The idea of Awareness Day began in 1992. The date of May 12th date was chosen to honor the birthday of Florence Nightingale, the English army nurse who was a pioneer of the Red Cross Movement. Nightingale was virtually bedridden with a painful and fatiguing illness resembling FM/CFS/ME, yet went on to inspiring accomplishments, including the founding of the first School of Nursing.

We are launching our FM and CFS/ME Awareness Campaign in an effort to increase public awareness about these disabling medical conditions. One of the most difficult aspects of having FM and/or CFS/ME is that most of the symptoms are invisible to others, making it hard for people to understand what living with FM and/or CFS/ME is really like. That's one of the reasons why Awareness Day is so important. We hope you'll join us by making your community more aware of these illnesses. Click on a link below for ideas.

• How To Raise Awareness
• Inform The General Public
• Alert The Media

• Writing Advocacy Letters
• FM/CFS/ME Fact Sheet
• Advocacy Links

• Write, call or visit your Congressional representatives. If you don't know who they are or how to contact them, visit our Advocacy Links section.


• Organize a project for your support group members.


• White an advocacy letter and take copies of your letter to your support group meeting. Other group members can either copy the letter by hand or use a photocopy of your letter.


• Make and bring copies of the enclosed FM/CFS/ME Fact Sheet, which explains what FM/CFS/ME is, who gets it and how it's treated.


• Ask each group member to bring at least one envelope and one first-class stamp to the meeting.


• Have each person place their letter and the FM/CFS/ME Fact Sheet in an addressed envelope, seal it, stamp it and then mail all the letters at once.


• Start this process early! You want to have lots of time for your elected officials to receive your letters.

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• Set up a display in your local library for the week of May 12th or the month of May. This can be done by the librarian with your suggestions on what information should be included in the display.


• If members of your support group can manage some time at the mall, you may wish to set up a display there.


• Consider asking your place of worship to include a notice about the significance of May 12th in its worship material.


• Place a classified ad in your local newspaper.


• Place an awareness poster in your local grocery store window.

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• Contact the health reporters at your local TV and radio stations, newspapers and magazines regarding FM/CFS/ME and Awareness Day 2008.


• Mail your letters or call the reporters early. Program directors often plan ahead and since May is a TV and radio ratings month, they are busy preparing feature stories now for broadcast in May.


• Designate someone as your group's spokesperson, so the media has a contact for stories.

Did you ever wonder how the pill you take for a headache, "knows" how to relieve the pain in your head and not somewhere else?

A lot happens in your body after you take a pill. Drugs that enter the body are transformed by many biochemical reactions that either break down the drugs into simpler substances or combine them (or parts of them) with natural body substances.

This is the process of drug metabolism. Drug developers are attentive to the complexities of drug metabolism, because the way medications are processed in the body can make the difference between a drug that is safe and one that is ineffective or even harmful. Here's how it works.

Some portion of a drug may be lost as it passes through the gastrointestinal tract. Digestive enzymes in the stomach and the intestines can break down drugs, as can the actions of bacteria that normally live in the gut. Drugs can also interact with foods and beverages in the gastrointestinal tract, in some cases reducing, but in other cases increasing, the amount that gets absorbed.

After being absorbed through the gut, drug molecules travel via the portal vein to the liver. The liver is where most of the work of drug metabolism takes place. As the liver metabolizes drugs, it may produce chemical byproducts that are toxic to the liver itself. This is why taking too much of certain medications or taking them too often can harm the liver. The most common example of such a drug is acetaminophen (Tylenol®).

In the liver, the work of drug metabolism is performed by enzymes (proteins that facilitate biochemical reactions). The liver's cytochrome P-450 system comprises more than two dozen chemically related enzymes that metabolize drugs.

Whatever remains of a medication after metabolism in the liver enters the hepatic vein, which carries blood from the liver to the heart. The heart then pumps the drug molecules out into the general circulation, which carries the drug throughout the body to its eventual target organ (and many other locations as well). Any molecules of the medicine that remain after traveling through the circulatory system eventually re-enter the liver via the hepatic artery, where the metabolic system can process them further.

The body eliminates water-soluble medications and their breakdown products (also known as metabolites) primarily in the kidneys, and the metabolites then pass out of the body through urination. Some medications or byproducts of drug metabolism that were handled by the liver pass back into the digestive tract through bile and later exit the body in the feces. Medications may also leave the body in saliva, sweat, exhaled air, and even in a mother's breast milk.

Serotonin is a neurotransmitter, a type of chemical that helps relay signals from one area of the brain to another. Although serotonin is manufactured in the brain, where it performs its primary functions, some 90% of our serotonin supply is found in the digestive tract and in blood platelets. The average adult has between five and 10 milligrams of serotonin in the body.

How Serotonin Is Made

Serotonin is made via a unique biochemical conversion process. It begins with tryptophan, a building block to proteins. Cells that make serotonin use tryptophan hydroxylase, a chemical reactor which, when combined with tryptophan, forms 5-hydoxytryptamine, otherwise known as serotonin.

The Role Serotonin Plays In Our Health

As a neurotransmitter, serotonin helps to relay messages from one area of the brain to another. Because of the widespread distribution of its cells, it is believed to influence a variety of psychological and other body functions. Of the approximately 40 million brain cells, most are influenced either directly or indirectly by serotonin. This includes brain cells related to mood, sexual desire and function, appetite, sleep, memory and learning, temperature regulation, and some social behavior.

In terms of our body function, serotonin can also affect the functioning of our heart, muscles, and various elements in the endocrine system. Researchers have also found evidence that serotonin may play a role in regulating milk production in the breast, and that a defect within the serotonin network may be one underlying cause of SIDS (sudden infant death syndrome).

Serotonin And Fibromyalgia (FM)

In 1989, I. J. Russell found low serum levels of serotonin in a group of FM patients. A subsequent study by Russell found lower levels of serotonin breakdown metabolites in the cerebrospinal fluid of a group of FM patients, as well as a group of patients with rheumatoid arthritis. In an extensive review of the neurochemical pathogenesis of FM and in other studies, both low levels of tryptophan and serotonin in the serum, and low levels of tryptophan and 5-HTP in the cerebrospinal fluid were found in FM patients.

Low serum serotonin levels have been found to have an inverse correlation with clinical measures of perceived pain. Studies showing higher levels of metabolites in the kynurenine pathway, which diverts tryptophan away from serotonin production, were found in the cerebrospinal fluid of FM patients. In animal studies serotonin has been shown to down regulate the nociceptive process in the spinal cord.

High levels of serotonin and its metabolites were found in the hippocampus area of the brain during stage IV sleep in a study of cats by Wilke suggesting increased synthesis in mammals in the central nervous system during deep sleep. Moldofsky, in one of the early seminal studies of FM, found a correlation between the nonrestorative sleep reported by most FM patients and a characteristic alpha-wave intrusion into stages III and IV of deep sleep. Whether this disturbance of sleep architecture is the cause, an effect, or an epiphenomenon of disrupted serotonin metabolism, disturbances in the serotonin pathway seem to be an intrinsic characteristic of fibromyalgia. These studies support the concept of a decreased flux through the serotonin pathway in FM patients.

Diet And Serotonin

Unlike calcium-rich foods, which can directly increase your blood levels of this mineral, there are no foods that can directly increase your body's supply of serotonin. That said, there are foods and some nutrients that can increase levels of tryptophan, the amino acid from which serotonin is made.

Protein-rich foods, such as meat or chicken, contain high levels of tryptophans. Tryptophan appears in diary foods, nuts, and fowl. Ironically, however, levels of both tryptophan and serotonin drop after eating a meal packed with protein. Why? According to nutritionist Elizabeth Somer, when you eat a high-protein meal, you "flood the blood with both tryptophan and its competing amino acids," all fighting for entry into the brain. That means only a small amount of tryptophan gets through - and serotonin levels don't rise.

But eat a carbohydrate-rich meal, and your body triggers a release of insulin. This, Somer says, causes any amino acids in the blood to be absorbed into the body - but not the brain. Except for, you guessed it - tryptophan! It remains in the bloodstream at high levels following a carbohydrate meal, which means it can freely enter the brain and cause serotonin levels to rise, she says.

What can also help: Getting an adequate supply of vitamin B-6, which can influence the rate at which tryptophan is converted to serotonin.

Exercise And Serotonin Levels

Exercise can do a lot to improve your mood - and across the board, studies have shown that regular exercise can be as effective a treatment for depression as antidepressant medication or psychotherapy. In the past, it was believed that several weeks of working out was necessary to see the effects on depression, but new research conducted at the University of Texas at Austin found that just 40 minutes of regular exercise can have an immediate effect on mood.

That said, it remains unclear of the exact mechanism by which exercise accomplishes this. While some believe it affects serotonin levels, to date there are no definitive studies showing that this is the case.

Men, Women And Serotonin

Studies show that men have slightly more serotonin than women, but the difference is thought to be negligible. Interestingly, however, a study published in September 2007 in the journal Biological Psychiatry showed there might be a huge difference in how men and women react to a reduction in serotonin - and that may be one reason why women suffer from depression far more than men.

Using a technique called "tryptophan depletion," which reduces serotonin levels in the brain, researchers found that men became impulsive but not necessarily depressed. Women, on the other hand, experienced a marked drop in mood and became more cautious, an emotional response commonly associated with depression. While the serotonin processing system seems the same in both sexes, researchers now believe men and women may use serotonin differently.

Although studies are still in their infancy, researchers say defining these differences may be the beginning of learning why more women than men experience anxiety and mood disorders, while more men experience alcoholism, ADHD, and impulse control disorders.

There is also some evidence that female hormones may also interact with serotonin to cause some symptoms to occur or worsen during the premenstrual time, during the postpartum period, or around the time of menopause. Not coincidentally, these are all periods when sex hormones are in flux. Men, on the other hand, generally experience a steady level of sex hormones until middle age, when the decline is gradual.

On the heels of the recent news that anti-depressants are beneficial to fibromyalgia (FM) patients, the FDA has approved a new medication specifically for the treatment of this "invisible syndrome." Savella is a product of Forest Laboratories, Inc. and Cypress Bioscience, Inc. and the companies report that the FDA approved the drug based on two clinical trials. The trials consisted of 2,084 FM patients, who took either Savella or a placebo for a period of three months or six months.

Savella is expected to be available by prescription in mid-March 2009. The introduction of Savella is important because it is the first drug approved to treat the symptoms of FM using a composite responder analysis. Savella is in a class of drugs which are called serotonin or norepinephrine reuptake inhibitors (SNRIs). This group of drugs includes some antidepressants. Although the exact way the drug works is not known, it is believed that it may affect abnormalities in certain brain neurotransmitters. The manufacturers believe that their product is superior to other drugs used to treat FM because it is the only medication approved to treat pain, function, and overall well-being.

The patients who took Savella reported at least a 30 percent reduction in pain and by their own ratings were "very much improved" or "much improved" in relation to their FM. According to information furnished by the companies, the drug was safe and generally well tolerated. Nausea was the most common side effect in the clinical trials. Other adverse reactions were constipation, hot flush, sweating, vomiting, palpitations, increased heart rate, dry mouth, and high blood pressure.

Savella is only approved for adults. When available for prescribing, expected in March, it will have the same "black box" warning as antidepressants about the increased risk of suicidal thinking and behavior in children, adolescents, and young adults. As with all medications Savella will have a guide outlining its risks. The FDA is also requiring studies regarding pregnancy and fetal outcomes in women who take Savella while pregnant. There will be a clinical trial of the drugs effects on babies exposed through breastfeeding.

If Savella can bring relief to at least some of the 6 million in the United States who suffer from FM it would be a welcome addition to treatment. During the tests some participants withdrew because of the side effects, but with continued work and research science may yet find relief for this mysterious disease.

Other Information For Savella

• Drug Information For Savella
• FDA Defers Final Action on Milnacipran NDA - October 24, 2008
• Pain Management in Fibromyalgia

We all know that one of the sypmtoms of FM and CFS/ME is "brain fog", but can what we eat and drink really increase our focus and concentration? Listen to the buzz about foods and dietary supplements and you'll believe they can do everything from sharpen focus and concentration, to enhance memory, attention span, and brain function. But do they really work?

There's no denying that as we age chronologically, our body ages right along with us. The good news? You can increase your chances of maintaining a healthy brain - if you add "smart" foods and beverages to your diet.

Caffeine Can Make You More Alert

There's no magic bullet to boost IQ or make you smarter, but certain substances, like caffeine, can energize and help you focus and concentrate. Found in coffee, chocolate, energy drinks, and some medications, caffeine gives you that unmistakable wake-up buzz, though the effects are short term. Just remember that if you overdo it on caffeine it can make you jittery and uncomfortable.

Sugar Can Enhance Alertness

Sugar is your brain's preferred fuel source, not table sugar, but glucose, which your body metabolizes from the sugars and carbohydrates you eat. That's why a glass of something sweet to drink can offer a short-term boost to memory, thinking processes, and mental ability. Consume too much, however, and memory can be impaired, along with the rest of you. Go easy on the sugar so it can enhance memory, without packing on pounds.

Protein & Brain Function Connection?

One of the great benefits of protein is that it generally makes you feel satisfied longer than carbohydrates and fats. Eating a diet rich in lean and low-fat protein is good for weight loss and overall health, though it's hard to draw a connection with brain function.

Fish Really is Brain Food

A protein source associated with a great brain boost is fish. Rich in omega 3 fatty acids, it's essential for brain function and development. These healthy fats have amazing brain power. Higher dietary omega 3 fatty acids are linked to:

• lower dementia and stroke risks
• slower mental decline
• may play a vital role in enhancing memory, especially as we get older

For brain and heart health, eat two servings of fish weekly.

Add a Daily Dose of Nuts, Chocolate

Nuts and seeds are good sources of the antioxidant vitamin E, which is associated with less cognitive decline as you age. Dark chocolate also has powerful antioxidant properties, and contains natural stimulants like caffeine, which can enhance focus and concentration. Enjoy up to an ounce a day of nuts and dark chocolate to provide all the benefits you need without excess calories, fat, or sugar.

Add Avocados and Whole Grains

Every organ in the body depends on blood flow, especially the heart and brain. Eating whole grains and fruits like avocados can reduce the risk of cardiovascular disease and enhance blood flow, offering a simple, tasty way to fire up brain cells. Whole grains, like popcorn and whole wheat, also contribute dietary fiber and vitamin E, while avocados have fat, but a good-for-you, monounsaturated fat that contributes to healthy blood flow.

Blueberries Are Super Nutritious

Research in animals shows that blueberries help protect the brain from oxidative stress and may reduce the effects of age-related conditions such as Alzheimer's disease or dementia. Studies also show that diets rich in blueberries significantly improved both the learning capacity and motor skills of aging rats, making them mentally equivalent to much younger rats.

Vitamins, Minerals, Supplements?

Store shelves groan with the amount of supplements claiming to boost health. Although many of the reports on the brain-boosting power of supplements like vitamins B, C, E, beta-carotene, and magnesium are promising, they're inconclusive. Researchers are cautiously optimistic about ginseng, gingko, or vitamin, mineral, and herb combinations and their impact on the brain.

A daily multivitamin is OK, but check with your doctor before taking other supplements.

For more information about the dangers of vitamins, supplements and medication please read Herbs & Prescription Drugs Don't Mix.

Conclusion

Want to power up your ability to concentrate? Start with a meal of 100% fruit juice, a whole grain bagel with salmon, and a cup of coffee. In addition to eating a well-balanced meal, experts also advise:

• Get a good night's sleep
• Exercise to help sharpen thinking
• Meditate to clear thinking and relax

Many people suffer from cold hands (and feet), and fortunately Chinese medicine has numerous solutions that can bring comfort and warmth back into your life. You will not have to endure another winter left out in the cold!

What Causes Cold Hands?

According to conventional medicine, cold hands and feet can be the result of one or more underlying conditions. One of these conditions is an overactive autonomic nervous system. During times of stress, the body conserves its resources by channeling blood flow away from the extremities and toward the vital organs (such as the heart). So you don't feel like you experience high levels of stress? Your body might think differently. Even such activities as being stuck in traffic, running late for work, rushing through lunch, or heading out for a night on the town can elicit a stress response. These days, with our society "on the run," we are overtaxing our system more often than is necessary.

Another possible cause of cold hands and feet is physical intolerance to cold, often combined with poor circulation. As temperatures outside drop, some people develop a significant aversion to cold. Instead of feeling chilly and zipping up their jacket, these people are often "freezing" and wear multiple layers, often having a difficult time staying warm. Symptoms can range from decreased blood flow in extremities to actual flu-like symptoms. A person may experience fatigue, a runny nose, congestion, cough, and/or body aches. These symptoms can seemingly last all winter, only resolving once warmer weather and sunshine return.

A third potential cause of cold hands and feet is Raynaud's Syndrome. While less common, Raynaud's phenomenon is a condition that affects blood vessels in the extremities – generally, the fingers and toes. It is characterized by episodic attacks in which the blood vessels in the digits constrict, usually in response to cold temperatures and/or emotional stress. People with Raynaud's Syndrome tend to notice color changes in their extremities, and the skin on the fingers and toes may become shiny and tight, with a loss of tissue under the skin. Raynaud's tends to occur significantly more often in women.

What Can I Do?

Chinese Medicine has the ability to effectively treat any of the above-mentioned causes of cold hands and feet by increasing the distribution of blood flow throughout the whole body. Many people begin acupuncture treatment for cold extremities, as well as a weak immune system. After four treatments many patients report an increase in the warmth of their fingers and toes, especially at night. They sniffled less and had more energy during the day. After 10 treatments, many felt strong and warm enough to use acupuncture only to maintain their results, going for treatment once every 2 weeks.

Other Help For Cold Hands

During the winter months, wind and cold can inflict damage on your delicate fingers and make your hands look weather-beaten and world-weary. To help you combat those ill effects, we assembled tips from some of the best experts in the beauty business. Follow their advice, and your hands will look their best all winter long, no matter how harsh Mother Nature decides to be.

Wear Gloves

It might seem obvious, but it bears repeating: Gloves are key to protecting the fragile skin of your hands. Even for quick errands outside, you should shield your hands from the elements. Keep a pair in your purse, in case you forget them on your way out the door.

Swap Harsh Soap For Something Milder

Marion Fenwick, head nail trainer at Bliss spas in New York City suggests:

"Trade in your bar soap and keep a bath and shower gel sink-side for hand washing. It's a nice change for the colder months, because while bar soaps can strip the skin of moisture, bath and shower gels are richer and can actually add moisture to dry hands."

Moisturize, Moisturize, Moisturize!

Moisturizer is crucial to hand care year-round, but in the winter it's even more important. Aside from regular application throughout the day and after washing your hands, consider an intensive treatment.

"Try applying your favorite hand or body cream to hands, then putting on [specialized hand treatment] gloves for 20 minutes," she advises.

You can also try regular cotton gloves for short intense treatments or overnight use. It's a good idea to keep a small bottle of lotion in your purse so you'll have it available while you're on the go.

Stay Hydrated

A refreshing glass of water may be the last thing on your winter beverage list, but it's actually one of the times you need water most: Water will keep your body hydrated and counterbalance the drying effect of indoor heating. By drinking water throughout the day, you'll help your skin stay supple and moist. You might also want to invest in a humidifier to put moisture back into parched indoor air.

Supplement Your Way To Softer Hands

In a recent study of 45 non-smoking, healthy women between the ages of 18 and 65, researchers in Dusseldorf, Germany, found that flaxseed and borage oils helped to significantly decrease roughness and scaling in the skin. If you don't want to take supplements, you can always add a sprinkling of flax seeds to oatmeal or a salad for some of the same nutritional benefits.

Practice Between Manicure Maintenance

Nothing beats a great at home treatment for keeping hands looking their best between manicures. Fenwick recommends this four-step treatment plan to her clients:

1. File or cut nails to the same length (this seems simple, she says, but is often overlooked).


2. Clean your nail tips thoroughly to make them look really white: Soak them in freshly-squeezed lemon juice for a natural bleaching, or use the lemon itself and rub it directly on the nails.


3. Moisturize, paying special attention to cuticles and knuckles.


4. Finish by buffing with a smooth buffer to make your nails shine like glass.

By following these simple tips, you'll have soft, supple hands all winter long!

Eating too much food once in a while might give you occasional heartburn, but eating too much on a regular basis may give you gastroesophageal reflux disease (GERD).

With both obesity and GERD on the rise in the United States, medical researchers have wondered if a link exists between the two. The answer to this question appears to be "yes." An article in The American Journal of Gastroenterology examined the results of 20 studies involving more than 18,000 people with GERD. Overall, people who were overweight were 50% more likely to have GERD than normal-weight people; obese individuals were more than twice as likely.

Several theories may explain the link between GERD and obesity. For example, extra fat in the abdomen may increase pressure on the stomach and cause the lower esophageal sphincter to relax, allowing stomach contents to flow back up into the esophagus. In addition, body fat may release chemicals that decrease pressure in the lower esophageal sphincter or slow the clearance of acid from the esophagus.

Another possibility: Estrogen levels may play a role in the connection between obesity and GERD. One study found that obese women were more likely than obese men to have GERD; the risk was highest in premenopausal women and in postmenopausal women taking estrogen.

Whatever may be causing the increased risk of GERD in obese people, losing weight seems to help. An article in Archives of Internal Medicine found that losing weight and elevating the head of the bed were the only lifestyle measures that helped relieve GERD symptoms.

How much weight loss is enough? According to a study in The New England Journal of Medicine, decreasing BMI by 3.5 points (the equivalent of losing about 20 lbs) may significantly improve your GERD symptoms.

On a personal note - I suffered from GERD for many years. In June of 2008 I began dieting to lose weight. I've lost 55 lbs and my GERD is essentially gone. Now I only suffer from acid reflux when I've eaten too much at any one meal, or if I eat too soon before going to bed.

St. Patrick, the patron saint of Ireland, is one of Christianity's most widely known figures. But for all his celebrity, his life remains somewhat of a mystery. Many of the stories traditionally associated with St. Patrick, including the famous account of his banishing all the snakes from Ireland, are false, the products of hundreds of years of exaggerated storytelling.

Who Was St. Patrick?

It is known that St. Patrick was born in Britain to wealthy parents near the end of the fourth century. He is believed to have died on March 17, around 460 A.D. Although his father was a Christian deacon, it has been suggested that he probably took on the role because of tax incentives and there is no evidence that Patrick came from a particularly religious family.

At the age of sixteen, Patrick was taken prisoner by a group of Irish raiders who were attacking his family's estate. They transported him to Ireland where he spent six years in captivity. (There is some dispute over where this captivity took place. Although many believe he was taken to live in Mount Slemish in County Antrim, it is more likely that he was held in County Mayo near Killala.) During this time, he worked as a shepherd, outdoors and away from people. Lonely and afraid, he turned to his religion for solace, becoming a devout Christian. (It is also believed that Patrick first began to dream of converting the Irish people to Christianity during his captivity.)

Guided By Visions

After more than six years as a prisoner, Patrick escaped. According to his writing, a voice, which he believed to be God's, spoke to him in a dream, telling him it was time to leave Ireland.

Patrick walked nearly 200 miles from County Mayo, where it is believed he was held, to the Irish coast. After escaping to Britain, Patrick reported that he experienced a second revelation, an angel in a dream tells him to return to Ireland as a missionary. Soon after, Patrick began religious training, a course of study that lasted more than fifteen years. After his ordination as a priest, he was sent to Ireland with a dual mission, to minister to Christians already living in Ireland and to begin to convert the Irish. (Interestingly, this mission contradicts the widely held notion that Patrick introduced Christianity to Ireland.)

Bonfires and Crosses

Familiar with the Irish language and culture, Patrick chose to incorporate traditional ritual into his lessons of Christianity instead of attempting to eradicate native Irish beliefs. For instance, he used bonfires to celebrate Easter since the Irish were used to honoring their gods with fire. He also superimposed a sun, a powerful Irish symbol, onto the Christian cross to create what is now called a Celtic cross, so that veneration of the symbol would seem more natural to the Irish.

We would like to wish all of our readers a very happy St. Patrick's Day!

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