Triggers and Causes of Panic Attacks

▪ Long-term, predisposing causes — Heredity. Panic disorder has been found to run in families, and this may mean that inheritance plays a strong role in determining who will get it. However, many people who have no family history of the disorder develop it. Various twin studies where one identical twin has an anxiety disorder have reported an incidence ranging from 31 to 88 percent of the other twin also having an anxiety disorder diagnosis. Environmental factors such as an overly cautious view of the world expressed by parents and cumulative stress over time have been found to be causes.

▪ Biological causes — obsessive compulsive disorder, post traumatic stress disorder, hypoglycemia, hyperthyroidism, Wilson's disease, mitral valve prolapse, pheochromocytoma and inner ear disturbances (labyrinthitis). Vitamin B deficiency from inadequate diet or caused by periodic depletion due to parasitic infection from tapeworm can be a trigger of anxiety attacks.

▪ Phobias — People will often experience panic attacks as a direct result of exposure to a phobic object or situation.

▪ Short-term triggering causes — Significant personal loss, including an emotional attachment to a romantic partner, life transitions, significant life change, stimulants such as caffeine or nicotine, or other drugs such as marijuana and psilocybin, can act as triggers.

▪ Maintaining causes — Avoidance of panic provoking situations or environments, anxious/negative self-talk ("what-if" thinking), mistaken beliefs ("these symptoms are harmful and/or dangerous"), withheld feelings, lack of assertiveness.

▪ Lack of assertiveness — A growing body of evidence supports the idea that those that suffer from panic attacks engage in a passive style of communication or interactions with others. This communication style, while polite and respectful, is also characteristically un-assertive. This un-assertive way of communicating seems to contribute to panic attacks while being consistently present in those that are afflicted with panic attacks.

▪ Medications — Sometimes panic attacks may be a listed side effect of medications such as Ritalin (methylphenidate) or even fluoroquinolone type antibiotics. These may be a temporary side effect, only occurring when a patient first starts a medication, or could continue occurring even after the patient is accustomed to the drug, which likely would warrant a medication change in either dosage, or type of drug. Nearly the entire SSRI class of antidepressants can cause increased anxiety in the beginning of use. It is not uncommon for inexperienced users to have panic attacks while weaning on or off the medication, especially ones prone to anxiety.

▪ Alcohol, medication or drug withdrawal — Various substances both prescribed and unprescribed can cause panic attacks to develop as part of their withdrawal syndrome or rebound effect. Alcohol withdrawal and benzodiazepine withdrawal are the most well known to cause these effects as a rebound withdrawal symptom of their tranquillising properties.

▪ Hyperventilation syndrome — Breathing from the chest may cause overbreathing, exhaling excess carbon dioxide in relation to the amount of oxygen in one's bloodstream. Hyperventilation syndrome can cause respiratory alkalosis and hypocapnia. This syndrome often involves prominent mouth breathing as well. This causes a cluster of symptoms including rapid heart beat, dizziness, and lightheadedness which can trigger panic attacks.

▪ Situationally bound panic attacks — Associating certain situations with panic attacks, due to experiencing one in that particular situation, can create a cognitive or behavioral predisposition to having panic attacks in certain situations (situationally bound panic attacks). It is a form of classical conditioning. 

▪ Pharmacological triggers — Certain chemical substances, mainly stimulants but also certain depressants, can either contribute pharmacologically to a constellation of provocations, and thus trigger a panic attack or even a panic disorder, or directly induce one. This includes caffeine, amphetamine, alcohol and many more. Some sufferers of panic attacks also report phobias of specific drugs or chemicals, that thus have a merely psychosomatic effect, thereby functioning as drug-triggers by non-pharmacological means.

▪ Chronic and/or serious illness — Cardiac conditions that can cause sudden death such as Long QT syndrome; CPVT or Wolff-Parkinson-White syndrome can also result in panic attacks. This is particularly difficult to manage as the anxiety relates to events that may occur such as cardiac arrest, or if an Implantable cardioverter-defibrillator is in situ, the possibility of having a shock delivered. It can be difficult for someone with a cardiac condition to distinguish between symptoms of cardiac dysfunction and symptoms of anxiety. In CPVT, anxiety itself can and does trigger arrythmia.Current management of panic attacks secondary to cardiac conditions appears to rely heavily on Benzodiazepines; Selective serotonin reuptake inhibitors and/or Cognitive Behavioural Therapy. Although often this group of people experience multiple and unavoidable hospitalisations as without an electrocardiogram it can be difficult to differentiate between symptoms of panic attack and cardiac symptoms in those with these types of diagnosis.

Fibromyalgia Quiz

To take the quiz, click here.

Is Irritable Bowel Syndrome Linked to Foods?

This is from 2005, but I thought It was an interesting article regarding IBS.

Study Shows Wheat, Beef, Pork, Lamb, and Soybeans Stood Out Among 16 Common Foods.

July 14, 2005 -- Are people with irritable bowel syndrome (IBS) more sensitive to certain foods than other people? And if so, what are those foods?

Science doesn't yet have an indisputable answer to that question. But a report in July's American Journal of Gastroenterology may provide more insight.

IBS is a functional condition of the intestine. While no one fully understands what causes IBS, it is not an anatomic problem. According to the American Academy of Gastroenterology, IBS patients have changes in bowel habits, such as constipation or diarrhea. They also have abdominal pain along with other symptoms including abdominal bloating and rectal urgency with diarrhea.

Researchers tested 16 common foods on blood from 132 IBS patients and 43 people without IBS.

IBS patients had higher levels of an antibody called IgG4 in response to five foods, compared with those without IBS. Those five foods were wheat, beef, lamb, pork, and soybeans.

Antibodies are proteins made by the immune system to help fight infections.

IgG is the major antibody in the body; another antibody called IgE is normally present in only trace amounts, but it is responsible for the symptoms of allergy.

However, the study doesn't prove that the five foods caused IBS.

IBS symptom severity and frequency weren't linked to antibody levels, write the researchers. They included Sameer Zar, MRCP, of St. Georges Hospital Medical School in London.

Food Sensitivity

Between one-fifth and two-thirds of IBS patients attribute their symptoms to food hypersensitivity.

By comparison, only about 5% of the general population claims food hypersensitivity.

Sameer Zar, MRCP, and colleagues cite those statistics in their report.

Food Test

Zar's study included 52 people with diarrhea-prominent IBS, 32 with constipation-prominent IBS, and 24 with alternating IBS.

Most subjects (91) were women. Average age ranged from 35 to about 43.

Foods tested included milk, egg white, egg yolk, cheddar cheese, rice, yeast, potato, peanut, cod fish, chicken, lamb, beef, pork, tomatoes, and soybean.

Study's Results

Those with diarrhea-prominent IBS had markedly higher levels of the antibody IgG4 for wheat, beef, pork, and soybean.

Those with constipation-prominent IBS had markedly higher IgG4 levels for wheat, lamb, beef, and pork.

Those with alternating IBS had markedly higher IgG4 levels for wheat, beef, and pork.

There was a large variability in the IgG4 antibody level to different food groups, write the researchers.

Skin Prick Test

Skin prick tests were done on a smaller group of participants -- 56 with IBS and five without IBS.

A skin prick test places a small amount of substance that triggers an allergic reaction into the skin. People with allergies to the specific substance have swelling in the injected region of the skin, a reaction caused by IgE antibodies.

A lot of participants didn't take the skin test, which required a separate visit to another center. Due to the low turnout, the test was dropped later on.

Five IBS patients had a positive skin test response to shrimp. So did one person without IBS.

The skin test results didn't sync up with results from the blood antibody tests, write the researchers.

Food Journal, Doctors May Help

"For many people, careful eating reduces IBS symptoms," says the National Institutes of Health (NIH).

"Before changing your diet, keep a journal noting the foods that seem to cause distress. Then discuss your findings with your doctor. You may also want to consult a registered dietitian, who can help you make changes to your diet," says the NIH.

By Miranda Hitti
WebMD Medical News

Reviewed By Brunilda Nazario, MD
on Thursday, July 14, 2005

SOURCES: Zar, S. American Journal of Gastroenterology, July 2005; vol 100: pp 1550-1557. WebMD Public Information from the National Institutes of Health: "Irritable Bowel Syndrome." National Cancer Institute. American Academy of Allergy Asthma and Immunology. American Academy of Gastroenterology.

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Spastic Colon

After researching articles on IBS, I just read that it's another name for Spastic Colon. I was diagnosed when I was 7 years old,  37 years ago with Spastic Colon.  I completely forgot about this diagnosis. I wonder if this was an indicator of my FM to come?

What is Generalized Anxiety Disorder?

It is characterized by excessive, uncontrollable and often irrational worry about everyday things that is disproportionate to the actual source of worry. This excessive worry often interferes with daily functioning, as individuals suffering GAD typically catastrophise, anticipate disaster, and are overly concerned about everyday matters such as health issues, money, death, family problems, friend problems or work difficulties.[1] They often exhibit a variety of physical symptoms, including fatigue, fidgeting, headaches, nausea, muscle tension, muscle aches, difficulty swallowing, bouts of difficulty breathing, trembling, twitching, irritability, sweating, insomnia, hot flashes, and rashes. These symptoms must be consistent and on-going, persisting at least 6 months, for a formal diagnosis of GAD to be introduced. Approximately 6.8 million American adults experience GAD.

Source

5 Tips for Handling Migraine In the Workplace

I'm not sure about you, but I've been on my office floor with the lights off suffering one of my most painful migraines ever. 

Once I thought the pain was subsiding, I left work for the day to experience how it felt to throw-up three times outside my car in the company parking lot, which is a very busy place. The maintenance men, customers, and guests in and out of the lobby all nearby. 

So, before you find yourself rolling around on your office floor and barely making it to your car, check out this great article.

A HarrisInteractive poll conducted for Pfizer Pharmaceuticals showed that 15 million men and women in the United States have either gone to work with a Migraine or gotten a Migraine at work. Two-thirds of those Migraineurs "struggled through" to stay at work. Dr. Jan Lewis Brandes, a headache and Migraine specialist at Vanderbilt University, says, “Many people struggle through the debilitating pain of migraine to get the job done and because they do not want to let down their co-workers.”

Although more people in the U.S. suffer from Migraine than from asthma and diabetes combined, Migraine remains one of the most underdiagnosed, misunderstood, and undertreated of diseases. Even Migraineurs don't understand the disease and realize how much help is available. The Harris poll also indicated that 61% of the respondents took over-the-counter medications or nothing at all for Migraines. Dr. Brandes emphasizes, “Migraine is a real disease, just like diabetes or high blood pressure. It is possible to keep migraine under control, and the best way to do that is to see a doctor and get effective treatment.”

Doctor Brandes shared some tips she offers her patients for handling Migraine in the workplace:

Understand that Migraine is a real disease – not just a bad headache. Migraine sufferers sometimes tend to minimize their Migraines as “just headaches,” not a disease with a range of symptoms that are as debilitating as the pain itself.  Migraine is a real medical condition just like diabetes or asthma.  Understanding this will better enable you to manage your Migraines and seek effective treatment.

Be your best advocate. Talk to a doctor about your Migraines and how best to manage them.  There are many effective new treatments specifically for Migraine. The newest class of these are called “triptans.”  They relieve Migraine pain quickly and also relieve the other symptoms of Migraine such as nausea and sensitivity to light and sound.

Make changes in your work environment that reduce your susceptibility to migraine triggers.

1. Make changes in your work environment that reduce your susceptibility to Migraine triggers.

2. Ask co-workers to go easy on perfume and cologne – smells can be powerful triggers; cigarette smoke, too.

3. Watch your caffeine intake. Small doses of caffeine may help treat a Migraine attack but large doses of caffeine can bring on Migraine.

4.Be sure to drink a lot of water and don’t skip meals.

5. Use an anti-glare screen on your computer – straining your eyes can increase your chance of getting a Migraine.

Be on the alert for early signs of migraine. Get to know your own Migraine patterns so that you can spot early signs of a Migraine attack.  Some people experience irritability, mild pain or nausea that are signals that a Migraine is about to hit.  Whenever possible, take your medication early. Dr. Brandes notes that 60% of Migraineurs have prodrome symptoms and can learn to recognize them early.

Educate your boss and co-workers about migraine. The Harris-Pfizer survey showed that many people tell their colleagues about their Migraine. This is encouraging because creating understanding and awareness of Migraine and its impact can cultivate support from the people you work with.

If Migraine increasingly makes you absent from work, forces you to go home early,  or impairs your ability to do your job in any way, your Migraine condition is probably not under control. Tell your doctor if your Migraines are impacting you in your work. Your doctor can work with you on a treatment plan to help you.

Remember that Migraine triggers are what Dr. Brandes terms "stackable." While encountering one trigger might not result in a Migraine, adding another one may be a different matter.

Source

Hey Jude

Could Growth Hormone Therapy Be Beneficial For FM?

Fibromyalgia is a chronic, idiopathic condition in which patients experience pain, asthenia and fatigue. The pathogenesis of the condition is unknown, and numerous mechanisms have been postulated, including neural hypersensitivity and autoimmunity. Symptoms of fibromyalgia are broadly similar to those of growth hormone deficiency (GHD), and there is evidence of decreased GH secretion and functional GHD in a subset of patients with fibromyalgia. Use of GH therapy in this patient population therefore represents a rational treatment strategy. Preliminary placebo-controlled trials have shown that GH therapy can significantly improve signs and symptoms of fibromyalgia and quality of life in patients receiving the current standard of care. Despite the use of relatively high doses of GH in these patients, treatment is well tolerated. Several mechanisms of action for GH in fibromyalgia have been suggested, including both central and peripheral effects.

Written By:

Cuatrecasas G.

Source

Endocrinology Department, Centro Medico Teknon & C Sagrada Familia, Barcelona, Spain. gcuatrecasas@cpen.cat

Arizona Trail For Fibromyalgia

 Here we have another courageous Fibro sister! 

She is so inspiring and encouraging. I'm sure to many of us sufferers.

I really love coming across these types of articles and websites to be able to share with everyone here.

When she set out to hike the 800-mile Arizona Trail last spring, Sirena Dufault worried that she might not finish.

 

The daunting trail stretches from Utah to the U.S.-Mexico border.

 

Dufault's concern stemmed from her decade-long battle with fibromyalgia, a little-understood chronic pain disorder.

 

"I was a little hestitant to publicize it because I didn't know how far I could go," Dufault said this week. "Now I can comfortably do a 15-mile day with a big pack, no problem."

 

Next Tuesday — on national Fibromyalgia Awareness Day — the 35-year-old will make a final, eight-mile hike north of Oracle to complete the trail, trudging from the Tiger Mine Trailhead to the American Flag Trailhead.

 

Dufault kept an online journal throughout her trek, which she made mostly by herself in one- to five-day trips. The May 12 leg marks the 80th day Dufault has spent on the trail.

 

She hopes her success will inspire the 10 million Americans suffering from the disorder, Dufault said. "There's not a whole lot of positive information out there about people getting their lives back after fibromyalgia."

 

Fibromyalgia's many symptoms include chronic, widespread body pain, according to the National Fibromyalgia Association. Symptoms can stem from an acute illness or injury, as in Dufault's case. Her diagnosis came in 1998, a year after she was hit by a car as she crossed a street. For months afterward, even as her initial injuries healed, Dufault's pain and fatigue worsened.

 

"I saw her probably at her worse," said Angi Edge, a nurse and massage therapist who treated Dufault after her diagnosis and became a fast friend. "So many people give up on themselves. They become their disease. She was just not going to give up."

 

Dufault's pain has not flaired up in a major way in the last three years, she said. "I attribute that to being very, very active."

 

For her next big adventure, Dufault might hike the Tonto Trail in the Grand Canyon.

 

She walked 25 miles of the 90-mile trail this past winter.

 

Arizona Woman with Chronic Pain Eight Miles Away from Completing Fibromyalgia Awareness Hike on the 800-mile Arizona Trail

Tucson, AZ- May 5, 2009- In February 2008, Sirena Dufault began hiking the Arizona Trail, an 800-mile trail that crosses Arizona from its border with Mexico to the border with Utah. Now, Dufault, 35, has only eight miles left to go. She is hiking the trail to raise awareness for Fibromyalgia, a complex chronic pain disorder that affects an estimated 10 million Americans. Sirena developed post-traumatic fibromyalgia following an accident in 1997 in which she was hit by a car while walking across the street. The pain and fatigue worsened, resulting in her being bedridden for several months. Dufault began walking as a form of gentle exercise following her fibromyalgia diagnosis in 1998, and very gradually worked up to longer and longer hikes. 

Dufault enjoyed the physical benefits of hiking so much that she decided to take on the 800-mile Arizona Trail. She is hiking to raise awareness for Fibromyalgia and is donating all proceeds from the hike to the National Fibromyalgia Association. “This experience has been so rewarding and has given me a deep appreciation for the diverse beauty found in the state of Arizona.” said Dufault. “And day after day of hiking, I found out that I am so much stronger than I ever dreamed possible. I want others with fibromyalgia to know that there is hope after the diagnosis.” 

Dufault has hiked most of the trail solo in one- to five-day segments, but on May 12, Fibromyalgia Awareness Day, Sirena will complete the final eight miles of the Arizona Trail with a group of supporters. They will start out at the Tiger Mine Trailhead north of Oracle at 7 am and hike south to the American Flag Trailhead, arriving around 11 am. “I conceived the idea of hiking the Arizona Trail at this spot in May 2007,” says Dufault, “so it’s fitting that my hike ends here.” 

To see Sirena’s blog, pictures, and videos from the trail as well as to make a donation, visit her website Arizona Trail for Fibromyalgia at www.aztrail4fms.org.

 

Contact: Sirena Dufault                                           

aztrail4fms@live.com

 

New Links

I just added two new links above for men with fibromyalgia.

Fibromyalgia and the Male Factor

Despite the fact that like 80% of all fibromyalgia patients are women, there are some males with the condition who also need to be able to deal with the condition on their terms. Males often approach illness in a totally different way then women do.

There is also a female stigma associated with the condition, fibromyalgia that could make it even more difficult for a man to receive a correct diagnosis based on his symptoms and medical history.

His doctor would have to be current on fibromyalgia research and open to the possibilities of all diagnosis’s that could be the root of his symptoms including fibromyalgia. Sometimes if we are not looking for something, we don’t see it.

It can be difficult for a man with fibromyalgia to receive the same level of recognition or emotional support that women with the condition receive. There is still very much the idea that fibromyalgia is “all in the head” anyways, and if a man should voice the notion that he is suffering from fibromyalgia he is more likely to receive ridicule and teasing especially from other men.

This isn’t to say that a man with fibromyalgia can’t find support because he can; he just has to look a little more for it. Online he can find support here:

http://www.menwit...hfibro.com/home.html

You can find other places online by searching under the keywords: “men fibromyalgia”.

Men can benefit from joining local or online support groups that are set up for men with fibromyalgia because they can find support for those times in life when stress can be compounded by the symptoms he has, the diagnostic stage can be very long (months even years).

This can be very wearing on a man, anxiety and depression can easily set in making support a necessity, adjusting to life with a chronic illness can be very stressful and change is never easy especially for men, and he may have very little support in his life other than that which he finds through support groups.

Most males still believe that they have to be “tougher” and not complain when they are in pain so it is emotionally more difficult for a man to admit to having symptoms that require medical intervention.

Men also hate to change lifestyles for any reason and being diagnosed withfibromyalgia pretty much demands that you do things differently if you hope to lessen the effects of your fibromyalgia symptoms.

The symptoms that may solicit some lifestyle changes for men with the condition are:

Muscle pain, muscle twitches, or leg cramps, Sleep disturbances, Fatigue

Sensitivity to light, sound, odors, cold, foods, or medications, Dizziness

Stomach upsets, Depression or anxiety, Headaches or migraines

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Fibromyalgia and Medical Marijuana

Fibromyalgia, a chronic pain syndrome, is hard to treat and impossible to cure. With pain so debilitating, patients may wonder about trying medical marijuana to ease their discomfort.

Still widely controversial, "medical marijuana" refers to the smoked form of the drug. It does not refer to the synthesized version of THC, one of the active chemicals in marijuana, that's available in a medication called Marinol. The FDA first approved Marinol (dronabinol) in 1986 for nausea and vomiting from chemotherapy. It later approved its use for nausea and weight loss from AIDS.

The history of medical marijuana

Medical marijuana was prescribed by doctors until 1942. That's when it was taken off the U.S. pharmacopoeia, the list of commonly available drugs.

"Marijuana has been a medicine for 5,000 years," says Donald I. Abrams, MD. "That's a lot longer than it hasn't been a medicine." Abrams, who is an oncologist and director of clinical research programs at the Osher Center for Integrative Medicine at the UCSF School of Medicine in San Francisco, is one of a handful of top-flight doctors in the country researching medical marijuana. "The war on drugs is really a war on patients," he says.

So why research medical marijuana when a pill, Marinol, is now available?

Marijuana -- the plant's Latin name is cannabis -- has a host of components called cannabinoids. These components may have medicinal properties.

"There are 60 or 70 different cannabinoids in marijuana," says Abrams. Marinol contains only one cannabinoid -- delta-9 THC. When THC is isolated from the plant, other ingredients are lost, including those that might be buffering any adverse effects of taking "straight" THC. "In Chinese medicine," Abrams says, "they prescribe whole herbs and usually combinations of herbs."

Abrams goes on to point out that, "In 1999 the Institute of Medicine did a report --Marijuana and Medicine. And they said, in fact, that cannabinoids have benefit in relief of pain, increase in appetite, and relief of nausea and vomiting."

Is medical marijuana legal?

The federal government, in the Controlled Substances Act of 1970, placed drugs into five groups called "schedules," driven by three criteria:

• potential for abuse or addiction
• medical usefulness
• dangers of abuse or addiction, both physically and psychologically

Marijuana, LSD, and heroin were all initially placed in Schedule I -- the most addictive, and least medically useful, category.

To further entangle the legal issues, several states have passed their own controlled substance laws that conflict with federal laws. That includes drug policy reforms and "compassionate use" laws that allow patients with terminal and debilitating diseases to use medical marijuana. In order to be able to use it, a patient needs to have documentation from a doctor.

The American Chronic Pain Society says in ACPA Medications & Chronic Pain, Supplement 2007: "Some states allow the legal use of marijuana for health purposes including pain, while the federal government continues to threaten physicians with prosecution for prescribing it."

Continue reading

Source

Make Mine Raw

Raw foods provide superior nutrition as well as the enzymes necessary for their own digestion. The cooking process destroys these naturally occurring enzymes, forcing the pancreas to produce more internal digestive enzymes. Try to eat at least one completely raw meal each day, or eat a raw salad with a cooked meal twice a day. 

World Me & FM Prayer & Meditation Days

Mark your calendar for August 3rd 2009.

Please click here for more details:
How to Participate

ME/CFS & Fibromyalgia Good Doctor List

Click Here

All Wheels for Fibromyalgia Finishes First

Despite run-ins with wildlife, a series of equipment mishaps, and stretches of pouring rain and 40-mile-an-hour headwinds, All Wheels for Fibromyalgia came in first place last month in the annual 3,000-mile Race Across America event. Click here to learn more. 

Has fibromyalgia been linked to heart palpitations?

Yes. There's a bit of an anxiety component associated with fibromyalgia (as with most patients in pain). This is probably part of the issue. I do hear this quite frequently. I found them in my practice to be benign. But, again, palpitations should be evaluated by a medical doctor.

Experts Launch Think Tank For Mystery Disease

Ten leading scientists in Europe have formed a Think Tank for ME and will hold their first meeting on the 13th of June. They want to initiate an effective research effort to find the secret behind the mystery disease that cripples an increasing number of lives. Myalgic Encephalomyelitis, often referred to as Chronic Fatigue Syndrome (CFS), is a disease which affects at least one million individuals in the US, and an even greater number in Europe. Despite the large number of people affected, there is a lack of serious large-scale research initiatives focused on the disease. The number of patients is rapidly increasing but healthcare personnel lack knowledge about existing research and possible treatments. 

Last year's winner of the Nobel Prize in Medicine, Professor Luc Montagnier of France, says, "Scientists have already uncovered a lot about ME, but this information does not reach professional healthcare personnel, and the disease is still not taken seriously. It is about time this changes." Montagnier, one of the discoverers of the HIV-virus, is a supporter of the Think Tank, but is unable to join the first meeting due to his demanding schedule. 

Treatable Disease 

Ten internationally recognized scientists, many of them prominent leaders in their respective fields of research, have decided to do something about it. They have come together in a Think Tank to promote cooperation among scientists from various disciplines and to stimulate intense focus on innovative and creative research. The first meeting is set in Stavanger, Norway on the 13th of June. 

"There are more than 5000 research papers which show that ME has an organic basis with abnormalities in the immune, nervous and gastrointestinal systems and that it is influenced by genetic and environmental factors," states Professor Kenny De Meirleir of Belgium. "Despite these findings, it has been close to impossible to initiate large-scale research to verify these facts and observations. We will never be able to treat ME properly if we do not initiate this type of research." 

Using new biotechnological techniques, much of the underlying pathophysiology of the disease has been unmasked. Several treatable clinical entities have been discovered, but this information does not reach healthcare personnel. The result is that patients remain undiagnosed and untreated for years with something that might be fully treatable. This is a huge drain on the economy, as the estimated socio-economic costs for Europe are estimated to be €20 billion annually. 

Educate Professionals

An important part of the Think Tank's mission is to spread knowledge about the disease. The incidence of ME and the impact on public health are actually higher than that of other better researched conditions like Multiple Sclerosis and HIV. Research shows that ME can be a very disabling chronic disorder which often diminishes patients' quality of life to levels lower than that of cancer, MS, HIV andlupus. 

Professor Ola Didrik Saugstad of Norway states, "There is a total lack of knowledge and understanding about this disease in the healthcare system. We wish to use our knowledge to educate and train doctors, therapists and other healthcare personnel so they can better understand how to manage an ME-patient." 

New in ME

The Think Tank meetings are the brainchild of a new organization, European Society for ME (ESME). This society will focus on organizing research and educating professionals in the field of ME. 

"Until now ME organizations have been patient-based and only focused on the needs of the patients, so this is something completely new and unique. We are a group of professionals who want to stimulate new research in the field of ME and to help doctors and healthcare personnel to stay informed about the latest developments in diagnosing and treating ME-patients," says ESME board member Mrs. Catherine Miller-Duhen. 

Source 
European Society for ME 

Doctor Offers Unbiased Overview In New Book

As many as fifteen million American women suffer from a disabling medical condition known as fibromyalgia. In the medical community, sides have been drawn over whether fibromyalgia is a genuine syndrome or a catchall diagnosis based on vague clinical criteria. In The Fibromyalgia Controversy, M. Clement Hall, MD presents an unbiased overview of the fibromyalgia situation today and reviews the most up-to-date opinions and studies on this condition and its surrounding controversy. 

Fibromyalgia - affecting approximately five percent of the American population, mostly women - is characterized primarily by widespread pain, tender spots, decreased pain threshold, sleep disturbance, fatigue, and psychological distress. It is a chronic condition characterized by a pattern of vague symptoms that are difficult to diagnose and treat. The controversy among doctors is whether or not there is an actual disease that can be cured, rather than just a set of symptoms to manage. 

"Despite being recognized as a diagnosable disease by the American College of Rheumatology, the Food and Drug Administration and most insurers, fibromyalgia has not completely shed the stigma of being dismissed as "psychosomatic" by some in the medical establishment." noted the Sacramento Bee in a May 31, 2009 article on patients not being taken seriously by their doctors. There are few conditions about which the medical profession is so polarised One side argues, sometimes heatedly, that patients are masquerading - pretending a disability they know they do not have. The other side counters, with equal passion, that fibromyalgia sufferers are abused by a society that fails to give them the support they deserve while painfully suffering from this severely debilitating illness. 

In The Fibromyalgia Controversy, Dr. M. Clement Hall presents six fictional, though factually based, case studies of typical patients from differing socioeconomic backgrounds and describes the varying investigations, diagnoses, and treatments they have undergone. Each of these case studies represents a composite of many years of clinical practice rather than one specific patient. Collectively, they cover the range of experiences fibromyalgia patients are likely to have encountered. By taking this unique approach, Dr. Hall presents an objective overview of the fibromyalgia situation today in North America. Patients, family members, and physicians will see themselves reflected in the descriptions and will gain a broader understanding of this challenging illness. 

"While several books address the challenges of living with fibromyalgia... Hall's is a uniquely objective account that surveys diagnosis, treatments, and the controversy surrounding the condition," says Rebecca Raszewski, University of Illinois at Chicago, in a Library Journal review. "Hall... delivers a balanced view... by presenting perspectives of skeptics who doubt whether fibromyalgia is a real medical condition - as well as comprehensive descriptions of the disorder and treatment options." 

By detailing the process by which clinicians make their diagnoses, explaining how those who think they may have fibromyalgia can make the most of their doctors' visits, discussing various treatments in current use (medication, physical therapy, diet modification, and alternative approaches such as massage or acupuncture), and looking at the historical record of various related disorders, Hall provides an unbiased, indispensable survey of data and views on this illness. 

Notes: 
The Fibromyalgia Controversy is a must read for sufferers, clinicians, and those interested in gaining insight about this heated dispute in the medical community and its long-term repercussions. 
About the Author: M. Clement Hall, MD (Toronto, Ontario, Canada), is the director of continuing education in the emergency department of Scarborough Hospital, and is the author of "Trauma Surgeon" among other works. 

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Article Date: 10 Jun 2009 - 0:00 PDT
Jennifer Kovach 
Prometheus Books