F.D.A. TO PLACE NEW LIMITS ON PRESCRIPTIONS OF NARCOTICS

From the News Desk of Jeanne Hambleton

By GARDINER HARRIS -Published: February 9, 2009

WASHINGTON — Many doctors may lose their ability to prescribe 24 popular narcotics as part of a new effort to reduce the deaths and injuries that result from these medicines’ inappropriate use, federal drug officials announced Monday.

A new control program will result in further restrictions on the prescribing, dispensing and distribution of extended-release opioids like OxyContin, fentanyl patches, methadone tablets and some morphine tablets.

These products are classified as Schedule II narcotics and already are restricted according to rules jointly administered by the Food and Drug Administration and the Drug Enforcement Agency. But the current restrictions have failed to “fully meet the goals we want to achieve,” said Dr. John K. Jenkins, director of the F.D.A.’s new drug center.

“What we’re talking about is putting in place a program to try to ensure that physicians prescribing these products are properly trained in their safe use, and that only those physicians are prescribing those products,” Dr. Jenkins said in a news conference on Monday. “This is going to be a massive program.”

Hundreds of patients die and thousands are injured every year in the United States because they were inappropriately prescribed drugs like OxyContin or Duragesic or they took the medicines when they should not have or in ways that made the drugs dangerous. The agency has issued increasingly urgent warnings about the risks, but the toll has only worsened in recent years.

The blame for this is shared among doctors who prescribe poorly, patients who pay little attention to instructions or get access to the medicines inappropriately, and companies that have marketed their products illegally.

The F.D.A. this year will hold meetings with manufacturers, patient and consumer advocates, and the public to ask for advice on how to carry out the new control program, officials announced. The first meeting will be on March 3, and no immediate changes in access to the drugs is planned.

The 24 medicines under review had 21 million prescriptions written for them in 2007, to 3.7 million patients, Dr. Jenkins said. They are extremely effective in reducing pain, which many medical studies suggest is widely undertreated in patients suffering serious illness. (A complete list of the drugs is at www.fda.gov/cder.)

But many doctors prescribe the drugs far too cavalierly, Dr. Jenkins said. The F.D.A. has received reports of patients’ being prescribed such medicines to treat something as simple as a sprained ankle, he said. In such patients, the medicines can be dangerous.

Part of the problem is marketing. Several reports, for instance, have suggested that Purdue Pharma, the maker of OxyContin, helped fuel widespread abuse of the drug by aggressively promoting it to general practitioners not skilled in either pain treatment or in recognizing drug abuse.

The company has denied such a connection, but a holding company connected with Purdue and three top Purdue executives pleaded guilty last year to criminal charges that the company had misled doctors and patients by claiming for five years that OxyContin was less prone to abuse because it was a long-acting narcotic.

Doctors are also to blame. A common reason for disciplinary actions at state medical boards is the use of narcotics in patients who show clear signs of addiction or for whom the drugs are obviously inappropriate.

The F.D.A. generally avoids interfering with the practice of medicine because doctor behavior is governed by state medical boards. Instead, the agency usually tries to provide doctors with the best and most current information, and then allows them to decide how to use it.

Most of the drugs withdrawn over the last 20 years, however, were taken off the market because doctors continued to use the medicines in ways that the F.D.A. warned against.

For decades, the agency’s armory in these battles held only a popgun and a cannon — the popgun being the issuance of widely ignored warnings; the cannon being its ability to force a medicine’s withdrawal. But a law passed in 2007 gave the agency a new, intermediate weapon — Risk Evaluation and Mitigation Strategies. Known as REMS, these programs allow the agency to place strong restrictions on the distribution of certain drugs.

 

Courtesy New York Times (Money & Policy – Health Alert) Copyright  & All Rights Reserved 

(http://www.nytimes.com/2009/02/10/health/policy/10fda.html?_r=1&emc=tnt&tntemail1=y)

 

 

Michael Grady and fibromyalgia awareness.

Michael Grady has recently become one of our featured artist’s on FMS Global News. We feature musicians that support fibromyalgia awareness and occasionally musicians that have overcome a disability to return to performing such as world class acoustic guitarist Billy McLaughlin and Tony Denardo of Detroits hard blues/rock band the Muggs.

“I am still feeling quite honored by how you’ve taken to my music, and especially Open Water, because It was such a strong image that I wrote that song from. Carolyn and I were at a John Gorka concert and he mentioned the frozen lakes in Minnesota, and BAM, this image from my childhood and early teens of frozen Lake Michigan hit me, and I knew it would be a song.

I grew up one quarter mile north of the Holland State Park “the mouth of Macatawa” And a good family friend actually did get swept off the pier one day, only to return in the spring. The whole song hit me in a split second, and I sat down to write it about a week later, after it had washed around in my brain for a bit.

Also, I want to thank you for making me the featured artist on your site.”

Watch Michael perform a solo version of his recent song, “Open Water” which he wrote about growing up on Lake Michigan.

This performance was part of the 2007 Summit County Songwriter’s Circle showcase.

More of Michaels music
http://www.myspace.com/michaelgradymusic

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Restless legs syndrome doubles risk of stroke and heart disease

Contact: Angela Babb
ababb@aan.com
651-695-2789
American Academy of Neurology

ST. PAUL, Minn. – People with restless legs syndrome (RLS) are twice as likely to have a stroke or heart disease compared to people without RLS, and the risk is greatest in those with the most frequent and severe symptoms, according to research published in the January 1, 2008, issue of Neurology®, the medical journal of the American Academy of Neurology.

The study, the largest of its kind enrolling both men and women, involved 3,433 people with an average age of 68 who were enrolled in the Sleep Heart Health Study. Participants were diagnosed with RLS by detailed questionnaire and asked if they had been diagnosed with a variety of systemic diseases including cardiovascular disease and cerebrovascular disease. Of the participants, nearly seven percent of women and three percent of men had RLS.

The study found people with RLS were more than twice as likely to have cardiovascular disease or cerebrovascular disease. The results remained the same after adjusting for age, sex, race, body mass index, diabetes, high blood pressure, high blood pressure medication, HDL/LDL cholesterol levels, and smoking.

“The association of RLS with heart disease and stroke was strongest in those people who had RLS symptoms at least 16 times per month,” said study author John W. Winkelman, MD, PhD, with Harvard Medical School in Boston. “There was also an increased risk among people who said their RLS symptoms were severe compared to those with less bothersome symptoms.”

Winkelman says although this study does not show that RLS causes cardiovascular and cerebrovascular disease, a number of potential mechanics for such a process exist. “In particular, most people with RLS have as many as 200 to 300 periodic leg movements per night of sleep and these leg movements are associated with substantial acute increases in both blood pressure and heart rate, which may, over the long term, produce cardiovascular or cerebrovascular disease.

Winkelman says there are limitations to the study, including that the diagnosis of RLS was self-reported by questionnaire rather than by clinical interview.

###
The study was supported by grants from the National Heart, Lung and Blood Institute.

The American Academy of Neurology, an association of more than 20,000 neurologists and neuroscience professionals, is dedicated to improving patient care through education and research. A neurologist is a doctor with specialized training in diagnosing, treating and managing disorders of the brain and nervous system such as stroke, Alzheimer’s disease, epilepsy, Parkinson disease, and multiple sclerosis.

For more information about the American Academy of Neurology, visit http://www.aan.com.

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Artist of the Day

GROWING SUPPORT FOR FIBROMITE AHEAD OF HER TIME

by Jeanne Hambleton © 2007
NFA Leader Against Pain-Advocate

You may remember the story about Linda Allen, a UK fibromite who in spite of being severely disabled with this invisible disability has been raising FMS awareness among medical students. Her gracious offer to help anyone willing to follow her example and spread the word has resulted in a flurry of emails, mostly from the USA and Canada.

While Linda and I are both willing to help, advise and encourage anyone from anywhere to pick up the gauntlet and run with it by talking to medical students, it is surprising that so few UK sufferers have written. It is here that we believe many GPs are still blinkered as far as diagnosing fibromyalgia is concerned.

For some long time those with this awful syndrome have been telling me that their doctor suggests it is all in their head. Trust me I am a fibromite – you are not imagining the aches, pains, chronic fatigue, sleeplessness, cognitive problems and many of the other nasties that cohabit with fibromyalgia. These ARE the symptoms.

All this time I have been thinking that in Canada and the USA, where there are so many knowledgeable experts in this field, fibromites were being recognised and diagnosed far more quickly than the years it takes here in the UK.

The moral behind this thinking is, we have a huge worldwide job to raise awareness about fibromyalgia, not only in the UK but just about everywhere. With this is mind it is even more important that you contact your local health authority or training hospital and offer to be interviewed by medical students and answer questions about your fibromyalgia and any other dispositions you may have living with your FMS. I hope they will jump at the opportunity. If they do not, tell us and we will name and shame them.

I often hear fibromites say, “It is so good to be able to share my problems, pains and concerns with someone,” – here is the golden opportunity – and you can talk about yourself and your health and you could be helping to find cure. Some of those young doctors may decide to specialise in this field. Whatever they do they will have an inside knowledge of fibromyalgia and be able to recognise FMS albeit in their own surgery, in accident and emergency clinic, or a hospital ward.

If you can do this it would be a giant step for fibromyalgia and would encourage more research as the world hears about the pain we suffer. It really is up to you – Linda and I cannot do it alone.

LINDA’S ANSWERS

Linda has asked me to thank everyone who has written to her like most families with young children she has struggling to get ready for Christmas with all the trimmings to delight her young son. Linda is making a great effort to reply to you as soon as she can.

We are delighted with the support so far and hope details of these emails will encourage you to go further with raising awareness.

Jane wrote, “One minute you are pleased that there is someone out there that has fibro then you feel bad that someone must hurt like you do”. 

Bambi sent an email saying, “You are my inspiration! I just read about you in an email I receive from Tenderpoints. I meant what I said.”

Bambi who lives in the States and suffers with fibromyalgia, rheumatoid arthritis, Lupus, chronic pain syndrome, and has undergone a number of operations, is taking “a variety of med’s and still going through the motions of trying to find what works best for me.” She writes about her journey through medications and diagnosis leading to the sad and frustrating times that so many FM sufferers go through.

Regardless of her pain she writes, “When I was reading about you, all I kept thinking was that I’ve found my mentor! You see, I am a 44 year old, mother of 2, wife of 22 yrs……. for too many years I have been battling the stigma’s of living with chronic pain. I won’t go into an entire boring full biography about myself! Let me just tell you briefly, I’m an ex-dancer…jazz, ballet, that kind of dancer! HA!…..most people assume with a name like ‘Bambi’, it’s another kind of dance I used to do!   I’m a freelance artist, who on a good day is lucky enough to work on sketching, painting, or some kind of inspiration I may have. I have a positive outlook the majority of the time.

“I say it this way because I feel it’s important to allow yourself to have those days that are bad, let your body heal itself, rest, etc. We have earned the right to every now and then have a little ‘bitch’ session. I think it is healthy to vent every now and then! I also feel though it is our fault we have what we have, we have to learn to accept what we can’t help, (not give into it though!) It is not anyone else’s fault that we feel bad, so why should they have to suffer too. I try to keep a good sense of humor, a smile even when I hurt….I can be in pain but still be glad I have my family.

(Hi Bambi I am the writer with FMS and it is not your fault. It is now thought to be genetic and if you ask your parents and grand parents you may find some have suffered very bad arthritis, rheumatism or fibrositis. If we have the gene it only takes a trauma or stress for an A type personality – workaholic – to trigger the fibromyalgia. I write this as a patient with no medical training, but this is what I have heard from medical experts. However I do agree you should not take your suffering out on other people and a positive outlook is so very important. Jeanne)

“Anyway, my point is that, through out this entire “journey” of chronic pain, I figured there is someway I can help, so other people don’t have to go through what I have had to endure! I admire what you and your Doctor are doing and would love to do the same!….I know, I apologize, I could have said this at the beginning, in one sentence!”
Bambi signed her email with “peace, laughter & miracles”.

Linda told her, “You have to have a sense of humour to survive being fibromyalgic…. life is for living is what I say and I refuse to sit in a chair and rock for the next 50 years!! I am not into feeling sorry for myself at all. It is counter productive and I am with you on the positive attitude thing, you have got to have this or you will go under. So you sound like an ideal candidate for doing what I am doing, chatting to medical students on an informal basis and educating them about ourselves, our condition and the whole shebang we go through for a diagnosis, treatment, support and help. Think about it, you’d be fab!!”

Catherine from somewhere in New York who read Linda’s story in Tenderpoints (from Fibrohugs) thanked her so very much for what she is doing for all FMS patients around the world.

She wrote, “I see a rheumatologist at a teaching hospital here in upstate New York, and I think I shall print this for him.  He always wants to learn and I wonder if I would ever have your strength.  Even if I didn’t, your story may be just what I need.”
Catherine signs herself a partner in FMS/CFIDS.

Karen has had FMS for seven years and writes, “When I read about what your doing, I thought that this lady is doing exactly what I have been wanting to do for years now. And I go for treatment for the perfect place for it. That is Oklahoma University Research Hospital. We call it OU for short. But my thinking has always been that this is such a complex disease that you would have to be a teacher just to discuss it, because 15 minutes with your GP just doesn’t get it.

“And only someone with this disease can tell you in detail anything about it and it takes a long time to do that because there is so much to tell. I would love to share my knowledge with some soon to be Doctors. This is where I know you will understand that we know a lot more than they do about FMS because we were forced to learn about what was wrong with us because nobody could tell us. All I ever heard was, ‘I am sorry for you but I can’t help you and good luck. Hope you don’t end up in a wheel chair.’

“I have never written to anybody else that has this disease, but your story was the one that turned on the light. I hope to hear from you, God Bless You.”

Mary who works in the medical profession in the States said she was given news of Linda’s story by a holistic nurse who has been helping her with pain control.
Diagnosed with fibromyalgia after many years of ‘non-diagnoses’ she said the problem was not only an unawareness on the physicians part, but her own unwillingness to accept it because of the attitudes I have encountered for quite some time of the doctors who label FMS as a non-existent disorder.”

Mary suggests these doctors think fibromyalgia is something, “We give patients to pacify them when they need a diagnosis”. In other words – for all the hypochondriacs out there.

“It angers me to think about it now, because these physicians have labeled me as such and put me on anti-depressants. Now I hear behind my back from their nurses and assistants that they diagnose fibromyalgia but don’t believe it,” she said adding she was frustrated and disillusioned with medicine.

Linda suggests the physician “desperately need educating into the severity of the condition you deal with 24/7. I could send you some information specifically for doctors to print off if you like? Maybe it would give them a kick up the butt? It couldn’t hurt to try eh?”

Joan from Canada said she could relate to Linda’s fibromyalgia and back problems. She suggests, “I have a specialist here in Toronto who insists fibro is related to disruption of the discs in the back and neck. Certainly the activity and especially horseback riding would contribute to your fibro. I have been on long term disability for 12 years now and everything she has directed me to do has been right. We do walk a very fine line in fibro. If we do too much we will relapse. 

“I admire the work you are doing in educating young would-be doctors and students. It is something I have wanted to do for a long, long time. I just did not know quite how to get started. 

“I felt such a pull in my heart when I read your bio, I just wanted to share with you what I believe has helped me.  Maybe it will help you too! We are the same age. Too young to let life pass us by!” said Joan.

Gloria who I think is also from the States offered congratulations to Linda for stepping up and adds, “I, like you, have had fibromyalgia since about the 1980′s, maybe even longer.  I was (and still am) very active, although I tire easily.  The specialty doctor that I saw at that time discovered my “trigger points” but he did not have a name for the illness.  Unfortunately, my regular GP was not the greatest.  I had a terrible flare-up about 7 or 8 years ago.  I went to my GP with a list of my symptoms.  He looked at the list, looked at me and told me that “someone who writes a list like this is mental.”  This was someone that I trusted my health with for over forty years.  I quickly changed physicians.  I started with an internist about a month later, gave the same list to him.  He took x-rays and blood work, sat for an hour asking me questions and told me to return in three weeks.  When I returned, he had all of the test results in hand.  We talked some more and he mentioned “myalgia.”  I asked him if he said fibromyalgia.  He said, “No, do you think you have that?”  I said I don’t know, but I had just heard of it.  He tested the trigger points and diagnosed me that day with fibromyalgia.  It has been a blessing to find a doctor that listens and is empathetic to the pain that FMS involves. I live with pain on a daily basis and some days are worse/better than others.”

This is just another story which shows just how important it is to educate the medical students and the young doctors who are willing to listen.

Jackie has such empathy with Linda she suggests, “I felt as if I were reading my life and medical condition on the page.  I have written to the FFC here in the states but have gotten no reply as of yet.  They have several centers here in the US but none are very close to me and you have to do your first visit in person, after that they do something either thru mail or something.  But it’s too hard for me to travel, as you probably know. I think my fibro was partially caused by having rheumatic fever twice as a child.  In my teens I had great pain, then they called ‘growing pains’. 

“I like you was active even after diagnosis until I just could not do it anymore.  It hurts so bad emotionally not to be able to do what I used to do. 

“In the past my son in law said that my house was so clean you could eat off the floors.  I am not able to do that anymore.  Nor do the things I want to do. And I agree with you that a loss can cause a real fibro flare, because I lost my youngest grandson age 16 in June.  The only way I can survive that is knowing that he is with God.

“Thank you so much for your article.  Just having someone out there that I can  “cry” to means a lot. Now I have to go, my back is hurting so bad. Love. A sister in fibro,”

Brenda who I think is from California (emails give little away) wrote and said,
“Thank you for your story particularly the “letter to normals” that I have sent this on to friends and family as it sums up how I feel. I would like to help spread the word. What can I do to help?”

Although Brenda believes her GP will not be very helpful she told Linda, “I do have an appointment with my rheumatologist in January so will ask her if I can talk to med students.”

Brenda who labels FMS as ‘the beast’, tells Linda. “It is very difficult here to get anything prescribed for pain as people have a tendency to sue their doctor if they get addicted to the drug. I had to give my GP a letter promising him not to sue him so he would give me a script for valium so I could sleep at night as the flexeril was no longer working. Anyway I am taking 4mg at night and it has helped tremendously so far. But I am stuck with over the counter pain killers which on bad days just aren’t effective. I have bought a couple of books on fibromyagia recently and it seems there is more research money being invested as FMS is on the rise.”

Encouraging Brenda to take up the challenge Linda replied, “I started speaking to medical students about our much misunderstood condition as they need to do ‘practice consultations’ as part of their training and speak to people who have a chronic pain condition.”

Betty who wrote to Linda about specific enzyme based natural medication which had worked for her own for back pains, added, “Today’s doctors still have no answers as I have fibromyalgia and chronic fatigue plus the latest visit to the doctor has her looking at something called Polymyalgia. I think that is what she called it. The only thing that helps that is Prednisone and I refuse to go on steroids, so I’m hoping the blood tests come back negative for that condition. Take care… and keep the faith.”

Replying Linda thanked Betty and is humbled by her kind words. She added the message “reaffirms my faith in humanity and for that I thank you from the bottom of my heart”.

Having invited the world to keep in touch with us, it occurs to me that as fibromyalgia fighters we should perhaps come together as a VIRTUAL FIBROMYALGIA AWARENESS GROUP.

This would allow us all to enjoy the successes of others and help with the few disappointments, if any, of trying to raise awareness about this rotten invisible disability. We will protect your privacy and will not divulge or print anything other than your first name and maybe the country in which you live…unless you instruct us otherwise or include your own email in the text.

If there is enough support for the idea we thought that for membership of our elite VFAG you should have FMS, CFS/ME or be a carer for someone with these disabilities. We will do our best to print your stories – maybe not always in full and will reserve the right to edit anything which may be deemed as offensive or likely to have any legal connotation.

I would ask you to send me your emails with information your endeavours to raise awareness with medical students or doctors, or in any other way, highlighting any publicity you have managed to achieve, with copies to both Linda and I.

We hope you will share your triumphs with others and we will ‘move mountains’ and raise awareness. With enough support we will start our own weblog where you will be published and able to tell our friends.

We are depending on you. Please email me at jeannehambleton@mac.com and Linda at lindajaneallen@hotmail.co.uk and with your success stories. You can also find me on
http://jeannehambleton77.wordpress.com

Take care. Keep well and go to it. Jeanne

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Detroits Best Music

MAKING MEMORIES AND SOBERING THOUGHTS FOR FIBROMITES

by Jeanne Hambleton © 2007
NFA Leader Against Pain-Advocate
 
I well remember how much I enjoyed Gene Kelly’s performance in the film “Singing in the Rain”. It made me feel so good, in spite of the bad weather, and between us, I really felt like being silly, running outside in the rain and singing my head off. But as my dear late Dad would have said, “Here’s a penny. Go in the next street!” That does not say much for my voice but the thought was there.

It is odd but these days you seldom hear children singing while playing. Do they still teach singing in school – all those pomp and circumstance songs like ‘Jerusalem’, ‘Land of Hope and Glory’ to name but two? Most children seem to know, ‘You’ll never walk alone’, but I guess that is down to the football fans. I seem to think we were encouraged to sing to get some fresh air in our lungs. I even remember doing breathing exercises at school – that must have been when Adam was a lad!

It also seems as if most children do not want to play in the rain and hate to get wet. What happy childhood memories come back when you see a picture of a young child in a hooded raincoat with wellies splashing in big puddles and giggling? I would think Health & Safety and the PC (Politically Correct) Brigade would have something to say about that these days – too dangerous – the child will slip over and hurt itself.

All this talk about singing and dancing in the rain brings me nicely to a little story, which I hope you will enjoy. To be truthful I am hoping to start an epidemic of people singing and dancing in the rain and getting them washed while they are at it. We could change the words, “I’m singing and washing in the rain”. Read on and you will understand where I am coming from. Regrettably I cannot remember which fibromite sent it to me – fibro fog – but thanks.
 
IT’S RAINING

A little girl had been shopping with her Mom in Zellers. She must have been 6 years old, this beautiful red haired, freckle faced image of innocence. It was pouring with rain outside the store. It was the kind of rain that gushes over the top of rain gutters, so much in a hurry to hit the earth it has no time to flow down the spout. We all stood there under the awning and just outside the door of Zellers.

We waited, some patiently, others irritated because it messed up their hurried day.  I am always mesmerized by rainfall.  I got lost in the sound and sight of the heavens washing away the dirt and dust of the world. Memories of running, splashing so carefree as a child came pouring in as a welcome reprieve from the worries of my day.

The little voice was so sweet as it broke the hypnotic trance we were all caught in.
“Mom, let’s run through the rain,” she said.

 ”What?” Mom asked.

“Lets run through the rain!” she repeated.

“No, Honey. We’ll wait until it slows down a bit,” Mom replied.

This young child waited about another minute and repeated: “Mom, let’s run through the rain,”

“We’ll get soaked if we do,” Mom said.

“No, we won’t, Mom.  That’s not what you said this morning,” the young girl said as she tugged at her Mom’s arm.

“This morning?  When did I say we could run through the rain and not get wet?”

“Don’t you remember?  When you were talking to Daddy about his cancer, you said, ‘If God can get us through this, He can get us through anything!’”

The entire crowd stopped dead silent.  I swear you couldn’t hear anything but the rain.  We all stood silently.  No one came or left in the next few moments.

 Mom paused and thought for a moment about what she would say.  Now some would laugh it off and scold the child for being silly.  Some might even ignore what was said.  But this was a moment of affirmation in a young child’s life:  a time when innocent trust can be nurtured so that it will bloom into faith.

“Honey, you are absolutely right.  Let’s run through the rain.  If GOD lets us get wet, well maybe we just needed washing,” Mom said.

Then off they ran.  We all stood watching, smiling and laughing as they darted past the cars and, yes, through the puddles.  They held their shopping bags over their heads just in case.  They got soaked.  But they were followed by a few who screamed and laughed like children all the way to their cars.

And, yes, I did.  I ran.  I got wet.  I needed washing.

Circumstances or people can take away your material possessions.  They can take away your money, and they can also take away your health.  But no one can ever take away your precious memories.  So, don’t forget to make time and take the opportunities to make memories everyday.

“To everything there is a season, and a time to every purpose under the heaven.” Ecclesiastes 3:1

I hope you still take the time to run through the rain. They say it takes a minute to find a special person, an hour to appreciate them, a day to love them, but then an entire life to forget them. Share this story with the people you’ll never forget.  It’s a short message and it will let them know that you’ll never forget them.

If you don’t tell anyone, it means you’re in a hurry.  A pity! Take the time to live!!!

Keep in touch with your friends.  You never know when you’ll need each other or you no longer can keep in touch – and don’t forget to run in the rain!

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Stress, depression high among Canadian peacekeepers

By Communications Staff

Thursday, December 13, 2007 Canada’s peacekeepers suffer similar rates of Post-Traumatic Stress Disorders (PTSD) as combat, war-zone soldiers, according to a London, Ont. research team.
Psychiatrist J. Donald Richardson and his co-investigators also found that PTSD rates and severity were associated with younger age, single marital status and deployment frequency.

Richardson is a consultant psychiatrist with the Operational Stress Injury Clinic at Parkwood Hospital, part of St. Joseph’s Health Care, London and a professor with the Schulich School of Medicine & Dentistry at The University of Western Ontario.

His team conducted a random, national survey of more than 1,000 Canadian peacekeeping veterans with service-related disabilities. The participants were below the age of 65 and had served with the Canadian Forces from 1990 to 1999.

The research, published in the Canadian Journal of Psychiatry, found a third of veterans deployed more than once suffered probable clinical depression, and 30 per cent of those deployed one time were affected.

The rates of probable PTSD were 11 per cent for those deployed once and 15 per cent for those deployed more than once. The authors also found peacekeepers were more likely to have PTSD and more severe symptoms if they were young, single, or had multiple deployments.

“This study has important clinical implications because understanding such risk factors can help predict potential psychiatric problems in veterans who have been deployed,” says Richardson.

“The high rates of depression observed in deployed veterans can have a significant impact when they seek treatment for PTSD because depression must be aggressively treated to help patients respond more effectively to psychotherapy.”

“Many veterans are also living and working in the community as civilians, therefore it is important that primary care physicians and psychiatrists become more knowledgeable about the emotional impact of military deployment and screen for possible PTSD,” says Richardson.

The Operational Stress Injury Clinic is funded by Veterans Affairs Canada and provides specialized services to help veterans and members of the Canadian Forces deal with PTSD, anxiety, depression or addiction resulting from military service.

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PETROL PROTESTS FROM SATURDAY

by Jeanne Hambleton © 2007
NFA Leader Against Pain-Advocate

A blog inviting comments from UK motorists about the hike in fuel costs and a protest, launched by Brendan McLoughlin from his website petrolprices.com has attracted more than 2600 signatures in 36 hours with overwhelming support for a fuel protest. The response has so far been far greater than the signatures received for many of the e-petitions for the eyes of the Prime Minister, Gordon Brown.

These are just a few of the pointed comments and criticisms of the fuel tax.

….the poor old pensioner is hit hard – I only wish my pension went up pro rata to fuel
……£1.08 a litre, compared to Tunisia where it was 22 pence a litre
……stop this legalised theft from the British driver
……RIP OFF Britain strikes again
……the government must be brought to task
……the obscene tax on fuel and ready to protest
……get a horse and cart, or protest?
……the government is shafting us at every angle

With such support in a short time, comments on the petrol blog have offered over whelming backing for action and a protest, with a very small minority opposed to blockades. When I last looked less than 36 hours after the first posting there were over 2600 comments and it was growing by the minute.

My poor e-petition for more funding for research for fibromyalgia appears to have stagnated at just over 550 signatures and I have been going on about that for months. Sadly it ends on 23 January 2008 when the Gordon Brown’s man will write back and say ‘tough’. Just in case I will leave the address here if you feel like giving me a bit of support before we get back to petrol http://petitions.pm.gov.uk/FIBROFUNDING/.

My grateful thanks to Brendan McLoughlin who this morning, Monday, sent me notice of likely petrol protests later this week. It is not what you know but who you know that counts!

Brendan, runs a very successful PetrolPrice.com newsletter service advising readers of the cheapest fuel prices within 5 miles of their home and this information can help you save money on petrol. His website, petrolprices.com, been working with a group called Transaction 2007 who have the latest news about plans for petrol protests.

The email I received today indicated protests were likely to happen from Wednesday but this now looks like action will be taken next Saturday… but it could be any time.

I hope Brendan can forgive me for quoting his email and website but, like me, I am sure he wants as many people as possible to be aware of what is happening.

We all know why it is happening and most of us are all disgusted at the tax levied by the Government on fuel, which adds insult to injury for the poor motorists and indeed ultimately the cost of living. As if we do not have enough problems with the growth of yellow speed cameras everywhere we look! Most thieves come in the dead of night and take maybe your TV, DVD, a bit of cash and jewellery and usually only strike once. But this ‘theft’ goes on week after week, year after year.

When travelling abroad I stand at petrol pumps with my jaw dropping at the price per litre. That, the cost of living and the government’s lousy governing is enough to make you emigrate.

While I have every sympathy with each and every motorists (I am one too), my heart goes out to the disabled and their carers – those with long term chronic pain, fibromyalgia, chronic fatigue syndrome, ME, arthritis – many living on benefits – who use their cars as their lifeline. If you read the national press you will see that many elderly folk cannot afford to keep themselves warm, quite apart from paying over £1 a litre for petrol to get themselves to their doctor for their check-up, or collect their prescription, or have tests at the hospital. I wonder are they trying to kill off the disabled and the old folks and starve the rest of us to death with higher food, fuel and heating costs? When I say the Government I guess I am talking about Gordon Brown and his Cabinet. So no offence to those good guys (MPs) who have been helping some of us. But enough of my soapbox chatter

Read what Brendan has to say – and my grateful thanks to him for telling us –

Dear Jeanne,

Last week I was informed that a group called Transaction 2007 had plans this weekend to release a statement announcing some kind of protest action relating to the price of fuel in the UK. I have just read a statement published on their web site in which they have confirmed that they are going to organise legal protest action, and that it could begin as early as this Wednesday.

I have got more on the PetrolPrices.com blog about this:

http://www.petrolprices.com/blog/petrol-price-protests-planned-for-this-wednesday-86.html

We will of course be following the story as it unfolds next week to keep you informed. If you want to express your opinion about the plans you can do so on our blog, as always, by leaving your comments and voting in our polls.

Regards,
Brendan

Brendan McLoughlin
Co-Founder
PetrolPrices.com
telephone: 0844 8160025
email: brendan@petrolprices.com

The website he refers to reads:
A group called Transaction 2007 is planning a “nationwide legal protest” this Wednesday.

You might remember the fuel protest of 2000, which initially gathered strong support from motorists. However, that support quickly turned when many motorists were prevented from filling up because of lorry blockades.

PetrolPrices.com expressed to the organisers that they might find public support for another fuel protest providing it was properly planned to be legal and orderly. So far, the Transaction 2007 organisers have been unwilling to confirm to us specifically what action they have planned for this week. When we pressed the group’s spokesman, Chris Hunter, he said, “This will be a numbers game levied against legislation. I can comment no further.”

With fuel breaking well beyond the £1 barrier, PetrolPrices.com has had a huge rise in the number of emails from concerned motorists. People were especially angry following the last fuel duty hike imposed by the Government in October. Despite being made aware of the huge resistance from motorists, the Government pushed ahead with the 2p duty increase, leaving the public frustrated and angry. Over 80,000 people had voted against the tax hike on our blog post.

The protests of 2000 achieved some success in that the fuel duty escalator was frozen. However, it has now resumed and with the rising price of oil motorists are paying ever increasing taxation due to VAT on fuel. Unlike fuel duty, which is fixed, VAT is charged at 17.5%, so for every 1p increase in the price of fuel, we are actually paying an extra 1.175p.

We’d love to hear what you think. How have the tax and oil price rises affected you? Will you be forced to tighten your belt this Christmas as a result?

UPDATE: This morning (10/12/07) Transaction 2007 announced a firm date for the protest. Protests will start Saturday 15th December 2007 at 10:00am. They say the date was decided by members as “the best possible to enable those who would normally be working during the week to attend.” According to a press release on the site, they plan to protest outside refineries or storage depots across the country.

THE COMMENTS

Do log on to the website mentioned in Brendan’s letter as you will get the chance to make comments about the petrol situation on Brendan’s blog and VOTE on do you think the government should have acted before these protests? YES or NO.

In the first hour there were already 75 comments with cab drivers lorry drivers, and the public willing to get behind any protest.

The support is overwhelming for the protest with calls cut the tax with comments -
Very soon I’m not even going to be able to afford to drive to work which will mean no pay….no job no home etc! Where exactly do they get off charging us these prices? Where I live to get public transport to work would cost me over £12 each way just to go by bus…hello?????????

Rising fuel prices add to the cost of virtually everything. Fuel eats into already thinly spread fixed incomes, but the government doesn’t seem to care.

I think you have heard me say this numerous times – it is time to write to your MP not only for fibromyalgia but for fuel tax

We MUST act together and hit the government hard – write to your MP and tell him unless he starts to act on your behalf then you’ll be looking for a new MP – remember that this government was elected and can be elected out…

The government and their taxes are a joke. Gordon Brown needs to improve public transport or lower fuel duty, or he could very well be out of a job come the next general election

I am absolutely disgusted in the Government’s behaviour in handling our taxes and fuel duties. I was part of the protestors at Kingsbury last time but, yes you’ve guessed it, they’re threatening to get the army in if we do it again. I say, LET’S DO IT AGAIN. They can’t arrest all of us if we all stand for the same thing can they? The prison’s are already over-full and can’t cope! It’s about time everyone in this country stood up for themselves. Are we going to let Gordon Brown bully us into submission??

The levels of taxation on fuel here are totally unjustified given the seriously poor public transport as an alternative.

It’s time we acted to show Brown how seriously unhappy we are with this stealth tax

If the government tried living on average wages they would see what a struggle life is already is without this outrageous tax hike!

I can understand why so many British people are now trying to emigrate, and that’s because they are all fed up of being robbed not by criminals but by our own government. I wouldn’t be surprised if we are taxed to breathe next.

Gordon – I’m sure you can save money by not paying so many benefits to lazy people and immigrants!!!

Posted by Peter, 9th December 2007 10:35pm
The reality is that oil is a finite resource, and as there becomes less of it then it will become more expensive. If you choose to live miles from where you work or work miles from where you live then you have to face the costs of your choices. Don’t blame everyone else for the consequences of your own decisions, particularly the government.
Posted by Steve, 9th December 2007 10:39pm
I take it that peter has a good well paid job and can afford to live in a built up area. Blockade now!

Personally I think this was this written by Gordon’s new spin doctor – could it be Alistair C.? If you want to receive e-mails from Brendan about the changeable petrol prices and the cheapest pump near you visit PetrolPrices.com to be added to his address book. It is a great service. If you want a good read – have a go at the blog. I could not get to the end it grew so fast.

I am thinking of getting a horse and cart. I might be late for work every day but I will blame Gordon Brown. He has got broad shoulders. The manure will be good for my rhubarb. I will keep you posted. Talk soon.

Jeanne

FMS Global News

Fibrohugs support

Tenderpoints Newsletter

GULF WAR VETERANS NEED YOUR SUPPORT

by Jeanne Hambleton © 2007
NFA Leader Against Pain-Advocate

Have you ever come across the R.E.S.C.I.N.D. website. Started in the 1990s by Tom Hennessy (now a very sick man who thought up the idea of an International Awareness Day – May 12) and his friends Nancy Solo, Paula Carnes, Maryka Ford, Lucie Dorais, Roger Burns and Chip Davis

It is important that I stress no copyright infringement is meant as this is not published for any financial gain, however I do have the permission of Tom Hennessy to use material from the websites.

But possibly due to Tom’s long and protracted illness the site has found a new home and appears to have been revamped. We wish you well Tom.

http://www.geocities.com/capitolhill/4277/

It appears this site is right up to date with the latest news about the problems associated with the Gulf War Syndrome and CFS/ME, FMS and other related problems thanks to Eileen Marshall and   Margaret Williams. I have apparently missed this news in my two newspapers. Perhaps I should give up reading the comic strips. But seriously….

Obviously a public inquiry relating to the Gulf War Syndrome has been rumbling on for some time and eventually the Lloyd Report from the Public Inquiry, carried out by the Rt. Hon. Lord Lloyd of Berwick, was published in November 2004. The brief was “To investigate the circumstances that have led to the ill health and in some cases death, of over 6,000 British troops following deployment to the first Gulf War, and to report on it.”

For more details of the report look at the Gulf War Illnesses Public Inquiry website.
http://www.lloyd-gwii.com/
According to the new R.E.S.C.I.N.D. website at ‘geocities’ above and Eileen Marshall and   Margaret Williams
http://www.counciloftruth.com/content/view/154/65/
The Ministry of Defence is to officially recognise Gulf War Syndrome after a 17-year campaign for justice by ex-military servicemen.

For 17 years the Ministry of Defence refused to recognise that Gulf War Syndrome existed. However, now Defence Minister Lord Drayson has backed down following pressure by Manchester peer Lord Morris. Lord Drayson said: 
“The issue of Gulf War Syndrome will be fully recognised by the Ministry of Defence and I accept on behalf of the MoD that this issue has not been handled well from the
beginning.

“The department was slow to recognise the emerging ill-health issues and to put measures in place to address them. We have apologised for this and I repeat that apology today.”

The belated apology has come too late for many servicemen. Thanks to government cover-ups many of these servicemen lost their lives for serving their country.

The website claims the Ministry of Defence are experts at covering up their failures and obstructing justice – now they need to follow the recommendations in the Lloyd Report and compensate the servicemen who suffered Gulf War Syndrome.     

Watch the video “Gulf War Syndrome – Killing Our Own”:
 If you log on to this website you can see the video.

http://www.counciloftruth.com/content/view/154/65/
Linking with this address you can keep the pressure on Gordon Brown too by signing this petition.

Before you do, it is interesting to read this website’s definition of the Gulf War Syndrome symptoms – sounds familiar?

GULF WAR SYNDROME (GWS)
Gulf War illnesses are a collection of disorders that for the most part can be
diagnosed and treated, if effective programs exist to assist veterans, and in some
cases their immediate family members. Although these illnesses are complex and have
multi-organ signs and symptoms, a proportion of these patients can be identified as
having Chronic Fatigue Syndrome/Myalgic Encephalomyelitis (CFS/ME) and/or Fibromyalgia Syndrome (FMS).
Nicolson GL, Nicolson NL, Institute for Molecular Medicine

Log on to this address for access to the petition

http://www.counciloftruth.com/content/view/154/65/ and click where it talks about Gordon Brown and the petition. This will take you to
http://www.petitiononline.com/gwsdrb/petition.html%20 In the Search box type Gulf War Syndrome Petition and click Search
This will reveal a number of on-line petitions but the one you want is the first one
“Gulf War Syndrome Implement the Recommendations of the Lloyd Report” and this will reveal the petition. It takes no time at all and you are asked to verify your signature. So easy all on line.
http://www.petitiononline.com/gwsdrb/petition.html
Do remember these lads are fellow sufferers who fought for their country. They need our support. I believe it has been running about 5 weeks and it has a poor 95 signatures. We can do better than that, can’t we?
The Petition is also on Facebook as a Group at
http://www.facebook.com/group.php?gid=5383334893
It reads:
To:  Gordon Brown, British Prime Minister
******************************
Petition British Prime Minister Gordon Brown to implement the recommendations of The Lloyd Report on Gulf War Syndrome ******************************

The gauntlet laid down for Gordon Brown:

Some 250,000 of the returning allied forces from the first Gulf War in 1991 (15 per cent) went down with illness that they insist was related to their service in that war. Of these, 10,000 are already dead.

Successive governments over the years have refused to recognise the existence of a single condition called Gulf War Syndrome and so the impasse continues.

On 14 June 2004 it was announced that there was to be a Public Inquiry into the illnesses suffered by veterans returning home from the first Gulf War.

This public inquiry was chaired by The Rt Hon The Lord Lloyd Of Berwick and on 17 November 2004, the inquiry published its report -The Lloyd Report on Gulf War Illnesses, commonly referred to now as The Lloyd Report.

The following are the 3 R’s of The Lloyd Report that Gordon Brown needs to accept:

1. REALISATION – realisation it IS Gulf War Syndrome
Paragraph 283 of the Lloyd Report:
283. It seems to us that with the termination of any legal proceedings against the MOD, and with the results of the three epidemiological surveys to hand, now is the time to reach agreement with the veterans. This was the strong thrust of Lord Craigís evidence. The MOD could initiate the process by taking the following steps: -
(1) The MOD should acknowledge publicly that the veterans who have made
claims (other than the 272 who have had their claims rejected) are indeed
suffering injury or disease as a result of their service in the Gulf.
(2) Since the name of the injury or disease is only a label for wrapping the
symptoms from which the veterans are undoubtedly suffering, the Ministry of
Defence should accept the name favoured by the veterans, i.e. Gulf War
Syndrome, as the most convenient label.

2. RECOMPENSE – Recompense Veterans

Paragraph 283 of the Lloyd Report continues:
(3) The MOD should set up a fund out of which ex gratia payments should be
made on a pro-rata basis to all those who have made successful claims.
(4) The 272 Claimants who have had their claims rejected should have those
claims reviewed in the light of this report.

3. RECOMMENDATION – The Government needs to follow the Recommendations of The Lloyd Report

Paragraph 224 of the Lloyd Report:
…. the picture is already sufficiently clear to enable the MOD to acknowledge forthwith that the illnesses of the Gulf War veterans, who have had their claims accepted, are attributable to their service in the Gulf. To wait for further research into the pathology would, after fourteen years (***now 16 years***), be a denial of justice to the veterans.

Is it no wonder that Dr B has been in touch with Sir Sean Connery, Jerry Weintraub, SKG and others with A View To A …Film! What happened to Nixon after Watergate and All the Presidents Men?

This year we have seen pressure on the Government as follows:
*28 January 2007: Wartime “forces sweetheart” Dame Vera Lynn branded the “endless” legal wrangling over payments to veterans of the first Gulf War a scandal. Dame Vera and ex-Formula One champion Sir Jackie Stewart wrote to the then Chancellor, Gordon Brown, accusing the Ministry of Defence of “haggling”.

*8 May 2007: A recent poll of 121 MPs from all parties found that more than 70 per cent thought that the Government’s actions towards ex-Service people suffering from Gulf War Illnesses had been very poor or inadequate.

The Lloyd Report resume also nails the need as follows:

“10. We come last to the question of compensation. This did not figure largely in the evidence of the veterans themselves. But it figured in the evidence of Lord Craig, Major General Craig, Paul Tyler MP, Michael Mates MP, Colonel Terence English and others. Lord Craig (Lord Craig of Radley, Marshal of the Royal Air Force, Chief of the Defence Staff throughout the Gulf War) said that the absence of closure after so many years was now indefensible. ‘A little magnanimity’ was called for, and an ‘imaginative one-off approach’. Mr Mates told us that what was needed was a political act of will.

“A minister has to say ‘this will be done’ and then it is done.”

We call on Prime Minister, Gordon Brown, to intervene now, without further delay

If you wish to call on Gordon Brown for “a little magnanimity”, to implement the recommendations of The Lloyd Report, then this is the petition to sign!
Sincerely,

The Undersigned

I believe this is just wonderful news and I really hope it does materialise. Let us also hope this a precedent and will bring benefit to our soldiers who are currently at war elsewhere on our behalf.

There is lots more to read on the Internet if you type in Gulf War Syndrome petition.

Please sign now – tell your friends, family, everyone you email, stir up some magnificent support. Our troops deserve our backing – it would seem the Government has been slow in giving them any backing.

Do it now. I have.

Jeanne

Additional Information:

FMS Global News

Fibrohugs Support

Tenderpoints Newsletter

Opioids for managing chronic non-malignant pain: safe and effective prescribing.

Kahan M, Srivastava A, Wilson L, Mailis-Gagnon A, Midmer D.
Addiction Medical Service, St Joseph’s Health Centre, Toronto, Ontario, Canada. kahanm@stjoe.on.ca

OBJECTIVE: To review the evidence on safe and effective prescribing of opioids for chronic non-malignant pain.

QUALITY OF EVIDENCE: MEDLINE was searched using the terms “opioid effectiveness” and “adverse effects.” There is strong evidence that opioids are effective for both nociceptive and neuropathic pain, but limited evidence that they are effective for pain disorder. There is little information on their effectiveness at high doses or on the adverse effects of high doses.

MAIN MESSAGE: Opioids should be initiated after an adequate trial of acetaminophen or nonsteroidal anti-inflammatory drugs for nociceptive pain and of tricyclic antidepressants or anticonvulsants for neuropathic pain. Patients should be asked to sign treatment agreements and to give informed consent to treatment. Patients should experience a graded analgesic response with each dose increase. Titrate doses of immediate-release opioids slowly upward until pain reduction is achieved, and then switch patients to controlled-release opioids. Most patients with chronic non-malignant pain can be managed with<300 mg/d of morphine (or equivalent).

CONCLUSION: Opioids are safe and effective for managing chronic pain.

PMID: 17279219 [PubMed - indexed for MEDLINE]

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Source

Tenderpoints

Prevalence of Interpersonal Abuse in Primary Care Patients Prescribed Opioids for Chronic Pain.

Balousek S, Plane MB, Fleming M.

Department of Family Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA.

BACKGROUND: Interpersonal abuse is associated with clinical problems including chronic pain disorders. OBJECTIVES: The objective of this study is to describe 30-day and lifetime prevalence of emotional, physical, and sexual abuse found in men and women prescribed opioids for chronic pain.

DESIGN: Cross-sectional interview is the design of this study.

PARTICIPANTS: Patients, 1,009, currently prescribed opioids for chronic noncancer pain. They were recruited from the practices of 235 Family Physicians and Internists in Wisconsin. The most common pain diagnoses were arthritis, low back pain, headache, and fibromyalgia/myofascial pain.

MEASUREMENT: Data for this secondary analysis on rates of interpersonal abuse were based on 3 questions from the Addiction Severity Index (ASI) regarding 30-day and lifetime emotional, physical, and sexual abuse.

RESULTS: Forty-seven percent of women and 22% of men reported a history of lifetime physical abuse. Thirty -five percent of women and 10% of men reported lifetime sexual abuse. Binary logistic regression identified the following variables associated with lifetime physical abuse: female gender (RR 2.81, CI 2.01-3.94), age 31-50 (RR1.77, CI 1.30-2.41), Caucasian (RR1.67, CI 1.19-2.35), increased psychiatric symptoms as measured by the ASI (RR 2.14, CI 1.56-2.94), and lifetime suicide attempts (RR 3.98, CI 2.76-5.74).
CONCLUSIONS: This study reports prevalence of abuse in both men and women prescribed opioids for chronic pain in primary care settings. Subjects who report experiencing interpersonal abuse also report significantly higher rates of suicide attempts and score higher on the ASI psychiatric scale. Screening patients taking opioids for chronic pain for interpersonal abuse may lead to a better understanding of contributors to their physical and mental health.

PMID: 17641933 [PubMed - as supplied by publisher]

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Global Health Vision

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