It’s My Life!

Woah! Really busy for me out in the real world – there is actually a life for me beyond Fibromyalgia Awareness…

As you know, last night was my fabulous shiatsu massage; but, before that, I had a very-overdue botox injection (or lots of little ones) across my forehead: Botulinum toxin, commonly referred to as Botox®, is well-known for its cosmetic use to eliminate glabellar lines, the frown wrinkles between the eyes (which is fabulous) frown_lines_beforeyet it can also relieve migraine-type headache, muscle tension headache, or chronic daily headache. Results can be dramatic. Some patients (about a third) who have suffered from daily headaches for years report being free of headaches for two to five months; so I’m hoping (at least) some of my head pain will disappear.

After that, it was an appointment with my lap-band doctor – basically unnecessary because, during this whole month, despite hardly eating because of teeth pain, I only lost 400 grams (that’s a poo!). Hopefully, after this whole ‘Lyrica-weaning’ process, I will start to lose some (much un-needed) weight!

Driving Miss DaisyToday I was lucky enough to receive my very belated birthday present – a matinee performance of Driving Miss Daisy with Angela Lansbury and James Earl Jones. I had seen the movie (a very, very long time ago – after googling it, the movie was around 1989 so I was 18) but I really didn’t remember the entire Jewish storyline, only the black racism. It was pretty damn cool and I had a (very uncomfortable) seat in the second row (that’s from the front!)

And now, tomorrow, it is Z’s 3rd birthday party (so I’ll see my father for the 1st time since The Letter) – he decided to have a gardening party with minimal decoration (BUM!) but I did what I was allowed to:

hungry caterpiller (window)hungry caterpiller

balloons

His real birthday is on Tuesday so I prepared a treasure chest of presents…

chest closed chest opened

and decorated the spare-room at my house for when he sleeps over.

view from door full view

We’re going to the Zoo!

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Bigger is NOT Better

There is a current ad in Australia about the 10,000 tonne woman. This woman has got a bit of weight to lose this year – she is asking for our help. She has been a weight loss consultant for years, so she has seen a lot of people try to lose weight, and the difference support makes. Why are we trying to do it by ourselves? She decided to lose weight with a friend, as a team. Then other people got on board, and then she noticed that the more people shared the weight, the easier it got for everyone.

That’s why she is asking the whole country to join in. Pledge some weight, support someone on their mission, and we’re going to lose 10,000 tonnes together.

biggerI have pledged 30kgs (about 66 pounds) – yes, it’s a lot but it is the amount of weight I have gained since being on antidepressants and FM medication. It is ironic that, although many of these medications cause us to gain weight, excess weight is known to aggravate FM symptoms – such as pain sensitivity and sleep disturbances – and reduce quality of life among patients.

New research now shows, the more severe the obesity, the more severe the FM symptoms, and those who have a body mass index, or BMI, of 35 or higher experience the worst symptoms.

“I’m not surprised,” says study co-author Terry H. Oh, MD, assistant professor of physical medicine and rehabilitation at the Mayo Clinic, in Rochester, Minn. She says that earlier studies have shown that obesity increases symptoms, but there hadn’t been concrete information before this study about whether different levels of obesity affected FM symptoms differently.

In other words, is all obesity the same when it comes to FM?

Help-with-ObesityThe answer is no: Bigger definitely is worse, leading to significantly more severe symptoms. “The severely obese seemed to have the most problems,” says Dr Oh.

The study, published online in the journal Arthritis Care & Research, divided 888 adults with FM into four groups: non-obese (BMI less than 25), overweight (BMI of 25 to 29.9), moderately obese (BMI of 30 to 34.9) and severely obese (BMI equal to or greater than 35). Patients were tracked for three years, underwent a physical evaluation and were asked to fill out health surveys and the Fibromyalgia Impact Questionnaire.

The researchers found – for most symptoms, but not all – that as the BMI category increased, so did the severity of the symptoms. But trends showed most symptoms worsened with higher BMI, but for the most part, the difference in the severity of symptoms was statistically significant for the highest BMI group compared with the other groups. Patients in the highest BMI group, for example, missed work more often because of symptoms and reported more pain, stiffness and fatigue compared with those who were not obese or less obese. Also, the study found that the severely obese patients had more tender points on their bodies and worse physical functioning than the non-obese and less obese.

Why is there a relationship between BMI and the severity of symptoms? Dr Oh and her team write that multiple factors may be at work, including a higher level of pain receptors in fat tissue, elevated levels of pro-inflammatory cytokines, loss of physical fitness and an increase in mechanical loads on the body. And the higher rate of obesity in FM patients “may be caused by a vicious circle of pain and physical inactivity.”

It is important that people with fibromyalgia find a way to stay active despite the chronic pain and fatigue that come with it.

obesity“Those who are severely obese may need more help for weight-loss management,” Dr Oh says. “The basic message is that they have to stay active and exercise by starting slowly and gradually in terms of duration, intensity and frequency. It’s more than saying ‘lose weight.’ They need specific recommendations or to see a dietitian or endocrinologist or get other treatment options.”

Akiko Okifuji, PhD, a psychologist at the Pain Research and Management Center and professor at the University of Utah, in Salt Lake City, conducted earlier research on FM and obesity, which found that obese patients had more pain, less physical strength and more sleep problems.

“Both obesity and fibromyalgia are very different persistent conditions that impact overall health, physical well-being as well as quality of life,” Okifuji says.

She believes people intuitively know what Dr Oh’s study showed – that severe obesity is bad for FM patients. “But it’s good to show it scientifically,” Okifuji says. “Patients need proper nutritional education. It is difficult when you don’t move much. Sometimes food becomes a comfort. They need education on how to deal with that and how to maximize calorie burning while minimizing intake. When dealing with chronic fatigue and chronic pain, it is very difficult to do weight management. The key issue for the scientific and clinical community is to come up with an effective [weight management plan] for people who can’t move that much. It’s a tricky thing.”

Want to check your BMI?

Mine is 39 and I have decided it is time to get myself together! Anyone else with me?

Wiggle It (Just a Little Bit)

Belly dancing was one of the first forms of exercise. Belly dance is found all over the Near East, including Egypt, Morocco, Lebanon, Greece, and Turkey.

Belly dance (also known as Middle Eastern dance, Danse Orientale, Raqs Sharki, Ciftetelli, Rakkase, Danse du Ventre) is a celebration of a woman’s body.  It is a unique style of world dance that intertwines improvisation originating from ancient folk and gypsy movements with trained professional choreography originating in the harems.

There is no definite origin of belly dance, but one can see traditional associations with many fertility rituals of the ancient world and the dances in the ancient Indian temples. The fertility rituals were meant to celebrate the reproductive aspects of life, both human and in nature. The movements developed into being used by female only groups for strengthening muscles and spirit for birthing. In this sense, the dance was seen as a private, sacred art. The undulating movements strengthen muscles and breathing techniques, making it easier to control your body.

The common people and travelling gypsy groups later performed belly dance movements on the street (the higher class did not dance in public). Eventually this moved into the harems, where beautiful slaves and dancing-girls learned to entertain their host. With harem girls began sophisticated dance and music training, incorporating choreography and “props”, and the dance was also taught to the higher-class female family members, who also lived and were educated in the harems.

So, it’s kinda weird that it was researchers in Brazil who found that, after beginning a belly dance program, FM sufferers reported reduced pain and improved functional capacity, quality of life and self-image.

Researchers studied 80 women with FM (the rest were doing the Samba! Lol!) who were randomly assigned to either a dance group or control group. The dance group participated in 1-hour belly dance classes twice a week for 16 weeks, with movements involving the upper limbs, scapular girdle, trunk and hips. A masked physiotherapist evaluated pain assessment, functional capacity, quality of life, depression, anxiety and self-image at the beginning, 16 weeks and 32 weeks.

The dancing FMers significantly improved from baseline to 32 weeks in pain, emotional aspects and mental health scales.

Health benefits of Belly Dancing (not just for FM sufferers)

  • Stress reduction

Belly dancing requires tremendous relaxation and concentration, as you must focus on isolating various parts of your body. The flowing movements of belly dance help to calm and soothe the mind. The repetitive movements of the dance and the concentration needed to do them can help a mind filled with daily stress to “let go” for a while and relax. It’s hard to worry about deadlines at work when you are thinking about getting that next drop just right, or while making sure that you are in time with the music.

One effect of stress is that our bodies tense up, causing contractions or spasms in muscle groups, such as those in the neck, shoulders, or back. Belly dance, on the other hand, gently stretches and uses these vulnerable muscle groups, and as they are utilized, blood flow increases and lactic acid is flushed away. Stressed muscles relax as they are gently exercised, relieving the “clenched” muscles often seen in FM sufferers. The body becomes supple and limber, and practitioners frequently report that pain diminishes in the back and neck areas.

  • Fitness and Muscle Building

Belly dancing is vigorous and will make you break a sweat. The fast movements of the hips and shoulders are enough to really get your heart pumping, offering tremendous cardiovascular benefits. When performed as exercise, belly dancing can be compared to any other aerobic workout.

Belly dancing is also a wonderful way to strengthen the major muscles of your body. When performed correctly, belly dancing can also stretch and release tension in the back. Because it is a low-impact form of exercise, belly dancing won’t jolt or jar your body.

  • Weight loss

Belly dancing can have a positive impact on your weight, improving your self-image. If performed regularly, belly dancing can actually encourage weight loss, as it burns calories as well as increases your metabolic rate. According to Dr. Carolle Jean-Murat, M.D., belly dance can burn up to 300 calories per hour. This estimate will vary, of course, depending on the intensity of your dancing.

Belly dancers come in a variety of body types and sizes. Belly dancing will make you more aware of your posture, grace, body language and facial expressions, all helping to improve your self-image. If you attend a belly dancing class, you will probably see several different sizes of bodies, all just as beautiful as the others.

  • An Internal Massage

Belly dancing can be very beneficial to the health of your internal organs. It is sometimes said that belly dancing was developed as a way to prepare the body for childbirth. Since belly dancing centres around controlling the muscles of the abdomen, it may make carrying and delivering a baby easier on your body. For women who desire natural childbirth, this form of exercise through dance, with its emphasis on muscle control not only facilitates natural childbirth, but also makes an excellent post-natal exercise that helps encourage abdominal tone.

Also, many women notice that belly dancing helps to relieve menstrual cramping.

Belly dance seems like a fun, healthy way to exercise. As we are continually being told, exercise is important in the treatment of FM. The Brazilian researchers concluded, “Patient education regarding how to initiate and continue exercise is crucial to the success of treatment. … Belly dance leads to improvement in pain, sleep pattern, functional capacity and self-image in patients with fibromyalgia. [It is] a safe, effective therapeutic strategy for women with fibromyalgia.” It can be a creative outlet that conditions, tones, and allows a woman to tune into the natural movements of her body. It can refresh, relax, and/or exhilarate. So why wait?

Caution: Many doctors have suggested belly dancing classes as part of rehabilitation from injury; it is, however, important to check with your own medical provider before starting any new form of exercise.

 

Blood on the Scales

 

Before getting into this post, allow me to tell you how much of a dippy-chick I can be: you know how bad I’ve been feeling? It appears that, while I was preparing my medicine dosette  and concentrating on the Cymbalta dosage for my dodgy two-week period, I (kinda) forgot putting in my morning dose of Lyrica! Duh! That’s 4 days with lower Cymbalta and only a half dose of Lyrica. No wonder I was feeling so awful.

And now to today’s post…

A common challenge for us FibroMAGICians (and my whole entire life) is weight gain.

Many patients complain that weight gain only became a major problem once FM established itself. It is not unusual for a person to put on a 25 to 30 pound weight gain in the first year after FM is diagnosed. Various factors are involved in weight gain and include:

Decreased Metabolism

Various hormone changes can slow down the metabolism: hormone deficiencies or imbalances (due to FM) with cortisol, thyroid, serotonin, and growth hormone. Insulin and other hormones are probably affected as well.

Closely linked with hormones is the autonomic nervous system. The autonomic nerves are the small nerves vital to the co-ordination of the body’s hormones, and thus they play a role in the regulation and delivery of nutrients to our cells.

Overall, neuroendocrine abnormalities may decrease the body’s metabolism, and part of the treatment involves replacing or supplementing hormones to help improve the body’s metabolism.

A slower body metabolism means fewer calories are burned ‘run’ the body. If fewer calories are burned, with no change occurring in calories consumed, obviously weight gain will result over time. Further, women in their late 30s and 40s often develop FM at approximately the same time as early menopause (decreased estrogen). This can further decrease metabolism and increase the potential for weight gain.

Hypoglycemia (Abnormally Low Blood Sugar)

As mentioned earlier, increased sensitivity to insulin will result in too much glucose being removed from the blood stream and pushed into the muscle. All this extra glucose pushed into the muscles has nowhere to go as the muscles have very limited ability to store glucose – the body is forced to go into a fat-storing mode where it converts this extra glucose into fatty tissue!

Contrary to the popular myth that obesity is a result of eating too many fatty foods, obesity is usually the result of eating too many carbohydrates (Bum! That’s my favourite food group). A carbohydrate rich diet causes weight gain by converting the extra glucose into fat and, if FM causes more insulin activity and sensitivity, then the weight gain can be even greater.

Another myth is that most overweight people overeat. Actually, most overweight people do not overeat. They may have a craving for carbs, and the carbs are easily converted to fat. FM facilitates this process. A diet modified in protein and lower in carbs may help (I know! Easier said than done!).

Medicines

Side effects of our medications can cause weight gain by decreasing metabolism, altering hormones, causing fluid retention, and increasing appetite. The most common offending medicines are the antidepressants.

Medicines such as estrogen and prednisone can also contribute to weight gain. If certain medicines are causing weight gain they may need to be stopped or adjusted depending on the individual’s medical needs.

Decreased Activity Due to Pain

FibroMAGICians hurt more (duh!) and are not as active because activity increases pain. It is difficult to increase the energy expenditure or calorie burning related to exercise and activity. Fewer calories burned = weight gain. Any treatment program must include attempts at increasing overall activity level.

The metabolism changes and the dysfunctional carbohydrate responses, especially, contribute considerably to many of our most bothersome (understatement?) symptoms, including: aching; fatigue; brain fog; irritability; anxiety; dizziness; carbohydrate craving; irritable bowel syndrome; food intolerance; and food sensitivity.

Since we developed FM, our ‘old’ diet probably no longer works for us and it’s making us worse:

  • Because of our slow metabolism, it is difficult for us to eat less and notice a difference.
  • Because of our pain, it is difficult for us to increase our exercise level to burn off more calories.
  • Ideally, we need a diet that improves the efficiency of our calories burned by providing us with the right food to enhance our metabolism and calorie-burning abilities.

SPECIFIC DIET STRATEGIES

Think Protein Always
Do not eat any carbs by themselves, even if they are considered good carbs. ‘Single’ carbs increase the risk of hypoglycemia/insulin hypersensitivity in someone with FM, so foods that have some protein in them should be consumed every time we eat. Therefore:

  • We shouldn’t eat pancakes and syrup for breakfast because it doesn’t contain any protein (maybe add some bacon – LOL!). Insulin is controlled by the balance of protein and carbs each time we eat.
  • If we want a salad for lunch, we should not just eat plain lettuce and vegetables. We need to have a protein source in our salad as well, such as chicken, tuna, turkey, eggs, cheese and more.
  • We should not eat a plain spaghetti supper. We should have spaghetti and meatballs (made with lean ground chuck meat) or lean sausage.
  • If we crave a snack, we shouldn’t eat a sugar cookie. A small bag of cashews would be a better protein-laden choice for a snack.

Once you are trained to think about protein every time you put something in your mouth, it becomes easier to stay within this kind of framework.

Avoid The Rush
Hypoglycemia is often the result of a sudden surge of glucose in our bloodstream after eating a carbohydrate-rich food. To avoid a carbohydrate surge, take a few bites from protein first whenever you eat.

Eat Until Full
At meals, eat until you are comfortably full but not stuffed. Some people with FM actually do better by eating 5 to 6 smaller meals a day or by eating 3 smaller meals and 2 larger snacks.

Those who are bothered by irritable bowel syndrome sometimes can do better by eating smaller portions more frequently.

Eat slowly and take your time to chew food well – and ENJOY!