Alternative Treatments for Fibromyalgia

From the FMS Global News Desk of Jeanne Hambleton (UK)

Courtesy WebMD.com 

 

How well do they work?

By Jeanie Lerche Davis  Reviewed by Brunilda Nazario, MD

 

To get relief from fibromyalgia pain, more and more people are trying alternative treatments. It is often instinctive — putting an icepack on a painful spot or reaching for the heating pad when muscles hurt. Or it feels good – like a massage. Even acupuncture is becoming a mainstream pain treatment, with endorsements from the NIH and the World Health Organisation.

Now, researchers are honing in on how these various home remedies and alternative treatments work.

“In all these therapies, we are stimulating pressure points… we think there may be a similar underlying mechanism in how they work,” says Tiffany Field, PhD, director of the Touch Research Institute at the University of Miami School of Medicine.

Pressure applied to the right spot triggers all sorts of changes in the body — in a good way, she explains. The pressure points have nerve connections to major nerves in the body that affects physiological processes.”

This reduces flow of stress hormones and pain-inducing chemicals — and ramps up production of mood-related brain chemicals such as serotonin, she says. The result: The body slows down, you feel calmer, sleep is more restful — and you are able to tolerate the pain of fibromyalgia better.

 

Massage and Fibromyalgia Treatment

 

For the past three decades, Field has conducted more than 80 studies looking at massage’s effects on various conditions. Her research team looks deeply at the underlying physiological processes involved in sleep — especially as it relates to fibromyalgia pain.

Researchers tracked patients’ sleep patterns, also measuring “substance P,” a brain chemical that is central to fibromyalgia pain. People with fibromyalgia pain have higher levels of substance P in the spinal fluid. They also have lower than normal levels of mood-boosting serotonin.

When they get a massage, all that changes. Field’s studies have shown less substance P in patients’ saliva — and they report less pain. They also have fewer painful tender points.

The studies typically involve 20-minute massages — which is only practical if a significant other is trained to do it, she says. One bonus for the family masseuse: People who give massages have lower stress hormone levels, too.

To get the most benefit, it is important to apply moderate pressure. “It does not matter whether you are rubbing, kneading, or stroking — it is the pressure that makes the difference,” Field says. “You have to move the skin, actually see finger indentations in the skin. It does not hurt, but it is more than light stroking. We have found that light stroking does not help.”

Massage also helps relieve depression, Field adds. “Depression is related to low serotonin, low dopamine, and increased cortisol. We can jazz that up with massage. There are a lot of positive benefits from massage.”

 

Acupuncture and Fibromyalgia Treatment

 

Acupuncture, a traditional Chinese treatment, also helps ease fibromyalgia symptoms. Acupuncture works on brain chemicals to decrease anxiety, depression, insomnia, stress, and pain.

 

Understanding Fibromyalgia

Fibromyalgia is characterized by chronic widespread pain and tenderness for at least three months. You can take steps to manage fibromyalgia pain and help yourself feel better.

Diagnosis

Currently there are no diagnostic tests, such as x-rays or blood tests, to detect fibromyalgia. The symptoms of fibromyalgia may overlap with the symptoms of some other conditions. That is why fibromyalgia is sometimes difficult for healthcare professionals to diagnose.

Some healthcare providers use certain guidelines to help make a diagnosis. According to guidelines set by the American College of Rheumatology, a person may have fibromyalgia if he or she has both:

Chronic widespread pain that affects the right and left sides of the body above and below the waist

Feels pain in at least 11 of 18 possible tender points (nine on one side of the body, nine on the other) when light pressure is applied

Your healthcare provider may use these guidelines or other methods to make a diagnosis of fibromyalgia.

Discuss all of your symptoms with your healthcare provider. Talk openly with him or her about what you are feeling and how your symptoms are affecting you. You can work together to create a plan that meets your individual needs and helps you manage your symptoms.

 

Fibromyalgia Symptoms & Potential Causes

Symptoms of Fibromyalgia

The common symptoms of fibromyalgia include:

Pain that can change location and intensity from day to day

Many tender places on the body that are painfu

Fibromyalgia can make it hard for you to function. This is not a complete list. You may have other symptoms. You should discuss all of your symptoms with a healthcare provider. Only a healthcare provider can diagnose fibromyalgia.

 

What Causes Fibromyalgia?

No one knows exactly what causes fibromyalgia. Some possible triggers may include:

A physically traumatic or stressful event

An emotionally stressful event

An illness or an immune disorder

Why Do I Hurt?

The cause of fibromyalgia is unknown. If you have fibromyalgia, you may be more sensitive to pain than people who do not have fibromyalgia.

 

 

 

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(http://www.webmd.com/fibromyalgia/fibromyalgia-pain-8/alternative?ecd=wnl_day_051609&em=amVhbm5laGFtYmxldG9uQG1hYy5jb20http://www.webmd.com/living-with-fibro/fibro-symptoms-causes   http://www.webmd.com/living-with-fibro/understanding-fibro   )              

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Fibromyalgia and Stress – Finding the Right Treatment

From FMS Global News Desk of Jeanne Hambleton (UK)

Courtesy of Fibromyalgiaconsultant.com

by Matt Dew

 

The two health problems puzzling many people are fibromyalgia and stress. Fibromyalgia and stress influence each other and often co-exist. Stress is a personalized response to the alterations in the environment that is based on personal perception of feeling in a certain situation. There is an inherent correlation between fibromyalgia and stress though perception differs from one to another.

Relatively, every individual feels some amount of stress throughout fibromyalgia and it surely worsens the condition to a significant amount. Stress generally offers a negative effect on healthy well-being. Furthermore, fibromyalgia is no exception.

Now we will shed light on the potential relationship between fibromyalgia and stress response. Then we will progress further by discussing about few stress management strategies that you can take on particularly when you are experiencing fibromyalgia.

The Relationship

In most of the cases, people with fibromyalgia are identified as having ‘Type A’ personality, the group of people featured as stress-prone as compared to other group of people belonging to ‘Type B’ personality. Astonishing but true, research proposes people with fibromyalgia experience hormonal imbalance that resembles the same disorder occurring during stress response.

Thus, it can be said that there is a biological relationship between fibromyalgia and stress response. However, more research is actually needed to prove the pattern and strength of the relationship.

Warm Bath Technique

You need to take a warm bath mixed with two to three drops of essential oils. Do not depend on anyone else for choosing your essence; rather choose the fragrance of your own preference. Lavender is suggested by many aromatherapists as one of the major fragrances that aids in relaxation. You may apply your own creative instinct to design your bathing environment.

Because you are suffering from fibromyalgia and stress is an inevitable part of it, you need to do something exciting and soothing to your mind too. Try using candlelight bathing or a bubble bath to revive yourself.

Deep Breathing and Guided Imagery

Instead of chest breathing, you have to practice deep abdominal breathing. Deep breathing is a necessary instrument to do an appropriate relaxation. You can simply lie down and breathe deeply. Not more than a few minutes practice of breathing relaxation can offer you a stress-free day.

When you practice deep breathing, do not forget to implement guided imagery to improve your experience of relaxation. In guided imagery, you should visualize beautiful scenes or events with the help of your mental eyes. This will bring an extremely peaceful effect to your mind.

Choose Healthy Diet

Healthy diet is proven to be an effective method to stay away from many illnesses includes fibromyalgia and stress. People with fibromyalgia must avoid broccoli, caffeine, aspartame and alcohol in their diet. Besides, it is suggested to walk for at least 20 to 30 minutes most days of the week as well to quicken the recovery. 

Fibromyalgia and Vitamin D Deficency – Recognising the Relationship

Many researches have been conducted to improve the understanding of relation between fibromyalgia and vitamin D deficiency. Those researches are connecting the muscular pain and debility which are experienced by fibromyalgia patients, to an insufficient intake or meager absorption of vitamin D in the body. Below is a brief explanation of relation between fibromyalgia and vitamin D deficiency.

A number of studies on both adult and children subjects have discovered that low levels of vitamin D in the body cause unexplained bone and muscular pain. These results have been accepted by health experts.

If there is a confirmation about relation between fibromyalgia and vitamin D deficiency, it will be possible to treat the pain and debility of fibromyalgia with sources of vitamin D. Even so, this does not mean that fibromyalgia is merely a deficiency of vitamin D in the body. Vitamin D deficiency is only one factor arising or aggravating symptoms of fibromyalgia.

The observed improvement in the overall condition of fibromyalgia patients using vitamin D indicates a strong connection between the disease and the function of vitamin D in maintaining bone and muscular health. The role of vitamin D in contributing to the development of fibromyalgia is thought to be rooted in its metabolic function. Vitamin D helps in the synthesis of parathyroid hormone (PTH) in the body.

The parathyroid hormone serves to extract phosphates, especially calcium phosphate, from the bones. Combined with other factors, a failure to extract adequate amounts of phosphates from bones can lead to fibromyalgia. In case of vitamin D deficiency, the body is depleted in parathyroid hormone and hence an abnormal retention of phosphates in the bones may initiate a march toward symptoms of fibromyalgia.

Sunlight, Fibromyalgia and Vitamin D Deficiency

One linking factor of significance in the connection between fibromyalgia and vitamin D deficiency is a person’s exposure to sunlight. Vitamin D forms in the skin upon exposure to sunlight for about 15 to 30 minutes. Limited exposure to sunlight on account of climatic factors, lifestyle, skin color, or any other reason, can result in vitamin D deficiency in the body, even when a normal course of nutrition is followed.

The connection between fibromyalgia and vitamin D deficiency lead health experts to bear to believe the small quantities of undefended sun exposure could be useful for health. Since fibromylgia grows slowly but surely in excess of many years, it is reasonable to minimize the use of sunscreen when out on a fairly bright day and change a totally sun-protected lifestyle. If you need more information, please explore links on this Fibromyalgia Consultant site.

 

Disclaimer: Any views or opinions expressed in this article are those solely of the author/writer  and do not necessarily infer endorsement by the FMS Global News Desk.  Any advice or recommendation of a medical or legal  nature, or regarding exposure to sunlight without sunscreen protection, must always be discussed with a qualified professional.  FMS Global News cannot be held responsible for omissions and/or errors.

MAY 12 – WORLDWIDE FMS AWARENESS DAY

by Jeanne Hambleton Copyright 2009

 May this 12 May blossom into a wonderful year

Somehow I just could not let today pass without making some effort to celebrate International  Fibromyalgia Awareness Day together with others who suffer chronic pain and long term illnesses.

We constantly strive to raise awareness about this chronic condition  but my thanks must go to Tom Hennessy who lives in the States and is now bedridden, for  launching this annual event. Hopefully around the country in the UK and possibly worldwide people with fibromyalgia will be doing their darnest to bring the invisible disability to the attention of the public.  Fibromyalgia has been described as more common that rheumatoid arthritis and often more painful.

While in the States, who proclaim a worldwide epidemic of FMS  is upon us,  there are something like 6 to 7 million folk suffering with fibromyalgia – here in the UK it is said 2.7 million people have  this condition. Has the epidemic started here at home  I wonder? Considering the vast different in the population  our number is very high –  I am told one in 50 people. 

Regardless of this high number let me reassure those who  are feeling down and full of despair, that there is light at the end of the tunnel. A huge army of volunteers are fighting daily battles to raise awareness, shame our government into giving  us funds for research to find a cure and the cause and FMA UK  are spreading the word on a regular basis. 

We are trying hard to move mountains – maybe with a bit more help we might be moving them a bit quicker. 

But we should remember this  May 12 as being a few days after the first ever  historic debate about fibromyalgia  in the House of Commons. There were some fine words spoken by  a few MPs who made the effort  to  be in the House at 9.30am to  back Rob Wilson MP (chairman of the All Party Parliamentary Group for Fibromyalgia) who  had secured a debate to consider support for the people who have fibromyalgia.

Rob Wilson’s opening speech was very detailed and covered many issues relating to  this rotten condition. Anne Milton MP, Shadow Minister, Health, and Norman Lamb MP, a member of the APPG for FMS,  provided great support for the call for to help those with fibromyalgia. They had done their homework and certainly knew quite a bit about our condition. 

In spite of the magnificent  backing from a small group of MPs, the Minister, Ann Keen,Parliamentary Under-Secretary (Health Services), Department of Health, gave no firm assurances that she could give her full support the plea for help. She did however point out where information on FMS was available on NHS websites although it was reported earlier that NICE has declined to consider providing guidelines on fibromyalgia finally after almost two years wait. This is the time it took for NICE to reply to a request from FMA UK. 

Although Ann Keen described herself as a  health professional (a former  community nurse) it appeared her hands were tied. On a positive note she did suggest, “Everyone of us wants the best for those suffering from that chronic, distressing, uncomfortable and painful condition,” but she made no commitments. She stated  the debate could be the start of important dialogue with the two  APPGs for FMS and Chronic Pain.

Hansard reported the Minister suggested that  ”…setting NHS must-dos is not easy…The Department of Health must be sparing in setting those priorities centrally because of the criticism that we often receive when we attempt to do so. I know that everyone in this Chamber is here in good heart, but it is important to put it on the record that if we were to keep giving the NHS priorities, my list, let alone those of the rest of the ministerial team, would be long.”

To read a comprehensive report of the debate  log on  http://fmsglobalnews.wordpress.com/2009/05/09/mps-call-for-fibromyalgia-education-for-doctors-in-first-ever-fms-debate-in-uk-parliament/

and listen to the debate (75 minutes approx.)  log on to

http://www.fibromyalgia-associationuk.org/content/view/385/1/

You may already know that in March the Chief Medical Officer of the Department of Health, Sir Liam Donaldson, in his annual report for 2008 highlighted the problems surrounding chronic pain. 

 He pointed out, “Every single day, millions of lives are ruined by long term pain. Chronic pain is common and is getting commoner. People of all ages are affected, from children to older people. Pain left untreated can eventually become untreatable.”

He added,”Chronic pain is devastating for sufferers and their families. Children with pain do worse at school. They have more mental health problems. Half the adults with chronic pain struggle to walk, drive or even sleep. A quarter will lose their jobs. Quite simply, pain ruins lives.  The costs to our economy are enormous. Over half a billion pounds is spent annually by the NHS on pain medication alone.

 ”Pain is too big a problem to ignore. Yet it seems we have not been paying it enough attention. Patients say they are rarely asked about their pain by doctors or nurses. When they are asked, the treatment they receive is often inadequate. Many patients with pain are not getting any medical help whatsoever. Modern pain treatment can allow people with chronic pain to get their lives back. Medication is an important part of this. Other treatments such as electrical stimulation, acupuncture and psychological methods can be important as well. Patients can learn from professionals, and from other patients, how to recover. These services and more should come together in a modern multi-professional pain service. This has been shown to make a big difference to patients’ lives.

“Unfortunately, services are variable around the country – both in primary and hospital care. Only 14% of sufferers have seen a pain specialist. In fact, there is only one full-time pain specialist for every 32, 000 people with pain. Improving the quality and availability of services would benefit the lives of millions of people. In this chapter, I recommend changes to the way we deliver pain services in this country. We must start to routinely ask patients about their pain, record the information, and use it to improve services further.

 ”Wherever pain services have already been reformed, it has made life better for thousands of people. Change on a national scale can make life better for millions.”

I recently heard that   Ann Begg MP,  the lady who fought so valiantly in the House, but sadly unsuccessfully,  to stop  the co-proxamol withdrawal is the chairman of the All Party Parliamentary Group for Chronic Pain. I wish her much success.  Let us hope  this APPG might be influential in changing  the listing of co-proxamol to a controlled drug like morphine. Then  GPs could  prescribe  this wonder pain killer that so many of us have relied upon for pain relief,  to named patients without fear of litigation. Let us hope  that talks between the two Groups  might prove beneficial to  all of those who suffer chronic pain including the fibromites. 

Perhaps I should remind you  of the words of Pam Stewart, chairman of the trustees of FMA UK and vice president of the European Networks of Fibromyalgia Association, “We have a fight on our hands.”  So yes there is still work to be done. Keep up the pressure on your MP. The MP is vunerable  right now and should be listening to your requests for support as he will thinking it could win him votes.  Press your MP for funding for research and maybe  May 12 as Fibromyalgia Awareness Flag Day. 

Do remember  when  writing to your MP or sending a reader’s letter to your local newspaper, that  Fibromyalgia IS REAL, it is not a murky illness.  It does relate to our quality of life and it is a huge financial burden on the family. There are 2.7 million people  with FMS in the UK, mainly women and stress is a primary trigger.   With a worldwide epidemic looming, this number could increase dramatically. Action is needed now- not when it is too late.  Take care and think positively – we must have hope. Jeanne

 

Sources include Hansard and theyworkforyou.com

Culinary Medicine: Can Certain Foods Make You Healthier?

From the FMS Global News Desk of Jeanne Hambleton (UK)

Courtesy of WebMD.com

By Elizabeth Lee -Reviewed by Louise Chang, MD - WebMD Feature

A best-selling diet book promises to prevent disease by teaching you to cook like a chef and think like a doctor.

 

Imagine preventing breast cancer by eating broccoli and kalamata olive pizza, avoiding Alzheimer’s by skipping the turnip greens, and holding off heart disease with an ounce of dark chocolate and a handful of almonds every day.

Sounds yummy, yes?

Eating your way to better health is a belief that echoes through the centuries, from the green tea of China to Hippocrates’ advice to “let food be your medicine, and medicine be your food.” Its most recent form comes in best-sellers like ChefMD’s Big Book of Culinary Medicine by John La Puma, MD.

 

Like La Puma’s other books — he co-wrote Cooking the RealAge Way and The RealAge Diet – culinary medicine promises that eating healthy foods can slow the effects of aging, prevent disease, and boost overall health.

 

Along with the usual super foods — almonds, blueberries, salmon, and the like — La Puma includes such gourmet fare as Parmigiano-Reggiano cheese, red wine, and the occasional indulgence of grass-fed beef.

 

Will preparing healthy recipes such as a Warm Beef Tenderloin Salad With Mango and Avocado keep the doctor away?

 

Maybe, nutritionists say. But they caution against focusing on any single ingredient.

 

“I think of food as nourishing and pleasurable, and I like to leave medicine to the pharmaceutical industry,” says Marion Nestle, PhD, MPH, a professor of nutrition and food studies at New York University and the author of What to Eat. “But eating a reasonable diet is one of the best things people can do for their health.”

 

Culinary Medicine: Healthy Foods = Healthy You?

La Puma was an internist and medical ethicist before he enrolled in culinary school to learn to prepare healthy foods in an appealing way. He worked for a time in the kitchens of Chicago chef Rick Bayless, known for his embrace of “sustainably” grown food and authentic Mexican food.

 

Now La Puma is medical director of the Santa Barbara Institute for Medical Nutrition and Healthy Weight. He promotes culinary medicine through appearances on Lifetime Television’s Health Corner and on his web sites, chefmd.com and drjohnlapuma.com.

 

“You have restaurant-quality food that helps to prevent disease,” La Puma says. “This is a fresh approach because of the soundness of the science and the flavorfulness of the food.”

 

By offering healthy food that is also tasty, in recipes that come together in 30 minutes or less with no more than 10 ingredients, La Puma hopes to encourage cooking at home. That will cut down on consumption of highly processed foods and increase the intake of whole foods higher in nutrients.

 

The healthy recipes are also low in calories, to help keep weight in line and reduce the risk of cancer, heart disease, diabetes, and stroke. That advice follows mainstream medical thinking, as public health workers have increasingly focused on reducing obesity rates to help prevent chronic disease.

 

So far, so good, nutritionists say. But where is the exercise,  equally key to good health and maintaining optimal weight?

 

Culinary medicine focuses on food, not fitness. But it does include an eight-week plan for optimal health that counsels being active at least six days a week, for 30 minutes.

 

“I don’t know anyone who would separate those two,” La Puma says. “If exercise as a regime had a pharmaceutical name, it would be penicillin.”

 

Culinary Medicine: What Nutritionist Say

 

La Puma’s culinary prescriptions are filled with references to studies of nutrition and chronic disease. But nutritionists say some of the connections the book draws between what you consume and long-term health effects are tenuous.

 

“There is no one nutrient, there is no one food that is going to reduce your risk of cancer,” says Colleen Doyle, MS, RD, director of nutrition and physical activity for the American Cancer Society. “What is important, and it sounds so boring, is the overall dietary pattern.”

 

Mainstream nutritional guidance, including government recommendations, calls for a diet rich in fruits and vegetables, whole grains, and low-fat dairy products, supplemented with lean meats, fish, beans, eggs, and nuts. Diets should be low in added sugar, salt, saturated fat, and trans-fatty acids, or trans fats.

 

La Puma echoes that advice, while also recommending tea, wine, and small amounts of dark chocolate.

 

Guidelines are more specific for preventing or easing conditions from acne to ulcerative colitis: Yogurt can help with diarrhea, and migraine sufferers should avoid beer. Coffee can protect men from Parkinson’s disease and in women, may prevent diabetes, as well as colon and breast cancer, according to the book.

 

Not so fast, Doyle says.

 

“The American Cancer Society is not aware of any evidence that coffee impacts colon cancer significantly,” she says. “I think that is a leap from research to practice. We haven’t seen it.”

 

Christine Gerbstadt, MD, RD, is a spokeswoman for the American Dietetic Association and a lifestyle coach who operates a Florida practice that focuses on food as the first medicine. “My advice is always, if you do not drink coffee, do not start. If you do not drink alcohol, do not start,” Gerbstadt says. “There is no one thing that is absolutely required to be healthy, other than breathing.”

 

La Puma advises avoiding high-fructose corn syrup, choosing organic meats and produce when possible, and using full-fat salad dressings rather than reduced-fat or nonfat, to make sure nutrients in produce can be absorbed by the body.

 

There is no scientific consensus on those topics, nutritionists say. “I personally avoid poultry and meat raised with antibiotics and hormones, but I think there is a lot more emotion about it than there is science,” Gerbstadt says.

 

The same holds true for the claim that high-fructose corn syrup is more unhealthy than white or brown sugar, she says. They are all simple sugars that have the same amount of calories per teaspoon, Gerbstadt says, and affect the metabolism in similar ways.

 

Studies have shown higher nutrient levels in organic produce raised in richer soils, one of the reasons La Puma recommends choosing organic. He emphasizes organic for produce with thinner skin such as apples, berries, peaches, and potatoes, which are more prone to containing chemical pesticides. Nestle agrees, but for the environmental reasons — reduced exposure to pesticides.

 

“Whether the higher nutrient levels make any difference clinically remains to be seen,” she says.

 

The health benefits of dark chocolate are also a tough sell. La Puma points to studies that have shown it can lower blood pressure. But chocolate is high in calories, and weight gain can increase blood pressure. He recommends keeping portions small.

 

“Is there evidence that dark chocolate is going to prevent chronic disease? No,” Doyle says. “But if you like dark chocolate, it has some healthy fats and antioxidants.”

 

Culinary Medicine: Preventing Chronic Disease

 

La Puma advocates eating a variety of healthy foods, saying the combination of certain foods can be especially beneficial: turmeric and onion, and broccoli with tomatoes. Eating a variety of foods is advice most nutrition professionals agree on.

 

But how food affects chronic health conditions is still up for debate. Chronic diseases like cancer take time to develop. That makes studying the impact of a single ingredient difficult. Many studies that do so, including those on dark chocolate and blood pressure, focus on a small number of people, followed for just a few weeks or months.

 

Nestle says she sees hardly any direct connections between consuming a specific food and health benefits. “The only one I can think of is alcohol and the risk for heart disease. People who drink moderately have a lower risk for heart disease.”

 

La Puma allows that specific foods only go so far, but says he wants to motivate people to adopt a healthier lifestyle.

 

La Puma says he believes that at least 70% of heart disease and 80% of cancer is preventable, and that some can be reversed. Before age 50, genes determine much of an individual’s health. After that, it depends on the individual’s choices, he says.

 

“Doctors understand that what I am trying to do is inspire people to make changes, and the science is all sound,” he says.

 

“If I get just one more clinician to say to a patient, ‘Look, I want you to try this eight-week plan, I want you to have better food before we put you on cholesterol medicine or triglyceride medicine or high blood pressure medicine, and here is a reference to start,’ that part of my job is done.”

 

Culinary Medicine: Tips for Improving Health Through Eating

 

1. Learn how to use a knife. Having even basic cooking skills is the secret to putting better food in your diet.
2. Eat breakfast. People who eat breakfast live longer, weigh less, and keep weight off once they have lost it.
3. If you want to make a change, find a structure. That could be Weight Watchers or Jenny Craig, weighing yourself, having a pedometer count, or writing down what you eat daily.
4. Do not worry about being perfect. If you are choosing a baked potato instead of a deep-fried one, you know what? That is progress. If you are ordering fish instead of meat or beef, if you are eating nuts instead of chips, that is progress.
5. Start with easy recipes.

 

 

(http://www.webmd.com/food-recipes/features/culinary-medicine-can-certain-foods-make-you-healthier?ecd=wnl_wmh_051109&em=amVhbm5laGFtYmxldG9uQG1hYy5jb20=)

 

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FDA Approves Simponi

From the FMS Global News Desk of Jeanne Hambleton (UK)

Courtesy of  Drugs.com

 Simponi (golimumab) Receives FDA Approval as First Once-Monthly Anti-TNF for Treatment of Theumatoid Arthritis, Psoriatic Arthritis and Ankylosing Spondylitis

HORSHAM, Pa., April 24 /PRNewswire

Centocor Ortho Biotech Inc. announced today that the U.S. Food and Drug Administration (FDA) has approved Simponi (golimumab) for the treatment of moderately to severely active rheumatoid arthritis, active psoriatic arthritis and active ankylosing spondylitis. Simponi is the first patient-administered anti-tumor necrosis factor (TNF)-alpha therapy that offers an effective once-monthly treatment option. Rheumatoid arthritis, psoriatic arthritis and ankylosing spondylitis are chronic inflammatory diseases that result in pain and inflammation, and in some cases, joint destruction and disability. These diseases affect more than three million Americans combined.

“Simponi has been studied in a broad range of patients with rheumatoid arthritis, psoriatic arthritis and ankylosing spondylitis who had previously received a wide variety of treatments, including adults with rheumatoid arthritis previously treated with anti-TNF therapies, and has been shown to be significantly effective in reducing the signs and symptoms of each of these diseases,” said Jonathan Kay, MD, Associate Clinical Professor of Medicine, Harvard Medical School and lead study investigator.

“The approval of Simponi offers rheumatologists an effective new anti-TNF therapy for patients living with rheumatic diseases.”

In the U.S., Simponi is approved as a 50 mg subcutaneous injection once a month and is indicated:

• In combination with methotrexate for the treatment of adult patients with moderately to severely active rheumatoid arthritis
• Alone or in combination with methotrexate for the treatment of adult patients with active psoriatic arthritis
• For the treatment of adult patients with active ankylosing spondylitis

Simponi is available in two dosage forms. The Simponi SmartJect is a novel autoinjector designed to meet the needs of arthritis patients that has received the Ease-of-Use Commendation by the Arthritis Foundation. Simponi is also available as an easy to use prefilled syringe.

The efficacy and safety of Simponi have been evaluated in one of the most comprehensive clinical development programs for an anti-TNF-alpha therapy, which included simultaneous studies in rheumatoid arthritis, psoriatic arthritis and ankylosing spondylitis. The program, which includes more than 2,000 patients across five pivotal Phase 3 trials, served as the primary basis for FDA approval. In rheumatoid arthritis, Simponi has been studied in a broad range of patients, including adults naive to methotrexate, adults responding inadequately to methotrexate and adults previously treated with at least one anti-TNF-alpha agent.

In each of the three trials, significantly more patients receiving Simponi 50 mg plus methotrexate achieved at least a 20 percent improvement in arthritis symptoms (ACR20), compared with patients receiving placebo plus methotrexate and/or other disease modifying anti-rheumatic drugs. Improvements were seen as early as four weeks after the first Simponi injection and continued to improve over time. A proportion of patients also achieved substantial improvements in arthritis symptoms, 50 percent improvement (ACR50) and 70 percent improvement (ACR70), with continued Simponi treatment.

A Phase 3 trial, the largest of its kind, evaluating Simponi in the treatment of psoriatic arthritis showed that Simponi 50 mg significantly improved signs and symptoms of active psoriatic arthritis. Similarly, a Phase 3 study evaluating Simponi in the treatment of ankylosing spondylitis showed that Simponi 50 mg significantly improved signs and symptoms of active ankylosing spondylitis. Patients with psoriatic arthritis and ankylosing spondylitis experienced rapid and sustained improvements with continuous Simponi treatment.

“With the approval of Simponi, we enhance our commitment to delivering effective and innovative treatments to the millions of patients living with chronic inflammatory diseases while expanding our immunology portfolio,” said Kim Taylor, President, Centocor Ortho Biotech Inc.

“Importantly, as patient safety remains our top priority, we have collaborated with the FDA to develop a Risk Evaluation and Mitigation Strategy to help ensure the risks of ant-TNF therapy are appropriately managed by doctors prescribing and patients receiving Simponi.”

“The approval of new and effective treatment options is always good news for the arthritis community, as not all patients respond the same to currently available treatment options,” said Dr. John Hardin, Chief Scientific Officer for the Arthritis Foundation.

“Anti-TNF agents have become an important advancement in the treatment of rheumatoid arthritis, psoriatic arthritis and ankylosing spondylitis, and each approval offers physicians and patients yet another option within this important class of therapy.”

 

About Rheumatoid Arthritis, Psoriatic Arthritis and Ankylosing Spondylitis

Rheumatoid arthritis, psoriatic arthritis and ankylosing spondylitis affect more than three million Americans collectively. RA is characterized by persistent and progressive joint inflammation, causing pain, stiffness and functional disability. The Arthritis Foundation estimates that approximately 1.3 million people in the United States are affected by RA. For more information visit the Arthritis Foundation.

Psoriatic arthritis is a chronic inflammatory disease that causes joint pain and swelling and can lead to joint destruction. Psoriatic arthritis is frequently associated with inflamed, scaly, red patches of skin psoriasis and nail psoriasis. According to the National Psoriasis Foundation, up to 30 percent of people with psoriasis also develop psoriatic arthritis. For additional information visit the National Psoriasis Foundation.

Ankylosing spondylitis is a painful and progressive form of spinal arthritis. In severe cases, the disease can result in fusing of the spinal vertebrae and cause structural damage to hips and other joints. An estimated 500,000 people in the U.S. are living with ankylosing spondylitis. For more information visit the Spondylitis Society of America.

 

About Simponi (golimumab)

Simponi is a human monoclonal antibody that targets and neutralizes excess TNF-alpha, a protein that when overproduced in the body due to chronic inflammatory diseases can cause inflammation and damage to bones, cartilage and tissue. The first once-monthly subcutaneous anti-TNF-alpha therapy, Simponi is approved for the treatment of moderately to severely active rheumatoid arthritis, active psoriatic arthritis and active ankylosing spondylitis, and is available either through the Simponi SmartJect autoinjector or a prefilled syringe. Simponi is also being studied as an intravenous infusion therapy for the treatment of rheumatoid arthritis. For more information about Simponi, visit www.simponi.com.

In March 2008, Centocor Ortho Biotech Inc. and Schering-Plough Corporation announced that a Marketing Authorization Application (MAA) had been submitted to the European Medicines Agency (EMEA) requesting the approval of golimumab as a monthly subcutaneous treatment for adults with rheumatoid arthritis, psoriatic arthritis and ankylosing spondylitis.

Centocor Ortho Biotech Inc. developed and discovered Simponi and has exclusive marketing rights to the product in the United States. Following regulatory approval, Schering-Plough will assume exclusive marketing rights outside the United States except in Japan, Indonesia and Taiwan, where Simponi will be co-marketed by Mitsubishi Tanabe Pharma Corporation and Janssen Pharmaceutical Kabushiki Kaisha; Hong Kong, where Simponi will be exclusively marketed by Janssen-Cilag; and China, where Simponi will be exclusively marketed by Xian-Janssen.

 

 Important Safety Information

Simponi is a prescription medicine. Simponi can lower your ability to fight infections. There are reports of serious infections caused by bacteria, fungi, or viruses that have spread throughout the body, including tuberculosis (TB) and histoplasmosis. Some of these infections have been fatal. Your doctor will test you for TB before starting Simponi and will monitor you for signs of TB during treatment. Tell your doctor if you have been in close contact with people with TB. Tell your doctor if you have been in a region (such as the Ohio and Mississippi River Valleys and the Southwest) where certain fungal infections like histoplasmosis or coccidioidomycosis are common.

You should not start Simponi if you have any kind of infection. Tell your doctor if you are prone to or have a history of infections or have diabetes. You should also tell your doctor if you are currently being treated for an infection or if you have or develop any signs of an infection such as:

• fever, sweat, or chills
• muscle aches
• cough
• shortness of breath
• blood in phlegm
• weight loss
• warm, red, or painful skin or sores on your body
• diarrhea or stomach pain
• burning when you urinate or urinate more than normal
• feel very tired

Tell your doctor about all the medications you take or if you are scheduled to or recently received a vaccine.

Reactivation of hepatitis B virus has been reported in patients who are carriers of this virus and are taking TNF blocker medicines, such as Simponi. Some of these cases have been fatal. Your doctor may do blood tests before and after you start treatment with Simponi. Tell your doctor if you know or think you may be a carrier of hepatitis B virus or if you experience signs of hepatitis B infection, such as:

• feel very tired
• skin or eyes look yellow
• little or no appetite
• vomiting
• muscle aches
• dark urine
• clay-colored bowel movements
• fevers
• chills
• stomach discomfort
• skin rash

If you take Simponi or other TNF blockers, your risk for developing lymphoma or other cancers may increase. You should tell your doctor if you have had or develop lymphoma or other cancers.

Heart failure can occur or get worse in people who use TNF blockers like Simponi. Your doctor will monitor you closely if you have heart failure. Tell your doctor right away if you get new or worsening symptoms of heart failure like shortness of breath or swelling of your lower legs or feet.

Rarely, people using TNF blockers can have nervous system problems such as multiple sclerosis. Tell your doctor right away if you have symptoms like vision changes, weakness in your arms or legs, or numbness or tingling in any part of your body.

Liver problems can happen in people using TNF blockers. Contact your doctor immediately if you develop symptoms such as feeling very tired, skin or eyes look yellow, poor appetite or vomiting, or pain on the right side of your stomach.

Low blood counts have been seen with people using TNF blockers. If this occurs, your body may not make enough blood cells to help fight infections or help stop bleeding. Your doctor will check your blood counts before and during treatment. Tell your doctor if you have signs such as fever, bruising, bleeding easily, or paleness.

Rarely, people using TNF blockers have developed lupus-like symptoms. Tell your doctor if you have any symptoms such as a rash on your cheeks or other parts of the body, sensitivity to the sun, new joint or muscle pain, becoming very tired, chest pain or shortness of breath, swelling of the feet, ankles, and/or legs.

Tell your doctor if you are allergic to rubber or latex. The needle cover contains dry natural rubber.

Tell your doctor if you have any symptoms of an allergic reaction while taking Simponi such as hives, swollen face, breathing trouble, or chest pain. Common side effects of Simponi include: upper respiratory tract infection, nausea, abnormal liver tests, redness at site of injection, high blood pressure, bronchitis, dizziness, sinus infection, flu, runny nose, fever, cold sores, numbness or tingling.

You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch, or call 1-800-FDA-1088.

The Full Prescribing Information and Medication Guide for Simponi will be available at www.simponi.com.

 

About Centocor Ortho Biotech Inc.

Centocor Ortho Biotech Inc. redefines the standard of care in immunology, nephrology and oncology. The company was formed when Centocor, Inc. and Ortho Biotech Inc. were consolidated in late 2008, and was renamed Centocor Ortho Biotech Inc. Built upon a pioneering history, Centocor Ortho Biotech Inc. harnesses innovations in large-molecule and small-molecule research to create important new therapeutic options. Beyond its innovative medicines, Centocor Ortho Biotech is at the forefront of developing education and public policy initiatives to ensure patients and their families, caregivers, advocates and healthcare professionals have access to the latest treatment information, support services and quality care. For more information about Centocor Ortho Biotech, visit www.CentocorOrthoBiotech.com. Centocor Ortho Biotech is a wholly-owned subsidiary of Johnson & Johnson.

(This press release contains “forward-looking statements” as defined in the Private Securities Litigation Reform Act of 1995. These statements are based on current expectations of future events. If underlying assumptions prove inaccurate or unknown risks or uncertainties materialize, actual results could vary materially from Centocor Ortho Biotech Inc. and/or Johnson & Johnson’s expectations and projections. Risks and uncertainties include general industry conditions and competition; economic conditions, such as interest rate and currency exchange rate fluctuations; technological advances and patents attained by competitors; challenges inherent in new product development, including obtaining regulatory approvals; domestic and foreign health care reforms and governmental laws and regulations; and trends toward health care cost containment. A further list and description of these risks, uncertainties and other factors can be found in Exhibit 99 of Johnson & Johnson’s Annual Report on Form 10-K for the fiscal year ended December 28, 2008. Copies of this Form 10-K, as well as subsequent filings, are available online at www.sec.gov, www.jnj.com or on request from Johnson & Johnson. Neither Centocor Ortho Biotech Inc. nor Johnson & Johnson undertake to update any forward-looking statements as a result of new information or future events or developments.

Drugs.com provides free, accurate and independent advice on more than 24,000 prescription drugs, over-the-counter medicines & natural products.                                                                                                                  

 For more health stories see: http://fmsglobalnews.wordpress.com 

Paws-ability: Dogs’ assistance immeasurable

From the FMS Global News Desk of Jeanne Hambleton (UK)

Courtesy StarTribune.com - © 2009 Star Tribune. All rights reserved.

Shelley  Hiemer has fibromyalgia

Bruce Bisping, Star Tribune

Shelly Hiemer and her service dog, Grace demonstrated how a service dog helps with

shopping at a Franklin Ave Coop grocery store.

By KRISTIN TILLOTSON, Star Tribune - April 17, 2009 

 

Seeing-eye dogs have long been used to help their owners around town. But a Minneapolis nonprofit trains loyal canines to do so much more for people with disabilities — such as opening doors, making bank deposits and helping them get dressed.

The job of most family dogs is simple. They are to bark when the doorbell rings, try to resist garbage diving and be really, really happy to see their humans when they get home. Those slacker pooches have it easy. A 4-year-old black Lab named Grace regularly opens and shuts doors, pulls packaged grocery items off shelves, carries handbag essentials in her vest like a sort of living purse, tugs her owner’s socks off at night, and fetches dropped cell phones and TV remotes. She appears to love every minute it.

Grace is no circus act. She was trained for practical purposes at Hearing and Service Dogs of Minnesota (HSDM), the most helpful little canine-related group you never heard of. Tucked into a semi-industrial area of south Minneapolis, the nonprofit has been quietly matching dogs with disabled people for 20 years.

Alan Peters, executive director of Hearing and Service Dogs, was successful in real estate and insurance sales before deciding at age 35 to “do what I could to put dogs and people together for curative effects,” he said.

Aided by a legion of volunteer puppy raisers and trainers, including many Lions Club members, 70 to 100 dogs are now placed annually. About half are rescued from shelters. They comprise a wide variety of breeds, including some you might not expect.

“We have placed everything from a 6-pound Malty-poo to a 92-pound Doberman,” said HSDM spokeswoman Shelly Hiemer. “A lot of breeds can be trained. It just might take longer with the smarter ones.” (Some terriers, for example, balk at first, but come around eventually.)

At the moment, a plucky, pint-sized Yorkie named Tex was learning to pick up dropped keys at HSDM’s ground zero, a mini-gym outfitted with tugging ropes tied to door and drawer handles, a battered cell phone for retrieval practice and a handicapped-door button on one wall.

“Smaller dogs cannot be guides, act as ballast or open doors,” Hiemer said. “But they can pick up small objects and alert owners who cannot hear ringing phones, doorbells or smoke alarms.”

Clients come from seven states and include people with a wide range of disabilities: autism, hearing impairment, quadriplegia. In a way, the dogs themselves have a say in their placement.

“We figure out what they most love to do, and then find a match on the waiting list,” Hiemer said.

Grace, the black Lab, is Hiemer’s service dog. Hiemer, who was a client of HSDM before getting a job there, has the joint and muscle condition fibromyalgia, which makes it painful for her to do things like carry a purse. She also has diabetes, and Grace can smell the chemical change in Hiemer’s body when her blood sugar is getting low, alerting her before she gets disoriented or loses consciousness.

“She is a dual-service dog,” Hiemer said. “She can pick up something as small as a dime, or drag a laundry basket — even picks up my husband’s dirty socks on occasion.”

On a trip to the Seward Co-op, Grace gamely soft-mouthed bags of brown sugar and snack chips for delivery to Hiemer’s cart. As they turned into the coffee aisle, they ran into two fellow students. Hayley, a smooth-coated collie, and Belle, a golden retriever, were practicing how to stay calm around lots of tempting food smells with trainers Angela Olson and Leslie Flowers.

It can take up to two years and $25,000 to prepare a dog for service, depending on the needs of the client. Trainers include four out in “the field,” within 100 miles of the Twin Cities, and inmates at Faribault Correctional Facility, where the program is one of the most popular jobs.

Only 50 to 60 percent of dogs that begin the program “graduate,” for various reasons, including health and temperament. Only puppies and young-adult dogs are chosen, so that once they are trained they are likely to be able to give many years of service — and, of course, undying love.

The canine traits of unconditional devotion and steadfast loyalty are a special bonus. Human helpers can get exasperated, picking up an object that was just dropped for the 50th time by an arthritic hand.

“Dogs never do,” Hiemer said.

 

 

 

 For more information on Hearing and Service Dogs of Minnesota,email info@www.hsdm.org or call  Kristin Tillotson

•612-729-5986. Watch video of service dogs in training at startribune.com/video. And they provide these dogs free of charge to their disabled clients! The staff, trainers, and puppy raisers deserve our highest praise.

(http://www.startribune.com/lifestyle/43183062.html?elr=KArksLckD8EQDUoaEyqyP4O:DW3ckUiD3aPc:_Yyc:aUUsZ)

 

SEE http://fmsglobalnews.wordpress.com for another dog story

Catalan Government Leaves CFS/ME/FMS Patients High and Dry

From the FMS Global New Desk (UK)

by Jeanne Hambleton  Copyright 2009 All Rights Reserved

I need your help again please  -  but this time BIG TIME!

In November 2007 I wrote two stories about the people of Catalonian Spain who have CFS/ME/FMS and their efforts to get recognition from their Government for their problems and health.  It was truly a story of courage and dedication. After years of badgering, lobbying, calling in favours  and protesting, they managed to a get Bill before their Catalan Parliament.

To make sure everybody was counted the Catalonians took pictures of faces, pasted to card on sticks to their protests. These faces represented the people who were too ill to leave their beds  to support the cause,so they were there in spirit,  so to speak.

In May 2008 Clara Valdverde declared the first victory with the Catalan  Parlament. After  a year and a half of hard work by the Catalan CFS/ME and FMS associations  a Parlamentary Resolution voted by unanimity to organize health services for people with these illnesses. This unanimous vote was only possible because the associations had gathered in 2007 almost 140,000 signatures as part of a Legislative Initiative (for which only 50,000 signatures were necessary).

Clara said the process has been a very hard one with, not only the signature gathering, but countless meetings with politicians, associations and organizations, writing documents, educating and press work.

The negotiations with the goverment have been very, very rough, nasty and intense until the last minute. They were not going to accept the demands as a law but we managed to get them all accepted as a Resolution. A law would have been more binding but it would never have passed. This Parlamentary Resolution has the advantage of having been voted unanimously by all parlamentarians and with full press coverage (live on television on real time), which will make it harder for the goverment to back down.

Barcelona May 21, 2008, and Clara decided it was an exciting day.  She wrote, “The Legislative Promoting Commission (half a dozen of us from various CFS/ME and FMS associations who were leading this initiative) was in the Parlament and we presented our demands. That was followed by presentations by all the parlamentary groups and then the vote. And a standing ovation. Outside the Parlament Building there were almost a thousand people, mostly women with CFS/ME or FMS  singing, cheering and celebrating.

         These are the main points that the Resolution covers:

-       The setting up 11 CFS/ME-FMS especialized units with three of them being research units also (right now there is one that is operating but it has a 3 year waiting list)

-       These units will have multidisciplinary teams (internal medicine, rheumatology, neurology, etc and even pediatricians)

-       Waiting lists cannot be longer than 90 days to access a unit (a big change from 3 years)

-       Doctors will be trained about CFS/ME-FMS (international specialists will probably have to be invited for this)

-       Medical inspectors will be trained on these illnesses

-       The follow-up of the setting up of these services will be done by a joint committee in which patients’ associations will be represented

 The Catalan Minister of Health, Marina Geli, was not so happy about having to carry this out and she said so on the goverment’s home page the same day it was voted in Parlament (this would require a long explanation about Catalonia, Spain, and many anthropological concepts…).

 So, the associations are not taking a break or taking the time to celebrate this victory because we know we cannot afford to slack. We have to keep a good watch on what the goverment is doing and not doing. So, we are back at work doing the following:

-       Educating patients and their associations to all be watch-dogs and to report on the implementation of this resolution in their area: we are teaching people how to file proper complaints that can be used in a legal case if need be.

-       Making sure that all patients know the content of the Resolution. To make this easier, we have written a song with all the main points to the tune of “Yes We Can” (thank you, Obama), so that people can remember it.

-       Working with a law firm, Collectiu Ronda, to do a proper and constant follow-up and to gather evidence in case the resolution is not carried out properly. In that case, the law firm will do a colective law suit against the goverment.

-       Going back to the press about how we are still on the “war path” until we make sure this Resolution is respected and carried out.

This last year and a half has been decisive for the CFS/ME-FMS movement in Catalonia:

-       The associations have joined forces

-       140,000 people have been educated one by one, by our 150 signature gatherers

-       Parlament has spent much time talking and arguing about the issue of services for CFS/ME-FMS (one parlamentarian told us that they had never talked so much about any issue before)

-       The Catalan Health Deparment has been challenged like never before by civil society and they now know that we are a force to be reckoned with

-       There has been an enormous rise in consciousness amongst people with CFS/ME-FMS in Catalonia

-       We are a lot less invisible now!

-       And we are on our way to getting proper health care services (although much work is still to be done).

 

We have had a lot of help and support from people, associations and experts in other countries and so to all of you we want to say a big GRACIAS!

 

AND THEN…..

Of course we were all delighted with the success of Clara and her team of supporters. We held the Catalan Parlament up as a shining example to the world.  We said if Catalan can do this for these patients who live with pain 24/7, through not fault of their own,  then the rest of the world should be able to do the same.

HOW WRONG WE ALL WERE!

It would seem the Catalan  Parlament has welched  ( big time) on its deal with  the CFS/ME and Fibromyalgia Associations.

BAD NEWS

This week I  had  bad news from Clara who was the driving force behind all this activity in Catalonia.   She wrote

“Dear Friends and Colleagues,

Just one month before the Catalan government (Spain) is supposed to have accomplished the setting up of new CFS\ME and FMS units as it was voted unanimously by the Catalan Parliament a year ago, we have found out that they plan a counter attack which consists of making CFS\ME\FMS units disappear. They have stopped all doctor’s training on CFS/ME and FMS, and have ordered CFS/ME specialists to not give disability status to any patients. They also have other ideas up their sleeve, including joining CFS/ME with certain psychiatric conditions and medicating them so.

This is a major set back.

We need help from all of you all over the world.

Please write to the four people in the government who are responsible for this:

The minister of health of Catalonia, Consellera Geli  <consellera.salut@gencat.cat>

The member of parliament of the ruling party in charge of health, Dr Caterina Mieras <caterina.mieras@parlament.cat>

The two adminstrators in charge of the plan:

Dr Josep Argimon <jargimon@catsalut.net>

Dr Maria Luisa de la Puente <mlpuente@catsalut.net>

With a copy to us: <info@ligasfc.org>

We will keep you informed and thank you for your help,

Clara Valverde - President, Liga SFC (Spain)

 EPILOGUE

If you think the Catalonian people with FMS and CFS/ME have been badly let down by this u turn, please help these unfortunate  people and write emails of support to the four addresses Clara lists.

I must say if the situation was reversed and we had been promised all these changes ( yes I know and pigs might fly) I would be asking Clara and her members to support us.  We should accept that we are  all part of the  Fibromyalgia Family  (it is us and the normals) and as such, we must stick together if we are to raise awareness and hope to get any funding for research to find a cure. Have you written to your MP urging him to press on your behalf for funding for research for a cure? I supposed you do want to be cured?

 

Who is your MP? Log on  to http://www.theyworkforyou.com/  put in your post code and hey presto – you can even write from that site – you do not even have to find a stamp or walk to the post box.

If you are looking for more background on this story look at the original stories

Nov.5 2007

http://fmsglobalnews.wordpress.com/2007/11/05/historic-magic-moment-for-catalan-fms-cfs-patients/

Nov.17.2007

http://fmsglobalnews.wordpress.com/2007/11/17/united-we-stand…-divided-we-fall…/

 

 

FOR MORE STORIES ON HEALTH  SEE    http://fmsglobalnews.wordpress.com 

 

Baroness Young: ‘Tell patients what their GP care costs’

From the FMS Global News Desk of Jeanne Hambleton (UK)

Courtesy PulseToday.com

By Gareth Iacobucci -16 Apr 09

The chair of the Government’s new health and social care regulator has re-ignited the debate over whether patients should be told the cost of their healthcare, by calling for them to be given ‘indicative bills’ showing how much was spent on treating them.

Speaking at a King’s Fund debate, Care Quality Commission chair Baroness Barbara Young said giving patients an idea of how much their treatment had cost would allow them to fully appreciate the value of the NHS.

Her call comes despite the Government recently rejecting calls to print the cost of medicines on labels, on the grounds that it would be unlikely to reduce wastage and may discourage patients from using medicines.

Although Baroness Young stressed that the proposal was a personal view, she said the move would be ‘the one thing we could do that would really help the public understand the quality of the NHS.

‘I know we would have to reassure people who did not quite understand what we are doing, but I do believe that if we gave people indicative bills whenever they got a service, it would start to turn the corner on the fact that this is a really good service,’ she said.

A public accounts committee report recently called on the Government to do more to make patients aware of the costs of drugs, by, for example, displaying costing information on the labels of dispensed drugs.

But a treasury response rejected the advice, claiming that research had shown that printing the cost of a medicine on the label would be ‘unlikely to reduce medicine wastage and could have a negative effect, such as discouraging use of the medicine.’

However, Baroness Young compared the plan to receiving a vet’s bill, which she said immediately allowed people to appreciate the costs involved.

‘It costs a shed-load of money, and everybody gets it free at the point of use. It’s a bargain,’ she said.

The new chair of the Government’s ‘super-regulator’ also rejected concerns that the recession would derail the drive towards quality, claiming that good providers would be able to provide cost-effective yet quality care.

‘Good quality care actually costs less, or at least certainly does not cost more,’ she said.

‘Good performers grapple with financial problems and deliver quality, poor performers fail on both.’

READERS COMMENTS:

Pulse, CMP Medica. All rights reserved. (http://www.pulsetoday.co.uk/story.asp?sectioncode=23&storycode=4122458&c=2&cid=young042209#)

 

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Bye-Bye Cellulite

From the FMS Global News Desk of Jeanne Hambleton (UK)

Courtesy WebMD.com

By Kathleen Doheny -Reviewed by Louise Chang, MD - WebMD Feature -Reviewed on March 16, 2009

 

From radiofrequency waves to lasers, a host of new treatments promises to help you get rid of cellulite.

At 39, Julie wears a svelte size 4 and works out regularly to stay lean. Still, she struggles with one frustrating figure flaw that most women can relate to: cellulite.

“I started getting it in my early to mid-30s,” says Julie, who lives in Chicago and asked that her last name not be used. It mostly cropped up on her buttocks and the backs of the upper legs.

When extra workouts did not seem to make a difference, she resorted to a new deep-heating technique that relies on radiofrequency technology to tighten collagen and firm up the dimply, cottage cheese-like skin that affects thin and heavy women alike.

After the treatment, she was pleased. “I am so happy I had it done,” she says. “My cellulite is drastically reduced.”

Julie’s heat treatment is not the only new option for banishing or reducing cellulite. In the past few years, a host of new options has become available. Which of these new cellulite treatments are the most promising and which ones should you skip? Read on for details.

Cellulite: Understanding It

Before seeking treatment for cellulite, it helps to understand what it is and why it occurs, experts say. “It is largely genetic,” says Carolyn Jacob, MD, a dermatologist and associate clinical instructor of dermatology at Northwestern Memorial Hospital, Chicago. “Ninety percent of women have it.”

Cellulite is fat, but with a different appearance than other fat. It looks like dimpled skin, sort of cottage-cheesy, and most often shows up on the thighs, hips, and buttocks. If it is mild, it can only been seen when the skin is pinched. But in more severe cases, the bumpiness and peaks and valleys show when the skin is not pinched.

Cellulite is much more common in women than in men, experts say. Why? Fat in women often accumulates in the thighs, hips, and buttocks. Underneath the skin, the fat contains fibrous bands.

In men, these bands are typically in even rows, says Robert Weiss, MD, president of the American Society of Dermatologic Surgery and a dermatologist in Hunt Valley, Md. But in women, even in women at a healthy weight, the bands are not in regular, even rows but are in more of a zigzag pattern, he says, probably due partly to hormonal influences. That allows the fat to push through the connective tissue that typically keeps it distributed evenly, resulting in the bumps, peaks, and valleys that appear as cellulite.

Genetics play a role in whether you will get noticeable cellulite, and so does the amount of fat in your body. Excess weight can make the cellulite more noticeable.

Cellulite Treatment: Exercise and Diet It Away?

Has anyone ever exercised away cellulite? “I think you can improve it somewhat with repetitive, low-weight exercises on the leg,” says Weiss. He presented new data on cellulite treatments at the 2009 annual meeting of the American Academy of Dermatology.

If you want to try to exercise away cellulite, he says, “use free weights or machines. Use 5- to 10-pound weights.” Include cardio exercise, too, for overall fat burning, he says.

Others agree diet and exercise can help. If you have excess weight, you should focus on reducing calories to shed the extra pounds, as well as doing regular strength training and cardio exercise to see improvement in cellulite, says Wayne Westcott, PhD. He is a fitness expert and fitness research director at the South Shore YMCA in Quincy, Mass., and co-author of No More Cellulite: A Proven 8 Week Program for a Firmer, Fitter Body.

In one study, he evaluated changes in 79 women, average age 45, who completed his eight-week cellulite reduction program. They trained three days a week, with each session including about 25 minutes for strength training and another 25 for endurance training such as jogging or cycling. The women lost fat and increased muscle, reversing the two problems Westcott blames for cellulite accumulation — muscle loss and fat gain in the hips and thighs.

When the underlying muscle is strengthened, he tells WebMD, “that makes the fat lay smooth, not crinkled.” His program includes 10 basic strength exercises — such as the leg curl, leg press, and hip adduction — as well as endurance exercise. In his study, the women who also reduced their calorie intake lost more weight — nearly 8 pounds compared to 1.5 pounds — and more fat — more than 9 pounds compared to a little more than 3.

Cellulite Treatment: Heat It Up?

Another option: radiofrequency waves, like Julie used, called Thermage. “Thermage uses radio wave energy through the skin to create heat, which then tightens the [fibrous connective] bands that cause the rippled appearance in your skin,” says Jacob, who treated Julie.

The Thermage technique has been used on the face for years but only recently for cellulite treatment. “The procedure takes about an hour and a half,” Jacob says. The handheld device that delivers the radio wave energy is placed on the skin in a grid pattern, Jacob says. The area is treated repeatedly. One procedure is typically all that is needed. “For some people it takes a couple months to see the results,” she says.

Jacob estimates the results may last up to 21 months or so.

In a company study, 18 of 20 women who had Thermage to improve their cellulite reported continuing improvement at up to 16 weeks after the procedure, while two saw no change.

The technique works best, Jacob says, for women ages 20 to 45 who are normal weight with a mild to moderate cellulite problem. Those beyond age 45 could try it, Jacob says, but she suspects less benefit.

The cost is about $2,000 or higher.

Cellulite Treatment: Lasers, Lights, Vacuums, Massage

Other approaches to banish cellulite work by combining treatments.

One example is SmoothShapes, which treats cellulite and subcutaneous fat by combining light energy and dynamic laser light with mechanical methods, says Weiss. He studied the approach for the company and has served as a consultant for some laser companies.

The laser is used to liquefy the fat, and then a special light increases the permeability of the cell membrane, helping to stimulate the production of collagen, the main protein in connective tissue. Suction is applied with a special vacuum to ensure consistent light penetration to the tissue, and rollers are used to gently massage the skin surface and help move the liquefied fats from the area into the body’s lymphatic system for drainage.

“The cellulite smoothes out,” Weiss says. In his study, they performed the treatment twice a week for four weeks. “We noticed improvement in some patients in as little as four treatments,” he says. The treatments run about $125 to $175 per treatment, Weiss says.

“I am going to advise our patients that it will last one or two years, assuming they maintain the same level of activity and the same dietary habits,” Weiss says.

Cheryl, 40, a Maryland attorney, went to Weiss in 2008. She hoped he could offer her a therapy to improve the cellulite that seemed to get worse after the birth of her daughter, now 5. She participated in the study he did for the company, having the SmoothShapes technique done on one leg. She had the six-month measure recently, and she definitely noticed a difference. “I could definitely see less dimpling,” she says. “It was firmer.”

Now Cheryl cannot wait to have the other leg done. “For me it will mean less hesitancy to wear shorts — and I do not mean short-shorts,” she says.

Cellulite Treatment: Lipo It Away?

Liposuction alone — the removal of fat from beneath the skin using a hollow tube inserted beneath the skin with assistance from a vacuum to suck out the fat — will change your silhouette, Jacob says.

“But do not count on it to take away the appearance of cellulite. It sometimes improves it but not every time.”

Cellulite Treatment: Creams and Potions

So-called anti-cellulite creams, widely available on the Internet and at drug stores, promise to at least improve the appearance of cellulite. Weiss tells patients to “not waste time and money on creams.”

But Jacob says those containing caffeine may have a bit of a temporary effect. “With caffeine there is some vasoconstriction,” she says. That, plus the recommended massaging of the cream into the skin, may help drain away a little fluid. “The appearance of the cellulite is improved, at least temporarily,” she says.

Cellulite Treatments on the Horizon

Scientists are looking at a treatment called cryolipolysis — basically chilling your fat — says Weiss. “It is the use of cold above the freezing mark,” he says. It can cause fat to be reabsorbed.

Viagra, the widely used erectile dysfunction drug, may someday help smooth bumpy cellulite, according to scientists in Croatia. The researchers speculate that the drug may also burn the fat underlying cellulite and improve circulation.

 

SOURCES: Robert A. Weiss, MD, president, American Society for Dermatologic Surgery; associate professor, Johns Hopkins School of Medicine; dermatologist, Hunt Valley, Md. Carolyn Jacob, MD, associate clinical instructor of dermatology, Northwestern Memorial Hospital, Chicago. Wayne Westcott, PhD, fitness research director, South Shore YMCA, Qunicy, Mass. Soltis Medical: White paper. Altabas, K. Medical Hypotheses, Feb. 27, 2009 online.

© 2009 WebMD, LLC. All rights reserved. 

(http://www.webmd.com/skin-beauty/features/bye-bye-cellulite?ecd=wnl_day_040109)

 

SEE: http://fmsglobalnews.wordpress.com for more stories on health issues. 

Pollen and Allergy Relief

From the FMS Global News Desk of Jeanne Hambleton  (UK)

Courtesy of WebMD.com

By Debra Fulghum Bruce, PhD - Reviewed by Brunilda Nazario, MD - WebMD Feature

Here is some allergy relief

Need some allergy relief? If you have allergies, you know that you can run, but you cannot hide from seasonal pollen.

With the first deep breath of spring, more than 50 million Americans begin their nearly year-round symptoms of sneezing, wheezing, coughing, snorting, and itching. And millions of allergy sufferers seek allergy relief in prescription medications that cost $6 billion dollars per year worldwide.

Let us be honest. If the miserable symptoms of pollen allergies do not push you over the edge, some allergy relief medicines can.  Sure, some older allergy relief medicines ease your symptoms, but they can also leave you feeling sluggish, sleepy, and unable to concentrate at work or school.

So how can something as miniscule as pollen make you feel absolutely awful? And where do you turn for effective allergy relief when you are plagued by weeks of impenetrable pollen?

What Is Pollen Anyway?

To know what you are up against, it is important to know something about pollen. Pollen, the microscopic powdery granules of flowering plants, is the mechanism for the fertilization of trees, grasses, and weeds. 

While pollen from plants with bright flowers like roses rarely trigger allergy symptoms, the tiny, dry pollens from grasses, trees, and weeds are the main allergy culprits. Even though your yard may have no true pollen offenders, pollen particulates blow in the wind. For example, one ragweed plant can produce up to 1 billion pollen grains, and each grain can travel more than 100 miles from its source.

Every plant has a specific period of pollination. Although weather changes can determine the pollen count in the air, the pollinating season stays constant with trees pollinating first during springtime, grasses pollinating from late spring to midsummer, and then weeds pollinating in late summer and early fall.

Need Allergy Relief When Pollen Counts Are High?

The best way to get allergy relief is to take allergy medicines on a regular basis and start before pollen season hits, says William E. Berger, MD, MBA, professor of medicine at the University of California, Irvine.  Berger is past president of the American College of Allergy and Immunology and author of Allergies and Asthma for Dummies.

In the body, histamines are chemicals that can cause swelling, sneezing, itching and a runny drippy nose or postnasal drip (mucus down the back of your throat).  Antihistamines (allergy relief medicines) are effective in treating some of the allergy symptoms caused by histamines.

Berger tells WebMD that the goal is to prevent allergy symptoms from occurring.

“Taking allergy medicines (antihistamines) regularly blocks the histamine receptors — the tissues that cause swelling. Histamine works by attaching itself to these receptors on the surface of cells. If you block the site where histamine works by pre-treating with allergy medicines, you prevent the allergic reaction and the allergy symptoms.”

To make his point, Berger uses an analogy: “What if someone takes your seat? Then you can no longer take that seat. It is now unavailable.”

The same concept works with allergy medicine, says Berger. “If you take the allergy medicine, it blocks the site so histamine cannot be released. If you take allergy medicines regularly, you continue to block the site and control allergy symptoms.”

Berger tells WebMD that taking antihistamines will not quickly stop today’s stuffy nose or sneezing from allergies. Nor will these allergy medicines reverse existing allergy symptoms. Antihistamines prevent future allergy symptoms, says Berger.  

Berger also recommends trying nasal corticosteroids, the first-line allergy relief medicines, two weeks before pollen season begins to keep symptoms at bay.

According to the American Academy of Allergy Asthma and Immunology, the best allergy medications work by inhibiting the immune system’s release of chemicals (IgE) that can trigger allergic reactions. As Berger suggests, if allergy medicines are taken before you are exposed to pollen, they can help to stabilize your immune system before you experience the miserable allergy symptoms.

Recommended treatment for pollen allergies includes: over-the-counter and prescription antihistamines such as Allegra, Benadryl, or Clarinex; decongestants like Sudafed; nasal steroids like Beconase, Flonase, or Veramyst; and drugs that combine antihistamines and decongestants like Allegra-D, Claritin-D, or Zyrtec-D. Allergy shots or immunotherapy are also a viable option for allergy relief for pollen allergies.

Need Quick Allergy Relief After Pollen Exposure?

So where do you turn when pollen hits you head-on and catches you without any protective allergy medicine? Are there remedies to ward off nasal congestion and still get allergy relief? Absolutely, according to Murray Grossan, MD, a Los-Angeles-based ENT and author of The Sinus Cure.  Grossan tells WebMD that using a saline nasal rinse or nasal irrigation several times a day during the height of pollen season gives allergy relief for two reasons.

“The saline solution removes miniscule particles of pollen from the nasal passages and also removes IgE, the chemical in the body that reacts with pollen to give you the allergy symptoms,” he explains. Lowered IgE levels mean fewer allergy symptoms.

Grossan knows all about nasal saline rinses and the respiratory system and with good reason: his Hydro-Pulse Nasal/Sinus Irrigator was featured in Time magazine (2000) as one of America’s best inventions.

On a lighter note, Grossan mentions that the singer Enrico Caruso used to suck pickled fish before giving performances. “The hypertonic solution diluted his mucus, making it easier to sing,” the doctor tells WebMD.

“In numerous published journal studies, findings show that patients with allergic rhinitis or chronic sinusitis who used saline nasal irrigation regularly left their doctors’ offices with the bacterial load reduced, requiring fewer antibiotics and expressing much greater patient satisfaction,” Grossan says.

To make a saline solution for nasal rinsing during pollen season, Grossan says use 1/4 teaspoon of salt to 4 ounces of bottled water.

See Your Allergist for More Allergy Relief

Lastly, if you are plagued by pollen allergies year round, your doctor may recommend allergy testing and allergy shots (immunotherapy). To get allergy relief, your doctor may also prescribe an inhaled steroid nasal spray, a non-sedating antihistamine, a decongestant, or other allergy medications.          

It is important to stay on your allergy medications daily to get full allergy relief and to prevent further problems.  Allergy medicines are especially necessary during spring pollen season when you risk being in allergy overload from all the offending substances.  

If you feel that your allergy medicines are not giving you enough relief, talk to your doctor or allergist.  Many of the newer inhaled allergy medicines can help stop inflammation and mucus production without side effects, allowing you to regain control of your active life.  

 

©2005-2009 WebMD, LLC. All rights reserved - (http://www.webmd.com/allergies/treatments-08/pollen-allergies)

 

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