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Why sleep is vital for improving fibromyalgia symptoms

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Dr Anthony Ordman, a leading UK Pain Specialist, explains why achieving proper restful sleep is so important for fibromyalgia patients and how cannabis medicines can help this happen.

Fibromyalgia is a long-term condition that causes pain all over the body and can completely destroy the patient’s quality of life.

Many fibromyalgia patients report it is the lack of ability to sleep properly that leads to the horrible brain fog, fatigue and ensuing depression that is one of most unpleasant symptoms of the condition.

“For me it was the insomnia, that came with the pain, that then led to everything spiralling out of control in a repetitive cycle.

“You were in pain so you couldn’t sleep, which would lead to fatigue and exhaustion, which again contributes to the level of pain you are in, which leads to anxiety and depression. The symptoms of fibromyalgia are like a runaway train that you just can’t stop.” – Steven, fibromyalgia patient.

Dr Anthony Ordman, senior clinical adviser and Hon. clinical director Integro Medical  Clinics.

explains why achieving proper restful sleep is so important for fibromyalgia patients and how cannabis medicines can help this happen.

“Long-term stress and resulting poor sleep can cause neuro-chemical imbalances in the central nervous system, impairing the processing of sensations.

Then sensations become mis-interpreted,  causing pain to be perceived by the brain, in the absence of actual incoming painful stimuli from the rest of the body. This results in abnormal amplification of pain signals, similar to a ‘pain volume control knob’ being turned up too high. At the same time, muscles throughout the body can become tight and go into painful spasm, adding to the pain syndrome.

“Research continues to determine the causes of fibromyalgia’s associated fatigue, non-restorative sleep, and thought and memory difficulty, but this must have to do with the fact that people with fibromyalgia often go for years without ever falling into deep, ‘stage 3 and 4’ sleep at night because of stress. This sleep abnormality may be the cause of the whole fibromyalgia syndrome in the first place.  

“Normally, in the deepest stages of healthy sleep, the body undergoes deep muscle relaxation, and our brain stores the memories of the previous day while, at the same time, toxins are flushed out of the brain’s nerve cells.

“But if deep sleep doesn’t happen, night after night, then it’s not difficult to see that tight, painful muscles and brain-fog may occur, along with changes such as the spinal cord neuro-chemical imbalances already mentioned. 

Potentially adding to this problem; if you treat insomnia and its ensuing anxiety with drugs like Zopiclone or other benzodiazepines, this doesn’t improve deep sleep, only sleep duration.  Those drugs can end up causing the patient all sorts of problems, adding to brain-fog, and dependency. 

There is no one conventional medicine to treat Fibromyalgia. Nerve pain medicines and anti-depressant medicines are often tried.  These sometimes do help, but more often add their own side effects to the patient’s difficulties.

Most conventional pain medicines such as morphine, amitriptyline and gabapentin/pregabalin, which are available for long-term pain, do not really work effectively for pain in the body’s spinal cord and central nervous system. 

By contrast, cannabis medicines have their main effect there.  And, as I am now seeing, cannabis medicines can offer effective treatment for fibromyalgia, as they seem to re-balance and regulate the human body’s endocannabinoid system, to reduce pain and spasm, and restore more normal sleep patterns.”

“For me the massive change was being able to get a decent night’s sleep. Once you can sleep it allows you to recover and this in turn helps your mood and motivation. Cannabis medicines have allowed me to function on an absolute minimum of traditional pain medications.”  –  Debbie, fibromyalgia patient 

Dr Ordman added: “Integro Medical Clinics Ltd always recommend remaining under the care and treatment of your GP and specialist for your condition while using cannabis-based medicines. The Integro clinical team would always prefer to work in collaboration with them.”

If you would like further information or to speak to Dr Anthony Ordman please contact Integro Clinics:  

Website: www.integroclinics.com

Email: [email protected]

Twitter: @clinicsintegro

For support groups and charities please visit:

UK Fibromyalgia

National Fibromyalgia Association 

National Fibromyalgia and Chronic Pain Association

 

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Fibromyalgia diaries: Travelling as a medical cannabis patient

Medical cannabis patient, Julia Davenport, on the challenges of travelling with a prescription.

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South Africa remains one of fibromyalgia patient Julia Davenport's favourite places - but getting there isn't always easy.

While cannabis oil has dramatically improved fibromyalgia patient Julia Davenport’s quality of life, it has brought with it new challenges when it comes to travel, as she explains here.

Chronic pain has a nasty habit of getting in the way of doing the things you love.

My big passion which I share with my husband, and I guess our one extravagance, is jetting off to far flung places.

Over the years, however, fibromyalgia, arthritis and aching joints have conspired to make travelling evermore arduous.

Now in my 70s with various replacement parts, difficult terrain is one of the biggest barriers to exploring new places.

Certainly, my husband’s bucket list destination, the Galapagos Islands, is on my no-fly list. I would have adored to go there at some point, but navigating those volcanic rocks, even with my walking stick, would be a nightmare.

Fibromyalgia: A banner advert for the medical cannabis clinic

Familiar holiday spots closer to home are also becoming increasingly inaccessible. Every year our extended family visits the same Northumberland cottage, which is at the bottom of a steep bank.

In years gone by, I’d be fine to walk down to it through the working farm in which it stands. Now, because my back and shoulders have deteriorated, I have to drive right to the door.

Finding ways to compensate for the things you can no longer do is a constant theme with chronic pain conditions.

Aside from mobility challenges, another restriction on travel with rheumatological conditions can be the weather, and humidity can play havoc with chronic pain. I’d love to go to Central America, for example, but I just couldn’t tolerate the heat and humidity.

Having said that, although hot dry weather is far better than the cold British winter, the difference is not enough to drag me away from my family at Christmas time.

For all my gripes about life on the road, though, traveling remains my great joy, and discovering medical cannabis and CBD has definitely helped; although it’s not all plain sailing.

Travelling with medical cannabis

In November I’m returning to South Africa, a place I’ve visited a few times and which has a special place in my heart.

On previous visits, because we’ve flown via Dubai, I’ve not taken medical cannabis or CBD with me.

There is no way I’d risk taking cannabis with me to the UAE, where people have apparently been arrested and put in jail for having codeine, never mind anything else, despite having a prescription for it.

They have a ridiculously long list of substances that they deem addictive which you can’t have. There are things you can apply for permission to take, but I just wouldn’t trust that I wasn’t going to get arrested.

When we’ve flown long-haul through Dubai in the past, I would tend to take enough medication just for the journey. I have even flushed pain medication down the toilet on a connecting flight to Dubai just to make sure I’m not in possession on arrival.

I’ve then managed to pick up cannabis products quite easily in certain final destinations.

In South Africa there was a shop similar to a Holland and Barrett which sold CBD products legally. They were able to match the equivalent of what I was already taking to their products.

In Japan, it was also relatively easy to buy CBD over the counter, even with the language barrier.

In the past, the ease at which you can buy CBD has definitely influenced my travel choices. There are lots of countries that I’d give a wide berth to because of their approach to medication, which is often underpinned by false views on addiction.

At the same time, with so many countries opening up to CBD, travelling is getting easier and the main challenge is the routing of flights through the Gulf.

Thankfully on my next trip to South Africa we are travelling direct to Cape Town directly so I can rest easy that I won’t end up behind bars.

Guidance for travelling with medical cannabis

Some countries allow medicinal cannabis and some even recreational cannabis. Some allow CBD but others do not.

Guidance from the Medical Cannabis Clinicians Society recommends that patients always contact the embassy to check the legal situation in the country they are visiting before travelling with medical cannabis.

 Some countries require a letter of proof from a clinician, some require a request to be submitted to the embassy requesting to travel, some restrict the amount of medication you are able to travel with, i.e. up to 30 days supply. It is suggested that any guidance is sought and confirmed in writing.

It is advised that travellers keep medication on their person, stored in its original packaging along with a copy of their issued prescription and relevant corresponding paperwork. 

You can get an idea of the country’s stance on cannabis initially by searching for “legality of cannabis” on Wikipedia – but always check with the embassy as well.

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Fibromyalgia

Medical cannabis linked to reduction in fibromyalgia symptoms in UK first

New data from the UK Medical Cannabis Registry has shown significant improvements in symptoms.

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Fibromyalgia
Fibromyalgia affects around three million people in the UK.

Medical cannabis is associated with an improvement in fibromyalgia symptoms and quality of life, according to new UK data. 

In what is thought to be a first for the UK, a new study has assessed the effects seen in fibromyalgia patients after being prescribed medical cannabis.

The study, which included patients being treated at Sapphire Medical Clinics, comprised of 306 patients enrolled in the UK Medical Cannabis Registry.

According to those behind the research, significant reductions in fibromyalgia specific symptoms were observed in patients as early as one month and continued to the end of the six month study period.

The patients also reported improvements in pain severity, anxiety symptoms, sleep quality and overall health-related quality of life.

In addition to showing a reduction in fibromyalgia symptom severity, the research found a 17 per cent reduction in overall opiate use by patients.

The full findings will be presented in full at the forthcoming International Cannabinoid Research Society (ICRS) Symposium, taking place from 25-30 June.

Delving deeper into fibromyalgia

Fibromyalgia affects around three million people in the UK and is often a cause of ‘invisible’ disability.

It affects women more often than men, with a typical onset between 35 and 50 years of age, however it can present earlier.

The chronic condition causes pain in the muscles and tissues such as the tendons and ligaments causing tenderness in the upper chest and back, as well as neck, arms, and legs.

Symptoms commonly experienced include anxiety, debilitating fatigue, chronic pain, sensitivity to light, sound, temperature and touch, as well as cognitive symptoms relating to short term memory or difficulty finding a word – often called ‘fibro fog’. These can be exacerbated by stress, cold weather and physical activity with patients reporting fatigue and extreme tiredness which is not relieved by rest.

Until now, there has been no recognised, formal diagnostic process for health care professionals. This may have caused fibromyalgia patients to become “stuck in the symptom” undergoing extensive medical investigations without an official label – navigating between pain management, rheumatology, and psychology experts.

As a result, many people receive an incorrect diagnosis and only receive the true diagnosis after years of searching for an answer. The Royal College of Physicians, however, has recently released new guidelines to support clinicians in the diagnosis of fibromyalgia syndrome.

Consultant rheumatologist at Sapphire Medical Clinics, Dr Wendy Holden, says: “Seeking an official diagnosis is important for patients and can be incredibly empowering by enabling them to validate their condition. An accurate and early diagnosis is vital to ensure symptoms such as anxiety, sleep, and cognitive function can be managed, mobility can be maintained – to avoid the risk of disability. Sadly though, many patients experience a late diagnosis after years of pain, finding themselves in devastating circumstances, unable to work and facing poverty.”

Patients often experience a long treatment “journey”, trying multiple medications to get on top of a set of complex symptoms. Fibromyalgia sufferers may undergo courses of analgesics, anti-depressants, complicated medical regimes and in some instances pain management programmes.

In addition to being a ‘treatment-resistant‘ condition, people with fibromyalgia often can’t tolerate certain medications as their bodies are more sensitive to their effects. When these first-line therapies fail to provide adequate symptom control, medical cannabis can be considered.

“Finding the right treatment regime for fibromyalgia is a huge problem – and 50 per cent of the patients I see at Sapphire Medical Clinics suffer from the condition,” Dr Holden adds.

“This study is the first of its kind into the outcomes of UK patients prescribed CBMPs for fibromyalgia – and results are very promising. One of the ways we can help patients in the future is to invest in this type of research to better understand the condition and the impact of emerging treatment options. From my experience, the results of the study mirror what I am seeing in patients sat in front of me during their follow up appointments.”

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Fibromyalgia diaries: To vape or not to vape?

Medical cannabis oil has been life-changing for Julia, but she’s still struggling to come to terms with vaping.

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Fibromyalgia diaries: To vape or not to vape?

Fibromyalgia patient Julia Davenport says cannabis oil has been life-changing for her, but she’s still struggling to get on board with flower.

My perception of cannabis has changed dramatically in the few years since I started taking it as pain relief. 

As I mentioned in my last entry, I’m from a generation which, despite living through the enlightened age of the 1960s, grew up believing the plant to be bad. 

This created a strong resistance to even trying CBD or medical cannabis when they emerged as possible treatments for pain associated with my fibromyalgia and arthritis. 

I’m over that now, and take CBD daily, with a private medical cannabis prescription to use orally whenever I have a flare-up. 

Fibromyalgia: A banner advert for the medical cannabis clinic

Read more about how Julia discovered medical cannabis

One taboo I’m still struggling to get past, however, is the use of vape. 

Buried in my kitchen drawer is a dry herb vapouriser, alongside the medical cannabis flower prescribed to me by a pain consultant.

With this, I’m armed and ready with what I understand to be the fastest route for medical cannabis to get into the bloodstream.  

But, sadly, although it could have rescued me on several occasions in the year since I bought the device, its box remains sealed.

I’m sure many Cannabis Health readers will be shaking their heads right now. What a travesty that something millions of people with a range of conditions could potentially benefit from is going to waste. 

I do truly feel lucky to have a private prescription at a time when countless others are unable to access medical cannabis through cost, red tape or misinformation.

The problem I have is my huge aversion to smoking. Yes vaping isn’t smoking, but the action of ingesting something that looks like smoke into your lungs just doesn’t feel right. 

While I’ve never smoked in my life, my father was a heavy smoker who suffered from the lung disease, chronic emphysema. My mother also had coronary artery disease, possibly related to smoking. 

For these reasons, I just have a mental block about vaping, despite reading about how effective it can be as a breakthrough remedy.

No doubt many people my age, who grew up with parents who smoked, also feel the same; and perhaps there is some way to go before vape vendors can escape perceived links to smoking.  

Maybe more evidence on the impact of vaping on the lungs will help to change this over time – and I’ll eventually make use of my vapouriser. 

Meanwhile, in putting my fibromyalgia diary together, I began to think about all the ways cannabis has changed my life. I thought I’d share perhaps the most unusual one – going cold turkey on my teddy bear collection. 

With chronic pain conditions, including fibromyalgia, night time can be particularly difficult and insomnia is common. It is a horrible experience to feel utterly drained but be unable to fall asleep, sometimes for days. 

Before discovering CBD and medical cannabis I would often find myself wide awake in the middle of the night. It was at these times that my attention drifted on my iPad to eBay. 

For some reason, possibly nostalgia, my search for distraction amid the pain and boredom took me to the furry world of vintage teddy bears.

Many nights spent bidding for bears in the blue light led to a considerable collection building up. 

Now, my days as an arctophile (yes there is a word for someone who collects or is very fond of teddy bears) are over.

My CBD and medical cannabis regime has significantly cut the number of sleepless nights I experience and, in turn, the volume of new bears taking up space on my shelves.

Next time: Travelling as a medical cannabis patient.

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