Friday, April 24, 2015

SEROTONIN SYNDROME: THE POISON APPLE












Things are not always as they seem.
The first appearance can deceive many.

A friend of mine disappeared from view for awhile. I was concerned but I understood. Chronic pain makes it very easy to hide. You want to curl up and pull the mantle of pain very close to you; like an old comfy sweater pulled tight. Sometimes it's such an effort to interact. It pulls the plug on whatever energy you have left. Plus, when pain is a constant, it's easier to be alone.

We have a hard time putting this on anyone else. Geez, we don't even like ourselves at this point.

On top of the issues with chronic pain she brought to light a little issue called serotonin poisoning. I'd never heard about it and started researching it. All I can say is, "oh my goodness!" I can't believe what I found and the more I read, the more scared I became.

What scares me the most is that it could happen to any of us.

First of all serotonin is a neurotransmitter that helps regulate many of the functions of the body. Research is showing that people with Fibromyalgia may have low levels of serotonin. Low levels of this neurotransmitter could include: fatigue, sleep problems, headaches, irritability, depression, mood issues, muscle cramps, emotional or behavioral outbursts and bowel and bladder problems. Some illnesses improve when you raise the serotonin levels. Then there is the other end of the spectrum: high levels, and it isn't good.  In fact, it can be fatal.


Part of the problem is that there are pills for everything and we get a lot of them prescribed to us. Compound that with over the counter medications and alternative medicine supplements. There are the antidepressants, the opiates, stimulants, herbs and even something as simple as cough medicine containing dextromethorphan. 

Serotonin poisoning or Serotonin Syndrome can occur in patients that have taken a combination of medications that increase these levels. We tend to forget that supplements can interact with our medications. We take supplements and herbal solutions and don't think twice about it. I know I'll try just about anything to feel better. We need to tell the pharmacist exactly what we're taking and make sure there aren't any problems. There is a website as well where you can list our medications and it will tell you of potential risks. It's called Medscape. Just click on the word "Medscape" and it will link you to the site.

Symptoms of serotonin poisoning are increased heart rate, shivering, sweating, dilated pupils, myoclonus (muscle tremors or twitching), high blood pressure, fever and this can progress to high fever above 106, seizures, renal failure, coma and, in rare cases, death.

If you're on antidepressants, please......please......please be careful and monitor all your medications carefully.

Watch everything. For example, a combination of antidepressant medication, an opioid for pain, taking a stimulant like phentermine and then going to Whole Foods and picking up some Yohimbe or St. Johns Wort can put you at risk for something like this. The problem can come alone in high doses or like the example of taking a combination of medications.

Just be careful.

We have enough issues that we have to deal with.

We don't need any more of them.

All these medications may seem like a pretty apple that will give us what we desire,

but it can be a carefully crafted, dangerous illusion.




Thursday, April 23, 2015

LYRICA: ONE AND DONE









It doesn't matter.
Every time I watch it.
Every single time.
I get really ticked off.


What am I talking about? I am talking about the truly amazing Lyrica commercial that's on TV. I can be in another room and hear, "I used to be active," in the pseudo-pain-filled voice designed to elicit a poor-pitiful-me response and I can feel my blood pressure start to rise.




Lyrica is Pfizer's number one selling drug and generates approximately 5.2 billion dollars in revenue for the company. I really don't understand how it got approved for Fibromyalgia. The side effects are frightening. I don't want to tell people not to take Lyrica. Some people have been helped and experience very mild side effects. I don't want to tick people off so maybe I should stick to the commercial. I would, however, like to see the women accurately portray the pain. Maybe one of the actors should look like something the cat dragged in. 

One of my favorites is the female architect. She's in full makeup and smiling. She puts on her hard hat, gathers her plans and sails out the door. Now, I used to work in new homes and would have to go on-site in homes that were anywhere from framed to complete. Sorry, but Lyrica just wouldn't cut it.

And I wouldn't be smiling.
Snarling is more like it.

Anyway, I noticed that the women, with the exception of the architect, on the commercial aren't thin. Does that mean that they've already experienced the weight gain from Lyrica or are they just starting out? Then, the commercial seems to tell the public that these poor people who are experiencing horrible pain can just take one of their pills and all will be right with the world. Does that mean if we don't take Lyrica we cannot be well? Or, if we choose not to, then maybe we want to be sick? 

Imagine that. 

You can flick that pesky fly of pain off your shoulder with just a little pill.

All the pain will go away and your life will resume.

Oh joy.

Everyone will get better.

But I still hate that fricking commercial.

By the way, here's the link to the FDA flyer on Lyrica. 

Click here.    http://www.fda.gov/downloads/Drugs/DrugSafety/UCM152825.pdf








Friday, April 17, 2015

HOW TO FIGHT FATIGUE?







Really?
I didn't know these things.
I'm sure they will help.
Right.



I read an article and it was about fighting fatigue if you've got a chronic illness. It's kind of interesting to me in a funny sort of way. I'll comment on the points that were brought out in the article because I found some humor in it.

Point number 1: See your doctor.
I've met a number of people who have Chronic Fatigue Syndrome, Fibromyalgia or as in my case, a combination of both. Most of them will say the same thing I do. Our doctors are on speed dial. I don't think seeing my doctor any more than I do will help anything; short of having him move in with me. I think they're actually sick of seeing me.

Point number 2:  Get enough sleep.
I hate to get pissy at this point in the post but one of the markers of a chronic illness like Fibromyalgia or Chronic Fatigue are sleep disturbances. Get enough sleep? Sometimes that's all we do! We sleep and sleep but it's not sleep that restores our bodies or our souls. We can take medication that would knock out a horse but sometimes that isn't even enough to keep us asleep. Most of us would give everything we had to get refreshing sleep; the sleep that allows our muscles and joints to heal. 




Point number 3: Aim for more refreshing sleep.
All I can say is WTF?  Go to bed earlier so I can wake up earlier. Don't watch TV in bed. Plan your evenings carefully. Who wrote this article? Are they on drugs???

Point number 4: Exercise for energy and to help you sleep.
It just keeps getting better and better. The article has a picture of this smiling, happy woman walking like she hasn't got a care in the world. There's not one look on her face that would give anyone a clue that she might have to crawl in the door because the pain is so overwhelming. Now I'm not saying that walking and gentle stretching doesn't help but that picture just really is annoying to me. The kicker of this point is that we shouldn't exercise late in the evening because it might interfere with sleep. Is anyone laughing yet?



Point number 5: Eat well to fight fatigue.
I hate to clue them in but I can eat like a champ and it has ABSOLUTELY no effect on the pain. Again, moderation in all things and as important as diet is you cannot make a blanket statement that this will always fight fatigue. Besides, when you carry the fatigue and pain that most of us do on a daily basis, I say Vive la Chocolat!



Point number 6: Step into the sunlight.
This is to bring to light (pardon the pun) the value of sunlight in setting our internal clocks. Again, I hate to be Debbie Downer but our body clocks are totally screwed up. Stepping out into sunlight isn't going to reset it. Sunlight can help us get valuable Vitamin D which we really need but I don't think it will help in the fatigue department.




Point number 7: Maintain a healthy weight.
I'd love to do this one. This has been the bane of my existence since I got sick. Between the autoimmune Hashimoto's Thyroiditis, the hypothyroidism and the inactivity that pain brings my calorie intake is down to almost nothing and I still don't lose weight. Except for the occasional chocolate binge my calorie intake is under 1200 a day. That isn't bad in anyone's book. I should be skinny. Hey, you tell me..............  Anyone else have trouble with this due to side effects of the Fibro and fatigue?

Point number 8: Manage Stress to fight fatigue.
I will totally agree with this one. Stress is a killer. The problem is these invisible illnesses is that there is fallout. There is a huge economic fallout that accompanies this illness. It's disabling and as hard as we try to keep some normalcy in our lives, it has a huge impact on your ability to make a living. In my case,  it makes a huge impact on my ability to make a living if your income is coming from a high stress environment. There's also relationship fallout. Whether it be from spousal, partner, familial or friends, everything is affected when you don't want to be around anyone. People do not understand and they take it personally. Top it all off from the stress that most people think this is all in your head. Stress????? What do you think??



Point number 9: Try Aromatherapy.
Personally, I like this one but there are people out there that have sensitivities to any kind of odors or smells. For me, I love it.  It does help me and I love the Bath and Body Works instant aromatherapy rollers. I have two that I use. One is Instant Comfort and it's vanilla and chamomile. The other is called Sound Sleep and it's lavender and chamomile. I roll the comfort on my wrists and the lavender on my pillowcase. I don't know if it helps the ability to stay asleep  but it does smell good when my head hits the pillow.




Point number 10: Be good to yourself.


This is so true. We need to realize that there are certain things that we have to accept. Fatigue will be with us no matter what we do. We can manage it and management is so important but until they find a cure flares will always be with us. 

So.....

I will try all these tips tonight.

I'll probably be exhausted from trying them.

But......

Will I be able to sleep?

Probably not.






Tuesday, April 7, 2015

I JUST LOVE PERSONAL GROWTH











One day it's 90.
The next night?
It's 49 degrees.
It just never stops, does it?

I shouldn't say too much about the weather change. I mean, really, I should be thankful. It isn't humid, or raining or snowing or freezing.  When it's 90 degrees I'm not a happy camper in Fort Stinking Desert or FSD as I call it. For starters, I know some people have trouble with the cold but I'm not one of them. I figure if I'm cold just pile on sweaters or comforters. If I'm too hot??? You can only peel down so far and you're still hot.

Ok, I'm rambling....
On too the next thought.......

Right now Fibromyalgia has been described as a neurosensory disorder characterized, in part, by abnormalities in the central nervous system pain processing center. The central nervous system (CNS) consisting of the  brain and spinal cord, are easily injured by accidents or stress. Studies show that people with trauma are 13% more likely to develop Fibromyalgia. Also stress, whether it is from emotional, physical or chemical means, is a cause of this disease.

Trauma and Fibromyalgia.

Fibromyalgia stemming from cervical or any kind of trauma is still very controversial in the medical community. One of my doctors doesn't believe it; one of them does believe that trauma from my auto accident is the cause. I truly believe the trauma from the accident that I had tipped the scale in Fibromyalgia's favor. I was so different 5 years ago. I wanted to move around and through any back pain that I had. I wore heels; high ones. I swore I'd never leave them behind.  Yeah, right. I look in my closet and cannot bear to get rid of them.

The humidity and the subsequent pain that it brings gets me a little moody and introspective. When I start to think about how different my life is today I then go from slightly moody to really pissed off. Sitting on my fanny or curled up in bed in pain isn't my idea of a good time. I don't like to be around a lot of people that know me because they see the difference in me and I hate the pity. Ok, this falls under AFGO. (another fu***ing growth opportunity)

Attention seekers.

I know that some people revel in the fact that they are chronically ill. It gives them the attention they crave. If they didn't find it in illness they would find it in something else. There is not a  question in my mind about it. I do not think that most people fall into this category at all, but the few that do taint it for everyone else. The problem is a two-edged sword. If you lay in bed because you hurt, you're a drama queen over-exaggerating your condition. If you get up and try to fight it then you're able to do something and it's not a disabling condition. It seems that you just can't win.

Life Sentence not Death Sentence.

No, this isn't an illness that will disappear after a round of antibiotics. This will be with me for the rest of my life. Being in jail handcuffed and bound is so tough to take. There will be limitations on my body and my psyche. There are days that I deal with it well and there are days that I don't. I think that I have to go through the process of grieving for the life that I once had but when does the process stop? I can't get to the acceptance stage and be done with it.  I can't worry about the loss and I have to be able to dig deep down and not be somewhat bitter about it.  I have to find something to do and I realize it isn't going to be what I once loved. What I used to do is too physically and emotionally taxing for me to handle at this point in my life. It was a life of stress squared, so I'm gradually learning how to leave it behind and search for another creative outlet. You'd think after five years I'd be able to do that. 

Still, 

it has a category.

It falls under......again......

AFGO.

(another fu**ing growth opportunity).

I'm tired of them........

But, I just never seem to learn.




Tuesday, March 31, 2015

PAIN CATASTROPHIZING AND OTHER NONSENSE










If beauty is in the eye of the beholder,
then pain perception is in the eyes of its victim.


Sometimes I wonder if the people who research chronic pain and Fibromyalgia have ever been in chronic pain. I love reading articles by PhD.'s that feel if chronic pain sufferers would stop thinking about their pain, then they might not experience as much of it.

It's called pain catastrophizing.
It means just what it sounds like.
What it implies is also just what it sounds like.
And I don't buy any of it.

I've been through painful situations in my life. When I was four I fell face first into a glass bowl full of potato chips. No, I wasn't the most graceful kid. When they threatened to take me to the hospital I dug in my heels and said "no."  Evidently, the doctor thought he would be cagey and tell me that he'd stitch me up right on the table. To hear my family tell it, I got right up on that table and didn't move a muscle. When he told me if I moved I'd have to go to the hospital I made good on that threat. The doctor stitched me up right there on the table. My brother told me that the only one in control that night was me.

I've always had a lot of control over my body. I learned when my brothers would tickle me until I cried that I could slow down my breathing and talk myself out of feeling what they were doing; I did it. To say that it infuriated them to no end is an understatement but it will give you an idea of what I would do when something felt unpleasant.

To tell me that the pain that I'm experiencing is amplified by the way I feel about it is absurd. If I could think my way out of this pain I would have done so years ago. I know how to distract myself enough so that pain doesn't have to take over. I've done it.

It works for acute pain.
It doesn't work at all for chronic pain.

Maybe it's because so much stimuli causes pain. We have the weather, auditory, hot and cold and noise being some of the issues that can trigger flares. Maybe it's because they still deep down don't believe that a lot of this is in our heads. After all, how much else can go wrong?

I'm back to central sensitization. People with Fibromyalgia have a lower threshold for pain because of increased sensitivity in the brain to it's pain signals. It's not what happens, it seems to be how it happens. Why they're stuck on cognitive behavioral therapy and trying to blame pain amplification on "catastrophizing" is beyond me. It's almost as if they can't find the on/off switch in our brains so they don't bother.  I really want one of these guys to experience chronic pain and then tell me that if we think good thoughts it will get better.

I've always said that attitude helps us get through very tough and painful times. It helps for a lot of things but it doesn't take away the pain. It is purely a coping strategy. That's all it is. There are affective dysfunctions, central nervous system abnormalities and cognitive dysfunctions. 

Even after all the research the treatments for Fibromyalgia include: Reduce stress, get sleep, exercise and maintain a healthy lifestyle. Boy, I can't tell you how much that advice helps me. Isn't that what we should be doing in the first place? 

It seems to me that the blood flow to the part of the brain that deals with pain and the cognitive function is off. There has to be a reason that they can't find out why the pain is amplified so much.

I'm in ponder mode.

I might as well be.

It's hot and summer is coming.

That's not a good sign.

I better think and write while I can.

Catastrophizing my a**.