Welcome to the October issue of FM/CFS/ME RESOURCES Newsletter. Our goal is to inform, entertain, and empower patients, caregivers, and families living with FM and CFS/ME. Helping them to lead a better life.

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A new web site has been created addressing Chronic Myofascial Pain (CMP). It is estimated that some 44 million Americans have CMP, (also called myofascial pain syndrome). CMP is a painful condition affecting the muscles and the sheath of the tissue, called the fascia, that surround the muscles. CMP can involve a single muscle or a group of muscles. It is characterized by pain and stiffness that is restricted to certain locations on the body. See figure 1 to the right.

CMP is not a psychological disturbance, neither is this condition a mental illness, although chronic pain can cause anxiety and lead to depression. The American Medical Association (AMA), the World Health Organization (WHO), and the National Institutes of Health (NIH) are among those who have accepted CMP as a legitimate physical illness and as major cause of disability.

The mission of CMP RESOURCES is to provide resources to assist and inform people affected with CMP, helping them to live a better life. Resources include:

Yom Kippur, also known as the Day of Atonement, is the most solemn and important of the Jewish holidays. Its central themes are atonement and repentance. Jews have traditionally observed this holiday with a 25-hour period of fasting and intensive prayer.

Five additional prohibitions are traditionally observed, as detailed in the Jewish oral tradition (Mishnah tractate Yoma 8:1):

Pain management specialists are concerned about the patient's ability to function and their quality of life. When pain is chronic or complicated by other medical conditions, the patient's primary care physician may refer the patient to a pain specialist, such as a physiatrist. Physiatrists are medical physicians who specialize in physical medicine and rehabilitation with a special interest in musculoskeletal conditions. Some physiatrists have advanced training in Interventional Pain Management (IPM). IPM is an area of medicine devoted to the diagnosis and treatment of pain related disorders.

A pain management specialist develops a treatment plan to relieve, reduce, or manage pain and help patients return to everyday activities quickly without surgery or heavy reliance on medication. To make sure all the patient's needs are met, the physician coordinates care through an interdisciplinary team of health professionals. Such professionals include:

Just because you don't need prescriptions to buy over-the-counter (OTC) drugs doesn't mean they don't contain powerful medication, they do. If you aren't careful, certain OTC medications can cause severe, even potentially deadly, side effects.

A new special report from the Health Sciences Institute shines a light on eight of the worst offenders. These are medications that most people think are perfectly safe, but they really pose quite a substantial threat to your overall good health.

Sominex and Nytol

The key ingredient in Sominex and Nytol is a chemical called diphenhydramine hydrochloride, the same active ingredient found in Benadryl. As anyone who's taken these drugs can attest, they will make you drowsy, which sounds like a dream come true if you're struggling with insomnia. But when you take diphenhydramine hydrochloride, you get a lot more than nighttime drowsiness. In fact, you're setting yourself up for a whole host of potentially dangerous side effects, especially if you make these sleeping pills a regular part of your nighttime routine.

A 2001 study conducted by doctors at Yale-New Haven hospital found that diphenhydramine hydrochloride, the key active ingredient in Sominex and Nytol, appears to contribute to cognitive decline. In fact, it turns out that this drug can be especially dangerous for people ages 70 and over, even after just one dose. In the Yale study, none of the 426 patients showed any history or signs of dementia or delirium before the drug was administered. Then diphenhydramine hydrochloride (a maximum total dose of 100 mg per day) was given to 114 of the patients, while the remaining 312 were not medicated. Within 48 hours of drug administration, trained specialists found that the diphenhydramine group fared much worse on every measure of cognitive decline. Overall, the medicated group demonstrated a 70 percent increased risk of cognitive decline as compared to the controls.

Here's the scariest part: The dosages used in the study are often used by people at home. A standard dose of either Sominex or Nytol contains 50 mg of diphenhydramine, so just two doses in a 24-hour period could put you at the 100 mg level. Add to that the fact that diphenhydramine hydrochloride is also found in many cold and allergy remedies, and you could inadvertently take more than 100 mg in a single day.

M.D.'s are trained in "allopathic" medicine, just as "osteopathic" and "naturopathic" practitioners are trained in their respective medical fields. Allopathic medical students begin with four years of undergraduate education at a college or university, followed by four years in medical school. After graduating from medical school with their M.D., physicians take an additional three to seven years of specialty training in a residency at a clinic or hospital. The American Board of Medical Specialties lists 24 recognized medical specialties, many of which also have sub-specialties. (An example, Cardiology is a subspecialty of Internal Medicine) In order to practice medicine, an M.D. must be licensed by the jurisdiction in which he or she intends to practice.

Doctors of Osteopathic medicine earn the degree D.O. by completing undergraduate work and graduating from an accredited four year medical school. In the case of an Osteopath, the medical school is devoted to Osteopathy. After graduation, osteopathic physicians serve a one year internship that provides patient care experience in internal medicine, obstetrics and gynecology, family practice, pediatrics, and surgery. Like M.D.'s, D.O.'s can prescribe medicine and perform surgery, and they must pass a state osteopathic medical board examination to practice.

Osteopathy is a system of therapy based on the theory that the body can make its own remedies against disease and other toxic conditions when it is in normal structural relationship, and has favorable environmental conditions and adequate nutrition. It uses generally accepted physical, medicinal, and surgical methods of diagnosis and therapy, while placing chief emphasis on maintenance of normal body mechanics and on manipulative methods of detecting and correcting faulty structure.

Some D.O.'s are also D.C.'s (doctors of chiropractics). Chiropractors believe that all body functions and dysfunctions are related to the nervous system. Hands-on alignment and manipulation of the neuromusculoskeletal system is their main form of treatment. Chiropractors not trained as medical doctors obtain their D.C. degree after completing four years of training in an accredited chiropractic school. they can not perform surgery or prescribe medicine.

Nurses, like doctors, may also specialize in certain areas of care. Nurses must be licensed through the board of nursing in the state in which they practice. The licensed practical nurse (LPN) is qualified to provide patient education and basic nursing care under the supervision of a registered nurse (RN). LPN's can be found in hospitals, nursing homes and home healthcare agencies. They have one year of nursing school.

RN's obtain their credentials by either earning a bachelor's of science degree at a four year college or university with an accredited school of nursing, or by completing an associate's degree at a two year community college. Some nurses choose to go on and obtain a master's degree. After passing a national licensing test and obtaining a license from their state's board of nursing, RN's are ready to practice. If an R. N. decides to move to another state they must be licensed in the new state in order to practice there. R. N., BSN, indicates a registered nurse with a bachelor's of science degree in nursing. Those with master's degrees are indicated by R. N., MSN.

Nurse practitioners (N. P.) have advanced nursing education and training. They can be found working in schools, rural healthcare clinics, taking histories, conducting physical exams, prescribing medication and generally providing basic healthcare in place of a physician.

The expanded use of the physician assistant (P. A.) is the newest trend in the healthcare field. The P. A.'s role is similar to that of the nurse practitioner. According to the American Academy of Physician Assistants, more than 29,000 P. A.'s are currently working in the United States, under the supervision of physicians. They assist doctors by doing everything from taking patient histories and counseling patients to assisting in surgery and in some states, prescribing medicine.

GSK and XenoPort Announce Submission of a New Drug Application (NDA) to the U.S. Food and Drug Administration (FDA). They are requesting approval of Solzira (gabapentin enacarbil) Extended Release Tablets for the treatment of moderate-to-severe primary Restless Legs Syndrome (RLS). RLS affects an estimated 12 million people in the United States and can result in distressing symptoms that disrupt sleep and significantly impact daily activities.

Solzira is a non-dopaminergic new chemical entity that provides improvement in the symptoms of RLS with the convenience of a once-daily formulation.

The NDA submission is based on a comprehensive Phase 3 clinical development program for Solzira in patients with moderate-to-severe primary RLS, including data from two randomized, double-blind, placebo-controlled trials (PIVOT RLS I and PIVOT RLS II), which evaluated the safety and efficacy of Solzira over 12 weeks. The submission also included results from a third pivotal trial (PIVOT RLS Maintenance) evaluating the ability of Solzira to maintain efficacy in treating RLS symptoms over a nine-month period. The most common side effects of Solzira were dizziness and somnolence.

Solzira is a new chemical entity that is designed to improve upon the pharmacokinetics of gabapentin by taking advantage of high-capacity transport mechanisms in the gastrointestinal tract to improve absorption.

The modern holiday of Halloween has its origins in the ancient Celtic festival known as Samhain (pronounced sow-in). The festival of Samhain is a celebration of the end of the harvest season in Gaelic culture, and is sometimes regarded as the "Celtic New Year". Traditionally, the festival was a time used by the ancient pagans to take stock of supplies and slaughter livestock for winter stores. The ancient Gaels believed that on October 31, the boundary between the alive and the deceased dissolved, and the dead become dangerous for the living by causing problems such as sickness or damaged crops. The festivals would frequently involve bonfires, where the bones of slaughtered livestock were thrown. Costumes and masks were also worn at the festivals in an attempt to mimic the evil spirits or placate them.

United States & Canada

The main event for children of modern Halloween in the United States and Canada is trick-or-treating, in which children disguise themselves in costumes and go door-to-door in their neighborhoods, ringing each doorbell and yelling "trick or treat!" to solicit a gift of candy or similar items. Upon receiving trick-or-treaters, the house occupants (who might also be in costume) often hand out small candies, miniature chocolate bars, nuts, loose change, soda pop, stickers, or even crayons and pencils.

Other common Halloween activities include ghost tours, bonfires, costume parties, visiting "haunted houses", carving Jack-o'-lanterns, reading scary stories and watching horror movies.

Halloween is largely celebrated, particularly by children of a young age, always chaperoned, otherwise it is unadvisable for little kids to leave the house. Young teens take to throwing Halloween parties (mostly to have a reason to throw a party; costumes and candy aren't usually remembered). Celebration of the holiday out on the streets asking for candy has declined.

All over Ireland, huge bonfires are lit. Young children in disguise go trick-or-treating, they are warmly received by their neighbors with gifts of fruit, miniature chocolate bars, loose change, peanuts and of course sweets for the "Halloween Party". Some homes will put up decorations including Halloween lights. Children have the week off from school for Halloween, and it is common for teenagers and for college students to spend weeknights out and about with friends, pranking and causing mischief, if not trick-or-treating themselves, and perhaps even "egging" (throwing eggs at houses), drinking alcohol, and setting off fireworks.

In England, trick-or-treating does occur, although the practice is regarded by some as a nuisance or even a menacing form of begging. In some areas, households have started to put decorations on the front door to indicate that trick-or-treaters are welcome, the idea being that trick-or-treaters will avoid a house not participating in the custom. Tricks currently play a less prominent role, though Halloween night is often marked by vandalism such as soaping windows, egging houses or stringing toilet paper through trees. More serious vandalism often occurs in the form of damage caused by fireworks. The holiday's date being close to the English celebration of 'Bonfire Night' on November 5th, which is traditionally celebrated with fireworks displays, means that those who do with to cause more serious mischief find them to be easily attainable.