Wednesday, October 22, 2014

A Guest Blog: Fibromyalgia Trigger Points

Fibromyalgia Trigger Points: a Guest Blog

by Celeste Cooper, R.N., as an interpretation of Dr. Robert Bennett's Work

Without much ado, let me point you to our Guest Blog poster today, Celeste Cooper, R.N. She is a fibromyalgia expert at Sharecare, and the distinctions she makes here in this article are well...they are good enough for a thorough look-through out of respect, because she has been in the field for so long. And she takes what Dr. Bennett's manuscript discusses, and simplifies it for patient understanding. I like that, too ~ both for the benefit of heath care workers as peers, and as avid patients with medical education. Plus, I think I might be developing CRPS, so I was "all eyes" on this one.

So Hat's Off to Nurse Cooper on this simplified, historical, data-driven, and grand explanation of where we are today on diagnosing fibromyalgia:

The 'best' take-home news that I got out of this article is that 
Fibromyalgia is not a"Diagnosis of Exclusion"
any more.


Bennett R, Friend R, Marcus D, Bernstein C, Han BK, Yachoui R, Deodar A, Kaell A, Bonafede P, Chino A, Jones K. Criteria for the diagnosis of fibromyalgia: Validation of the modified 2010 preliminary ACR criteria and the development of alternative criteria. Arthritis Care Res (Hoboken). 2014 Feb 4. doi: 10.1002/acr.22301. [Epub ahead of print]

Wolfe F, Clauw DJ, Fitzcharles MA, Goldenberg DL, Katz RS, Mease P, Russell AS, Russell IJ, Winfield JB, Yunus MB: The American College of Rheumatology preliminary diagnostic criteria for fibromyalgia and measurement of symptom severity. Arthritis Care Res (Hoboken) 62(5):600-10, 2010 May.

Wolfe F, Clauw DJ, Fitzcharles MA, Goldenberg DL, Häuser W, Katz RS, Mease P, Russell AS, Russell IJ, Winfield JB: Fibromyalgia Criteria and Severity Scales for Clinical and Epidemiological Studies: A Modification of the ACR Preliminary Diagnostic Criteria for Fibromyalgia. J Rheumatol 38;1113-1122, 2011.

Saturday, May 17, 2014

The Battle Rages Onward and Upward

by Dr. Margaret Aranda

There are two major battles affecting women of every age. They affect women of every age, because they affect our daughters and our granddaughters. "Oh, I don't have a daughter," someone said to me. Well, you had a mother, and you are a daughter. So don't think this doesn't affect you.
"Your uterus is the key to the generations."
So she looked down at her toes really fast, and offered no appeal to that argument. Are we even in an argument? What is there to argue about except us vs. them? I expect women to be on the same page, and yes, I actually expect women to care, to count, to matter, to make a difference, to institute change, and to leave this world a better place.  To me, it is our duty as women, just as some are called to serve in the military, that is to serve.  Some are called to law enforcement. LAPD's logo is "To protect and to serve." What is your motto? Why are you here? What are you doing to make this world a better place?
Read on if you want to institute change. 
If you are ashamed and intend to do nothing, go to "Words for Friends"or "Candy Crush", or go the mall and pick out yet another pair of shoes. Just let the world spin by with you as an inert, breathing blob consuming donuts and soda to kill yourself with diabetes, blindness, leg amputations, and kidney failure. As you slide into dementia, you will simply roam the hallways, picking up what is not yours, and accusing everyone of stealing your things. 
150 million women in the USA and I think we are a giant snail. We are slow, passive, and excrutiatingly painful to observe. We have "let" them maim and kill us for money and corporate greed. And we are too busy making money to survive, so we see in the periphery 'something' about a female doctor and cancer after surgery, and we overhear 'something' about a contraceptive device that left metal shrapnel in a lady's uterus. "I'll never get one of those things put in me." If we are on an Ob/Gyn rotation, we may be lucky enough to actually discuss these issues out loud with other medical professionals. 
Well, how does that help the ones that already died? How does that help the future women that are going to die or be maimed, or bear unwanted children unnecessarily? If you give a damn and if you put your energy into it, it is hard to raise a child. We are trying to stop it and anything that does not help stop it is unhelpful and distracting. So get ready to get on the stick. Period.
(Keep in mind that there are 150 million women in the USA.)

1.                            MORCELLATION OF THE UTERUS FOR FIBROMAS: 
Dr. Hooman Noorchashm took his fight, with only 8,000 signatures (now past 9,000), to the Senate, the Congress, and the FDA. Did you sign? Are you part of this gigantic change, or you a useless bystander that walks by a dead body in NYC just because every one else does? Go take a look and you tell me that it doesn't make you cry: How One Man Fought for his Wife and All Women. Tell me one person doesn't make a difference. Tell me your signature doesn't make a differenct. Tell me one more person doesn't make a difference. I refuse to believe that, because it is not true. If one person challenges me on this, I will devote an entire blog to the subject of the Value of one Vote. 
On April 20, 2014, Dr. Hooman's Petition was before the FDA (head's up, women against Essure(R)): FDA Makes Major Change in Morcellation of the Uterus. While it is not a ban or a moratorium, the new FDA regulations restrict morcellation to "young" women who are less likely to be in the (now here's the known statistic) 1 in 350 incidence of a lipoma actually being a cancer. And, now the FDA requires that women be given proper Informed Consent, including the risk of cancer spread. It is a huge step in the right direction, sure to put a dent in the way hysterectomies are done. With 600,000 hysterectomies done/year, and 90% of them being for fibroids, ladies, this will save lives. Before Dr. Amy Reed got Stage IV uterine cancer and her husband blew the lid off this issue, the American College of Obstetrics and Gynecologists (ACOG) took it upon themselves, I believe, to determine that since they thought the risk was only 1:6000, or 1:10,000, there was no NEED for Informed Consent because the 'n' was so small. As researchers and scientists, we all know that if someone has to be that 'n', we don't want it to be us, or anyone we love. So c'mon. It's time to care. It's time to act. Because your not doing anything screams louder to me than your platitudes of words or the nods of your heads. Sign the petitions! Do something!


Erin Brockovich (yes, that Erin Brockovich) is on the front lines to expose the debauchery and deaths associated with this coil placed in both Fallopian tubes. The formal petition is on her site and to date, I think the number of signatures is pitifully small. I think that if she was selling shoes, more people would be signing. What's happened to our world? We let women die and get metal shrapnel splatted through their uteruses, only to end up with #1 above, a hysterectomy? It is a 'damned if you do, and damned if you don't' situation. My best solution ladies, is to have your husbands get a vasectomy. 
A vasectomy is external, not internal. He can even freeze the sperm if he wants to have babies again.
When my book comes out, Archives of the Vagina: A Journey through Time, you will read all that women have gone through since the time of Aristotle. You will follow a girl through multi-cultural puberty through menopause, and how to deal with today's long-term care, nursing homes, and Caregiving. Hat's off to you ladies who have baby after baby on Essure(R). You do not rise in rage against your babies. You accept them as beloved as they are, as beloved as they were meant to be, and you move on with one on your hip and one on your back. Hat's off to you. Don't think you are alone, because you are not. 
God sees everything and your reward will come in time. 
3. Essure(R) Ladies, sign the Morcellation Petition.
4. Morcellation Ladies, sign the Essure(R) Petition.
5. Together, we are One. We have to be One, and we can't be one Snail. 

Now go. Do your duty to humanity and to future generations.
Make this world a better place.
Why else would you visit a virtual med school site, unless you had some altruistic innocence
that somehow, you could make the world a better place?
Well, you don't have to wait to get in to medical school.
You don't have to wait to graduate.
You have today, and you have now.
So go and sign both petitions. 

You will have accomplished something good.
You will have left your name down on a petition that leaves a legacy of change 
in Women's Medicine, Health, and Wellness.
You don't have to be a rocket scientist; just have some passion
and some compassion. And next? Pass it on to your friends, ladies.
Where are all the 150 million women in the USA?


Tuesday, October 30, 2012

January 4, 2013: Interviewing with Stephanie Riggs on Talk Radio

This is just delightful!  Stephanie Riggs and her radio station, Divine Calling with Stephanie Riggs, have interviewed and featured so many wonderful books, that I just must have you take a look at her FaceBook page: Click Here.  She is out of Denver, CO on TalkRadio 94.7 KRKS.

What a Blessing!

She will be interviewing me on my book,  No More Tears: A Physician Turned Patient Inspires Recovery.

Many of you have known me since the times I was still on iv fluid, and this represents an accomplishment for all of us!  
Onward & Forward for Invisible Disabilities.  Onward & Forward we Go!

Monday, April 30, 2012

Wheelchairs from China and Carbon Black from Britian

China holds the proud honor of recording the first use of a wheelchair. Stone slate inscriptions are dated to 600 B.C. Thereafter, the German Renaissance uplifted the scientific progression of the wheelchair to European countries. German travels to Italy heralded the advances of the German Renaissance in the 15th and 16th Centuries. James Heath of Bath, England invented the Bath Chair which was mainly for invalids and could be pulled by a horse or donkey. During the mid-18th Century, James Heath created this bath chair with a folding hood to protect the inhabitant from the elements. The first entrepreneurs to produce wheelchairs were friends and mechanical engineers Harry Jennings and Herbert Everest. In 1933, Mr. Everest was disabled from a mining accident and their "x-brace" design is still used today.

Basic categories of wheelchairs include: manual, electric, sports, transfer, mechanical, stretcher, and all-terrain. The all-terrain wheelchairs allow entry into the water, as well as transport on sand and irregular surfaces. In England, all-terrain wheelchairs are available free of charge in many beaches that are wheelchair accessible. Other varieties of wheelchairs include standing, mobility, bariatric, pediatric, knee, and power-assisted. There are sports wheelchairs made for the sports: basketball, tennis, rugby, and racing. Power soccer is now the only competitive sport for powersport teams.

Paris, France is the homeland of the governance of this Powerchair Football, with The Federation Internationale de Powerchair Football Association (FIPFA) having world-wide affiliated branches. Michael Platini is featured as the Guest of Honor for the World Cup Draw. Powerchair Football Associations have recently sprung up in Canada and Switzerland. Brazil was the first South American member of FIPFA. Senior Football Associations meet up and cast rival games, with England players meeting the World Football Association National Team in Wembley. Competition and more competition continue!

These days, one can not mention wheelchairs without mentioning Accessible Tourism. Coined by Darse and Dickson in 2009, it is an ongoing endeavor to bring tourism to those with physical limitations or disabilities. This includes but is not limited to people with children, those in wheelchairs, and the elderly. Accessible Tourism is a movement in and of itself, with many publications catering to the needs of those who travel by wheelchair.

The iBOT halted production in 2009, at $25,000.00 US. It used gyroscope technology so the user could balance on 2 wheels, and the user appeared to be standing. Special features included the ability to climb stairs and utilize 4-wheel drive. It gave way to the Segway Personal Transporter, specifically market for mass production and mainline affordability.

Recent features include the handcycle, and stationary trainer platforms allowing one to exercise as if one is on a treadmill. The omnidirectional treadmill, or ODT, allows one to move in any direction. Using virtual reality environment and a wheelchair trainer at the Department of Veteran's Affairs, researchers continue to study and promote exercise as a therapy.

In 2011, the Carbon Black wheelchair was developed by Britian's Andrew Slorance. Making its debut in utilizing F1 Technology, Carbon Black was presented at Naidex South in London. This is the first wheelchair almost wholly made of carbon fiber. Supported by funding from Devices for Dignity (D4D), it is said to revolutionize the industry. Less wheelchair and more you.


Friday, April 27, 2012

Stethoscopes: Focus on Laennec

The physician is often associated with the stethoscope as one of the main tools of the profession. 

The history of the stethoscope really belongs to Frenchman and Professor of Medicine Rene Laennec (1781-1826), who invented the stethoscope in 1816. Laennec was a gifted child whose mother died of tuberculosis when he was three. Raised first by his great-uncle until age eleven, Laennec's uncle Guillaime-Francois then took over his care and often took him to his place of work as Faculty in the Medical University Nantes (1).

Laennec was trained in the art of acoustics and was a skilled flautist. In Paris medical school, he was also trained to use sound diagnostically and studied under such famous physicians as Nicolas Corvisart des Marest, who helped re-introduce percussion during the French Revolution. Laennec also studied under Baron Guillaume Dupuytren (1777-1835). Dupuytren of course, is known today for describing the surgical correction of Dupuytren's Contracture, published in the Lancet in 1831 (2) . This is the same Dupuytren French military surgeon and anatomist who received much notariety for treating Napolean Bonaparte's hemmorhoids.

In 1819, Laennec published a treatise on the following clinical terms that are still used to describe lung sounds: egophony, crepitance, rales, and rhonchi (3). He wrote this from the "Hopital Necker - Enfants Malades". In 1821, the New England Journal of Medicine published the stethoscope as a new invention.

Laennec termed his instrument the stethoscope, after stethos for chest, and skopos for examination. He used a long wooden tube as depicted above. At the time, Laennec's invention was not completely acclaimed. The clinical exam consisted of the physician putting his/her ear to the patient's chest. This was embarrassing especially if the patient was obese and had a large bust. Many physicians carried a silk kerchief that was used to place on the patient's chest for direct, "immediate auscultation". Laennec described the stethoscope as "mediate auscultation", for indirect listening. Today, the four clinical examinations still taught to medical students include inspection, palpation, auscultation, and percussion (4).

Laennec died of tuberculosis in 1826.
British physician Golding Bird (1814-1854) is attributed with casting the first flexible stethoscope in 1840.
Irish physician Arthur Learned described the biaural stethoscope meant for both ears in 1851.
This design was later perfected by George Cammann for commercial production in 1852.
"He that hath ears to hear, let him use his ears and not a stethoscope." ~ A Professor of Medicine, in 1885.
Carried a silk handkerchief for direct auscultation ~ L.A. Connor (1866-1950), Founder of the American Heart Association.
Rappaport and Sprague described a stethoscope with two sides, one for the heart and one for the lungs, in the 1940's.  Hewlett-Packard later made this one, and it can still be purchased as the Rappaport-Sprague stethoscope.
A Professor and researcher at Harvard Medical School, German cardiologist David Littmann (1906-1981) invented a newer, lighter stethoscope with better sound in the 1960's.
3M-Littmann invented both the tunable diaphragm and "cardiology tubing" that included a bifurcating tube with an internal septum that houses separate  left and right channels in the 1970's.
The DRG Puretone was invented by Richard Deslauriers as a noise-reducing stethoscope in 1999.
The fetal stethoscope is used to ascultate fetal heart tones through the abdominal wall of the pregnant woman (5). It is also known as the Pinard's stethoscope, or simply a pinard, named after the French obstetrician Adolphe Pinard (1844- 1934).

Today, super sensitive electronic stethoscopes with MP3 recording and playback capabilities are used for satellite care.


(3) Laennec, RTH (1819) De l'Auscultation Mediate ou Traite du Diagnostic des Maladies des Poumons et du Coeur. Pris: Brosson & Chaude.

For today's online buys, visit
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