Wednesday, May 27, 2015

Fibromyalgia and Pain Modulation by Exercise


I’ve stumbled upon an article by Laird Harrison on Medscape: Exercise Stimulates Pain Modulation in Fibromyalgia. The article is about a study by Laura Ellingson, PhD, which has been presented at the American Pain Society (APS) 34th Annual Scientific Meeting.
12 female patients with fibromyalgia had a brain scan by functional MRI after exercise and at rest. Pain was measured by the McGill Pain Questionnaire Visual Analogue Scale. It dropped by 5 points and increased after rest (7 days). “The brain scans showed significantly greater activity in the patients' left anterior insulae after exercise than after rest as well.”
This is a good start, but findings have to be verified in larger groups.
As we are already combing exercise programs and cognitive behavioral therapy since the late 1990ies at our center, we feel that these findings support our therapeutic approach. I hope that functional MRI studies will be done in the combination of exercise programs and cognitive behavioral therapy in the near future.
For the time being, please exercise as much as you can without getting into exertion, which I call the comfort range (Wohlfühlbereich).



Friday, May 22, 2015

FreitagsGedichte / #KurzLyrik 22.05.2015

 

Leichtigkeit
    was wäre
Das Leben
Ohne
Eine
Gewisse
Leichtigkeit?
Und
Was ist es
Mit dem
    Üblichen
Leichtsinn?

VerGängnis
    aus Schwarz
Wird
Grau
Wird Weiß
Und umFängt
VerGängnis
Die Zeit
    Unser
VerHängnis

Feuer
    das Feuer
ErStirbt
Und
AufWärts
Fliegt
Die Seele
Asche
Weht
Kurz auf
Und
    Setzt sich
Unten

Wahrheit
    die Wahrheit
Zu Wörtern
Zu Silben
ZerStükKelt
Von
Der Schlach-
Bank
Aber
    Tropft
Blut

Weiß
    die weißen
Wolken
Und
Die Schaum-
Kronen
Der Wellen-
Brecher
WieViel
Weiß
    Erträgt das
HimmelsBlau

TeeSchale
    die letzte
Schale
Tee
Ist
GeTrunken
Du
Aber
Bleibst
    Noch
Sitzen

Schmerz
    welche Farbe
Mag
Der Schmerz
Nur
Haben?
Rot
Weiß
Schwarz
Oder
    Ist er
FarbLos?

Ebene
    wenn Du
In der
Ebene
Nicht
Den Wind
ErWartest
Was
ErWartest
Du
    Dann
Im Grab?

Am See
    der Dümmer
Im Dämmer
Die Ammer
Singt
Nimmer
Im
MondLicht
Brechen
    Die silbernen
Spiegel

Vergessen
    nur
Wenn du
Vergessen
Kannst
BeKommst
Du
Auch
Platz
    Für
Neues

AufBruch
    steigt aus
Den Gräbern
In die
Ihr
Nicht
GeHört
Und
Wandelt
    Weiter
Im Leben

Ritzen
    sich die
Haut
Ritzen
Mit einer
RasierKlinge
Um
Botschaften
Heraus
Zu senden
Weil
Schreie
    Nicht sein
Können

MitNahme
    aus dem
Tag
Nehmen wir
Mit
In die
Nacht
Aber
Warum
Nehmen
Wir nicht
Aus der Nacht
    Was uns
ZuSteht?

Licht
    entZünde
Kein
Licht
In der
Dunkelheit
Denn
Dann
Findet
    Dich
Die Dunkelheit

Reinheit
    das reine
Bier
Das reine
Wasser
Die reine
Luft
Wie viele
Träume
    Mehr
ZerPlatzen


Weitere #KurzLyrik:

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Tuesday, May 19, 2015

The Very Basic Guide to Italian




Even beautiful without a bathing beauty


Italian is spoken in Italy and even in the U.S., capisce? Italian has its ancestry in Latin. But if you know some Spanish, you already may understand quite a lot. If not, you're welcome to look at these very basic words and expressions.

Thanks – grazie
Yes - si
No - no (no kidding!)
Do you speak English? - parla inglese?
Please – per favore
Excuse me – mi displace  
Sorry – scusi
Good morning – buon giorno
Good evening/night – buona notte
Hello – ciao
Goodbye – arrividerci
How are you? come sta?
I would like ... - vorrai ...
How much is it? – quanto costa?
Please write it down - si prega di scrivere
I don’t understand – no capisco
Where is – dove si trova
Where's the nearest ... - dove la più vicina ...
Where are the toilets? – dove sono i bagni?
I'm lost - mi sono perso/persa
What is your name? – qual è il tuo nome?
My name is LMK – il mio nome è LMK
Left – sinistra
Right – destra
Please call a doctor quickly - mi chiami pronto un medico, per favore

Links:
The Very Basic Guide to Turkmenian, Uzbek and Kyrgyz http://rheumatologe.blogspot.de/2014/10/the-very-basic-guide-to-languages-of.html


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Sunday, May 17, 2015

Methotrexate and Hydrating


A couple of days ago I had a very nice and informative chat on Twitter. I chanced upon a tweet of Jody (@RheumerHasIt) telling that she is going to hydrate herself before taking methotrexate. Actually the tip comes from Hurt Blogger | Britt (@HurtBlogger). Hydrating and salt helps limit nausea and other side effects.
I think that methotrexate is a very valuable drug in rheumatology, but there are people, who develop side effects. Any tip to alleviate side effects and allow people to stay on the drug is muchly warranted. I’ve never had heart about this before, but will pass the tip on to help others to better tolerate methotrexate. Under hospital conditions we often start methotrexate in patients new to the disease. I tell them to keep in mind, that in a hospital for rheumatic diseases they will encounter other patients, who either had side effects or methotrexate (MTX) wasn’t effective, but that these facts doesn’t diminish the great value of the drug, as more patients tolerate it well and reduce disease activity, so they they won’t see these people in hospital.
But back to our chat. Kelly (@rawarrior) advices to take green olives with MTX to decrease nausea. I had the Idea of taking wakame or nori (different sorts of seaweed). And Gina Renée (@GinaRClark) provided a study on sodium alginates by A. Yamamoto (Sodium alginate inhibits methotrexate-induced gastrointestinal mucositis in rats.) I remember the pre-PPI era, even the pre-H2-inhibitor era, when alginates were used. Nowadays these alginate are still in use as over the counter drugs (at least in Germany) to better cope with GERD (gastroesophageal reflux disease).
Miso soup with seaweed could be part of a solution to fight nausea and better tolerate methotrexate.

I'll promote this as the American hydrating method to better tolerate MTX.
Thanks everyone for taking part in the chat and contributing.


Friday, May 15, 2015

FreitagsGedichte / #KurzLyrik 15.05.2015


Schneiden
    wie kannst
Du
Alles
Faulende
Fleisch
Weg-
Schneiden
Wenn
Auch
Deine
    Hand
Fault

Traum
    VerBanne
Nicht
Deinen
Traum
Hinter den
Horizont
Denn
Dort
Gerät
    Er Dir
Aus den Augen

QuerSchläger
    Heute
Mehr
Ein Tweet
Der
Sich verIrrt
Um
Dann
Jemanden
Zu treffen
    Der nicht
Gemeint war

SteinVögel
    nur die
Trolle
Unter
Den Vögeln
Fallen
Als
Stein
Zu Boden
Wenn der
    SonnenStrahl
Sie triftt

Röhren
    unter den
Städten
Röhren
Die bringen
Die
WegBringen
Oder
Beides
GleichZeitig
    London
The Tube

FernSeher
    ich habe
Den FernSeher
Auf
Stumm
GeStellt
Jemand
Wird in
Aller Ruhe
ErMordet
    Zeit zum
AbSchalten

Erinnerungen
    Erinnerungen
Steigen auf
Wie
Rauch
Eines
Räucher-
Stäbchens
NachBlicken
NachDenken
Nach und
Nach
Wie sich
    Der Rauch
AufLöst

Die Welt
    die Welt
UmRunden
Führt
Doch
Wieder
Zurück
Auch
Der Lebens-
Kreis
    Führt wieder
Zurück

Steine
    nehmt
Steine
Von der
Letzten
Steinigung
Und
Macht
FaustKeile
Daraus
    So weit
Sind wir wieder

EndMoräne
    hier werden
Wörter
VorGeschoben
Bis
Sie
In einer
End-
Moräne
    AufGeschichtet
Sind

Frühling
    die Mittel-
GebirgsKetten
Mit
Sanft-
Welliger
Landschaft
In der
Sich
Der Frühling
    Wohl-
Fühlt

Flucht
    sie flieht
Vor Dir
Die Zeit
Flieht vor
Dir
Die Zeit
    Flieht
Dir

EinSiedelei
    grauer Stein
Innen
Weiß
GeTüncht
Ein
Kreuz
Hier also
Kam es
    Zu der
VerZückung

Haut
    deine Haut
Kennt
Den Wind
Die Sonne
Die streichelnde
Hand
Des anderen
Aber
Kennt
OberFläche
    Und
Tiefe

Sturm
    der dunkle
Sturm
Wurde
Jählings
Heller
Weicher
Seine
BeDrohung
    Endete
Im Wind


Weitere #KurzLyrik:

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Tweetup EULAR 2015 Meeting in Rome





Sorry, that's in mid-city

The EULAR 2015 Meeting in Rome lies only about 3 weeks ahead of us and we should plan our tweetup. Let's plan for a Tweetup at the meeting itself as well as a social Tweetup as we already did a couple of times.

I propose communication should be done on twitter with the hashtag #EULAR2015.

There are the usual problems, which I believe shouldn't be too difficult to solve, like how many people to expect and coming to a consent as for time and place.
The Congress Center of Rome is outside the city, but easily accessible by train. The EULAR 2010 Meeting had been at the same Congress Center. It stretches quite a bit from the entrance to the last hall, but in between there were nice places to sit in the sun and relax - perfect meeting points for a group like ours. Don't forget to bring sun tan lotion. Sitting outside means catching the sun, at least it had been the case five years ago. Perfect also for a break in between sessions.

Let’s first try to make sure, who is coming. Next step would be, where we could meet.

The meeting will start at the 10th of June and end at the 13th of June. More on the homepage of EULAR: http://www.eular.org/. The Congress Center is called Fiera Roma (Via Portuense 1645/1647, 00148 Roma; Tel: +39 06 5178260 www.fieraroma.it).
“The Fiera Roma is less than 5 kilometres from the Leonardo da Vinci (Fiumicino) airport”. More information: http://www.congress.eular.org/congress_venue.cfm. Have a look at the map: http://imgpublic.mci-group.com/ch/PCO/EULAR/EULAR%202015%20-%20Hotel%20list,%20Rates%20&%20Maps.pdf. OT: You can already look up abstracts: https://b-com.mci-group.com/AbstractList/EULAR2015.aspx; observe the embargo policy.




Maybe we can meet in the vicinity ...

I suggest one meeting at the Congress Center Thursday noon – ample time for everyone to reach, and one at a Trattoria (maybe in the city or Trastavere) Thursday evening. Someone would have to make arrangements for it.
Here is a link to the map of the Congress Center: http://www.congress.eular.org/myUploadData/files/EULAR_2015_Exhibition_Plans.pdf - we could meet in between halls 5,6,7 and 8, right in the middle.


Some people already announced that they’ll be at the congress or not:
Attending:
Dr Irwin Lim @_connectedcare
Lyn March @lynmarch1
Dr Ai Lyn Tan ‏@DrAiLynTan

Not attending:
Philip Gardiner @PhilipGardiner
Jose Campos  @JoseCamposMD

Sorry, if it looks like a „Friends of Carlotta" list.

Vers. 1.20 17.05.2015


Friday, May 8, 2015

Fibromyalgia and Creatine Supplementation


Ch. R. R. Alves and colleagues published a study: “Creatine Supplementation in Fibromyalgia: A Randomized, Double-Blind, Placebo-Controlled Trial. Results: „ After the intervention, the creatine group presented higher muscle phosphorylcreatine content when compared with the placebo group (+80.3% versus −2.7%; P = 0.04).” Furthermore, the creatine group presented greater muscle strength in the leg press and chest press exercises and also isometric strength was greater in the creatine group than in the placebo group. “However, no general changes were observed in aerobic conditioning, pain, cognitive function, quality of sleep, and quality of life. Food intake remained unaltered and no side effects were reported.“
Body builders use creatine supplementation to boost muscle growth. So, it isn’t surprising if people, who haven’t trained due to pain, gain something out of a training and may benefit in muscle strength from this supplementation. But muscle strength isn’t the problem in fibromyalgia!

Do fibromyalgia patients need a creatine supplementation? No! The impact on more clinically relevant measures for fibromyalgia, such as aerobic conditioning, pain, cognitive function, quality of sleep, and quality of life had been disappointing as these remained unchanged.

Supplementation of creatine in fibromyalgia patients is a dead end and might stir false hopes. I recommend to stay away from it.