The solution to reversing fibromyalgia and other chronic illnesses

Fibromyalgia, like many chronic illnesses or diseases today is a condition that results from an environmental trauma (physical, emotional, toxic, etc.) that the body is attempting to adapt to. Or, the result of toxicity and deficiency and no drug on the planet can “cure” toxicity and deficiency.

Why is fibromyalgia an epidemic right now? Why are type II diabetes, gluten intolerance, allergies, cancers, and many other diseases and chronic illnesses growing more than ever in the last 50 or so years? It seems simple-just looking at trends and statistics. The four top culprits are: (1) Immunizations and medications, (2) poor food quality, (3) emotional stress, and (4) the lack of activity. This makes fibromyalgia and many other auto-immune diseases and chronic illnesses “lifestyle” illnesses.

Antibodies from immunizations are injected in people in huge numbers and become stored in huge numbers all before the age of 6. Antibodies have one purpose which is to kill their target infection and then to self-destruct. So what happens when we are full with antibodies that cannot all self-destruct? They build up and at some point “may” cause an overactive immune system as is seen in so many diseases today. At some point an environmental trigger starts the chain reaction that forces the immune system to malfunction. Most medications are violations of human biologic law and do nothing to “cure” problems and most cause more problems. (lifestyle trigger #1)

Food quality has been decreasing for decades but in just the last two decades with additives, preservatives, pesticides, and GMO foods, the majority (90%) of our foods are impacted by these toxins. What do toxins do in the body? They build up and at some point “may” trigger the trauma that initiates a chronic illness or disease. Our diets make us acidic and this produces disease symptoms. (lifestyle trigger #2)

Emotional stress that is chronic causes cumulative stress on every aspect of the body. We need to have a balance of stress in our lives so that it does not become chronic and be a trigger for disease or chronic illness. It seems impossible to “control” the amount or severity of stress in our lives but with a little practice it becomes realistic. Maybe some of us need therapy like CBT, maybe some need meditation, self-hypnosis, or other relaxation exercises-because we can’t all change our job for a less stressful one or change other things that are out of our control. That being said, we control what we can and we change ourselves versus expecting the environment around us to change. (lifestyle trigger #3)

The lack of activity is a major issue in the U.S. Just look at obesity levels in the last two decades-they are over 50% of the nation and growing. Part of the equation is the foods we eat and the rest of the equation is the sedentary lifestyle that technology has graciously provided for us. Why do overweight people have more diseases and chronic illnesses? Because they store more nutrients from food. What kind of foods are obese people eating? Processed and junk foods. What is in processed and junk foods? Toxins et al. So what is the obese person storing more of than a thinner person? Toxic nutrients. Plus many junk foods are pro-inflammatory. The next thing the individual experiences is systemic inflammation. Often the exercise piece of the wellness puzzle comes after detoxing, getting nutrition balanced, and reducing stress-things that will reduce pain and other symptoms so that the individual can actually go to the gym without exacerbating their symptoms and quitting altogether. (lifestyle trigger #4)

Today there is no cure for most diseases for one reason-science attempts to use chemicals (medications) to alter our physiology which attempts to reduce or eliminate the symptom expression that manifests from whatever trauma that happened to us versus addressing the underlying issue. So science attempts to change the physiology but fails most of the time.

We are living a lie. We’re violating a biologic law by using medications to bandage our symptoms without examining the underlying cause. Some people say that diseases and chronic illnesses aren’t really what hurt us, but rather the body adapting incorrectly to the environment- the body adapting to deficiency or toxicity. Over time, failed attempts to address the underlying problem promote severe stress in the body and many more symptoms begin and the severity of current symptoms will increase.

So here when our bodies are over stresses and we are given a chemical to “help” with this problem, it truly is just a band aid. The number one prescribed “drug” for any chronic pain condition are opioids like Vicodin, with antidepressants a close second. The function of an opioid isn’t to solve an underlying problem but to act as a band aid, which simply makes you care a little bit less that the pain is present. The fourth leading cause of death in the U.S. is properly prescribed medications. That is people are given the right meds for their “condition” but die anyways from that treatment that altered their biology.

Today physicians don’t teach nutrition and fitness as “the key” to reversing chronic illness and disease symptoms. Why? Because they didn’t learn that in medical school. Medical school taught them to use all kinds of band aids to address symptoms, and to avoid the underlying problem. Most lifestyle diseases are greatly improved or “cured” by getting your diet and exercise in check. However, nobody wants to hear this.

Physiologic issues to address:

The first thing we do is detox the body to eliminate toxins, balance cholesterol levels, eliminate medication expression, and right size the immune system. Every 140 days our blood is replaced. So we detox for 140 days.

The second thing we address is the gut to help many things, one of which is serotonin levels produced in the gut. We do this by creating the right diet. In a sentence, if man created it-don’t eat it.

The third thing we address is the psychological component which includes therapy, meditation, self-hypnosis, and other natural interventions, etc.

The fourth thing we address is sleep. We get our sleep architecture as good as it can be and we allow ourselves to enter all four stages of sleep so that we allow our body and our mind to heal as God had intended.

The fifth thing we address is exercise. Since we live in an era with toxic foods and too many technological distractions that keep us fat and lazy, we add in an exercise curriculum for life.

Serotonin side note:

Most physicians will look to serotonin as a possible suspect for some of the symptom expression seen in many chronic diseases. As such, physicians prescribe opioids and antidepressants for many diseases which positively impact serotonin levels-at least in small amounts and for a short time (under 3 months). Most serotonin is produced in the gut. So doesn’t it make sense to repair the gut and get it working correctly so that the body will produce the natural amount of serotonin which will help control pain and depression naturally?

Top food offenders:

If I were to attempt  to do the bare minimum to positively impact my symptoms I would eliminate a few food products in an attempt to do a partial detox. These foods are not a problem for everyone but are suspect in a number of nutritional disorders and many cause major issues in small numbers. (1) Aspartame (causing excitotoxicity) or any artificial sweetener. (2) MSG, (excitotoxicity). (3) white sugar, corn syrup, fructose, simple carbs, agave, (yeast love eating sugar so eating sugar produces an overgrowth in yeast and is thought to cause pain among other symptoms), plus sugars cause insulin spikes. (4) caffeine (stimulant) burns out adrenal glands which makes it difficult to regulate your blood sugar and inflammatory system. (5) gluten (allergen) only if you have a problem with gluten (as 70% of people in the U.S. do). However, eliminating gluten won’t hurt anything and may be worthwhile to rule out. Some people have a predisposition for gluten intolerance or celiac disease, but most people today develop gluten intolerances due to a bad diet that results in leaky gut syndrome.  (6) dairy, due to leaky gut, can cause someone with leaky gut to develop allergies to dairy, and the (7) casein in dairy is the culprit. (8) Soy proteins are similar to gluten and casein and cause inflammatory reactions in the body. All these foods may exacerbate your symptoms.

Making this plan into action:

Putting this plan into action requires a complex lifestyle make-over. It’s not going to be easy but the alternative is you stay sick! I have written many articles about what it takes to put this plan into action and will not go into that in this article.

Chronic pain states

Watch this on Youtube: http://www.youtube.com/watch?v=VrGhJiBoDL0

Recently I attended a conference from 2012 featuring the research of Dr. Doley’s Audio Digest on Psychology and chronic pain states.

He discussed psychosocial approaches to pain management and how clinicians can implement evidence based psychological and psychosocial aspects for chronic pain mgmt.

Pain is an evolving concept and leading experts consider current pain definitions as very fluid.

Recently pain has been called a problem of homeostasis, or dysregulation in the body.

But today we are still undecided as to what pain actually is.

Even though we recognize pain as whatever, wherever, and whenever the patient says it is.

Pain is a biopsychosocial problem. Meaning if you haven’t evaluated the biology, the psychology, and the sociology, then you haven’t effectively evaluated pain.

Pain is a perception, a product, a byproduct, and an emergent phenomenon.

Pain as an emergent phenomenon means that it is bigger than the sum of its parts, but cannot be broken down into its parts-meaning it has to be viewed as a whole, and as such must be treated as a whole. Treating the symptoms has been viewed as a Band-Aid producing almost zero positive results.

You cannot have pain without some psychological factors-otherwise you would not be alive.

If you have pain from an injury there may be some psychological impact from the pain, but as the etiology of the pain becomes more generalized or vague as seen in fibro, the higher the likelihood that there will be a greater impact to the outcome.

Pain conditioning

Studies suggest that there is a possibility for people to condition pain, meaning create or exacerbate pain.

Especially considering the placebo response.

After a while, electrical impulses in the spinal thalamic tract will be present, even prior to the stimulus of pain, this is conditioned nociception.

What I am going to say next is a critical piece to the chronic pain we suffer from fibro.

Conditioned nociception means our expectations of pain condition us to experience more pain than we should.

You can have pain without any physical stimulus.

Think of phantom pain. Pain can be present with people who lost a limb, but it can also present in limbs that never existed, as seen in children being born without a limb. This is breakthrough information and needs to be included in chronic pain education.

If there is a pain generator and you stop it, the pain still exists most of the time, especially in chronic pain.

Some ways of coping with pain are to overcome it, ignore it, increase activity, praying, hoping, reinterpret the pain, or diverting your attention elsewhere, and these may or may not help.

Acceptance to illness isn’t giving in to it, instead it is a realistic appraisal of your situation.

It provides perspective and it IS a coping mechanism.

If you are sitting around at home waiting for your pain to begin or to get worse you are likely to not get better regardless of what is done. If you are expecting pain, pain is what you will get (conditioned nociception).

There has to be commitment in spite of the pain.

It has to be realistic to physical pathology and to your ability.

There are things we can do. Is it going to hurt? Probably, but if we wait for the pain or symptoms to stop prior to rejoining life, then we are going to have huge problems regardless of what we try to do, and we will never rejoin life.

So acceptance becomes critical-more so than coping skills. Until we accept what we have and that we are in control of our wellness, and that we can get better, then the coping skills are meaningless.

Its like the placebo response.

The placebo effect has shown us that the mind can heal, but also that the mind can create. The mind creates pain in people every day. And the placebo effect has shown to reduce or eliminate pain just the same.

When we seek treatment for chronic illness, we ask our clinicians to do whatever they can to help us, and they do.

They exhaust medical insurance options, behavioral therapies, medications, fusions, surgeries, whatever.

Then clinicians marvel that the patient isn’t better and they say: treatment was successful=but the patient didn’t respond.

And this is most commonly seen with those who treat chronic illness patients.

Cognitive behavioral therapy is a great modality for chronic pain illnesses.

So we turn to therapy interventions like CBT. CBT literally changes the brain. It’s brain management or brain washing in the positive sense.

Getting rid of the bad and replacing it with the good causes good things.

Everything in your life makes a difference in your brain chemistry, especially catastrophic thinking.

You are capable of directing what physical changes happen in your brain, especially thru CBT.

This is documented over and over again. If you measure the brain volume of chronic pain patients, their cortical brain matter shrinks over time as a result of the pain.

Chronic pain, then, IS a progressive disease with a neurodegenerative component. Brain damage does in fact occur. So when we hear from our clinicians that fibro is not degenerative, I beg the question, don’t we in fact see neurodegeneration when facing chronic pain? Yes, yes, yes. fMRI has shown this time and time again.  What’s wonderful is that it gives us something to wrap our heads around and something to address.

If not addressed, pain will continue to develop. CBT can partially reverse the central atrophy associated with chronic pain, reducing neurodegeneration.

What about the expectation of pain?

Uncertain expectations enhance the anterior cingulate brain response, causing us to begin feeling all stimuli as painful, even the non-painful stimulus like putting on our socks or brushing our hair.

So if we expect that our pain will be horrible, we force changes in our brain.

Intensity and unpleasantness of the pain are two components that have to be looked at regarding quality of life.

Our expectations can exaggerate our perception of pain.

Suppressed emotional thoughts, worries, and fears tend to reoccur especially under mental load or unusual intensity.

In terms of pain, we need to accept versus suppress, and modify versus ignore.

We accept that our condition comes with some pain and we do not suppress the pain.

We modify our behaviors to keep on going versus ignoring the pain which forces us to withdraw.

Over a long period of time, you can no longer over look pain, or your pain will get worse.

What about the perception of pain?

There is survival value in protecting brain functions like memories. When something bad happens, connections are made in the brain.

There will be a connection that creates a memory and if it has significance, there will also be a peri-neuronal net, which is a group of structures that encompasses memory networks protecting it from being destroyed.

The significance of this is that this makes a painful memory permanent.

So as pain becomes a memory, in some cases, it becomes protected and permanent.

This permanence has a survival value. We don’t want to deny or ignore these memories, instead we want to learn how to do different things in their presence, accepting them, reacting to them, and dealing differently with them.

Let us also look at controlling the secondary psychosocial aspects of pain like our financial problems, work issues, our relationship issues, or just generally too much stress.

How many of our symptoms do we cause by not managing our lifestyle?

What can we accept responsibility for?

Accepting responsibility will reduce our symptoms.

And clinicians need to attempt to understand the pain generator, if one exists.

Often it’s not in the periphery or the spinal cord, it’s in the brain-as we see with fibro.

So if we want to not hurt, we change our brains (like with CBT and education. Education informs our brains and prepares them and sets expectations).

All the drugs and western medicine in the world may not help some chronic illnesses, meaning they won’t change the brain chemistry. The brain may react a little sometimes, but not enough.

Often what we see in fibro is that pain meds don’t remove the pain, they just make you care a bit less that the pain is present. This isn’t what we should be looking for.

It doesn’t suppress the intensity or sensory component of the pain, but it alters the unpleasantness and the brains emotional reaction to the pain. That’s not a cure. That’s not even acceptable to most of us in the way of symptom relief.

What about depression and Pain?

Most people who have depression and pain will complain about the pain versus the depression, due to fewer stigmas about pain, plus depression doesn’t hurt as much as physical pain, and sadly insurance pays better for pain symptoms versus depression symptoms (until recently with the ACA).

Sometimes treatment is driven by insurance.

Not always the most effective treatment though.

Studies have shown that patients with pain and depression who were just treated for depression reported pain decreases of 30%, with 50% less depression.

But remember that antidepressants have analgetic value and reduce pain too.

The basic substrates of pain involve norepinephrine, serotonin, and dopamine. Most antidepressants address one or maybe two of these neurotransmitters and can’t help the whole problem, so combining these with CBT, the fibro sufferer can get a well rounded therapeutic approach.

Aggressive depression treatment is a valuable part of pain mgmt in general.

The long-term goal is to get off meds and manage your illness on your own.

What about variable heart rate?

With medically unexplained symptoms as seen in Fibro, heart rate is typically not stable.

It adjusts moment to moment according to the environment, our pain, and our stress loads.

So we combine psychology and medicine to view a systems analysis, versus a symptom or behavioral analysis.

So with FM you don’t have good coherence you have an inconsistent variability of heart rate, and biofeedback, another psychological therapeutic intervention, can reestablish coherence and normal heart rate.

Biofeedback has been shown to re-establish heart rate variability to normal.

What about dysregulation and fibro?

Dysregulation can be applied to fibro which means the body stops adjusting to the demand put on it.

When this happens it can be a prelude to death-in theory.

When the organs no longer do what is expected of them and they stop adjusting accordingly, eventually the systems fail.

I am doing some research in this area, and I think there is merit here.

MRI’s show what part of the brain is reacting, and using biofeedback, the patient can be taught how to change the anterior cingulate gyrus, to alter this activity in the brain. This is reversing your symptom expression.

Distracting cortical processes helps with pain coping mechanisms-in a study of patients in private rooms versus semi-private rooms, the patients in the private rooms used more pain meds, suggesting the disruptions and commotion in the semi-private rooms from all the people coming in and out caused a distraction of the cortical processes resulting in the patient experiencing less pain and requesting less pain meds.

The worst thing a pain patient can do is nothing.

Something very interesting about pain that one study showed was of a patient with multiple personality disorder, with 5 personalities, and 2 of them did not have any pain, meaning pain can be controlled or managed.

Stages of change discusses the willingness to be ready for the changes for wellness.

If a pt has 3 or more risk factors like a history of physical or sexual abuse, or alcoholism, they have a higher likelihood to not get better even with treatment when they suffer from chronic illness.

This is known as self-directed neuroplasticity. Our maladaptive thoughts impact our pain expectations.

The take away message here is that our brain is constantly changing according to what we feed it.

If we feed our brain positive things, we get positive outcomes.

If we are negative about our disease, if we catastrophize about our symptoms being severe, if we EXPECT that our symptoms will never go away, we change our brain to succumb to these expectations.

Through pain/brain education, we can control our disease to a degree.

chronic pain relief

In 2002 the mayo clinic published their chronic pain practical advice book. They state that “a reasonable goal is to reduce your pain by 50%” (p.73). This relief will come by way of stimulator, pain pump, and narcotics as the latest in pain management, and may include all the other pain management modalities like: PT, CBT, exercise, massage, and meditation, etc. This is to suggest that rehabilitation is the overall goal-and to return you to the life you once knew pre-chronic pain. Depending on your situation, immediate pain relief may be the only short term goal.

Anticipating pain makes pain worse

Did you know that anticipating that you will be in pain will amplify the actual pain response-regardless of the reality? This reinforces the fact that psychology impacts actual pain. Optimism reduces pain and a pessimistic attitudes increases pain. Are you in a chronic stress environment? This not only exacerbates a current pain condition but can be the onset of a new chronic pain condition. Control your environment by controlling your emotions. Catastrophic thinking promotes any illness. I like the idea of using a gratitude journal to document the positive experiences in your life. I always report that attitude is everything in the pain game.

Healed without being cured

Watch this on youtube: http://www.youtube.com/watch?v=1bjqkvxiiXM&feature=g-crec-u

Recently I was explaining to a friend how I felt that those with chronic illnesses can be healed without being cured. I talk to individuals with different disabilities every day, and at times we all ask the questions: When will the pain go away? Will I always feel this sick? What can I do to get better?

Today, many of us have to accept that there is no cure for the diseases many of us have. That is a hard pill to swallow. There is a broad gamut of treatment options available for most of us though; sometimes it just takes work to find it.

So what do we do in the meantime? What do we do with the time we have to live that is after acceptance of illness, but before we experience relief. How do we become healed without becoming cured?

Hearing “you will have to go home and learn to live with this for the rest of your life” isn’t a realistic answer for chronically ill patients. Almost nothing really fixes the problem in illnesses like fibro-but numerous things treat the symptoms.

But for a large population of chronically ill individuals in the US alone, medicine has failed to provide them sufficient benefits or relief. Without going into great detail, this has a compounding effect on the economy, society’s medical costs, and missed time from work; and of course on the government for those who must resort to collecting retirement benefits from the Social Security Disability Department.

I’ve had people I have helped cope with their illness explain to me that if they don’t find relief soon that they will strongly consider suicide. I beg the question what has it taken for those people to arrive at that point in their lives, where they are ready to end it due to pain? But when I think long and hard about it, which I have, it makes some sense.

After all, some days I am just hanging on by a thread; and I pray that just one more disaster doesn’t happen to me that causes me to take just one step backwards; to gain just one more symptom; to face one more emotional loss.

How do we heal ourselves without being cured?

I mean, it can’t be as simple as accepting one part of your illness and moving on from there can it? I have accepted my illness-there it is. I accept what has happened to me. Is that a form of a cure? It is my understanding that it is. It is one issue I don’t have to address again; I’ve moved beyond that issue; I’m ready for my next battle.

I’ve also learned to laugh at my situation. I laugh as often as possible. I create cartoons to share on FB; I spread comedy where possible, and when I do, I know I am receiving therapeutic effects, such as endorphins being released, making me feel just a bit better.

These things make up my foundation some days. They are not big commitments; they are not challenging to pursue; and they lift my spirits and those around me up a little. So that being said, I have found a cure in the shape of unusual actions. It is a cure none the less. No one can take that from me and I like being the one who can provide this for anyone reading; for anyone needing something; or for anyone missing something, but not sure what it is.

Everyday I have my foundation to stand on, and from there I begin to develop principles with which to live by; to find happiness with; and to help others with. I write in this blog about many things that are real for many people.

Its my goal to responsibly report what information I decide to write about so that when people read what I have written, they can feel confident that taking this research and writing seriously is my passion, not just a hobby; and not a job.

When you are ill, you are often left with too much down time and sick or not, it’s still your down time and your choice of what to do with that time. After you meet the basic needs in your life, it’s time to find the next thing; the next chapter in your life that will become your next cure. You are very unlikely to find it in your doctor’s office or at your pharmacy. You have to search your life and passions and find that thing that gives new meaning to your illness-and you have to do that.

Time is going to come whether you are ready for it or not; whether you are excited for it or not; and whether you sick or not. You get to make the choice to be sick-and have a rotten life; or you can choose to be sick, to accept your illness as is, and begin to move on with plans for the future.

You can choose to be healed without being cured. It is your responsibility to live your life to the fullest, sick or not. You need to find a way. I did it. I wasn’t lucky, or feeling better. I did it with every constraint in the world thrown in my face. I expect no less from you.

Reflex Sympathetic Dystrophy (RSD)

RSD (also called complex regional pain syndrome CRPS) is a chronic neurological disorder characterized by burning pain and changes to the bone and skin, resulting in, among other things, pain, inflammation, excess sweating, and sensitivity to the touch. RSD can be caused by nerve injury or trauma, or tissue injury with no nerve injury present, or when no event can be identified. Common injuries that lead to RSD are: bone fractures, soft tissue sprains, blood vessels or nerves, and surgery. It can affect nerves, bones, skin, joints, muscles, and blood vessels simultaneously. RSD is one on the 100+ types of arthritis/rheumatic diseases. There is an estimated half to three quarters of a million people with RSD in the US.
The increased pain sensitivity seen in RSD is not unlike the hyperalgesia experienced with fibromyalgia. The pain can initially develop in the injured area and spread; and can come and go. Type 1 involves no nerve injury, and Type 2 involves nerve injury; and both may present with the same symptoms.
Triggers can be: injury or trauma, surgery, degenerative arthritis of the neck, shoulder issues, heart disease, stroke, diabetes, cancer, infection, brain disease, thyroid disorders, carpal tunnel, shingles, and medications. 33% of RSD patients have no associated trigger.
RSD progresses in three stages: stage 1: lasts 1-3 months, severe burning pain, muscle spasm, rapid hair growth, skin color and temp changes, and joint stiffness. Stage 2: lasts from 3-6 months, pain increases, swelling, decreased hair growth, nails become cracked, brittle, grooved and, spotty, softened bones, stiff joints, weak muscle tone. Stage 3: irreversible changes to skin and bone, pain is chronic, muscle atrophy, severe limited mobility, contractions of muscles and tendons, and limbs may become twisted.
For many years, scientists believed that RSD was a malfunction of the sympathetic nervous system, but this theory is in question today. RSD can be treated with surgery, physical therapy, exercise, CBT, nerve blocking, spinal cord stimulation, intrathecal drug pumps, and medications like: topical analgesics, anti-seizure drugs, antidepressants, corticosteroids, and opioids.
The National Institute of Neurological Disorders and Strokes (NINDS) reports that “2–5% of peripheral nerve injury patients and 12–21% of patients with paralysis on one side of the body (hemiplegia) develop reflex sympathetic dystrophy as a complication. The Reflex Sympathetic Dystrophy Syndrome Association of America (RSDSA) reports that the condition develops after 1–2 percent of bone fractures.”
The actress Paula Abdul has had RSD for 25 years.
Some RSD resources to check out:
National Institute of Neurological Disorders & Stroke
National Institute of Health
http://www.ninds.nih.gov
Reflex Sympathetic Dystrophy Syndrome Assn.
Tel: 877-662-7737

Home

American RSDHope Group
Tel: 207-583-4589
http://www.rsdhope.org/
American Chronic Pain Assn. (ACPA)
Tel: 800-533-3231
http://www.theacpa.org
National Chronic Pain Outreach Assn. ((NCPOA)
Tel: 540-862-9437
http://www.chronicpain.org
Mayday Fund (For Pain Research)
Tel: 212-366-6970
http://www.painandhealth.org

Low Dose Naltrexone (LDN): Does it work for fibro?

Watch this on youtube: http://www.youtube.com/watch?v=FrIxQwBAwIg

LDN is a pure antagonist to narcotics, which blocks opioid receptors in the brain. It was originally developed to treat drug addiction. LDN can work on pain relief and as an immune system stimulant. The idea of using a dose of 1.5mg to 4.5mg is that it blocks the opioid receptors for a several hours, and benefits reduce as dose goes up beyond that. While LDN is actively blocking the opioid receptors, natural endorphins will not attach to these receptors, thus causing pain. LDN helps to balance the endogenous endorphins, which translates into a normally functioning immune system.

Low dose naltrexone (LDN): Treatment for pain conditions?

Watch this on youtube: http://www.youtube.com/watch?v=FrIxQwBAwIg

LDN is an inexpensive medication that helps to mobilize your immune system, and treats many illnesses like autoimmune, and CNS disorders. LDN is not FDA approved to treat pain disorders, but is currently being used off label to treat many conditions. LDN acts to restore the body’s production of endorphins, meaning LDN provokes the production of endogenous (natural) opioids, thereby reducing pain. LDN was approved by the FDA in 1984 to counter the effects of drug addiction, by blocking the opioid receptors, and also by blocking the reception of beta-endorphins and metenkephalin. Naltrexone was initially approved at a 50mg dose, but has been shown to be effective at around 3mg (between 1.5- 4.5mg).
According to a 2003 article in the New England Journal of Medicine, “opioid-induced immune modulation…preclinical evidence indicates overwhelmingly that opioids alter the development, differentiation, and function of immune cells, and that both innate and adaptive systems are affected.” Thus opioids directly affect the immune system. Because of the way naltrexone blocks the opioid receptors; the immune system is essentially stimulated, increasing endorphins and enkephalins, reducing pain. It is also suggested that LDN can increase natural killer cells, boost the immune system against cancer; believed to actually cause cell death to cancer cells.
Illnesses naltrexone is suggested to treat: ALS, PLS, Alzheimer’s, Autism, cancers, Crohn’s disease, MS, fibromyalgia, Parkinson’s, transverse myelitis, Celiac, Hashimoto’s Thyroiditis, psoriasis, RA, Sjogren’s, SLE, Wegener’s, AS, endometriosis, IBS, MG, HIV/AIDS, and more. All of these illnesses share the common theme of “immune system” disorders, which is what naltrexone treats. At first glance, it seems unusual that one medication could treat so many different types of illnesses. Especially, since in AIDS for example, the immune system is underactive, and in many autoimmune diseases, like MS or SLE, the immune system is overactive. This makes grasping the effects of naltrexone that much more difficult to understand; it’s kind of a contradiction on terms.
At this point, LDN needs to come from a compounding pharmacy. You cannot take opioid agonists at the same time as LDN, since naltrexone blocks the opioid receptors. If you take medication for Hashimoto’s Thyroiditis, you may need to reduce your thyroid dosage as your immune system calms down.
In summary, despite often unfavorable results in clinical trials, LDN has provided a reduction in pain for many chronic pain sufferers. My philosophy on LDN is- consider it. In a matter of a few weeks, you will experience something; or nothing, and in either case it’s not much of a risk.

Pain Receptors and fibromyalgia

Watch this on youtube: http://www.youtube.com/watch?v=t5RaGfdovXA

Pain starts with nerves. Pain receptors are found on nerve endings throughout the body like: skin, muscles, joints, connective tissues, and internal organs. Pain receptors become activated as a response to a painful stimuli. This stimuli may involve trauma or injury, but in the case of fibromyalgia, where pain states like hyperalgesia and allodynia are present, the stimulus may be very mild.

Pain receptors release neurotransmitters (NT) when they become stimulated, which send pain messages to the brain and spinal cord, via the nerves. What was just described is called nociception, since the pain receptors in question are called nociceptors.
The damaged tissue in question releases second messengers including: bradykinin, prostaglandins, histamine, serotonin, leukotrienes, and potassium.

Pain medications have the ability to inhibit, or reduce some of these pain transmissions. When this happens, the pain receptors will possibly not be activated, making the pain impulse incapable of reaching the brain, and the perception of pain is reduced or more likely eliminated.

The afferent nerve fibers (2 types: A-delta and C-sensory fibers) are the peripheral nerve fibers that contain pain receptors. These send nerve impulses (pain messages) back to the brain and spinal cord. MS affects the A-delta fibers, known as myelinated nerves, which produce somatic pain, typically arising out of damage to the skin or muscle. However, the C-sensory pain fibers respond to dull, achy, non-localized pain stimuli (unmyelinated). These typically respond to visceral pain, or internal pains to organs etc.

When second messengers activate pain receptors, they send the pain stimulus along the afferent nerves to the dorsal horn in the spinal cord. These pain signals are then sent to various parts of the brain for a response. The last step in a pain transmission is the brain responding and telling the body how to react. These impulses move along the efferent nerves from the brain. At this point, many different substances may be released from the brain and spinal cord that impact the perception of pain (neurochemical mediators) of which include endorphins-natural opioids, and serotonin, and norepinephrine.

Pain medications and antidepressants acting as pain killers target these processes to address pain. The neurotransmitter glutamate is the dominant NT when the threshold to pain is first experienced, and is associated with acute pain; pain that warns us that something is wrong. Substance P is a peptide that is released by C fibers. Usually associated with chronic pain. Glycine suppresses the pain transmission in the dorsal root ganglion, blocking the potential for pain or inflammation.

Neuropathic Pain: Pain caused by trauma or injury to the nerves from damage, inflammation, and tumors. Visceral Pain: Pain originating in the ANS’s sensory neurons. This visceral pain is not felt in a discrete location as pain signals transmitted by the sensory-somatic system are.

Summary: So pain strikes; activating nociceptors near the injury site; the nociceptors send a response (nerve impulse) through the spinal cord toward the brain. This happens in a fraction of a second. The spinal cord acts as a middle man in the pain transmission process most of the time, but can mitigate a response to some pain with reflexes.

The dorsal horn in the spine acts as a central hub for information. So some responses come from the brain, and some from the dorsal horn; the brain does most of the work though. The brain makes sense out of the injury, cataloging the pain, gearing up to make a response. Pain signals first arrive at the thalamus in the brain where it gets directed for interpretation. The thalamus sends signals to the cortex and limbic system. Then the cortex compares the pain to previous pain and determines its origin. The limbic system releases an emotional response (like crying, or sweating).

Pain is not a simple cause and effect system. It is impacted by everything occurring in your nervous system including: mood, past experiences, expectations; many things that can influence the way you experience or perceive pain. You may have a higher pain tolerance than someone else as a result of previous pain experiences.

Chronic pain: acute pain is eliminated when the injury has healed, as a rule, and the nociceptors no longer detect damage or injury. BUT when pain receptors continue to fire, (even in the absence of damage or as seen in fibromyalgia) as a result of disease or illness causing damage, pain signals are traveling to the brain constantly. The cause of the pain has been eliminated in some cases, but pain continues. This pain has become chronic and just became difficult to diagnose and treat.

Dealing with disability insurance or social security

DEALING WITH SOCIAL SECURITY OR DISABILITY-part 1
At some point you may need to deal with disability insurance or Social Security for income while you’re disabled. It can be a difficult process while you have fibro, especially if that’s you’re only diagnosable illness. The state (ODAR Office of Disability Adjudication and Review) may likely be looking for a more tangible diagnosis than FM, and it may take you every bit as long as two years or more to get a court hearing before you get to speak to an administrative judge regarding your health and disability.
Your best bet is to retain an attorney or service agency like Allsup to help expedite the Social Security process. Depending upon your state laws, an attorney or servicer may only be legally able to claim up to a specific amount of your settlement/claim that you are awarded, in many cases it can be as little as $4500, one time.
The bottom line here is that this process can be very taxing on your already over-taxed system. The process IS lengthy, complicated, and I would say that it is designed to force a percentage of people to quit the process due to difficulty of getting through the process itself. You may need help with the process, and you’re allowed to have help every step of the way, even if it’s a friend or family member who’s just got it together a bit better than you do these days. Keeping in mind how FM can wear you down cognitively, you may want help filling out this important documentation.
Make copies of each document you fill out before you send it to the state, because you may need to refer to what you wrote last time on the next document they send you; because they will send you redundant, overlapping documentation for review and to re-sign or to fill out again, and sometimes again.
Take each phone call from your Social Security representative and make calls when asked to in the documentation. Always keep your information in a well-organized file in a safe, consistent location that you can access each time you need to over the duration of the two years or so. Write notes each time of who you talked to, at what time and what date and what was said, and what they expect from you. They’re job is very routine for them, but what they’re going to ask of you will not be routine to you, so keep notes. Consider that you may be subject to investigation during this whole process, and that anything goes.

The power of hypnosis

Watch this on youtube: http://www.youtube.com/watch?v=7-p3Eu4z1C8

Today I attended an informative seminar on hypnotherapy, and the group was comprised of primarily fibromyalgia sufferers. Dr. Elaine Kissel, PhD is a hypnotherapist with 35+ years of experience working with patients. She has spent a lot of time with chronic illnesses, and has had much success with symptom relief. Her Website is http://www.elainekissel.com. Dr. Kissel is the author of The Mind Is Willing, and is the creator of the Mind Mastery Course. Dr. Kissel spoke wonderfully, and is the most knowledgeable hypnotherapist I have ever encountered.
Some of what Elaine discussed is: Hypnotherapy is a powerful modality for chronic pain. Hypnosis deals with the relationship between the conscious and the unconscious mind. Much of what you do every day, all day, is controlled by your unconscious mind; and it even controls your perception of pain. Hypnosis is essentially the act of letting go, whereas meditation is more of the mental focus of holding on. In hypnosis you can reproduce a positive state, and with reinforcement, you can change the behavior that is causing, for example, pain. Stress is cumulative and forces restrictions within the body. So does catastrophic thinking. The expectation of pain increases pain occurrences. Your mind has the ability to make you well in many cases. The expectation of pain is similar to the intention; if you expect to be in pain, you will be. Hypnotherapy teaches you to use your powers for yourself, versus against yourself, helping you reach an ideal state. Hypnosis takes you to a place where you can regain control.
So whether you believe hypnotherapy has merit as a modality for alleviating pain or not, you have to consider that your mind has a very large impact on your body. Pain originates in the same place as your thoughts do, your brain, and having the ability to apply yourself in such a way through hypnosis and self-hypnosis, that you can have a greater influence on your unconscious mind to control what happens in your body is conceivable.

Step therapy: Ethical practice or beaurocratic mess?

Watch this on Youtube: http://www.youtube.com/watch?v=jGhsWNQ5XXI

Blue Cross/Blue Shield (BCBS) defines step therapy as “to ensure that members receive the most appropriate and cost-effective drug therapy, some plans require that additional steps be taken before certain drugs are covered, In a prior authorization, certain clinical criteria must be met before some drugs are covered.

Your doctor should call our pharmacy help desk to request prior authorization for these drugs. Step therapy requires that you have tried an alternative therapy first or that your doctor has clinically documented why you cannot take the alternate (less expensive) therapy. Step therapy may include select covered over-the-counter products” (bcbsm.com).

Some feel as though this process gets in the way of effective, or immediate treatment when it is needed most.
When you suffer from chronic illness, likely you are working closely with a specialist who is inherently knowledgeable about your condition, and knows what you need for treatment. When your physician prescribes a medication for you, you should expect that you can run over to the pharmacy and simply get it. That’s just not the case with so many expensive or new medications today, and not just by BCBS, all insurance companies practice step therapy, and prior authorizations, even Medicare. This is to save them money, not you, and most often creates heart ache to you, as you spend several days or longer and many phone calls, trying to get the medication you need, while you suffer in pain etc.

So when you have to meet the criteria of a step therapy program for a medication, first your script must be filled by a cheaper medication, next, if after the first medication is ineffective for your condition, you advance to the second step, of being allowed to get a more expensive medication, but maybe still not the one you were prescribed.

After you have exhausted a trial of all of the pre-drugs, you MAY be allowed to get the medication you initially needed and were originally prescribed by your physician who knew you would not respond to all of the other medications in the first place. So the script gets rejected back to the doctor’s office with a form from the insurance provider that must be filled out describing your medication needs and then the insurance provider determines the steps they will take with you-which will be to make you follow protocol, and start with the cheapest and least likely drug to work effectively. That process just took two weeks, and the patient suffered through it to satisfy the insurance companies.

The insurance providers want you to believe they use physicians, pharmacists, and medical experts to determine what medications are safest for use and most effective, then the insurance provider approves what drugs will be stepped, and how they will FIT into the drug levels. Make no mistake, the insurance providers do this all in house and are completely responsible for the selections and levels of medications, because in the end, it saves them money. Oh it saves you money too, the $10-$20 you save on your copay, but what you really want and need is the right medication at the RIGHT time; not to save $10.

Step therapy programs are purposely activating the “law of unintended consequences” by trying to regulate a complex process, which promotes a slippery slope of unfavorable results; and exacerbates both overall well-being and cost consequences. This throws risk back onto the physicians. The physicians feel as though they have to jump through hoops to accommodate the insurance provider, who subsequently is not even in the health equation in question, and the only way to conform effectively and safely is for the physician to fabricate the form to suggest that the patient has already tried the other drugs-unsuccessfully.

Most of the time this won’t work either since all the insurance provider has to do to check if the criteria was met is to look at records or notify the Medical Information Bureau, who document everyone’s health history. Additionally, adhering to step therapy protocols has a direct impact on driving up ER and inpatient costs since patients are not being effectively treated when they need to be, they are spending more time in medical care searching for help. Plus there will be longer stays in intensive care, longer rehab stays, more time missed from work etc.

This does not always simply mean that the patient who is being dragged through the step therapy process merely has to wait a week to get the drug they need and thus suffers a little extra chronic pain that week. You have to consider the thousands of instances where patients who may be suicidal are waiting for the correct antidepressant drug and does not get it in time. What is the cost savings in that instance? There are another 1000 examples just like this one that clearly state the need to eliminate step therapy insurance programs. People want to save money where possible, and will gladly accept a generic medication most of the time, but when there are extenuating circumstances, the physician may reach for the restricted drugs first.

A good example of this is I had major reconstructive foot surgery last year and afterwards was given a mild narcotic, every 8 hours. This was totally ineffective for controlling my pain and I asked for something stronger and was told my insurance requires step therapy after surgery. The step therapy started with a very low dose of Dilaudid, which has a short half-life and provided 20 minutes of pain relief per injection-EVERY 8 HOURS!!!! I was going crazy, but there was nothing I could do.

Needless to say, I spent the next three days in agony waiting for my insurance criteria to be met so that I could get something stronger. After three days of satisfying that first step of criteria, I was moved on to the next step of therapy which was a low dose of Percocet, every 6 hours. This was almost as bad as the Dilaudid. I had to take this medication for 7 days before step three would kick in and I could finally get Oxycontin, which by the way, was what my doctor prescribed in the first place, and provided sufficient pain relief. I’m not sure I could go through another ten days in that kind of pain again.
You can write to your state legislator about these programs and voice your opinion if you wish, it may help the cause overall.

Are antidepressants the answer for chronic pain?

Watch this on youtube: http://www.youtube.com/watch?v=yNtBywYPx5E

Antidepressants are one of the most prescribed medications in the US, but can carry with them a negative connotation. Even though there an estimated 10%-20% of people in the US taking them, the general public still frown’s on the idea of treatment with antidepressants.

Antidepressants are a hallmark for the treatment of chronic pain today. After all, some of the most commonly used medications were initially developed for something else and used “off label” to treat another condition, and antidepressants are a great example of this. I think the misconception is in the name-“antidepressants”-which certainly doesn’t suggest pain relief to the lay person. Instead, people feel “labeled” as depressed and incapable of being in control of their emotional aspects.
There is suggested to be a biological and psychological connection between depression and pain. Depression is based on a dysregulation of the neurotransmitters serotonin, norepinephrine and dopamine. Chronic pain is based on a dysregulation of the neurotransmitters serotonin and norepinephrine. Pain signals begin in the sensory neurons in the brain and end in the dorsal horn of the spinal cord, and the end result is the experience of pain.

Patients with depression may also experience comorbid pain explained by the dysfunction of serotonin and norepinephrine. When you live with chronic pain, you are more likely to develop depression as a result of the constant bombardment effect of continued pain. So essentially, pain and depression share a reciprocal relationship.
Your clinician should determine the etiology and basic parameters of your pain before deciding on medications like antidepressants for treatment of pain. Pain parameters include location, effect on function and activities, levels at rest and during activity, quality, radiation, medication history, precipitating factors, and timing. It’s a lot to take into account, and clinicians have been known to disregard these parameters, and thus ineffectively treat pain conditions like fibromyalgia.
The FDA has not approved antidepressants to treat chronic pain as of yet (duloxetine has been approved to treat fibro), and maybe they never will. Not to worry, clinicians the world over have been prescribing them for the treatment of chronic pain for decades; even when depression is not present. While antidepressants do not treat every type of pain, they are useful in treating neuropathic pain such as: arthritis, diabetic neuropathy, fibromyalgia, migraine, post-herpetic neuralgia, and many more. What is interesting is that like many other medications, researchers are not sure how antidepressants actually reduce pain.
Antidepressants are believed to work by increasing neurotransmitters in the body, and most often provide only a mild to moderate amount of pain relief (estimated at around 30%). There are a number of different types of antidepressants, many of which work on different neurotransmitters, providing various mechanisms of relief. Often, a patient will receive a lower dose of antidepressant medication versus someone who is being treated exclusively for depression.

Antidepressants can typically take several weeks to become effective in treating depression, but can be expected to produce results much faster with chronic pain. It will likely still take a minimum of a week to see results-much longer than traditional opioid analgesics.
It is not uncommon for a clinician to resort to antidepressants for the treatment of pain after conventional pain relievers have failed, or have produced unsatisfactory side effects. It is also common to use antidepressants in addition to other opioids to address complex pain syndromes like fibromyalgia for example, or conditions where neuropathic and nociceptive pain are both present, such as is seen with cancer.
Often pain syndromes are exacerbated by the lack of sleep. This can be difficult to address using conventional pain relievers. Antidepressants often offer a benefit to sleep patterns, and can therefore reduce pain secondarily. Since the theory of pain is centered around neurotransmitters, and the lack of function or malfunction, it makes sense that antidepressants have value modulating a pain response.

Antidepressants are believed to work by effecting serotonin and norepinephrine ascending the nerve pathways from the brain to the spinal cord. Antidepressants are classified according to which neurotransmitters they impact. While there are many antidepressants, for the purpose of this article, I will only focus on three categories that are commonly used to address pain: Tricyclics, SSRI’s, and SNRI’s. (antidepressants act as co-analgesics when treating pain).
Tricyclics: TCA’s are used most often in the treatment of neuropathic pain. TCA’s work by inhibiting the reuptake of serotonin and norepinephrine at the synapse. What this means is that antidepressants block the synaptic transmission process of serotonin, norepinephrine, and dopamine. This increases the level of these neurotransmitters, enhancing mood, emotions, and reducing pain. The TCA’s that are suggested to be the most efficacious in treating neuropathic pain include: amitriptyline, amoxapine, butriptyline, clomipramine, desipramine, dibenzepin, dothiepin, doxepin, imipramine, iprindole, lofepramine, maprotiline, melitracen, nortriptyline, opipramol, protriptyline, and trimipramine.
SSRI: These work by blocking the reuptake of serotonin primarily, and include: alaproclate, etoperidone, citalopram, escitalopram, fluoxetine, fluvoxamine, paroxetine, sertraline, and zimelidine. SSRI’s are not suggested to be as effective in the treatment of neuropathic pain versus other antidepressants, and have been labeled a disappointment by some clinicians. SSRI’s are suggested to provide mild pain relief and the most effective are paroxetine and citalopram. Fluoxetine is not believed to provide much pain relief.
SNRI: Also known as dual reuptake inhibitors, for their ability to block the reuptake of both serotonin and norepinephrine (similar to a TCA). Currently duloxetine is the only FDA approved antidepressant to treat fibro. SNRI’s include: duloxetine (Cymbalta), milnacipran (Savella), venlafaxine, and bupropion.
So what antidepressant is right for what conditions? That answer is not clear. My position on that issue is that everyone’s condition is unique, even when symptoms may mimic another’s, and medications should be used in a trial and error fashion until you find what works for you. Working closely with your physician, and adjusting dosages periodically is best; although relief may come much slower than desired waiting for results.
SNRI’s and TCA’s are comparable in effectiveness, and are superior for pain relief to SSRI’s. TCA’s have the most side effects, SSRI’s have the least. TCA’s are most effective at reducing pain from fibro, and sometimes combining SSRI’s with TCA’s can be effective to treat fibro pain for example.
It is estimated that 40% of chronic pain sufferers do not achieve effective pain relief. So while it may not be popular to take antidepressants, they may give you your life back to some degree if you suffer from a chronic pain condition. The benefits, of course, need to outweigh the risks. At the end of the day, you are responsible for your wellness, not your physician, which means you need to educate yourself about what you put into your body.

Opioid focus: Buprenorphine’s positive effects

Watch this on youtube: http://www.youtube.com/watch?v=ReNpa3vJJ-o

I have tried a number of opioids for pain relief and have found that they all work to some degree for a little while, taken as needed only; but then the risks outweigh the benefits after some point. It is suggested that most opioids have no ceiling, or upper limit for the dosage, meaning the dose must be increased periodically, which allows for the development of tolerance. Oxycodone, for example, is a semi-synthetic opioid, and has a tendency to lose efficacy over time.

Most opioids produce a reduction in efficacy over time, whereas, fully synthetic opioids like: fentanyl, methadone, Demerol, and buprenorphine, which as a rule don’t lose efficacy over time like the other three classes of opioids (which are shorter acting). Buprenorphine is an interesting opioid for a few reasons. It has a high non-dependency index, which translates to less adverse effects upon cessation, and less addiction potential, due to built in receptor antagonists that prevent abuse. Plus you can get this medication in a once a week transdermal patch, maximizing dosing, and minimizing your dosing schedule. So this opioid essentially performs as a powerful narcotic, and simultaneously prohibits addiction. Plus as a patch versus a pill, you will not experience the digestive and bowel issues most opioids produce. It is expensive though, and requires a pre-authorization with most insurance companies.

Side effects from opioids can be difficult to live with. It is irritating when side effects include really unpleasant effects like weight gain, unless they were also providing the recommended alleviation of symptoms-but often they don’t. Fibromyalgia must be one of the most difficult illnesses to treat; and it is treated by so many different types of medications, with different results for everyone. I have found that SSRI’s like Prozac work for some pain, sleep, and cognition issues. What Prozac does that helps alleviate these symptoms is it blocks the uptake pump that would reabsorb the leftover serotonin after release-increasing the amount of serotonin that can be delivered to the receiving cell. This is a more complete transmission between brain and nerve cell.

How do opioids attach to pain receptors

Watch this on youtube: http://www.youtube.com/watch?v=qg-LEd2OPDY

When we are in pain we have the option of taking opioids. Opioids attach to pain receptors in the brain, spinal cord and GI tract, and can block the perception of pain by blocking pain transmissions from the body to the brain. Opioids have the ability to control pain, but also control reward and addictive behaviors.

There are three opioid receptors: mu, delta, and kappa, all exhibiting a different biological effect on the body. Opioid receptors can be activated endogenously (from within), and exogenously (using medications), which simply means that your body produces natural painkillers, and medications are synthesized to act similar to your natural painkillers.

There are three categories of opioids, all of which attach to different receptors in the brain, they are: full agonists, partial agonists, and mixed agonists-antagonists. Full agonists, like morphine and fentanyl, continue increasing in efficacy over time and are the most effective at blocking pain. Partial agonists, like buprenorphine, are less effective and will eventually reach a ceiling of pain relief. Mixed agonists-antagonists, like pentazocine, only work on the mu opioid receptor in the brain. Like partial agonists, these will also reach a ceiling in efficacy.

In some chronic pain conditions, like fibromyalgia, one theory is that there are less mu opioid receptors available for unknown reasons, which translates into a reduction of pain relieving abilities, thereby reducing the analgesic effect, also reducing dependence behaviors.

It is suggested that when you have less mu opioid receptors, your reward/addiction properties are reduced or eliminated, even for non-opioid drugs that can be abused like: marijuana, alcohol, and nicotine. This may help explain how opioids don’t work well for fibromyalgia sufferers for example. Additionally, the mu opioid receptor is linked to depression when dependence is present.
Like most medications, continuing to take opioids causes the body to adapt to the medication, resulting in dependence, and rarely addiction. Over time, more of the drug is needed to achieve the same results. By default, opioids provide the feeling of euphoria by mediating the pleasure centers in the brain, along with blocking pain transmissions.

Fibromyalgia dedication

Fibromyalgia is a highly misunderstood illness with an estimated fifteen million sufferers in the US and another twenty million sufferers worldwide. Fibromyalgia is classified as a syndrome versus a disease because it is a collection of signs and symptoms that are not related but occur together. Individuals with some rheumatic diseases like lupus or rheumatism are suggested to be more likely to also develop fibromyalgia at some point. Receiving a diagnosis and further coping with its devastating effects is a life changing experience. Learning to beat the disease requires acceptance, education, support, treatment, and hope, among other things. Accurate information about FM can be hard to find and sort through and determine what steps you need to take. This site aims to teach you how to learn to live with this disabling illness.
The goal is survival and the absolute sacrifice is giving up and giving into this disease; letting go of hope, surrendering to your symptoms, and giving up on everything positive in your life that you need to keep you one step ahead of the disease. Successfully living with this disease day in and day out is a testament to your strength. The rest of the world does not yet understand what it means to have this disease; and most often, neither do a large percentage of the medical staff you may encounter. The key to surviving fibromyalgia is a complex process that involves two primary efforts on the patients’ part: The first is to never stop looking for answers and help and the second is to never stop hoping for all the things you desire that will get you to a place that you can effectively cope with the illness. This, of course, is different for everyone. What’s important to remember is it’s how you get there that counts, and that you keep trying different things and never stop trying to improve your health that will benefit you in your pursuit for wellness. Chronic illness does not have to translate to a poor quality of life if you don’t let it.
The information about fibromyalgia that exists today is not common knowledge; it is not openly shared by those in the medical field; and it is not widely accepted across the board either, despite what some experts suggest. Quality information is buried among the many layers of disbelief, distrust and beaurocracy. Many clinicians who accept fibromyalgia as a legitimate disease typically don’t know how to accurately diagnose it in a timely manner, cannot effectively treat it, and may further perpetuate their patient’s illness and myriad of symptoms due to their lack of knowledge about the illness. Finding the right clinician is critical.
Currently there are many organizations, universities and clinicians working on treatments for fibromyalgia. This is an illness of pandemic proportions. The wheels are turning slow, but they are turning.

Until recently, research funding has not being allocated toward fibromyalgia by comparison to most other diseases of proportion, possibly due to the confusing and non-terminal nature of the illness; despite the fact that fibromyalgia affects more individuals than many diseases combined, and is growing in epic proportions. But that is all changing. When you consider the cost fibromyalgia has on society in medical expenses and lost wages alone, the numbers are staggering. The more that is publically known about this illness, the lower the overall impact will be worldwide. Individuals will get diagnosed sooner, treated more efficiently, less time will be spent away from work, and less money will be spent on FM overall.
The goal is to spread the word about the validity and severity of this disease and to help foster the appropriate medical environment for patients to receive effective care. Often it can take many years to get a diagnosis, and another several years until any degree of symptom relief is experienced once treatment begins. Those facts are avoidable with the right flow of information to help you navigate your way through the rigorous, seemingly impossible journey to wellness.
I try to provide some compassionate but realistic information to understanding the impact of the disease. An overview of practical advice of what to look for and how to get where you need to go to get the help that’s available today, and not just get bumped around from doctor to doctor; wasting precious time while your disease becomes more disabling.
This is a true insider’s view of fibromyalgia, from a life-long patient, examining the trial and error treatments and fundamental successes and failures of this disease. I examine the reality of living with one of the most misunderstood and devastating chronic illnesses today, which has lacking support and treatment from the medical community. This is a disease with very little in the realm of treatment; and has been disregarded by medical professional’s for centuries, which adds to the already tarnished name of the disease.
This site takes you through the trials and tribulations of fibromyalgia. From the beginning of dealing with a complicated disabling force to the many steps of acceptance, coping, loss and learning to deal with physicians, the psychology of chronic illness and finding hope where there is none.
Together we will examine some of the controversy surrounding FM like: misdiagnosis, hormones, sleep, fatigue, nutrition, medications, the social security process, symptoms, lab testing, treatments, staying positive, emotional support, depression and more. This site was developed to help those with fibromyalgia help themselves; to help those who cannot find hope buried within this tragic, chronic illness; and to help those who want to educate themselves to stay one step ahead of fibromyalgia.

This illness can have disabling results and the key to wellness is educating yourself and advocating for yourself where others will not, and this site is the key to finding those answers. Someday everyone will appreciate the impact of this illness and the importance of its severity. Everything that matters today about this disease is covered in detail in this site and offers the reader a well-rounded understanding of the disease, from diagnosis to effective coping; and everything in between. What were once thought to be invalid diseases by the world eventually become validated with time and research and so will fibromyalgia. Sadly, for millions of people, time is not on their side and help is desperately needed NOW.
Science is narrowing the gap with fibromyalgia between ability and disability. Scientists are eliminating invalid theories every day and we definitely know a lot about what FM IS NOT. Unfortunately all that the medical field offers many people with FM today are hollow theories and trial and error therapies. Fibromyalgia is an illness that is grossly misunderstood in every possible category and in greater number than most people in the world realize. So learn for yourself everything you can about FM and discover for yourself your road to wellness.

Self-hypnosis: learning to detach from your pain

Watch this on youtube: http://www.youtube.com/watch?v=q85ZkDLTyb8

I did not develop this site as a venue to complain about illness. I developed it as a source for positive, rehabilitative information to help those like me, suffering with chronic illness. I believe that education is the path to wellness, and my mission is to help make sense of chronic illness.

For the purpose of this article, I wish to make a point which I think is critical to wellness, so I have listed those illnesses that I live with, so that you may visualize and relate to my challenges-and to my mission. I have been diagnosed with and suffer from: lupus, fibromyalgia, Hashimoto’s thyroiditis, heart disease, inflammatory bowel disease, Temporomandibular joint, postural orthostatic tachycardia syndrome, dysautonomia, neurogenic bladder disease, reflux disease, and sleep apnea.

The myriad of symptoms I am faced with every minute of every day are endless, and for me, the pain never ends. Illness has rendered me mostly disabled, so I beg the question: where do we go from here? Like many of you reading this and likely suffering from these or other chronic illnesses, the challenges life presents for us are also endless.

We learn to live life by a different set of rules from those not suffering from illness. We redefine our lives and are tasked with re-learning much of what we have already learned; we restructure our activities to accommodate our short comings; we become dependent on medications, on physical aids, and on other people, to do just enough to get by; we suffer from psychological disorders like depression and anxiety, as a result of living with our illnesses; we fail, fall short, and let people down.

Life with chronic illness can sometimes seem like a tragedy. But that’s not where it ends. Life can be what you make it-even with disease. And we don’t have to be consumed by our symptoms-especially chronic pain. It took me many years to learn that I don’t respond to pretty much any medication or treatment for my pain. And it also took me many years of educating myself to find something outside the box that did address my pain.

I felt as though I could say “I tried everything, and nothing works” which was true from a traditional sense. As I would spend many hours lying there trying to talk myself out of pain, I began to calm myself to a point of deep meditation, which became a place where I could focus on the pain so deeply, that I could detach myself from it, visually the same way you would distance yourself from harmful stimuli.

Just as most medications don’t work for everyone, neither does hypnosis, and for me, it does not alleviate pain; it just allows me to draw my focus elsewhere, and detach from the pain. This has literally reduced my pain baseline and my pain threshold, and I am able to “live again.” This is not something I can teach and clearly I have not done a thorough job explaining it, but discover it for yourself through education about meditation and hypnosis and learn how to distance yourself from your pain.

Future directions in chronic pain research

The future of chronic pain research is broad. Advances need to be made in understanding its etiology, assessment and treatment. Research is needed in the understanding of how psychological and social factors impact brain processing to determine illness or wellness. The development of newer imaging tools that can look deeper into the brain and nervous system is needed. The study of operant conditioning for chronic pain management may lead to new advances in pain control. Advancing the study of self-management approaches may also lead to better control of pain. It is important to consider the following: What is the relationship between fear and pain? How does catastrophic thinking translate into pain? Does chronic pain produce a cascade of counterproductive behaviors, both cognitive and physiological? Is there a high fear level of addiction and dependence in patient’s using opioids?

Challenges and barriers to chronic pain

Watch this on Youtube: http://www.youtube.com/watch?v=bZtgNtwCCvk

The topic of chronic pain and psychological comorbidity is one of growing concern in the medical field. There seems to have been a paradigm shift from physicians blaming chronic pain on trauma or injury, (or depression) to recognizing chronic pain as its own disease, capable of being comorbid with numerous other conditions and syndromes; physical and psychological.

Medicine has moved from a pharmacologically based treatment approach for chronic pain, to a multidisciplinary, complementary approach; often involving very little if any pharmaceuticals. Many physicians also share the belief that managing chronic illness and its comorbidity is often more appropriate and reasonable than curing the illness. Much of the management of the chronic condition is left to the patient; since the clinician can only do so much for the patient, and medicine will only go so far. Creating a true partnership between the patient and all clinicians will prove most beneficial in the long run.

There are some additional barriers that present challenges for physicians treating chronic illness. There is sometimes a lack of understanding opioids and their efficacy or spectrum. There also seems to be a negative stigma about prescribing opioids in general, as physicians fear creating addicted patients. The ability of many physicians to accurately assess the patient’s pain can create barriers to effective and timely treatment (Glajchen, 2000).

There also exist barriers that are brought on by the patient. Poor communication can be a critical miss in the doctor’s office. A patient needs to be able to effectively explain their condition to their physician. The patient may not properly participate in the treatment for the fear of side effects or addiction to medications. The fear of pain itself poses a strong barrier that exacerbates pain. Beyond the physician and patient, the health care system in general can be a major constraint to treatment (Glajchen, 2000).

Managing chronic pain and return to work

It is a major challenge to return chronic pain patients to work today and often unsuccessful. After two years off on disability for fibro, lupus, or a related illness, you are only 1% likely to return to work. This presents a huge challenge for the patient. Often in extreme cases a functional capacity evaluation (FCE) is performed by your employer to determine the extent of objectivity in symptoms. Typically then the patient participates in occupational therapy from home, which teaches the patient effective coping strategies. The patient will attend psychological counseling the whole time the other strategies are in place. And finally, the patient is introduced back to work with a schedule they can handle, where applicable. This management program is suggested to take six months on average, and longer in some cases depending upon pain severity. Patients who experience chronic pain and do not return to work as expected have a major impact on not just the patient, but society as well. So there are challenges that will throw up brick walls with getting back to work; but these challenges can be mitigated and strategies for effectively returning to work are possible.

Improved drug therapies for chronic pain

With the advent of better and newer drugs, patients can reduce their frequency and dosage and receive the same or superior benefits. Drugs that digest and release faster are becoming more popular and efficacious. These new drug therapies equate to the patient experiencing less pain by way of advanced formulation design and better delivery systems.
There are many new pain management drugs that provide an advanced benefit to the patient such as: Morphine ER, OxyContin ER, Hydromorphone ER, Opana ER, Duragesic ER, Neurontin IR, and Ketalar. These new medications provide a dramatic improvement in the treatment of chronic pain. Overall patients will experience a reduced dosing schedule for around-the-clock pain therapy (DiNunzio, Miller, and Williams, 2008).

Difficulties is pain rehab

The aporia of chronic pain describes the “puzzle” that is the process of pain. Chronic pain as a barrier to returning to work is a major concern in most countries. Donelly, Matthews & Wales (2010) explains that, “the experience of pain is linked to the social context in which it occurs and that explanations of pain which focus only on physiological process are incomplete unless the effect of the external environment is also considered.”
Not until the last 50 years, did clinicians believe that pain occurred absent of tissue damage. Clinicians are more readily accepting chronic pain as a complex phenomenon. Central sensitization has become a popular cause for chronic pain from an unexplainable origin. Pain is an individual experience, combining the patient’s biology and their experiences in life. The Biogenic model suggests that pain has an identifiable pathological process. The psychogenic model suggests that pain in the absence of objective evidence of injury, is psychological in nature. The biopsychosocial model suggests that pain is not felt in relation to the amount of injury (Donelly et al. 2010). These models undermine common assumptions and present barriers for treatment. With fibro, lupus, and many other chronic illnesses, we cannot limit ourselves to understanding the nature of illness, using the standard scientific models; we have to be willing to step back and observe the illness with new perspective.

Psychotherapy and comorbidity

Interpersonal psychotherapy (IPT-P) is personalizing therapy approaches when chronic pain and depression co-occur. This may be very helpful with fibro patients. Patients who have pain and depression will realize less of a positive outcome than patients with only one condition (Cerrito et al. 2010). The biopsychosocial approach means considering both physical and psychological symptoms together.
CBT is the most used treatment for psychotherapy when pain is present, however, the efficacy of CBT for chronic pain are suggested to be somewhat inconclusive. The biopsychosocial approach suggests it is important to consider the physical as well as the psychological symptoms and social contexts in patients. Pain patients have difficulty with role transitions, job loss, disability, relationships, and feelings; and that IPT-P can help with these issues where other therapies have failed.

Counseling those with chronic pain

Research has shown that psychological factors play a large role in how patients experience and express pain. Patients need to be convinced that they can play a role in fixing part of their problem with the clinician. It has become typical to see an interdisciplinary treatment protocol allowing patients the tools needed to help themselves function and cope. It has been determined that using self-help programs with a counselor was more effective than self-help by itself (Burns, 2010).
Chronic pain therapy is more effective with an interdisciplinary approach involving medication. Chronic pain patients have often suffered trauma, sexual and physical abuse, fear avoidance, and anxiety. Patients suffering from chronic pain often realize pain that is disproportional to their trauma or injury, and are typically unsuccessful with treatment (Burns, 2010).

The biopsychosocial approach to chronic pain

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The biopsychosocial approach has become the most widely accepted understanding to treating chronic pain. “Psychological and social factors can interact with brain processes to influence health and illness as well as on the development of new technologies, such as brain imaging, that provide new insights into brain-pain mechanisms” (Bo Peng et al. 2007). Emotional pain and psychiatric disorders often accompany chronic pain. To effectively treat a patient’s pain, the clinician must understand the relationship between biological changes, psychological status, and sociocultural context (Bo Peng et al. 2007). New theories surrounding chronic pain are currently being researched such as: Neuromatrix theory, brain imaging, and brain pain mechanisms.
The nociceptive process of pain describes the experience of pain from noxious stimuli. Gate control describes the spinal cord having a neurological gate that blocks or allows pain signals to pass to the brain. Neuromatrix theory suggests that pain is a multidimensional experience generated in the brain. It is common for there to be an HPA axis dysfunction in those suffering from chronic pain, especially fibromyalgia. The neuroscience of pain has opened doors to new and better understanding of the basic mechanisms of pain processing. The human genome was mapped out completely in 2001, revealing many medical mysteries. All biological functions were thoroughly examined and documented. Chronically ill patients with many categories of disease have been studied using: PET, SPECT, fMRI, IOS, and nanotechnology-quantum dots. Scanning tools like CT and fMRI have advanced present knowledge of CNS; PET, SPECT & MEG have advanced present knowledge of the brain response to tasks and stimuli.
Pain is typically viewed as a symptom of injury, and being of secondary importance. This is no longer the case, as pain is now viewed as being outside the emotions. The end result of pain is a composite of sensory-discriminative, cognitive-evaluative, and motivational features (Bo Peng et al. 2007). Anxiety is commonly seen in those suffering from chronic pain as well. As much as 50% of chronic pain patients suffer from depression, which is a growing concern. A large percentage of chronic pain patients also often exhibit anger. Patients can gain voluntary control of activation in areas of the brain when trained to. Social and behavioral factors can act on the brain to influence health, illness and death. Psychological and social factors interact with brain processes and influence health or illness-providing insights into brain-pain mechanisms. This suggests a lead into an interdisciplinary pain management approach.