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| December 2009 eNews Alert |
As we approach 2010, it marks 20 years since the official tender point criteria was published for diagnosing fibromyalgia (FM). The criteria were an important catalyst for the start of a new era of research that began with a handful of investigators (mostly in North America). Today, there are hundreds of scientists around the world with a strong interest in identifying the real physiological processes contributing to the symptoms of FM. Much progress has been made and so much more is yet to take place. In this issue of the eNews, we talk about new research but also offer you novel suggestions on how to be happier and make the most out of life in the coming year. Living with a chronic illness is always a challenge, but let’s hope that it gets easier for everyone in 2010! |
In this eNews Alert:
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| Could Fibro Make Arthritis Worse? |
Most people assume that as they age, the wear and tear on their joints will eventually lead to osteoarthritis (OA). Indeed, OA is the leading cause of pain and disability around the world, but have you ever considered if having fibromyalgia puts you at greater risk of developing OA? Find out what two important researchers have learned and what you can do to help yourself in the Latest News section of our website. |
| Medical Marijuana: Myths vs Science |
While authorities in the United States struggle on the ethical and legal issues surrounding the use of medical marijuana, scientists in Canada continue to show the effectiveness of the drug. With a widening interest in the U.S. to use medicinal cannabis (MC) for symptom relief in seriously ill patients, the National Institutes of Health has called for further study. Unfortunately, only 19 researchers in the United States have the required license to conduct these studies. Recently, Dunil K. Aggarwal, Ph.D., M.D., candidate and a team of researchers at the University of Washington School of Medicine set out to learn more about the chronic pain patients in his state who are being treated by this drug.1 Currently, 13 United States have a functional MC program, but only four are collecting statistics. While an estimated 20,000 patients are using the medication in Washington alone, there has been no statewide effort to study them. After looking at previous reports, the research team pieced together a chart review of 139 patients using MC through local pain management clinics. Studies of cannabis since the ’70s have shown analgesic effects “in virtually every experimental pain paradigm,” with no risk of lethal overdose, and mild side effects.2,3 Due to an increasing number of chronic pain patients pressuring physicians to try anything that may help, doctors face an important issue regarding the use of MC for treatment. Reviewing the patient charts, the researchers determined that the people using MC had documented pain or a combination of painful illnesses including: myofascial pain syndrome, 123 (88%), neuropathic pain (64%), back pain (51%), osteoarthritis (27%), among others. In most cases, these patients had gone through several hoops and hurdles trying different treatments and therapies over time to find pain relief before seeking MC. While 63 percent of the patients were men, women tended to use MC longer. The average age of patients was close to 47. Many doctors noted how difficult it was for the patients to obtain MC, which at times involved legal issues with local authorities. The researchers concluded that many concerns by the public could be deflated and several myths surrounding the use of the medication could be overcome with bigger and better studies. “The results presented here should help to deconstruct mythologies about the kinds of patients accessing MC treatment, including their young age or propensity to malinger or feign disease,” writes Aggarwal. Synthetic Marijuana Treating FM in Canada In contrast to the problems in the United States, a study in Canada supports the positive effects of nabilone, a synthetic cannabinoid, on improving the sleep of fibromyalgia (FM) patients.4 In a small double-blind, crossover study of 26 women and three men, researchers at the McGill University Health Center in Montreal, Canada, determined that FM patients preferred nabilone over amitriptyline for treating insomnia. The researchers selected amitriptyline, a tricyclic antidepressant, in the comparison study because of its similar sedating effects to nabilone. In addition, amitriptyline is considered standard treatment for FM in Canada. Patients were given one of the medications (nabilone 0.5 mg or amitriptyline 10 mg) at night for seven days. Both medications were specially made to look identical so that the patients and the physicians remained blinded as to what they were getting. After one week, a physician assessed each patient’s sleep quality and if it remained poor, the patient’s medication dose was doubled (regardless of what they were taking). At the end of the second week, all patients were given a placebo pill for two weeks. Then the two-week trial was repeated using the other medication (nabilone or amitriptyline). While both medications improved sleep, patients reported falling asleep faster, having better quality of sleep, and fewer periods of wakefulness with nabilone. There was no noted difference between the medications in the areas of pain, mood, or general quality of life. The most common side effects from the nabilone included dizziness, nausea, and dry mouth (similar to the side effects of amitriptyline). Researchers also noted that the dose of amitriptyline was doubled after one week by 92 percent of the patients. Only 41 percent of the nabilone users felt they needed to double their dose after the first week. The investigators agreed that longer-term studies at various doses would be needed to determine the safety and effectiveness of the drug. However, as the first study to evaluate the effects of nabilone on sleep for a chronic non-cancer condition, the researchers felt it was superior to the amitriptyline. The pharmaceutical company Eli Lilly initially received Food and Drug Administration (FDA) approval to sell nabilone (Cesamet) in 1985 to treat nausea and vomiting caused by cancer chemotherapy. Lilly withdrew the drug from the market in 1989. Valeant Canada Limited since purchased and updated the manufacturing process of the drug and reintroduced nabilone to the market in May of 2006. However, the FDA has made it clear that it does not support the use of marijuana for medical purposes. 1. Aggarwal SK, et al. J Opioid Manag 5:257-86, 2009. |
| Track Your Progress in the New Year |
Feelings of isolation or aloneness are common emotions experienced by patients with chronic illnesses because they are no longer the individuals they used to be. Members of the Fibromyalgia Network share their best tips and coping strategies on how to deal with these feelings of isolation in the January, 2010 Journal. In addition, experts in the field offer steps on how to rebuild your new self. While you are recreating a new identity, a website can help you track your improvements. Connie O’Reilly, Ph.D., a psychologist in Beaverton, OR, suggests that her patients use www.moodtracker.com. Change sometimes comes slowly, and it's easy to get discouraged, says O’Reilly. “Some form of self-monitoring helps remind us that all things change. If we're in a great mood, it will change. If we are hurting, it will change. If we are sad and lonely, it will change. Change is the one constancy in the universe.” O’Reilly says that sometimes it helps to actually keep track of changes in our mood as we are changing other aspects of our life. “It can be comforting to see visual evidence that nothing stays static … neither the good nor the bad.” This free online self-tracking program will help you monitor levels of sadness, anxiety, and irritability, along with things like the amount of sleep you get and your medications. You can plot your results from the past week, month or year. Because it is online, you can share it with anyone you like, such as your doctor, therapist, or trusted friends. You can even program it to send a text message to your cell phone to remind you to take medications. “I often have my clients set it up to send them messages to practice their mindfulness, relaxation, or exercise. I encourage clients to journal about their daily activities and especially how they feel about them. They actually enjoyed it more than they expected. It helps them to tie behavior changes to mood changes over time, and in combination with something like moodtracker.com, it can reinforce the value of becoming more engaged with people and activities.” Log on to www.moodtracker.com to sign up and get started! |
| 10 for 2010 | If you plan to make a New Year’s resolution to try something new in 2010, the January Fibromyalgia Network Journal article “Don’t feel Alone with your Illness” will get you off to a good start. But Members gave us so many great tips and suggestions for the article, we could not fit all of them on three pages. So here are ten more activities that you may wish to consider when creating a new you. If you are so inspired, you may wish to print out this list and stick it on your refrigerator to stimulate your thought possibilities throughout the year. 1. “It’s never too late to reconnect with family members and friends you want to be closer to. Sometimes you have to take the first step toward them.” 2. “I just sit on the front or back porch for a while. I think it makes me feel better because then I don't feel like I am completely trapped inside.” 3. “I just get up and go, even when I don't feel good. It is always better than sitting at home feeling sorry for myself. I take a short nap and then go out the door.” 4. “I offer to go along with a friend while she runs her errands. I don’t have to drive. We both enjoy the conversation. While I am out, I get my mind away from my messy house. It’s an escape.” 5. “Most days of the week I commit myself to at least one hour to do something outside the house. I have to get dressed and comb my hair. This gets me going, keeps me active and in touch with others. It’s not only good for me physically, mentally, and emotionally, it lifts and strengthens my spirit.” 6. “I Walk the dog or the dog walks me. Either way, it’s good for both of us.” 7. “It is so important to have someone in your life to talk to that has FM, whether it be a family member or someone from a support group. Sometimes only another fibro patient can truly understand.” 8. “If I catch myself avoiding people, I make an effort to join in a family activity or call a friend to come over for coffee and visit.” 9. “Take baby steps to get out and do something you enjoy when you do feel well. It goes a long way to relieve feelings of isolation.” 10. “Facebook, Twitter, MySpace, online chat rooms, forums, or blogs can close the gap on the miles between smiles. Take it light and easy, and don’t get bogged down with other people’s problems.” |
| Keep Your Membership Current |
Don't let the holidays derail you. If your Membership expires soon, renew now before you forget. To find out when your Membership expires, look above the mailing address on the back of your Journal or call us at (800) 853-2929 for your expiration date. The January issue of the Fibromyalgia Network Journal is in press and will be arriving in your mail box before the end of the month. This next issue is packed with breaking news that reveals the truth about your tender points. It also includes valuable information on treatments, and lots of coping suggestions to help you break in the new year right. Don't miss this issue. Call us today at (800) 853-2929 or renew online. If you have question about your Membership expiration date, please call us. |
Wishing you the best of health in 2010, Kristin Thorson & the Staff of FM Network |
| To remain unbiased, we do not accept endorsements, advertisements, government funds, or pharmaceutical industry grants. Articles are for informational purposes only. Consult your physician for treatment. Fibromyalgia Network ... Helping Patients Since 1988 Copyright © 1988-2009 Fibromyalgia Network |