This is from the Januray 2009 issue of The Fibromyalgia Network Newsletter:
"One would think that fibromyalgia's high prevalence and burdensomeimpact on patients , their families, and society would command the attention of doctors and researchers everywhere. Yet, speaking at the National Fibromyalgia Research Association conference in October, Manuel Martinez-Lavin, M.D., of Mexico City, points to the 'fibro paradox' in which many physicians have an attitude of rejection and evasion. They don't want to see patients with FM. Furthermore, he pointed to a recent survey of doctors in Norway asking them to rank the prestige of more than 100 diseases. FM ranked last.
Why is there a disconnect between the problems FM patients face and the lack of interest by physicians? The multiple symptoms that make office visits time-consuming and no underlying blood test or biopsy to prove the diagnosis are partly to blame. 'Worst of all,' says Martinez-Lavin, 'a direct blow to the physician's inflated ego is the fact that many FM patients do not get better with prescribed medications. And perhaps the most essential disconnect between patients and physicians is hte linear thinking used by the medical communtiy that cannot explain complex diseases like FM.'
In medicine, Martinez-Lavin says this approach can be seen by many medical specialists such as cardiologists, gynecologists, opthalmologists, and others who have a narrow view of their patient's medical problems. Certainly, this linear viewpoint fails to understand or acknowldege complex diseases, such as FM.
When studying complex diseases, such as FM, scientists need to shift their approach away from traditional linear thinking. 'We have to see the humban being as a whole,' says Martinez-Lavin. 'We must end the mind-body split and see how this human being is related to the environment.' Complex systems are continually sampling their environment and have the ability to adapt to changes. He added that one of the most adaptable complex systems in the human body is the autonomic nervous system (ANS) and its faulty performance generateds the symptoms of FM.
The ANS is in charge of controlling organ systems, regulating important body functions, and adapting to the environement. It maintains vital signs like blood pressure and respiration by using harmonious signals from its two opposing branches: the symptathetic and the parasympathetic. The sympathetic nerves communicate through the release of norepinephrine and the parasympathetic nerves release acetylcholine. The ANS has a close relationship with higher brain function as well as the immune and hormonal systems, while it works below the level of consciousness.
'The ANS is the interface between mind and body. Autonomic activation transforms emotions like fear or anger into biological functions like paleness, pupil dilation, and rapid heart rate, among many other reactions.' Its intricate nework constitutes the body's main stress response mechanism and its ability to be molded or altered by the environment enables it to adapt and survive.
Conventional medical thinking suggests that diseases arise from the disruption of the orderly machine-like systems of the body. Yet, disorder is what gives a complex system its ability to maintain life, says Martinez-Lavin. Systems that lose their elasticity or resilience are unable to respond to the changing environment and are more likely to become ill or readily die. Disorder is healthy and uniformity leads to disease in a complex systme.
Martinez-Lavin points to seven published studies showing sympathetic hyperactivity in FM patients compared to age-matched controls. 'This is one of the most consistent alerations found so far in FM. Patients have an unbending heart rate variability and their sympathetic nervous system is already committed and is unable to respond to stimuli.'
'The ANS in most FM patients is characterized by a sympathetic nervous systme that is persistently hyperactive,' says Martinez-Lavin, making it hard to sleep. When the system is maxed out, and the norepinephrine receptors are tired of being bombarded, the sympathetic nervous system is hypo-reactive. 'When the tiger comes charging , the ANS of people with FM is unable to respond,' says Martinez-Lavin referring to the fight-or -flight stress response mechanisms of the sympathetic system.
The ANS in healthy people operates differently during sleep and wake periods. During the day, the sympathetic branch is dominant. At night, the parasympathetic component is dominant, although less so during rapid eye movement (REM) sleep. In contrast, Martinez-Lavin found that in FM patients, the parasympathetic system, which is essential for the functions of rest and digest, does not take over during sleep in FM patients. Given the sympathetic dominance during the night, it should be no surprise that patients have difficulty falling asleep and staying asleep and staying asleeep.
Hyperactive sympathetic systems can explain FM's most troublesome symptoms: chronic widespread pain and numbness-tingling sensations in the extremities. Excessive norepinephrine can stimulate the pain-transmitting nerve nodules that lie along the spine."
sue in ohio
"One would think that fibromyalgia's high prevalence and burdensomeimpact on patients , their families, and society would command the attention of doctors and researchers everywhere. Yet, speaking at the National Fibromyalgia Research Association conference in October, Manuel Martinez-Lavin, M.D., of Mexico City, points to the 'fibro paradox' in which many physicians have an attitude of rejection and evasion. They don't want to see patients with FM. Furthermore, he pointed to a recent survey of doctors in Norway asking them to rank the prestige of more than 100 diseases. FM ranked last.
Why is there a disconnect between the problems FM patients face and the lack of interest by physicians? The multiple symptoms that make office visits time-consuming and no underlying blood test or biopsy to prove the diagnosis are partly to blame. 'Worst of all,' says Martinez-Lavin, 'a direct blow to the physician's inflated ego is the fact that many FM patients do not get better with prescribed medications. And perhaps the most essential disconnect between patients and physicians is hte linear thinking used by the medical communtiy that cannot explain complex diseases like FM.'
In medicine, Martinez-Lavin says this approach can be seen by many medical specialists such as cardiologists, gynecologists, opthalmologists, and others who have a narrow view of their patient's medical problems. Certainly, this linear viewpoint fails to understand or acknowldege complex diseases, such as FM.
When studying complex diseases, such as FM, scientists need to shift their approach away from traditional linear thinking. 'We have to see the humban being as a whole,' says Martinez-Lavin. 'We must end the mind-body split and see how this human being is related to the environment.' Complex systems are continually sampling their environment and have the ability to adapt to changes. He added that one of the most adaptable complex systems in the human body is the autonomic nervous system (ANS) and its faulty performance generateds the symptoms of FM.
The ANS is in charge of controlling organ systems, regulating important body functions, and adapting to the environement. It maintains vital signs like blood pressure and respiration by using harmonious signals from its two opposing branches: the symptathetic and the parasympathetic. The sympathetic nerves communicate through the release of norepinephrine and the parasympathetic nerves release acetylcholine. The ANS has a close relationship with higher brain function as well as the immune and hormonal systems, while it works below the level of consciousness.
'The ANS is the interface between mind and body. Autonomic activation transforms emotions like fear or anger into biological functions like paleness, pupil dilation, and rapid heart rate, among many other reactions.' Its intricate nework constitutes the body's main stress response mechanism and its ability to be molded or altered by the environment enables it to adapt and survive.
Conventional medical thinking suggests that diseases arise from the disruption of the orderly machine-like systems of the body. Yet, disorder is what gives a complex system its ability to maintain life, says Martinez-Lavin. Systems that lose their elasticity or resilience are unable to respond to the changing environment and are more likely to become ill or readily die. Disorder is healthy and uniformity leads to disease in a complex systme.
Martinez-Lavin points to seven published studies showing sympathetic hyperactivity in FM patients compared to age-matched controls. 'This is one of the most consistent alerations found so far in FM. Patients have an unbending heart rate variability and their sympathetic nervous system is already committed and is unable to respond to stimuli.'
'The ANS in most FM patients is characterized by a sympathetic nervous systme that is persistently hyperactive,' says Martinez-Lavin, making it hard to sleep. When the system is maxed out, and the norepinephrine receptors are tired of being bombarded, the sympathetic nervous system is hypo-reactive. 'When the tiger comes charging , the ANS of people with FM is unable to respond,' says Martinez-Lavin referring to the fight-or -flight stress response mechanisms of the sympathetic system.
The ANS in healthy people operates differently during sleep and wake periods. During the day, the sympathetic branch is dominant. At night, the parasympathetic component is dominant, although less so during rapid eye movement (REM) sleep. In contrast, Martinez-Lavin found that in FM patients, the parasympathetic system, which is essential for the functions of rest and digest, does not take over during sleep in FM patients. Given the sympathetic dominance during the night, it should be no surprise that patients have difficulty falling asleep and staying asleep and staying asleeep.
Hyperactive sympathetic systems can explain FM's most troublesome symptoms: chronic widespread pain and numbness-tingling sensations in the extremities. Excessive norepinephrine can stimulate the pain-transmitting nerve nodules that lie along the spine."
sue in ohio
