Why is Fibro such a Problem?

Fibro is so Damned Misunderstood?

Fibromyalgia is not a new illness by any means, there are records dating back even 200 hundred years ago. In fact many historians believe that the famous nurse Florence Nightingale suffered with fibro.

Firstly, I’ve spoken about the fibromyalgia merry-go-round. to refresh your memories or if you hadn’t heard me speak of this, the merry-go-round is as follows. You body seems to not be functioning well with all kinds of symptoms, from pain to fatigue, in fact I’ve compiled a list of 63 symptoms and I’m sure that there are many more.

You go to your family doctor, who takes your history, does some tests and blood work and can’t find a thing wrong, so he recommends some anti-inflammatories which don’t help much as fibro pain is not caused by inflammation. The doctor than sends you to an orthopedist where an MRI or perhaps a Cat scan is done, looking for something or other, but again comes up blank. The doc might than send you to a Physical therapist and low and behold, the therapy causes the symptoms to become worse. Back you go to the orthopedist, who than send you to a neurologist and they rule out Lupus, Rheumatoid Arthritis, Multiple sclerosis and other neurological illnesses (all which can be seen by blood work or imaging. Problem is you again come up zero.

You are than sent to a Rheumotologist (if the doc is savvy enough), and he/she ultimately does the tests where they touch 12 to 18 trigger points and if these points are painful, the diagnosis becomes Fibromyalgia. (By the way, studies have shown that the trigger point test is not an indicator of fibro and very recently has been discounted in the research in very strong language).

However, now that you have a diagnosis, what is the next step? Lyrica, Cymbalta, Savella, Tramadol, on and on. the problem is that to date, there has not been one medication developed for Fibromyalgia. Lyrica is an anti-seizure med and Cymbalta and Savella are anti-depressives. The pain might become so bad to where you now using narcotics such as Morphine or other very intense pain killers and the interesting thing is that after a while, these don’t work either.

You go around and around and just can’t find a solution, you live from day to day never knowing how you’ll feel, some days you can’t get out of bed, other days, you can’t think straight.

Probably the most insulting aspect of Fibromyalgia is being referred to the Psychiatrist, who has the gall to tell you that it is in your head, it is psychosomatic etc. The fact is that this is just plain incorrect as many studies have shown countless times.

Another problem which occurs is that there are still Medical Professionals who will tell you that they don’t believe in Fibromyalgia, that it does not exist. Again, this is plain incorrect as the literature is clear that it is a very real illness. Why do they say this. My guess is that they don’t know what to do with it. Most doctors (from my experience) really do care about their patients, but as in all professions, there are the good and not so good. The not so good will say it does not exist out of ego.

There is a peculiar situation where some Doctors believe they are the authority on every ailment known to man. These are the ones who generally say that fibromyalgia does not exist and my advise is to immediately fire this doctor (yes, a Doctor is your employee), and find another one.

Therefore, you’re find yourself on the Fibromyalgia Merry-go-round.

So what do you do? One of the big problems is that there is so much misinformation out there, not only with the public, but with doctors, that you’re stuck and don’t know who to turn to. Meanwhile, you are becoming more and more depressed. You’re family is backing away from you as are your children and friends, (In fact, it is said that a way to find who your real friends are is to develop an illness).

1 Support groups can be very helpful, however the key is to find the right one. You want a group where the people are uplifting, supportive and have an affirmative attitude. A group where everybody is constantly whining and complaining will just make you more depressed. From my own experience running groups, I’ve concluded that it is up to the monitor or head of the group to keep people on track, to keep the conversation on a positive note. This can be done as I do it all the time. When the group is good, people will leave with some optimism, with tools to help them research their illness and without a depressed feeling. Therefore, if you find that a group is “a downer”, don’t return.

A support group might be run by a local hospital, but this does not mean that it will be good. Ask around, speak to some fibro people you might know until you find a comfortable group. they really can be a god-send.

2 A good psychotherapist is worth their weight in gold. Again, there are good ones and bad ones. You want a therapist who has much training not only in chronic illnesses but in fibromyalgia as fibro is really so unique. Psychotherapists came in many varieties, Psychiatrists, Psychologists, Social workers, Family counselors and many others. Again, the key is to find one who knows Fibromyalgia and who you feel comfortable with. It takes a bit of work to find the right one, but it is well worth it.

3 Be wary of all the ads you see about this one or that one having the cure. There is an old expression (attributed to astronomer Carl Sagan, but really going back much further, that extraordinary claims require extraordinary evidence. I do run a fibro clinic and have seen many recover, but I believe that I am a rare one, as I’m always looking for other Docs who do similar work. Unfortunately I generally just see docs prescribing tons of meds and alternative healers (Acupuncturists and Chiropractics) making claims but not being able to follow through. In fact, a wrong doctor can actually make your symptoms much worse, so be careful.

4 Never doubt yourself, no matter what others may think or tell you. You sometimes have to develop a strong skin, but you are the one with the illness. don’t let yourself get bullied and do not push yourself.

5 Slow start to separate yourself from people who are not good for you, you kno0w..the ones who criticize, who are negative, who never have a positive thing to say, who are always complaining. This is the last  thing you need in your life!

More to come:

The Big Six (Depression)

Lets talk about Depression, another very common symptom of Fibromyalgia!

Depression: It is natural for all of us, even the non-fibro patients to experience depression at times, this is part of life. You don’t get the raise or have a fight with your boss or spouse, something doesn’t quite work out the way you hoped etc. In fact life has it’s ups and downs,

However when a person has Fibromyalgia, depression is one of the big six symptoms, meaning that almost everybody with fibro will experience depression. This depression can be mild or run to unbearable, even make people suicidal. Unfortunately, I’ve seen people with fibro over the years commit suicide.

Emotionally dealing with a chronic illness can be quite devastating, after all, who wouldn’t be depressed. There seems to be no end in sight, every day is more of the same pain and symptoms. There is that feeling of utter uselessness, the feeling of not wanting to leave your bed, the frustration of not being about to find a solution to the illness. You have days where you feel like giving up, than you have better days. This is a psychological depression.

However there is another form of depression that affects Fibromyalgia people and this is totally physiological in nature. As we’ve spoken about repeatedly, Fibromyalgia causes an over active nervous system, which means that the Adrenal glands are on overdrive.To review for a second, the Adrenal glands are these two little triangular glands that sit above the kidney.

Adrenal glands, as all endocrine (hormone glands) produce needed hormones in small amounts as the body requires them. An example would be that every time you eat something with sugar, the pancreas secretes just enough insulin to process that sugar.

Why the Depression? As I had mentioned, your body is producing a huge amount of adrenalin (remember that this is what makes sleep so difficult). The excess Adrenalin also passes through the blood brain barrier and attaches itself to serotonin, nor-epinephrine and dopamine receptors in the brain leading to a physiological depression. Remember that meds such as Prozac work with serotonin receptors while Wellbutrin work with nor-epinephrine receptors. This process is a part of what is called Adrenal Syndrome.

Thus, in summary, there are two types of depressions occurring which are overlapping.

The commonly prescribed anti-depressives are:

amitriptyline
tricyclic
Elavil
amoxapine
tricyclic
Asendin
bupropion
aminoketone
Wellbutrin
citalopram
SSRI
Celexa
clomipramine
tricyclic
Anafranil
desipramine
tricyclic/SNRI
Norpramin, Pertofrane
doxepin
tricyclic
Adapine, Sinequan
duloxetine SNRI Cymbalta
escitalopram
SSRI
Lexapro
fluvoxamine
SSRI
Luvox
fluoxetine
SSRI
Prozac
imipramine
tricyclic
Tofranil
isocarboxazid
MAOI
Marplan
maprotiline
NRI
Ludiomil
mirtazapine
“NaSSA”
Remeron
nefazodone
SNRI
Serzone
nortriptyline
tricyclic
Aventyl, Pamelor
paroxetine
SSRI
Paxil
phenelzine
MAOI
Nardil
protriptyline
tricyclic
Vivactil
sertraline
SSRI
Zoloft
tranylcypromine
MAOI
Parnate
trazodone
serotonin modulator
Desyrel
trimipramine
tricyclic
Surmontil
venlafaxine
SNRI
Effexor

Some definitions:

Tricyclics

These older drugs affect norepinephrine and serotonin. They are as effective as SSRI’s in many people, but have stronger side effects and so are used as a second or third level of treatment. Common side effects of tricyclics include dry mouth, constipation, bladder problems, sexual dysfunction, blurred vision, dizziness, drowsiness, and increased heart rate.

MAOI’s

Monoamine oxidase inhibitors are effective for some people with major depression who do not respond to other antidepressants. They are also used to treat panic disorder and bipolar depression. The limited population for whom MAOI’s are indicated need to avoid taking decongestants and consuming certain foods that contain high levels of the monoamine tyramine, including fish, chocolate, and fermented foods such as alcoholic beverages, cheeses, soy sauce, processed meats, and pickles. The interaction of tyramine with MAOI’s can bring on a sharp increase in blood pressure that can lead to a stroke.

SSRI’s

Side effects of SSRI’s (serotonin reuptake inhibitors) include sexual dysfunction, nausea, nervousness and insomnia, agitation, decreased sweating with increased body temperature.

Any of these side effects may be amplified when an SSRI is combined with other medications or herbs that affect serotonin (such as St. John’s Wort and SAM-e). In the most extreme cases, such a combination of medications (e.g., an SSRI and an MAOI) may result in a potentially serious or even fatal serotonin syndrome, characterized by fever, confusion, muscle rigidity, and cardiac, liver, or kidney problems.

Heart attack patients who take both selective serotonin reuptake inhibitor (SSRI) antidepressants and antiplatelet drugs such as aspirin or Plavix have a higher risk for bleeding than those who take anti-clotting drugs only, a new study finds.

Newer drugs

New classes of antidepressants are steadily being developed and brought to market. Classifying them is not always straightforward due to their combined pharmacokinetic action. One of these newer classes, the SNRI’s (serotonin/norepinephrine reuptake inhibitors), like the tricyclics, affects both norepinephrine and serotonin. SNRI’s include Effexor (venlafaxine) and Serzone (nefazadone).

Cases of life-threatening hepatic failure have been reported in patients treated with Serzone, and this tradename was actually discontinued in 2003; however, the generic version of Serzone, nefazodone, remains available. Patients should call the doctor if the following symptoms of liver dysfunction occur: yellowing of the skin or whites of the eyes, unusually dark urine, loss of appetite that lasts for several days, nausea, or abdominal pain.

The most recent research out of Canada, published about two weeks ago are showing the following:

Antiplatelet drugs prevent blood cells from sticking together and forming a blood clot. Heart attack patients are commonly prescribed antiplatelet therapy to reduce their risk of another heart attack. But there’s an increased risk of bleeding, which increases even further when certain other drugs are taken at the same time.

It so happens that many heart attack patients have depression symptoms and are prescribed antidepressants, noted the researchers at McGill University in Montreal.

In the Canadian study, the researchers looked at more than 27,000 heart attack patients, aged 50 and older, and found that patients taking aspirin or Plavix alone had a similar risk of bleeding. But taking an SSRI antidepressant and aspirin increased the risk of bleeding by 42 percent, and taking an SSRI with both aspirin and clopidogrel (dual antiplatelet therapy) increased the risk by 57 percent.

Bleeding included gastrointestinal bleeding, hemorrhagic stroke or other bleeding that required hospitalization or occurred in the hospital during treatment.

In summary, there are no free rides, you must weight the risks versus the benefits. One thing is known that there really is very little knowledge of how anti-depressives work and there are questions as to if they really do work.

Vegetarian Recipes Part 5 (thanks to my wife)

More Vegetarian recipes:

Tomato and Mushroom Pasta Bake with Creamy Vegan Béchamel Sauce

Ingredients:

400g spiral pasta, cooked (lasagna sheets are fine too)
olive oil
1 onion, chopped
1 1/2 lb fresh or canned tomatoes (about 2 cans, I like half fresh half canned), chopped
1 1/2 pounds mushrooms, chopped
3-4 Tablespoons vegan margarine
3 garlic cloves
2 slices of bread
4 cups Béchamel Sauce

Directions:

1. Boil pasta and make the béchamel sauce (recipe below).

2. Preheat the oven to 400F and place your bread slices in there. Bake them while you’re cooking everything else, until they are toasted through.

3. Saute onion in olive oil, add tomatoes and cook for 6-8 min, stirring often. Season with salt and pepper and set aside.

4. Melt margarine in a pan and add mushrooms. Cook until the juices have been released. Add garlic (and a little lemon juice if desired), season, and cook until most of the juices have evaporated.

5. When bread is done, remove from the oven and out in a food processor or finely chop to make breadcrumbs.

6. To assemble, start with a little béchamel sauce, then a layer of pasta.  Layer on half of the tomato mixture, and another thin layer of béchamel. Add another layer of pasta, then half of the mushroom mixture, and béchamel. Repeat with the rest of the tomato and mushroom mixtures. Finish with a layer of pasta and béchamel.

7. Add about 2 Tablespoon of olive oil to the breadcrumbs and mix with your hands so it’s nicely coated. Sprinkle on top.  Bake for 20 minutes and serve.

Serves: 4-6

Preparation time: 1.5 hours

Veggie, Tomato, and Cheese Pasta Bake

Ingredients:

1 tablespoon olive oil
1 large zucchini, slice or dice into 1-inch pieces
1 medium yellow onion, slice or dice into 1-inch pieces
1 bell pepper (your choice of color), slice or dice into 1-inch pieces
1 carrot, slice or dice into 1-inch pieces
1 cup diced eggplant, slice or dice into 1-inch pieces
3/4 cup peas
handful of mushrooms, slice or dice into 1-inch pieces
1/2 (12-ounce) block firm tofu, crumbled
1 tablespoon garlic powder (fresh would be good too!)
1 tablespoon basil
1 tablespoon oregano
1 teaspoon salt
1/2 tablespoon crushed red pepper flakes
1 (28-ounce) can crushed tomatoes
1/2 tablespoon sugar or sweetener of your choice
1/4 cup vegan sour cream
16 ounces pasta, cooked
vegan cheese

Directions:

*Feel free to substitute whatever vegetables you would like. This is a very versatile dish.*

1. In a large saute pan, heat olive oil. Add zucchini, onion, bell pepper, carrot, eggplant, peas, and mushrooms. Saute for 5 minutes.

2. Stir in tofu, garlic powder, basil, oregano, salt, and red pepper flakes. Cook 5 more minutes.

3. Stir in crushed tomatoes and sugar.  Cook until warmed through.

4. Turn off heat and stir in sour cream. Place pasta into a large baking dish. Add vegetable/tomato mixture on top and stir it all up.  Sprinkle as much cheese on top as you’d like.

5. Cover with foil and bake at 375 degrees F for 30 minutes. Take off foil and cook for an extra 2 minutes. ENJOY!

Makes: 6 to 7 servings, Preparation time: 10 to 15 minutes, Cooking time: 30 minutes

Ziti-Cheeze and Broccoli Casserole

Ingredients:

10 oz block of frozen chopped broccoli
1 cup yellow corn chip crumbs
1/2 cup boiling water
1 cup nutritional yeast
2 tablespoons vegan soy margarine
1/4 cup unsweetened soy milk
1 3/4 cup dry ziti
1/4 cup corn oil
1/4 cup white flour
1/2 teaspoon salt
1/2 teaspoon coarse ground black pepper
1/2 teaspoon garlic powder
1/2-1 teaspoon onion powder
1/4 teaspoon turmeric

Directions:

– Smash or food process some corn chips until you get about a cup of crumbs.

– Set the pasta to cook

– Put the frozen broccoli block in a 1-qt casserole by itself and microwave for 5 minutes on high or until done.

– Heat corn oil in saucepan and add flour.  Cook on low and stir until roux is a perfect golden yellow color.

– Add about 1/2 cup nutritional yeast.  Add soy milk, boiling water, vegan soy margarine, and additional yeast by tablespoons until you reach a good consistency (to coat the ziti and broccoli and then bake).  Add garlic and onion powder, salt, turmeric, and pepper to taste and color.  Make it pretty strong — the pasta will dilute the flavor.

– Strain the ziti and add it to the broccoli in the casserole dish.

– Pour the cheese sauce onto the ziti and broccoli and mix in.  Correct seasoning if needed.

– Cover the casserole with the corn chip crumbs.

– Bake at 350F for 15-20 minutes or until bubbly and fragrant.  Let cool slightly before serving.

Serves: 4 as main dish, 8 as side dish

Mangia Manicotti

Ingredients:

1 tablespoon olive oil
1/2 onion, small dice
2-3 cloves garlic, minced
3-4 oz. fresh spinach, washe’d and chopped
1 lb. regular soft tofu, pressed of excess water
1 oz. sundried tomatoes, soaked in hot water until soft, coarsely chopped(reserve the
soaking liquid)
1 tablespoon nutritional yeast
2 tablespoon reserved soaking liquid
2 tablespoon lemon juice
salt and pepper to taste
3 cups tomato sauce
1 box manicotti tubes, boiled until slightly softened, but not limp

Directions:

Saute onion in oil over low to med. heat until slightly golden, about 5-7 minutes.  halfway through, add the garlic.  If the onion is sticking to the pan, add a splash of reserved sundried tomato liquid or vegan white wine.  Add spinach and cook until softened.  Remove from heat.  Crumble tofu into a food processor;add sundried tomatoes, yeast, soaking liquid, lemon juice, salt and pepper and pan mixture.  Blend, scraping down sides, until very well mixed.  Romove from processor and refrigerate in covered bowl for at least an hour.  Fill each she’ll with about 2 oz. filling.  Lightly layer a baking dish with tomato sauce.  Line up stuffed shells and cover with remainder of tomato sauce.  Cover and bake for about 30 min. in pre-heated oven at 325 F.  Tastes best if you let the flavors marry for several hours.

Serves: 4-5

Tater Tot Casserole

Ingredients:

1 onion, diced
8 ounces mushrooms, chopped
12 ounces frozen meatless crumbles
1 tablespoon soy sauce
garlic salt, to taste
black pepper, to taste
28 ounces frozen tater tots
1 packet (1.8 ounces) dry onion mushroom soup mix
2 cups vegetable broth
4 ounces vegan sour cream
1 tablespoon corn starch
4 ounces French fried onions, to top, optional
8 ounces vegan cheddar cheese, shredded, optional

Directions:

1. Preheat oven to 400 degrees F. Saute onion until just translucent. Add in mushrooms, and saute additional 2 minutes.  Add in frozen crumbles, soy sauce, garlic salt, and black pepper. Heat thoroughly.

2. Spoon mixture into 9×13″ dish. Top with frozen tater tots. Mix together dry soup mix, broth, sour cream, and corn starch in pot. Bring soup mixture to a boil. Reduce heat to medium-low, and simmer until slightly thickened, stirring constantly. Pour soup mixture over tater tots.

3. Sprinkle French fried onions and/or shredded vegan cheddar cheese on top, if desired. Bake 30-35 minutes or until tater tots are golden brown.

Source of recipe: This recipe was inspired by a dish my grandmother cooked often years ago.

Makes: 6-8 servings when served as main course; 10-12 when served as a side dish, Preparation time: 20 min, Cooking time: 40 min

Baked Potatoes Au Gratin

Ingredients:

4-5 medium Yukon gold potatoes, sliced
1/2 cup chopped spinach, optional
vegan butter, to taste
2 cups plain nondairy milk (I use soy)
2/3 cup nutritional yeast
1 tablespoon flour
vegan bacon bits, to taste
French fried onions, to taste (I use French’s)
salt and pepper, to taste

Directions:

1. Preheat oven to 375 degrees F. Place potatoes in a casserole dish. Add spinach and top with butter.

2. In a separate bowl, whisk together milk, flour, and yeast. Pour onto potatoes. Top with vegan bacon bits and fried onions.

3. Cover and bake for about 1 hour, or until the top is browned and potatoes are cooked. Top with more vegan bacon bits and fried onions. Serve.

Serves: 4 people; Preparation Time: 15 minutes; Cooking Time: 60 minutes

Potato Casserole

Ingredients:

1 32 oz package diced frozen potatoes
1 container vegan sour cream (I use Tofutti vegan sour cream)
1/2 block vegan cheddar cheese, shredded (I use Vegan Gourmet cheddar cheese)
1 package smashed crackers (not a box, but one of the 4 packages from within box. I use Ritz.)
1/4 cup softened vegan margarine
salt and pepper to taste

Directions:

Once potatoes are thawed, in a casserole dish, mix potatoes, sour cream, salt, pepper, and shredded vegan cheese.

In a separate bowl, smash crackers with butter and spread on top of the potatoes.

Cook at 300 degrees Fahrenheit for 45 minutes or until golden brown.

Easy-peasy-hot and cheesy.

Sweet Potato and Fennel Bake

Ingredients:

3 large sweet potatoes
1 fennel bulb
1 (or 2) Granny Smith Apples (or the apple of your choice)
1 onion (I like onion so I used lots)
1 or 2 tablespoons soy sauce
1 tablespoon cornstarch (may substitute potato starch)
1 tablespoon hoisin sauce
1/2 teaspoon cumin (or to your taste)
1/2 teaspoon cayenne pepper (or to your taste)
1 tablespoon maple syrup (or to your taste)
1 packet stevia

Directions:

Mix the Soy Sauce, Hoisin Sauce, Cumin, Cayenne, Maple Syrup and Stevia with approximately 1/2 to 3/4 cup of cold water. Stir in the cornstarch

Peel Sweet Potatoes, onion and Apple (you can leave the peel on the apple if you’d like) and clean and wash and trim the fennel bulb. I used a slicer to slice them all fine. If you don’t have one, slice by hand. You can either layer the ingredients in a shallow baking pan (which has either been sprayed with non-stick oil or greased with a little oil) or mix the ingredients and dump them into the baking pan which is what I did since it’s way easier. Pour over 1/2 of the liquid mixture (stir to make sure the cornstarch is blended) cover and bake at 400 degrees for 1/2 hour. Turn the heat to 350, uncover, pour the rest of the liquid over the vegetables and bake another 1/2 hour or until the sweet potatoes are done/tender

(I served mine with a dollop of vegan sour crème)

Serves: 4

Preparation time: 1 hour 15 minutes

Green Bean Mashed Potato Casserole

Ingredients:

3 cups textured soy protein, re-hydrated with 2 1/2 cups water
1 onion, diced
2-4 garlic cloves, minced
3 cans cut green beans, drained
3 cans tomato soup
6 medium potatoes
1/2 package silken tofu, whipped in blender or processor

Directions:

Oven 350º

Saute the onions, garlic & textured soy protein in oil until Textured Soy Protein is golden brown.

Cook potatoes in water until tender, drain. Mash with the tofu (or use soy milk if you prefer).

Layer ingredients in pan this way:
textured soy protein/onion mixture
Green beans
Tomato soup
Mashed potatoes

Bake in oven for approx 30 – 35 minutes at 350 degrees. Let set for 10 minutes after taking out of oven.

Serves: 9 x 13 pan

Preparation time: approx 1 hour