch or on the floor next to their feet. Actually, I like to drape myself across their foot. Debbie thinks that is because I miss my five brothers and sisters. That might be, as their feet are the same size as my siblings.

They want me to sleep when it is dark outside. I would rather be awake at night and sleep during the day. What’s wrong with that? Many people have this schedule, granted most are teenagers and those under 30. Just because Dwain and Debbie happen to be over 30 (he he), should I change what makes me happy? Besides, Debbie stays up with me. That won’t last much longer, because she says she can’t take it anymore. Her Fibromyalgia is flaring. I don’t like to make her hurt, so we may need to compromise. While I’m taking a cat nap…oh…I’m a dog…they put me in my crate. I show them…I wake up immediately and come out of the crate and sleep in front of it.

I went to Josh’s baseball game last night. There were kids who wanted to hold me. It was nice for awhile, but I was glad Debbie retrieved me. Patrick then came along and saved me from Debbie’s lap. Unfortunately, he dropped something, bent over to pick it up and I tumbled out of his arms. That hurt! But I survived. I have a voice like my sister Heather and the whole ball field heard me.

Time for me to sleep for a couple hours more.