Wednesday, February 27, 2013

Pelvic Pain, Bladder Disorders, Prostate Problems, Fibromyalgia, Chronic Fatigue Syndrome, and Other Female and Male Related troubles: Is it more than co-incidence?



The muscles in the pelvic girdle are what keep our organs from falling to the floor. These muscles make up the perineum, the urogenital triangle, and the anal triangle. They support the rectum, the vagina/penis, and the urethra, but they may not be the only muscles involved in your pain and dysfunction.


Causes

Pelvic pain can be from many causes such as, vulvodynia, irritable bladder or interstitial cystitis, infection, vaginal atrophy, prostate problems/pain, testicular and or pain in the penis, pain in the urethra (where your urine comes out), rectal pain, ovarian cysts, ectopic pregnancy, neuralgia, endometriosis, inflammatory bowel diseases, irritable bowel syndrome, diverticulitis, and myofascial trigger points (MTrPs), but for this blog we are looking specifically at the bladder and the perineum (area of the urethra, penis, vagina, and rectum).

Myofascial trigger points have been identified as the greatest aggravator of chronic pelvic pain, and pain is not the only symptom. Pelvic floor problems can also cause a decrease in urine flow in men and women, erectile dysfunction, urinary retention (setting the stage for infection), urgency (always feeling like you have to urinate), and constipation.

For more on myofascial trigger points and myofascial pain see “Myofascial Pain” at my website and
 my blog: Points That Need More Than Pondering: Defining Myofascial Trigger Points


Offending trigger points

Myofascial trigger points in adductor magnus (thigh), or internal oblique (abdomen), are capable of causing bladder pain and frequency, and MTrPs in the adductor magnus can cause a host of referred pain to groin and inner thigh, pelvic and pubic bones, rectum and vagina and can cause menstrual cramping (as can MTrPs in the rectus abdominus, abdomen), and trigger points in the internal oblique can also cause bladder difficulties. The muscles of the pelvis, and the multi-layered muscles of the pelvic floor can become tight, unforgiving and short due to MTrPs. Myofascial trigger points in pelvic related muscles can refer pain to the urethra, rectum, coccyx, or the crease of the buttocks.

This is speaking in generalities, but it’s important to understand that the source of your pain can be close by or well away from pelvis itself.  Treating MTrPs, whether active (painful without touching) or latent (only painful with touched) that refer pain to a specific region is just as important as treating those directly relatable. Often times, those who claim to know myofascial trigger points do not understand the complexity, this includes physicians, physical therapists, and body workers.


Chronic myofascial pain in fibromyalgia, chronic fatigue syndrome, and pelvic dysfunction

Myofascial pain syndrome often co-exists in fibromyalgia, and has been identified in some chronic fatigue syndrome (ME/CFS) patients, chronic pelvic and bowel disorders.  Myofascial trigger points are a peripheral nerve to muscle problem that lends to centralized (amplified) pain in fibromyalgia, interstitial cystitis, bladder difficulties, ME/CFS, IBS, and other overlapping conditions.  This hypersensitive state is also present in these disorders. Ignoring the obvious bloodies the diagnostic waters and most importantly delays appropriate treatments and leads to flawed research.


Therapies

It is important to identify perpetuating factors, such as, co-existing hip problems, piriformis syndrome, pudendal neuralgia, low back or sacroiliac joint dysfunction, and other overlapping conditions, bringing them under control when possible. Pay close attention to aggravating factors such as, sitting too long or on hard surfaces and chairs that can’t be adjusted to your body type, over activity, infection, poor posture, wearing pants that are too tight, consuming offending foods, etc.

There are a variety of therapies to help you, including intravaginal and pelvic floor trigger point injections, external and internal massage of the perineum and in women the vagina, biofeedback, bladder retraining, transcutaneous electrical nerve stimulation (TENS), tennis ball therapy (as discussed in our book),
acupuncture, dietary changes, over-the-counter probiotics for the bladder, stretching movements, topical analgesics (such as oragel), oral analgesics, and of course specific myofascial therapy by a trained specialist. Sometimes, all are necessary.

Seldom are doctors well informed about myofascial pain s and trigger points, so I am a firm believer that women should see a urogynecologist, that men should see a urologist and in both cases, the physician should understand the role of the myofascial in chronic pelvic pain.  The same is true for the physical therapist. Why? Those who do not understand the role of trigger points chronic pelvic pain and dysfunction may suggest traditional therapies, such as, Kegel exercise, which can worsen your symptoms, and when co-existing conditions such as piriformis syndrome, spinal disease, IBS, etc. are involved; a host of referral patterns are involved.  This is why identifying ALL your pain patterns (whether you feel a trigger point there or not) is important information for your specially trained healthcare provider.

Always discuss your symptoms with your doctor to make sure other causes are ruled out. If your pain and dysfunction is not found to be from another source, please look for those myofascial trigger points and a specialized therapist, they are treatable.

Resources for you:

IC and Irritable bladder
Blatman Pain Clinic
What Your OB/GYN Should Know About FMS and CMP by Devin J. Starlanyl
Pelvic Floor Myofascial Trigger Points: Manual Therapy for Interstitial Cystitis and the Urgency-Frequency Syndrome by Jerome Weiss
Fibro Care Center
National Association of Myofascial Trigger Point Therapists
ICA – Physical Therapy
ICA – Pelvic Floor Dysfunction
International Myopain Society
IC Network


(Signature line appended, March 2018)

In healing,
Celeste Cooper, RN / Author, Freelancer, Advocate

Think adversity?-See opportunity!

~ • ~ • ~ • ~ • ~ • ~

Learn more about Celeste’s books here. Subscribe to posts by using the information in the upper right hand corner or use the share buttons to share with others.

All blogs and comments are based on the author's opinions and are not meant to replace medical advice.  

Thursday, February 14, 2013

Walk a mile in my shoes: : The FDA and opioid labeling and restrictions, where does the problem really reside?


It is important to set atop the sky scraper, looking down on both sides of the building, weighing concerns in either direction, with the wind or against it.  I have deliberated over the power of addiction from any source, whether it be food, drugs, gambling, smoking, video games, shopping, sex, alcohol.  As I look into the wind and away from it, I question, “Is addiction a behavioral choice or an illness?” “Does restricting opioid medication from chronic pain patients reduce risk or increase it?”

Pain trumps all other basic functions. We are facing a critical turning point in our culture, and the consequence of wrong choices could be devastating. Why aren't we concerned with pain related deaths in this country? Could it be because we are afraid to admit our system is failing?  Will banning or limiting opioids increase the epidemic of untreated, pain? Does the potential for addiction outweigh the risks of not treating pain?

Addiction is the illness not the substance or behavior that feeds it. Have we stopped selling alcohol even though we know it has the potential for abuse and can kill instantly or slowly over a period of time?  Aren't programs like Alcoholic Anonymous a better answer? Is banning certain foods going to stop the obesity epidemic?  Do we treat addictions to gambling, smoking, video games, shopping, or sex by making it illegal to participate in any of these activities? As I sit on this grandiose pentacle, I realize to restrict the use of opioids as a choice in management of chronic pain is not the answer. Relieving pain is necessary; the use of alcohol, playing video games, etc is not. That does not mean I am in favor of government regulation, it means I am in favor of protecting our freedoms to choose how to relieve our pain.

Gaining favor as an alternative to opioids is antidepressants or anti-convulsants which we know create suicidal ideation in some patients, and can cause diabetes and a host of other serious medical problems.  These medications, in the medicine cabinet of a great many homes across America, have the potential for abuse. But why would we deprive patients who need them to function on a daily basis or prevent a very serious seizure disorder? Then I question, why these would be prescribed for pain when many patients report they are only minimally helpful, if at all, or that they come with a laundry list of interactions and side effects, when we already have effective pain medication?  Here we are atop the skyscraper once again.

I ask each person to relive their experience with pain and imagine it on a continual basis with no interventions possible.  Then I ask, “How long could you endure this pain before wanting to end it all?”  Is there any doubt you would be emotionally distraught?  Many pain patients feel alone and abandoned, because they are. Should we not address the emotional, mental, and spiritual affects of chronic pain, and provide education on how to use opioid medications safely and effectively?

We are missing the core problem of any addiction, poor access to mental health programs, lack of funding, and cultural attitudes. I would argue that the epidemic is not the use of opioids to treat chronic pain; the problem resides in our perception.   The days of using words like crazy or addict in a demeaning way should be long gone. The social injustice of ignoring those in need of professional council is the real epidemic. 

Those who take opioid pain medication to improve their activities of daily life and use them responsibly should not be vilified, and neither should those fewer people with a genetic tendency toward addiction. We must ask, before we make the decision to stand into the wind or away from it, choose one side of the building or the other, “Is it fair to deny a basic human right to have our pain treated by restricting access to medications that will help?” Addiction is not a moral collapse, it is a disease, and isn't addiction best treated by professionals rather than withholding the tool of addiction? Can we withhold food, sex, video games, alcohol, tobacco, gambling from everyone, and will that really solve the problem? History tells us from our experience with prohibition, that it will not.

Have we turned into machines worried about numbers rather than human beings? I hope not.



Monday, February 4, 2013

February is Raynaud’s Syndrome Awareness Month: What does this mean to you?



“When [Raynaud’s] occurs by itself, it is called Raynaud’s disease, or primary Raynaud’s phenomenon. When it occurs along with other diseases, such as scleroderma, rheumatoid arthritis, systemic lupus erythematosus, polymyositis, dermatomyositis, Sjogren’s syndrome, or mixed connective tissue disease, it is called secondary Raynaud’s phenomenon.”
Cooper and Miller, 2010, pg. 106-107

The symptoms of Raynaud’s are common in fibromyalgia and chronic fatigue immunodysfunction, and may be present if you have thoracic outlet syndrome.  The symptoms should not be confused with feeling cold, which is often associated with FM and CFID (ME/CFS).  These symptoms could be due to an upset in neuro-endocrine system, and can be attributed to autonomic effects or hypothyroidism. 

The defining characteristic of Raynaud's is that it generally affects only the fingers, toes, and  sometimes nose, and most commonly occurs when exposed to cold. Changes in skin color occur from pale to blue, and turn red during re-warming.  Also associated is extreme numbness during the acute phase. Though the cause is unknown, it is suspected that the nerves to the blood vessels cause them to spasm depriving the skin of blood and oxygen.  When the arteries relax during re-warming, blood flow returns causing the redness, which is frequently associated with pain, stinging or a burning sensation.

Your doctor may order a cold stimulation test to confirm diagnosis or do a nail fold capillaroscopy  or vascular ultrasound if secondary Raynaud’s is suspected.

Myofascial trigger point (MTrP) nerve entrapment can worsen symptoms of Raynaud’s so check MTrPs associated with the referral patterns to the affected area. (Cooper and Miller, 2010).

Treatment goals:

  • Re-warm slowly.
  • Protect fingers, toes and nose from cold exposure to prevent frostbite and skin ulcers.
  • Avoid emotional stress.
  • Avoid alcohol, particularly when you know you will be exposed to cold.
  • Don’t smoke.
  • Avoid use of tools that vibrate the hands.
  • Vasodilator type medications may be indicated in severe cases.
  • There are certain medications to avoid if you have Raynaud’s, so be sure to consult with your physician or pharmacist.


Report any unusual symptoms or skin breakdown to your physician immediately.



All blogs, posts and answers are not meant to replace medical advice.

Wednesday, January 23, 2013

Women, Men, Autoimmune, Neurological disease, and Fibromyalgia: Meeting Gender Bias Head On



The women to men ratio affected by fibromyalgia are 7:1 or 8:1, but are these statistics accurate?  

We once thought more men were affected by heart disease than women and we now know that is not the case, and even more alarming, women’s heart attacks are twice as likely to be fatal. So we ask, “Why the disparity in diseases between male and female?”  And an even bigger question, “Why are we not paying closer attention?”

Statistically, fibromyalgia is a leading female syndrome, and therefore, few studies are done on men.  Men typically do not report their symptoms, do not receive the right emotional support (though women many times don’t either), and suffer gender bias, leaving them undiagnosed and untreated. Females dominate other autoimmune and neurological diseases such as systemic lupus erythematosus (SLE), rheumatoid arthritis (RA), scleroderma, Hashimoto's thyroiditis, chronic fatigue syndrome, migraine, and multiple sclerosis   This by no means suggests that men do not also have any one of these syndromes or diseases.  So I ask,  “Why are men so frequently left out when evaluating fibromyalgia?” 

Since women seem predisposed to neuro-endocrine-immune disorders, their is a theory that hormones play a role. However, ankylosing spondylitis (another autoimmune disease) affects more men than women, so that theory is purely speculative, in my opinion. 

Men are more likely to keep their symptoms to themselves. Many do not understand the co-occurrence of myofascial pain syndrome and that it can cause male related issues, such as impotence, testicular pain, and male pelvic dysfunction, which men are less likely to discuss with their doctor than women, and often overlooked on exam for both men and women.  

Historically men avoid seeking healthcare, because of the long tradition that one should “buck up” and “take their lumps,” which could be a factor in under diagnosis.  Personally, my own husband would be dead had it not been for my insistence that I accompany him to the doctor to report his symptoms, which he wanted to dismiss as GERD and a pulled muscle. 

It is my opinion that more men are affected by fibromyalgia than what the statistics show, because of the factors I just mentioned, and I believe that men are not represented in proportionate numbers in clinical trials.  Like studying women in heart disease separate from men, the same should be true for fibromyalgia.  Women do tend to have a greater affinity toward autoimmune diseases, but believe me, if you are a man and suffer with fibromyalgia, MS, migraine, disordered sleep, restless leg syndrome, or any of the other overlapping neuro-endocrine-immune disorders, it is just as real. 

Gender bias must hit the road, it is immoral, counterproductive, and unethical for men and women. 

In healing and hope, Celeste

All blogs, posts and answers are not meant to replace medical advice.

Want to know more about Celeste’s books?  (click on the title)



Contributing author to Fibromyalgia Insider Secrets: 10 Top Experts, Kindle Ed. 


Tuesday, January 15, 2013

Here comes Peter Cotton Tail: Is he wreaking havoc in your mouth?


What is it?

Xerostomia, impressive word, right? Not!  

Xerostomia (pronounced ‘zero-stow-mia’) is commonly known as chronic dry mouth. When we don’t have enough saliva it affects the health of our mouth, and can cause gum disease, mouth sores, bad breath, cavities and tooth loss. It also affects our ability to enjoy food, can affect our speech and cause difficulty swallowing.  You know you have it when your lips are parched and you can’t peel your tongue off the roof of your mouth.  


Susceptibility

Dry mouth, xerostomia, can be caused by the nature of an illness or the side effect of medication/s. People with Sjögren’s, a condition that causes dry mucous membranes (the moisture layer of tissue), and SICCA, a syndrome with the same symptoms without the antibodies of  Sjögren’s,  is significant in causing dry mouth. It is important to note that Sjögren’s/ SICCA has a relationship with a subset of fibromyalgia and chronic fatigue syndrome patients, and certain other autoimmune diseases.  Dry mouth is also often associated with chronic use of certain classes of medications, such as, antihistamines, blood pressure medications, and antidepressants.

Saliva provides lubrication for the mouth protecting it from forming bacteria and other unwanted microorganisms. It helps with moving food debris out of the area.  When we don’t have enough moisture to perform these functions, then we have to help it along. 

What to do

  • Brush your teeth and floss regularly.
  • Stay hydrated.
  • Keep your doctor and dental appointments.
  • Avoid sugar.
  • Suck on sugar free hard candy or chew gum to stimulate saliva production.
  • Use oral probiotics, S. salivarius and B. coagulans, that can protect the mouth, gums, teeth, and throat from the bad bacteria. (Katz, Huffington Post)
  • Avoid smoke.
  • Consume alcohol judiciously.
  • Sip on water frequently.
  • Rinse your mouth frequently.
  • Include foods with high water content in your diet, such as fruits and soups.
  • Avoid foods that tend to absorb saliva, such as crackers.
  • Report any mouth pain, lesions, or a white coated tongue (suggesting yeast, or dehydration), to your doctor right away.


If you are plagued with dry mouth, be sure to let you doctor and dentist know. Your doctor may be able to change your medications, or the time of day you take them.  Your dentist can prescribe mouth washes that help prevent dry mouth, tooth decay and gum disease.

Hop along now Peter Cotton Tail, we know what to do when you have worn out your welcome. Bye, bye. 

In healing and hope, Celeste

If you think there is someone this might help, please share it. Copy and paste the link, http://fmcfstriggerpoints.blogspot.com/2013/01/here-comes-peter-cotton-tail-is-he.html 


All blogs, posts and answers are not meant to replace medical advice.

Want to know more about Celeste’s books?  (click on the title)



Contributing author to Fibromyalgia Insider Secrets: 10 Top Experts, Kindle Ed. 

Wednesday, January 9, 2013

KaleidoPain NEWS: Ever Changing Colors of Chronicity, 1-9-13



Have the KaleidoPain News and my blog delivered right to your Inbox by subscribing to the RSS feed.


KaleidoPain NEWS: Ever Changing Colors of Chronicity, containing news for all pain and neuro-endocrine-immune patients, healthcare providers, and caregivers.
                                               

“A bird doesn't sing because it has an answer,
it sings because it has a song.”
~ Maya Angelou








  
FEATURED BLOGs or Website

Pain sufferers speak RAW



Ten People to Follow on Twitter for Thyroid Information By Mary Shomon

HEALTHY HABITS

Back exercises in 15 minutes a day by Mayo Clinic.  Nice slide presentation




INSPIRATION

By David O. Wiebers, neurologist/neuroscientist.

The Do’s and Don’ts of Fibromyalgia Caregiving. Find out what to do -- and not do -- to help a person suffering from fibromyalgia. [I was a collaborator for this article.  Sharecare and Real Age are meeting the needs of the fibromyalgia community. In healing and hope, Celeste]



FEATURING Q&A by Celeste at Sharecare

Milestone – My 300th answer as fibromyalgia expert on Sharecare. How do I handle other people's reactions to my fibromyalgia?”




Don’t have a Sharecare account?  Just copy and paste the question in the ask a question tool bar at www.Sharecare.com



THE ADVOCATE

Stopmold cold mom. A great deal of helpful information regarding mold.


PAIN STRATEGIES

There are 100 million Americans in pain. The Pain Alliance to Implement a National Strategy of which I am privileged to be a part, takes on the charges set forth in the IOM report Relieving Pain in America.


ANNOUNCEMENTS

Insider Secrets for Treating Fibromyalgia: 10 TopExperts by Glen Depke, Celeste Cooper, Deirdre Rawlings and Jacob Teitelbaum (Dec 1, 2012)Now available in Kindle 

January is thyroid awareness month.  Read my article:

Is your butterfly dead: your thyroid and you?


IN THE NEWS

Rescheduling hydrocodone from II to III
RE: Docket No. FDA–2012–N–1172Impact of Approved Drug Labeling on Chronic Opioid Therapy; Public Hearing;Request for Comments AGENCY: Food and Drug Administration, HHS...Notice by FDA on 12/19/2012 ID: FDA-2012-N-1172-0001


Dr Stephen Grinstead Speaks Out About the War onDrugs Is Now A War on Pain Patients.


Not on Twitter?  Follow my tweets from Celeste Speaks 


NEWS FOR YOU!

When pain and disability is life limiting. The Seven Rules

The Seven Rules:
Rule #1 - Know what programs are available.
Rule #2 - If it isn’t in your medical record, it’s not so.
Rule #3 - Provide evidence of how your symptoms obstruct your daily living, and what alterations you have made to survive. Get your documentation into your medical records.
Rule #4 - Hire an appeal attorney that is familiar with chronic pain and invisible illness.
Rule #5 - Don’t assume anything.  Making the information available to your physician should be welcome and it helps you track your successes and failures too.
Rule #6  - Brainfog? Get a neurocognitive exam.
Rule #7 - Don’t give up.




ROLFING THE RESEARCH 


Fibromyalgia Syndrome (FM)
Chronic Fatigue Immunodysfunction (ME/CFS)
Myofascial Pain Syndrome (MPS/CMP)
Migraine
Chronic Pelvic Pain
Co-occurring Disorders
Therapies


WHAT OTHER’S ARE SAYING ABOUT OUR BOOKS



The goal of living with any chronic illness is to focus on the living and move the illness to the periphery. This book beautifully collects the wisdom of the author and of the ages as daily exercises to focus on life, growth, and health despite the presence of pain. Best wishes to all who use this book to reclaim life day by day.
- Patricia Geraghty, RNC, MSN, FNP-BC, Sharecare Editorial Advisory Board


A nurse recommended this to me, as I've had FM for 10 years now. I was really helped by Dr Devin Starlynal's "Fibromyalgia Advocate" and seeing her name associated with this book gave me more assurance there was good information here. The authors write first person stories and more fact focused pieces in a combination that keeps it very interesting. Like Dr. Starlynal's books this does not promote a single theory or cure...Read More
A nurse recommended this to me, as I've had FM for 10 years now. I was really helped by Dr Devin Starlynal's "Fibromyalgia Advocate" and seeing her name associated with this book gave me more assurance there was good information here. The authors write first person stories and more fact focused pieces in a combination that keeps it very interesting. Like Dr. Starlynal's books this does not promote a single theory or cure but shows the range of thinking on these disorders. I had not made the connection with CFS & CMP but it certainly bears out in talking with others. This is a very comprehensive and up to the minute book, wish I had it 10 years ago



SNEAK PEEK

BROKEN BODY, WOUNDED SPIRIT: Balancing the See Saw of Chronic Pain, FALL Devotions
Day Twenty-three, I strive to keep my words assenting,so they don’t come back to bite me.~Celeste  Topic “You said what?”..........

INTEGRATIVE THERAPIES FOR FIBROMYALGIA, CHRONIC FATIGUE SYNDROME AND MYOFASCIAL PAIN: The Mind-Body Connection
There are many helpful tools to help you in chapter two of Integrative Therapies…, “Communicating Your Healthcare Needs,” including  relating symptoms & health history, identifying and explaining aggravating and alleviating factors, in-depth explanation of possible coexisting conditions, how to communicate with all healthcare team members, a Summary Exercise, Medication Log, Symptom Inventory Sheet, Anatomical Diagram of Pain, and Health History Log.


BOOK REVIEW

Living in the Theater of the Absurd (Kindle Edition)2012 review By Celeste Cooper
Susan McIntyre gives a well written and empowering account of her personal experiences with pain and fibromyalgia, including many faith-full tips for coping. She writes of the vortex and within minutes you are pulled in with her. She speaks to each of us in an amazing and uplifting way. I chuckled in many spots as I thought she was writing a book about me! Honestly, I am not certain if it is aging with fibro or that we share some inner connection. Spell binding, and I mean that literally.

Do you have a special book that has helped you?  Pay it forward by writing a review on Amazon, and send it to me so I can post it in the newsletter.  You can contact me through my website, http://TheseThree.com


POINT TO PONDER    (Inspired by the daily devotions in Broken Body Wounded Spirit: Balancing the See Saw of Chronic Pain.)

How can I live an enlightened, aware life?


Paying it forward, in pain, for pain, Celeste, RN, author, pain patient/activist, educator, and fibromyalgia health expert  

Visit my website for more helpful information.
This blog available in RSS feed


*This virtual newsletter is for informational purpose only and is not meant as medical advice.

Sunday, January 6, 2013

Is your butterfly dead: your thyroid and you?



January is thyroid awareness month and I have added an article on my website titled:

 

 Is Your Butterfly Dead: Your Thyroid and You (click the title)

I hope you will stop by and find out things like:

  • What is the thyroid?
  • Weird but true
  • Hypothyroidism
  • Hyperthyroidism
  • Diseases involving the thyroid
  • Thyroid resistance
  • Blood tests
  • Other tests
  • Treatment


You can leave your comments here. I look forward to hearing from you.

In healing and hope, Celeste

Celeste's Website

Celeste's Website
Click on the picture