Top 6 Myths: About Bottled Water

From the FMS Global & UK News Desk of Jeanne Hambleton

Courtesy of WebMD – Feature from “Marie Claire” Magazine

By Anndee Hochman

Bottled water — already a more than $10 billion industry — is the fastest-growing beverage category in the U.S. But is it good for you? Here’s the pure truth.

Myth #1: BOTTLED WATER IS BETTER THAN TAP

Not necessarily. While labels gush about bottled water that “begins as snowflakes” or flows from “deep inside lush green volcanoes,” between 25 and 40 percent of bottled water comes from a less exotic source: U.S. municipal water supplies. (Bottling companies buy the water and filter it, and some add minerals.) That’s not really a bad thing: The Environmental Protection Agency oversees municipal water quality, while the Food and Drug Administration monitors bottled water; in some cases, EPA codes are more stringent.

Myth #2: PURIFIED WATER TASTES BETTER

The “purest” water — distilled water with all minerals and salts removed — tastes flat; it’s the sodium, calcium, magnesium, and chlorides that give water its flavor. The “off” taste of tap water is the chlorine; if you refrigerate it in a container with a loose-fitting lid, the chlorine taste will be gone overnight.

Myth #3: BOTTLED WATER WITH VITAMINS, MINERALS, OR PROTEIN IS MORE HEALTHY THAN REGULAR WATER

“Vitamins, color, herbs, protein, and all the other additions to water — those are a marketing ploy,” says Marion Nestle, Ph.D., professor of nutrition studies at New York University. Plus, the additives are usually a scant serving of the vitamins you really need in a day, adds Amy Subar, Ph.D., a nutritionist with the National Cancer Institute. Enhanced waters usually contain sugars and artificial flavorings to sweeten the deal and can pack more calories than diet soda. When it comes to providing fluoride, tap water usually wins, though that element is increasingly being added to bottled waters.

Myth #4: YOU NEED EIGHT 8-OUNCE GLASSES OF WATER EACH DAY

The Institute of Medicine recommends about 91 ounces (a little more than 11 8-ounce glasses) of fluid daily for women. But here is the thing: It expects 80 percent of that to come from water, juice, coffee, tea, or other beverages and the remaining 20 percent from food. That means if you drink a 12-ounce cup of coffee and a 12-ounce can of diet soda, you only need 48 more ounces (three 16-ounce glasses, or four soda cans’ worth) for the day.

Myth #5: AFTER AN INTENSE WORKOUT, BOTTLED WATER IS BEST

There is a reason volunteers hand out Gatorade during marathons. If your workout lasts longer than an hour, you need to replace the water and electrolytes, such as sodium and potassium, that you have lost (that is what sports drinks generally do). For less intense workouts, regular water is fine.

Myth #6: WATER BOTTLES ARE EASY ON THE ENVIRONMENT BECAUSE THEY CAN BE RECYCLED

Wouldn’t it be nice? And it is not just the bottles. Eco-costs include manufacturing, trucking, shelving, and marketing. And meeting the annual U.S. demand for plastic bottles requires enough oil to keep 100,000 cars on the road for a year, says Janet Larsen of the Earth Policy Institute. Sure, the 70 million empty water bottles the U.S. produces per day can be recycled, but the sad truth is, about 86 percent of them end up in the trash. Hardly worth it, for what flows out of the tap and into a reusable glass for free.

(http://www.webmd.com/food-recipes/features/top-6-myths-about-bottled-water?ecd=wnl_day_033109)

EDITOR’S NOTE: Often known as Adam’s Ale, as presumably he had nothing else to drink, did you know that water covers 70% of the earth’s surface and that water makes up between 60% to 70% of the human body. (http://encyclopedia.farlex.com/Adam’s+ale)

If you are really interested in learning more about Adam’s Ale, water, and wells, read Chapter 14 of Maybole, Carrick’s Capital Facts, Fiction & Folks by James T. Gray, Alloway Publishing, Ayr, first published 1972, reprinted on the following link below:
(http://www.maybole.org/history/Books/carrickscapital/adamsale.htm)

Cognitive behavioral therapy — What is it?

From the FMS Global News Desk of Jeanne Hambleton

Courtesy of MayoClinic.com

By Gabrielle J. Melin, M.D. -March 19, 2009

Have you ever heard of cognitive behavioral therapy or CBT?

If you haven not, this blog will help you to understand how your thinking can affect your mood. The thoughts in your head can affect the way you feel, which can affect your behaviors.

For example, say you are talking with a group of other people. Your mood is good and you have been experiencing a positive day overall. The subject turns to a complaining session regarding work. Others chime in about how awful their job is, how they are overworked, etc.

Soon your mood sours and you are angry and upset, too. You add your two cents about how horrible your job is. When the conversation is over, you are starting to dwell on other negative aspects of your life. You return to your work area with a scowl on your face and another co-worker asks you what is wrong.

The same thing that happened in this situation can happen in your head when you are alone. You may start focusing on your depression and have a thought such as, “I got up late this morning, so now my whole day is ruined.”

This thought can be the spark that gets the fire burning. Fuel is added by thinking, “I can’t even get up on time, what use am I to myself or others?” The negative thoughts feed on themselves. You continue to talk negatively to yourself and, ultimately, you feel more depressed.

The thoughts can also be inaccurate. Inaccurate thoughts are also called “cognitive distortions.” These negative and inaccurate thoughts can be so ingrained that they become “core beliefs” that you live by. An example is, “I have never been successful at anything, so why even try?”

Cognitive distortions can worsen depression. Working with a trained cognitive behavioral therapist is the best way to learn CBT and to apply it effectively to your life. Depression and anxiety can be effectively treated with CBT. Cognitive behavioral therapy alone may not be enough, depending on the severity of your depression. Medication may be recommended along with CBT. Cognitive behavioral therapy is just one type of talk therapy. There are numerous other effective types. Talk with your health care provider to find the best type for you.

Definition
By Mayo Clinic staff

Cognitive behavioral therapy is a type of psychotherapy based on the idea that your own distorted thoughts and beliefs lead to your negative moods and unhealthy behavior. Cognitive behavioral therapy says that other people, situations and events are not responsible for your mood and behavior — you are.

According to the theory behind cognitive behavioral therapy, you have automatic but inaccurate thoughts or beliefs in certain situations. These inaccurate thoughts lead to unhealthy moods and behavior, such as anxiety and overeating. Cognitive behavioral therapy helps you become aware of these inaccurate thoughts and beliefs. You learn to view situations more realistically. This allows you to behave and react in a healthier way — even if the situation itself has not changed.

Cognitive behavioral therapy is a common type of psychotherapy. It combines features of both cognitive therapy and behavior therapy. Cognitive behavioral therapy is helpful for numerous mental illnesses and stressful life situations.

Dr. Gabrielle Melin, board certified in general psychiatry and psychosomatic medicine, is looking for ways to empower patients and families dealing with chronic mental illness. She encourages patients to commit to working together with their physicians and health care teams. Dr. Melin completed medical school at the University of Minnesota. She completed both her psychiatry residency and consultation-liaison

© 1998-2009 Mayo Foundation for Medical Education and Research (MFMER). All rights reserved

(http://www.mayoclinic.com/health/cognitive-behavioral-therapy/MY00593)

Defend Yourself with a Good Night’s Sleep

From the FMS News Desk of Jeanne Hambleton

Courtesy FibromyalgiaNetwork.com

Persistent pain and disturbed sleep create a tremendous stress on the body that could potentially drag down a person’s immune system. Given that people with fibromyalgia battle sleep disruption, pain and a number of other stressful symptoms, you may be wondering what impact this is having on your immune system. In fact, this was a question asked by Ines Kaufmann, M.D., and co-workers in Munich, Germany.1

Comparing 22 fibromyalgia patients with 22 age- and gender-matched healthy control subjects, Kaufmann found a significant reduction in two immune system markers. The markers in question, CD62L and CD11b/CD18, are called adhesion molecules because they stick to the surface of the white blood cells that circulate as part of the immune system.

These adhesion molecules work as communication “flags” in the immune system to get white blood cells to travel to places in the body where they need them, such as tissue injury sites. They also are involved in recognizing and destroying infectious organisms, as well as removing toxic substances and debris from the body.

A reduced number of adhesion molecules on the surface of your white blood cells would likely lead to a compromised immune system, one that lags in its ability to get rid of infections and clear up inflammation in the tissues. As a consequence, you may have a more difficult time getting over colds or flu-bugs that commonly occur during the winter months. So if you find yourself trapped with a head-cold, flu, or other infection that lingers on and on, try increasing your sleep time to help power up your immune system.

Besides lowering your ability to fend off infections, a decline in adhesion molecules on your white blood cells may also compound your painful symptoms. These molecules also play a role in triggering your white blood cells to release powerful opioid-like pain relievers in the muscles and other tissues where local injury may easily occur.

While the reduction in adhesion molecules may explain why you have trouble getting rid of infections and why the slightest injury produces more pain than it should for you, these defects in immune function cannot use these immunological findings to identify people specifically with fibromyalgia.

Kaufmann’s team has reported similar findings in people with complex regional pain syndrome.2 This means that additional studies are needed to determine the relationship between the immune system changes and the development and persistence of painful conditions. For now, your best defense is a good night’s sleep, and anything else you can do to minimize the stress of your chronic illness.

(http://www.fmnetnews.com/basics-news.php#goodsleep)

Sleep Deprivation Linked to Prediabetes
Study Shows Increased Risk for People Who Get Less Than 6 Hours of Sleep a Night

Courtesy of WebMD.com

By Caroline Wilbert – WebMD Health News

March 12, 2009 – Here is one more reason to get a good night’s sleep.

People who sleep less than six hours per night are more likely to develop impaired fasting glucose, or prediabetes, a study shows.

The research was presented this week at the American Heart Association’s Annual Conference on Cardiovascular Disease Epidemiology and Prevention.

The study examined the health records of nearly 1,500 participants in the Western New York Health Study. Researchers identified 91 participants who had fasting blood glucose levels of less than 100 milligrams per deciliter (mg/dL) during baseline exams between 1996 and 2001; the participants had higher blood fasting glucose levels — between 100 mg/dL and 125 mg/dL — at follow-up exams in 2003-2004.

Those 91 participants were compared with 273 people who had blood glucose levels of less than 100 mg/dL both at baseline and follow-up. Researchers matched the groups according to gender, race/ethnicity, and year of study enrollment.

A normal fasting blood glucose level is less than 100 mg/dL. A fasting blood glucose result of 100mg/dL to 125 mg/dL is considered impaired fasting glucose. Having impaired fasting glucose is commonly referred to as prediabetes because many people with prediabetes go on to develop type 2 diabetes.

Participants reported how much they slept during the work week. Participants fell into three categories: short sleepers (less than six hours), mid-sleepers (six to eight hours), and long sleepers (more than eight hours).

During the six-year study period, participants who slept on average less than six hours a night during the work week were 4.56 times more likely than those getting six to eight hours of sleep to convert from normal blood sugar levels to impaired fasting glucose, researchers said. These findings took into account other factors such as age, obesity, and family history of diabetes.

No association was found in people who slept more than eight hours compared to those who slept six to eight hours.

“This study supports growing evidence of the association of inadequate sleep with adverse health issues,” study researcher Lisa Rafalson, PhD, a National Research Service Award fellow and research assistant professor at the University at Buffalo in New York, says in a news release.

(http://diabetes.webmd.com/news/20090312/sleep-deprivation-linked-to-prediabetes)

Nuclear Medicine: New World of Diagnosing and Treating Illness

From the FMS Global News Desk of Jeanne Hambleton

Courtesy of the Society of Nuclear Medicine – Advancing Molecular Imaging and Therapy
(https://interactive.snm.org/)

IMAGES THE BODY’S BIOLOGICAL PROCESSES

Nuclear medicine is a medical specialty that uses very small amounts of radioactive materials (radiopharmaceuticals) to diagnose, guide management and treat disease. Most nuclear medicine procedures are molecular imaging procedures that use radioactive substances. Molecular imaging procedures are highly effective, safe and painless diagnostic imaging and treatment tools that present physicians with a detailed view of what is going on inside an individual’s body at the cellular level.

Molecular imaging/nuclear medicine specialists can safely, effectively and painlessly determine if certain organs, such as the heart, brain, kidneys, liver, thyroid and lungs, are working properly. A molecular imaging/nuclear medicine procedure commonly used in diagnosing and guiding treatment of cancer patients is PET/CT scanning (see also “PET/CT Scanning: Get the Facts” – see below).

When very small amounts of radioactive materials are introduced into the body by injection, swallowing or inhalation, specific body organs can be targeted. These trace radiopharmaceuticals are detected by special cameras that work with computers to provide pictures of an area of the body, offering information about an organ’s physiology or function. The presence of disease is determined based on biological or molecular changes, rather than changes in anatomy. Radiopharmaceuticals go directly to the organ being targeted and are also used as treatment for hyperthyroidism, certain types of cancer such as thyroid and lymphoma, blood imbalances and pain relief for certain types of bone cancer.

Improves Patient Care

Today, molecular imaging and nuclear medicine offer procedures that are essential in many medical specialties, from pediatrics to cardiology to neurology to oncology. Molecular imaging and nuclear medicine procedures are an invaluable way to gather medical information that would otherwise be unavailable, require surgery or necessitate more expensive diagnostic tests.

These commonly performed biological imaging procedures are an integral part of patient care, identifying abnormalities very early in the progression of a disease-often before medical problems are apparent with other diagnostic tests. Early detection allows a disease to be treated when there may be a more successful prognosis.

Helps in Diagnosis and Treatment

In 2007, an estimated 16 million patients received nuclear medicine procedures in over 7,300 hospital and non-hospital sites in the United States, or approximately 68,000 patients daily (http://www.imvinfo.com). Nearly all hospitals-in addition to many clinics and private doctors’ offices-perform nuclear medicine tests and scans. Safe, effective, painless and commonly performed procedures include positron emission tomography (PET) scans to diagnose and monitor treatment in cancer, cardiac stress tests to analyze heart function, bone scans for orthopedic injuries and lung scans for blood clots.

More than 100 different nuclear medicine imaging procedures are available, and every major organ system can be imaged. Nuclear medicine procedures are used in the diagnosis and evaluation of treatment of:

Neurological diseases
Alzheimer’s disease and dementias
Seizure disorders
Coronary artery disease
Many types of cancer
Endocrine diseases
Thyroid
Parathyroid
Adrenal
Gastrointestinal diseases
Stomach
Liver and gallbladder
Genitourinary diseases
Kidneys
Bladder
Testicles
Pulmonary diseases
Bone diseases
Trauma
Infections

SNM and Nuclear Medicine

SNM is an international scientific and medical organization dedicated to raising public awareness about what molecular imaging is and how it can help provide patients with the best health care possible. SNM members specialize in molecular imaging, a vital element of today’s medical practice that adds an additional dimension to diagnosis, changing the way common and devastating diseases are understood and treated.

SNM’s more than 17,000 members set the standard for molecular imaging and nuclear medicine practice by creating guidelines, sharing information through journals and meetings and leading advocacy on key issues that affect molecular imaging and therapy research and practice. For more information, visit http://www.snm.org.

WHAT IS NUCLEAR MEDICINE?

Nuclear medicine specialists use safe, painless, and cost-effective techniques to image the body and treat disease. Nuclear medicine imaging is unique, because it provides doctors with information about both structure and function. It is a way to gather medical information that would otherwise be unavailable, require surgery, or necessitate more expensive diagnostic tests. Nuclear medicine imaging procedures often identify abnormalities very early in the progress of a disease – long before many medical problems are apparent with other diagnostic tests.

Nuclear medicine uses very small amounts of radioactive materials (radiopharmaceuticals) to diagnose and treat disease. In imaging, the radiopharmaceuticals are detected by special types of cameras that work with computers to provide very precise pictures about the area of the body being imaged. In treatment, the radiopharmaceuticals go directly to the organ being treated. The amount of radiation in a typical nuclear imaging procedure is comparable with that received during a diagnostic x-ray, and the amount received in a typical treatment procedure is kept within safe limits.

Today, nuclear medicine offers procedures that are essential in many medical specialties, from pediatrics to cardiology to psychiatry. New and innovative nuclear medicine treatments that target and pinpoint molecular levels within the body are revolutionizing our understanding of and approach to a range of diseases and conditions.

Would you like to know more about Nuclear Medicine? The SNM has two versions of our What Is Nuclear Medicine brochure available for download and bulk purchase. One is for General Educational Purposes and the second brochure is geared for Patients.

To download the Patients Brochure log on to
http://interactive.snm.org/docs/whatisnucmed2.pdf

© 2009 SNM. All rights reserved
(http://interactive.snm.org/index.cfm?PageID=3106&RPID=#URL.PageID%23)

WHAT IS PET?

Positron Emission Tomography (PET) is a major diagnostic imaging modality used predominantly in determining the presence and severity of cancers, neurological conditions, and cardiovascular disease. It is currently the most effective way to check for cancer recurrences, and it offers significant advantages over other forms of imaging such as CT or MRI scans in detecting disease in many patients. In 2005, an estimated 1,129,900 clinical PET patient studies were performed at 1,725 sites around the country. If you’re interested in learning how a PET scan can benefit you and need additional information, talk with your local health care provider or referring physician. At the end of this page are links to other sites with PET information too.

PET images demonstrate the chemistry of organs and other tissues such as tumors. A radiopharmaceutical, such as FDG (fluorodeoxyglucose), which includes both sugar (glucose) and a radionuclide (a radioactive element) that gives off signals, is injected into the patient, and its emissions are measured by a PET scanner.

A PET scanner consists of an array of detectors that surround the patient. Using the gamma ray signals given off by the injected radionuclide, PET measures the amount of metabolic activity at a site in the body and a computer reassembles the signals into images. Cancer cells have higher metabolic rates than normal cells, so they show up as denser areas on a PET scan. PET is useful in diagnosing certain cardiovascular and neurological diseases because it highlights areas with increased, diminished or no metabolic activity, thereby pinpointing problems.

Cancer and PET

PET is considered particularly effective in identifying whether cancer is present or not, if it has spread, if it is responding to treatment, and if a person is cancer free after treatment. Cancers for which PET is considered particularly effective include lung, head and neck, colorectal, esophageal, lymphoma, melanoma, breast, thyroid, cervical, pancreatic, and brain as well as other less-frequently occurring cancers.

Early Detection:

Because PET images biochemical activity, it can accurately characterize a tumor as benign or malignant, thereby avoiding surgical biopsy when the PET scan is negative. Conversely, because a PET scan images the entire body, confirmation of distant metastasis can alter treatment plans in certain cases from surgical intervention to chemotherapy.

Staging of Cancer: PET is extremely sensitive in determining the full extent of disease, especially in lymphoma, malignant melanoma, breast, lung, colon and cervical cancers. Confirmation of metastatic disease allows the physician and patient to more accurately decide how to proceed with the patient’s management.

Checking for recurrences:

PET is currently considered to be the most accurate diagnostic procedure to differentiate tumor recurrences from radiation necrosis or post-surgical changes. Such an approach allows for the development of a more rational treatment plan for the patient.

Assessing the Effectiveness of Chemotherapy:

The level of tumor metabolism is compared on PET scans taken before and after a chemotherapy cycle. A successful response seen on a PET scan frequently precedes alterations in anatomy and would therefore be an earlier indicator of tumor response than that seen with other diagnostic modalities.

PET and CT or MRI

Because PET measures metabolism, as opposed to MRI or CT, which “see” structure, it can be superior to these modalities, particularly in separating tumor from benign lesions, and in differentiating malignant from non-malignant masses such as scar tissue formed from treatments like radiation therapy. PET is often used in conjunction with an MRI or CT scan through “fusion” to give a full three-dimensional view of an organ and the location of cancer within that organ. The newest PET scanners are a combination of PET and CT devices that provide the important metabolic information from PET superimposed on the high-quality anatomic information from CT.

Neurological Disease

PET’s ability to measure metabolism also has significant implications in diagnosing Alzheimer’s disease, Parkinson’s disease, epilepsy and other neurological conditions, because it can vividly illustrate areas where brain activity differs from the norm.

Alzheimer’s Diagnosis: Until recently, autopsy has been considered the only definitive test for Alzheimer’s disease (AD). Recent studies indicate that PET can supply important diagnostic information and confirm an Alzheimer’s diagnosis. When comparing a normal brain versus an AD-affected brain on a PET scan, a distinctive image appears in the area of the AD-affected brain. This pattern is seen very early in the AD course. Conventionally, the confirmation of AD is a long process of elimination that averages between two and three years of diagnostic and cognitive testing. Early diagnosis can provide the patient access to therapies, which are more effective earlier in the disease.

PET also is useful in differentiating Alzheimer’s disease from other forms of dementia disorders, such as vascular dementia, Parkinson’s disease, Huntington’s disease, etc.

Epilepsy:

PET is one of the most accurate methods available to localize areas of the brain causing epileptic seizures and to determine if surgery is a treatment option.

Cardiovascular Disease

By measuring both blood flow (perfusion) and metabolic rate within the heart, physicians using PET scans can pinpoint areas of decreased blood flow, such as those with blockages, and differentiate living muscle from damaged muscle, which has inadequate blood flow (myocardial viability). This information is particularly important in patients who have had previous myocardial infarction (heart attack) and who are being considered for a procedure such as angioplasty or coronary artery bypass surgery.

Cost & Reimbursement:

PET scan charges range from $850–$4,000, depending on the type of scan. American Insurance companies will cover the cost of many PET scans. Medicare reimburses for almost all cancers. Some indications have already been determined to be reimbursable, others are reimbursed as long as they are part of a qualified clinical trial or a clinical study to determine the effectiveness of PET in imaging specific cancers. Medicare is constantly updating reimbursements, so visit the SNM Web site to find the latest information.

History of PET

In the 1970s PET scanning was formally introduced to the medical community. At that time it was seen as an exciting new research modality that opened doors through which medical researchers could watch, study, and understand the biology of human disease.

In 1976, the radiopharmaceutical fluorine-18-2-fluoro-2-deoxyglucose (FDG), a marker of sugar metabolism with a half-life of 110 minutes, enabled tracer doses to be administered safely to the patient with low radiation exposure. The development of radiopharmaceuticals like FDG made it easier to study living beings, and set the groundwork for more in-depth research into using PET to diagnose and evaluate the effect of treatment on human disease.

To perform PET studies in the late 1970s, a large staff was needed: physicists to run the cyclotron that produces the fluorine-18 and to oversee the scanner, chemists to make the tracers such as FDG, and dedicated, specialist physicians.

During the 1980s the technology that underlies PET advanced greatly. Commercial PET scanners were developed with more precise resolution and images. As a result, many of the steps required for producing a PET scan became automated and could be performed by a trained technician and experienced physician, thereby reducing the cost and complexity of the procedure. Smaller, self-shielded cyclotrons were developed, making it possible to install cyclotrons at more locations.

Over the last several years, the major advance in this technology has been the combining of a CT scanner and a PET scanner in one device. The modern PET/CT scanner allows a study to be done in a shorter amount of time but still provides more diagnostic information.

PET Today

PET and PET/CT are widely available today. The technology is robust and provides high-quality images. Some of the earlier roadblocks to having or using a PET or PET/CT device—such as availability of particular radiopharmaceuticals—are no longer present.

Reviewed by R. Edward Coleman, MD

© 2009 SNM. All rights reserved.

Chronic Opioid Therapy Guidelines Offer Direction for Physicians

From the FMS Global News Desk of Jeanne Hambleton

Courtesy of Fibromyalgia Network – February 2009

While patients are rightfully concerned about not receiving adequate pain relief, physicians harbor fears about drug abuse, safety issues, and government oversight. New clinical guidelines for the use of chronic opioid therapy in chronic non-cancer pain patients, developed by consensus of the American Pain Society and the American Academy of Pain Medicine, may ease both patient and physician concerns.

The guidelines, published in the February issue of the Journal of Pain, offer a roadmap for physicians on how to safely prescribe opioids to patients with moderate to severe pain.* The authors specifically state that their report applies to patients with “chronic non-cancer pain conditions, including common conditions such as back pain, osteoarthritis, fibromyalgia, and headache.”

Throughout the guidelines, physicians are urged to evaluate their patients’ pain and function on a regular basis. And, if doctors are worried that a patient is abusing or misusing the prescribed opioid, they may need to reduce the time between scheduled office visits. In addition, physicians are encouraged to look at all of the available options for treating patients’ chronic pain, including the use of opioids, and it is emphasized that this class of medications will seldom provide sufficient pain control. This means that patients placed on opioids will likely need to be prescribed medications from other drug classes as well as non-drug therapies. And, physicians who do not have the skill-set to prescribe opioids need to coordinate their patients’ care with another doctor who is experienced in providing this therapy.

The American Pain Society emphasized the following three points to all its members this month:

The guidelines are comprehensive and evidenced-based to assist physicians in managing chronic opioid therapy, according to the American Pain Society President Charles Inturrisi, Ph.D

“Regular monitoring of chronic opioid therapy patients is warranted because the therapeutic benefits of these medications are not static and can be affected by changes in the underlying pain condition, coexisting disease, or in psychological or social circumstances,” said Gilbert J. Fanciullo, M.D., director of the division of pain and palliative care at Dartmouth Hitchcock Medical Center.

Cochair Perry Fine, M.D., professor of anesthesiology at the University of Utah Medical Center, added that doctors do not have to solely rely upon patient self reports. Pill counts, urine drug screening, family member or caregiver interviews, and prescription monitoring data may all be used to check for possible abuse or other opioid-related problems.

The message is clear that under most circumstances, there are reasonable ways for physicians to prescribe chronic opioid therapy for their patients in pain while emphasizing safety issues and minimizing side effects or the potential for drug misuse. The guidelines offer physicians 25 recommendations with detailed explanations on how to follow them—all to help doctors prescribe opioids to their chronic pain patients in a responsible fashion. In addition to the key points already made, here are other highlights from the published guidelines:

Clinicians may consider a trial of chronic opioid therapy (COT) for moderate to severe pain that is having an adverse impact on a patient’s function or quality of life as long as the therapeutic benefits outweigh the risks (abuse, misuse and addiction). Three different patient screening tools (questionnaires that are easy to administer) are included with the guidelines to help doctors assess potential risks associated with COT for a given patient (the SOAPP, the ORT, and the DIRE).

Before initiating a trial of COT, physicians should provide their patients with informed consent, which alerts patients to all of the potential risks associated with taking opioids. After informed consent, doctors should discuss with their patients a COT management plan that outlines the goals of therapy, expectations, monitoring requirements, etc. A sample consent form and management plan are included in the guideline.

Initial treatment with an opioid should be regarded as a therapeutic trial to determine if COT is effective. If the first opioid does not work or produces adverse side effects, other types of opioids may be tried, but patients need to keep in mind that opioids are prescribed on a trial basis.

Physicians should anticipate, identify, and track common opioid-associated side effects. Constipation is the most frequent problem, and unfortunately it does not go away or get better with continued use of the medication. With this in mind, doctors should recommend stool softeners or increased fiber intake when issuing patients an opioid prescription. Nausea or vomiting may occur but tends to diminish over a few days. If it lasts longer, doctors can prescribe a medication to treat this side effect. Sedation and clouded thinking usually goes away with continued opioid use, while reduction in sex hormones may appear down the road with COT. If a patient begins to experience a decrease in libido, sex hormones can be checked and supplemented if necessary. Other side effects may also occur, so patients and physicians need to be on the lookout for them.

Chronic pain is often a complex condition and physicians who prescribe COT should routinely promote other therapies, such as psychotherapy (pain can be awful to cope with), physical and occupational therapies for restoring function, and other non-drug approaches in addition to prescribing other non-opioid medications. The purpose of this recommendation is to treat the whole person and improve the odds that a patient with chronic pain will achieve a more fulfilling life.

Doctors need to counsel patients prior to starting COT and continue until a stable dose is reached or if the dose is later increased as the patients’ cognitive skills may be impaired for a short period of time. If clouded thought processes do occur, driving should temporarily be avoided … so patients might want to start an opioid on a weekend when they do not have to drive. After a stable dose is reached, there is no evidence to suggest that patients on COT should be restricted from driving or engaging in most work activities.

The opioid guidelines give your doctor the “how to” advice for prescribing opioids, including sample copies of patient screening questionnaires, a consent form, management plan, and full details on how to responsibly prescribe opioids. However, they also assume that the prescribing physician is already knowledgeable about issues concerning this class of medications (i.e., the guidelines cannot possibly convert a novice into an expert on COT). Neither the patient nor physician should feel awkward about the consent and management forms, or random urine tests. Doctors who follow these guidelines should be better equipped to implement opioid therapies for their chronic pain patients (such as fibromyalgia) in a safe manner.

* Chou R, Fanciullo GJ, Fine PG, et al. J Pain 10(2):113-130, 2009.

Calling the Kettle Black
… editorial comment

By Kristin Thorson, Editor, Fibromyalgia Network

Posted: February 27, 2009

If your newspaper ran the February 8th Associated Press article “Drugmakers’ push boosts ‘murky’ ailment,” implying that the drug industry has fabricated fibromyalgia in an effort to churn a profit, you have every right to be furious!1 Controversy sells, and that was what the reporter, Matthew Perrone banked on. Perrone sought out Fred Wolfe, M.D., of Wichita, KS, because he knew from the January 14, 2008 front-page article in the New York Times that Wolfe had a track record for trashing patients with fibromyalgia and big, bad pharma as well. It is ironic, however, that Wolfe would make derogatory statements about the drug industry when he is heavily funded by six drug companies himself.

Wolfe is the director (and paid employee) of the National Data Bank for Rheumatic Diseases, a nonprofit registered as The Arthritis Research Center Foundation, Inc. Its mission is “conducting ongoing research to improve conditions for people with arthritis, fibromyalgia, lupus and other conditions.” He openly declares in his research papers, in which he is testing the effectiveness and safety of drugs for rheumatoid arthritis, that he is funded by Centocor, Aventis, Pfizer, Bristol-Myers Squibb, Amgen, and Abbott. So perhaps Wolfe’s dislike is not so much for the drug industry as it seems for fibromyalgia.

Prompted by mixed reports on increased cancer rates in people with rheumatoid arthritis (RA), Wolfe conducted an observational study on the incidence of cancer in RA patients who took the tumor necrosis factor (TNF) blocking agents Enbrel (etanercept) or Remicade (infliximab).2 His findings were derived from information in the National Data Bank (NDB) and per the NDB’s agreement with Centocor, the maker of Remicade, the drug company was allowed to review Wolfe’s manuscript prior to publication. But Wolfe does not just cater to Centocor. His NDB organization has similar contractual agreements with Bristol-Myers Squibb and Sanofi-Aventis.

Wolfe’s study contradicted earlier reports of increased cancer risks for RA patients taking Enbrel or Remicade. It also confirmed that TNF blocking drugs are linked to skin cancers, including potentially deadly melanomas. Instead of using his findings to alert the medical community that these drugs may pose a health hazard, Wolfe went on record with WebMD as stating: “The drugs, at this moment, do not seem to add any risk except for skin cancer and melanoma. This is a small overall risk and I do not think people should be concerned.” He also added that the risks did not outweigh the benefit for patients who truly need the new drugs.3

While there is no argument that people with RA deserve effective therapies, do you not think it is odd that Wolfe is the one pushing drugs on RA patients while in the recent AP article he bashes the drug industry for fabricating fibromyalgia to boost their sales? Yet he is quoted in the AP article as saying, “I think the purpose of most pharmaceutical company efforts is to do a little disease-mongering and to have people use their drugs.” Further in the article he says, “The underlying purpose here is really marketing, and they do that by sponsoring symposia and hiring physicians to give lectures and prepare materials.” Wolfe’s negative sentiments about fibromyalgia appear clear in a February 2009 report in which he writes, “Recently, regulatory authorities have approved treatments for fibromyalgia, offering some de facto support, although no proof, for fibromyalgia as a distinct disorder.”4 However, there was a time when RA had no “proof,” but that does not mean that the patients who suffered with it years ago did not have a real disease.

It is true that Wolfe was the lead author for the 1990 American College of Rheumatology criteria for fibromyalgia, but that was 18 years ago and much has changed.5 In 1990, the number of rheumatologists who were skeptical about the realness of fibromyalgia far outnumbered the believers. I should know, because I hosted an information booth on fibromyalgia at the annual rheumatology meetings throughout the 1990s, and in the early years I can attest to the ugly controversies surrounding this disease.

In 1994, Wolfe orchestrated a consensus conference (paid by the insurance industry) whose primary goal was to trivialize fibromyalgia and restrict patient care.6 Why he wanted to turn his back on fibromyalgia is still unknown, but his efforts failed. During the past eight years, the rheumatologists have rallied to increase the legitimacy of fibromyalgia by developing guidelines for improving the quality of research and for testing therapies to treat this patient population. Today, Wolfe and many of his colleagues do not see eye to eye when it comes to issues concerning fibromyalgia. At age 74, he appears to get his jollies by trash-talking fibromyalgia to headline-mongering reporters.

For all of you who were subjected to the AP story, I hope my comments help you understand the nonsensical nature of the article and that you can ignore any future reports that happen to quote Wolfe. I also want to make three additional points about the AP article:

Although Wolfe’s own nonprofit takes money from the drug companies, this does not mean that all nonprofits and organizations that help patients must do the same to stay afloat. Fibromyalgia Network and its sister organization, the American Fibromyalgia Syndrome Association (AFSA), have never received money from the pharmaceutical industry or other companies that could bias the way these two organizations operate.

Daniel Clauw, M.D., of the University of Michigan, did receive a small grant award from the National Fibromyalgia Research Association (NFRA) in Salem, OR, but the NFRA should not be confused with the National Fibromyalgia Association (NFA). NFRA does not receive money from the drugmakers.

The article implies that Clauw’s brain imaging research, which has documented many brain processing abnormalities over the past ten years, was tainted by drug money. That simply is not true because the funding for these studies came from government grants based on the merits of his proposals. “Most of us conducting research in the field of fibromyalgia were here ten years before the drug industry even took notice of this disease,” Clauw points out.

Perrone M. Associated Press © hosted by Google, Feb 8, 2009; (AP article).
Wolfe F, Michaud K. Arthritis Rheum 56(9):2886-2895, 2007.
DeNoon DJ. WebMD Health News Aug. 29, 2007; (WebMD article).
Wolfe F, Michaud K. J Rheumatol First Release Feb. 15, 2009; doi:10.3899/jrheum.080897.
Wolfe F, et al. Arthritis Rheum 33(2):160-72, 1990.
Wolfe F. J Rheumatol 23(3):534-9, 1996.

Kaufmann I, et al. Rheumatol Int [epub ahead of print] December 4, 2008.
Kaufmann I, et al. Clin Immunol 125:103-111, 2007.

(http://www.fmnetnews.com/basics-news.php#opioid)
All information on this site is copyrighted by
Fibromyalgia Network, P.O. Box 31750, Tucson, AZ 85751 (800) 853-2929.
This site is provided for informational purposes only. To remain unbiased, we do not accept endorsements, advertisements, or pharmaceutical industry grants. Patients should always consult their physician for medical advice and treatment.

Prescriptions for opioids jump following co-proxamol ban

From the FMS Global News Desk of Jeanne Hambleton

Courtesy PulseToday.co.uk.

By Lilian Anekwe – 17 March 2009

Opioid prescriptions have jumped during the withdrawal of co-proxamol, with GPs apparently struggling to find adequate means of pain control for some patients.

Prescriptions for morphine have risen by more than 40% and those for tramadol by two-thirds since co-proxamol use was first reduced in anticipation of the drug’s withdrawal.

An analysis for the Medicines and Healthcare Products Regulatory Agency, obtained by Pulse under the Freedom of Information Act, reveals prescriptions for co-proxamol plummeted from 835 million in 2004 – the year prior to legislation on its withdrawal – to 121 million in 2007.

But over the same period, opiod prescriptions overall rose by 40%. Prescriptions for morphine rose by 44%, from 757,000 in 2004 to 1,093,000 in 2007, and tramadol prescriptions increased by 61%, from 3,130,000 to 5,036,000.

Co-proxamol was removed from the British National Formulary on 1 January last year, but the NHS Information Centre analysis shows GPs continued to prescribe co-proxamol to approximately 150,000 patients in England on a named-patient basis.

The MHRA downplayed the impact of the withdrawal and said the ageing population was to blame for increasing demand for analgesics. But the agency’s pharmacovigilance group concluded: ‘Opioids, especially tramadol, have followed an increasing trend and some patients may have been switched to this class of analgesic.’

Dr Adam Bajkowski, a GP in Wigan and president of the primary care rheumatology society, said the analysis suggested the MHRA’s argument that full-strength paracetamol was as effective as co-proxamol was flawed: ‘If GPs are having to switch patients to a stronger opioid, then it suggests the MHRA’s reasoning wasn’t really true.’

READERS’ COMMENTS
MHRA | 20 Mar 09
Your report on analgesic prescribing following the withdrawal of co-proxamol presented a distorted picture of the relevant information.

The withdrawal of co-proxamol in the UK has saved approximately 300 lives per year and there is no evidence that the death rate due to other analgesics is increasing. Prior to the withdrawal of co-proxamol, the MHRA issued guidance on pain management from the former Committee on Safety of Medicines (now known as the Commission on Human Medicines) to help doctors find the best options for individual patients, setting out a graduated range of possible therapeutic interventions.

Opioid prescriptions have not “jumped” during the three-year phased withdrawal of co-proxamol, as suggested in the article, and we do not have evidence that patients are being switched from co-proxamol to other opioids. Even though opioid prescriptions have increased steadily over the last 5 years they still make up a very small proportion of the overall prescriptions for painkillers.

There were increases in the numbers of prescriptions of paracetamol and of co-codamol around the time of the co-proxamol withdrawal. These increases were sufficiently large to suggest that patients may have been switched from co-proxamol. A research project to look at the analgesics that patients have been switched to will be started shortly.

Pulse, CMP Medica. All rights reserved.
(http://www.pulsetoday.co.uk/story.asp?sectioncode=23&storycode=4122142&c=2)

EDITOR’S NOTE As someone who suffers with pain 24/7 from fibromyalgia, I managed very nicely with co-proxamol and some pain killing gel for the aches and pains until the withdrawal on December 31 2007. We were promised that those who really could not manage without it would be prescribed on a named patient basis. The Government and the Ministers failed to mention the under handed action of making co-proxamol an ‘illegal’ drug.

After I fought my own personal battle to reverse the withdrawal and tried to become a named patient, all unsuccessfully, I tried the alternatives which aggravated the old IBS. So I am left with nothing but pain. My GP will not prescribe co-proxamol for fear of litigation and I do not want to fill my body with drugs where the side effects for me are unbearable.

Why was co-proxamol not listed as a controlled drug. Those in need could then have received the pain relief they need so badly.

I imagine with the increase in these alternative medications mentioned in the article above, the cost of pain treatments has soared against what was a relatively cheap pain killer – £2.79 for 100 tablets – before the Government got involved. Is it any wonder the NHS is always short of funds and this is just a small example of failure to see the whole picture.

Why did GPs stop prescribing co-proxamol read this article from Pulse just after the withdrawal on 17 January 2008.

PCTs threaten GPs over co-proxamol

By Nigel Praities – 17 Jan 2008

PCTs are piling pressure on GPs to switch patients from co-proxamol to alternative medication, after the reimbursement price of the drug soared with loss of its licence.

In December 2007, co-proxamol was listed as Category M medicine with a reimbursement price of £2.79 for 100 tablets. From January 2008 it has been available as an unlicensed drug, but has been changed to Category C with a reimbursement price of £20.36 for 100 tablets – a sevenfold increase in price.

The price hike has galvanised trusts into action, with several already having contacted GPs to urge them to prescribe alternative analgesics, just weeks into the new year.

West Essex, Islington and West Hertfordshire PCTs are all planning, or have already, written to GPs about the price increase.

Norfolk PCT is planning a series of meetings and individual visits to reinforce the status and cost of co-proxamol to GPs. Other PCTs have indicated to Pulse that they are monitoring the situation in their area before taking action.

Dr Iain Gilchrist, a GP in Essex and treasurer of the Primary Care Rheumatology Society, who has taken all his patients on co-proxamol off the drug, said the price increase would put even more pressure on those GPs still prescribing it.

‘No doubt with GPs who still have patients on co-proxamol, the prescribing advisors will be wanting to have a little word in their ear. There is nothing like a price hike to concentrate the mind,’ Dr Gilchrist said.

Dr Gilchrist received an email in early January from a prescribing adviser at West Essex PCT, which said the price of co-proxamol had ‘rocketed’ and is a ‘very expensive option, as well as being unlicensed.’

PCTs are worried about the cost implications as many practices have struggled to find alternatives for many of their patients on the drug. A Pulse investigation in December revealed as many as 60,000 patients may still be on co-proxamol and 60% of practices reported that a hard core of their patients continued to take it.

The latest pressure from PCTs adds to the medico-legal headache surrounding co-proxamol. Patients can still be prescribed the drug on a named-patient basis, although GPs assume legal liability if they continue to prescribe the unlicensed drug.

TROUBLED WITHDRAWAL OF CO-PROXAMOL

Jan 2005 – MHRA announces withdrawal of co-proxamol
Oct 2006 – A Pulse survey reveals 70% of GPs demand the MHRA review its decision
Jan 2007 – MPs demand u-turn on withdrawal at special House of Commons debate
Oct 2007 – 60,000 patients remain on co-proxamol
Dec 2007 – Final withdrawal of co-proxamol
Jan 2008 – PCTs panic as price of co-proxamol soars

(http://www.pulsetoday.co.uk/story.asp?storycode=4116799)

On 21 September 2006

One GP asked, “Is it time for a rethink on the co-proxamol ban?”

Co-proxamol is so accessible because it is the most useful analgesic in general practice and so a lot has been prescribed.

The academics who recommended banning it have made a kneejerk reaction without listening to those of us facing the realities at the coalface of medicine. All the alternatives, including paracetemol itself, are more toxic than co- proxamol. Tablet for tablet, they all have more paracetemol than co-proxamol. Dextropropoxyphene is not toxic to the liver. Paracetemol, co- codamol and co-dydramol are all readily available, more toxic and more expensive than co-proxamol, tramadol and so on.

Prescriptions will increase. More bleeds, more deaths and more drug interactions will occur. There will be more prescriptions for laxatives, more bowel obstructions, more hospitalisations. Drug costs will go up substantially and more successful suicides will occur.

I plead – think again. What do other GPs think?

(http://www.pulsetoday.co.uk/story.asp?storycode=4010484)

EDITOR’S NOTE: Just this week a member of my own family haas been hospitalised for 36 hours. The hospital doctors blamed the medication (pain killers) prescribed for broken bones. He was lucky to be diagnosed quickly or the complication might have been fatal. Afraid to take more medication he is living with unbearable pain. If he had been taking co-proxamol I doubt this would have happened. I literally ‘lived’ on co-proxamol for almost five months when I broke my wrist and my pelvic bone in three places – without any side effects.

So what do you think? Are you ready to press your MP to ask questions in the House to have co-proxamol licensed as a controlled drug?

Many Chronic Patients Cannot Afford Care

From the FMS Global News Desk of Jeanne Hambleton

By Kristina Fiore, Staff Writer, MedPage Today
Published: March 20, 2009

WASHINGTON, March 20 — One patient in four with a chronic condition has postponed healthcare or filling a prescription in the past year because he cannot afford it, researchers here said.

Latinos (43%) and middle-age women (39%) are among those more likely to report delaying care, according to a survey by the National Council on Aging.

Although the poor are more likely to report delaying care, 22% of patients with household incomes above $50,000 have done so, according to the survey.

Those who have put postponed treatment are also more likely to be in frequent physical pain (45% versus 28% of those who have not delayed care), to be fatigued (49% versus 28%), and to be stressed (40% versus 17%).

The survey — conducted between Jan. 5 and Jan. 30, 2009 among 1,109 adults ages 44 and up with at least one chronic condition — is a snapshot of patients living with chronic conditions such as heart disease, arthritis, hypertension, and diabetes.

The survey included an oversample of those 65 and older (n=594 total), as well as an oversample of Latinos (n=142 total). The margin of sampling error for the total results is +2.9 percentage points.

Many report dissatisfaction with the care they receive. Some 44% wish their physician had more time to spend talking to them about their condition, and 45% said they never get referrals to important chronic care resources such as counselors and health educators.

Nearly a third report leaving their physician’s office confused about what they should do regarding their care, and many say their providers aren’t doing anything to improve their care.

About 57% said their physicians have not asked whether they have help at home to manage their problems, and 45% said they rarely or never receive referrals to support services such as classes, counselors, or health educators.

Many patients are living with several chronic diseases: 68% report having two or more conditions and 20% have four or more.

Those with one chronic condition are healthier, have higher incomes, and have more support at home; while those with multiple conditions tend to have low incomes and less support.

Half of those with chronic conditions are unhappy or depressed at least occasionally because of their health problems, and 32% report having to cut back on social activities. A little more than a quarter report having to miss work.

Almost 40% of patients said they do not have the money to begin improving their health, a percentage that is particularly high among Latinos (63%), African Americans (58%), the poor (65%) and those with four or more chronic conditions (59%).

However, 70% said learning how to exercise or eat better in ways that work with their limitations would help them cope, and 68% say getting advice from others with similar conditions would help as well.

Fifty-six percent of Americans 44 and older with chronic conditions are Internet users — and of these, 63% say they would be interested in going to Web sites sponsored by health organizations to get information and support.

Even 27% of those who rarely or never use the Internet say they would be interested in going to Web sites for information and support.

Nancy Whitelaw, senior vice president of the Center for Health Aging at the National Council on Aging, said the report highlights the need to reform the healthcare system in order to support patients with chronic conditions.

“We encourage physicians not to take on the responsibility themselves, but to build a mechanism to refer patients to community-based health education programs that are effective,” Whitelaw said.

She added that physicians can help connect patients to such programs via a community agency that deals with the aging.

EDITOR’S NOTE: If it is happening in the USA, it must be happening here in the UK. This must also apply to visits to the opticians and the dentist. We can no longer afford luxuries, so health must be the next concern to be hit by the credit crunch. The offending financiers have a lot to answer for….Now is the time to make all prescriptions free before the UK falls apart at the seams. There is an old saying which tells us that health and happiness are more important than wealth. Are you listening Mr.B? You have helped everyone else – you can at least do this for the people Mr.B.! Write to your MP and put some pressure on the Government! JH

The survey was funded by the Atlantic Philanthropies and the California HealthCare Foundation.

Primary source: National Council on Aging
Source reference: “Reforming healthcare: American speak out about chronic conditions and the pursuit of healthier lives” NCOA 2009.

(http://www.medpagetoday.com/PublicHealthPolicy/PublicHealth/13358?utm_source=mSpoke&utm_medium=email&utm_campaign=DailyHeadlines&utm_content=GroupB&userid=206539&impressionId=1237776625926)

Can a Magnetic Connection Cure Pain?

From the FMS News Desk of Jeanne Hambleton

Courtesy Healthnews.com – ALTERNATIVE MEDICINE

By: Lara Endreszl

As a kid, I had a bunch of little round magnets that were supposed to be glued onto the back of homemade refrigerator magnets. Instead I used to stack them up on the kitchen table and turn them around and around attracting and repelling the little discs for the sheer wonder of the power they held. Little did I know magnets have been widely used as an alternative method of treating pain from headaches and motion sickness to joint pain.

For centuries magnets have been used for various health purposes and were first used in stone form. Called lodestones, ancient Greeks used the magnetized stones as a way to cure certain ailments. To keep patients from bleeding, physicians used amber pills that were magnetized, as well as magnetic rings, to ease arthritis suffering. The Middle Ages found magnets being used against poison, gout, and the threat of baldness, as well as for pulling out objects containing iron (like arrowheads) and as an antiseptic for cleaning wounds.

Ancient healers thought that the blood contained magnetic energy and when it became low or displaced, the patient became ill. After the Civil War, magnets were put into clothing in order to reduce the need for doctors, which were hard to find. In the United States, magnets are still in use today, not so much in clothing to replenish deficiencies in the body, but for shoe insoles to stabilize painful foot symptoms, inside a mattress pad for general body well being, and inside discreet elastic bands to wear against pressure points (most common on the inside of your wrist) to ward off sickness from the sea, from altitude, or motion in genera—like a long car ride in the backseat.

Multiple conditions are said to be fought by manipulating the magnetic fields coursing through your body. Liver and kidney problems, back pain, and fibromyalgia are some of the major health concerns people look to magnets to solve.

Popular, yes, but healthy? No one can say for sure. Dr. Andrew Weil—renowned alternative medicine doctor and famous for being a specialist in giving practical health advice related to his field to public figures such as Oprah Winfrey—says the jury’s still out. Weil addresses their popularity and widespread use on multiple causes, but is not sure spending money on gimmicky magnets are worth your while in the long run, especially because there have been no previous studies confirming their positive results.

Weil says there are two main types of magnets, static and electromagnetic. Static magnets are like the ones I used to play with on my kitchen table which do not change their magnetic field. These are the types that are usually associated with small adhesive patches and the elastic bands for cabin pressure and motion sickness and inside shoes and key rings and other devices said to “balance” out the body. Some people have claimed that these types of magnetic fields are able to help temporarily relieve pain associated with chronic back symptoms and can even give you a boost of energy throughout daily wear, but concrete research has yet to back those theories up.

On the other hand, electromagnets are often used in hospitals in devices like MRI machines using magnetic fields with an active electrical current, using radiation to help doctors see inside the body and sometimes speed up the bone-healing process. As recently as March, a medical journal published a paper that touts researchers’ findings that electromagnetic technology was able to reduce depression in people who did not respond to other methods of treatment. With all of these methods, more research always has to be done.

The National Center for Complementary and Alternative Medicine (NCCAM) cites that science may find a way to propose the worth of magnets for the body and have conducted small trials using animals instead of humans. Possibilities are that magnets may be able to change nerve cell functions and block pain signals from getting to the brain, blood flow and oxygen transport can be increased thereby inducing body temperature to ailing areas of the body, and by balancing the rate of cell growth and death. With every type of medicine there are risk factors involved and a consultation from a doctor or natural healer would always be wise before starting any type of radical therapy.

Whatever type of medical theory you subscribe to, doctors and researchers alike warn to use your own judgment when applying magnetic fields to what ails you. Talk to your physician and rate the pros and cons. Whether or not this type of magnetic manipulation appeals to your common sense, I think we all have learned that magnets are not just for the refrigerator anymore.

(http://www.healthnews.com/natural-health/alternative-medicine/can-a-magnetic-connection-cure-your-pain-2265.html) Copyright 2009 HealthNews.com.

MD accused of falsifying findings in 21 important pain-drug studies

From the FMS Global News Desk of Jeanne Hambleton
Without prejudice
Courtesy of ProHealth.com
March 16, 2009

Apparently, the medical community was “universally hoodwinked” by the highly respected, influential, and much-published pain drug researcher, Dr. Scott Reuben, who has reportedly admitted making up “some or all” of the data in at least 21 important studies between 1996 and 2008. Now, researchers in the field say, they will be re-examining the literature and may need to repeat certain clinical trials.

These were studies supporting the safety and ‘benefits’ of such drugs as Pfizer Inc.’s Bextra, Celebrex, and the Fibromyalgia drug Lyrica; Merck’s Vioxx; and Wyeth’s antidepressant Effexor, which Reuben’s studies reported could also be used for pain.

While the others maintain their FDA-approved status, Bextra and Vioxx (both Cox-2 inhibitors) became infamous when they were pulled off the market after evidence mounted that they increased patient risk of stroke, heart attack, and death.

An anesthesiologist specializing in post-surgical pain relief at Baystate Medical Center in Springfield, Massachusetts, Dr. Reuben was put on leave of absence after the hospital’s internal review board reportedly ascertained in a routine review that they had not approved some of his research. Their subsequent investigation revealed the extent of his allegedly unsubstantiated publications.

Journals which have retracted at least 13 of Dr. Reuben’s published studies so far include Anesthesia and Analgesia, and Anesthesiology. They have emphasized that Dr. Reuben’s co-authors on the papers have not been accused of wrongdoing, according to Anesthesiology News, which broke the story on March 4.
(http://www.anesthesiologynews.com/index.asp?ses=ogst&section_id=3&show=dept&article_id=12634)

“The retracted studies are not expected to affect the drugs’ regulatory status because Dr. Reuben’s studies were not part of the packages that manufacturers submitted to the FDA or European authorities,” according to a New York Times report on the situation dated March 11.

Nevertheless, some hospitals, including University of Pittsburgh Medical Center, say they are reviewing their pain treatment protocols and conducting their own studies to verify the effectiveness of drugs that Dr. Reuben has reported on.

To review a listing of articles that Baystate allegedly “found were based on fabricated data,” compiled by Anesthesia and Analgesia, log on to http://www.aaeditor.org/HWP/Retraction.Notice.pdf

(http://www.prohealth.com/library/showarticle.cfm?libid=14403)

Is gabapentin (Neurontin) an effective fibromyalgia treatment?

From the FMS News Desk of Jeanne Hambleton

Courtesy of MayoClinic.com

Gabapentin (Neurontin), an anti-seizure medication, may be an effective fibromyalgia treatment.

In a 12-week study, published in April 2007, researchers looked at the potential treatment benefits of gabapentin in a group of 150 people with fibromyalgia. Participants who were treated with gabapentin reported less pain and fatigue and improved sleep compared with participants who received a placebo. The most common side effects of the medication are dizziness and drowsiness.

It is important to note that gabapentin has not been approved by the Food and Drug Administration (FDA) for the treatment of fibromyalgia. However, some doctors may prescribe it off-label for such use.

In June 2007, the FDA did approve pregabalin (Lyrica) — an anti-seizure medication that is structurally related to gabapentin — for fibromyalgia treatment. A study published in April 2005 suggested that pregabalin is more effective than is a placebo in reducing pain and fatigue and improving sleep in people with fibromyalgia. The most common side effects of pregabalin are dizziness and drowsiness.

If you have fibromyalgia and have questions about whether gabapentin or pregabalin may be an appropriate treatment for you, consult your doctor.

(http://www.mayoclinic.com/health/fibromyalgia-treatment/AN01650)