Over the last two years (since my fibromyalgia has been worst), I have somehow felt that I have been getting stupid. I can't seem to think as clearly as I did before, and I certainly don't seem to be as clever. Now I know why.

In the first episode of the Fibromyalgia Weekly podcast, I heard Betsy Singh-Anand mention a link between chronic pain and the loss of IQ points due to brain shrinkage. I asked her for more information, and oh my gosh! What scary stuff for the chronic pain sufferer!

According to a study at the Northwestern University Institute of Neuroscience, by Professor A. Vania Apkarian, chronic pain causes cognitive losses due to shrinkage of the prefrontal cortex and other areas. Previous research found that ongoing back pain (at least 6 months) causes abnormal brain chemistry in areas important in emotional assessments, decision-making and control of social behaviour.

So, if I've gone postal at you, my friends, at any time in the last few years (a specific MTG tournament organising thing comes to mind), well, I'm sorry, its obviously that my brain has gone loopy.

Further research using MRI, published in the Journal of Neuroscience, showed that people who lived in chronic pain had brain shrinkage per year equivalent to 10-20 years of normal aging! (Shaky voice: You know, when I was young...). Although this shrinkage is indicated in the gray matter (i.e., the thinking part of the brain), the study did not link this loss to brain function, so it could be non-critical areas that are becoming atrophied. And, they're not sure whether this brain damage is irreversible. Suck to be me right now!

Another study has linked an overweight or obese BMI to brain shrinkage.

Double whammy for me! Another reason to lose weight post haste!

Other studies by Catherine Bushnell, a researcher at McGill University's Center for Research on Pain in Montreal, have shown that it helps to be distracted from your pain, so tell your family to stop asking you how you feel and listen to more music or something.

http://www.futurepundit.com/archives/002482.html
http://abcnews.go.com/Health/PainManagement/story?id=531217&page=1
http://www.livescience.com/041122_brain_pain.html
http://www.webmd.com/content/article/97/104181
http://www.worldhealth.net/p/237,1863.html

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Filed as: Fibromyalgia »
 

26 Comments:

• At Thu Jan 26, 02:22:00 pm GMT+2,  Anonymous said…

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• At Fri May 18, 01:35:00 pm GMT+2,  Anonymous said…

  I must certainly can relate to what you're feeling (ie, those days when you feel the need to keep running tabs on your current levels of functioning brain cells), as I have FMS and several other chronic (exhausting) conditions as well. On days when the "fibro fog" parts it sometimes seems like our minds return to (nearly) their former (aka, pre-fibro) days, but still I've really turned to things like lists and alarms to help me keep my sanity and whits about me (and not forget to pay the rent half a month late again, as I did about a year and a half ago during a really rough month).
  
  On a side note, this is my first time posting on your blog, and I think it's terrific. Keep up the wonderful (FMS themed or otherwise) writing.
  
  Healing wishes to you ~ Jessica
  

   

• At Fri May 18, 01:37:00 pm GMT+2,  Anonymous said…

  Opps, let us not forget the infamous fibro typos (seriously, it's like sometimes FMS puts blinders on you while you're writing...so very frustrating). I meant to say "I most certainly can relate". Sorry to post a second time, my dear.
  
  
  Tender fibro hugs ~ Jessica
  

   

• At Sat Jun 30, 02:45:00 pm GMT+2,  Anonymous said…

  Hi, have you ever considered doing any emotional/spiritual cleansing or healing? I had a horrendous candida problem, and I couldnt' really shift it properly until I started looking at the mind and heart issues. A friend of mine who suffers from fibro has had amazing results from doing Kundalini Yoga practice, and she's a total skeptic.
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  Love, Kaetie
  

   

• At Fri Oct 12, 07:00:00 am GMT+2,  Anonymous said…

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• At Sat Nov 24, 09:05:00 am GMT+2,  Anonymous said…

  Oh boy, some comment moderating needed!
  
  I just foudn this blog via technorati and wanted to post that despite the loss of brain matter, the loss of IQ from fibro is, in my exeperience, still largely down to cognitive fog brought on by lack of dopamine in the brain. I though I'd lost it, but since getting the fms treated, my marbles have come back!
  

   

• At Mon Apr 28, 04:04:00 pm GMT+2,  Anonymous said…

  Fibromyalgia is real and serious but, like most diseases it leaves you with one choice, fight it or sign your life over to it. Fighting it is not just taking a couple pills to feel better, it is about lifestyle change.
  We need to nurse our bodies to health with good food, exercise and less stress. Managing those changes will take a lot of energy and support. Here is a great link to the DISB, great info there.
  

   

• At Sun Jun 08, 10:28:00 am GMT+2,  Anonymous said…

  Hi Nice blog.
  My wife has suffered from fybro for the last 3 years but we have worked very hard together to try to make things better, from massages to regular medication. She recently under went some acupuncture treatment which has helped her allot, I was very skeptical at first but after a few days she said that she actually felt much better, to my surprise. I suppose you don't know until you try. Still just thought i would say hi, my wife does not like me talking about it to others much she is a very quite person, so don't tell her i am here ;)
  After working on this together to help her get better we have now created our own ebook called Fibromyalgia symptoms and treatments
  which many people have bought and have left some really nice comments, we have also added some of their info to the book now as well. The great thing about the ebook is that it has all the facts and tips i could find over three years stuffed into one place, and we are always adding new things to it when we get new information. Still hope you are feeling well soon. Take care and God bless
  

   

• At Mon Jun 16, 12:25:00 am GMT+2,  Anonymous said…

  daniel has a good point. it's hard to find empathy. fibro sufferers want to be "normal" especially when they look fine on the outside and others don't "see" their difficulties.
  
  More Fibro News
  

   

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• At Fri Nov 28, 11:42:00 pm GMT+2,  Anonymous said…

  Interesting that you say you are losing your mind. There is current research that indicates that fibromyalgia is related to blood flow issues in the areas of the brain responsible for pain measurement and emotional response to pain. You can read more at Fibromyialgia May Be In Your Head
  

   

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• At Fri Sept 04, 01:49:00 am GMT+2,  Vicodin U:S Doctor said…

  There are different views on fibromyalgia although all are based on the constant pain that produces the disease and although not yet really know the accurate cure for it, I have my father suffering from this disease and I am interested in the topic to be able to help their pain to dissipate in any way and have read many books on fibromyalgia and chronic pain and to find findrxonline indicate that opioid narcotics for pain control are excerpts from the opium and are very effective and are commonly used to control and remove moderate to severe pain, these drugs are controlled NARCOTICS opioids which required a medical prescription.
  

   

• At Fri Dec 04, 07:38:00 pm GMT+2,  Federer said…

  The doctor gave me lortab long time after suffering from back pain, I did not take importance to this icon in order to feel pain, until no stamina, after many doctor visits and many tests I found chronic fibromyalgia, and after evaluating and conduct a comprehensive review told me that the most appropriate to ease the pain were lortab, vicodin or oxycodone, but I asked my doctor to prescribe me the most effective and less addictive and prescribed Lortab, have already taken this medication 2 years and though it causes some kind of anxiety I control myself properly, I have no problems so addictive, I think if they know their anxiety is effective restraint, this is good because these narcotics findrxonline indicate that opioids can be very dangerous.
  

   

• At Tue Dec 15, 07:39:00 pm GMT+2,  Joe Purdue said…

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• At Thu Jan 28, 04:35:00 pm GMT+2,  buy propecia said…

  very interesting post about Fibromyalgia: I'm losing my mind! Literally, I want to add this information Fibromyalgia is characterized by chronic widespread pain and allodynia, a heightened and painful response to pressure. Fibromyalgia symptoms are not restricted to pain, leading to the use of the alternative term fibromyalgia syndrome for the condition. Other core symptoms include debilitating fatigue, sleep disturbance, and joint stiffness. Some patients may also report difficulty with swallowing, bowel and bladder abnormalities, numbness and tingling, and cognitive dysfunction. Fibromyalgia is frequently comorbid with psychiatric conditions such as depression and anxiety and stress-related disorders such as posttraumatic stress disorder. Not all people with fibromyalgia experience all associated symptoms. Fibromyalgia is estimated to affect 2-4% of the population.
  

   

• At Tue Feb 02, 09:33:00 pm GMT+2,  Colleen said…

  That was a very interesting about how pain affects the mind...thanks for sharing that. I can't pass by without sharing that fibromyalgia is reversible. I work for a small little wellness center that uses lifestyle methods to help people regain their life. Even if you never come you might be interested in visiting www.newstart.com
  

   

• At Thu Feb 11, 08:55:00 pm GMT+2,  watson said…

  Fibromyalgia is a disease that causes severe pain and affects quality of life of people. Many of these people are immersed in a profound tension and stress that even your doctor should prescribe anti anxiety drugs like Xanax or Valium to calm them. Many of these anxiety medications are controlled and must be prescribed by a doctor.
  

   

Post a Comment

I am psychologically invested in the TLC program I wrote about earlier.

[+/-] WARNING: technical stuff follows - and it's a bit of a whopper of a post [+/-]

The theory of cognitive dissonance (in a nut shell), links thoughts with attitudes, focussing on attitude change. Basically, the brain can't hold two opposing thoughts for a prolonged period of time without rationalising it in some way:

Two cognitions (thoughts) are consonant if one follows from the other, e.g. "smoking causes illness" and "one shouldn't smoke." Two cognitions may be said to be dissonant when the obverse (or opposite) of a cognition follows from the other, e.g. the smoker who knows smoking causes illness, and yet continues to smoke. Cognitive dissonance, then, is the state of tension or discomfort that occurs when a person simultaneously hold two cognitions that are psychologically inconsistent, or holds a belief that is incongruent with the person's behaviour.

This state is psychologically uncomfortable, and the person is motivated to reduce this discomfort. The intensity of dissonance is influenced by the degree of discrepancy between cognitions, the number of dissonant beliefs and the importance the person has attached to those beliefs. Additionally, the intensity of dissonance decreases with an increasing number of consonant beliefs which support an otherwise incongruent behaviour.

Dissonance can be reduced or eliminated by changing cognitions (i.e. adding new consonant cognitions or removing dissonant cognitions) or by changing the importance of cognitions (i.e. increasing the importance of consonant cognitions and/or reducing the importance of dissonant cognitions). A classic example is the behaviour of smokers. Cigarette smoking is dissonant with the awareness that smoking causes illness. The smoker could reduce dissonance by changing his/her behaviour and quit smoking. Alternatively, the smoker could add consonant cognitions by emphasising the benefits of smoking ("Smoking helps me relax"), or could reject the dissonant cognition ("Smoking isn't really bad for you"). The smoker might also reduce the importance of the dissonant idea ("I'm more likely to die in a car crash") or increase the importance of a consonant cognition, such as the enjoyment the smoker gets out of smoking.

There are specific paradigms of dissonance theory, including:

Induced compliance:
Individuals are persuaded to behave in ways which are at odds with their beliefs, or private attitudes, creating cognitive dissonance. Individuals can be induced to engage in this behaviour by promises of rewards, or threats of punishment – in other words, providing consonant cognitions that support or justify the behaviour. Dissonance can be reduced by a change in attitude or belief towards the behaviour (which is generally easier than changing the behaviour itself). For example, students were induced to write essays which strongly contradicted their personal beliefs and were offered a variety of incentives, ranging from $0.50 to $10 (a reasonably large sum of money at the time of the experiment). It was found that students offered a large sum of money had little or no attitude change – the money was enough to justify writing the essay, and thus little dissonance occurred. On the other hand, students who were offered a small sum had a greater shift in attitude towards the beliefs they wrote about in the essay – dissonance between their original beliefs and their behaviour was high, while the sum of money offered was not enough to justify this behaviour; therefore, an attitude change towards the beliefs in the essay was required to reduced dissonance, and hence their discomfort. The main points gathered from these experiments are that (1) behaviour that is inconsistent with one's attitudes can produce a change in those attitudes, and (2) the degree of attitude change increases as the justification for performing the behaviour decreases. So if one wants to obtain private attitude change rather than public compliance, the rewards should be just enough to induce compliance, and not so much that the reward itself becomes the justification for compliance. This is contrary to conventional wisdom, or common sense. However, the issue isn't logical inconsistency, but psychological inconsistency.

So, for me, my induced compliance is this: I have just spent R1100 and had a needle stuck in my arm. This is going to have to be justified by forcing this program to work for me - I didn't go through the needle thing for nothing. (I am completely terrified of needles). Clearly, I must really want this healthier lifestyle... right?

A number of factors critical to this theory include:

1. Freedom of choice – if the participant feels forced to engage in behaviour that is at odds with his/her beliefs, dissonance is reduced because, ultimately, the coercion is the justification for the behaviour, and so no attitudinal shift is required. If, however, the choice has been made freely, a change in attitude is likely to occur in order to reduce the tension felt by the dissonant cognitions. For example, compulsory military training would produce little dissonance with the fact that basic training is difficult and unpleasant, while a voluntary recruit might try to convince himself that the training isn't all that bad. Similarly, I've volunteered for this, and its already working for me - this is the first time in more than ten years that I had a needle in my arm and I didn't cry!

2. Commitment – the degree of commitment to the disliked position influences the degree of dissonance felt by the participant, and hence the likeliness of a change in attitude. If such behaviour is performed publicly, or if the behaviour is seen as important or irrevocable, dissonance is greater, and hence an attitudinal shift is required to ease psychological tension. For example, there is no dissonance between "I spent a great deal of money for this camera equipment" and "I'm not fond of photography" if one knows one can return the equipment or re-sell it and recuperate the money. In these instances, one is sometimes motivated to reduce dissonance by seeking social support and reassuring information. This is often seen after purchasing a new car – the decision is hard, with many models to choose from, it's expensive, and one usually cannot change one's mind. People in this situation often exaggerate some positive quality of their car, criticize the qualities of other cars and/or seek reassuring information about their car in consumer reports. In my situation, I am making my efforts public (and I would appreciate it a lot if my friends could hum and hah and threaten me with I-told-you-soes if it is not working for me). While they do offer a money back guarantee, it includes a minimum guarantee of 1 kg a week, or 4 kg per month. Of course I am going to lose at least this amount. So there is no way I am going to get any of my money back from this... More dissonance.

3. Personal responsibility for aversive consequences – if the induced behaviour leads to an unwanted event, especially consequences which could have been foreseen, the dissonance is greater. For example, if one runs over a dog, less dissonance is experienced if one never saw the dog coming than if one saw the dog at the side of the road and didn't slow down. I don't know how much of this applies in this situation, except that maybe my muscle pain is exacerbated by the overweightness, so its all my fault...

A second paradigm of dissonance is:

Justification of effort
This is closely linked to induced compliance. Dissonance occurs whenever a person chooses to "suffer" for something they really want – if an unpleasant activity is required to obtain something desirable, dissonance can be reduced by "exaggerating" the desirability of the outcome. Nuff said about that one...

There are some others, but basically, I'm tired of typing now... anyway, its all summed up very nicely in this Dilbert cartoon, as well as this Dilbert cartoon.

Additionally, this program alleges to improve serotonin levels, and they say (I'm a little sceptical of this one) that I will probably be able to come off my anti-depressants within three weeks. Hell, if it works, great - I was considering asking my doc for an increased dosage, but I will try this first.

Also, I'm hoping that there will be less strain on my muscles if I weigh less, and I need to do that quickly - this taking of morphine pain killers thing is a pain in the ass...

---

Filed as: My Diet »
 

0 Comments:

Post a Comment

After promising for ages to post about my diet program, here it is (no, don't have a hernia - I typed this post out ages ago, well before I decided on my Hiatus, and I just needed to email it in, so there):

The TLC (Therapeutic Lifestyle Changes?) diet program is, I think (in a nutshell), Atkins (low carb) cross weight watchers (weekly weigh ins).

[+/-] This is quite a long post. Click here to expand the rest of the post [+/-]

It involves a batch of blood tests (mostly for blood glucose, thyroid function, liver enzymes, stuff like that) and a supposedly tailored diet plan for your specific blood profile, by a "panel of doctors". Most likely, the "panel of doctors" is a computer program, but frankly my dear, I don't give a damn, if it works. Having blood tests done eliminates the Get-Out-Of-Diet free card of "Oh, I'm sure I have a thyroid problem").

It's mostly a low carbohydrate plan (in fact, almost no carbohydrate - some low GI carbs are allowed... this is to rid you of carbohydrate addiction, which I'm sure most people have), with a list of "allowed foods" - if the food is not on the list, you can't have it. I know Psychomuffin doesn't like this idea (she likes practising making the choice), but it makes things very easy for me. Plus, I have authority issues - no, the other kind of authority issue - I like being told what to do. I'm a bit of a sheep that way (funny that - seems that little animal quiz was accurate). I like someone in authority saying "You may not eat bread". "Well ok then, I may not eat bread. Done."

Admittedly though, the allowed foods list is dismally small... It's almost like a food tolerance diet - cut back on everything, then slowly reintroduce foods back into your system and see what disagrees with you (I have a sneaking suspicion that I am intolerant to bread. White bread seems to exacerbate my depression).

I don't believe its an unhealthy diet - lean meat and vegetables, fruit, yoghurt, 3 liters of water a day (min), multivitamins, cutting out/back on the milk, alcohol and refined carbohydrates. It's just in small quantities until the weight loss is achieved, and then in less moderation as a lifestyle change. I think that's a reasonable way to go towards building a lifestyle change - we all know we are supposed to have wholewheat instead of brown instead of white bread. We all know chicken skin is bad for you. We all know too much sugar is not good either, etc etc.

I feel a need to defend the low-carb way as much as Psychomuffin feels a need to defend the low-fat way.

As a biochemist, the low-carb way makes the most sense to me. The basic principle is this:
Your body has two principle metabolic pathways - (1) carbohydrate and (2) fats & proteins. In order to burn fat, you need to promote pathway number (2). To do this, you need to inhibit pathway (1), since this is the "path of least resistance" for your body - given a choice of (1) or (2), your body will go for (1), since it takes less effort on the part of your body.

So, how to inhibit (1) and increase (2):

• lower your insulin levels, since this hormone inhibits fat metabolism (pathway 2) and stimulates pathway (1)
• increase your protein intake - more protein means pathway (2) is switched on to break down those proteins, and hey, whaddya know, fat burning happens as a bonus...
• rid your body of glycogen stores. In plants, carbs are stored as "starch". In animals, carbs are stored as "glycogen". When you don't eat carbs, your body will first try to use its glycogen stores (easiest energy source, as explained above). Once those are depleted, it will grudgingly go to its fat stores.
So there you have it. It's not easy, I'll tell you that much. But it's working for me, and I must say, I feel a lot healthier in general having given up sugar, milk and bread.

Anyway, I kind of see this as training for a lifestyle change - its all normal foods - essentially what I know I should be eating for a healthy lifestyle anyway (cutting back on fats and oils, cutting out the chips, chocolates, sugars, cokes, etc), just eaten in a very strict combination designed for me. If I can get into the habit of eating these low GI foods, lean meats, cure my coke addiction, my chip addiction, etc... that's a great start to a lifestyle change, in my opinion.

I remember when I first became thin in high school when I started Figure Skating - I lost my taste for fizzy drinks and junk food relatively quickly, and then actually eating those things made me physically ill. If I ate a packet of chips, I could almost feel the oil swimming around in my blood stream , depositing itself on my skin, hips, stomach. That is what I am aiming for again... to get to a stage where my body's reaction to "bad food" is heard, and not drowned out by carbohydrate craving saying "gimme gimme gimme".


Psychomuffin asked me " Why do you want to change? (A) Because you hate being fat, or (B) because you'd love to be thin?"

Its both really - I can't separate the two. I hate looking in the direction of the mirror in case I catch a glimpse of myself in it. And, I fantasise about what it will be like to be thin again. And healthy (let's not forget healthy, because of course, wanting to be thin for the sake of being thin is Wrong and Succumbing to The Media).

The psychological investment I have made in this program follows in a later post.

---

Filed as: My Diet »
 

2 Comments:

• At Fri Jan 20, 01:19:00 pm GMT+2,  thinblueline said…

  Hmm,
  Rather than change what you eat you shuold really be chaning your attitute to the foods themselfs
  
  Why do you eat what you eat is more important that simply what you eat!
  
  Once you understand why you eat certian foods and change that realtionship then it is far easer., and a lot more long term.
  
  Treat the underlying issues not the responce.
  

   

• At Sun Jan 22, 07:34:00 pm GMT+2,  Amanda said…

  did I not spend a whole post talking about lifestyle changes?
  

   

Post a Comment

I have found a fabulous weekly podcast on fibromyalgia and fibromyalgia syndrome (FMS) http://www.fibromyalgiaweekly.com. It's hosted by Betsy Singh-Anand, who is a registered nurse and licensed massage therapist, and who also has FMS. Her podcasts, which are published every Monday, are wonderfully informative, and the Yahoo Group she has set up as a companion group is also really great to be subscribed to - its newish, meaning that there are not yet that many people on it, and its not just a support group, its an information group as well. So many of the other FMS Yahoo groups are really big and have degenerated into whining sessions.

Now, I love whining as much as the next person, but I do enough of my own whining, and I don't need to be subjected to more of the same. Now, before you start thinking I'm cold-hearted and callous, I know how it is to need to just speak out and be heard, especially with something like FMS, because so many people don't believe, or just don't understand how you can be in pain when there's nothing visibly wrong with you. That is the whole reason I started blogging in the first place. However, I believe that just complaining isn't very helpful - there needs to be a flow of information for me in order for the group to have value for me.

Fortunately, this group does that.

---

Filed as: Fibromyalgia »
 

1 Comments:

• At Wed Apr 12, 08:34:00 pm GMT+2,  Margaret said…

  I just found this site and will be a regular listener.Thanks for sharing your knowledge.
  

   

Post a Comment

I really over-did it yesterday. I pushed myself so hard that I was forced to take a pain killer by the afternoon, which ultimately means that the rest of my week is poked. It takes me about a week to recover from one or two (or three at most) hard days in a row, in the lab. How am I ever going to keep on track this way?

And no, I can't do something non-physical, like write, on "recovery days", because my brain gets poked too. The only thing I am capable of doing is arbitrary anal retentive stuff, like tidying and organising, or ideally some kind of repetetive task (I find the repetetiveness soothing) or stuff that doesn't require any thinking on my part. Like reading fiction, or watching TV, or whining for a back rub. Or sleeping.

---

Filed as: Fibromyalgia »
 

1 Comments:

• At Tue Mar 30, 04:59:00 am GMT+2,  Fibro Chick said…

  Wow, amazing to read someone else having the same problems, I can totally relate. If I do something on Friday my entire weekend is spent recovering and trying to build up more energy to get back to performing the basics in life - making meals, laundry etc.
  

   

Post a Comment