When Surang Janyasing was diagnosed with Parkinson’s disease five years ago she was devastated. The 55-year-old mid-ranking police officer knew that the disease cannot be cured, and that she would be on medication for the rest of her life, with the probability of deteriorating health.

The main symptoms of Parkinson’s include stiffness of the muscles, shaking and slowness of movement. It mainly affects the way the brain coordinates the movements of the muscles in various parts of the body.

Patients with Parkinson’s have a tendency to isolate themselves and are easily exhausted. The effects of the disease plunged Ms Surang into depression.

“I think of my Parkinson’s as a disease of snobbishness. my body was very stiff, I couldn’t turn to see anyone who called me from behind, and my face was grim from depression. I didn’t have the heart to chat with anyone,” Ms Surang says. “People who weren’t close to me thought that I was a snob.”

Since then Ms Surang has taken three types of medication four times a day. However, she noticed that she wasn’t getting any better. Finally Ms Surang left her job so she could care for her 90-year-old mother. Parkinson’s has made caring for her mother more difficult, and she started to worry what would happen if her symptoms worsened.

But her life changed rapidly after she joined a Thai dancing class organised by a physical therapist who was researching ways to help Parkinson’s sufferers improve their quality of life.

Dr Roongroj Bhidayasiri.

In a dance class on the day of our interview, Ms Surang was lively, dancing with a radiant glow of happiness on her face. Her movements were smooth and close to those of a normal person. Along with Ms Surang, her seven classmates were also moving with the music. some were moving awkwardly and slowly, others had helpers to prevent them from falling. Only one or two were moving as smoothly as Ms Surang.

This group comprises patients from Chulalongkorn Hospital. they were carefully selected to join a programme, which formed part of the doctoral thesis of Surasa Khongprasert, a PhD student at Chulalongkorn University’s Faculty of Sports Science.

Twenty-eight patients participated in the research, all from the Chulalongkorn Centre of Excellence for Parkinson’s and Related Disorders, run by director Roongroj Bhidayasiri.

Fourteen were selected to learn Thai dance while taking medication, while the rest received only the medication. There were three dancing classes held over a period of four years. each lasted three months, and were four or five months apart from each other. The last class was almost a year and a half ago, but the patients still meet from time to time to dance and chat.

The programme started in 2008, when Ms Surasa was looking for a topic for her thesis, and traditional Thai dance caught her attention. She found that the symptoms of Parkinson’s _ such as stiffness and difficulties in movement _ might be helped by the postures and movements of Thai dance.

“I thought it would be a good form of exercise. However, it was not enough to be the topic for a doctorate degree thesis, so I searched for other factors that could enhance the importance of my study,” Ms Surasa says.

There are 108 postures considered as the basic movements of Thai dance, called Tha Mae Bot or Ram Mae Bot in Thai. Ms Surasa chose eight movements that could have beneficial effects for patients, covering muscles from head to toe.

The new PhD holder recently completed her thesis, and her research was rated as “excellent” by the professors overseeing her work. The results are quite amazing. All of the pariticipants’ symptoms improved and they saw improvements in balance, speed of movement, range of motion and ability to shift between different movements.

“Moreover, their quality of life has markedly improved, such as an increase in communication skills and while their depression has lessened,” says Ms Surasa.

TAKING a CHANCE ON DANCE: Parkinson’s sufferer Surang Janyasing has benefited from dance therapy.

The findings from her thesis might help Parkinson’s sufferers in Thailand _ who have been increasing in number in recent years _ to live better lives, according to Dr Roongroj.

There are 60,000 known Parkinson’s sufferers in Thailand. However, Dr Roongroj believes the number is under-reported because of poor record keeping and administrative procedures in some facilities, and there is also an unknown number of sufferers who are not properly diagnosed because of inadequate facilities and staffing in some areas.

The causes of Parkinson’s are still unclear, but interactions between genetic weaknesses and exposure to environmental factors are widely believed to be the main causes. Pesticide exposure is believed to be an especially important environmental risk factor.

The recent report, “A National Registry to Determine the Distribution and Prevalence of Parkinson’s Disease in Thailand: Implications of Urbanisation and Pesticides as Risk Factors for Parkinson’s Disease”, suggested that urbanisation and exposure to pesticides may both be risk factors for the disease in Thailand. The two central provinces of Chai Nat and Sing Buri have the highest prevalence of Parkinson’s and are also reported to use the most pesticides.

What concerns Dr Roonroj the most is Thailand’s greying population _ the rise in the elderly population and decline in the proportion of children and teenagers. since Parkinson’s is more common among those over the age of 50 that might result in a spike in the number of sufferers.

Parkinson’s is a progressive, neurodegenerative disease that occurs when the neurons within the brain responsible for producing the chemical dopamine become impaired or die. Dopamine is essential for the smooth control and coordination of the movement of voluntary muscle groups. once approximately 80% of the brain’s dopamine-producing cells no longer function, the symptoms of Parkinson’s begin to appear.

“There are four subtle early signs of the disease that should not be overlooked _ permanent loss of smell, chronic constipation, depression and REM

[rapid eye movement] sleep behaviour disorder, or para-somnia. There are reports worldwide indicating that these signs can predict the disease 20 years before the symptoms are clearly seen,” Dr Roongroj said.

But even with the onset of these symptoms, misdiagnoses occur and that can result in the loss of precious time in tackling the disease at an early stage. Ms Surang was also diagnosed with spinal stenosis and was subjected to neck surgery.

“But it didn’t have any affect on my symptoms, so I was transferred to the neurology department to be tested for Parkinson’s,” Ms Surang said.

Once the symptoms of the disease are present, a sufferer’s quality of life declines. The most obvious symptoms are movement-related; these include shaking, rigidity, slowness of movement and difficulty with walking. Later, cognitive and behavioural problems may arise, with dementia commonly occurring in the advanced stages of the disease. Other symptoms include sensory, sleep and emotional problems.

THEORY INTO PRACTICE: Left, Surasa Khongprasert’s research for her doctoral dissertation led to an innovative breakthrough in Parkinson’s treatment.

That’s why exercise is essential for patients with Parkinson’s disease. Medication alone cannot increase body strength to better control the body’s movements, but there are many forms of exercise that can help, such as walking, cycling on a static bike and stretching.

In other countries, ballroom dancing and Tai Chi are being used to help sufferers, and many reports clearly state the benefits when patients participate in certain exercise regimens.

Many researches also point out that music with a lively rhythm helps patients in guiding their movements.

“And, in Thai dance with the music, there are a lot of rhythms of variable or frequency as well. so, we think that Thai dance is a good idea in combination with stretching and balancing exercises, and rhythm guidance. so we developed these classes for the patients,” said Dr Roongroj.

Ms Surasa also pointed out other advantages of traditional Thai dance. besides it being a low impact exercise it can help stretch and move small joints such as finger and toe joints, wrists and also palm muscles with its different postures. and it is also able to help improve balance and prevent joints stiffening.

“Patients have to learn to shift their weight to the rhythm, and traditional Thai dancing can improve a body’s balance and prevent joint stiffening. Sufferers can do just one Thai traditional dance movement, but get the same physical benefit as doing two or three physical therapy-based exercises.”

For example, traditional movements such as Prom-See-Na and Nok-Yoong-Fon-Hang can increase movement around shoulder joints and wrist areas as well as helping to stretch flexor muscles. Sod-Soi-Ma-La exercises the fingers, especially the thumb and index finger.

And Thai dance requires a lot of toe tilting and the movement of legs to the front, side and back which increases leg flexibility.

Ms Surasa’s research has now been completed. The class has been over for months. However, Ms Surang and her friends still meet up once a month to review their progress. Ms Surasa has also given them songs so that they can dance at home.

However, many say they feel better in a class. “I feel a bit lonely when I do it alone at home,” Ms Surang says.

“However, I have my one-year-old nephew to cheer me up while I’m dancing at home. he loves the songs and tries to move along.”

Currently, Ms Surasa and her two advisers, Dr Roongroj and Vijit Kanungsukkasem, the dean of the School of Sports Science at Chulalongkorn University, are trying to publicise the dance programme so it can be used by Parkinson’s sufferers across the country.

Posters with Thai dance postures are being distributed to physical therapy units, and a story about the programme was also published in a local health magazine.

With the hope that her findings can improve the lives of Parkinson’s sufferers, Ms Surasa says she will try to publicise the benefits of Thai dancing as widely as possible.

Visit chula-parkinsons.org for more information.

ALL THE RIGHT MOVES :Ms Surasa with some of the patients whose lives have been improved by her novel ideas on dance as physical therapy for Parkinson’s sufferers. PHOTOS: COURTESY OF FACULTY OF SPORTS SCIENCE, CHULALONGKORN UNIVERSITY

About the author Writer: Busaba Sivasomboon Latest stories in this category:

“Don’t you worry about a thing, ’cause every little thing is going to be all right.” -Bob Marley

“Mom says to tell you that now I have the most expensive hair in the house,” my daughter, Coco, tells me over the phone from our home in Georgia. Coco called me as soon as my wife, Margaret, brought her back from the salon where Coco apparently got a major, life-changing, going-back-to-school, radical cut and dye job. For the last 10 days, Coco and Margaret have waited patiently for me to get back from my latest trip to my parents’ place in Delaware to help my mother take care of my father who is living with dementia from a brain injury he suffered last year. but Coco starts her sophomore year in high school in three days, Margaret starts teaching middle school part time the same week, the carpet in my mother-in-law’s room in our house needs to be shampooed, the dog needs to go to the groomer, new furniture needs to be assembled (yes, the same furniture I mentioned in my last post — the one about procrastination), the yard’s a mess, and they needed me back home yesterday.

I tell Coco that I thought her long blond hair looked great already. I ask her what it looks like now, but she won’t say. “OK, then are you even more beautiful than you were before?” I ask her.

“What? I don’t know. It’s cool, though. but I’m not telling you anything about it until you get back and see for yourself,” Coco says. “And Mom isn’t telling you either!” she yells to my wife who’s with her in our living room. Coco’s 15 years old and, like me, has attention deficit hyperactivity disorder (ADD/ADHD) and a bit of a problem with her temper.

“Watch your tone, sweetie,” I say over the phone from my parent’s house in Delaware. I’ve got the phone cradled on my shoulder as I clear dinner dishes from their dining room table.

“I’m just kidding around, Dad,” Coco says.

My 87-year-old father glares at me as I take away his dinner plate. I smile back at him. He shakes his head and looks away. He’s been even more confused and irritable lately. My mother thinks the recurring pain from yet another fall he took recently has intensified his spells of dementia. whatever the cause, all we can do at this point is stay as cheerful and calm as possible so that he doesn’t get more agitated and hurt himself again.

“OK,” I say to Coco. “But still that’s your mother you’re talk–…”

The cell phone begins to slip away from my ear, and I press my shoulder and head together harder to keep it from falling as I head to the kitchen with the dirty dishes. For some reason this causes my lower back, which I strained this afternoon pulling weeds in my parents’ yard, to spasm.

“Dad?” Coco asks. “Are you OK?”

“I’m fine, honey,” I tell her.

“For God’s sake!” my father yells. “Stop all this, right now!” He tries to lurch up from the dining room table but he’s stuck halfway, one hand on the table and the other on his wheeled walker.

“Darling, sit back down,” my mother says from the kitchen, where she’s getting ice cream. “Just for a second, OK?”

“No, damn it, it’s not OK at all! why won’t you listen?” my father yells, his voice straining. And ignoring her and me, as he ignores everyone these days, he continues struggling to stand, bending over, teetering dangerously on unsteady legs. 

I know none of this is my father’s fault. He’s suffered a traumatic brain injury, and as a result, he has recurring headaches and back pain, has bouts of dementia and depression, and copes by drinking. but a rush of irrational anger surges through me. I know I’m in an ADD/ADHD overload. I can feel my heart racing and my breath quickening, but I don’t care. I should take a minute, do my deep-breathing exercises, and let the storm settle in my brain. but I don’t want it to settle. though part of me fights to stay calm, the truth is, I want to explode. My cell phone squeezed between my ear and my shoulder, the dirty plates and silver rattling in my hands, I snap. “Stop acting up,” I yell at my father. "And sit back down!”

My mother looks over at me, startled. The only bright spot in all of this is that my 89-year-old mother, who continues to be strong and lucid, seems determined to plow on with good cheer through her 90s. but doing what? being a permanent caretaker for this irritable, demanding man who, lost in his own pain and confusion, lashes out at those, especially my mother, who just want to try to help? why does she let herself be used like this? It’s a terrible, dark, heartbreaking trap that I suddenly have no patience for, and here I am taking it out on my defenseless father.

Over the phone, real concern in her voice, Coco asks, “What’s going on, Dad?” And I realize, as I told Coco a minute ago, that I had better watch my tone. I tell Coco everything’s fine and that I’ll call her right back. I let the phone fall to the carpet, place the plates back on the table, and help my dad get up. but my mother is quickly by me. “It’s all right,” she says with a pat on my shoulder. “Talk to Coco. I’ve got him.” as she holds out a steadying hand for Dad, she tells him, “You should listen to your son, you know. He’s trying to help you.” “Nonsense,” my father says.

I pick up the phone and take the dishes into the kitchen. After the kitchen’s clean, dishwasher cycling, and Mom’s got Dad in his chair peacefully eating mocha java ice cream with a martini on the side, I go to the guest bedroom and call Coco back. I assure her that everybody’s fine in Delaware and that I’ll be getting on the plane home tomorrow.

“I can’t wait for you to come home,” Coco says. “There’s a centipede in the garage you’ve got to get rid of and a huge dead cockroach in the living room behind the couch. And oh yeah, my new bed was delivered. You’re going to put it together as soon as you’re back, right?”

I tell Coco I’ll take care of all that. I tell her I love her, that I’ll see her tomorrow, and to put her mother on. I lie down on the bed. as Margaret and I talk, my breathing and heart rate slow, my back spasm eases, and I feel calmer and a little more human. Margaret says she knows how much my mother and father have needed me. They’re OK now, I tell her; things have settled down. She says she’s sorry to put more pressure on me, I tell her she isn’t.  She’s sorry that they need me so much at home too. “Thank God you do,” I tell her.  as Margaret and I talk, joking and comforting each other, I realize how much I treasure the sound of her voice. And suddenly I understand that my mother isn’t being used. She knows she’s needed by her husband, a man she loves and vowed to have and hold in sickness and in health over 60 years ago, and that means the world to her. Then my anger at my father and the pain his injury and disease have brought us begins to ebb under the influence of my mother, my daughter, and my wife’s gentle voice. 

As I fly home to Georgia the next day, I begin to see that family is a messy proposition, full of conflicting needs, and maybe an ADD/ADHD family is a little messier and more conflicted than most, I don’t know. but I do know that the world can be a dangerous and uncaring place. And I know that to need those you love, and to be needed by them in return, is a profound gift. when you have that, you have proof that no matter how tough the times, every little thing will be all right.

When I walk into the house from the airport, Coco runs down the stairs and jumps into my arms nearly knocking me over and wraps me in a hug. Then she steps back and says, “What do you think?”

Her hair is a little shorter. And deep black. And in the middle front, a purple stripe down each side. It’s not what I would have picked out as a look for her. It’s not anything really that I could imagine. I miss her blond hair. but as she stands there smiling expectantly at me, I can see that she loves it and that when you give it a chance, the black frames her face dramatically and the purple brings out the sparkling blue in her eyes.

“It’s gorgeous,” I say.

I dont think that I have ADD or ADHD because I dont seem to be hyperactive. when it comes to listening in school and reading something more than a page it takes SO MUCH to focus on what I'm doing. I truly honestly want to be a good student but it seems impossible some times. I have a job that requires me to read chapters and big packets, once again it takes a lot.

What could my doctor do, if anything?

They just give you pillsthat will help you focus

I overdosed on tylonal 3 about a month and a half ago, presently I feel great, I've changed my ways and become healthy…..am I still at risk of liver failure?

The liver is a tough organ; I suppose that given its job as Chief Waste-Filterer, it needs to be tough. I lost a friend to liver cancer a few years back; he showed no symptoms until just a few months before his death.

Congratulations on your comeback, but don't get cocky now; see your doctor and do what s/he tells you. good luck.

well done , now go and find all the medical stuff out

As a rule, I crave stability. in my job, in my home, in the people I surround myself with. I like a sure thing. Unpredictability, flakiness and variables outside of my control freak me out. Too much open space or free time, which can sound awesome at times, can stress me out. I prefer structure. a schedule of activities. Lists. Things I can plan on. and I don’t like it when people change my plans unexpectedly. I can adapt to change, but I appreciate a heads-up–and really would like to be involved in the decision in the first place.

Multiple Sclerosis obviously throws a huge wrench in my plans. It goes without saying, really, but you can’t plan for MS.

So, even though I know all this, why do I let it bother me so much when my symptoms suddenly act up, like they have this week? I was doing fine. or as fine as I’m used to, with the ever-present numbness in my right leg and a grab bag of other random, but pretty mild, symptoms. but yesterday, I noticed while taking a shower (shower water is a really great way to discover What’s New in Numbness), that my upper right thigh was also numb. okay. whatever. and then throughout the day, I began to notice how numb the back of my left leg was, as well as my left shin. Hold on. That’s not part of the deal. I’m willing to accept right Leg = Numb, but my left leg is supposed to be the steady one. I can’t have them both acting up on me. It makes walking and standing especially hard.

I wobbled through the day, clinging to and leaning on walls and countertops, staying seated during meetings and generally taking it slow. I hoped (and am still hoping) that this increase in numbness was a side-effect of the start of my Lady Time, but I’m still bothered by it because it’s not typical for my symptoms to get *this* bad in conjunction with my period (TMI? Deal with it.).

Anyway, I should know better than to worry about it. This is what happens with MS. Things change unexpectedly. there doesn’t have to be an explanation or warning signs. It just does what it does. I have no control. I know this to be true.

But three years since my diagnosis, I still resent how flaky this disease can be, like an unwelcome and inconsiderate house guest that invites friends over who drink all your beer, make a mess and stay too long. If it can’t tell me when extra symptoms are going to show up, I wish it could at least tell me how long they plan to stay. because I really don’t want to feel like this every day forever.

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Malaria: Signs and Diagnosis by Vanni Jain Send Feedback to Vanni Jain Request Reprint | Print | About Author | Report Problem | Tweet This Understand Malaria disease

more Details about Understand Malaria disease here.

Malaria is an infectious disease transmitted by the Plasmodia parasites. there are five identified species of this parasite causing malaria in humans, namely, Plasmodium vivax, P. falciparum, P. ovale, P. malariae and P. knowlesi. it is transmitted by the female anopheles mosquito. it is a disease that can be treated in just 48 hours, yet it can cause fatal complications if the diagnosis and treatment are delayed. the malaria parasites (called sporozoites) migrate to the liver where they mature and release another form, the merozoites.

These enter the bloodstream and infect the red blood cells. the parasites multiply inside the red blood cells, which then rupture within 48 to 72 hours, infecting more red blood cells and thus results in malaria signs & symptoms. the majority of malaria signs are caused by the massive release of merozoites into the bloodstream, the anemia resulting from the destruction of the red blood cells, and the problems caused by large amounts of free hemoglobin released into the circulaion after red blood cells rupture.

Malaria is the fifth cause of death from infectious diseases worldwide after respiratory infections, HIV/AIDS, diarrhea and tuberculosis and the second in Africa, after HIV/AIDS. Malaria can also be transmitted congenitally from a mother to her unborn baby and by blood transfusions.

What are the signs and symptoms of Malaria?

the malaria signs & symptoms are somewhat similar to influenza. the common malaria signs are fever, chills, nausea, headache, and fatigue. Infection with the P. falciparum parasite is usually more serious and may become life-threatening. the severity of malaria also vary depends on the general health and the kind of malaria parasite.

how is Malaria diagnosis?

Malaria diagnosis involves identification of malaria parasite or its antigens/products in the blood of the patient. Although this seems simple, the efficacy of the Malaria diagnosis is subject to many factors. Malaria diagnosis is confirmed by blood tests and can be divided into microscopic and non-microscopic tests. making a Malaria diagnosis begins with taking a thorough personal and family medical history, including symptoms and travel history, and completing a physical examination. recent travel to sub-tropical or tropical areas of the world is an important clue that may increase the suspicion of a Malaria diagnosis.

Malaria diagnosis includes blood tests that check for the plasmodia parasites that cause malaria. a series of tests may need to be done to definitely diagnose malaria.

Author is giving best information about malaria disease, what are malaria causes, malaria signs, malaria diagnosis, malaria symptoms, malaria prevention and malaria treatment.

Contact the Author Vanni Jain Health

more Details about Understand Malaria disease here.

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Whenever I try to commit to being proactive, it always puts me in such an agitated state of being. The muscles in my shoulder tense up, instead of breathing normally I hold it in and sigh a lot, and I get really bad heartburn. I wind up feeling nervous in social interactions and my sense of fun and humor disappears. this seems to last until I give up on however it was I decided to be proactive.

Example #1: my current job doesn't pay very well, so earlier this I resolved to apply to better jobs and force my self do so on a regular basis. but after browsing some ads, the nervous symptoms appeared and kept getting worse, even after I quit and did something else. The next day at work they got so bad it almost felt like a panic attack, so I just gave up.

Example #2: Earlier today I wrote up a list of things I've been meaning to do. (#1. Do laundry. #2 Apply to some jobs. # fill out some medical paperwork. Etc.) At first I felt good and excited, but then the nervousness set in.

you need a drink to realax.

Maybe see a life coach or something. Medication?

maybe it's because u think about everyting u have to do all at the same time or one anxious thought after another. try doing one thing at a time and taking it one day at a time and set a reasonable time frame for yourself. and if u dont get the task done in time, dont beat yourself up because then you'll only focus on your failure. Instead, focus on your next goal one day at a time because tomorrow is not promised and no a drink would not help, it would just cloud your judgment.

  There are so many great newsletters out there. Fibromyalgia Network is one of the best. Instead of trying to pick out one or two articles, I am letting your read their whole newsletter to see what you’re missing if you haven’t got your own subscription. I hope you will find it as interesting and informative as I do and subscribe for your own version. JW

View this in your web browser.  

   February 2011 eNews AlertIn this eNews:

Questions?

Call: 1 (800) 853-2929E-mail:
Visit: fmnetnews.com

Reader-Friendly Version

This eNews is available for viewing and printing in a larger size.Dear Jonnie Wright,

Commitment to a job, child or grandchild can fill you with a sense of purpose, but can it also wear you thin? a new study in this month’s Latest News looks at the impact employment and caregiver roles have on the overall health of people with fibromyalgia (FM). In general, FM patients appear to respond differently to regular commitments than people from the community who are matched for age but don’t have FM.

Troubled by joint stiffness or painful bladder? Research confirms the high prevalence of these two symptoms in FM and offers an explanation for what makes them tick. Exercise intolerance is another bothersome symptom and a recent study sheds light on why people with FM have trouble initiating an exercise program. if your treatment plan leaves you guessing about FM and wishing you had more time with your doctor, read about a new program being tested in Spain.

Hope 2011 is shaping up to be a good year!

Kristin ThorsonFibromyalgia Network EditorFibro Patients Benefit from Role CommitmentsStaying employed with fibromyalgia can obviously provide you with social support and economic rewards. however, Laura Zettel-Watson, Ph.D., states, “Middle-aged and older adults often occupy several roles simultaneously; for example, they may be employed as well as giving care to children, grandchildren, or parents.” So the question that needs answering is: how does employment and caregiving impact the overall health of people with fibromyalgia?

Read the complete article in the Latest News section of our website.

[Back to Top]Joint Stiffness Stiffness is a common symptom of fibromyalgia (FM). Typically it is worse early in the morning and then it may ease up some by midday. Yet, the joints are not swollen in fibro as they might be in patients with arthritis. however, a recent study by a team in Belgium documented the presence and degree of severity of this symptom in three different age groups of FM patients.*

As we age, we expect to get more arthritis and stiffness in the joints. this means that measurements of stiffness will be influenced by a person’s age, so the researchers looked at this symptom for three different age groups. the average age of the three groups of FM subjects were 26, 45, and 70 years. For comparison, three groups of healthy controls of similar age were also recruited for this study. all subjects had the musculoskeletal stiffness of their ankle measured by a device that moves the foot passively to both extend and flex the ankle.

All three of the FM age groups rated their ankle stiffness close to 5 on a scale of 0 to 10 (where 0 is no stiffness and 10 is worse possible stiffness). the degree of ankle stiffness measured by the device in the younger and middle-aged FM patients was more than twice that of the age-matched controls.

“The self-perceived stiffness increase in the ankle reported by younger and middle-aged FM subjects is due to changes in the elastic structures around the ankle,” state the authors of the study. “However, stiffness differences were not observed in the older FM women.” Does this mean that as patients age, they outgrow the symptom of stiffness? no. As people age, the symptom of stiffness increases. In this study, the measured stiffness in the older group of healthy controls increased significantly, leaving little difference between the controls and the older FM patients.

This study shows that the degree of joint stiffness in young to middle-aged FM patients is more than twice that of healthy controls. Joint stiffness is likely present to a greater extent in the older FM group as well, but it may not differ substantially from the degree of stiffness that healthy people get with normal aging.

* Dierick F, et al. Nature of passive musculoarticular stiffness increase of ankle in female subjects with fibromyalgia syndrome. Eur J Appl Physiol [Epub ahead of print] Feb. 6, 2011.

[Back to Top]Bladder Pain and FibroWhat does interstitial cystitis (IC) have to do with fibromyalgia (FM)? a study looking at 312 cases of women with IC sought to answer this question.* In addition, the study examined the association of IC with chronic fatigue syndrome (CFS), irritable bowel syndrome (IBS), and sicca syndrome (dry eye syndrome)—conditions that overlap substantially with FM.

The symptoms of IC include bladder pain with urgency and frequency (day and night). Pain worsens with bladder filling and improves with voiding. the 312 people with IC evaluated in this study had experienced bladder symptoms for less than one year. this enabled the authors to examine the medical records for each IC patient during the preceding year to search for evidence of other non-bladder syndromes that might pre-date the onset of IC.

When the IC patient had one or two non-bladder symptoms preceding the onset of IC, allergy was most often one of the conditions that pre-dated the IC. Allergy just happened to be very common and appears coincidently with IC. however, when five or more non-bladder symptoms preceded the onset of IC, a different picture unfolded. FM, CFS, IBS, and sicca syndrome were the most common pre-existing conditions. not only do these conditions overlap with one another, pain is a prominent feature for all.

The authors present two likely hypotheses to explain their findings. one is that the onset of FM, CFS, IBS, or sicca syndrome might possibly contribute in some way to the process that triggers the development of IC. the other possibility is that each of these non-bladder syndromes and IC might be caused by a shared abnormality. Well-designed studies to follow the development of these syndromes in patients will be needed to distinguish between these two hypotheses.

* Warren JW, et al. Numbers and Types of Nonbladder Syndromes as Risk Factors for Interstitial Cystitis/Painful Bladder Syndrome. Urology 77:313-320, 2011.

[Back to Top]Moving past the Exercise HurdleLow-intensity exercise is often recommended to people with FM to help maintain physical function. Yet finding the right level of activity is often a challenge because overdoing it can easily lead to an exacerbation of FM pain. this paradox may occur due to an alteration in the way the body’s sympathetic nervous system responds to an exercise challenge in people with FM.

The physiologic responses to a sustained contraction of the thigh muscles in FM patients were compared to the results obtained for healthy control subjects. the study led by Eva Kosek, M.D., Ph.D., of Sweden, placed particular focus on examining the role of the body’s fight-or-flight sympathetic nervous system, which is involved in regulating muscular blood flow and influencing the modulation of pain.*

During a sustained contraction lasting up to 20 minutes, the sympathetic nervous system should become activated and trigger the adrenal glands to secrete adrenaline. however, the patients with FM had reduced adrenaline levels before the start of the contracting exercise as well as during it. the sympathetic-adrenal system was hypo-active in the FM patient group, but this was not the only problem.

During exercise, the hypothalamic-pituitary-adrenal (HPA) system should also become activated to release more ACTH, a stress hormone from the pituitary. In the healthy controls, the ACTH secretion increased during the sustained contraction (as it is supposed to), but this hormone remained unchanged in the FM patients. So not only is the sympathetic nervous system under-active in FM, but the the HPA system doesn’t react to the stress of exercise the way it does in healthy control subjects. according to Kosek, these two findings could contribute to exercise intolerance in FM patients.

So what about the recommendations of low-intensity exercise for people with FM? Kosek comments that regular exercise should help restore the function of the sympathetic-adrenal system and the HPA response system. In turn this should lead to improved muscle blood flow and reduced pain. At the start of an exercise program, your body may seem exercise intolerant. however, with continued low-intensity practice, you will get over the hurdle and it should eventually become easier.

* Kadetoff D, Kosek E. Evidence of reduced sympatho-adrenal and hypothalamic-pituitary activity during static muscular work in patients with fibromyalgia. J Rehabil Med 42:765-772, 2010.

[Back to Top]Adding more to Standard Care Shows BenefitA little knowledge can go a long way when it comes to alleviating symptoms related to fibromyalgia.

Researchers in Barcelona, Spain wanted to know if newly diagnosed fibromyalgia (FM) patients who participated in a program that offered management strategies beyond the “standard course of treatment” would find more symptom relief.* FM patients from the region were randomly assigned to one of two groups for treatment.

General practitioners provided one-half of the group (108 patients) with the usual care that included medication to help with treating individual symptoms. this control group was also counseled about how to perform aerobic exercise with modifications made to accommodate the physical limitations of FM.

The study group of 108 patients was also provided with the usual care. In addition, the patients were enrolled in an educational program that consisted of nine, two-hour classes. They were divided into small groups of 18 for their weekly sessions. five of the classes focused on typical symptoms, potential causes of their illness, related medical conditions they may experience, current medications available, the long-term effects of pain on their lifestyle, the benefits of regular exercise, and typical barriers they would face. Another four classes offered patients lessons in physical and mental relaxation, pain relief through distraction techniques, and stress reduction. the classes were given by four general practitioners, a rheumatologist, and a psychologist. Patients in the study group were encouraged to ask questions and discuss the issues with the speakers. They also were allowed to talk with other patients in the group, share experiences and emotions.

Patients in both groups were allowed to drop out of their program at any time over the course of the treatment plan. After nine weeks, seven patients in the study group had dropped out, while twice as many patients who were receiving standard treatment quit. overall, more than half (53%) of the study group participants felt they benefitted from the program with at least 20 percent symptom relief. only 17 percent of the control group felt they benefitted from their treatment. Specifically, the study patients reported improvements in physical function, pain, fatigue, stiffness, anxiety, depression, and the number of days they felt well.

The researchers attribute some success of the study group to the patients themselves who credit the doctors for investing their time and effort to treat them, but the “tendency to please is not likely to be the main cause of the improvement,” the published study says. “We suspect that patients’ motivation and expectations may have greater importance. our findings indicate that … education and relaxation made by an interdisciplinary team is an effective treatment for FM, at least in the short term.”

When the study ended, the authors could not predict if the improvements would be permanent. but there is no harm in continuing your own study by practicing relaxation techniques and seeking out information for a better understanding of FM and improved ways to cope with this illness.

* Luciano J et al. Effectiveness of Psychoeducational Treatment Program Implemented in General Practice for Fibromyalgia Patients: a Randomized Control Trial. Clin J Pain [Epub ahead of print] Feb 11, 2011.

[Back to Top]You Know you Have Fibro when …As submitted by our Fibromyalgia Network Facebook friends for your shared amusement:

• the microwave beeps and I look in the freezer.
• I sprayed my hair with spray deodorant instead of hair spray. both are blue spray bottles … now I wonder if I have done that before and just didn’t notice.
• I couldn’t find the bagel I was preparing for lunch when I realized I had already split it and placed in toaster.
• I notice that most things I lose end up in the freezer. now, that’s the first place I look when I’m missing something.
• I pour a cup of coffee, then I can’t find it. I pour another cup and lose that too. I pour more coffee—can’t find it. I find four cups of coffee all together. They are stone cold, the pot is empty, and I have a “caffeine headache” from a lack of coffee.
• I poured diet soda on my cereal and didn’t register anything was wrong until I took a spoonful.
• I walk around at work with a pen and paper just in case someone asks me to do something. if I don’t write it down, I might forget it by the time I get back to my desk.
• I have tried to use my work swipe card to get in the front door of my house.
• I was talking on the speaker phone to my sister. I told her I had to let the dog in and would be right back. we started talking again and she said she could hardly hear me. That’s because I was talking into the TV remote control.
• I am driving with my husband. we are deep in conversation and I have to ask … “Where were we going again?”

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The feminine body is surely an organic and natural machine created involving nerve, muscle as well as bone tissue. it will develop infants for up to 9 calendar months. however, like all machines, it is prone to the occasional breakdown, such as, well, getting infections – better known as a yeast infection, or even in this case genital thrush. How do we go about diagnosing candida albicans?

Not quite Yeast, Really…

To begin, genital thrush is not brought about by yeast. the problem is actually caused by a fungus called Candida albicans that has yeast-like attributes. it develops naturally within warm, damp, dim parts of the body, such as the oral cavity and the vaginal canal. Its development is kept in balance by a kind of advantageous bacteria which also develops in the body. the job associated with Candidiasis is to look for harmful bacteria and eliminate all of them.

The problem starts when the actual very good bacteria which keep track of the actual growth of Yeast albicans perish, possibly due to the fact of anti-biotics or the weak defense system. once these bacteria die, Yeast albicans grow rapidly as well as propagate boldy. Include to this the fact which all candida fungi can move by means of muscle or body organ walls within the actual entire body (it has been known to permeate intestinal wall space), and there you have it – an contamination which irritates the vaginal canal as well as the vulva.

So exactly how Undertake You Diagnose it, Really?

The actual very first action in order to figure out the signs and symptoms. Your many informing symptom is if your own system produces the white or even whitish-gray release which will come out clumpy as well as has a odor that makes you think of about bread or ale. other typical caution indicators extreme itching, a burning as well as tingling sensation, and also even soreness, all of make walking, switching placements, urinating and sexual challenging. Some of these symptoms may end up being heightened via publicity to chemical substances, such because fragrances and household cleaning materials.

Sufferers are also more prone to develop allergies through inhaling airborne mold. Damp, dark locations can make them feel worse. They may also display a craving for sugar, breads, carbohydrates and alcohol, though sufferers may not necessarily be tolerant to alcohol. But even then these symptoms altogether may make you a candidate for another infection called bacterial vaginosis, which merits its own article.

With these symptoms in mind, the next step is to visit your obstetrician-gynecologist or ob-gyne. the ob-gyne will begin questioning you about your symptoms, your medical history and your exposure to certain chemicals. He or she will take a swab of your vaginal discharge, and inspect the presence of candida from this sample under a microscope. the ob-gyne may also ask you to assist him or her in identifying the exact location of the itching or pain using a magnifying lens.

Keep in mind that not all doctors are able to diagnose thrush or yeast infections properly. there are times that the indicators could be signs of thrush as described here, and there are times that they may actually be symptoms of a kind of vaginitis, most likely bacterial in nature. Also, when left unchecked, thrush may cause dangerous side-effects, such as endometriosis, ovarian dysfunction and the release of toxins which may further jeopardize your immune system.

Diagnosing yeast infection can be difficult, mostly because its symptoms are no different with those of other illnesses affecting the genital region. Therefore, it is extremely important to be pro-active in getting an accurate diagnosis as soon as you experience the warning signs.

You must able to recognize and keep track of what is going on with you in your genital region. and you must be very forthcoming when asked about the medication you are taking and the products you are using.

If you found this information helpful and you’d like to learn more check out chronic yeast infections and yeast infection creams.

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I've never had any other symptoms of dyslexia, I think my spelling is ok, I work with numbers as part of my job and have never had a problem with them either. But one thing I have so much trouble with is 'left' and 'right'.

Is this a common problem for non-dyslexics? I am in my 20s and I still get confused. It's embarrassing.

No, dyslexia is seeing the numbers or letters in reverse, or backwards. I know of many adults who don't know there left from their right. would it help you to remember things like, when turning water faucets on and off Left-loose and Right-tight. so that when you loosen the faucet, turn left, and when you turn it off, turn it right, to tighten. ?

Or if you write using your right hand, that can help you remember right.

Well it coulod just be that you struggle with it, but most learning disabilties have this symptom, if you have no problem with reading or wrting it is probably not dyslexia.

No. I used to be that until I broke my left arm and now I know left and right!

Confusion between left and right is very much a symptom of dyslexia, but its only one part of Dyslexia. Dyslexia can affect many aspects of learning, such as reading, writing, spelling, maths, memory, sequencing, letter reversal of d, b, m, w, p & q etc, and transposing or omiting words when reading or writing.

I know a few people who are not dyslexic who don't know left from right. if you wear a watch, then always wear it on your preferred wrist, and ask a trusted friend which hand is the one that has the watch on, or you can draw a capital L on a piece of paper, and then use your hand to make the letter L, extend your hands out with your fingers pointing upwards, then extend your thumbs so that they are directed toward each other, the left hand will look like an L.

Both my daughter & I had a lot of problems learning left to right, I learnt by putting my watch on my left hand, and asking my father which hand was which, and then would always put my watch on my left hand. my daughter as a toddler often had problems putting her shoes on the wrong feet. so I taught her to make a letter L with her hand, by drawing a large L on a piece of paper, then hold up her hands (as above), and the one that looks like the L on the paper was correct, I would also put a bracelet on her left wrist to help her. We knew we were successful in teaching her left to right, when she placed her left on her forehead, and shouted looser to a school bully.

We later learnt, that we were both dyslexic, I was some what shocked and dismayed that I had gone through school, and no one picking up on it and was the reason I struggled through school, eventually failing high school.