RxPG News : CFS

Pregnant women with fibromyalgia experience significant psychological stress

Fri, 30 Jun 2006 02:36:37 PST

( from http://www.rxpgnews.com ) Pregnant women with fibromyalgia (FM) experience significant pain, fatigue and psychological stress, symptoms that are often misdiagnosed or under treated as a normal part of pregnancy, according to a pilot study by Karen M. Schaefer, D.N.Sc., R.N., assistant professor of nursing at Temple University's College of Health Professions.

Fibromyalgia is a chronic condition commonly found in women that causes pain in the muscles and soft tissues of the body. Many sufferers get so fatigued that they become weak, and the condition, at its worst, can lead to disability.

Until now there was only anecdotal evidence suggesting that women with FM had a rougher time during pregnancy, said Schaefer. This data is the first step toward gathering hard evidence of FM effects on this group and will hopefully help us identify ways to reduce the impact of fibromyalgia during pregnancy.

For this study, Schaefer recruited both pregnant women with and without FM through an Internet announcement on a fibromyalgia website. Study subjects were between the ages of 29-31, in their third trimester, with no history of stillbirth and free of chronic illnesses other than FM.

The women were then mailed a questionnaire about fatigue, depression, pain and ability to function. A demographic form was also used to assess the number of painful areas in the body as well as age, marital status, education, hours slept and use of medication.

Schaefers results revealed that the pregnant women with fibromyalgia had a hard time functioning, felt more stiff and tired and experienced pain in more body areas than women without FM.

Most women with FM have trouble getting this condition properly diagnosed let alone knowing where to turn for help once their condition is identified. We need to start looking at how FM affects all areas of these womens lives and come up with ways to provide as much comfort and support as possible, said Schaefer.

Schaefer, whose research focuses on women with chronic illness (fibromyalgia, lupus, ovarian cancer) is currently expanding her study to include a larger group of subjects.

Chronic Fatigue Syndrome Linked to Neurological Abnormalities

Sun, 04 Dec 2005 09:42:38 PST

( from http://www.rxpgnews.com ) Researchers at Georgetown University Medical Center have found that chronic fatigue syndrome (CFS) may be rooted in distinct neurological abnormalities that can be medically tested. Although the sample studied was small, this research provides objective, physiological evidence that the controversial disorder can be considered a legitimate medical condition.

Chronic fatigue syndrome defines a range of illnesses including fibromyalgia and Gulf War syndrome, all of which have fatigue as a major symptom. Even among medical professionals, there is a disagreement about the causes, diagnosis and treatment of CFS because so much about the disorder remains unknown. One reason CFS is difficult to diagnose is because it shares symptoms with many other diseases, including multiple sclerosis and lupus. Even when other illnesses are ruled out and a CFS diagnosis is given, there is not a standardized course of treatment and its difficult for doctors to measure patient improvement. Estimates are that two to four times as many women as men are diagnosed with CFS.

The Georgetown study, published in the December edition of the BMC Neurology Journal, an online publication, reveals that patients diagnosed with CFS and its family of illnesses have a set of proteins in their spinal cord fluid that were not detected in healthy individuals. These proteins might give insight into the causes of CFS and could someday be used as markers to diagnose patients with the disorder.

"For years, patients with chronic fatigue syndrome have suffered from painful symptoms for which there is no blood test, diagnosable physical condition or any method for doctors to measure improvement," said James Baraniuk, MD, assistant professor of medicine at Georgetown University Medical Center and first author on the study. "Our research provides initial evidence that chronic fatigue syndrome and its family of illnesses may be legitimate, neurological diseases and that at least part of the pathology involves the central nervous system."

The disorder is characterized by profound fatigue that is not improved by bed rest and that may get worse with physical or mental activity, according to the Centers for Disease Control and Prevention. Persons with CFS usually function at a lower level of activity than they were capable of before the onset of illness, feeling too tired to perform normal activities or easily exhausted with no apparent reason. Patients also report various nonspecific symptoms, including weakness, muscle pain, impaired memory and/or mental concentration, insomnia and post-exertional fatigue lasting more than 24 hours.

The study looked at 50 individuals suffering from at least two disorders related to CFS, including fibromyalgia and Gulf War syndrome. By examining spinal cord fluid in patients with CFS and in healthy individuals, the researchers found that CFS patients have 16 proteins that healthy individuals do not. Five of these 16 proteins are found in all patients with the illnesses but in none of the controls. The results indicate that those 16 proteins could possibly serve as a "biosignature" for the disease and could someday be used to diagnose CFS.

"Although this is a small study and more research on the subject is necessary, these results indicate it might be possible to develop a simple laboratory test to diagnose these disorders in the future," Baraniuk said.

Gulf War Veterans have more chronic fatigue, fibromyalgia

Thu, 09 Jun 2005 18:00:38 PST

( from http://www.rxpgnews.com ) More than a decade after the first Gulf War in 1991, a detailed comparison of the health of veterans who were deployed to the Persian Gulf region and veterans who served elsewhere has found that the health of the two groups is very similar.

However, the study also found that Gulf War veterans are more likely to have chronic fatigue syndrome and fibromyalgia syndrome. The proportion of Gulf War veterans with these two illnesses is very small, according to lead author Seth Eisen, M.D., physician at the St. Louis Veterans Affairs (VA) Medical Center and professor of medicine and psychiatry at Washington University School of Medicine in St. Louis.

"But that doesn't mean these conditions aren't serious concerns for those veterans who still have them 10 years later," Eisen says. Fibromyalgia syndrome afflicts sufferers with persistent, widespread pain. Chronic fatigue syndrome leaves sufferers with a disabling loss of energy. Despite decades of awareness of both conditions, their causes remain unclear, and no definitive cure exists for either condition.

The study, funded by the Department of Veterans Affairs, appears in the June 7 issue of Annals of Internal Medicine. It was conducted at 16 VA medical centers across the nation over a period of approximately 3 years. For the study, researchers performed a detailed series of medical and psychiatric assessments on approximately 1100 veterans deployed to the Gulf War region and 1100 veterans who were not deployed in that war.

"In addition to a comprehensive standard medical examination, we arranged a series of very specialized tests based on areas of potential problems suggested by earlier studies of veterans," Eisen explains.

Based on their age, gender and racial characteristics, there were no significant differences between rates of chronic fatigue and fibromyalgia in the non-deployed veterans and in the general population. However, while 0.1 percent of non-deployed veterans met the criteria for chronic fatigue, 1.6 percent of the deployed veterans did.

"When statistically adjusted, that's a risk of chronic fatigue 40 times higher in the deployed veterans than in the non-deployed veterans, "Eisen says. "That's statistically very significant."

Similarly, while about 1.2 percent of the non-deployed veterans had fibromyalgia, a significantly higher 2 percent of deployed veterans had the persistent, diffuse pain that is characteristic of the disorder.

Although researchers have yet to give a formal medical definition to Gulf War syndrome, Eisen says the findings affirm that a very small percentage of Gulf War veterans are at increased risk of disabling long-term medical conditions.

Given that fibromyalgia and chronic fatigue can develop in non-veterans who have never even left their home city, let alone the country, scientists are unsure what factors in the Gulf War combat theater might explain the increased risk of these conditions in veterans.

"We also don't know of anything special in regard to how to treat Gulf War-deployed veterans with these syndromes compared to people who were never in the military," Eisen says. "Often the most important thing for someone who's not feeling well is to know that they have a medically recognized condition. And that their condition will not damage any of their vital organs."

Eisen notes that physicians often advise patients with these conditions to try to keep a physically active schedule. Research into the causes and treatments of both disorders is ongoing.

"Any research advances made in studying Gulf War veterans specifically are very likely to help individuals with these syndromes in the general community and vice-versa," Eisen says.

Other conditions with increased incidence in deployed veterans included upset stomach and skin rashes. Eisen and his coauthors are further analyzing the data they gathered on veterans and their family members.

Exercise breaks the cycle of Chronic Fatigue Syndrome

Mon, 12 Jul 2004 22:55:38 PST

( from http://www.rxpgnews.com ) Children with chronic fatigue syndrome (CFS) who leave their beds, start to exercise and are supported by parents who acknowledge the psychological dimension of this debilitating condition, recover faster than children who are encouraged to give way to their symptoms.

Dr Josie Brown, a consultant child and adolescent psychiatrist with Southampton Primary Healthcare Trust, told delegates that a daily timetable, with regular exercise, and structured sleeping times for children with chronic fatigue syndrome was vital to recovery.

Dr Brown works at Bursledon House, a unit for young people up to the age of 17 run by psychiatrists and paediatricians and with a school on site.

We discourage daytime napping, give them a graded exercise programme and introduce some time at school, said Dr Brown. This is crucial to success and enables young people to get some kind of sense that they are in control of their lives, which would have spun out of control when they were admitted to hospital.

Children with CFS often woke at midday, snacked and cat-napped through the day, and went to bed late. They had little or no structure to their day, and this, said Dr Brown, compounded their symptoms.

Sleeping and resting only made matters worse, as with backache,. With each day spent in bed, 3 per cent of muscle bulk was lost, bones thinned and joints stiffened. Children fell behind in their schoolwork and lost both their friends and their confidence.

Its important to break the link between the symptoms of chronic fatigue syndrome and fear of activity, said Dr Brown. It can be a slow process sometimes taking weeks or months but there will be improvement.

While there are no randomised controlled trials that this graded exercise therapy works with children, there are two studies which show that it substantially improves measures of fatigue and physical functioning in adults with chronic fatigue syndrome.

Between 50-100 children per 100,000- two thirds girls to a third boys - come to the attention of doctors suffering from chronic fatigue syndrome, but experts believe many more are not seen by the medical profession.

Many parents believe that their childs condition was caused by a virus and that rest was the answer, Dr Harvey Marcovitch, a consultant paediatrician and a member of the governments working party on CFS told delegates. This rigid belief, and the idea that their child would get better only when a cure was discovered, was a barrier to recovery, he said. Children whose parents felt that the cause of their childs illness has a psychological element had a greater chance of recovery.

Professor Elena Garralda, a child and adolescent psychiatrist at Imperial College, London, agreed. She said it was important to give parents a clear diagnosis that underlined the fact that CFS had real physical symptoms and that it was not depression, anxiety, anorexia nervosa, school phobia, or psychosis.

Nevertheless, it did have a psychological dimension, and children with the condition were often perfectionists, setting themselves higher than normal standards for academic attainments and physical activity. She regarded it as a stress-related disorder, coupled with a real fear of activity.