Archive for January, 2011

Chronic Fatigue Syndrome: Study Shows Cognitive Behavioral Stress Management improves stress, quality of life, and symptoms of CFS

San Jose Care Resource Guide: Chronic Fatigue Syndrome is not well undrerstood and it’s causes are unclear. Recent work has tried to tie it to a retrovirus [MediNewsDigest], but the the linkage is not necessarily causal.

San Jose Care Resource Guide: So what is one to do? Some drugs are used but they are not necessarily FDA approved for that purpose . Click hear ffor a link to Adienne Dellwo’s article on the CFS drugs

San Jose Care Resource Guide: What about alternative medicine?

• Click here for a link to the Mayo Clinic on alternatives for CFS
• Then there is this study on the benefits of  CBSM or  ”Cognitive Behavioral Stress Management”. This study was published in the Journal of psychosomatic research
  • Conclusions of this study  are positive, quoting: “…Results suggest that CBSM is beneficial for managing distress, improving quality of life, and alleviating CFS symptom severity…’
  • But what is “Cognitive Behavioral Stress Management”. Here is a helpful introduction lecture video by Dr Jason Satterfield, UCSF,  on Youtube/UCtelevision

What this post helpful to you? Click Here to let us know

Talk to your Doctor

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Sleep Remedies and Strategies in Fibromyalgia & Chronic Fatigue Syndrome

San Jose Care Resource Guide: Adrienne Dellwo has an interesting blog on Fibromyalgia, this time the topic is sleep problems  Click Here for link.

San Jose Care Resource Guide:  Here is a link to a study showing some help from  pregabalin (Lyrica)

San Jose Care Resource Guide: On an alternative note Hydrotherapy seems to also help sleep for FS patients, click here for link to Brazilian article in sciencedirect

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Medicare: Lawsuit charges government with denying care to thousands of chronically ill

San Jose Care Resource Guide: Yes,  we sometimes have to sue Medicare, i.e. our government, to get proper care.  Here is a link to the article in the  Chicago Tribune. This article was brought to our attention by Ernest A. Wahrburg, BA(PSY), MSW, LCSW (NC & NY)/LinkedIn

Quoting the Chicago Tribune: “…The  Center for Medicare Advocacy, which filed the lawsuit with Vermont Legal Aid on behalf of the National Multiple Sclerosis Society, Parkinson’s Action Network, Paralyzed Veterans of America, National Committee to Preserve Social Security and Medicare, and American Academy of Physical Medicine and Rehabilitation…”

So what is the Center for Medicare Advocacy? Seems like a large well organized pro-Obamacare health care advocacy site. In fact one one their article’s title is “HEALTH CARE REFORM DOES NOT CUT MEDICARE BENEFITS” ….

So why are they suing Medicare, A.K.A, the (Obama) government?

Quoting the Tribune, quoting them,

“…Under the law, Medicare is obligated to provide health care and therapy that are “reasonable and necessary for the diagnosis or treatment of illness or injury,” according to the legal complaint. Yet through the years, program administrators have decided that services will only be reimbursed if patients show signs of getting better, the complaint notes…..”

San Jose Care Resource Guide: This Medicare policy, of course, choose to ignore that , for many  chronically ill, not getting worse is the name of the game!

San Jose Care Resource Guide: Fact is, bombast or not, liberal government will cut and/or weazzle out of social obligations like anybody else….Particularly when the group targeted for cuts does not seem politically significant. I.e. the disabled….The Obama admistration will rather spend our healthcare money on worthy  causes like

See our previous posts on the topic

• With Medicaid waiver, California dives into health care reform (stateline)
• Multiple sclerosis and it’s Financial Burden: Comments on the Guardian’podcast
•  HealthCare: California’s Gov. Brown’s proposed steep healthcare cuts
• Ways The New Health Law May Affect You in 2011 (KHN)
• Health Care Law Should Help With Jail Inmate Treatment (thecrimereport)
• Medi-Cal and Gender Reassignment Procedures

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Palliative Care and End-of-life: How it’s Done

San Jose Care Resource Guide:  In End-of -Life decisions, it is important to realize how the “patient”  would  be

1.  Euthanized, or
2. Terminated, or
3. Killed.

 Pick your choice of terms according to your belief system,  (yes, atheism is a belief system too…)

San Jose Care Resource Guide: 

Since a lot of patients are on respirators at the time this would be done. [We use the word "done"  instead of "happen" because this is an active decision on the part of the patient (if conscious), the medical palliative care  team, and of the family.]   We found this article in the  Journal of Pain and Symptom Management .  This study is about  the influence of morphine injection on time to death after withdrawing ventilation from a terminal patient. Click  Here Article is from East Carolina University.

San Jose Care Resource Guide,  quoting:  “…The mean time to death after terminal extubation was 152.7 ± 229.5 minutes without correlation with premorbid diagnoses..After extubation, each 1 mg/hour increment of morphine infused during the last hour of life was associated with a delay of death by 7.9 minutes …”(Extubation: remaval of the respiration devices}

San Jose Care Resource Guide: So,

• 152.7 + 229.5 minutes=382.20min  6.37 hrs:       We are kinder to criminals with lethal injections…see below
• 152.7 - 229.5 minutes=382.20min=-76.8 min:       Negative time a little confusing??

Compare the duration of death by extubation we mentionned above,  to the duration of the death penalty procedure by lethal injection.  

Quoting Medscape Today:   “….According to the North Carolina Department of Corrections, once the ECG monitor displays a flat line for 5 min, the warden declares death and a physician certifies that death has occurred. Execution start times and declaration times were available for 33 of the 42 lethal injections conducted in North Carolina … Mean times to death [for lethal injection ececutions] were 9.88 ± 3.87 min for Protocol A, 13.47 ± 4.88 min for Protocol B, and 9.00 ± 3.71 min for Protocol C…..”

San Jose Care Resource Guide: You can draw your own conclusions…

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Multiple sclerosis and it’s Financial Burden:Comments on the Guardian’podcast

San Jose Care Resource Guide:The Guardian brings us a podcast on the worsening financial  burden of  MSers. True, this is about NHS in England, but the austerity tidal wave has certainly hit the US too. For starters, look at our recent post on the cuts in California social and health safety net  by Gov. Brown (Click Here for that post)

San Jose Care Resource Guide: The guardian’s podcast is not going to make MSers feel better about their plight. Maybe it could emphasize the need to advocate for them and their family caregivers. Here is the link to the ‘cast

San Jose Care Resource Guide:  The recent change in the US Health Care system has emphasized dilution of the concept of disability and included questionnable ills in the society’s network. Just check out some of our previous posts:

• Ways The New Health Law May Affect You in 2011 (KHN)
• Health Care Law Should Help With Jail Inmate Treatment (thecrimereport)
• Is your government draining money away from the benefits of the highly disabled?

We must force the government to distinguish between true the true hardship of the auto-immune diseases such as Multiple Sclerosis, Parkinsons’,  Rheumatoid Arthritis, Lupus as well as all the forms of Cancers and Spinal cord Injury from more benign ills. The culprit? Here you have it :

“SUMMARY OF KEY PROVISIONS: EEOC’S NOTICE OF PROPOSED RULEMAKING (NPRM) TO IMPLEMENT THE ADA AMENDMENTS ACT OF 2008 (ADAAA)”

Please help hep Advocate for the truly disabled and/or chronically ill! CLICK HERE TO CONTACT US

Either way, we would love to hear your comments!

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HealthCare: California’s Gov. Brown’s proposed steep healthcare cuts

San Jose Care Resource Guide: Gov. Brown announces “painful” [for whom?] cuts in California’s healthcare system. Click Here for the Kaiser Health News/California Healthline link

Quoting:

The cuts, which total $12.5 billion, include some large reductions in health care services, including:

• $1.6 billion cut from Medi-Cal;
• $1.5 billion savings from reducing eligibility period for state health services;
• $1 billion cut from developmental services;
• $1 billion cut from In-Home Supportive Services; and
• $ 716 million reduction in child care services, including reduction in levels of subsidies.

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Sleep: The Importance of Body Clock and Metabolism Regulation (Mercola)

SanJose Care Resource Guide: Dr Mercola has a clear, straightforward, and convincing appeal for a normally simple behavior which as probably as important,nay, more important than all the supplements we are gobling down…Sleep and aiding and abetting your Circadian rhythm. Click Here for a link to his post

Quoting Dr Mercola, 

• Short term memory
• Creativity and learning performance
• Weight gain/loss
• Diabetes and heart disease risk
• Immune system
•  a stronger immune response
• Cancer risk

In addition:

• Parkinson disease (PD)
• Alzheimer disease (AD)
• Multiple sclerosis (MS)
• Gastrointestinal tract disorders
• Kidney disease
• Behavioral problems in children
• Stress response related issues: Headaches,Indigestion,Insomnia ,Increased anxiety,Depression,High blood pressure

You name it, sleep is part of the remedies.    So, yes, sleeping enough can be a good investment of your time…

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Aging: Pain and worry about health in older men and the CHAMP study

San Jose Care Resource Guide: Pain and health worry seem to be a common issue for older people. Here is a link to a study on a group of  1217 community-dwelling men in australia, aged 70years or older the CHAMP study, published in the pain journal. 

Results are interesting,quoting :

•  12.5% had persistent and intrusive pain,
• 22.4% were worried about their health,
• and 6.3% had anxiety.

Let us us rephrase this:

       Of the men studied,

•  87.5% did not have persistent and intrusive pain,
• 77.6% were not worried about their health,
• and 93.7% did not have anxiety

Remarkable! The Australian sun?

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Depression: Bright Light Treatment in Elderly Patients With Nonseasonal Major Depressive Disorder

San Jose Care Resource Guide: Study shows that “..Three weeks of 1-hour early-morning Bright Light Treatment [ BLT]  (pale blue, approximately 7500 lux) can lift someone out of Major Depression. The study followed Eighty-nine outpatients 60 years or older who had MDD underwent 3 weeks of treatment (T1), and were evaluated  and 3 weeks after the end of treatment (T2).

The study concludes that :”..  In elderly patients with MDD, BLT improved mood, enhanced sleep efficiency, and increased the upslope melatonin level gradient. In addition, BLT produced continuing improvement in mood and an attenuation of cortisol hyperexcretion after discontinuation of treatment. 

That does sound like a substantial treatment achievement. Click here for article in the Archives of General Psychiatry

• Notes: The “elderly men” are 60+….
• That the  depression is not season related is counter intuitive, but also consider another study with similar results for Seasonal Depression: “Phototherapy for seasonal major depressive disorder: effectiveness of bright light of high or low intensity.”  With these differences:
  • The patients are not elderly
  •  The treatment is from 8 p.m. to 10 p.m. ( using light at 2000 lux, as opposed to 7500lux  for the nonseasonal case.)

Talk to your psychiatrist

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Fibromyalgia: Comparative Effectiveness of Drugs

San Jose Care Resource Guide: The study we are linking you to is mostly about  pregabalin (Lyrica) and gabapentin (Neurontin). Study is from the Journal of Pain

The study’s conclusion is not enthusiastic:  “…We conclude that pregabalin and gabapentin are modestly effective for the treatment of fibromyalgia but that their long-term safety and efficacy remain unknown….”

Background:

• Pregablin/Lyrica                       click here for wikipedia article
• Gabapentin/Neurontin        click here for wikipedia article

Another  article from Medscape Today gives more detailed information about what the FDA approved for Fibromyalgia Treatments ”Recent Advances in the Treatment of Pain Associated With Fibromyalgia: FDA-approved Medications” Click here for article

Note the medscape article brings in SNRI ( Serotonin–Norepinephrine Reuptake Inhibitor) like duloxetine, milnacipran

That brings two classes of drug treatment against Fibromyalgia

• anti epileptic
• SNRI
  • The efficacy of SNRI sounds also moderate, click here for expert opinion in PubMed

Conclusions:  Some medicines are there  against fibromyalgia, but with moderate efficacy

Talk to your doctor..

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