Showing posts with label fibromyalgia research. Show all posts
Showing posts with label fibromyalgia research. Show all posts

Saturday, March 29, 2008

Progress: One marbles to two marbles -- 1つのビー玉から2つになった進歩。


If one activity (e.g. grocery shopping, going to a doctor, taking a walk) was represented as a marble, how many marbles do you have in a day?

One of the tips I got from the fibromyalgia study was to imagine that you have a certain number of marbles (probably less than the normal population) in a bowl, and that you spend your marbles by moving from the original, "available" bowl to another, "spent" bowl. Once all the marbles are gone from the original bowl, you should stop.

A little over a year ago, I'd say I had zero marble on many days. I couldn't get up from bed. Other days I had one marble to spend. I'd go grocery shopping, and I'd be done for the day. I'd get together with a friend, and I was down for a few days. All I could manage was making it to doctors' appointments to figure out what's going on.

Then between last January and March, I was diagnosed with fibromyalgia, chronic fatigue syndrome, and celiac disease. I started treatment with the fibromyalgia clinic last April, and went on gluten-free diet at the end of March.

Progress comes slowly, but it is there (this I need to tell myself). Now, on most days I have two marbles to spend. On good days, even three! Hey, that's a 100%-200% improvement! If I were a company, my stocks should be skyrocketing.

But if I go over my allotment, or do an activity that requires two to three marbles all at once (e.g. going out to eat and then seeing a play, symphony, etc., coupled with taking buses or driving), I have less marbles on following days.

I think it's also helping that I'm getting a nutrition IV every week, especially since I seem to have lost about 10 pounds while fighting multiple opportunistic infections. (I wasn't particularly that tiny before, so I'm not really underweight yet. I'm OK, but my chest goes away!!)

I try to pace myself, but often, I've had to say no to planned social activities when I felt a bit too spent, so I wouldn't be down for weeks. I love people, so this has been hard. In the past couple of months, I've been trying to see more friends and schedule activities I enjoy for my spirit (music, play, movies, tea with friends, etc.), and I feel terrible when I can't make it.

Thank you to all my friends (you know who you are) -- for always being so understanding, and standing by my side. Please know, if I had a choice, I'd get together with you (or write you or call you) much more often.

I'm recharging; I hope I continue to make progress. I dream of coming days when I have enough marbles to fill a small bowl :-)

-A

(日本語訳は疲れたのでちょっと後で。。。Japanese to come later. I just spent about 0.5 marble.)

[そして余分なビー玉がないまま、あっという間に一週間+! Oops!]

唐突ですが、もし、ひとつひとつなにか行動すること(お買い物とか、お医者さんに行くとか、お散歩とか)をそれぞれ1個のビー玉に置き換えるとしたら、あなたは一日何個分ビー玉をお持ちですか?

線維筋痛症の治療研究グループに参加したとき、勉強したことの中にこんなことが書いてありました。
「無理をしないよう、一日に使えるエネルギーをビー玉に置き換えて(多分普通の人より数は少ないけれど)、それがボウルの中に入っていると想像します。 そして何かしてビー玉を一個使うたび、「使用済み」側のボウルに移していきます。 もとのボウルにあったビー玉がなくなってしまったところで、それ以上無理をせず休みましょう。」

1年ちょっと前、ほとんどの日、私のビー玉の数は0でした。 ベッドから起き上がるのが出来るか出来ないか。 その他のときは、一つビー玉があるくらい。 スーパーに行ってお買い物をして、帰ってきてバターン。 ちょっとお友達とランチをして、その後数日お休み。 (悪いカードをひいた双六みたい。) ほとんどのエネルギーは、数々のお医者さんに行って、何でこういう風なのか解明しようとするのに費やしていました。

そして去年の1月から3月にかけて、いくつか答えが出てきました。 まず痛くてたまらないのが線維筋痛症、そして疲れて何もできないのが慢性疲労症候群、そしてお腹が痛くなって偏頭痛のもとで栄養不良にになったのがセリアック病。 (アポがそれまでとれなかった)4月に線維筋痛症・慢性疲労症候群専門のクリニックで治療を始め、3月にはグルテンフリー(と乳製品と卵フリー)の食事療法を始めました。

進歩はゆっくりですが、着実にあると思います(自分に言い聞かせてる)。 だって最近を振り返って見ると、ほとんどの日には2つくらいビー玉があります。 調子のいい日には、3つあるかも! それって、100~200%の向上です。 もしこれが株式会社だったら、株がすごい上がるところです。

でも無理してその日支給されたビー玉以上の行動をしたり、いっぺんに2~3個使ってしまった場合(例えば友達と食事をしてその後に演劇とか交響楽団とかを見にいって、さらにそれと移動時間を足すと確実に越えてしまいます)、その後の日々のビー玉の数が減るわけです。

毎週続けている栄養点滴も、助けになっていると思います。 慢性感染と戦うのにエネルギーを使ってしまうせいかここ何ヶ月かで10パウンドほど体重が減ってしまったので、なんとかある肉はとっておこうとしております。 (もともと大柄だから痩せすぎということはないけれど、胸がなくなる~。)

できるだけ安定したペースで過ごそうと思っても、予期できずビー玉が突然少ない日もあるので、その後週単位でダウンしないよう、予定していた約束が果たせないこともあります。 ここ何ヶ月か、引きこもらないよう、できるときは、自分の気持ちが盛り上がるような好きなことをいろいろするようにしてきましたが(音楽、劇、映画、お友達とお茶、などなど)、人好きなので、行けないときはつらいです。 それにすっごく悪くてしょうがありません。

私の周りの優しい方々、いつもおおらかにご理解くださって、できるときに付き合って下さって、支えて下さって、ありがとうございます。 もしできるものなら、もっと頻繁に手紙を書いたり電話したり会ったりしたいこと、身勝手ですけど知っていてください。

充電中で、すこーしずつ良くなってきています。 たとえ小さいボウルでも、将来ビー玉の数が増えて、もう少し盛れることを夢見ています。 (^_^)

(真夜中したもので、ほんとに英語を訳した~という感じの日本語ですみません!)

-英

Wednesday, August 8, 2007

Gettin' used to feeling chunky - 自分のずんぐりした姿に慣れること。

Weather: Cloudy; 62°F - but in the 70s during the day
Energy Level: 3.5 out of 10
Mood: Still yo-yo'ing
Health: Better than the last time I wrote, but tired from the weekend

↑ Tiffany & Andy's deck -
right in the smack middle of Genesee Park,
where SeaFair was! Blue Angels were coming
right at us. No kidding. Really.

Maybe I'm being vain, but I can't help being a girl. I totally feel chunky.

Let me back up a little. This past weekend was great fun, because Chris and Ian, our friends from Colorado (although Chris lives in Burbank, CA now) were visiting to attend a friend's wedding here in Seattle. Ruth, Chris's lovely wife, was supposed to be here too, but a glitch in her pregnancy prevented her from coming :-( She's feeling OK, but please send some good energy in the direction of Southern California!

So among other things, we got to visit with the familiar faces from Colorado. We hadn't seen Tiffany and Andy (who also moved to Seattle) forever, at least not since they bought their house, and we got to do a brunch at their place. I was happy because I was dying to get something for their housewarming. Among other little things, I found a "Foot in the Door" door stopper, which you can see a bit of in the picture.

It was great to socialize and soak up some sun. I realized I must be more extroverted than I previously thought - having (good) people around really cheered me up.
I realized, even if I wasn't feeling completely up to it physically (hence the mountain of pillows I brought to alleviate pain), I should go ahead and try to socialize.

Being a good, responsible man that he is, Chris already sent us the online picture album of his trip to Seattle, which included the picture above among others.

I really enjoyed the pictures, so I really don't want Chris to feel bad about sending them around. But I must admit, it was kind of hard to see myself kind of out of it, sickly, and chunky.

I've had a sneaky suspicion that I was getting a little heavier, because my jeans have been tighter. (We don't own a scale.) I've been having thyroid dysfunction which makes me retain more water, but I don't think that's the main issue. It's the low activity level with the same amount of appetite (which I seem to have no problem with - even when I'm sick I can eat).

This realization was also aided by the fact that I ordered a sweater dress in size XS in the mail (since I was too dizzy to go shopping), tried it on, and had to take it off right away when I realized I no longer fit comfortably in extra small.

Some of you reading this in the U.S. (where I believe the average size is 10-12) might say "What's the big deal?! You went from a size 2 to a 4," but I must tell you, I don't have the height or big enough bone structure to support the extra weight. What might look like 5 pounds on you would look like 10 or 15 on me. Coming from a land of tiny women, stepping into the present day American size 4 (which is apparently about 2 or 3 sizes bigger than the size 4 in the 50s/60s, BTW) means I became a Japanese size L from M.

I've never been one of those people with great metabolism to begin with, so I've always had to work pretty hard to maintain the feel-good weight. (Also I became really heavy when I first came to an American high school as an exchange student, so I had to really work off the weight.) It works when I'm able do that. Right now, I can't. I've been walking/biking at least 3-4 times a week since I joined the FMS Research Program, but that's apparently not enough, considering my metabolism has slowed down and I'm sedentary the rest of the time. I've been itching to go running, but if I did, that would put me out of commission for days, which would negate the whole point of running.

I also have a very (brutally) honest husband who can't lie, which is usually a good thing. Upon being asked, "I've become a little chunky, huh," his response was at first silent, then, "...you haven't been able to be as active, so..." He then hastily added, "You are still beautiful to me and that's what's important! And you need to feel healthy first!"

(Even if it were a white lie, if he had said something like "Not at all! You're probably bloated!" I probably could have slept more.)

...I appreciate his nice(?) thought, and yes, it's true, I need to feel healthy first. I feel like I am getting better little by little, so that is probably possible. Yet, late at night (especially after a setback), sometimes I lay awake and wonder: "What if this is as good as it gets?" (It's like that movie.)

And such nights make me want to eat my gluten-, dairy-, and egg-free chocolate cookies. (Yes, such a thing exists, available for purchase. Who knew?) Aggghhh. But since I'm making my thoughts (semi) public, I won't this time. Maybe this is the benefit of a blog :D

-A

P.S. I broke down and ate some rice crackers. Hey, at least they seem less fatty. :P

天候:  曇り。 17°C (日中はもっとあったかいです。)
元気度: 3.5/10
気分: まだちょっと、行ったり来たり
体調: 疲れてるけどすぐ前のポストよりずっとまし。


↑ R2-D2の郵便ポスト!
Awesome R2-D2 mailbox, n'est-ce pas?

自意識過剰と思われるかも知れませんが、女心と笑ってください。
ぽっちゃりしてきたのが気になってしょうがありません。

ちょっと時間を遡って補足すると・・・。

コロラドのお友達が何人か、結婚式に出席するため訪ねて来ていたので、
先週末は非常に楽しい週末でした。

いくつか一緒に行動できた中で特に嬉しかったのは、
他のコロラドから越してきたお友達にも何人か会えたこと。

シアトルで毎年ある、
ボートレースや航空ショーを含めたお祭り騒ぎ、
シーフェアーの会場になる公園のまん前に住んでいる
ティファニーとアンディの家に行って、みんなでブランチをしました。

少し日に当たって、お友達に会うのはいいことだと実感しました。
ちょっと疲れて体中痛かったので枕やクッションを一杯持参したのですが、
それでも、人に接するのは気分が盛り上がっていいもんだ、と
思いました。 自分ではどちらかというと内向的な性格かと
考えていたのですが、思ったより実は外交的なのかも知れません。

写真を撮ったクリスはとっても頼りになる実直な人なので、
例にもれず、帰って1日しか経たないのにもう写真をオンラインアルバムで
送ってくれました。

写真をいろいろ見るのは楽しかったのですが、
いやはや、ぽーっとして具合が悪そうな、ぽっちゃりした自分を見るのは
つらいものですねー。

ジーンズがちょっときつかったりしたので、前々からちょっと太ったかなー、と
思ってはいたのですが・・・。 (体重計は持たない主義)

甲状腺機能が低下(と言うんだろうか)しているとかで、多分むくみます、とは
言われていたのですが、そういう次元の問題ではなく太ったと思います。
運動不足と、変わらない食欲が原因でしょう。
(具合が悪くてもお腹は減るんですよねー、これが。)

めまいがしてショッピングに行けなかったので、
メールオーダーで頼んだニットワンピースがちょうど今日届いたのも
災いしました。 XS を頼んだのですが、着てみてぎょっとしたので
すぐに脱がざるを得ませんでした。

(日本で読んでいる方、ご存知でしょうがアメリカのサイズは
ばかでかいので、S の域に入ると日本では
L だと思います。)

昔から新陳代謝が良い体質ではないので、それなりの体重を維持するのに
かなり努力してきました。 (それにアメリカに高校のとき留学して来た際、
どーんと太ってしまったので、それを必死に落とさなければいけませんでした。)

その努力、運動が出来ればいいのですが。
いまの状態では、はっきり言って出来ません。

線維筋痛症の治療法研究グループに参加して以来、
週に3~4回は痛くても30分以上歩いたり自転車に乗ろうと努力して
いますが、その他の時間はおとなしくしているので、どうしても
足りないのでしょう。 新陳代謝は余計悪くなっているし。
走りに行きたくてここのところむずむずしているのですが、
行ったらきっと3~4日はダウンしてしまいそうです。
そうすると元も個もないし。

幸か不幸か、私の主人は全く嘘のつけない性質です。
(普段はそれがいいんだけど、悪く言えば融通が利かない。)
「私、やっぱり最近太ったよね」と聞くと、「・・・」と返事がすぐ返って来ません。
そして、「・・・あんまり今活動的な生活が出来ないから、しょうがないよ。」と
言うのです。 (漫画だったら、ここで涙がダーッと出るところ。
「そんなことはないよ、君は充分魅力的さっ」とか言ってくれれば
眠れたものをー。) その後に慌てて、「それでも君は僕にとっては
美しいから! 健康になるのが第一だし!」と。

うーん、慰めてくれてるんだか落ち込ませようとしてるんだか。
(前者だとは思うけど。) そうね、回復するのが第一よね、とは
思いますです、ハイ。 でも、こんな眠れないとき(特に調子を崩してるとき)、
目が冴えながら、「これ以上良くならなかったら~?」と悩んでしまうのです。
(元気なときと同じ量食べなきゃいいのか。)

そしてこんな夜、グルテンフリー、乳抜き、卵抜きのチョコクッキー
(あるんですよこれが。 買うなよって?)食べたくなってしまうのです。 
しょーもない。

でも、そんな考えを公にしてしまったので、食べないことにしようっと。
これがブログのメリットかも。 チャン、チャン (*^_^*)

-英

P.S. 誘惑に負けて米しょうゆを使ったおせんべいを食べてしまった・・・。
   でもクッキーより脂肪分は少ないよね?!

Tuesday, July 10, 2007

Progress = washing behind my ears - 耳の後ろを洗うことは嬉しい。

Weather: Super Sunny; 73°F
Energy Level: 4 out of 10
Pain Level: 5-6 out of 10
Mood: OK but worried about a few things...

↑ Ender (left)
sleeping on my pillow
with Momo.

Sorry I haven't posted in a while - Daniel took some time off around July 4th, and I wanted to do things together with him, and in the process I wore myself out a bit. Plus I was a bit preoccupied with cat matters.

Ender is a tiny black cat I'd inherited from a house mate a long time ago. She is 8 years old but remains kitten-sized, and has never been that tough. We had to give away Ender to our dear friend Pete last year, because she kept getting attacked by our other cats that she couldn't get down from the top of the bookshelf or refrigerator all day :-(

Ender came to visit us while Pete was out of town, and I noticed ominous little bumps on her head which she kept scratching - similar to ones she got shortly after coming home from a Denver shelter. At that time it was determined she had ringworm (not worms despite the name; it's a fungal infection, same thing as athlete's foot), and Momo ended up getting it from her.

So I took Ender to the vet, they took some culture from her skin, and we're waiting for results after they'd try harvesting the culture (it apparently takes about two weeks to try to grow the fungal culture). If it's not ringworm, it could be some form of cancer, so we'd need to do a biopsy. So we'd wait for now. We'd isolated Ender promptly afterward, and she's gone home to Pete.

In the meantime, I got nervous about Momo catching it again (only Momo was allowed near Ender since other cats tend to beat up Ender), so I inspected Momo - and it turns out she was losing hair underneath her collar. I guess it could be due to old age (Momo is 13), but for good measure we took her in to the vet, too. They didn't see much wrong with her, but they're running some lab work to see if she has a thyroid issue. So much drama. I can't imagine having human kids!

I myself am going in to my doctor's appointment today at Fibromyalgia and Fatigue Center to see about my progress. I think I am making progress with my thyroid and cortisol medication, because 1) I'm up and typing; and 2) I used to even have a hard time getting over the bath tub ledge to take shower in the morning, and now I don't dread every movement getting to that point, and I even think about washing behind my ears. That may seem like a small thing to normal folks, but it used be that I found it hard to even wash my head and body in the most basic sense because of pain and weakness, so I find joy in that I have energy to think about washing behind my ears!
-A

P.S. My awesome friend from the FMS research group, Gabi, posted another yummy gluten-free (which most are, when you make your own - I've just been lazy) drink recipe on her blog - it's horchata! I've had it in restaurants but was never sure how it was made. Very cool. I'll have to try making one! I feel like we're becoming culturally richer because I found out about my celiac disease, hehehe.

天候: 快晴; 23°C
元気度: 4/10
痛み度: 5~6/10
気分: まあまあだけれど心配事がいくつか。

ご無沙汰してしまいました~。
ダニエルが独立記念日にあわせ何日か休みをとってくれたので、
一緒にお買い物に行ったりしたくて、頑張ってる間に
ちょっと疲れてしまったようです。

それと、猫の関係で心配事があったりしたもので。。。

昔同居人が飼っていたのを引き取った、小さな黒猫のエンダー。
(ツキノワグマみたく首に白い三日月マークあり。)
8才になっても子猫サイズで、体があまり強くありません。
もともとダニエルが飼っていた2匹の猫にどつかれて、
本棚や冷蔵庫の上から餌を食べるのにも降りて来られなかったので、
お友達のピート君に去年もらわれていったのですが・・・

先々週末ピート君が旅行に出かけたのを機に、
里帰り(?)してきたエンダーですが、頭になんだかポツポツ
出ていて痒そうにしてるので、また白癬菌感染症かと
心配になったのでした。 昔デンバーのシェルターからもらわれてきた
すぐ後になったことがあって、そのとき私の飼い猫モモにも
うつったのです。

そこでエンダーを獣医さんに連れて行って、肌から菌見本を採って
培養してもらうことになりました。 なかなか自分で育てようとしても
育たない菌なので(それなのに水虫になるのは簡単?!)、2週間ほど
はらはら待たなければいけないそう。 白癬菌でなければ癌の可能性も
あるので、さらに生体組織検査に進むかどうか今は待つのみ。

その後エンダーをすぐ隔離して彼女は最近ピート君の家に
帰ったものの、今度はまたうつっていたらどうしようとモモが
心配になりました。 (他の猫はエンダーをいじめるので近寄らせなかった。)

そこでモモをよーく調べたところ、首輪の下の毛が一部なくなってる!
ということが判明。 けっこうゆるくしてあったのですが・・・
歳だから毛が摺れて抜けると生えない、ということもあるかも知れませんが、
一応お医者さんに連れていくことに。
見たところ悪いところはなさそうですが、甲状腺機能が私みたいに
弱っているのかどうか調べ中です。

は~普段から疲れてるのに気が疲れた。
猫でもこれなのに、お子さんがいらっしゃる方のご苦労は
計り知れませんね。

自身も今日、線維筋痛症のクリニックに今日出かけて、
甲状腺コルチゾール関連の薬が効いて免疫機能が少し
戻ってきているかどうか診てもらいに行きます。

自分ではだいぶ前より良くなってきているような気がするのですが・・・
だって、(1)起きてタイプしているし、
(2)前はよいしょっとバスタブを乗り越えてシャワーに
入るのも大変だったのに、「耳の後ろをよく洗おうっと」とか
考えるまでになりましたもん。 それって普通の人からすれば
当たり前のことのようですが、一番弱っていた時は立って
頭と体を手早く洗うのも大変だったので、耳の後ろを洗おう、
と考えるようになれただけでも嬉しいのでした。

-英

P.S. FMSちけんグループのギャビーさんが、美味しい南米の飲み物、
ホーチャタレシピを教えてくれました。 今度作ってみようっと。
なんだかセリアック病と分かったおかげで、いろいろ美味しい飲み物を
作れるようになって得してるみたい (^o^)

Sunday, June 24, 2007

FDA approves Lyrica for FMS treatment - ライリカが線維筋痛症治療薬に認可される

I got news that Lyrica, a drug from Pfizer, has just received FDA approval for treatment of fibromyalgia on June 21. It's the first drug that receives such approval.

Lyrica (a.k.a. Pregabalin) has already been in use for treatment for neuropathic/nerve pain (burning, stabbing, shooting pain) related to diabetes and shingles, and also has been used to treat seizures and generalized anxiety disorder. Some doctor has used it to treat fibromyalgia so it's not a new thing on the market and it wasn't particularly developed for FMS. Pfizer said "Hey, it might work for fibromyalgia, too," and ran a trial, then FDA just approved it, so it's receiving some renewed media coverage.

The pharmaceutical industry is characteristically putting an joyous spin on this, but FDA cautions that it's not a cure-all - in a recent APA meeting, it was reported to have 30% to 60% response rate. I guess that's pretty good - higher than the placebo - at least it's something.

As with all drug approval, the study Pfizer used to get approval claims a higher success rate - in a "preliminary report" (I need not remind you these tend to get revised) of a clinical trial, 63% of patients reported some pain relief. It is notable, however, that almost no one mentions that by the end of the six-month two-phased study, 32% of those getting Lyrica "lost therapeutic response." Since many drugs seem to offer a short-term benefit, this could be one of those.

I personally remain optimistically cautious, because as with any drug, there are side effects (most common being "mild-to-moderate dizziness and sleepiness"; also "blurred vision, weight gain, dry mouth, and swelling of the hands and feet also were reported in clinical trials") - and I tend to be sensitive to those. Also there was "no mechanistic explanation for response."

It certainly could be a good news for those with unbearable pain who would respond to the drug. The fact remains, though, it does not particularly address the underlying etiology of the individual, nor associated disorders/infections (for example, since FMS patients' immune system is often deficient, they suffer from chronic infections they can't shake). I will ask about it the next time I see my FMS doctor and let you know what she says.
-A

Some news sources:

FDA News (very brief)
Pfizer's Lyrica Receives FDA Approval for Fibromyalgia

PharmaLive (News from the pharmaceutical industry - very favorable to Pfizer)
Pfizer’s Lyrica Receives FDA Approval for Fibromyalgia

MedPage Today "Product Alert" (News for physicians - a little more in depth)
Pregabalin (Lyrica) is First Drug Approved for Fibromyalgia

Lyrica official site
http://www.lyrica.com

FDA(食品医薬品局)が、ファイザー製薬の作っているライリカ
Lyrica)という薬を線維筋痛症(FMS)の治療薬として
6月21日付で認可したそうです。
薬品がFMSの治療薬として認可されるのはこれが
初めてとのこと。

ライリカはプレギャバリン(Pregabalin)とも呼ばれ、
糖尿病や帯状疱疹にまつわる神経痛(ひりひりしたり、
刺しこむような痛み)にすでに使われている薬です。
医師によってはすでにFMS治療に試しに使っている
医師もおり、新しい薬ではありません。
FMSの為に開発された薬ではなく、
すでにあった薬をファイザーが「これ、もしかしたら
線維筋痛症にも効くんじゃない」と患者に投薬してみて、
効いた患者が多かったので認可を申請したもの。
ただFMSに関しては最初の認可ということで、
ニュースになっている訳です。

製薬業界はいつも通り、かなりいいようにニュースを
伝えています。 「線維筋痛症の患者に朗報!」と
いうことですが、FDA側は「全てに効く特効薬ではないことを
患者は覚えておくべきだ」とも。
アメリカ精神医学会の最近の学会で発表されたところでは、
薬が効いた患者は30%~60%と、ばらついた結果です。
まあ、プラシーボよりいい、というところでしょうか。

ただ、研究例が2件しかないのと、認可に使われた研究は
一番高い成功率であることがちょっとあやしいと言えなくもありません。
「仮報告書」によると、63%の患者が痛みの軽減を経験した、
というのですが、「仮報告書」はだいたいにおいて後で
訂正されるのと、業界から認可を早めるよう圧力があったような
言い回しがニュースに見られます。

それに、6ヶ月の研究が終わった時点で、
ライリカを処方された患者のうち32%は
薬の効き目がなくなった、と研究報告にはありますが、
それはニュースでは言及していません。
FMS治療では短期間だけ薬が効くことがままある、
と言うベテラン医師も言います。

個人的には、肯定的にとらえつつ、
慎重にどうなるか見ていきたいと思います。
他の薬と同じで副作用があるのは明らかですし
(主な副作用は軽~中度のめまいと眠気、
あとは視覚のぼけ、体重増、口渇、手足の腫れなど)
薬には敏感な方なので。
それと、「機構的に、なぜ効果があるかは不明」というのが
なんだかあやふやな感じがします。

耐えられないほどの痛みに悩む方で、
薬が体に合えば朗報には違いありません。
ただ、患者一人ひとりに関して体にどんな
負担がかかって病気になっているのか、
さらにはよくあるようにFMSのせいで免疫機能が低下して
何らかの慢性感染症になっている場合、
それを治せるような薬ではないと考えられます。

今度FMSのお医者様に行ったとき、
彼女の意見を聞いてみようかと思います。

いくつか情報源:

FDA(食品医薬品局) ニュース (かなり簡潔)
Pfizer's Lyrica Receives FDA Approval for Fibromyalgia

PharmaLive (製薬業界発のニュース。 ファイザーにかなり肩入れ)
Pfizer’s Lyrica Receives FDA Approval for Fibromyalgia

MedPage Today "Product Alert" (医師向けの薬品ニュース。 もう少し情報あり)
Pregabalin (Lyrica) is First Drug Approved for Fibromyalgia

Lyrica ライリカホームページ (ファイザー発)
http://www.lyrica.com

Friday, June 22, 2007

I'm alive and (slept) well - 生きてます。。。

Weather: Cloudy/Some Showers, 63°F
Energy Level: 3 out of 10

↑ Since I'm bad at keeping a "health journal" that my doctor recommends to keep, I thought I'd keep records here.

Someone wondered if I was alive, since I hadn't posted in a while. I am alive. I had a bit of a flare-up - this week has been tough. I woke up earlier this week feeling like I got run over by a truck, and then my menace, Mr. (Ms.?) Migraine had shown up, threatening to split my skull. I did learn from the booklet they gave us at FMS Research Program that I can't take relapses/flare-ups personally as failures, so I remained hopeful.

I had recovered somewhat by Thursday afternoon, and a good night sleep last night did me a world of good. Sleep is so important although it's hard to get for us FMS sufferers.

I picked up a good tip from a friend, which I'd like to share: have your melatonin pills by your bed, and when you wake up too early in the morning, take another one.

I take these doctor-prescribed melatonin supplement pills every night, which contain Melatonin, GABA, Valerian (root) extract, Scullcap (leaf), Passion flower (aerial), Chamomile (flower), L-Theanine, and 5-HTP. I'm told to take anywhere between 2-6, but since I want to take as little as possible, I've been trying to only take 2-3 (equaling .5 mg of Melatonin). It didn't seem to matter how many I took though, because with little correlation to the dosage I kept waking up way before sunrise, after I'd go to sleep at 2 AM. Last night I took a couple more at 4:30 AM when I woke up - and I was able to go back to sleep! Yay. Thank you, Gwynn!

So instead of 1 out of 10 (not able to get up), I'm at 3 out of 10. I'll take any gain I can get.
-A

天気: 曇り/ときどき雨, 17°C
元気度: 3 (10点満点)

↑ お医者さんが健康日誌をつけると良いですよーとおっしゃっていたのですが、
日記をつけるのはなにぶん苦手なのでここに記録してみます。


最近書き込みがなかったため「おーい生きてる?」と聞かれましたが、
おかげさまで生きております。
今週はちょっとつらい週でした。
ある日トラックに轢かれたような(轢かれたことないけど)感じで
起きて、その後下り坂、しかも宿敵の偏頭痛さんが出現!
頭が割れるかと思った。

でも症状の突発を自分の不出来・失敗と思って落ち込んではいけない、と
ちけんグループの勉強会で学んだので、ポジに生きていくことにしました。

幸い木曜午後にはだんだん頭痛が薄れて来、
ゆうべやっと眠れたおかげで今日は少し元気です。
睡眠って本当に大事ですね~。
でも他のFMS患者の皆さんと同様、
一晩眠るのは難しいです。

知り合いの方からいいヒントを教えて頂いたので、
ここに書きとめておきます。
寝床のそばにメラトニンの錠剤を置いておいて、
夜や早朝起きてしまったときに駄目押しの一~二錠
飲むとまた眠れる場合が多いということ。

私の場合、お医者様にもらったメラトニンの入ったサプリ錠剤を
毎晩飲むのですが(メラトニン、GABA(ガンマアミノ酸)、
吉草根(カノコソウ)、スカルキャップ、トケイソウ、カモミール、L-テアニン、
5-HTPL-5水酸化トリプトファン)が入っています)、
2~6錠飲むようにと言われたものの、出来るだけ頼りたくないので
最近は2~3錠だけ飲むようにしていました。 
(3錠でメラトニン0.5mgになります。)
あまり服用量に関係なく、2時ごろ寝ても夜明けにどうしても
目が覚めてしまっていたからです。

そこでお友達の言った通り、明け方起きてしまったときに
数錠飲んでみたところ、本当に眠れたのです。 
やった~。 (グウェンありがとう!)

ということで、10点満点のうち1の元気度(起き上がれない~)が、
3ぐらいに上がりました。
上昇する限り、いくら少しの違いでも嬉しいです。

Friday, June 15, 2007

Becoming my own healthcare manager - 自分のケアマネージャーになる

(My hands/wrists and arms hurt too much to continue onto the Japanese part... sorry; I'll do that when I can. / 手と腕が痛くなって日本語の部分が出来ませんでした。 また少しよくなったら書き足します。 悪しからず。)

One of the first things I did when I figured out I had fibromyalgia (FMS) last year was to try to find a fibromyalgia research program nearby. Luckily, I found one at the clinic run by University of Washington, (almost) right next door from where I live!

Why? I know some people are afraid they'd be guinea pigs in a research program. It was because I was feeling so crappy after our wedding in September, I was desperate for any help (I also had a scary day that summer when I couldn't even cross one crosswalk without excruciating pain in some muscle and stopping, so that really freaked me out). And because there was so little information out there about how to feel better when you have FMS. There are standard blah blah blah's about what happens, what the symptoms are (it hurts all over your body, you're tired all the time, you become even more of a space cadet from "fibro brain fog"), but not much on what could be the cause (they don't know exactly) or what makes you feel/get better. (Except for pain meds and SSRI/SNRIs which may or may not help you suppress the pain.)

Fibromyalgia seems VERY common. By some estimates, 8 to 12 million people in the U.S. have it. That's like 1 in 22-33 people, which is about the size of a normal person's social circle. So naturally, every time I talk to someone, it seems they know someone who's had it ("oh, my mom's friend has that;" "yeah you know, so-and-so has that"). Not to make light of any cancer by any means, because cancer is devastating, but that's much more common than, say, breast cancer. About 4 to 6 times more common.

So why is there no public awareness campaign, colored ribbon, or charity walks (or whatever) for this disease, which takes away life-as-you-know-it from so many people? My theory is that no one dies from it. It's much more traumatic to see someone die; or see them go through chemo therapy, be in excruciating discomfort from treatments for a period, lose hair and/or lose a breast, than seeing someone with FMS whose symptoms are invisible and persistent. People with FMS probably stop complaining after a while about their relentless pain all over the body all day every day, afraid to alienate friends and family. All our body parts are still intact. So we don't have those friends/family advocating for their lost ones or lost body parts.

(To prove this point, when a famous Japanese former news anchor killed herself supposedly because of her agony with FMS, a flurry of attention was paid to the condition right after.)

Another thing is, very few people get completely better from it, so there are no "survivors" who are pumped up to advocate for the remaining/upcoming patients. People with FMS are always tired and in pain, and a lot of times blood flow to the brain decreases that they feel like they may not be as sharp as they used to feel (my theory is your brain is busy reacting to the "ItHurtsItHurtsItHurtsItHurtsItHurts OuchOuchOuchOuchOuch" thoughts that it has little room left). When you're tired, in pain AND feeling dumb, it's kind of hard to lead a great public awareness campaign.

Also since the condition varies so greatly from one person to the next, which means each person's etiology is very individual, there is little hope that we can create a drug or "cure" to help all FMS patients. It's a complex, often mysterious series of symptoms, which affects more than one body part. It's not like Viagra, where they could say, "Look! We made your penis stand up!" That means the big drug companies are not that motivated to put money into it or create public awareness about the condition (have you noticed that a lot of PR campaign about a condition usually comes after some drug comes out?).

All of this results in poor information distribution, and less awareness in the medical community. Although it is a distinct set of symptoms and it's known that FMS patients' central nervous system is somehow affected in a particular way to screw up our pain mechanism, a lot of doctors still call it a "waste basket diagnosis," or something that's "all in her/his head." Some say it's "difficult to diagnose," but I've learned that for a doctor who knows what she/he is doing, they can take a systematic approach and diagnose you fairly easily (it may take time and lots of tests, but it is very clear).

This is kind of understandable, considering in modern medicine, doctors are encouraged to have only one "specialty," whether that be neurology or surgery or family medicine. As any specialist's practice is focused in one area, doctors tend to dismiss what doesn't fit in the mold/thinking of their particular practice. Most of the time we see a family practice physician who is required to know a bit about hundreds of conditions if not thousands, and since most of them don't come across an FMS patient very often, it's only fair that they may not be most up-to-date about it (although some doctors are willing to learn more than others). A lot of the doctors have heard about it, read about it in some journal, which may or may not be up-to-date. So rather than "I've seen a lot of this, I know what to do," it's more like, "I've heard that this may or may not work for some FMS patients."

While I really liked my naturopath, I realized, and he realized, that his expertise may be limited in order to stabilize my urgent symptoms and possible underlying infections. He was diligent enough to test me for - and find out - my vitamin D deficiency and Epstein-Barr virus (EBV) infection, but wasn't really comfortable to interpret the EBV data as he hadn't seen enough of it.

So I figured, I need to get myself close to the source of FMS information - the people who are actively trying to find out what works. (This was before I found my doctor at Fibromyalgia and Fatigue Center, who is working to stabilize my immune deficiency.) I wasn't the type to sit back and wait to see if someone would deliver some latest drug to me via an ad in REDBOOK magazine. I'd have to become an expert myself, so I can manage my care and symptoms, choose what treatments I want - I need to become my own health care manager, not a passive patient!

The big drug companies may not be interested, but NIH is concerned enough to make a grant for fibromyalgia research, and there are people at Univ. of Washington (UW) Fibromyalgia Research Program who cared enough to apply for that grant. And their research program doesn't involve drugs; it's more about effects of self-management of pain through progressive stretching/strengthening exercises and proven pain management techniques, so the pain doesn't get worse and hopefully get better. The program also teaches us to kind of trick our brain, so it would be distracted from pain, so to speak. They also taught us: Endorphins we can make our body produce is more powerful than any opiates, even morphine; so if we can trick our body to produce it, their theory is that it must help our pain with no side effects. Sounds good to me. (It also helps that it's not one of those double-blind studies, so everyone who participates get the most effective program.)

I Google'd them, contacted them and signed up a long time ago (like 6 months ago), but because I was recovering from an acute Epstein-Barr virus infection (a.k.a. mono), they had to have me wait for more than the normal 8-week waiting period (they were afraid my body was too weak to start the exercises). So I just started a couple of weeks ago. We meet with a health psychologist and physical therapist every week for 8 weeks, to learn better pain management skills (tricks of the trade).

One of the problems with FMS patients is that since it hurts everywhere all the time, it becomes hard to get up and move about (sometimes it feels like someone's inserting needles into my feet/legs/hands/arms/back/neck - other times they're sore - other times it feels like some broken glass particles are going through my veins every time the blood pumps). Just like when you wear a cast on a broken leg or arm, not moving around weakens/shortens your muscles, bones and other soft tissues. Then moving becomes even harder, and soreness worse when you do move (since the pain is kind of amplified in an FMS patient's brain). This vicious cycle continues, and for some, becomes a road to disability.

So one of the study's premises is to keep your flexibility and mobility through exercise - every day, no matter how much it hurts. So I end up stretching/strengthening my various body parts for about 30 minutes every day, going through breathing exercises to relax all my muscles, and doing an aerobics exercise for 20-30 minutes every day (started from 6 minutes/day), hopefully to increase over time. Theoretically, certain exercises help us produce more endorphins, so we may hurt less in the future. It doesn't sound like much, but when your body feels like you've just ran a marathon on all fours while having a bad flu, it becomes an epic journey.

I guess sometimes the best thing you can do is to put one foot in front of the other, and hope that leads to a better place. :-)

P.S. A bonus: I must become really, really healthy at the end of this, even if it hurts! Yay!

P.P.S. (Post June 21) Now that Lyrica (see my post on June 25) from Pfizer has been approved by FDA for fibromyalgia treatment, I bet we'll see ads popping up, asking us: "Can you have fibromyalgia?"