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                                                                                                                                                                                                  EXERCISE CAN EASE FIBROMYALGIA PAIN
                                                                                                                                                                                                  December 7, 2007
                                                                                                                                                                                                  Nursing Spectrum - Nurse Week

                                                                                                                                                                                                  Researchers in Boston have found regular walks and stretching exercises can help ease the chronic pain of fibromyalgia. In a study of 207 women between the ages of 18 and 75 diagnosed with fibromyalgia, researchers from Brigham and Women’s Hospital and Harvard University assigned one group to a twice-weekly aerobic and stretching program for 16 weeks. Another group added mild strength training, while a third group attended a 2-hour education course every two weeks. A fourth group combined all of the approaches. The study found an exercise program that included progressive walking and flexibility movements, with or without strength training, improved physical, emotional, and social function.

                                                                                                                                                                                                  MIGRAINES - PREVENT THE POUNDING - DIET TIPS FROM THE TODAY SHOW
                                                                                                                                                                                                  Prevent the pounding! Diet tips to stop headaches
                                                                                                                                                                                                  Joy Bauer lists the common foods and drinks that can trigger migraines
                                                                                                                                                                                                  By Joy Bauer 
                                                                                                                                                                                                  TODAYShow.com contributor
                                                                                                                                                                                                  November 2, 2007

                                                                                                                                                                                                  By identifying your personal triggers, you can often reduce the frequency and intensity of migraine headaches. Keep a migraine diary to spot cause-effect relationships. Common non-food triggers include:
                                                                                                                                                                                                  • Stress
                                                                                                                                                                                                  • Hormonal changes
                                                                                                                                                                                                  • Intense sensory stimuli
                                                                                                                                                                                                  • Physical exertion or abrupt lifestyle changes
                                                                                                                                                                                                  • Environmental factors
                                                                                                                                                                                                  • Medications
                                                                                                                                                                                                  Food can also act as a big, big trigger for some people. The following foods are the most common offenders. It’s a daunting list, but rest assured only a few of the foods may apply to you (in fact, some people have no food sensitivities). If you discover that one of the foods listed here is a trigger, then you know that you should avoid that particular food if you want to minimize migraine frequency. 


                                                                                                                                                                                                  Tyramine or Phenylethylamine: Two amino acids found in chocolate, aged or fermented cheese, soy foods, all nuts and most seeds, citrus fruits, and vinegar (red and balsamic).
                                                                                                                                                                                                  Alcohol: Beer, red wine, sherry, and vermouth contain large amounts of tyramine, which can cause migraines. In addition, all alcohol can cause dehydration, which also can trigger headaches.
                                                                                                                                                                                                  Avoid eating leftovers: Tyramine content in food increases over time, especially if food is improperly stored.
                                                                                                                                                                                                  Tannins: Tea, red skinned apples and pears, apple juice and cider, and red wine, which contain tannins.
                                                                                                                                                                                                  Deli meats and other foods containing Nitrites: These include pepperoni, bacon, hot dogs, sausages (including chicken, turkey and soy sausages/bacon/hotdogs that list nitrites in their ingredients), bologna, pastrami, jerky (beef and turkey), corned beef, and all other beef/poultry/pork/wild game/fish that have been cured, smoked, pickled, canned, or preserved with nitrites.
                                                                                                                                                                                                  Sulfites: This preservative is commonly found in wine (more so in white wine), most dried fruits (including prunes, figs, apricots), canned vegetables, and many processed foods. Check labels.
                                                                                                                                                                                                  Additives: Check labels carefully and avoid foods that contain monosodium glutamate (MSG), hydrolyzed vegetable protein (HVP), hydrolyzed plant protein (HPP), kombu extract, any products claiming to have “natural flavor” or “natural flavorings.”
                                                                                                                                                                                                  Aspartame: Be cautious of foods and beverages made with this artificial sweetener (also known as Nutrasweet and Equal).
                                                                                                                                                                                                  Caffeine: People with sensitivity to caffeine can develop migraines after drinking black tea, green tea, coffee, cola soft drinks, or other caffeinated soft drinks. But caffeine can also be used to stop a migraine that is just beginning—that’s why many over-the-counter migraine medications contain caffeine. Test your personal response to caffeine. If it gives you headaches, avoid it.

                                                                                                                                                                                                  5 nutrients/supplements that can help minimize migraines:
                                                                                                                                                                                                  • Magnesium (beans, swiss chard, spinach, potatoes; sweet and white)
                                                                                                                                                                                                  • Riboflavin (skim milk, asparagus, kale, mushrooms; portabella and white)
                                                                                                                                                                                                  • Omega 3 fats (wild salmon, sardines, omega 3 fortified eggs)
                                                                                                                                                                                                  • Feverfew
                                                                                                                                                                                                  • CoQ10
                                                                                                                                                                                                  Joy Bauer is the author of “Food Cures.” For more information on healthy eating, check out Joy’s Web site at JOY BAUER NUTRITION
                                                                                                                                                                                                  DOCTORS DIFFER IN APPROACHES USED IN TREATING FIBROMYALGIA
                                                                                                                                                                                                  By Gary White
                                                                                                                                                                                                  The Ledger ( The Online Ledger.com )
                                                                                                                                                                                                  Published Sunday, April 1, 2007

                                                                                                                                                                                                  The treatment for fibromyalgia varies according to the doctor administering it. Patients often wind up seeing a rheumatologist or a pain-management specialist, and the most common medical approach involves reducing the symptoms - widespread muscle or joint pain, weakness, burning sensations, extreme skin sensitivity and fevers - and increasing the patient's capacity for activity. Dr. Edward Lubin, a pain-management specialist at Winter Haven's Gessler Clinic, said the most important element of his treatment comes at the beginning. Many patients arrive hoping for a sudden and permanent fix, and Lubin stresses the need to regard fibromyalgia as a chronic disorder, like diabetes or hypertension, lifelong ailments with symptoms that can be managed through consistent treatment. "The first thing they need to understand is the adage, 'Chronic pain is chronic,'" Lubin said. "There are patients who will never be able to wrap their arms around the chronicity or durability of their pain and how much we understand it to be chronic. That makes for at times a very difficult practice." Lubin, who trained at Yale and Harvard, uses various methods to combat the symptoms of fibromyalgia and similar maladies, including nerve blocks, nerve excision, steroid injections, radiofrequency ablation and various kinds of injections into trigger points, as well as pain medications ranging from anti-inflammatories to morphine.

                                                                                                                                                                                                  He also sometimes prescribes antidepressants or refers patients for psychiatric counseling. The Food and Drug Administration has not approved any medications specifically for fibromyalgia, meaning any drugs are prescribed "off-label." Dr. Roland Staud, a professor at the University of Florida's school of medicine, said several drugs are nearing submission to the FDA for the treatment of fibromyalgia. Staud is also involved in studies of cognitive behavioral therapy, which he considers an essential element in treating chronic pain. There is continuing scientific debate over the pain centers stimulated by fibromyalgia, and Staud focuses his research on the spinal cord as the source of pain transmission. "When it is difficult on the physical level to reduce pain generation, then we need to also affect the central mechanism, which is, for example, negative mood, anxiety, fear, anger - all these things come into play in chronic syndromes like fibromyalgia," Staud said. "This acknowledges the mind-body connection that everybody has. It doesn't just marginalize this as purely a psychological syndrome."

                                                                                                                                                                                                  Dr. Patrick Wood, an assistant professor of medicine at Louisiana State University, has also devoted his career to studying chronic pain disorders. In Wood's view, fibromyalgia results from the failure of patients' brains to make and use dopamine, a chemical involved in transmitting signals between cells. Wood said experiments with drugs that mimic the effects of dopamine have shown promise, and he stressed the difference between this approach - targeting the source of pain - and the prevalent strategy of managing the symptoms. "Our treatment of the symptoms has been sort of a shot in the dark because we don't really understand what it is we are treating," Wood wrote in the January issue of The Journal of Pain. 

                                                                                                                                                                                                  One Lakeland doctor takes an entirely different approach. Dr. David Reifsnyder, an infectious disease specialist, suggests many patients diagnosed with fibromyalgia and similar maladies actually have an undiagnosed viral or bacterial illness, such as chronic mononucleosis, chronic mycoplasma, Lyme disease or even cat scratch disease. He said in other cases he finds a simple cause of the symptoms - for example, a bad reaction to a medication. "In my own personal experience, (in) about 95 percent of the people I see with either chronic fatigue syndrome or fibromyalgia, the cause is found, and the vast majority of those respond to treatment and recover completely," Reifsnyder said. He said many of his patients are referred by other local doctors, who are happy to pass along patients with seemingly intractable ailments. Reifsnyder has long-term patients who now live as far away as California but still come to Florida to see him.

                                                                                                                                                                                                  Reifsnyder, who operates a solo practice, devotes a full hour to a patient's first visit to take a thorough medical history, looking for clues to any undiagnosed chronic illnesses. "Often patients come out of his office crying with relief," said Reifsnyder's wife, Nellda, who works in his office. "One patient said, 'This is the 44th doctor I've seen.' They're very angry. They say no one has listened to them."

                                                                                                                                                                                                  Gary White can be reached at gary.white@theledger.com or 863-802-7518.
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