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Year 12 Issue 6 April 2012SEVEN TYPES OFFIBROMYALGIAPAINKnife in theVoodoo Doll(an intense stabbingpain that seems to cutthrough your body)Hyperalgesia(increased response to apainful stimulus)Allodynia(painful response to a normallyinnocuous stimulus)Paresthesia(numbness, tingling, pinsand needles)Randomly Roving Pain(pain that migratesaround the body)Sparkler Burns(tiny pin-pricks of pain thatwhen scratched triggers tactileallodynia)Rattled Nerves(ache all over with nausea,dizziness and anxiety)Inspired by an article by Adrienne Dellwo http://chronicfatigue.about.com/od/whatisfibromyalgia/a/fibromyalgiapain.htmIn this issue: Supporting the Support- Blackburn, Witney, Wakefield, and Selsey Groups. Discover which foods andchemical additives cause arthritis inflammation, gout and fibromyalgia pain By JB Bardot. Friendly Fibromyalgia Fashion forSpring - Special Footwear Edition By Rosie Sanders. THE DREADED BROWN ENVELOPE!! By Helen Watts from the Forum.Working for a cure – sooner rather than later. Living with Fibromyalgia: What Helps Me By Kathy Gamble, RN. FibromyalgiaMedication- Trazodone By Dr Colin Dell. Moving on By Jan Sadler. Unlock the fibro brain-fog with acetyl-L-carnitine By MarcusWebb. Don’t let ignorant rants get you down By the Fibromyalgia Coach -Pam Wright. Carob Cake & Potato Scones -FM CookBook By Christine Craggs Hinton. Legal Questions answered by Brian Barr and Clare Primett . Letters Page. FM Resources:Phone Friends, Local Meetings information, Facebook and Twitter.This magazine is for informational purposes only and should not be used as a substitute for the medical advice or services of your health care providers. Every effort has been made to make this publication as accurateas possible. This information and adverts are not intended for self-diagnosis, treatment, or the justification for accepting or declining any medical treatment for any health problems or diseases. Any applicationof the information presented in these pages is at the reader’s own discretion. The advertising of a product ,therapy or clinic in FaMily does not imply that it has been tested or it’s use endorsed by UK Fibromyalgia.

In the autumn of 2011 we were lucky enough to receive a boost to group funds from the WaitroseCommunity Fund, in Witney. It enabled us to subscribe to Fibromyalgia UK!!! We also plan to investin a few books because some members find books to heavy to hold while reading. There is alsoa plan to advertise more widely in the community such as medical centres to increase awarenessof FM and support groups.Alma Tumilowicz, Group Leader.Helen Matkin demonstrating Health Kinesiology on volunteer-Niki Clarke.Wakefield and District Fibromyalgia Support Groupwww.fibromyalgiawakefield.org • fibrowakefield@gmail.com0844 887 2362 -office hours if possibleOur background story is on our website and we have now have grown to over 70 members in less than two years. We achieved ourOlympic award following our Fibrogames project that we ran last year to celebrate International Awareness Day. We are particularlyfortunate in the Wakefield district in that our NHS partners are very supportive and we are lucky to work closely with FamilyServices, LINK, local councillors etc. Our group also have their own chair based exercise classes which are proving to be popular.We meet every fourth Tuesday from 10.30 am till 1.00pm and in between times our social team organise outings, shopping trips,craft days etc. Not a week goes past that we don’t meet for something be it a coffee or a trip to Newcastle by train. Our idea is thatwhilst we might well have Fibro for life we will LIVE with it and enjoy life in the process.When I started the group I thought maybe four or five would appear for meetings but last meeting we had 41 members attending.This month we are having a talk by a reflexologist/nutritionist then the following month we are taking part in a silk painting classarranged for us by the NHS. In March we are hosting the Yorkshire and Humberside Regional group leaders meeting at a localcommunity centre but this is tying in with a Fibromyalgia Awareness day and Fayre. We have seven groups from as far afield asScarborough and Shipley coming along to sell homemade crafts, cakes, run raffles etc and the money raised will be for their group.It will give us all chance to meet and exchange ideas.The attached photos are of our Chairs famous Fibro Cupcakes, a few of us at a fund raising day at the local Rugby club and four ofthe Newcastle party enjoying a sneaky sherry on the train home!Our website was started with a donation from the local NHS Rheumatology Trust Fundand has received over 5000 visitors in less than twelve months. From the website I havereceived calls from sufferers from as far afield as Hong Kong (honestly) and Scotland. Ourgroup are currently trialling a new booklet for FMA UKcalled a Care Plan. This is a tool to be used by boththe patient and their carers be that at the hospital,dentist or whatever. So far the trail is proving verysuccessful with everyone feeling it is a very usefultool. Hopefully this will be run throughout the UK eventually as finance’s allow.We aim to continue with our success and to raise Awareness where ever we can as themore people are aware the more easily recognised the illness will become and hopefullyfuture sufferers won’t have to suffer as many of our group have done with along diagnosis time.June ChilversUK Fibromyalgia recently gave a grant to the Wakefield Group to help buya video cameraPage two - Supporting the SupportThe Fibromyalgia Magazine. Year 12 Issue 6. April 2012. www.ukfibromyalgia.com

Foods to Avoid By JB BardotDiscover which foods and chemical additives cause arthritisinflammation, gout and fibromyalgia painCertain foods and chemical additives disguised as food canaggravate or cause muscle and joint pain associated witharthritis, gout and fibromyalgia. Avoiding these foods canpave the way for reduced inflammation, stiffness and pain -setting the stage for on-going relief, with increased mobilityand a better mental attitude. Although it may be a challengeto avoid well-loved foods, keep in mind that many of thosefoods are causing widespread systemic problems that result indebilitating pain, so they are not your friends.Nightshade VegetablesThe nightshade vegetables are lesser-known offenders;however, for some people, eating any nightshade cancause excruciating pain and disability. This small family ofvegetables contains a natural substance called solanine; whenconsumed, it can produce severe pain in the joints and thesoft tissue, giving rise to arthritis and fibromyalgia flare-ups.The nightshades include tomatoes, peppers, white potatoes,eggplant and tobacco. Because several of these vegetables areincluded in so many recipes, special attention must be givento eliminating them from the diet. Smokers suffering fromarthritis might view the possible cause and effect relationshipof tobacco on their condition.Purine-laden ProteinsPurines are the by-product of protein digestion, and theybreak down into uric acid, the main cause of gout. All proteinsproduce some purines; however, eating certain types of proteinis more likely to create a gout flare. Red meats, organ meatsand shellfish are considered particularly harmful. Some peopleare more sensitive to one protein, so each should be monitoredfor its effects on the disease. Vegetable-based proteins, leanorganic poultry and fresh fish are excellent substitutes forthose foods eliminated.Wheat and GlutenWheat and wheat gluten are implicated in several diseases,including certain types of arthritis, fibromyalgia, and digestivedisorders such as irritable bowel syndrome, Crohn’s and celiacdisease. Wheat and gluten are especially harmful to the bodywhen highly processed, as in white flour where nutrients arecompletely stripped from the grain. Less sensitive people areable to eat sprouted wheat products without negative effects;however, eating a gluten-free diet may help reduce mostpainful joint symptoms.Trans FatsResearch has shown that eating trans fats can contribute tomusculoskeletal pain and aggravate gout, arthritis and a hostof other conditions. A diet including regular consumption offat-laden proteins found in most fast foods may aggravate orcause pain for many people with these conditions. Replacebad fats with healthy fats found in avocados, olives, coconuts,flax seeds and their oils.MSG and Artificial SweetenersFood additives and preservatives and artificial sweeteners areused in almost all packaged products; and they can cause awide range of mental and physical symptoms including jointand muscle pain. MSG -- in all of its disguises -- is knownto create a multiplicity of symptoms, especially in those whoare sensitive to this chemical. Severe joint and body pain,cognitive dysfunction, dizziness and headaches are just a fewof the side effects. Artificial sweeteners stimulate the pancreascausing an imbalance in insulin and blood sugar levels andcan produce body aches and pains as well as severe digestivedisorders and cancers. Replace MSG with spices to flavourfoods and use natural foods like raw honey and stevia assweeteners.Most people should experience a reduction in their muscle andjoint pain and an overall improvement in their conditions aftera period of avoiding these offending foods. Always consult ahealth practitioner before making any major changes in yourdiet.Sources for this article include:Harvard School of Public Health: The Nutrition Source -- Fats andCholesterolhttp://www.hsph.harvard.edu/nutritionsource/what-should-you-eat/fats-and-cholesterol/Hospital for Special Surgery: Eating Right with Arthritis: Arthritis NutritionFAQshttp://www.hss.edu/conditions_eating-right-with-arthritis.aspUniversity of Washington Orthopaedics and Sports Medicine: About Dietand Arthritishttp://www.orthop.washington.edu/uw/tabID__3370/print__full/ItemID__81/mid__0/Articles/Default.aspxHarvard Health Publications-Harvard Medical School: Arthritis--KeepingYour Joints Healthyhttp://www.health.harvard.edu/special_health_reports/Arthritis.htmUniversity of Michigan Health System: Gouthttp://www.uofmhealth.org/health-library/hn-1023001University of Maryland Medical Center: Gout -- Lifestyle Changeshttp://www.umm.edu/patiented/articles/what_specific_drugs_used_gout_000093_8.htmAbout the author:JB Bardot is trained in herbal medicine and homeopathy, and has a postgraduate degree in holistic nutrition. Bardot cares for both people andanimals, using alternative approaches to health care and lifestyle.Learn More: http://www.naturalnews.com/034679_foods_inflammation_gout.html#ixzz1kGyWd8hcPage four - Foods to AvoidThe Fibromyalgia Magazine. Year 12 Issue 6. April 2012. www.ukfibromyalgia.com

Page five - Friendly Fibromyalgia Fashion for Spring 2012Friendly Fibromyalgia Fashion for Spring 2012.Special Footwear Edition By Rosie Sanders.When it comes to fashion, footwear is just as important as theclothes. It makes or breaks an outfit. Whatever is in fashionin clothes applies to the feet too. For example, this seasonis carrying on from the last and has 2 defined and differentlooks. The first look is all about being whimsical with softshapes, pretty hues and delicate pastels vias being bravewith statement patterns/prints (especially tribal, tropical andanimal) and bright bold and metallic colours.Choosing suitable footwear can be bit of a nightmare, whenhaving to find something that’s easy to wear, accessible,practical, comfortable, provides support in all the right placesand still fashionable. Never mind adding into the mix, actuallyfinding something to your own taste, it’s a lot to ask and find infootwear. On my search to find the perfect pair of shoes to fit allmy needs, it wasn’t easy, as some days the thought of havingto put on shoes made me feel sick because my feet are so soreand swollen and so tired I just don’t have the energy to getthem on but then I discovered that in recent years collections,variety and availability of functional fashionable shoes hasimproved considerably and more and more company’s seem tobe realising that there is a need for them. People are realisingthat what you put on your feet, has further purposes than tolook nice and by not wearing the appropriate footwear, it cancause further pain and health problems.Here are my suggestions and choices that cover all of theabove and hopefully more.Essential - Is the Hotter Comfort Concept, who specialise ingiving individual attention to guarantee the ultimate, lightweightand comfortable feel to shoes for men and women, ensuringyour feet are as stylish as they are snug.They provide a widerange, each shoe has itsown individual name,style and features.Seemingly trying to caterfor every need with softpadding and supportfor ankles, naturalbreathable leathers andlinings, smooth internalseams (so no rubbing),supportive flexible soles and even come in extra wide fittingsand half sizes (which is a joy for me for as I’m a 7.5 and cannever usually find them) and that’s just the basics! For thisseason my favourites are the “Faith”, a really good all yearround shoe with light air filled soles, unbelievably supportiveand really soft and flexible too, also now available in newlovely pastel on trend colours. If feeling bold, the “Hollie”comes in raspberry or teal with a beautiful feature flower onthe side, has a soft antibacterial foam cushioning with an easytouch close fastening. They even have the must have shoe ofthe season -the loafer, its called “Etna” has microfibre-linedheel, fresh removeable insole and available in 6 differentcolours. And for the men, the “Vulcan” shoe is waterproof,breathable and durable. Prices start from £59, free p&p andfree returns. A free catalogue is available (which includes apersonal handy size guide,so you can measure yourfeet, ensuring you order theright fit for you) phone 0800525 893 or contact websitewww.hotter.com, also thereis a link from our fibromyalgiashop website. Hotter alsodo a range in handbags andaccessories.Pick - Is fitflop shoes, i havementioned fitflop before butthe company has expandedits variety and choice overthe last 2 years, it’s incredible. The shoes, boots or sandalshave the potential to increase leg muscle activity and absorbmore shock which relieves joint stress, alleviates foot pain andreduces foot pressure, also known to help circulation too. For thisseason I recommend the FF Supersneaker, very comfortablebut supportive and easy to wear and comes in some fantasticcolours (for example-very on trend stunning bold purple withmetallic detailing and even in this season’s must have leopardprint). I’ve even converted my husband who also has a pairand says they’re themost comfortableshoes he’s ever worn,(like walking oncushion’s) and he’s adifficult customer toplease when it comesto shoes. I recommendtrying shoes on instore if you can, as size and weight can vary between styles.Available from fitflop.com, which has a sale on at moment, socatch a bargain while you can, the supersneaker starts at £50but there are many other styles, in a full range of sizes andcolours for men, women and even children. Also available onamazon.co.uk via fibromalgia shop.For further options in light, flexible, and shock absorbingshoes, Rieker and Gabor are also very good, slightly moreexpensive but do have diverse ranges, styles and fits andsome stunning dress shoes for a special occasion. Both caterfor men and women, available from many stores or direct fromriekerfootwear.co.uk or gaborshoes.co.uk.Finally - Super comfy and supportive shoes isn’t enough,proper foundations are needed or there is no point, which iswhy I recommend Cosyfeet seam-free, soft hold, elastic freesocks. Extremely comfortable and soft, barely tell your wearingthem. They have a massive diverse range, style and size,catering for every need for men and women. Cosyfeet alsodo ranges in tights, stockings, slippers, toe care products andmobility aids.A free Cosyfeet catalogue is available- phone 01458 447275 orcontact cosyfeet.comThe Fibromyalgia Magazine. Year 12 Issue 6. April 2012. www.ukfibromyalgia.com

THE DREADED BROWN ENVELOPE!!By Helen Watts from the ForumDo you get nervous every time you hear the post comethrough the letter box? Do you hope that there are nobrown envelopes laying on the mat? If you’ve answeredyes then you are not alone. Contrary to the popular opinionof the media being on benefits is not easy. At times it isan endless round of form filling, assessments, medicalsand interviews. You become terrified of opening brownenvelopes for fear of reading about more hoops you’ll haveto jump through or the ultimate fear of losing your benefit.This all adds up to making us feel very stressed which inturn can lead to a flare up.The benefits system is a complete minefield and veryconfusing. The forms are extremely long and very complex.The forum has always had a lot of topics on benefitsdiscussed, in fact there is a whole section devoted to Workand Benefits. ESA,ATOS and Medicals‘mellabella’ posted that she felt the ATOS questions seemedstupid and utterly unconnected to most medical conditions.The questions they ask seem to presume that unless youcan prove you have the intelligence of a 2 year old thenyou will be found fit for work. She felt the questions weredesigned to trap people.‘Bobbio8’ replied that when she had her ESA medical shegot handed an envelope and was asked if the postmangave it to her would she be able to take it into the house?She felt this was to try and catch her out and it made hervery upset with the way the system treats people and theirdisabilities.‘Fliss’ asked about medicals, she is really worried abouther impending medical. She wanted to know what sheshould wear, should she do her hair, should she try to useher sticks instead of her wheelchair.‘Ldyalb’ replied that if you are currently using a wheelchairthen you should go to the medical in it and explain whyyou’re needing it. She said people should be aware thatnot all medical assessment units are wheelchair accessible,which sounds mad but true. If you are in the wheelchairand you find when you get there that it is not accessiblemake sure that you stay in the chair, they’re are doingthis to try and trick people to see if you can get up andwalk into the room. With regards to what to wear Ldyalbadvises that you wear things you normally wear, tracksuitbottoms etc, anything that is easy to dress in. Ldyalb saidshe has got her medical soon and plans to wear somethingcomfortable. She said she’s not going to put any makeupon as she doesn’t normally wear it indoors and she wantsATOS to see the dark circles under her eyes which showhow tired she is and how she struggles to sleep.DLA‘Beki’ came on to say that she had been refused DLA andwas upset. She said that apparently according to DWP sheis able to do everything she told them she couldn’t do. Shefelt that they honestly didn’t have a clue about fibro andseemed to think that we all like to pretend we have thisand make our lives difficult in the things we do. Beki saidshe would love them to live a week in her life, although shedoubted that they’d cope, just so they could understandjust how agonising, degrading and difficult everything is.She says she needs help to do most things and finds itdepressing that they make you out to be faking it all.‘Daisymay’ posted that she was about to fill in theapplication forms for DLA and what a mammoth task itseems when she can’t remember anything. She doesn’twant to make any major mistakes through not knowingwhat they are getting at with each question. She asked ifthere was anything she should be aware of that is reallyimportant for her claim.‘FluppyPuffy’ replied that the forms are a nightmare and itcan be easy to read things one way when it was meant tobe answered in a totally different way. She suggested thatpeople should seek help with form filling from CAB, DIALand Welfare Rights etc as the people there understand whatis being asked and the best way to answer the question.As you can see this is an extremely confusing area andit is important that you get advice with the form filling inorder to give yourself the best possible chance of a goodoutcome. The Benefits and Work site has invaluable guidesto filling in forms and lots of information on ESA, DLA andalso on PIP which is what DLA is planned to become. Theweb address is www.benefitsandwork.co.ukYou will also find these subjects regularly being discussedon our forum so come along to the forum for support or toask questions.Helen WattsThe Fibromyalgia Magazine. Year 12 Issue 6 April 2012. www.ukfibromyalgia.comWhy not try the UK Fibromyalgia Forum yourself?There are thousands of fibromyalgia sufferersjust like yourself who can shareyour thoughts and worries.Visit www.ukfibromyalgia.com and click on the“Forum” link in the left hand margin.Page six - Online Forum

THE PAIN CLINIC:Moving on… by Jan Sadler ofPainSupport www.painsupport.co.ukPage seven - The Pain Clinic: Moving on…Living with pain can have a huge impact on your life creatingmany different levels of feelings about what you have lost.Perhaps we face job, financial and status loss; there is alsothe potential loss of friendships and other relationships. Andnot only may we lose our previous way of life but we maylament the loss of our hoped-for future.One of the most difficult feelings of loss is the loss of ouridentity, self-image and confidence. At the time when weneed most support we may meet with criticism and evendisbelief, so it’s not surprising that we may experiencelow mood, anxiety, anger, isolation, loneliness, and othernegative feelings - we want things to be the same as theywere before!We can’t wave a magic wand and make that happen butwe can show you ways to move forward. You are not alone,there are plenty of us on this same journey and we can shareideas and support one another to get through these negativeevents and feelings and build a new fulfilling life. Here aresome creative and constructive starting points to help youon your way.Feelings First: Allow yourself to feel and express yourfeelings, in writing or out aloud, for what you have lost. It’snormal to feel fearful, angry, sad and unhappy. Express yourfeelings of loss, and then begin to move on to finding waysforward.Healthcare: Establish a good relationship with a supportivehealth care team, including your doctor, a support group,friends, counsellor, therapists, etc. Find out all you can aboutyour condition and be pro-active in your treatment. This willhelp regain a sense of control and boost your self-esteem.Activities: Set reasonable, and realistic, goals for yourself.Adapt and modify what you do and look for new activities tofulfil yourself. Include plenty of fun!Communication: Keep lines of communication open withpartners, friends and family members to avoid resentmentsbuilding up. Think about the best way for everyone’s needs tobe met as far as possible. Use the PainSupport Contact Cluband/or Discussion Forum to look for some new friends whowill understand your situation.Body and mind: Value your own company, nurture and buildyour confidence and self-esteem. Listen to your body as itreally will tell you what it needs. Do things that you know aregood for you. Follow a healthy diet, pace your activities soyou don’t overdo things, take gentle exercise and appropriaterest. Take time to enjoy pampering and nurturing yourself.Make peace with your pain: Let go of others’ expectations.Do what you need to do for yourself. Don’t think of your painas an enemy, perhaps regarded it as your fellow traveller withneeds of its own. Rather than resist your pain, see if you canaccept and flow with it, taking care of it.By taking on even one of the above ideas you are on theright track. There is no right or wrong way to win through, butall of the above ideas will certainly help to give you a morecontent, peaceful, useful and fulfilling life.Moving on from loss isn’t a “do it once and you’re done” task,but more of a continuous undertaking. Feelings of loss andsorrow will arise from time to time because of circumstancesyou encounter or because of a change in your condition, butthe way through will be very similar. The underlying idea is toexpress your emotions, accept what has been lost and thento focus on positive and constructive ways to help yourself toforge a new and different, and possibly even more fulfilling,life than before.Always remember your self-worth is not based on yourphysical limitations. You are much MORE than your pain.HOT TIPFind new friends in the PainSupport Contact Club andDiscussion Forum:Discussion Forum -http://www.painsupport.co.uk/connect/dfviewtopics.aspContact Club -http://www.painsupport.co.uk/connect/contactclub.aspThe Fibromyalgia Magazine. Year 12 Issue 6. April 2012. www.ukfibromyalgia.com

Keep Energy Levels HighCoping with pain is tiring. Help to keep your energy levelshigh by eating little and often - say every three hours. Thiswill help to keep your blood sugar up and your energy on aneven keel. Choose fruit, nuts or honey on toast. Reduce yourintake of coffee and alcohol, they give you an energy surgebut unfortunately it’s followed by an energy slump.Website RecommendationPainSupport member ShirleyAnn recommends the Let’s TalkPain Websitewww.letstalkpain.org/index.htmlShe says they also offer a free download of a pain Journal:www.letstalkpain.org/resources/journal.htmlFree to You.We have lots of goodies for you…Newsletter and pain relief ToolkitSign up for monthly email newsletter and pain relief Toolkit:signmeup@painsupport.co.ukStress Reducing TipSpend some time alone and quiet every day, even if it’s justfor ten minutes. Practice doing nothing, or nearly nothing. Youmight spend the time in your bedroom, a special quiet placeor take a short walk alone.And relax some more with one of our CDs or downloads. Eachone has beautiful visualisations and wonderful imaginaryplaces to explore.www.perfectrelaxation.com/generalrelaxationcds.htmorwww.painsupport.co.uk/products/cdsdownloads.aspRelaxation Tips.Download our two collections of relaxation tips:http://www.painsupport.co.uk/enewsletter/relax1.htmhttp://www.painsupport.co.uk/enewsletter/relax2.htmPain Logs.Print as many copies of the Pain Logs as you need. They willhelp you keep track of your pain and find out what affectsit. They can be used for medical consultations to show yourdoctor how your pain affects you:www.painsupport.co.uk/enewsletter/painlevelslog.pdfwww.painsupport.co.uk/enewsletter/painfeelingsandactivitylog.pdfContact Others.Join or Login the Discussion Forum and/or the Contact Club:http://www.painsupport.co.uk/pages/forumclubintro.aspIt worked for me!Bronwen, one of our PainSupport members sent in this tip,“I have been given an Acticare electronic unit to try by thePain Clinic I attend. It looks like a TENs unit but works bymodulating the nerve signals of chronic pain. It does not takethe pain away but dulls it sufficiently to help me cope. I likeusing it instead of analgesics as a first call with the pain -and I take fewer analgesics now that I am using the Acticareregularly every day. Bron”Acticare units are said to work in a more effective way thanstandard TENs machines.www.acticare.comPlease tell us!!If you try any product or therapy that helps you in some way,please let us know, even if it only reduces symptoms a little,as it may help others too.ItWorkedForMe@PainSupport.co.ukGel for Massage or TENs‘Purevive’ Gels are water-based gels with herbal extracts thathave been especially developed for use with TENS or formassaging into those hurting places to relieve pain. Let usknow if you try them!Ask for a free trial from:www.win-health.com/purevive.htmlWords of wisdom“Develop interest in life as you see it, in people, things,literature, music -- the world is so rich, simply throbbing withrich treasures, beautiful souls and interesting people. Forgetyourself.”Quote from Henry MillerEditor’s NoteI hope you find the above ideas useful. For more informationand ideas for pain relief, please go to the PainSupport and/orPerfect Relaxation websites, addresses below.All best wishes – and keep smiling!Jan at PainSupportwww.painsupport.co.ukwww.perfectrelaxation.comFind us on Facebook:http://www.facebook.com/PainSupport.ukCopyright © Jan Sadler 2012Page eight - The Pain ClinicThe Fibromyalgia Magazine. Year 12 Issue 6 April 2012. www.ukfibromyalgia.com

Page nine - Christine’s Cookbook & Dear PamChristine’s RecipeFor those of you who struggle to find recipes forbaking that are not loaded with unhealthy sugars andfats, the following should be helpful:Carob CakeMakes one 20 cm (8 in) cake3 organic free-range eggs, medium sized3 tbsp raw honey125g (5ozs) organic stoneground wholemeal flour25g (1oz) carob flour (sometimes called carobpowder)100g (4oz) dates2 tsp dessicated coconutPlace the eggs and honey in a blender and combine.Mix the two flours together, then add gradually tothe eggs and honey, whisking between additions.When thoroughly mixed, pour into a greased andlined 8in sandwich cake tin and bake in the centreof the oven for about 20 mins at 170C (350F). Allowto settle for a couple of minutes, then turn out into acooling rack. Although the result will look like a pieceof old tyre, it should taste really good!Potato SconesMakes 12 scones100g (4oz) potato, cooked75g (3oz) ground rice25g (1oz) lentil flour (gram flour)50g (2oz) olive oil25g (1 oz) muscovado sugar2 eggs, beaten150ml (1/4 pint) rice milk1 tsp bicarbonate of sodapinch of cream of tartarBeat the cooked potato to a smooth purée with themilk and egg. Mix all the dry ingredients togetherand add the olive oil. Fold the flour mixture into thepurée. Immediately spoon the mixture into smallheaps on a greased baking tray, or use a greasedbun tin. Cook in a pre-heated oven at 220C (425F) for15-20 minutes, until brown.Christine Craggs-Hinton is the author of ‘Living withFibromyalgia’, The Fibromyalgia Healing Diet’ and ‘TheChronic Fatigue Healing Diet’, from Sheldon Press. Theyare available from the www.ukfibromyalgia.com websiteand from all good book shops.Dear Pam,Life Coach Pam Wright is here to answer yourquestions on managing life with Fibromyalgia.Email Pam at office@ukfibromyalgia.com orwrite to Dear Pam Fibromyalgia Magazine7 Ashbourne Road, Bournemouth, Dorset BH5 2JSDear PamI’ve always taken a pride in my appearance, withmake-up and nail polish on every day. Since havingFM my nails hurt when I put on the polish, and thereare days when I just can’t be bothered to put onmake-up. I feel I’m losing my identity and I’m gettingdepressed. Any ideas?JulieDear JulieHow you feel about yourself is an important part ofmanaging your FM and minimising its effect on yourlife. Everyone is different; for you, your makeup andnails are an important part of your identity; for othersit could be even more basic things that are top oftheir priority list.Be your own best friend at this time. You are stillyou, with or without your makeup and nail polish.There will be some days when you need to use yourenergy just to keep warm, fed and comfortable. Gowith the flow on these occasions particularly as everyday is different. Take each day as it comes and makedecisions according to how you feel on that day, oreven hour by hour. Lots of people with FM becomesuper-sensitive to the chemicals in beauty products,so it might be good to do some research on findingnail polish that is more FM friendly than the ones youhave at present.PamThe Fibromyalgia Magazine. Year 12 Issue 6 April 2012. www.ukfibromyalgia.com

ASKBRIANBrian Barr is a solicitor at Brian Barr Solicitorswho specialises in representing fibromyalgia suffererswith accident and insurance claims.ASKclareClare Primett is a solicitor from DF Legal LLP whospecializes in representing fibromyalgia suffererswith employment law issuesDear BrianI suffered a neck and back injury as a result of a roadaccident in 1998. I instructed solicitors, the other partyadmitted liability and I settled my claim for £2,100 inJanuary 2000. I was never told that I might developfurther symptoms in the future.In 2004, my neck and back pain flared up and I wasdiagnosed with fibromyalgia in 2005. My specialistseems to think that the accident in 1998 is the cause ofmy fibromyalgia. Is it possible for me to either:• receive additional damages from the person whocaused the accident in 1998? or• make a claim against my original solicitorswho may have been negligent for under-settling myclaim?SallyDear SallyAs you have already agreed a settlement with theDefendant in relation to your accident in 1998, solicitorswould not be able to re-negotiate a higher settlement.In any event, as there was a six year gap until yourfibromyalgia symptoms began, I believe that it wouldbe very difficult to link your accident in 1998 to yourfibromyalgia.It is therefore also unlikely that your previous solicitorswere negligent as your chronic pain symptoms wouldhave had to be present before your claim was settled.You would also have to show that your previous solicitorsshould have known of your condition from your medicalrecords or instructions.Additionally, a claim for professional negligence againstyour previous solicitors would have had to be broughtwithin six years of their negligence i.e. by January 2006,so you are considerably past this time limit.Brian BarrBrian Barr Solicitors has moved to:Grosvenor House, Agecroft RoadManchester M27 8UWTel: 0161 737 9248 Fax: 0161 637 4946Email: info@brianbarr.co.ukDear Clare,I have had problems at work and have not been able tosecure the reasonable adjustments I think I need to continueat work. I would like to work reduced hours, and these weregranted but every time work is busy they put my hours backup. I am therefore completely exhausted and have beenoff work for the last 12 weeks. I have been told as I havealready had a further 5 weeks off earlier in the year I maybe dismissed for ill health/capability. Can my employer dothis and what are my rights?A: If your employer does dismiss you they will have toprove a fair reason for dismissal i.e incapability and showthey have not discriminated against you. They will have toshow a rigorous and fair procedure to get to the point ofdismissal as well as having considered medical records ororganized their own Occupational Health Report.There are two basic claims you can make under the EqualityAct 2010 for disability discrimination 1) a breach of the dutyto make reasonable adjustments and 2) that your employerhas treated you less favourably. Usually the second istriggered on dismissal but it can be triggered by singlingyou out for poor performance or for having a bad sicknessrecord. Any claim must be brought within 3 months of thelast discriminatory act and can be brought while you are stillin employment.If you are actually dismissed then the less favourabletreatment can be deemed as the dismissal itself and maytrigger not only a claim under the Equality Act of disabilitydiscrimination but also a claim for unfair dismissal. Anyclaim must be in within 3 months of the discriminatory actfor discrimination and within 3 months of the terminationdate for unfair dismissal.The usual remedy is compensation, an award for injuryto feelings for discrimination and a basic award and acompensatory award for loss of future earnings for unfairdismissal. However note this last head of loss can bereduced if you are simply too ill to look for/ or to work.Clare PrimettIf you have any employment queries relating toFibromyalgia please e-mail office@ukfibromyalgia.If you are a Fibromyalgia sufferer, and think youcome within the above definition of disability and arehaving problems at the workplace please contact ClarePrimett at DF Legal T: 01531 633 222 or e-mail office@ukfibromyalgia.Page ten - Ask Brian & Ask ClareThe Fibromyalgia Magazine. Year 12 Issue 6 April 2012. www.ukfibromyalgia.com

Living with Fibromyalgia: What Helps MeBy Kathy Gamble, RNPage eleven - Living with Fibromyalgia: What Helps MeWhen I was diagnosed with fibromyalgia, it felt like the laststraw in my world coming apart. My divorce had been final themonth before, and the year had already been filled with otheremotional traumas. While I was grateful that the diagnosisexplained the aches and the fatigue I had experienced forseveral months, having a chronic illness felt like one moreloss.My doctor reviewed with me a short list of options fortreatment of fibromyalgia that included medications as wellas other treatments such as heat, massage and stretching.He also advised staying as active as possible and suggestedsomething I found amusing: “Eliminate unnecessary stressin your life.”I was taking only over-the-counter pain medications and didnot want to start more medications yet. I preferred to see howI could manage on my own first. I was still working full-timeas a nurse and I rarely missed work due to my symptoms.Most days I did okay, so I thought I would just continue onas I always had. I functioned at 75 on the CFS & FibromyalgiaRating Scale - www.cfidsselfhelp.org.Looking for AnswersHowever, in my secondyear with fibromyalgia, myhealth declined. I wouldcome home from work andcollapse in bed, unable andunwilling to move. Eachmorning brought anotherstruggle to get out of bed,and I would drag throughwork. This daily grind ofdragging myself out of bed,struggling through the dayand then collapsing whenI got home did not seem tobe much of a life. I was tooexhausted to do anythingelse that had been helpful to me before - all I wanted to dowas rest!But I knew I couldn’t keep on like this, so I started to look formore answers. The thought that there might be other waysto manage this condition motivated me to look for moreinformation on fibromyalgia. Usually if one is ready to learn,the teachers appear and I found this to be true for me in thiscase.One teacher was a book by Stacie L. Bigelow titled Fibromyalgia:Simple Relief Through Movement. The author comparedthe muscles of a person with fibromyalgia to wet concrete.She stated that if muscles aren’t moved frequently, they canstiffen and set, just like real concrete does. She explainedhow movement can assist with feeling better from the painof fibromyalgia. (Ed this book is available at http://www.fibromyalgiashop.co.uk/ for £10.79 )I found this book to be extraordinarily helpful. It distinguishedbetween “movement” and “activity” on the one hand and“exercise”. I learned that I would feel worse if I stayed in oneposition for too long. I began to pay attention to how longI was sitting in a meeting, working at a computer, or evenlying down and resting. I found that a change in position,moving around, or walking briefly, meant less soreness andstiffness.Self-Help and GuaifenesinShortly after reading the book, I started exploring the About.com section on Chronic Fatigue Syndrome and fibromyalgia.This is where I found out about the CFIDS Self-Help course,now called the CFIDS & Fibromyalgia Self-Help course.The course was described as a “blending of CognitiveBehavioural Therapy with group support and principles ofself-management”. The description was appealing to me,because it seemed consistent with what I was graduallylearning: that I was the best manager of my condition andcould learn what was helpful and what was harmful to me.I signed up.I found in the class that there were other people like meacross the US and in other countries. Plus, there seemed tobe hope, as specific behaviours were identified that couldhelp to manage the symptoms. The course textbook alonewould have been a benefit, but to have a group that workedthrough the chapters together was even better.I also continued to explore the CFS/FMS section of About.com.It was here that I first read about the guaifenesin protocol, andpeople who claimed wonderful responses to this treatment. Ichecked out the linked websites: www.fibromyalgiatreatment.com andwww.guiadoc.com. I was intrigued, so I orderedthe source book, What Your Doctor May Not Tell You AboutFibromyalgia, by Dr. Paul St. Amand. .(Ed this book is availableat http://www.fibromyalgiashop.co.uk/ for £14.95 )I started the guaifenesin protocol on my own, as I am a nurseand since I had taken guaifenesin previously for coughs. Afteronly a few days, I noticed that I had some energy again. Myenergy kept improving for the first month or so, and I didn’tseem to have any of the expected worsening symptoms. Butthen I experienced the first of several “reversal cycles,” inwhich my symptoms worsened and I felt as bad as beforestarting the treatment. But these have faded over time and Icredit guaifenesin with helping to improve my quality of life.What Works for MeIn the three years since being diagnosed with fibromyalgia, Ihave encountered various treatments, activities, and learningexperiences. I do have to admit that I really wanted somethingto “cure” my fibromyalgia. I wanted to get rid of this condition,like taking an antibiotic for an infection.The Fibromyalgia Magazine. Year 12 Issue 6 April 2012. www.ukfibromyalgia.com

I know now there is no single panacea for treating thiscondition. But I have discovered ways of being and copingthat have worked for me in managing my health withfibromyalgia. Here is what I have learned so far, what I havefound helps me:Resting - I rest when I need it, and also when I think I don’tneed it. When I listen to my body, it tells me when I need torest. I do much better when I listen and respond appropriatelythan when I ignore what I am trying to tell myself. I had tolearn to rest, as I was used to using my time “productively.” Ihad to learn to stop and rest, and use the self-help course’sdefinition of rest: lying down with eyes closed in a quietenvironment. Being on the phone or watching TV while lyingdown did not qualify as rest.Sleeping well at night - My outlook on life improvesdramatically when I have had a good night’s sleep. In contrast,if I am awake all night or even part of the night, the next dayis difficult. To help me sleep better, I had to quit staying uplate, eliminate stressful evening activities (like being on thephone), and identify what could help me get a good night’ssleep. This includes going to bed by 10 p.m., taking 20 to30 minutes for reading or prayer, and using medications, asdescribed in the next section.Taking medication as needed - Besides the dailyGuaifenesin, I also take Ibuprofen (Advil, Motrin) during theday as needed, and a dose of Naproxen (Aleve) at night. Ialso have a prescription for a muscle relaxant that I take onlyat night which usually helps me with sleep. Sometimes I willadd in an Excedrin PM tablet to help with sleep.Using low heat - Either a heating pad or an electric blanket,depending on how much and where I ache. If I turn the heatup past low, I start to feel worse. A warm bath also helps!Avoiding certain foods - I read the Sugarbusters book, TheZone, and the dietary guidelines in the book on guaifenesin.While I don’t adhere to all their principles, I do feel betterwhen I keep to the guidelines than when I don’t, particularlyin avoiding foods with white sugar.Moving/activity - I feel better if I take “walk breaks” at workor have some sort of change in position if I have been sittingfor more than 30 minutes. As mentioned earlier, I learnedthis from reading Stacie Bigelow’s book. Mild stretching in themornings or in the evenings also helps to decrease some ofthe aches and soreness, particularly in my lower back.Being aware of how I feel - Denying my pain and not payingattention to myself and how I feel can lead to my feelingworse, so I have learned to adjust and do what helps me. Atthe same time, it doesn’t help me to ruminate on how bad Ifeel, because then I feel worse and notice the pain more.Limiting social activities and having a quiet home life -Being around a lot of people is hard on me, and I have thatsituation every day at work. So when I get home, I usually letthe answering machine take the calls, and I keep to myselfwith just me and my children. It helps me to be at home inquiet surroundings and to be peaceful.Planning for work - It helps me to have some control overmy work hours. Having to be at work very early or stayinglate is hard on me but manageable one or two times a week,as long as I plan for how I will make up for it on other days.Also, I have learned that I am more effective if I set a limitednumber of priorities for each day. Otherwise, the details canoverwhelm me.Reframing - I don’t have control over what happens in myday, but I am working on determining how I will react to whathappens. Sometimes that means choosing not to react ornot to respond. For example, I get a lot of emails at workthat contain new assignments or requests for information.Some are rather demanding. If I responded immediately toevery one of them, I would spend time and energy on thingsthat may be better handled another way. Now I choosewhether to respond immediately or answer later when I havehad an opportunity to think it through or talk with othersfirst. Sometimes I choose not to answer at all, and that hashelped me on several occasions. I have either followed upwith a phone or a conversation in person to explain. Thesestrategies have often kept me from reacting negatively touninvited demands.Scheduling in recovery time - By scheduling planned timeto rest, I can help defray some of the excesses as they comeup. For example, if I have to stay late at work one day, thenI may leave early the following day. Likewise, when I havecompany during holidays, I set aside days before or afterwhen I can have time by myself to rest. By planning for andscheduling my needed recovery time in advance, I am morelikely to stick to it. This strategy helps me decrease additionalpain or flares from overdoing.Seeking help from outside sources - When life becomestoo much for me, I seek help from outside sources. I haveparticipated in some online and in-person 12 step groups,and I entered counselling. Both have been extraordinarilyhelpful. Also, allowing and requesting help from othershas been helpful. Sometimes this has resulted in positivedevelopment for others, as well as decreasing my burdentremendously.Praying/meditation - I have found that particularly in timesof increased symptoms, simply to be quiet and reflect or praycan have a very calming effect.Scheduling massages - It may be painful at the time, but Iusually feel better afterwards.Utilizing aromatherapy - Particularly lavender and some ofthe citrus scents, either in candles that I burn or in lotions.Page twelve - Living with Fibromyalgia: What Helps MeThe Fibromyalgia Magazine. Year 12 Issue 6 April 2012. www.ukfibromyalgia.com

Page thirteen - Living with Fibromyalgia: What Helps MeTaking the self-help follow-up courses and participatingin the alumni group - I participate in two groups offered tograduates of the CFIDS & Fibromyalgia Self-Help class: followup courses and an alumni group. The follow up courses focuson helping people reach short-term goals. Despite knowingwhat I need to do to manage fibromyalgia, putting it intopractice is not always easy. The follow up courses have beenone of the best opportunities for putting knowledge intopractice through making weekly targets. Even when I don’tmeet my targets, I learn more about myself and what I cando to manage this condition. The alumni group provides anopportunity for on going support plus discussion of topicsrelated to living with chronic illness. We all continue to learnfrom each other through our responses. We also can keep upwith one another through the monthly “check-ins” with ourresponses.Making a NOT TO DO list - I pick up up this wonderful ideafor me from the program’s site! It helped to know what thingsI consciously wanted to avoid.Over all, my quality of life has improved dramatically usingthe strategies I’ve described. I rate myself currently at 90on the CFS & Fibromyalgia Rating Scale. I am not back to“normal,” but I’ve learned that that is OK. I don’t want to beas driven as I was before getting fibromyalgia. I have a clearerunderstanding now of my boundaries and I do well as longas I stay inside them. It took some time, but I finally learnedthat I have to respect and honour my body, and listen to themessages it gives me. The messages are to slow down, tolearn to “be” and not just “do,” and to focus on what is reallyimportant.[Editor’s Note: Kathy Gamble, a fibromyalgia patientfrom Florida and graduate of the CFIDS/FibromyalgiaSelf-Help course, works full-time as a nurse.] To order telephone 01202 259155Self-Help Course for CFS/ME & FibromyalgiaLearn practical skills for managing your illness and share supportwith fellow patients in a low-cost six-week self-management course,conducted via emailThe class explains how to manage your symptoms, and discusses pacing,stress management, relationships, emotions and loss.Offered by US charity CFIDS & Fibromyalgia Self-Help Program, which hasconducted several hundred groups since 1998.For more information and to register, see: http://www.cfidsselfhelp.org/The Fibromyalgia Magazine. Year 12 Issue 6 April 2012. www.ukfibromyalgia.com

The Cyclo-ssage Pro Personal 7-day Fibromyalgiaproduct trial started in January this year, and Iam pleased to announce that they have had anoverwhelming response from UK Fibromyalgia readersvolunteering to take part.To meet demand for the 7-day trial Cyclo-ssage haveextended the Trial from 3 months to 12 months to tryto cater for as many FM sufferers and Focus groupsas possible. They have also had to develop a mini trialallowing individuals who are unable to participate inthe 7-day trial the opportunity to give feedback from 2therapy sessions in the comfort of their own home.Cyclo-ssage has designed The System with home use inmind. The infra-red heat areas have 3 heat adjustmentsand the Therapy motors are also adjustable in intensityfor comfort. The System has 5 Manual Therapy Settingsand 9 Medical Programs. One of the medical settings(medical program 4) has been developed to benefitthe sufferers of Fibromyalgia and M.E, by relaxingthe muscle spasm commonly experienced and thusalleviating the all over ache that plagues most people.At the same time it will also stimulate both Blood andLymphatic circulation and bearing in mind that 80% ofall ailments affect the circulatory system, you shouldautomatically feel a physical benefit, whilst enjoyingvastly increased energy levels!With regular twice daily use of the System it wouldappear that one’s quality of life can be greatlyimproved.Preliminary results shown below are from participantsfrom various parts of the UK that have seenimprovements after just 2 x 15 minute therapytreatments. Pain levels significantly drop and some veryfortunate FM sufferers have seen their pain disappearaltogether with effects lasting over 12 hours.All Trial volunteers will be contacted during this comingyear but as Cyclo-ssage are trying to conduct this Trialalongside their usual busy work schedule it mightbe sometime before they are able to arrange a Trialwith all FM sufferes who have volunteered. Howeveras you can see from the preliminary results table theaverage reduction in pain scores of nearly 50% arevery encouraging.www.cyclo-ssagetrials.com Email: admin@cyclo-ssagetrials.comAlternately contact Mr. Mark Stephenson 07919 146239Individual Pain score before Pain score after Pain score after Pain score after1st treatment 1st treatment 2nd treatment 2nd treatmentMrs. R (Hale) 6 4 4 3Mrs. S (Corby) 9 5 5 3Mrs. L (Ipswich) 9 7 7 6Mrs. P (Llanelli) 6 6 6 6Mrs. C (Swansea) 5 3 5 3Mrs. G (Port Talbot) 8 6 6 4Mrs. B (Norwich) 6 4 4 3Mrs. D (Warickshire) 7 5 5 5Mrs. D (Norwich) 3 2 3 2Mrs D (Norwich) 5 3 4 3Mrs. S (Norfolk) 5 5 5 5Mrs. J (Dudley) 8 7 6 5Mrs. D Rugby 9 5 6 4Mrs. H (Harvington) 5 5 5 0Mrs. P (kidderminster) 5 4 4 1Mrs. E (Atherton) 8 5 5 4Mrs. E (Birmingham) 7 3 3 2Mr. H (Pershore) 5 2 2 0Mrs. G (Oldbury) 8 6 6 6Mrs. T (Wolverhampton) 4 2 2 0Mrs. B (nottingham) 3 0 0 0Mrs. B (Nottingham) 7 5 5 3Mrs. D (Milton Keynes) 7 2 2 0Mrs. P (Notts) 8 5 5 2Mrs. B (Kent) 3 2 2 1.5Mrs. F (Milton Keynes) 4 2 2 1Mrs. H (Notts) 4 0.5 0.5 0Mrs. M (Kent) 6 7 7 6Mrs. W (Bexhill) 8 7 7 5Mrs. S (Conwy) 5 2 2 1Mrs. L (Shrewsbury) 8 7 8 6Mrs. B (Oswestry) 7 6 6 5Mrs. M (Kent) 7 0 1 0Average 6.21 4.08 4.26 2.89Percentage decrease in pain score after the 1st treatment –52.12%Percentage decrease in pain score after the 2nd treatment - 47.2%Page fourteen - CyclossageThe Fibromyalgia Magazine. Year 12 Issue 6 April 2012. www.ukfibromyalgia.com

Helen LewisB.A. Hons, Dip. MBACP [Accred] UKRCP. Dip Sup.CounsellorFMS can impact on all aspects of lifeWould you benefit from a safe place to explore thisand other issues?I can offer a supportive environment withface to face or telephone counsellingOver ten years experience of counselling clients withlong term health issues including FMSand MPSNo charge for initial consultationTel: 01225 [Bath] 442176email: helew@vodafoneemail.co.ukwww.bath-counsellor.co.ukTAKE ABREAK INTENERIFEComfortable one-bedroomground-floor apartment to letin a quiet area ofLos Cristianos, Tenerife, butwith plenty of goodrestaurants, shops and barsclose at hand.The complex boasts a securityentrance, large swimmingpool, bar, restaurant,supermarket, car hire and anexcursion shop.The complex is a slow 10-minute walk to the beach, with amobility shop that rents out wheelchairs anddisability tricycles close by.Prices: £225 per week for two people, and £40 extra eachfor a third and fourth person.For year round sunshine, come to Tenerife!TEL. 0034 922 796715, ANYTIME.MOBILE: 0034 665 344232email: cc.hinton@virgin.net

Fibromyalgia Medications: TrazodoneBy Dr Colin Dell.This month’s article picks up on some research that hasonly recently been published. It concerns a drug calledtrazodone. Also known as molipaxin, trazodone is marketedfor depression and anxiety in adults. Whilst trazodone isnot approved for the treatment of FM, a research group hasconducted two clinical studies, one with trazodone alone,and the follow on with the addition of pregabalin (Lyrica).The results of these two clinical trials with trazodone in FMhave recently been published (2010 and 2011). In the first study,the efficacy and tolerability of trazodone was examined in agroup of 66 FM patients over a 12 week period. Patients whofulfilled the American College of Rheumatology criteria for FMwere eligible for the clinical trial. Additional requirements foradmission to the study were a willingness to discontinue thecurrent drug treatment regime, and furthermore a referral froma general practitioner, rheumatologist or pain managementconsultant. The demographics were 61 women and 5 men,in the age range of 22-70. After a washout period, trazodonewas started at 25 mg at bedtime and titrated upwards inthis flexible dosing study until either a benefit or side effectswere noted (maximum dose 300 mg per day). The primaryoutcome measure was the Pittsburgh Sleep Quality Index(PSQI). Secondary outcome measures were the FibromyalgiaImpact Questionnaire (FIQ), the Beck Depression Inventory(BDI), the Hospital Anxiety and Depression Scale (HADS), theBrief Pain Inventory (BPI), the Short Form health survey (SF-36) and the Patient Global Improvement scale (PGI).Results from this brief trial indicated that trazodone markedlyimproved sleep quality (PSQI) with additional positiveimpacts on a variety of sub dimensions of “sleep” (duration,efficiency). Significant improvements were also noted in thescores in the FIQ, HADS and BPI. However, a major causefor concern was noted in the incidence of tachycardia as aside effect (21.6% of patients) and the authors of the studymade a recommendation to monitor this adverse eventin any further studies. During the clinical trial, 23 patientswithdrew. Treatment emergent adverse events accounted for12 of these withdrawals.In a follow on study conducted by the same research group,41 patients who completed the 12 week trazodone studyelected to continue treatment with trazodone plus a flexibledose of pregabalin (75-450 mg per day) for a further 12weeks. Assessment of the outcome of the clinical trial wasagain made using the PSQI, FIQ, BPI, BDI, HADS, SF-36 and PGI(abbreviations as above). The quality of sleep as assessedby the PSQI failed to improve further during the secondphase of the trial presumably because pregabalin is notcontributing further to the sleep component of the trazodoneeffect. Significant effects on the FIQ were seen in the secondphase of the trial, with particular positive outcomes in thedimensions of work, pain, fatigue, morning tiredness andstiffness. The authors elected to use a responder analysis forthe assessment of pain relief by the BPI, with 28% of patientsobserving a ≥30% reduction and 18% a ≥50% reduction in thissecond phase. It is most likely that the pregabalin is the keycontributor to this effect – whilst modest effects were seenin the first 12 weeks, only 13% of patients achieved a ≥30%reduction in pain, and none achieved ≥50%, as measured bythe BPI. Depression and anxiety scores, as measured by BDIand HADS, also decreased. Only 2 patients withdrew fromthe second phase of the trial, indicating that once stabilisedon a dose of trazodone the addition of pregabalin causedfew major problems. Treatment emergent side effectswere noted by 34 patients but they were typically mild andtransient, including dizziness, light-headedness, dry mouthand oedema.Whilst the positive results are very encouraging, the authorsacknowledge that the two phases of the trial lacked a control(placebo) group meaning that the improvements cannot beaccurately ratified. However, it is suggested that the resultsusing an old antidepressant in combination with a morerecent FM drug warrant further investigation in a largerpatient group.References:Morillas-Arques, P., Rodriguez-Lopez, C. M., Molina-Barea, R.,Rico-Villademoros, F. And Calandre, E. P. (2010). “Trazodone forthe treatment of fibromyalgia: an open-label 12-week study”,BMC Musculoskeletal Disorders, 11, 204. [PDF available freeonline at: http://www.biomedcentral.com/content/pdf/1471-2474-11-204.pdf]Calandre, E. P., Morillas-Arques, P., Molina-Barea, R., Rodriguez-Lopez, C. M. and Rico-Villademoros, F. (2011). “Trazodone pluspregabalin combination in the treatment of fibromyalgia: atwo-phase, 24-week open-label uncontrolled study”, BMCMusculoskeletal Disorders, 12, 95. [PDF available free onlineat: http://www.biomedcentral.com/content/pdf/1471-2474-12-95.pdf]Page sixteen - Living with Fibromyalgia: What Helps MeThe Fibromyalgia Magazine. Year 12 Issue 6. April 2012. www.ukfibromyalgia.com

Page seventeen - Pam WrightDon’t let ignorantrants get you downby Life Balance and Health Coach PamWright, author of “The Fibromyalgia Coach”.ISBN 9781906546014Years ago, I stopped listening to Radio4 morning news programmes on my30 mile journey to work. The politicalinfighting and backbiting which werechurned out every day raised my stresslevels to such a point that one day, Ifound myself shouting at the radio.The rows, arguments, blame cultureand snide comments that were putout as political debate at that timewas affecting my mood, and I shockedmyself into recognising that I neededsomething more creative and fun to listen if I was not to beovercome by the negativity. Terry Wogan came to the rescue onRadio 2 and instead of being wound up I spent the journeyenjoying the music and laughing at the absurdity of thecomments between the songs.It was for similar reasons that I now rarely buy a newspaper.Recent events with the phone-hacking scandal has backed upmy view that readers can be manipulated, given half-truths andlies so it is important not to believe everything we read, butinstead to gather as much information from a variety of sourcesbefore forming our opinions. News can be skewed, and muchnewspaper journalism has moved away from the search fortruth and reporting of facts. It has been overtaken by the needto make sales, no matter what the cost in human terms.In January of this year, Rod Liddle of the Sun newspaper wrotean article under the heading ‘Pretend disabled really ARE sick’.The gist of the article was appropriate and sound – it is not rightfor anyone to pretend to be disabled when they are not, butthe first sentence of ‘My New Year’s resolution for 2012 was tobecome disabled’ was an opening gambit that set the shallowtone for the rest of the article and no doubt had many a reader’sblood pressure soaring immediately. In one particular sentencehe managed to show his factual ignorance by describing FMand ME as ‘those newly invented illnesses which make you abit peaky for decades’. No doubt it was supposed to be a witty,clever blast at the present chaos in the reorganisation of thebenefit system, but the genuinely ill people reading the articlewould have felt let down and demoralised by such a lack offactual awareness.When you don’t feel well, it is hard to laugh off attacks such asthis. About 15 years ago I was recuperating from an operation athome. Teachers were the political football at that time; all the illsof society were their fault it seemed! I remember feeling weakand depressed and, as I heard yet another person who’d neverstepped inside a classroom tell us what we were doing wrong,I burst into tears and considered giving up teaching altogether.A few weeks later, when I was less vulnerable, I felt righteouslyindignant, decided I was doing the very best job I could do in thecircumstances and if anybody wanted to have a go, then bringit on! What had changed? My illness had initially affected myenergy and my lack of energy had made me feel very vulnerableand victimised by the political fuss at the time.Right now, the disabled and people on benefits are under thespotlight. The recession has bitten hard into any goodwill thatmight have been there and people know that they have to beready to justify their position if asked to do so. This is particularlyhard for those with multiple and complex disabilities, many ofwhich, like FM or ME are not always obvious to any outsideobserver.As the collective target of these public yet ignorant rants, howcan we as individuals stop ourselves from being badly affectedby such damaging scribblings? The obvious answer of courseis don’t buy the paper anymore – it’s amazing how losing saleshurts the media most.Apart from that, you need to ask yourself the followingquestions:• Am I doing everything I can to help myself manage andminimise the effect of my illness?• If I were well, would I be working?Your answers will differ according to your age, stage, or job, andthe way you view your own ability to handle personal changeand challenges. So there is no right or wrong answer here.The government is shaking up everything and there is nodoubt that the benefit system has been open to abuse. Do youremember the old man happily dancing in front of the nation onTV’s ‘Britain’s Got Talent’ but was found to be collecting benefitsawarded because he had difficulty walking?You are the only one who knows about your health. If youare worrying about any benefit reviews at this time, do yourhomework, take advice and get positive help to deal with it. Makesure that the reality of your situation is explained thoroughly andconsistently on the form. Don’t assume that you’ve only got thelittle allotted box to fill in. Add sheets of information if you needto. You’ll do yourself a disservice if you give up on the detail oryou forget things. It all matters, and remember to keep a copy ofthe completed form.The genuine people will be searching their consciences as theydo this. Those people who are pretending to be ill or disabledhave no conscience and I’m sure nobody like that would bebothering to read this!Maybe Mr. Liddle, like most people, broke his New Year Resolutionwithin the first two weeks of January. Choosing to be disabled isa dangerous game, particularly as the genuinely disabled haveno choice in the matter. Inspirational stories of triumph overadversity take courage, determination and perseverance. Let’shope he never has to find out what it’s like for real!See you next month.PamThe Fibromyalgia Magazine. Year 12 Issue 6. April 2012. www.ukfibromyalgia.com

Unlock the fibro brain-fog with acetyl-L-carnitineBy Marcus WebbThere is sometimes no escaping jargon and technical wordswhen discussing the finer points of nutrition and its effects onhuman metabolism but getting to the heart of understanding thebenefit of nutritional therapy means we have no choice! Like somany aspects of fibromyalgia management, defective metabolicpathways appear to need special support but actually gettingthe right nutrients to the right areas of the body can presenta problem. This is highlighted by the problems faced by keynutrients required by the brain and nervous system. Inherentto all humans, the internal brain environment is protected fromtoxins by a special circulatory system that forms the blood-brainbarrier(BBB). In essence, this is composed of a tightly fitting celllining within the blood vessels of the brain that does not occurin other regions of the body. The end result is an ingenious wayof keeping chemicals and other compounds within the circulationand available to the body but away from the delicate environmentof the brain. Getting substances to cross the BBB has presenteddrug developers with considerable challenges but many naturallyoccurring nutritional compounds appear not to be affected by thistoxin filter. One such nutrient, known as acetyl-L-carnitine (ALC),happily crosses the BBB and has been attracting considerableattention from researchers because of it’s ability to improve certainaspects of energy metabolism as well as enhancing neurologicaland brain functions.Fighting the CFS/FM plague of brain-fogOne of the most difficult aspects of CFS/FM for many people isthe issue of brain-fog. So many sufferers experience a severeimpairment of their cognitive (thought processing) functions tothe point where they fear they are loosing their minds. There areas many theories as there are remedies for the brain-fog issuebut one theory that looks to stand the test of science relates toan enhancement of the cognitive functions by improving theability of neurons (nerve and brain cells) to communicate witheach other. For this to happen, tiny gaps between nerve cells,known as synapses, require chemical messengers to be releasedthat bridge the gap and facilitate nerve-to-nerve communication.These chemical messengers are called neurotransmitters andthe most abundant neurotransmitter in the body is known asacetylcholine (Ach). Because Ach is not exclusively found withinthe brain it also influences many aspects of nerve and muscleactivity as well as organ and blood vessel function. Within thebrain itself Ach is a vital neurotransmitter involved in the formationand maintenance of memory and the ability to learn. It has alsobeen associated with influencing maintaining emotional health.Interestingly, ALC is structurally very similar to the bodies own Achand it is known that the neurons that respond to Ach are alsoreceptive to direct ALC stimulation. Because ALC crosses the BBBit’s potential to assist brain function is now becoming apparent.Another key aspect of ALC’s ability to assist neurological healthlies in it’s ability to supply the required building blocks for Achproduction. Supporting this is a controlled study in which 481elderly people with memory impairment showed improvementafter 90 days of 1500mg ALC. While no one is saying that this isa cure for age related memory loss or Alzheimer’s, the study didillustrate the ability of ALC to enhance cognitive function, an actionthat may benefit those with CFS/FM related brain-fog. Keepingin mind the observation highlighted by the CFS/FM expert DrJacob Teitelbaum who reported on the discovery of low ALC inthe blood and muscle of CFS/FM sufferers by two independentresearch centers, a case for a trial of ALC supplementation maybe reasonable.Acetyl-L-carnitine vs placebo in managingfibromyalgia symptomsIn the spirit of all good science what people report and whatcan be proved to actually happen needs testing using a placebostudy. In this type of study, a non-active but otherwise identicalpill is given to one group while the other group takes the real pill.However, none of the subjects know is they have the ‘read deal’or the dummy (placebo) pill!The study, using 102 patients who met the criteria for beingdiagnosed as having fibromyalgia, looked at the effects of a courseof acetyl-L-carnitine (ALC) over 10 weeks compared to placebo.To establish the effects of ALC the researchers measured tenderpoints and assessed fatigue, depression, sleep and other commonFM symptoms using well established and tested questionnaires.At the end of the 10 week trial the total number of tender pointshad declined significantly along with an improvement in overallpain and mood in the group taking the ALC supplement. In theirconclusion, the researchers commented; “The results indicate thatALC may be of benefit in patients with fibromyalgia, providingimprovement in pain as well as the general and mental healthof these patients.”Intake and safetyFrom the literature there has been a wide range of intake levelsrecommended, ranging from 1500mg (500mg taken 3 x day)up to 3000mg (1000mg taken 3 x day) taken in divided doses2 or 3 times a day. As a supplement it should not be used byanyone taking drugs that alter blood clotting such as warfarinor acenocoumarol. Because of the lack of data ALC can’trecommended during pregnancy or breast feeding and there hasbeen some cautions against using if you suffer from seizures ortake thyroid hormones.Useful resources:Low acetyl-L-carnitine in CFS/FM sufferers: http://www.endfatigue.com/health_articles_c/CFS_FM-acetyl-l-carnitine_for_cfs.htmlPlacebo controlled acetyl-L-carnitine & fibromyalgia study: www.ncbi.nlm.nih.gov/pubmed/17543140Acetyl-L-Carnitine 500mg (vegetarian formula): http://www.supersupps.com/Acetyl_L_Carnitine_500mg60_Vcaps.asp?cat=0&sub=0&prod=831Page eighteen - Unlock the fibro brain-fog with acetyl-L-carnitineThe Fibromyalgia Magazine. Year 12 Issue 6. April 2012. www.ukfibromyalgia.com

I am a sufferer of Fibromyalgia and my attention wasbrought to an article written in the Sun newspaper by RodLiddle in January, that Fibromyalgia is a pretend illnessgood for having some time off work and getting yourselfa disabled card! I personally never read the article as Idon’t read rubbish, but felt that a response was necessaryfrom one of your experts regarding his comments. To sayI’m livid is a gross understatement and if I could get holdof him for half an hour would tell him straight to his facewhat I and other sufferers go through day in day out. Somaybe you could pass this message onto him.I left school at 14 years and 11 months in July of 1965and have worked all my life up until 2006. In 2003 I wasdiagnosed with Sleep Apnoea, and Depression. I wasfinding it more and more difficult doing my work becauseof the lack of sleep and the depression but I carried onworking as my manager was very understanding andnew of my problems. I then started to get all over bodypains and aches such as I’ve never before experiencedeven after weight training and golf which I used to play alot of. It got to the stage where I was unable to get up inthe morning and to move around was impossible for atleast a few hours. I was finally diagnosed at Guys Hospitalby Professor J Davies as suffering from Fibromyalgia,which according to the experts goes hand in glove withSleep Apnoea, and Depression. I was made redundant in2006, after a working life of over 45 years. I do not forone minute find your comments enlightening funny oramusing with regards to Fibromyalgia being a pretendillness and feel you should apologise to people like mewho suffer from this crippling disability. I know as wellas you do there are people out there milking the systemwhich makes it bad for us genuine disabled people, and Istart to get paranoid when I do get out on the house onthe occasional good days I get and try and help my wifewith the house hold chores, but I can assure you, you willnot find me on the golf course or refereeing a footballmatch or doing some cash in hand work, but you mightfind me out on the odd occasion struggling to take somelaundry to the laundrette for drying. I take Morphine60mg a day for pain along with a host of other painmedication, and as I have told others I would rather losea limb than suffer from Fibromyalgia and the problemsassociated with it.Terry Callowcallow51@hotmail.comIs it a trait of FM for your hips to be burning? Mine seem to be doing that more and morethese days.Janettejanette@hicks63.plus.comPage nineteen - LettersDear Pam Wright,I read your article on hydration with interest and wondered if any research had been done on saltin food. I haven’t put salt into my cooking for years, with one or two exceptions, to help counteractmy husband’s high blood pressure. However, I went out the other evening for a lovely fullblown, exceptionally tasty, three course evening meal, something I haven’t done for months andmonths. I didn’t sleep well and the next morning I was stiff, tired and achey, and thirsty. I wouldn’thave thought anything of it except my husband said he felt the same and had noticed that the foodwas much saltier that we are used to. It would be interesting to know if any work has been doneon this.Best wishes,Margaret WiggallThe Fibromyalgia Magazine. Year 12 Issue 6. April 2012. www.ukfibromyalgia.com

Letters continuedDear EditorI am writing following the article in the November magazine by Avril Watson. I have been using BowenTherapy for 2 years now and found it to be a great success. Last year we had to stop it for a while,but my physios were very demanding that I start it again at the earliest opportunity. My therapist isexcellent, and he trained in Bowen after finding it was successful in treating himself. I would certainlysupport it being provided on the NHS!!Viv.viv@priceub10.freeserve.co.ukDear Editor,I have found one method that helps keep fibro manageable.Even though after trying all types of medications and treatmentsI had almost given up, I decided it was time to give itone last shot. So my mum introduced me to the Ayurvedicworld through a famous lady called Smita Naram. The mainclinic is based in Bombay so we went for a four week bodydetox to see if it would help. They changed our diet to suiteach individuals body needs, gave us massages and treatmentsto help with individual problems and herbal medicationto build us up from the inside. The whole process is a bodycleanse as fibro is deep routed within so after releasing mytoxins, they gave me medication to build my body and makeme stronger and help with my pains. This has been the mostamazing experience in so many ways and I can confidentlysay it is the only method that has made some difference tomy pain, sleep and attitude to life. I would recommend anyoneto try this out as they understand fibro and have dealtwith many patients suffering from this like myself and I giveyou my word that it makes a difference if you believe and giveall your time and effort to this method. The website is Ayurshakti.co.ukand the Doctors and Pankaj Naram and SmitaNaram (husband and wife)Simran GillTHE INVISIBLE ENEMYIt never leaves me.Every second of every minute,Every minute of every hour,Every hour of every day,And night, the nights are the worst.An ache that encompasses my every cell.A tenderness that prevents skin touching sheets,And then the enemy moves in for the attack:Fiery arrows released in a volleyOf stinging, burning missiles.No analgesic comes near,Untouchable, all-consuming furnace,I toss and writhe and spasm,Admitting defeat, feet on floorAre treading on icy shards of broken glass.All this is my usual,Fibromyalgia and neuropathy,Pain-the invisible enemy.Sue GoodallReproduced from www.unitedpress.co.uk - 2011.ISBN is: 978-0-85781-180-6ME-SocialNew social networkingsite for people with ME& Fibromyalgia.Many features includinggames,chatrooms, blogging,photo/video upload.profilecreation, instant messaging.Meet like-minded peopleJoin for free atWWW.ME-Social.comPage twenty - Letters ContinuedThe Fibromyalgia Magazine. Year 12 Issue 6. April 2012. www.ukfibromyalgia.com

Page twenty-one - Supersupps and Working for a cure – sooner rather than laterWorking for a cure –sooner rather than laterDo you want a cure for Fibromyalgia? We do. If you feel as strongly as we do thatresearch is urgently needed to find a cause and a cure, then please join us.We are The Fibroduck Foundation, the brainchild of Fibroduck and the Rambling Duck. We exist for onepurpose: to raise funds for UK-based biomedical research into Fibromyalgia syndrome.We also believe that research progresses faster when scientists and patients collaborate, so we aim toprovide an environment in which this can happen.By very visibly raising money and supporting scientists, we hope to kick start a whole programme ofresearch in this country.But, we can’t do this alone. We need the patient community to mobilise behind this effort. We need patientpower.We believe the days of waiting for Government to take the lead are over. For those who think that the MRCor the NHS ought to be leading on this, reflect for a moment on their track record to date. While those whoguard the money twiddle their thumbs, our lives are ticking away. If we can’t encourage Government tofund Fibromyalgia research, we’ll have to lead the way.We need to raise £26,000 for our first research project. You can read about it here:http://www.fibroduckfoundation.com/page15.htmlWe are absolutely serious about launching biomedical research into Fibromyalgia in this country.Come and join us.The Fibromyalgia Magazine. Year 12 Issue 6. April 2012. www.ukfibromyalgia.com

FaMily Phone Friends- Make a new friend-Phone Today!We receive a lot of requests from FaMily readers who do not have access to the internet (or a local support group) tohave telephone numbers of fellow FM sufferers, so that people can chat to people who understand what having FMentails. We have launched this FREE service for paid up FaMily subscribers where you can add your details for peopleto get in contact. To appear on this page we need your Name, Town, County, Telephone number and convenientcontact times. Send to: 7 Ashbourne Rd, Bournemouth, BH5 2JS Tel 01202 259155 Fax 01202 259155 Email: family@UKFibromyalgia.comJennifer CarterMs Gill GalyerMiss Bede MilesHailsham, East Sussex 01323 848590 7 days a weekNewark, Notts- Ring between 11am and 4 pmMonday to Friday 01636 526160West London 020 8840 7759 Not morningsMrs Viv Norrie Angus & Mearns Fibromyalgia Support Network (Montrose, Scotland)Monday & Friday 5pm to 7pm 0844 887 2389 ore-mail am-fm@hotmail.co.ukMaureen Schofield Stoke on Trent 01782 264071 7 days a weekMrs Linda Pedder Heysham Lancs. 01524 859068 AnytimeMargaret Evans Cardiff 02920 258526 12noon-6pm weekdaysAnn Adams Ring Anytime 01304 382335Yvonne Singleton Fibromyalgia support group South Wales 01639 681468Pamela Buckle Warwickshire 01789 765587 Tues/Wed/Thurs 17.00-22.00Janice Dipper Winchester Fibromyalgia Support 0845 345 2678janicedipper@googlemail.comMrs Ulla Deichelmann Redruth, Cornwall 01209 213123 10am – 10pmulla.deichelmann@btinternet.comBexhill & Hastings Bexhill On-Sea, East Sussex. 0845 345 5974Tuesday & Thursday 10am until 12pm only.Liz BarberHull & East Riding Support Group 0844 887 2370 11am – 7pmbarber101@barber101.karoo.co.ukPamela Smith Lincolnshire Tel 01754 810440 Mon –Fri Evenings please.Nicki Southwell Carlisle FM support group 0845 345 2305 10am-7pm weekdaysMandy Wordsworth TEL: 0113 2795936 Leeds Contact anytime.Janette Leeds Fibromyalgia Support Group -0844 887 2371 - 11am - 5pmAlan SmithRhondda Valleys 01443 433027 Please call 6pm to 10pmJohn AllenSwindon & area Wiltshire Fibromyalgia information & support01793 751920 (answer-phone phone buddy etc support)highfly29@hotmail.com (emails preferred)21 Heberden House: Cricklade: Wilts: SN6 6ASMaddie Seacombe Bristol, Tel 07790130403- best time is 3pm - 8.30pm.Claire Hilton43 Alexandra Road, Thornton Cleveleys (nr Blackpool) Lancs FY5 5DBTel 07912 792250 Any day 11am-6pm shelbyeatenton@hotmail.comLinda Holder Luton, Bedfordshire, 01582 570240. Phone chats or meetings please phone inthe afternoon.Mrs Teresa White Bracklesham/ Witterings / Selsey Support Groups West Sussextelephone support / group meetings / social lunches01243 670 783 any pm or eveningsDenise Shotter Guildford and Bordon monthly meetings 08448872358 5-7pmemail denise.guildfordfibro@yahoo.co.ukDiane Jaques Burnley, Lancashire 01282 701390 after 7.30pm Mon-Friif you would like to chatDiane LeakSorrel CromptonMrs Jane WallaceDarlington Friendship Group - 1st Wednesday of the month12pm -2pm.Upstairs Café of the Darlington Dolphin Centre.3 Upper Green, Trefeglwys Road, Caersws, Powys, SY17 5HN.Telephone number is 01686 689894, after 11 am please, any day.Area: Bursledon County: HampshireContact number: 08448872409 Email: bursledonfibrofriends@gmail.comPublished by UKfibromyalgia.com,7 Ashbourne Road,Bournemouth, Dorset BH5 2JSwww.ukfibromyalgia.comTel: 01202 259155Fax: 01202 259155E-mail: family@ukfibromyalgia.comManaging Editor: Martin WestbyAll content remains the property ofFaMily Magazine unless copyrightis acknowledged and can only bereproduced with prior agreementwith the copyright holder.Back issues of Fibromyalgia MagazinePrinted copies are available at £2.10including postage The first issuecame out in October 2000.Email family@ukfibromyalgia.comSecure online ordering facilitywww.ukfibromyalgia.comCheque payments should be madeto: UKFibromyalgia and postedwith order to: UKFibromyalgia, 7Ashbourne Road, Bournemouth,Dorset. BH5 2JS •Fax: 01202 259155A percentage of the net profit ofUK Fibromyalgia is donated to UKFibromyalgia Support groups in theform of small grants.Subscription ServicesSupport Group DistributionFibromyalgia Magazine is available inprinted version through UK supportgroups. Copies can be sent everymonth to leaders to be distributed attheir meetings. A year’s subscriptionin this format will cost £16.50 perperson for a 12-month period.The group leaders need to collectthe cheques and organise theadministration for the first order.If you run a support group andare interested in this option emailfamily@ukfibromyalgia.com or callthe number below.Home DeliveryHome delivery of a printed versioncosts £23.85.Please note that partial refundsare not available for Fibromyalgiamagazine subscriptions once aninitial 4 week period has passed fromtime of ordering.International Printed DeliveryTo send 12 monthly issues of FaMilyoutside of the UK (Europe only inc.EIRE) costs an additional £6.00 -Making a total of £26.85 + Rest ofthe world £48.85AdvertiseAdvertising is available in thismagazine as well as the UKFibromyalgia website and the UKFibromyalgia email newsletter. Todiscuss advertising rates please ringMartin on 01202 259155.The Fibromyalgia Magazine. Year 12 Issue 6. April 2012. www.ukfibromyalgia.com

UK FM/ME ClinicsPrivate Clinics in London and Bristol. Enquiries: 01438 821188We specialise in treating FibromyalgiaWe use an evidence based and integrated approach based onthe latest scientific research and years of experienceWe are recognised by all major insurance companiesWe offer big discounts to patients on benefitsFor further information on our clinics, please visit ourwebsite: www.fmsclinic.co.uk or contact ourClinic Manager, Daniel Austen, on 01438 821188 or07777 654436 or email: danielausten@fmsclinic.co.uk