THE HIGH HOPES OF 2014 PARADIGM

Death,

Destruction,

Chaos.

That's just the tip of the iceberg

Well, it's been one heck of a year and, personally, I am glad to see it go. Life always has its challenges and mine is no different than yours. It's when you live with chronic pain and fatigue that it gets a little tricky. Even in the best of times resolutions are a little tough for me. I start out very enthusiastic and then I seem to forget that I had any. I guess goal setting isn't my strong suit. 

I know I'm not big on follow-up, I'm more of the idea man.

But I think this will work.

Here we go.....

First, I resolve to be a little more accepting of me. I know, I make this resolution every year but I think I need to be reminded of this every year.  OK, so I have limitations and pain kind of reminds me on a daily basis that it's there but.........

Next, I need to be a little kinder to my body. I know that if I push I will pay but I still do it. I want to get things DONE! It's that pesky old Type A personality that has plagued me since birth that keeps coming out but..........

Also, I need to be patient and not make myself crazy because I'm frustrated. I need to stop and think "this too shall pass." No, I'm not going to get my wonderful memory back. It falls under the category of "oh well". I'm going to forget words because this is the nature of the fog.......but..........

I need to stay focused on joy. 

I'm not going to go into some sort of nirvana. That just isn't me. I'm not the type of personality that wouldn't recognize stress if it jumped up and bit them. The idea of acceptance of this thing we call Fibromyalgia, to me, means that I climb in bed and pull the covers over my head and then, that's it, life is over. That I can't do and I won't do.

What I mean is that in the worst of times we need to stay thankful and grateful. We need to put one foot in front of the other and keep going. As tough as it is at times; as overwhelming as the pain can get, as tired as we are, as easy as it seems just to give up, we can't. 

I've seen some pretty dark stuff this year. I've seen what happens when the human spirit doesn't have the will to take it any longer. It tends to put things into perspective. I will never minimize what chronic pain can do and I don't want anyone to think that is what I'm doing. Pain is one tough cookie to deal with on a daily basis and it definitely changes you. As bad as it can get and as rough as it is, I'm saying we need to get through it.

As I've always said,

Fibromyalgia isn't for sissies.

My mantra for this year?

IT COULD BE A WHOLE LOT WORSE.

Because it can.

To all my friends, family and followers.....

I wish for a happy, healthy and prosperous 2014.

God Bless every one of you.

Be kind to each other and, most of all....

Be kind to yourself.

Happy New Year!

Rosemary

THE HOSPITAL, CHRISTMAS EVE AND THE DOCTORS TRIANGULATION

What is it about the holidays?

or just the month of December.

It has been a doozy.

And that is an understatement. There was the loss of a family member and the almost-loss of another. I sat in a hospital (which I hate) for hours on end.....for days.....until the crisis was over. Then a funeral.  That, funnily enough, made things a little bit better. While sad for the rest of us left behind, that funeral was truly a celebration of a remarkable man's life. I can only hope when it's my turn that I will be loved as much.

Then shopping for presents.

I know, I know......I could have done this all online but it seems that I'm a glutton for punishment. I just had to go to the mall. No, that's not quite the truth. I just love Nordstroms. Between Nordstroms and Costco, I'm in heaven. Actually, I admire their return policy. So, I brave all of that and start to wrap presents.

For some reason the present wrapping is worse than braving the mall.

The motions of wrapping presents seem to set me off for some reason. Maybe it's the repetitive motions.....I don't know but by the time I was done, I was done. I am now officially sick of shopping and wrapping presents. That, my friends, doesn't happen very often. 

This year has been bad.

Just bad.

I don't mean about the losses. I don't mean to minimize them...that's not my intention at all. I'm talking about the flares and the pain and the overall fatigue. It just hasn't stopped.

And I'm sick and tired of being sick and tired.

It's not just the fibro that's been flaring. I've got quite a few disks from "the accident" that have been acting up. Now the doctor wants to implant a neuro-stimulator that will help mask the pain. I've heard pretty good things about them. The people that do have them think they are the greatest thing since sliced bread. Even the shrink I had to see said they give you a new lease on life.

I know leases and the only ones who win are the landlord. 

And this little baby will surely be the one in charge.

I'm not sure I want a battery operated "thing" surgically implanted. For some reason, it is required to see a psychiatrist before you can be implanted with this device. He found me very well adjusted considering the extent of my back injuries. I mentioned the Fibro and he didn't seem to flinch. Maybe that's a good thing. Well adjusted?? I had to laugh at that one.

But therein lies my problem.

If it was just the back I'd be OK with it, but it's not. It's the Fibromyalgia that concerns me. This will set off a flare. The reason I know this is because every single time I have a procedure done, it takes me months to recover. I have no idea what kind of reaction this will set off. I get poo-pooed by the doctors but it's my body and I know it well. It may help my back but it's going to wreak havoc with the Fibromyalgia.

So what to do?

Oh......and then????

To top it all off?

I got the flu on Christmas.

Let's just add that ol' tiara!

Oh......just one more thing!

I got a flu shot this year.

Oh yeah.....that worked.

WHAT CAME FIRST, THE THYROID OR THE FIBRO?

Oh yay!

Another cure!!

Never mind the research.

Everyone else has been wrong.

It seems that everyone else has been misguided and the cure for Fibromyalgia has been right under our noses all this time.

It's your thyroid that causes the Fibromyalgia.

Sounds simple, huh?

I will agree that a lot of the symptoms sound the same but, at the same time, managing one does not automatically mean the cure of the other. The interesting part? The irrefutable evidence is currently on a website that is offline. 

Hmmmm.......

My doctor gets it. He knows there is a difference between normal and optimum. I don't feel well just being barely normal (OK, don't even go there!!!). I also need T3 and T4. I can't take levothyroxine alone, it just doesn't work for me. Getting my levels in check took some doing but now they seem to be where they need to be. 

I think it's interesting that that a lot of these symptoms are the same. I don't mean to sound flippant. There are a lot of issues with our body and the thyroid may just be one of them. The HPA axis dysfunction has long been a favorite theory of mine. I just think it's suspect when you take the same symptoms and point them to a simple fix.

Don't you think researchers have thought of this?

Maybe there is a problem with the thyroid due to low body temperature and basal metabolism that is common in Fibromyalgia patients, I don't know. Maybe some patients who were diagnosed with Fibromyalgia were actually severely hypothyroid. Maybe it is a problem but, right now, we just don't know. It's a shame that promising studies set themselves up for ridicule.

Why can't they just say, "another piece of the puzzle found."

Or, "study looks promising,

But, no......

Everyone else is stupid

And the cure was right under their noses.

So far, no one has been cured of Fibromyalgia,

But we can!!

(oops, the website with the proof is gone)

Is there any reason this shouldn't be suspect?

The thyroid science study link

IS THE F.D.A. ON D.R.U.G.S UPDATE

Yes, Virginia....

There is a Santa Claus.

All it takes is a little pressure from the Attorney Generals from 28 states and, guess what? 

VOILA!

Now maybe, just maybe the F.D.A. will rethink their approval of Zohydro. 

Believe me, I am not against pain medication. I need it to control the constant pain that I live with, BUT, I keep a tight control on the medication. These drugs, even in low doses, are very powerful and they need to be monitored. I've seen what drugs can do and it isn't pretty. You can take them and not wake up. 

The letter from the attorney generals have asked for the revocation of the approval or to make it conditional and the company must reformulate the product so that it is more difficult to abuse.

What I didn't know?

Zohydro is five to ten times more powerful than the currently available hydrocodone that's on the market. WOW! To my mind? These pills shouldn't be available to everyone. It should be for terminal pain patients. If you're walking around, you shouldn't need Zohydro. It's that simple. 

The company that makes Zohydro declined to comment but the FDA representative said they are reviewing the letter.

Again, pain medication is necessary.

I believe that.

In responsible hands they make one able to enjoy life.

But you don't need an Zohydro if you got a tooth pulled.

The 5 Stages of Kidney Disease

The kidneys are the body's filtering system. They pull waste and extra water from the blood and take it out of the body as urine. The filtering parts of the kidneys are called nephrons. Nephrons have many small blood vessels in them. High blood sugar levels and uncontrolled high blood pressure can damage these small blood vessels.

Damage to the nephrons is called nephropathy. In the early stages of nephropathy, the body doesn't give any warning signs that the damage is happening. The earliest sign of diabetic kidney disease is an increased excretion of albumin in the urine. This is present long before the usual tests done in the doctor's office show evidence of kidney disease, so it is important for diabetics to have this test on a yearly basis. 

As a diabetic's kidneys fail, their blood urea nitrogen (BUN) levels will rise as well as the level of creatinine in the blood. Diabetics may also experience nausea, vomiting, a loss of appetite, weakness, increasing fatigue, itching, muscle cramps (especially in the legs) and anemia (a low blood count). Diabetics may find you need less insulin. This is because diseased kidneys cause less breakdown of insulin. If a diabetic develops any of these signs, they should call their doctor.

Signs of kidney disease in patients with diabetes include but are not limited to the following:
-- Albumin/protein in the urine
-- High blood pressure
-- Ankle and leg swelling, leg cramps
-- Going to the bathroom more often at night
-- High levels of BUN and creatinine in blood
-- Less need for insulin or antidiabetic medications
-- Morning sickness, nausea and vomiting
-- Weakness, paleness and anemia
-- Itching

Stages of Kidney Disease
Diabetes can lead to changes in the kidneys that happen in stages. In the early stages, stages 1 through 3, the kidneys are able to make up for the damage and there aren't any obvious signs that the damage is happening. When enough damage occurs, in stages 4 and 5, the kidneys lose their ability to filter and cleanse the blood.

Stage 1: In this very early stage, the blood flow through the kidneys increases and the kidneys get slightly larger. Good blood pressure and blood sugar control are very important at this stage to help prevent any more changes. Remaining kidney function: 90% or more. Glomerular Filtration Rate(GFR):  90+%

Stage 2: The kidneys start showing damage in stage 2, as small amounts of protein (albumin) begin to leak into the urine. The kidneys will normally try to keep from filtering protein into the urine because protein is such an important building block for the body.

Albumin in the urine in this small amount (200 micrograms or less per milligram of urine) is found by a test called the microalbumin urine test, done at the lab. Remaining kidney function: 60% or more.
Glomerular Filtration Rate (GFR): 60-89%

At this stage, treatment includes quitting all tobacco products, controlling high blood pressure, keeping blood sugar levels as close to normal as possible, and, if really necessary, using an ACE inhibitor or similar drug. Doing these things can protect the kidneys against any further damage. (But, keep in mind that extended drug use can damage the kidneys over a period of years).

Stage 3: The loss of albumin into the urine is more than 200 micrograms per milligram at this stage. This is enough protein to be found by using a urine dipstick test, which can be done at your doctor's office. Treatment will still focus on controlling high blood pressure and keeping blood sugar levels as close to normal as possible. Remaining kidney function: 30% to 59%.
Glomerular Filtration Rate (GFR): 30-59%

Stage 4: By stage 4, also called advanced clinical nephropathy, the kidneys have become badly damaged from poorly controlled diabetes. Large amounts of protein leak out into the urine and signs of kidney damage start to show. These signs can include swelling in the legs and feet, high blood pressure, and high cholesterol and triglyceride levels. Remaining kidney function: 15% to 29%.

Treatment will include supporting remaining kidney function, controlling blood pressure, and keeping blood sugar levels as stable as possible.

Stage 5: By the time a patient gets to this stage, called end stage renal disease, the kidneys have failed. The patient will need expensive therapy and medicine as well as kidney dialysis. When kidneys fail, waste products have to be regularly removed from the blood by a dialysis machine that does the filtering work of the kidneys. Remaining kidney function: Less than 15%.
Glomerular Filtration Rate (GFR): <15 font="">

Some people might benefit from getting a kidney transplant, but most will have to wait years for a donor kidney. After having a kidney transplant, people need to take many different medicines to make sure the body doesn't reject the transplanted kidney. 

Kidney Health Tip: Your kidneys will work better and last longer if you:

• Eat a plant-based diet (such as the Death to Diabetes Diet)
• Control your diabetes and blood sugar (with diet and lifestyle)
• Control high blood pressure (with diet and lifestyle)
• Get treatment for urinary tract infections
• Correct any problems in your urinary system
• Avoid any medicines that may damage the kidneys (especially OTC pain medications)

Note: About 30 percent of patients with Type 1 (juvenile onset) diabetes and 10 to 40 percent of those with Type 2 (adult onset) diabetes eventually will suffer from kidney failure.

The 5 Stages of Kidney Disease Chart

Stage	Description	GFR
1	Kidney damage with normal or raised GFR	≥90
2	Kidney damage with mild decrease in GFR	60-89
3	Moderate decrease in GFR	30-59
4	Severe decrease in GFR	15-29
5	Kidney Failure	<15 span="">

IS THE F.D.A ON D.R.U.G.S???

I'd say....

ARE THEY ON DRUGS?

But I never like to state the obvious.

For those of us in the chronic pain community, we know how difficult it is to receive adequate treatment. If we tell the truth about our pain, we are considered neurotic. If we underplay it, we obviously don't need medication. 

There's no easy way to play it.

On October 25, 2013 the FDA drew huge praises from the addiction community by moving hydrocodone with acetominaphen to a Schedule 2 narcotic. What this means is that instead of going back to your physician every six months for followup, you have to return in three months. In addition, the doctor cannot call in your refills. You must hand the prescription to the pharmacist personally. They have made it harder to get Lortab, Vicodin and other addictive painkillers. They are supposed to make painkillers harder to abuse. For example, they inject Oxycontin with a gel that makes it harder to crushed and snorted. This kind of abuse deterrent is supposed to be a public health priority. 

So what did they do?

They approved Zohydro. 

Zohydro is a long acting opioid. This drug is not intended for as-needed use. This is for patients who need long term, around the clock treatment. Obviously, you wouldn't get this for a tooth extraction. 

This drug is not messing around. You can't drink alcohol. Let's face it, you're not supposed to drink with any pain medication but alcohol with this medication can result in fatal hydrocodone plasma levels in the blood. You even have to be careful taking anything that contains alcohol. This can even mean cough syrup.

You are also instructed by the insert to swallow Zohydro whole otherwise it can be fatal. 

This is their strong stance against substance abuse?

So what that tells me, this drug has the ability to be crushed up and snorted. To be fair, the makers of Zohydro have contracted with a Canadian company to come up with an abuse deterrent formula but who knows how long that will take. This drug was meant for cancer patients but everyone knows it will be on the street soon enough. Pill mills will push these babies out and they can be crushed, snorted and will kill people.

I love the insert on this drug. When addressing who should be prescribed this drug they talk about the opioid "naive." WHAT?? I've never heard that phrase before and I'm not sure I like the way that sounds.

What does this mean to me? It means people will start abusing this powerful drug and many will die. The people who it is intended for will have a hard time getting it after the stats start coming in. People need to be out of pain but because of pill mills and addicts those who truly need opioid therapy will be out of luck.

I thought the difference between Schedule 3 and Schedule 2 narcotics, as far as the refill requirements, was interesting. I live in Nevada and I have to go every 30 days to the doctor for a refill. 

Go every three months?

Not even close.

And you better not take it to a new pharmacy either.

They probably won't fill it.