Thriving with Fibromyalgia

The weather and fibromyalgia

You knew it!  Now it has been demonstrated scientifically.  Fibromyalgia patients feel more aches and pains in cold and damp weather.  Researchers had 955 patients with number of different problems like arthritis and fibromyalgia fill out pain logs.  Their conclusion: "In our study as well as in literature we found that a high percentage of patients (70 percent) perceived that weather conditions influenced their pain and disease. Fibromyalgia patients seemed to be strongly influenced by weather changes. Our study confirms that patients perception on the influence of climate on pain and therefore their disease is an important clinical factor and it should be considered when evaluating rheumatic patients."

http://www.ncbi.nlm.nih.gov/pubmed/18159202?ordinalpos=1&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum

Fibromyalgia-a different type of pain

One of the problems that many people with fibromyalgia face is that there are no tests that definitively show that you have fibromyalgia.  However, what scientists have learned quite a bit about what causes fibromyalgia what goes wrong to create whole body pain.  There are some genetic factors that have been shown to be related to a higher risk of getting fibromyalgia.  In addition, stress can be a factor, including physical, like car accident, viral infections, repeated intense emotional stress, and other autoimmune disorders.

It is clear that there is too much activity in the nervous system, and the whole central nervous system becomes hypersensitive.  Brain scans of people with fibromyalgia and examination of spinal fluid have shown that fibromyalgia is a real thing, not something that is "just in your head."

Dadabhoy D, Clauw D. therapy in sight: fibromyalgia-different type of pain needing a different type of treatment.  Nature clinical practice rheumatology posted 07/12/2006.

www.fibroinfoservice.com

Dopamine and fibromyalgia

Dopamine is a chemical in your brain that is used to send messages to the nerve cells or neurons in your brain that control your muscles.  James Parkinson figured out in 1817 that the tremors and speech problems seen in what we now call "Parkinson's disease" were improved by giving dopamine.  Before that, people with Parkinson's disease were sent to mental hospitals (because doctors then thought if you can't figure out the cause for a disease, it must be "all in your head").

Fibromyalgia patients still find that doctors think their symptoms are "all in their heads."  Andrew J. Holman, M.D., an assistant clinical professor at the University of Washington in clinical rheumatology, did some studies with medications that increase dopamine in your brain.  Since it cannot be easily measured, dopamine has not attracted much attention from doctors before.  Dr. Holman wondered if the sleep problems and other muscle problems that fibromyalgia patients have could be improved by the same medicine that is used for patients with restless leg syndrome.  Mirapex, or pramipexole, was given to fibromyalgia patients.  Patients found a tremendous benefit, and it also seems to help with depression.

Turn your bathtub into a hydrotherapy spa

There are a few research studies that have shown the benefits of Hydrotherapy, or what most of us call soaking in hot water, sometimes with minerals added. Most fibromyalgia patients do find that heat helps temporarily relieve their aches and pains.

How can you take advantage of this without spending a fortune? If you have a working bathtub, you can get some great benefits from soaking. Here are a few tips:
Get an inexpensive plastic bathmat with suction cups for the bottom of the tub; this will make it much more comfortable to lie on your back.
Get an inexpensive plastic bath pillow with suction cups for the bottom of the tub.
Use a washcloth under your rear end to keep from sliding around while you are lying down in the tub.
If you want to lie down so that your neck and shoulders are in the hot water, you will not be able to fill the tub up to the point that it covers your stomach. Fill the tub to the point where you can just barely feel your upper body lifting a tiny bit off the bottom of the tub, but so that your hips are securely on the bottom of the tub and your head is able to relax on the bath pillow.
Use a hand towel soaked in hot water to keep your chest and stomach warm (the water will not cover you up this far if you are actually lying down with your head in the tub).
If you have a little extra money, buy a small space heater, the kind that is oil filled and is safe for using in a bathroom. This will heat up a small bathroom quite quickly, and make you feel a lot more comfortable getting in and out of the tub.
Dry off quickly, and put on lotion, mineral oil, or sesame oil; soaking in hot water will be tend to dry your skin out.
You can buy Epsom salts pretty cheaply at the grocery store. Adding these to the water will help relieve bruises and aching muscles.

No pill treatments for fibromyalgia

Is there anything that really works for fibromyalgia aside from medications?  This was the subject of a systematic review of the literature, published in a peer-reviewed journal.  After doing their review of articles, they came up with 25 randomized controlled trials.  These are considered the gold standard of figuring out whether something works or not.  It means that people are assigned by chance to either get the treatment or not get treatment, and that information about whether you are getting the treatment or not is not available to the person doing the analysis.

The studies covered exercise therapy, educational intervention, relaxation therapy, cognitive behavioral therapy, acupuncture, and forms of hydrotherapy.  They found a lot of problems with the studies, with poor methodology, small numbers of people involved, and not enough statistical power to really give a good outcome.  The longest follow-up was 16 weeks.

The bottom line from all this was that strong evidence did not emerge for any single intervention, although there was some good support for aerobic exercise.  They ended by recommending more studies in the area.

Sim J, Adams N. systematic review of randomized controlled trials of non-pharmacological interventions for fibromyalgia.  The clinical Journal of pain, volume 18 (5), September/October 2002.  324-336.

http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&Cmd=ShowDetailView&TermToSearch=12218504&ordinalpos=5&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum

Treatments for irritable bowel syndrome

Too many bacteria in the small intestine (small intestinal bacterial overgrowth) is often the cause of irritable bowel syndrome.  One way to test for this is to see if patients have more methane on their breath after they eat some lactulose (lactulose breath test). One study showed that treating irritable bowel syndrome patients with non-absorbable antibiotics resulted in the symptoms going away completely.  This can happen after only 10 days of rifaximin, a non-absorbed oral antibiotic that acts mostly in the small intestine.  Even after patients stopped the antibiotics, they still felt better.  Probiotics have also been used in studies of irritable bowel syndrome with good results.

Othman M, Aguero R, Lin H. Alterations in intestinal microbial flora and human disease (Gastrointestinal infections: edited by Edgar C. Boedeker).

Bugs in your gut

It's not something we usually want to think about, but all of us are born with a variety of "bugs" in our intestines.  Shortly after birth, hundreds of species of bacteria and archaea establish themselves in the colon.  There are over 400 species of microbes that are normally concentrated in the colon, but surprisingly, the small intestine is not supposed to have very much.  When you get too much bacteria in the small intestine, it is called small intestinal bacterial overgrowth, or SIBO.  This can cause a lot of health problems, and has been shown to make acute pancreatitis worse, to cause irritable bowel syndrome, to make inflammatory bowel disease worse, and to be related to fibromyalgia.

Othman M, Aguero R, Lin H. Alterations in intestinal microbial flora and human disease (gastrointestinal infections: edited by Edgar C. Boedeker).

More hardware issues

Sorry I have been unable to write for awhile.  In continuing to tweak my computer after its return from the HP workshop, I had several trips to Fry's for various cables and missing bits.  Helpfully now things are working better, although half the time my Golden Touch keyboard seems to have trouble getting recognized.  Here's hoping everything will keep on working without further glitches!