|
FOR MULTIPLE SCLEROSIS AND RHEUMATOID ARTHRITIS SEE CUSTOM PAGES
what is M.E/CFS
an illness known as MYALGIC ENCEPHALOMYELITIS(M.E.) & CHRONIC FATIGUE SYNDROME(CFS). This illness is characterized as follows:
MYALGIC - muscle pain
ENCEPHALO - brain
MYEL - spinal cord
ITIS - inflammation
CHRONIC - Persisting for a long time
FATIGUE - Extreme tiredness after exertion
SYNDROME - a group of symptoms
M.E/CFS has many symptoms: swollen lymph glands, low grade fever, headaches, sore throat, fatigue, muscle pain, depression, sleep disturbances, cognitive problems (poor concentration, memory lapses), mood swings, irritability and digestive problems.
M.E/CFS is a condition, not an infection . In fact, it is a number of conditions with overlapping symtoms, which will not be identical in every sufferer. The myalgic bit refers to the aching muscles, while the encephlomyelitis refers to symptoms caused by disturbance to the brian and the central nervous system.
M.E/CFS often starts after a persistent viral infection, which your immune system cannot deal with. It is as though the immune system has become unbalanced, half of it working overtime and the other half watching. The infection my be something serious, very often glandular fever, or quite trivial, but afterwards you get worse and worse instead of better.
M.E/CFS affects the whole body and gives rise to an enormous number of systems, making it very difficult to identify. It is an illness of relapses and remissions and there is no single diagnostic test for it, although doctors are working on a possible blood test to diagnose it, which is good news. Diagnosis has to be based on close examination of possibilities of other diseases. It can, however, take time for some symptoms to develop and for the illness to `bottom out` , making the diagnostic process even more difficult.
The illness is probably as old as the hills, but as only recently received proper recognition. There are no reliable statistics relating to the number of current sufferers, as it is so hard to diagnose, but it is known that women are three times more likely to suffer than men. There may be a psychological or genetic predisposition involved in M.E/CFS, and often more than one member of a family will suffer from it. Over the years, it has been referred to by many names , including epidemic neuromyasthenia, Royal free disease, post-viral fatigue syndrome and chronic fatigue syndrome The last two are the most commonly used, and certainly give some clues to the nature of the condition, but they
are not strictly accurate. M.E. after suffering a viral attack, but not everyone dose.
WHAT CAUSES M.E/CFS
The causes of M.E/CFS are, in fact, still something of a mystery. It is, however, generally accepted that some sort of stress is the primary factor, whether it be from an illness, an accident or injury (frequently to the back), overwork, hormonal imbalance or even perhaps a vaccination. One of the most common factors seems to be a recent viral infection, which may be serious - like glandular fever - or relatively mild. Even the fittest amongst us can be struck down; most of us know of an apparently healthy teenager who has suddenly been afflicted and it is not known amongst athletes. My own feelings is that the cause is multifaceted - there is more than one stress involved and the last problem or trauma is just the last straw.
M.E/CFS comes in various strengths. It can start quite suddenly or creep up unnoticed over a period of months. Some people come abruptly to an halt and can do virtually nothing, while others struggle on with their lives, feeling dreadful and not knowing why, until finally it gets the better of them.
|
 |
what is fibromyalgia
A separate condition known as FIBROMYALGIA (FM), an arthritic type condition:
FIBRO - fibrous tissue
MY - muscle
ALGIA - pain
FM has many similar symptoms to M.E/CFS - in fact many M.E/CFS patients have a diagnosis of Fibromyalgia as well as M.E/CFS The biggest difference between M.E/CFS and FM is that FM does not have as much cognitive problems or exercise intolerance Some symptoms of FM are: wide spread muscle pain, intestinal problems, fatigue, non-restorative sleep, tender points at specific sites of the body, depression and headaches. If you have a lot of pain in your shoulders or down your back, you my have Fibromyalgia, or fibrositis, as it used to be called. The symptoms are tender spots in the muscles and muscles that feel like stiff cords, even when relaxed. I found that Guaiacum, a homoeopathic remedy, was particularly effective in relieving this pain. Guaiacum is noted for its ability to help joint pain, loss of flexibility, catarrh sore throats. The theory is that the guai in the remedy melts away the build-up of phosphates in our joints and muscles, literally `free us up `. Incidentally, people with a lot of tartar on their teeth may notice that this is also reduced. My teeth now need much less frequent attention from the hygienist and my shoulders are far looser. Approximately 75% of M.E/CFS patients have a diagnosis of F.M. as well as M.E/CFS Fibromyalgia produces some of the symptoms of M.E/CFS, although not all. There is many more "F.M. only" people than M.E/CFS people. The definition for Fibromyalgia is a "non-articulate rheumatic condition of widespread pain and fatigue" or a "soft tissue condition". Doctors believe that Fibromyalgia is a condition that can be a secondary problem in addition to a major illness such as Lupus, Irritable Bowel Syndrome, or it can be the primary condition. If you skipped the previous chapters, and started reading this FM one please go back. The preceding chapters have a lot of details on why both M.E/CFS and FM are talked about interchangeably through the book. So in essence almost the whole book is on FM. I do not consider them the same illness which is why I name this the "M.E/CFS & FM book" the "&" is to show the two are different using a infers that they are two different names for the same illness and they are separate.
Are M.E/CFS and FM the same illness?
If anyone tells you that everything points to them being the same or not the same they are wrong. No one knows for sure. I try throughout this to show the facts and not my opinion, so far the facts from what experts and other people say is that 60% feel they are different, but cousins just as GWS (Gulf War Syndrome), Multiple Sclerosis, lupus, Post-Polio Syndrome, lyme and mabe MCS are. My personal view is 90% that they are not the same illness, 10% is because they appear so closely related. How is it that so many M.E/CFS people have FM, but so many FM people do not have M.E/CFS I talk about this in many other chapters but will review it quickly here. FM can be a primary or secondary
Illness, just like Sleep apnea can be a primary condition all on it's own or a secondary condition with insomnia. Every person with Sleep apnea is not necessarily an insomniac and every insomniac does not have to have sleep apnea. Further examples are: -NMH (nuraly mediated hypotension) can be a primary condition on it's own or can be a secondary illness with M.E/CFS; this is a good example because in (1996) some were trying to say NMH was the cause of M.E/CFS and this has been shown not to be the case, but that NMH is a common symptom. -In the same way arthritis can be a secondary illness due to a car accident that caused spinal damage. -Or sever severe Fatigue may be a secondary illness with Cancer or MS. -IBS (irritable bowel Syndrome) may be a primary illness or a secondary one with Severe allergies. Since FM can be a secondary condition with so many other illnesses it would make sense that it could be a secondary illness to M.E/CFS
Diagnosing F.M. & M.E/CFS
F.M. is usually diagnosed by a rheumatologist who specializes in rheumatic and arthritic conditions. M.E/CFS is usually diagnosed by an infectious disease or internal medicine specialist.
One of the diagnostic tools used for F.M. is whether or not the patient has at least 11 of the 18 tender points for Fibromyalgia. An aid to determine which of these two illnesses you may have, is to start an
Exercise program. After a period of two months of daily walking only two blocks, (once your muscles are back in shape) if you are feeling slightly better, you may have Fibromyalgia only. However, if you
are feeling more exhausted with more cognitive and neurological problems, you may have M.E/CFS, or (M.E/CFS and F.M.) Moderate exercise has been proven to be harmful and reduces the bloodflow to the brain of the M.E/CFS patient. There is nothing I have read to suggest that once you have F.M., you cannot become ill with M.E/CFS as well.
Misdiagnosing of M.E/CFS & F.M.
It is mainly up to the patient to discover if they have F.M. only, M.E/CFS only, or both. The answer is not extremely important to know 100%, because there is so much grey area. No one is 100% certain. One treatment of importance after a diagnosis of M.E/CFS or F.M. M.E/CFS patients should only do very light exercise, while F.M. only patients may be able to do light aerobic exercise. Some problems arise when: An F.M. person goes to an internal medicine specialist, they get labelled as having M.E/CFS only; or When an M.E/CFS person goes to a Rheumatologist, and are told they have F.M. only. Separate M.E/CFS & F.M. support groups . I believe the interests of both illnesses are best served by separate support groups, if the numbers in the area can sustain continuing both. If numbers do not permit, a combined group may be the second best choice. I run a combined M.E/CFS & F.M. group, as do most of the other M.E/CFS groups.. Fibrositis. Fibromyalgia was previously referred to as Fibrositis. The name was changed as this illness has no inflammation as the name "sitis" suggests.
F.M. - Condition or Infectious Viral Disease? It is generally accepted that F.M. is a condition, not an illness or disease. a leading F.M. sleep expert, did a study, using 20 healthy students, who were deprived of deep sleep for two weeks. It was found that 80% of the students developed Fibromyalgia symptoms. After two months of normal sleep, the Fibromyalgia symptoms subsided. Of the 20% that did not develop Fibromyalgia, all were extremely physically fit. (I do not believe the study showed, or other materials suggest, that this means only unfit people get F.M., or that by exercising a lot you can get rid of F.M.; it could also be possible that this 20% would still have developed F.M. if depravation of deep sleep was continued for a longer time. It is evident that the cause of F.M. is due to much more than poor sleep. An F.M. doctor. It is important to have a doctor who is familiar with Fibromyalgia in
order to receive proper treatment for this condition.
How many M.E/CFS and FM people are disabled. The number of M.E. people and FM only people that are disabled and unable to work even part time, are probably close to the same number. FM has a bigger impact on sosiety because it effects more people. FM effects many more people but is not as debilitating, in most cases. M.E/CFS effects less people but is more debilitating to those that get it.
Does it matter what label M.E/CFS or FM you get. In a perfect world no, but once you get either illness to a moderate degree you will see how imperfect the world is. Sadly I have noticed a trend by some people, Doctors and insurance companies to claim that if 5 percent of the population has FM then it is really "just a minor irritation and every FM person should go back to work". This is like saying arthritis is a minor irritation for everyone, except many people are crippled with arthritis. In this way FM people do not get the respect they deserve. M.E/CFS seems to get looked at as more disabling by the insurance, government and media but still has the same "its all in your head stigma" that both M.E/CFS and FM are gradually dispelling. The treatment for M.E/CFS and FM are fairly similar except for exercise, this is discussed in later chapters.
what is lupus
Lupus is a chronic inflammatory disease that can affect many parts of your body, including your skin, joints, kidneys, blood cells, heart and lungs. Episodes of lupus tend to come and go throughout your life, and may cause you to feel tired and achy. But with treatment and self-care, you can lead an active, healthy life.
About 40 to 50 Americans out of every 100,000 have lupus, and most of them are women. There are several types of lupus, but systemic lupus erythematosus (SLE) is the most common and the type that causes the most difficulties. It can lead to problems ranging from fevers to sore muscles to anemia.
Signs & Symptoms
Not everyone with lupus will experience the same signs and symptoms of the disease. In fact, your own symptoms may vary from time to time. Still, there are some common symptoms associated with the disease. They include:
Rash. A butterfly-shaped rash called a malar rash may appear across the bridge of your nose and cheeks. Or a scaly, disk-shaped rash called a discoid rash may appear on your face, neck or chest.
Sensitivity to sunlight. People with lupus often experience severe rashes or sunburns from minimal sun exposure.
Skin ulcers. Sores may appear on your tongue or inside your mouth or nose. These ulcers are usually painless.
Arthritis. You may experience joint pain, stiffness and swelling.
Serositis. Inflammation of the lining of some organs such as the heart and lungs can cause you to have painful breathing, shortness of breath or chest pain.
Kidney problems. You may have kidney problems such as inflammation. This can occur without any symptoms, or you may have leg swelling (edema) and high blood pressure.
Brain or spinal cord problems. You may experience headaches, seizures or mental problems.
Other symptoms also may occur that are not specific to lupus. These include:
Fatigue. This symptom may be accompanied by dizziness, headaches or depression.
Fever. An unexplained fever may be an early sign of lupus.
Raynaud's phenomenon. This is a condition in which your fingers, toes, cheeks, nose and ears turn pale when exposed to cold temperatures.
Chest pain. This pain may be accompanied by coughing.
Swelling. You may have swollen glands or swelling in your legs or around your eyes.
Digestive problems. These problems may include loss of appetite, weight loss, nausea and diarrhea.
Unusual hair loss.
People with lupus may also experience depression or difficulty concentrating, either because of the disease or as a reaction to living with a chronic disease.
Diagnosis and treatment of lupus has improved tremendously in the past half-century. In the 1950s, if you had a diagnosis of SLE, there was a 50 percent chance you'd die within 5 years. Today there's a 97 percent chance that lupus won't shorten your life span. Many new treatment options are available to help you cope with the symptoms of lupus.
Causes
Lupus is an autoimmune disease, meaning that your body's own defenses attack your tissues, resulting in inflammation. The cause is unknown, but doctors believe it results from a combination of factors, which may include heredity, environment and hormones. Although lupus itself cannot be inherited, it's likely that inheriting a certain combination of genes makes you more susceptible to developing the condition. A viral or bacterial infection may then trigger the disease. Because so many more women than men have lupus, researchers also are looking at the possible involvement of hormones, such as estrogen.
When to Seek Medical Advice
If you develop an unexplained rash, fever, persistent aching or fatigue, see your doctor. If you've already been diagnosed with lupus, meet with your doctor on a regular basis so he or she can monitor your condition and treatment. Also, because people who have lupus can experience different symptoms at different times, see your doctor if new symptoms arise. This includes symptoms such as depression, which should be treated.
Risk Factors
Although anyone can develop lupus at any age, common risk factors include:
Gender. Women are approximately eight times more likely than men to develop lupus.
Race. Black women are three times more likely than white women to develop lupus.
Family history. Having a relative who has lupus increases your odds of developing the disease.
Pregnancy. Lupus sometimes shows up for the first time during pregnancy or shortly after giving birth
.Screening & Diagnosis
Lupus is often difficult to diagnose because symptoms vary from person to person and can fluctuate with time. In fact, your doctor may not initially consider the disease until the symptoms and signs become more obvious. Nearly all people with lupus experience changes in disease activity. At times, the disease may flare. At other times, there may be no evidence of lupus (remission).
The American College of Rheumatology (ACR) has developed clinical and laboratory criteria to help physicians classify lupus. If you have four of the 11 criteria at one time or individually over time, you probably have lupus. Your doctor may consider the diagnosis of lupus even if you have fewer than four of these signs and symptoms. The criteria identified by the ACR include:
Malar rash
Discoid rash
Sensitivity to sunlight
Ulcers
Arthritis
Serositis
Renal (kidney) disorder, such as inflammation
Neurological disorder, such as seizures or psychosis
Hematologic (blood) disorder, such as anemia
Antinuclear antibody, an indication that you may have an autoimmune disease
Immunologic disorder, another indication that you may have an autoimmune disease
In addition to using your clinical history and a physical examination to check for the classification criteria, your doctor will use laboratory tests. These may include:
Blood count. This test measures the amount of hemoglobin, red blood cells, white blood cells and platelets in your blood. Results may indicate you have anemia, which commonly occurs in lupus. Low white blood cell counts may occur as well.
Erythrocyte sedimentation rate. This blood test determines the rate at which red blood cells settle to the bottom of a tube. A faster-than-normal rate may indicate a systemic disease such as lupus. The sedimentation rate is not specific for one disease but may be elevated in lupus, other inflammatory conditions or with infection.
Kidney and liver assessment. A blood test can assess how well your kidneys and liver are functioning. Lupus may affect these organs.
Urinalysis. An examination of a sample of your urine may show an increased protein level, which may occur if lupus has affected your kidneys.
Antinuclear antibody (ANA) test. A positive test for the presence of these antibodies _ produced by your immune system _ indicates a stimulated immune system and is common if you have lupus or another autoimmune disease. Your doctor may advise more specific antibody testing and refer you to a rheumatologist.
Chest X-ray. An image of your chest and pleura, which surrounds your lungs, may reveal abnormal shadows or inflammation of your lungs, which may occur with lupus.
Electrocardiogram (ECG). This test measures the pattern of electrical impulses generated in your heart. It can help identify irregular rhythms, damage to your heart or enlargement of your heart, any of which may occur with lupus.
Syphilis test. If your doctor orders a syphilis test, it's not because he or she thinks you might have syphilis. Rather, a false-positive to a syphilis test can indicate antiphospholipid antibodies in your blood. The presence of antiphospholipid antibodies has been associated with an increased risk of blood clots, strokes and recurrent miscarriages
Complications
With treatment, most people with lupus can live active, healthy lives. Without treatment, complications from lupus can be life-threatening. These complications can include the following:
Kidneys. Lupus can cause the kidneys to become inflamed (nephritis). This can occur without pain, but would be detected through a urine and blood test. A blood test called creatinine is used to check kidney function. This is one of the reasons it is important for you to receive ongoing medical care.
Central nervous system. If your central nervous system is affected by lupus, you may experience headaches, dizziness, difficulty concentrating, mood swings or even seizures.
Blood and blood vessels. Lupus may lead to blood problems including anemia and increased risk of bleeding or blood clotting. It can also cause inflammation of blood vessels (vasculitis).
Lungs. Having lupus increases your chances of developing an inflammation of your chest cavity lining (pleurisy) that can make breathing painful. You also may be more susceptible to a noninfectious form of pneumonia.
Heart. Chest pain may also be the result of an inflammation of your heart muscle (myocarditis and endocarditis), your arteries (coronary vasculitis) or heart membrane (pericarditis). Today, the leading cause of death for people with lupus is cardiovascular disease, which can lead to heart attacks. It's unclear whether this is because people with lupus are living longer, or whether it may be a complication of treatment. Controlling high blood pressure and cholesterol, being a nonsmoker and getting regular exercise may be ways to reduce the risk of cardiovascular disease.
Infection. People with lupus are at increased risk of infection, both from the disease and from some of the treatments.
Avascular necrosis. Avascular necrosis, which means tissue death, can occur when the blood supply to a bone is decreased. For people with lupus, this can be caused by the disease or by high doses of corticosteroids. The hip joint is commonly affected, and may cause you pain when you walk.
Lupus poses special health risks for women in their childbearing years. Complications may include:
Difficulty conceiving. If you are a woman with lupus, your fertility may decline during flares. Some medications used to treat lupus may result in infertility.
Increased risk of miscarriage. The risk is usually highest early or late in your pregnancy. This risk can be minimized through careful planning and medical treatment.
Increased risk of complications during pregnancy. A woman with lupus is more likely to experience a flare during her pregnancy. She is also at higher risk for high blood pressure, diabetes, high blood sugar (hyperglycemia) and kidney problems during pregnancy.
Limited birth control options. Women with lupus may not tolerate birth control pills well and should not use intrauterine devices (IUDs) because of an increased risk of infection.
Treatment
Currently, there is no cure for lupus. But treatments can ease symptoms and reduce complications. Treatment of systemic lupus erythematosus (SLE) depends on which organs are affected and how severely. Because lupus may assume many forms, finding the most effective treatment may take time.
A variety of medications, including the following, may be involved in the treatment of lupus:
Nonsteroidal anti-inflammatory drugs. Aspirin or nonsteroidal anti-inflammatory medications (NSAIDs) may reduce joint and other tissue inflammation.
Antimalarial drugs. There is no known relationship between lupus and malaria, and no one knows why antimalarial drugs help improve lupus. These medications may be useful for treating skin and joint problems and inflammation of the surface of organs like your heart and lungs. These drugs also may prevent flares of the disease.
Corticosteroids. These drugs counter the inflammation of lupus. The dosage depends on which organs are involved and how severely. Side effects of steroid use include weight gain, puffiness in your face, easy bruising, thinning of bones (osteoporosis), high blood pressure, diabetes and increased risk of infection.
Immunosuppressive medications. These drugs, such as azathioprine (Imuran) and cyclophosphamide (Cytoxan), reduce your normal immune response. Your doctor may prescribe them if lupus is widely affecting your organs, especially your kidneys. Other similar medications are methotrexate (Rheumatrex), chlorambucil (Leukeran) and cyclosporine (Neoral, Sandimmune, SangCya). Immunosuppressive medications may cause anemia and a low white blood cell count. They may also increase risk of infection and cancer. Your doctor may prescribe them if corticosteroids aren't effective, or with a lower dosage of corticosteroids (to reduce side effects).
Sometimes, even with the use of corticosteroids and immunosuppressive drugs, your kidneys may fail. You may need kidney dialysis or, if kidney failure is permanent, a kidney transplant.
Self-Care
For many people with lupus, the disease isn't a major illness. But for some, it's a serious condition.
Recognizing when your symptoms are getting worse and knowing how to treat them can reduce your chance of permanent tissue or organ damage. Early treatment can also reduce the time you spend on higher doses of medications, which can cause serious side effects. Working with your doctor and taking medications only as prescribed is important.
Because ultraviolet light can trigger a flare, use sunscreens with a sun protection factor (SPF) of at least 15 and avoid tanning beds even if your symptoms don't include skin problems. You should avoid being in the sun when it is at its strongest, 10 a.m. to 3 p.m.
In addition, managing lupus means taking good general care of yourself. You can take the following steps to improve the function of your immune system:
Get adequate rest and regular exercise.
Don't smoke. Smoking increases your risk for cardiovascular disease and can worsen the effects of lupus on your heart and blood vessels.
Limit alcohol. Alcohol can affect your liver, kidneys, heart and muscles, and may interact with your medications.
Eat a healthy, balanced diet.
If you're a woman with lupus and are considering pregnancy, seek medical counseling to determine what steps you can take to ensure the safest possible pregnancy. Planning and preparing for pregnancy can help reduce risks to you and your baby.
what is irritable bowel syndrome
Irritable Bowel Syndrome (also known as "spastic colon" or "nervous stomach") is a functional disorder of the colon or large intestine. It is caused by excessive muscle contractions in the intestinal tract usually occurring during times of tension or stress.
What are the symptoms?
Extreme diarrhea
Constipation (sometimes alternating with diarrhea)
Abdominal pain
Cramping
Gas
How is it treated?
For many, dealing with the source of tension or stress helps prevent recurrence of irritable bowel; however, the following self-care measures can also help relieve uncomfortable symptoms:
DIET
Increase fiber or "roughage" (non-digestible vegetable matter) in your regular diet by including foods such as fruits, vegetables, whole grain breads and cereals and bran. Note: Acute diarrhea will require excluding fiber until symptoms subside.
Avoid known irritants during acute attacks. They may include:
fried or greasy foods
gas-forming foods (i.e. cabbage, broccoli, corn, beans, nuts)
fresh fruits
caffeinated beverages (i.e. coffee, black tea, cola)
milk and milk products
beer
foods containing sorbitol (i.e. diet candies and gum)
Decrease chances of ingesting air by avoiding chewing gum, hard candy and carbonated beverages.
Eat three meals daily. Skipping meals and then eating on an empty stomach can cause havoc with your digestive system and aggravate uncomfortable symptoms.
MEDICATIONS
Metamucil is the great equalizer; it loosens up constipation and firms up diarrhea. Take one teaspoon in a glass of liquid three times a day (available without prescriptions).
Avoid laxatives. For relief of constipation, stool softeners (i.e. Surfak, Colace) are preferable and are also available without prescription.
Avoid antibiotics which can aggravate your condition.
ACTIVITIES
Get daily physical exercise to allow your bowels to relax. Include at least one leisurely walk a day.
Consult health care personnel:
if you are having trouble coping with daily tension or stress.
if your symptoms are not relieved by self-care measures.
if you notice blood in your stool.
anytime you are unsure of what to do.
JOIN OUR CLUB HERE FOR SUPPORT .
|
 |
|
