April Fools' Day or All Fools' Day, although not a holiday in its own right, is a notable day celebrated in many countries on April 1. The day is marked by hoaxes and other practical jokes of varying sophistication on friends, family members, enemies, and neighbors, or sending them on a fool's errand, the aim of which is to embarrass the gullible. Traditionally, in some countries, the jokes only last until noon: someone who plays a trick after noon is called an "April Fool". Elsewhere, such as in Ireland or France, the jokes last all day.

The April 1 tradition in France and French-speaking Canada includes poisson d'avril (literally "April's fish"), attempting to attach a paper fish to the victim's back without being noticed. This is also widespread in other nations, such as Italy (where the term poisson d' avril (literally "April's fish") is also used to refer to any jokes done during the day).

In Scotland, April Fools' Day is traditionally called Hunt-the-Gowk Day ("gowk" is Scots for a cuckoo or a foolish person), although this name has fallen into disuse. The traditional prank is to ask someone to deliver a sealed message requesting help of some sort. In fact, the message reads "Dinna laugh, dinna smile. Hunt the gowk another mile". The recipient, upon reading it, will explain he can only help if he first contacts another person, and sends the victim to this person with an identical message, with the same result.

One thing that is common to all cases of FM and CFS/ME is stress. It is not clear whether the stress causes the symptoms, or the symptoms cause the stress.

Stress sufferers feel under pressure continuously and this continued state can cause serious problems. In fact doctors estimate that over 90% of diseases are either directly caused by stress or severely worsened by stress, so FM and CFS/ME being a result of stress is not only possible, but statistically it is almost certain.

In our online survey we asked the question: Does stress make your FM and/or CFS/ME symptoms worse? Of the people who responded, (589 responses - Mar. 15, 2009), 95% said YES!

Some of the most useful stress management skills you can learn are healthy coping strategies. Many of these can be done with little or no instruction. No one strategy is preferable, you need to find what works best for you. Using these techniques regularly until they become habits that are part of your lifestyle is the key.

Writing

There is evidence that writing about stressful events and circumstances may help relieve stress and improve diseases linked to stress. Write for 10 to 15 minutes a day about stressful events and how you felt. One way to use writing to deal with stress is to keep a stress journal. This can really help you identify the sources of stress in your life so that you can find better ways to cope with them.

Express Your Feelings

Discussing how you feel with friends, family members, or a counselor is an important way of coping with and relieving stress. Laughing and crying are also natural ways to release tension and frustration. They are both part of a normal emotional healing process.

Mindfulness Activities

Mindfulness activities help relax your mind and are often combined with body centered relaxation exercises.

• Autogenic training consists of six standard exercises that make the body relax. For each exercise, you use visual imagination and verbal cues to relax your body in some specific way.


• Self-hypnosis can open your mind to suggestions that can relieve stress or change the way you respond to stress.


• Meditation, where you focus your attention on the things that are happening right now in the present moment. One way to do this is by paying attention to your breathing.


• Use guided imagery. With guided imagery, you imagine yourself in a certain setting that helps you feel calm and relaxed. You can use audiotapes, scripts, or a teacher to guide you through the process.


• Music therapy can relax your body, improve your mood, and change the pace of your day.


• Humor therapy is becoming widely accepted as a tool for reducing stress and boosting the body's immune system.

Ways To Relax Your Body

• Physical activity. Exercise can reduce stress and the stress response. Aerobic exercise, the kind that increases your heart rate, such as walking, running, bicycling, or swimming is especially useful for counteracting the harmful effects of stress. Even everyday activities such as house cleaning or yard work can reduce your stress level if you do them vigorously. Stretching is also a good way to relieve muscle tension. Regular, moderate physical activity may be the single best approach to managing stress.


• Doing something you enjoy. A meaningful activity helps relieve tension. This can be a hobby, such as gardening; a creative activity, such as writing, crafts, or art; or doing volunteer work for a cause that benefits others. Playing with and caring for pets also can help you relax. Although you may feel that you are too busy, making time to do something you like can help you relax and make you more productive in other areas of your life.

Mini Relaxations Techniques

Mini relaxations can help allay fear and reduce pain while you sit in the dentist's chair or lie on an examining table. They're equally helpful in thwarting stress before an important meeting, while stuck in traffic, or when faced with people or situations that annoy you. Here are a few quick relaxation techniques to try.

When you've got 1 minute

Place your hand just beneath your navel so you can feel the gentle rise and fall of your belly as you breathe. Breathe in slowly. Pause for a count of three. Breathe out. Pause for a count of three. Continue to breathe deeply for one minute, pausing for a count of three after each inhalation and exhalation.

Or alternatively, while sitting comfortably, take a few slow deep breaths and quietly repeat to yourself I am as you breathe in and at peace as you breathe out. Repeat slowly two or three times. Then feel your entire body relax into the support of the chair.

When you've got 2 minutes

Count down slowly from 10 to zero. With each number, take one complete breath, inhaling and exhaling. For example, breathe in deeply saying 10 to yourself. Breathe out slowly. On your next breath, say nine, and so on. If you feel lightheaded, count down more slowly to space your breaths further apart. When you reach zero, you should feel more relaxed. If not, go through the exercise again.

When you've got 3 minutes

While sitting down, take a break from whatever you're doing and check your body for tension. Relax your facial muscles and allow your jaw to fall open slightly. Let your shoulders drop. Let your arms fall to your sides. Allow your hands to loosen so that there are spaces between your fingers. Uncross your legs or ankles. Feel your thighs sink into your chair, letting your legs fall comfortably apart. Feel your shins and calves become heavier and your feet grow roots into the floor. Now breathe in slowly and breathe out slowly. Each time you breathe out, try to relax even more.

When you've got 5 minutes

Try self-massage. A combination of strokes works well to relieve muscle tension. Try gentle chops with the edge of your hands or tapping with fingers or cupped palms. Put fingertip pressure on muscle knots. Knead across muscles, and try long, light, gliding strokes. You can apply these strokes to any part of the body that falls easily within your reach. For a short session like this, try focusing on your neck and head.

• Start by kneading the muscles at the back of your neck and shoulders. Make a loose fist and drum swiftly up and down the sides and back of your neck. Next, use your thumbs to work tiny circles around the base of your skull. Slowly massage the rest of your scalp with your fingertips. Then tap your fingers against your scalp, moving from the front to the back and then over the sides.


• Now massage your face. Make a series of tiny circles with your thumbs or fingertips. Pay particular attention to your temples, forehead, and jaw muscles. Use your middle fingers to massage the bridge of your nose and work outward over your eyebrows to your temples.


• Finally, close your eyes. Cup your hands loosely over your face and inhale and exhale easily for a short while.

When you've got 10 minutes

Try imagery. Start by sitting comfortably in a quiet room. Breathe deeply for a few minutes. Now picture yourself in a place that conjures up good memories. What do you smell, the heavy scent of roses on a hot day, crisp fall air, the wholesome smell of baking bread? What do you hear? Drink in the colors and shapes that surround you. Focus on sensory pleasures: the swoosh of a gentle wind; soft, cool grass tickling your feet; the salty smell and rhythmic beat of the ocean. Passively observe intrusive thoughts, and then gently disengage from them to return to the world you've created.

In 2008, I began surveying people with FM and/or CFS/ME in an attempt to learn more about FM and CFS/ME, while I looked for a cause. I've already received 768 completed surveys. The FM/CFS/ME Survey is still on-going for those of you have yet to participate. This month I will begin reviewing the data we have accumulated thus far, starting with General Statistics.

Average Age of Survey Respondent:
Average Age of Onset/First Experience:
Average Age When Diagnosed:
Respondents Living in the U.S.:
Female Respondents:
Male Respondents:

44 years old
32 years old
39 years old
72%
92%
5%

We've learned that 92% of the people surveyed were women. Of those surveyed, 72% of them we Americans. The average age of the people surveyed was 44 years of age. The people surveyed were in their early 30's when they first developed FM and/or CFS/ME, and it took an average of seven years for them to be diagnosed.

Family Members With FM and/or CFS/ME:
Mother With FM and/or CFS/ME:
Sister With FM and/or CFS/ME:
Daughter With FM and/or CFS/ME:
Cousin With FM and/or CFS/ME:

36%
17%
9%
5%
5%

Only 36% of those surveyed had family members with FM and/or CFS/ME. Seventeen percent of the people we surveyed said that they had a mother with FM and/or CFS/ME. Nine percent listed having a sister with FM and/or CFS/ME, and 5% were tied with having a daughter or a cousin with FM and/or CFS/ME.

Primary Doctor is a Family Doctor:
Primary Doctor is a Rheumatologist:
Primary Doctor is a Pain Specialist:
Primary Doctor is Other:

26%
18%
6%
6%

The majority of those surveyed, 26%, listed Family Doctors or PCT's as their primary doctor for treating their FM and/or CFS/ME. Rheumatologists were used by 18% of those surveyed, while Pain Specialists and other types of doctors were tied for 6%. The numbers show there isn't any one specialty that has "taken on" FM and/or CFS/ME. In many cases, family practioners seem to be more in tune with FM and CFS/ME than other types of doctors.

Suffered Trauma Before FM and/or CFS/ME:
Grew Up With Alcoholic Parent:
Grew Up With Chronically Ill Parent:

57%
24%
21%

Fifty seven percent of the people we surveyed had experienced some sort of trauma before acquiring FM and/or CFS/ME. The trauma varied between automobile accidents to death and abuse - both physical and mental. Twenty four percent said they had grown up with an alcoholic parent, while 21% had grown up with a chronically ill parent. These numbers show that early childhood stress may play a part in FM and CFS/ME.

Received Disability:
Changed Careers Since Onset:
Applied for Disability:
Employed Outside The Home:

66%
52%
42%
37%

Of the people we surveyed, 42% percent were disabled to the extent that they felt the need to apply for disability. Sixty six percent of those who applied were able to receive disability. From a personal stand point, I've known many people to be turned down on their application for disability. So I found these numbers to be very encouraging.

Pain Level During Remission is 3:
Pain Level During Remission is 2:
Pain Level During Remission is 4:
No Pain During Remission:
Pain Level During Remission is 5:
Pain Level During Remission is 1:

26%
19%
8%
7%
2%
2%

In this next area, 329 people told us how intense their pain levels were during periods of remission. The highest percentage, 26%, said their pain levels were moderate during remission. Other responces ranged from 19%-2% feeling pain during remission.

Pain Level During Flares is 5:
Pain Level During Flares is 4:
Pain Level During Flares is 3:
No Pain During Flares:
Pain Level During Flares is 2:
Pain Level During Flares is 1:

45%
20%
6%
3%
1%
0%

This area maps out the amount of pain survey respondants felt during flairs. The highest percentage, 45%, felt their pain levels were high, while 20% felt their pain levels were slightly less than high. Very few people had moderate to low pain levels during flairs.

Next month I will be continuing our look at the FM/CFS/ME Survey responses by looking at the Symptoms Statistics.

A review of previous clinical trial results shows that a multifaceted approach can be effective for treating Fibromyalgia (FM), German researchers report.

FM is characterized by pain, fatigue and difficulty sleeping. It's a somewhat mysterious condition with no clear-cut cause.

Dr. Winfried Haeuser told Reuters Health that German guidelines recommend "multicomponent treatment" of FM - "at least two components: patient education or psychological therapy and exercise as second-line therapy for patients whose symptoms and restrictions in daily life are not sufficiently reduced by a single therapy, such as medication."

To investigate how well this strategy works, Haeuser, of Klinikum Saarbruecken, and her colleagues examined pooled evidence from nine clinical trials of multicomponent therapy involving more than 1100 patients. The researchers report the results in the medical journal Arthritis and Rheumatism.

The findings, Haeuser explained, "demonstrated that multicomponent treatment was superior to monocomponent treatment in relieving pain, depressed mood and fatigue and improving physical fitness."

However, she and her colleagues found, "There is strong evidence that the positive effects of multicomponent therapy on the key symptoms of fibromyalgia syndrome decline with time."

The longest follow-up was for 15 months. The researchers conclude, "Strategies to maintain the benefits of multicomponent treatment in the long term need to be developed."

Passover (Pesach in Hebrew) is one of the most important Jewish festivals. Passover celebrations start on Sunday, the 20th of April and will continue for 7 days until Saturday, the 26th of April. Passover commemorates the freedom and exodus of the Israelites (Jewish slaves) from Egypt during the reign of the Pharaoh Ramses II. According to the Book of Exodus, Moses was instructed by God to go to the pharaoh and demand the freedom of his people. When his pleas were ignored, Moses warned the Pharaoh that God would send severe punishments to the people of Egypt if the Israelites were not freed. Still, the Pharaoh ignored Moses' request of freedom. In response God unleashed a series of 10 terrible plagues on the people of Egypt.

Still, the Pharaoh refused to free the Jewish slaves, until the last of the plagues. The Israelites left their homes so quickly that there wasn't time to bake breads. They packed raw dough to take with them on their which they quickly baked in the hot sun. The resulting hard crackers are called matzos, and are to this day, an important Passover symbol.

But even as the Israelites left Egypt, they were pursued by the Pharaoh's army through the desert. It seemed like their journey would end at the Red Sea where they were trapped from escape. But a miracle occurred when the waves of the Red Sea parted and the Israelites were able to cross to the other side. After reaching safety, the sea closed sweeping away the Pharaoh's army. The Israelites were finally free and Passover celebrates this rich history.

The world has become healthier because of medications that are available to treat and control disease and illness. But a problem exists when the medications interact with each other, causing complications, or are abused.

Some drug interactions are easy to predict. Take a narcotic pain pill, add a few drinks after dinner, and toss in a sleeping pill. The combination of three sedative medications may cause problems with the brain forgetting to tell the body to breathe. Other interactions are tougher to predict. For example, warfarin (Coumadin), a blood thinner, will become too active in the body and cause significant bleeding if almost any antibiotic is added. Your healthcare provider needs to predict the problem and take action to avoid possible deadly complications.

How Do Drug Interactions Occur?

Whenever two or more drugs are taken concurrently, there is a chance that there will be an interaction among the drugs. The interaction may increase or decrease the effectiveness and/or the side effects of the drugs. It also may result in a new side effect, that is, a side effect not seen with the use of any one drug alone. The likelihood of drug interactions increases as the number of drugs being taken by a patient increases. Therefore, people who take several medications are at the greatest risk for interactions. Drug interactions contribute to the cost of healthcare because of the medical care costs that are required to treat them. Interactions can also lead to pain and suffering that could be avoided. This month's topic discusses the issue of drug interactions and several ways to avoid them.

Medical care has become fragmented in recent years. The family doctor of old no longer acts as a gatekeeper to coordinate the medications patients are prescribed. A gynecologist may prescribe a birth control pill to a patient, and then the patient goes to a walk-in clinic who then prescribes an antibiotic. How can a healthcare provider inform the patient that antibiotics decrease the effectiveness of birth control pills, if full disclosures of medications, supplements, or OTC medications are not provided to all providers the patient visits? You could argue that the patient is responsible for letting people know, but in reality, the patient doesn't have the expertise to figure out the complications and interactions of medications.

Further, the safeguard of the family pharmacist has been lost to mail-order pharmacies and overworked pharmacists. With increasing numbers of prescription and OTC medications, doctors and pharmacists are using computer programs to help figure out what is safe and what isn't. But to do so, they have to know what medications are in the patient's body.

How Often Do Drug Interactions Occur?

Drug interactions are complex and chiefly unpredictable. A known interaction may not occur in every individual. This can be explained because there are several factors that affect the likelihood that a known interaction will occur. These factors include differences among individuals in physiology, age, lifestyle (diet, exercise), underlying diseases, drug doses, the duration of combined therapy, and the relative time of administration of the two substances. (Sometimes, interactions can be avoided if two drugs are taken at different times.) Nevertheless, significant drug interactions occur frequently and they add millions of dollars to the cost of healthcare. Moreover, many drugs have been withdrawn from the market because of their potential to interact with other drugs and cause serious healthcare problems.

How Can Drug Interactions Be Avoided?

• Give healthcare providers a complete list of all of the drugs that you are using or have used within the last few weeks. This should include:
  • over-the-counter medications
  • vitamins, food supplements
  • herbal remedies


• Inform healthcare providers when medications are added or discontinued.


• Inform healthcare providers about changes in lifestyle.


• Ask your healthcare provider about the most serious or frequent drug interactions with the medications that you are taking.


• Since the frequency of drug interactions increases with the number of medications, work with your healthcare providers to eliminate unnecessary medications.


• This brief overview of drug interactions does not cover every possible scenario. Viewers should not be afraid to use their drugs because of the potential for drug interactions. Rather, they should use the information that is available to them to minimize the risk of such interactions and to improve the success of their therapy.

On Easter Sunday, Christians celebrate the resurrection of the Lord, Jesus Christ. It is typically the most well-attended Sunday service of the year for Christian churches.

Christians believe according to Scripture, that Jesus came back to life, or was raised from the dead, three days after his death on the cross. As part of the Easter season, the death of Jesus Christ by crucifixion, is commemorated on Good Friday, always the Friday just before Easter. Through his death, burial and resurrection, Jesus paid the penalty for sin, thus purchasing for all who believe in him, eternal life in Christ Jesus.

In Western Christianity, Easter marks the ending of Lent, a 40-day period of fasting, repentance, moderation and spiritual discipline in preparation for Easter. Lent begins on Ash Wednesday and ends on Easter Sunday. Eastern Orthodox churches observe Lent or Great Lent, during the 6 weeks or 40 days preceding Palm Sunday with fasting continuing during the Holy Week of Easter. Lent for Eastern Orthodox churches begins on Monday and Ash Wednesday is not observed.

There are many different medications used to treat fibromyalgia symptoms, including sleeping pills and antidepressants. Some fibromyalgia (FM) medicines help ease pain. Others boost mood and improve sleep. Working with your doctor will help you find the right FM medication to add to your treatment regimen. That way, you can manage your symptoms effectively.

The FDA has approved three drugs to treat FM: Lyrica, Cymbalta, and Savella. Lyrica is an anti-epileptic drug. Cymbalta is an antidepressant known as a serotonin and norepinephrine reuptake inhibitor (SNRI). Savella is also an SNRI.

What's The First-Line Therapy for FM?

About three out of every 10 people with FM also have depression and/or anxiety. As a result, doctors frequently prescribe antidepressants that boost mood, ease pain, and improve sleep. In fact, tricyclic antidepressants and the muscle relaxant cyclobenzaprine (Cycloflex, Flexeril) are often used first for FM.

How Do Tricyclic Antidepressants Treat FM Symptoms?

The tricyclic antidepressants, including Elavil and Pamelor, work by raising the levels of neurotransmitters in the brain. When the tricyclic antidepressants are prescribed in low doses, they often help improve the quality of sleep.

Tricyclic antidepressants increase levels of serotonin and norepinephrine in the brain. Patients with chronic pain often have decreased levels of these calming neurotransmitters. Tricyclics can relax painful muscles and heighten the effects of endorphins - the body's natural painkillers. On the other hand, tricyclic antidepressants may cause:

• drowsiness
• dizziness
• dry mouth
• dry eyes
• constipation

Do Other Antidepressants Give Relief of Pain and Fatigue?

The selective serotonin reuptake inhibitors (SSRIs) are one of the newer classes of antidepressants. These FM drugs include Prozac, Zoloft, and other antidepressants. They block the reuptake of serotonin and allow more serotonin to travel from neuron to neuron. That results in improved mood.

Increased amounts of serotonin may also help to ease pain and reduce fatigue. SSRIs may interfere with sleep, some FM specialists prescribe SSRIs with a tricyclic antidepressant to increase restful sleep.

Which FM Medications Help Relieve The Pain?

Different types of analgesics or painkillers are sometimes recommended to ease the deep muscle pain and trigger-point pain that comes with FM. The problem is these analgesics don't work the same for everyone with FM.

The over-the-counter pain reliever acetaminophen (Tylenol) elevates the pain threshold so you perceive less pain. Aspirin blocks the production of prostaglandins, the chemicals in the body that cause pain, inflammation, and swelling.

Nonsteroidal anti-inflammatory drugs (NSAIDs), when taken alone, haven't been shown to relieve pain in FM. However, when combined with other FM medicines such as Elavil, Flexeril, or an SSRI, NSAIDs often do help. NSAIDs are available over the counter and include drugs such as aspirin, ibuprofen (Advil), and naproxen (Aleve).

People with FM also get the "regular" pains of life. They get menstrual cramps, muscle sprains and strains, and headaches. NSAIDs and Tylenol can be effective for these everyday pains in people with FM.

Are There Side Effects With Pain Relievers for FM?

Be careful taking aspirin or other NSAIDs if you have stomach problems. These medications can lead to heartburn, nausea or vomiting, stomach ulcers, and gastrointestinal bleeding. They can also increase clotting time.

Aspirin and other NSAIDs can cause or exacerbate peptic ulcer disease (ulcers of the stomach or intestine). If you've had ulcers or any kind of gastrointestinal bleeding, talk to your doctor before taking NSAIDs. Acetaminophen is relatively free of side effects. But avoid this medication if you have liver disease.

Some people cannot take aspirin or NSAIDs because of what's known as the aspirin/nasal polyp triad. Although uncommon overall, this aspirin sensitivity occurs in about 10% to 15% of people with asthma. Among people with asthma and nasal polyps the rate of occurrence is 30% to 40%. If you have aspirin sensitivity, you might have symptoms such as:

• itching
• rashes
• hives
• swelling
• nasal congestion
• wheezing

Talk to your doctor about alternative therapies for resolving FM pain if you have this sensitivity.

Are Muscle Relaxants Helpful for FM Pain?

The muscle relaxant cyclobenzaprine (Cycloflex, Flexeril) has proved useful for the treatment of FM. It's often prescribed to help ease muscle tension and improve sleep. Muscle relaxants work in the central nervous system to relax skeletal muscles. They are also used to ease pain problems associated with FM, including TMJ, headache, muscle pain, and other aches and pain.

With muscle relaxants, you may experience:

• dry mouth
• dizziness
• drowsiness
• blurred vision
• clumsiness
• unsteadiness
• change in the color of your urine

These medications may increase the likelihood of seizures. Older adults sometimes experience confusion and hallucinations when taking them.

When Are Anticonvulsants Used For FM?

Lyrica is a newer drug for treating FM. This anti-epileptic or anticonvulsant drug slows down impulses in the brain that cause seizures. With FM, Lyrica affects chemicals in the brain that send pain signals across the nervous system. So it reduces pain and improves sleep.

Lyrica is the first drug to be approved by the FDA specifically for treating the symptoms of FM. Gabapentin (Neurontin) is an anticonvulsant medication that is being studied for use in people with FM.

Other anticonvulsants are often used to treat related pain such as TMJ, nerve pain, migraines, and myofascial pain. These medications work by decreasing substance P activity and stabilizing neuronal activity in the brain at high doses.

Are There Other FM Pain Medications Available?

Non-narcotic analgesics such as Ultram - a stronger analgesic than acetaminophen - are commonly used to treat FM. This narcotic-like medication acts centrally in the brain to modulate the sensation of pain. It has no anti-inflammatory effect, however, and is not as addictive as narcotics.

In addition, many doctors prescribe benzodiazepines such as Klonopin, Xanax, Ativan, and Valium to help relax painful muscles, improve sleep, and relieve symptoms of restless legs syndrome (unpleasant sensations in the legs that force you to move them constantly). These medications act to depress the central nervous system. The result is sedation, hypnosis, skeletal muscle relaxation, anticonvulsant activity, and sometimes coma in large doses. Benzodiazepines are addictive and must be used with caution on a short-term basis.

Powerful opioid pain medications, such as OxyContin, should only be considered if all other drugs and alternative therapies have been exhausted and there is no relief.

Next Month!

I am beginning a new series entitled, In-Depth Look at FM Medications. Each month a new medication used in the treatment of Fibromyalgia will be the topic. Everything from how it works, to side effects and drug interactions will be discussed.

Cats and dogs, America's favorite furry family members, take the blame for most pet allergies in the United States, where about 10 percent of the population is allergic to animals. Other pets, such as horses, guinea pigs, and even fish, can cause allergy flare-ups as well. Unlike other allergies, to peanuts and ragweed, for example, allergies to animals are accompanied by emotional ties that make the prevention of attacks difficult.

"It's a rather amazing phenomenon. People will choose to be ill, or choose for a family member to be ill, rather than give up the pet."

Says Russell Leftwich, MD, an allergist in private practice in Nashville, Tennessee.

Cats: Clean But Contaminated

Cleanliness is next to ungodly allergies where cats are concerned. When fastidious felines clean themselves with their tongues, they unleash both the potent allergenic protein "Fel d 1" from their saliva, and dead skin particles, or dander. In sensitive people, the protein and the dander can trigger watery eyes, runny noses, and, in severe cases, trouble breathing.

"The stuff that makes you sick forms very small particles - smaller than what makes you sick from dogs. So it circulates in the air very easily and can get down into your lungs."

Says Dr. Leftwich.

Dogs Vary in Allergy Risk to People

Unlike cats, not all breeds of dog produce the same universal allergen, says Hugh Windom, MD, a Florida-based allergist. For people who are allergic, the American Kennel Club recommends breeds with nonshedding coats because they produce less dander. Irish setters, German shepherds, various hunting breeds, and cocker spaniels shed a lot and are among the worst breeds for people with allergies. Bathing a dog weekly will help cut down on allergens, but be wary of other potential allergens, such as flea insecticide, in dog shampoos.

Puppy Love and Allergies

Many people report more allergy trouble with puppies than with full-grown dogs. Perhaps it's all those puppy kisses laden with allergenic slobber. Alternatively, medical experts warn that there's a "priming effect" with some allergies, such that symptoms might not show up right away.

"You might be able to tolerate the allergy for a couple of years before it gets really bad,"

Says James Sublett, MD, chief of pediatric allergy and immunology at the University of Louisville in Kentucky.

Next Month:

Allergies in a Cage: Guinea Pigs, Hamsters, and Gerbils

Forest Laboratories Inc. and Cypress Bioscience Inc. said that they were pushing back the U.S. launch of their fibromyalgia drug Savella while they seek approval for a minor cosmetic change.

The companies said they now expect to ship Savella to pharmacies by mid-2009, after previously saying they expected the drug to be available in March.

They are waiting on approval from the U.S. Food and Drug Administration for a "minor post-approval cosmetic formulation change." An FDA response is expected by no later than May, the companies said.

Forest and Cypress won approval in January for Savella for treating fibromyalgia, a chronic pain condition. Their shares rose sharply on news of the approval.

The drug is set to compete with Eli Lilly's Cymbalta, which is also prescribed for depression, and Pfizer Inc's Lyrica, which also treats nerve pain.

Forest is counting on Savella as one of the products that can help make up for expected steep revenue declines when its Lexapro antidepressant loses U.S. patent protection in early 2012.

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