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Biggest CameI toe at gym
The Challenge of Fibromyalgia
“The Healthy Geezer” answers questions about health and aging in his weekly column
Question: My sister went through a nightmare of doctor visits before she finally found out she has fibromyalgia. Why did it take so long for her to get a correct diagnosis?
Answer: What your sister endured is common. It’s not easy to diagnose fibromyalgia with just a laboratory test. Healthcare practitioners have to rely on symptoms to make a diagnosis.
Unfortunately, symptoms of fibromyalgia can vary, depending upon the person. To further complicate matters, fibromyalgia imitates other conditions, including rheumatoid arthritis, multiple sclerosis and lupus.
The word fibromyalgia comes from the Latin term for fibrous tissue (fibro) and the Greek terms for muscle (myo) and pain (algia). Fibromyalgia is not a disease. It’s a syndrome, which is a group of symptoms that doesn’t have a single cause. It is characterized by widespread pain, tenderness and fatigue.
Other symptoms of fibromyalgia may include cognitive difficulties (the so-called fibro fog); sleep disturbances; morning stiffness; headaches; irritable bowel syndrome; painful menstrual periods; numbness or tingling of the extremities; restless legs syndrome; and sensitivity to heat, cold, noise; and light.
About 5 million people in the United States have fibromyalgia. More than 80 percent are women. Most people are diagnosed during middle age.
While fibromyalgia is a chronic condition, it is not progressive. It is never fatal, and it will not damage the joints, muscles or internal organs. In many people, the condition improves over time.
The causes of fibromyalgia haven’t been found. There is speculation that the syndrome may be caused by trauma or repetitive injuries. According to one theory, people with fibromyalgia may have genes that cause them to react strongly to stimuli that most people would not perceive as painful.
The American College of Rheumatology has established criteria for diagnosing fibromyalgia. A person must have diffuse tenderness and a history of widespread pain lasting more than three months. Pain is considered to be widespread when it affects all four quadrants of the body.
Fibromyalgia can be difficult to treat. Often, treatment often requires a team of healthcare professionals including a doctor, a physical therapist and others. There are clinics that specialize in fibromyalgia.
Antidepressants may be prescribed to people with the syndrome. They work by elevating the levels of brain chemicals that are associated not only with depression, but also with pain and fatigue. Increasing the levels of these chemicals can reduce pain in fibromyalgia sufferers.
People with fibromyalgia also may benefit from a combination of physical and occupational therapy; pain management and coping techniques; and a proper balance of rest and activity. Some people also report benefit from massage, movement therapy, chiropractic treatment and acupuncture.
Lifestyle changes can also minimize the effects of fibromyalgia. Getting enough sleep, exercising and making changes at work can make a difference. For example, some people cut back on the number of hours they work or switch to a less demanding job. Working with an occupational therapist to design a more comfortable work station may also help.
Question: My sister went through a nightmare of doctor visits before she finally found out she has fibromyalgia. Why did it take so long for her to get a correct diagnosis?
Answer: What your sister endured is common. It’s not easy to diagnose fibromyalgia with just a laboratory test. Healthcare practitioners have to rely on symptoms to make a diagnosis.
Unfortunately, symptoms of fibromyalgia can vary, depending upon the person. To further complicate matters, fibromyalgia imitates other conditions, including rheumatoid arthritis, multiple sclerosis and lupus.
The word fibromyalgia comes from the Latin term for fibrous tissue (fibro) and the Greek terms for muscle (myo) and pain (algia). Fibromyalgia is not a disease. It’s a syndrome, which is a group of symptoms that doesn’t have a single cause. It is characterized by widespread pain, tenderness and fatigue.
Other symptoms of fibromyalgia may include cognitive difficulties (the so-called fibro fog); sleep disturbances; morning stiffness; headaches; irritable bowel syndrome; painful menstrual periods; numbness or tingling of the extremities; restless legs syndrome; and sensitivity to heat, cold, noise; and light.
About 5 million people in the United States have fibromyalgia. More than 80 percent are women. Most people are diagnosed during middle age.
While fibromyalgia is a chronic condition, it is not progressive. It is never fatal, and it will not damage the joints, muscles or internal organs. In many people, the condition improves over time.
The causes of fibromyalgia haven’t been found. There is speculation that the syndrome may be caused by trauma or repetitive injuries. According to one theory, people with fibromyalgia may have genes that cause them to react strongly to stimuli that most people would not perceive as painful.
The American College of Rheumatology has established criteria for diagnosing fibromyalgia. A person must have diffuse tenderness and a history of widespread pain lasting more than three months. Pain is considered to be widespread when it affects all four quadrants of the body.
Fibromyalgia can be difficult to treat. Often, treatment often requires a team of healthcare professionals including a doctor, a physical therapist and others. There are clinics that specialize in fibromyalgia.
Antidepressants may be prescribed to people with the syndrome. They work by elevating the levels of brain chemicals that are associated not only with depression, but also with pain and fatigue. Increasing the levels of these chemicals can reduce pain in fibromyalgia sufferers.
People with fibromyalgia also may benefit from a combination of physical and occupational therapy; pain management and coping techniques; and a proper balance of rest and activity. Some people also report benefit from massage, movement therapy, chiropractic treatment and acupuncture.
Lifestyle changes can also minimize the effects of fibromyalgia. Getting enough sleep, exercising and making changes at work can make a difference. For example, some people cut back on the number of hours they work or switch to a less demanding job. Working with an occupational therapist to design a more comfortable work station may also help.
3 Behaviors Make Kids More Likely to be Hit By a Car
Three behaviors put children at higher risk for being hit by a car, a new study finds.
Among kids under age 6, darting into the middle of the street — even while under supervision — was a common cause of injuries from cars. Older children were less likely to be supervised, and more likely to be hit by a car while they were crossing in the middle of the block (rather than at a corner), or while they were using an electronic device.
Increasing parental supervision and educating kids on how to cross safely, as well as reducing common distractions could play an important role in preventing accidents, the researchers said.
Dr. Nina Glass, of New York University’s Langone School of Medicine, and colleagues analyzed information from about 1,075 people who were struck by cars and treated at the researchers’ hospital between 2008 and 2011. Of these, 145 were under 18 years old.
When compared with adults, children struck by cars were more likely to be male (65 percent versus 53 percent), have head injuries (82 percent versus 73 percent).
Of the 39 children in the study under age 6, 17 were injured when they darted into the middle of the street, and 14 were hurt during a mid-block crossing. In all cases, the children were supervised at the time of the accident.
Among children ages 7 to 12, 53 percent were unsupervised at the time of the accident. Forty-seven percent were injured during a mid-block crossing, and 25 percent were injured after darting into the street.
Among teens ages 13 to 17, 88 percent were hit by a car while unsupervised. Thirty-two percent of accidents involved crossing mid-block, 18 percent involved use of an electronic device and 14 percent happened when a teen darted into the street. Just 4 percent of the teen accidents involved alcohol use.
In comparison, 18 percent of the adult accidents occurred while pedestrians were crossing in the middle of the street, 15 percent during alcohol use and 9 percent during electronic device use.
The study will be presented today (Oct. 19) at the annual American Academy of Pediatrics meeting in New Orleans.
Among kids under age 6, darting into the middle of the street — even while under supervision — was a common cause of injuries from cars. Older children were less likely to be supervised, and more likely to be hit by a car while they were crossing in the middle of the block (rather than at a corner), or while they were using an electronic device.Increasing parental supervision and educating kids on how to cross safely, as well as reducing common distractions could play an important role in preventing accidents, the researchers said.
Dr. Nina Glass, of New York University’s Langone School of Medicine, and colleagues analyzed information from about 1,075 people who were struck by cars and treated at the researchers’ hospital between 2008 and 2011. Of these, 145 were under 18 years old.
When compared with adults, children struck by cars were more likely to be male (65 percent versus 53 percent), have head injuries (82 percent versus 73 percent).
Of the 39 children in the study under age 6, 17 were injured when they darted into the middle of the street, and 14 were hurt during a mid-block crossing. In all cases, the children were supervised at the time of the accident.
Among children ages 7 to 12, 53 percent were unsupervised at the time of the accident. Forty-seven percent were injured during a mid-block crossing, and 25 percent were injured after darting into the street.
Among teens ages 13 to 17, 88 percent were hit by a car while unsupervised. Thirty-two percent of accidents involved crossing mid-block, 18 percent involved use of an electronic device and 14 percent happened when a teen darted into the street. Just 4 percent of the teen accidents involved alcohol use.
In comparison, 18 percent of the adult accidents occurred while pedestrians were crossing in the middle of the street, 15 percent during alcohol use and 9 percent during electronic device use.
The study will be presented today (Oct. 19) at the annual American Academy of Pediatrics meeting in New Orleans.
Children Can Increase Their Physical Activity By ‘Exergaming’
A study published in Pediatrics by researchers at the University of Montreal offers positive news for Wii-loving teenagers and their parents: games such as Wii Sports and Dance Dance Revolution can bring them closer to recommended physical activity levels. The study is the first of its kind. “Teenage exergamers – people who play video games that require physical activity – are most likely females who are stressed about their weight. On average, they play two 50 minute sessions per week,” said study author Jennifer O’Loughlin of the university’s Department of Social and Preventative Medicine. “As less than 15% of children and adolescents currently participate regularly in physical activity, we are pleased to report that exergaming can add to regular physical activity to attain physical activity guidelines” Current guidelines recommend that youth engage in 60 minutes of moderate or vigorous physical activity most days of the week.
The study looked at the family background and videogame habits of 1,209 Montrealers aged between 14 and 19. Teenagers and their parents completed surveys that covered subjects such as household income, drug use, body weight and education, enabling the researchers to ensure that their portrait of gamers was not influenced by a particular socio-economic profile. The questionnaire also covered what games were played, where, for how long, with whom, and with what intensity. Wii Sports (68% of exergamers), Dance Dance Revolution (40%), Wii Fit Yoga (34%), and Boxing (Punchout; 15%) were the most popular exergames played at home. WiiSports (26%) and Dance Dance Revolution (29%) were played most frequently at friends’ homes. Less than 1% of exergamers reported exergaming at school.
The researchers underscored that although previous studies have shown that boys are more likely to play videogames in general than girls, girls are more likely to play exergames. “Girls might be uncomfortable exercising at school because they feel judged and these games could be providing an alternative,” O’Loughlin said, noting that the games are particularly popular amongst youth of both genders who are concerned about their size. “On the other hand, there could be something about the kind of social interaction that exergaming provides that appeals to them.”
Exergaming could provide an avenue for addressing the serious obesity epidemic and O’Loughlin hopes that the practice will increase. “Factors such as competitions, new consoles, multiplayer modes, and contact with other players via the Internet could improve participation,” she said. “Additionally, the feasibility of exergaming in community centres or at school should be tested.” Noting that other studies have shown that boredom and other factors eventually may diminish the amount of exergame activity, O’Loughlin added that more research is needed to understand how to increase and support this kind of physical activity.
The study looked at the family background and videogame habits of 1,209 Montrealers aged between 14 and 19. Teenagers and their parents completed surveys that covered subjects such as household income, drug use, body weight and education, enabling the researchers to ensure that their portrait of gamers was not influenced by a particular socio-economic profile. The questionnaire also covered what games were played, where, for how long, with whom, and with what intensity. Wii Sports (68% of exergamers), Dance Dance Revolution (40%), Wii Fit Yoga (34%), and Boxing (Punchout; 15%) were the most popular exergames played at home. WiiSports (26%) and Dance Dance Revolution (29%) were played most frequently at friends’ homes. Less than 1% of exergamers reported exergaming at school.
The researchers underscored that although previous studies have shown that boys are more likely to play videogames in general than girls, girls are more likely to play exergames. “Girls might be uncomfortable exercising at school because they feel judged and these games could be providing an alternative,” O’Loughlin said, noting that the games are particularly popular amongst youth of both genders who are concerned about their size. “On the other hand, there could be something about the kind of social interaction that exergaming provides that appeals to them.”
Exergaming could provide an avenue for addressing the serious obesity epidemic and O’Loughlin hopes that the practice will increase. “Factors such as competitions, new consoles, multiplayer modes, and contact with other players via the Internet could improve participation,” she said. “Additionally, the feasibility of exergaming in community centres or at school should be tested.” Noting that other studies have shown that boredom and other factors eventually may diminish the amount of exergame activity, O’Loughlin added that more research is needed to understand how to increase and support this kind of physical activity.
Surprising Cause Found for Woman’s Wonky Pupils
When the pupil of one eye, but not the other, dilates abnormally or does not respond to light, doctors might suspect a nerve problem, or an aneurysm.
But in the case of one 35-year-old woman with an abnormally dilated pupil, the culprit turned out to be an over-the-counter medication she was using to treat her facial perspiration, according to a report on her case.
The woman’s spouse was a paramedic, and had noticed that one of her pupils was dilated when she woke up that morning. Doctors in the emergency room found that her left pupil measured 4 millimeters across, and responded to light. But her right pupil was twice that size, and didn’t respond to light.
She also had a mild headache, but no eye pain, trauma to her eye or change in vision. She initially reported that she was not taking any medications. About a year earlier, she’d suffered chronic headaches and had been diagnosed with a benign cyst on her brain, but a new MRI showed the cyst hadn’t grown, and so could not explain her pupil problem.
After further questioning, the patient said she regularly used medicated wipes to control hyperhidrosis, or excessive sweating, on her scalp and forehead. The wipes contained a drug called glycopyrrolate, and were purchased from a Canadian pharmacy.
The woman stopped using the wipes, and by the next day, her pupil had returned to normal.
The drug works by blocking a chemical, called acetylcholine, which is involved in nerve signaling, Dr. Clare Johnson and Dr. Janet Smereck, both of the emergency medicine department at Georgetown University Hospital in Washington, D.C., wrote in their findings.
The nerve signals to the sphincter muscle that controls the pupil were likely affected by the drug, causing the dilation, they said.
Emergency room doctors should be aware that all medications — including topical treatments, and those used for cosmetic reasons — may cause side effects, the researchers said.
The report was published online Nov. 19 in the Journal of Emergency Medicine.
Pass it on: An anti-perspiration drug may cause pupils to dilate.
But in the case of one 35-year-old woman with an abnormally dilated pupil, the culprit turned out to be an over-the-counter medication she was using to treat her facial perspiration, according to a report on her case.The woman’s spouse was a paramedic, and had noticed that one of her pupils was dilated when she woke up that morning. Doctors in the emergency room found that her left pupil measured 4 millimeters across, and responded to light. But her right pupil was twice that size, and didn’t respond to light.
She also had a mild headache, but no eye pain, trauma to her eye or change in vision. She initially reported that she was not taking any medications. About a year earlier, she’d suffered chronic headaches and had been diagnosed with a benign cyst on her brain, but a new MRI showed the cyst hadn’t grown, and so could not explain her pupil problem.
After further questioning, the patient said she regularly used medicated wipes to control hyperhidrosis, or excessive sweating, on her scalp and forehead. The wipes contained a drug called glycopyrrolate, and were purchased from a Canadian pharmacy.
The woman stopped using the wipes, and by the next day, her pupil had returned to normal.
The drug works by blocking a chemical, called acetylcholine, which is involved in nerve signaling, Dr. Clare Johnson and Dr. Janet Smereck, both of the emergency medicine department at Georgetown University Hospital in Washington, D.C., wrote in their findings.
The nerve signals to the sphincter muscle that controls the pupil were likely affected by the drug, causing the dilation, they said.
Emergency room doctors should be aware that all medications — including topical treatments, and those used for cosmetic reasons — may cause side effects, the researchers said.
The report was published online Nov. 19 in the Journal of Emergency Medicine.
Pass it on: An anti-perspiration drug may cause pupils to dilate.
Inattentional Blindness: How Memory Load Leaves Us ‘Blind’ To New Visual Information
Trying to keep an image we’ve just seen in memory can leave us blind to things we are ‘looking’ at, according to the results of a new study supported by the Wellcome Trust.
It’s been known for some time that when our brains are focused on a task, we can fail to see other things that are in plain sight. This phenomenon, known as ‘inattentional blindness’, is exemplified by the famous ‘invisible gorilla’ experiment in which people watching a video of players passing around a basketball and counting the number of passes fail to observe a man in a gorilla suit walking across the centre of the screen.
The new results reveal that our visual field does not need to be cluttered with other objects to cause this ‘blindness’ and that focusing on remembering something we have just seen is enough to make us unaware of things that happen around us.
Professor Nilli Lavie from UCL Institute of Cognitive Neuroscience, who led the study, explains: “An example of where this is relevant in the real world is when people are following directions on a sat nav while driving.
“Our research would suggest that focusing on remembering the directions we’ve just seen on the screen means that we’re more likely to fail to observe other hazards around us on the road, for example an approaching motorbike or a pedestrian on a crossing, even though we may be ‘looking’ at where we’re going.”
Participants in the study were given a visual memory task to complete while the researchers looked at the activity in their brains using functional magnetic resonance imaging. The findings revealed that while the participants were occupied with remembering an image they had just been shown, they failed to notice a flash of light that they were asked to detect, even though there was nothing else in their visual field at the time.
The participants could easily detect the flash of light when their mind was not loaded, suggesting that they had established a ‘load induced blindness’. At the same time, the team observed that there was reduced activity in the area of the brain that processes incoming visual information – the primary visual cortex.
Professor Lavie adds: “The ‘blindness’ seems to be caused by a breakdown in visual messages getting to the brain at the earliest stage in the pathway of information flow, which means that while the eyes ‘see’ the object, the brain does not.”
The idea that there is competition in the brain for limited information processing power is known as load theory and was first proposed by Professor Lavie more than a decade ago. The theory explains why the brain fails to detect even conspicuous events in the visual field, like the man in a gorilla suit, when attention is focused on a task that involves a high level of information load.
The research reveals a pathway of competition in the brain between new visual information and our short-term visual memory that was not appreciated before. In other words, the act of remembering something we’ve seen that isn’t currently in our field of vision means that we don’t see what we’re looking at.
It’s been known for some time that when our brains are focused on a task, we can fail to see other things that are in plain sight. This phenomenon, known as ‘inattentional blindness’, is exemplified by the famous ‘invisible gorilla’ experiment in which people watching a video of players passing around a basketball and counting the number of passes fail to observe a man in a gorilla suit walking across the centre of the screen.
The new results reveal that our visual field does not need to be cluttered with other objects to cause this ‘blindness’ and that focusing on remembering something we have just seen is enough to make us unaware of things that happen around us.
Professor Nilli Lavie from UCL Institute of Cognitive Neuroscience, who led the study, explains: “An example of where this is relevant in the real world is when people are following directions on a sat nav while driving.
“Our research would suggest that focusing on remembering the directions we’ve just seen on the screen means that we’re more likely to fail to observe other hazards around us on the road, for example an approaching motorbike or a pedestrian on a crossing, even though we may be ‘looking’ at where we’re going.”
Participants in the study were given a visual memory task to complete while the researchers looked at the activity in their brains using functional magnetic resonance imaging. The findings revealed that while the participants were occupied with remembering an image they had just been shown, they failed to notice a flash of light that they were asked to detect, even though there was nothing else in their visual field at the time.
The participants could easily detect the flash of light when their mind was not loaded, suggesting that they had established a ‘load induced blindness’. At the same time, the team observed that there was reduced activity in the area of the brain that processes incoming visual information – the primary visual cortex.
Professor Lavie adds: “The ‘blindness’ seems to be caused by a breakdown in visual messages getting to the brain at the earliest stage in the pathway of information flow, which means that while the eyes ‘see’ the object, the brain does not.”
The idea that there is competition in the brain for limited information processing power is known as load theory and was first proposed by Professor Lavie more than a decade ago. The theory explains why the brain fails to detect even conspicuous events in the visual field, like the man in a gorilla suit, when attention is focused on a task that involves a high level of information load.
The research reveals a pathway of competition in the brain between new visual information and our short-term visual memory that was not appreciated before. In other words, the act of remembering something we’ve seen that isn’t currently in our field of vision means that we don’t see what we’re looking at.
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