Introduction

Alzheimer’s disease is a brain disorder named for German physician Alois Alzheimer, who first described it in 1906. Scientists have learned a great deal about Alzheimer’s disease in the century since Dr. Alzheimer first drew attention to it. Today we know that Alzheimer’s:

Is a common and serious brain disease. More than 5 million Americans now have Alzheimer’s. Although symptoms can vary widely, the first problem many people notice is forgetfulness severe enough to affect their work, lifelong hobbies or social life.

Inside the Brain: An Interactive Tour
Learn how the brain works and how
Alzheimer's affects it.

Gets worse over time. As the disease progresses, other symptoms include confusion, trouble with organizing and expressing thoughts, misplacing things, getting lost in familiar places, and changes in personality and behavior. For more information, see Warning Signs or Stages of Alzheimer’s Disease.
Is the most common form of dementia, a general term for the loss of memory and other intellectual abilities serious enough to interfere with daily life. Vascular dementia, another common type, is caused by reduced blood flow to parts of the brain. In mixed dementia, Alzheimer’s and vascular dementia occur together. For more information about other causes of dementia, please see Related Diseases.
Has no current cure. But treatments for symptoms, combined with the right services and support, can make life better for the millions of Americans living with Alzheimer’s. We’ve learned most of what we know about Alzheimer’s in the last 15 years. There is an accelerating worldwide effort under way to find better ways to treat the disease, delay its onset, or prevent it from developing. Learn more about recent progress in Alzheimer science and research funded by the Alzheimer’s Association in the Research section.

Alzheimer's and the brain

Just like the rest of our bodies, our brains change as we age. Most of us notice some slowed thinking and occasional problems remembering certain things. However, serious memory loss, confusion and other major changes in the way our minds work are not a normal part of aging. They may be a sign that brain cells are failing.

The brain has 100 billion nerve cells (neurons). Each nerve cell communicates with many others to form networks.
Nerve cell networks have special jobs. Some are involved in thinking, learning and remembering. Others help us see, hear and smell. Still others tell our muscles when to move.

To do their work, brain cells operate like tiny factories. They take in supplies, generate energy, construct equipment and get rid of waste. Cells also process and store information. Keeping everything running requires coordination as well as large amounts of fuel and oxygen.

In Alzheimer’s disease, parts of the cell’s factory stop running well. Scientists are not sure exactly where the trouble starts. But just like a real factory, backups and breakdowns in one system cause problems in other areas. As damage spreads, cells lose their ability to do their jobs well. Eventually, they die.
Learn more about Alzheimer's: Brain Tour

The role of plaques and tangles

Two abnormal structures called plaques and tangles are prime suspects in damaging and killing nerve cells. Plaques and tangles were among the abnormalities that Dr. Alois Alzheimer saw in the brain of Auguste D., although he called them different names.

Plaques build up between nerve cells. They contain deposits of a protein fragment called beta-amyloid (BAY-tuh AM-uh-loyd). Tangles are twisted fibers of another protein called tau (rhymes with “wow”).
Tangles form inside dying cells. Though most people develop some plaques and tangles as they age, those with Alzheimer’s tend to develop far more. The plaques and tangles tend to form in a predictable pattern, beginning in areas important in learning and memory and then spreading to other regions.

Scientists are not absolutely sure what role plaques and tangles play in Alzheimer’s disease. Most experts believe they somehow block communication among nerve cells and disrupt activities that cells need to survive.

Early stage and early onset

Early-stage is the early part of Alzheimer’s disease when problems with memory, thinking and concentration may begin to appear in a doctor’s interview or medical tests. Individuals in the early-stage typically need minimal assistance with simple daily routines. At the time of a diagnosis, an individual is not necessarily in the early stage of the disease; he or she may have progressed beyond the early stage.

The term early-onset refers to Alzheimer's that occurs in a person under age 65. Early-onset individuals may be employed or have children still living at home. Issues facing families include ensuring financial security, obtaining benefits and helping children cope with the disease. People who have early-onset dementia may be in any stage of dementia – early, middle or late.

History

At a scientific meeting in November 1906, German physician Alois Alzheimer presented the case of “Frau Auguste D.,” a 51-year-old woman brought to see him in 1901 by her family. Auguste had developed problems with memory, unfounded suspicions that her husband was unfaithful, and difficulty speaking and understanding what was said to her. Her symptoms rapidly grew worse, and within a few years she was bedridden. She died in Spring 1906, of overwhelming infections from bedsores and pneumonia.

Dr. Alzheimer had never before seen anyone like Auguste D., and he gained the family’s permission to perform an autopsy. In Auguste’s brain, he saw dramatic shrinkage, especially of the cortex, the outer layer involved in memory, thinking, judgment and speech. Under the microscope, he also saw widespread fatty deposits in small blood vessels, dead and dying brain cells, and abnormal deposits in and around cells.

The condition entered the medical literature in 1907, when Alzheimer published his observations about Auguste D. In 1910, Emil Kraepelin, a psychiatrist noted for his work in naming and classifying brain disorders, proposed that the disease be named after Alzheimer.

Auguste D.

Dr. Alois Alzheimer

More information

The Basics of Alzheimer's Disease
(32 pages)

Learn About Cancer http://www.cancer.org/docroot/home/index.asp

What Is Cancer?

Cancer occurs when cells in a part of the body begin to grow out of control. Normal cells divide and grow in an orderly fashion, but cancer cells do not. They continue to grow and crowd out normal cells. Although there are many kinds of cancer, they all have in common this out-of-control growth of cells.

Different kinds of cancer can behave very differently. For example, lung cancer and breast cancer are very different diseases. They grow at different rates and respond to different treatments. That’s why people with cancer need treatment that is aimed at their kind of cancer.

Sometimes cancer cells break away from a tumor and spread to other parts of the body through the blood or lymph system. They can settle in new places and form new tumors. When this happens, it is called metastasis (meh-tas-tuh-sis). Cancer that has spread in this way is called metastatic cancer.

Even when cancer has spread to a new place in the body, it is still named after the part of the body where it started. For example, if prostate cancer spreads to the bones, it is still called prostate cancer. If breast cancer spreads to the lungs, it is still breast cancer. When cancer comes back in a person who appeared to be free of the disease after treatment, it is called a recurrence.

American Diabetes Association http://www.diabetes.org/home.jsp

All About Diabetes

Diabetes is a disease in which the body does not produce or properly use insulin. Insulin is a hormone that is needed to convert sugar, starches and other food into energy needed for daily life. The cause of diabetes continues to be a mystery, although both genetics and environmental factors such as obesity and lack of exercise appear to play roles.

There are 20.8 million children and adults in the United States, or 7% of the population, who have diabetes. While an estimated 14.6 million have been diagnosed with diabetes, unfortunately, 6.2 million people (or nearly one-third) are unaware that they have the disease.

In order to determine whether or not a patient has pre-diabetes or diabetes, health care providers conduct a Fasting Plasma Glucose Test (FPG) or an Oral Glucose Tolerance Test (OGTT). Either test can be used to diagnose pre-diabetes or diabetes. The American Diabetes Association recommends the FPG because it is easier, faster, and less expensive to perform.

With the FPG test, a fasting blood glucose level between 100 and 125 mg/dl signals pre-diabetes. A person with a fasting blood glucose level of 126 mg/dl or higher has diabetes.

In the OGTT test, a person's blood glucose level is measured after a fast and two hours after drinking a glucose-rich beverage. If the two-hour blood glucose level is between 140 and 199 mg/dl, the person tested has pre-diabetes. If the two-hour blood glucose level is at 200 mg/dl or higher, the person tested has diabetes.

Major Types of Diabetes

Type 1 diabetes
Results from the body's failure to produce insulin, the hormone that "unlocks" the cells of the body, allowing glucose to enter and fuel them. It is estimated that 5-10% of Americans who are diagnosed with diabetes have type 1 diabetes.

Type 2 diabetes
Results from insulin resistance (a condition in which the body fails to properly use insulin), combined with relative insulin deficiency. Most Americans who are diagnosed with diabetes have type 2 diabetes.

Gestational diabetes
Gestational diabetes affects about 4% of all pregnant women - about 135,000 cases in the United States each year.

Pre-diabetes
Pre-diabetes is a condition that occurs when a person's blood glucose levels are higher than normal but not high enough for a diagnosis of type 2 diabetes. There are 54 million Americans who have pre-diabetes, in addition to the 20.8 million with diabetes.

American Heart Association http://www.americanheart.org

Heart Attack, Stroke and Cardiac Arrest Warning Signs

Quick Links:
Heart Attack Warning Signs
Stroke Warning Signs
Cardiac Arrest Warning Signs

Act in Time
The American Heart Association and the National Heart, Lung, and Blood Institute have launched a new "Act in Time" campaign to increase people's awareness of heart attack and the importance of calling 9-1-1 immediately at the onset of heart attack symptoms. Find the links here.

Dial 9-1-1 Fast
Heart attack and stroke are life-and-death emergencies — every second counts. If you see or have any of the listed symptoms, immediately call 9-1-1. Not all these signs occur in every heart attack or stroke. Sometimes they go away and return. If some occur, get help fast! Today heart attack and stroke victims can benefit from new medications and treatments unavailable to patients in years past. For example, clot-busting drugs can stop some heart attacks and strokes in progress, reducing disability and saving lives. But to be effective, these drugs must be given relatively quickly after heart attack or stroke symptoms first appear. So again, don't delay — get help right away!

Statistics
Coronary heart disease is America's No. 1 killer. Stroke is No. 3 and a leading cause of serious disability. That's why it's so important to reduce your risk factors, know the warning signs, and know how to respond quickly and properly if warning signs occur.

Heart Attack Warning Signs
Some heart attacks are sudden and intense — the "movie heart attack," where no one doubts what's happening. But most heart attacks start slowly, with mild pain or discomfort. Often people affected aren't sure what's wrong and wait too long before getting help. Here are signs that can mean a heart attack is happening:

Chest discomfort. Most heart attacks involve discomfort in the center of the chest that lasts more than a few minutes, or that goes away and comes back. It can feel like uncomfortable pressure, squeezing, fullness or pain.
Discomfort in other areas of the upper body. Symptoms can include pain or discomfort in one or both arms, the back, neck, jaw or stomach.
Shortness of breath with or without chest discomfort.
Other signs may include breaking out in a cold sweat, nausea or lightheadedness

As with men, women's most common heart attack symptom is chest pain or discomfort. But women are somewhat more likely than men to experience some of the other common symptoms, particularly shortness of breath, nausea/vomiting, and back or jaw pain.

Learn the signs, but remember this: Even if you're not sure it's a heart attack, have it checked out. Minutes matter! Fast action can save lives — maybe your own. Don’t wait more than five minutes to call 9-1-1.

Calling 9-1-1 is almost always the fastest way to get lifesaving treatment. Emergency medical services staff can begin treatment when they arrive — up to an hour sooner than if someone gets to the hospital by car. The staff are also trained to revive someone whose heart has stopped. Patients with chest pain who arrive by ambulance usually receive faster treatment at the hospital, too.

If you can't access the emergency medical services (EMS), have someone drive you to the hospital right away. If you're the one having symptoms, don't drive yourself, unless you have absolutely no other option.

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Stroke Warning Signs
The American Stroke Association says these are the warning signs of stroke:

Sudden numbness or weakness of the face, arm or leg, especially on one side of the body
Sudden confusion, trouble speaking or understanding
Sudden trouble seeing in one or both eyes
Sudden trouble walking, dizziness, loss of balance or coordination
Sudden, severe headache with no known cause

If you or someone with you has one or more of these signs, don't delay! Immediately call 9-1-1 or the emergency medical services (EMS) number so an ambulance (ideally with advanced life support) can be sent for you. Also, check the time so you'll know when the first symptoms appeared. It's very important to take immediate action. If given within three hours of the start of symptoms, a clot-busting drug can reduce long-term disability for the most common type of stroke.

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Cardiac arrest strikes immediately and without warning. Here are the signs:

Sudden loss of responsiveness (no response to tapping on shoulders).
No normal breathing (the victim does not take a normal breath when you tilt the head up and check for at least five seconds).

If these signs of cardiac arrest are present, tell someone to call 9-1-1 and get an AED (if one is available) and you begin CPR immediately.

If you are alone with an adult who has these signs of cardiac arrest, call 9-1-1 and get an AED (if one is available) before you begin CPR.

Use an AED as soon as it arrives.

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Arthritis Foundation http://www.arthritis.org/

Learn About Arthritis

What is Arthritis?

Adapted from The Arthritis Foundation's Guide to Good Living with Rheumatoid Arthritis

While often referred to as if it were a single disease, arthritis is actually an umbrella term used for a group of more than 100 medical conditions that collectively affect nearly 46 million adults and 300,000 children in America alone. While the most common form of arthritis -- osteoarthritis (OA) -- is most prevalent in people over 60, arthritis in its various forms can start as early as infancy. Some forms affect people in their young-adult years as they are beginning careers and families and still others start during the peak career and child-rearing years.

The common thread among these 100-plus conditions is that they all affect the musculoskeletal system and specifically the joints - where two or more bones meet. Arthritis-related joint problems include pain, stiffness, inflammation and damage to joint cartilage (the tough, smooth tissue that covers the ends of the bones, enabling them to glide against one another) and surrounding structures. Such damage can lead to joint weakness, instability and visible deformities that, depending on the location of joint involvement, can interfere with the most basic daily tasks such as walking, climbing stairs, using a computer keyboard, cutting your food or brushing your teeth.

For many people with arthritis, however, joint involvement is not the extent of the problem. Many forms of arthritis are classified as systemic, meaning they can affect the whole body. In these diseases, arthritis can cause damage to virtually any bodily organ or system, including the heart, lungs, kidneys, blood vessels and skin. Arthritis-related conditions primarily affect the muscles and the bones.

Together, arthritis and related conditions are a major cause of disability in the United States, costing the U.S. economy more than $124 billion per year in medical care and indirect expenses such as lost wages and production - and costing millions of individuals their health, their physical abilities and, in many cases, their independence. And unless something changes, the picture is going to get worse. As the population ages, the number of people with arthritis is growing.

Number of Americans with arthritis or chronic joint symptoms:

1985 - 35 million

1990 - 37.9 million

1998 - nearly 43 million (1 in 6 people)

2006 – 46 million (nearly 1 in 5 adults)

Arthritis is one of the most prevalent chronic health problems and the nation’s leading cause of disability among Americans over age 15.

Arthritis is second only to heart disease as a cause of work disability.

Arthritis limits everyday activities such as walking, dressing and bathing for more than 7 million Americans.

Arthritis results in 39 million physician visits and more than a half million hospitalizations.

Costs to the U.S. economy totals $128 billion annually.

Arthritis affects people in all age groups including nearly 300,000 children.

Baby boomers are now at prime risk. More than half those affected are under age 65.

Half of those Americans with arthritis don’t think anything can be done to help them.

Arthritis refers to more than 100 different diseases that affect areas in or around joints.

Arthritis strikes women more often than men.

Overall arthritis:

Women - 24.3 million of the people with doctor-diagnosed arthritis

Men - 17.1 million of the people with doctor-diagnosed arthritis

The disease also can affect other parts of the body. Arthritis causes pain, loss of movement and sometimes swelling. Some types of arthritis are:

Osteoarthritis, a degenerative joint disease in which the cartilage that covers the ends of bones in the joint deteriorates, causing pain and loss of movement as bone begins to rub against bone. It is the most prevalent form of arthritis.

Rheumatoid arthritis, an autoimmune disease in which the joint lining becomes inflamed as part of the body’s immune system activity. Rheumatoid arthritis is one of the most serious and disabling types, affecting mostly women.

Gout, which affects mostly men. It is usually the result of a defect in body chemistry. This painful condition most often attacks small joints, especially the big toe. Fortunately, gout almost always can be completely controlled with medication and changes in diet.

Ankylosing spondylitis, a type of arthritis that affects the spine. As a result of inflammation, the bones of the spine grow together.

Juvenile arthritis, a general term for all types of arthritis that occur in children. Children may develop juvenile rheumatoid arthritis or childhood forms of lupus, ankylosing spondylitis or other types of arthritis.

Systemic lupus erythematosus (lupus), a serious disorder that can inflame and damage joints and other connective tissues throughout the body.

Scleroderma, a disease of the body’s connective tissue that causes a thickening and hardening of the skin.

Fibromyalgia, in which widespread pain affects the muscles and attachments to the bone. It affects mostly women.

Read the CDC Report on the Impact of Arthritis.

Visit the CDC for additional statistics about arthritis.

CASA Court Appointed Special Advocate http://casaoc.org/

History of the CASA Movement

In 1977, a Seattle Superior Court Judge named David Soukup was concerned about trying to make decisions on behalf of abused and neglected children without enough information. He conceived the idea of appointing community volunteers to speak up for the best interests of these children in court. He made a request for volunteers; 50 citizens responded, and that was the start of the CASA movement.

Today, there are more than 50,000 advocates serving in 948 state and local program offices nationwide. CASA programs across the country are known by several different names, including Guardian ad Litem, Child Advocates and Voices for Children.

Since the inception of CASA advocacy, volunteers have helped well over 1,000,000 children find safe, permanent homes in which they can thrive.

CHADD Children and Adults with Attention –Deficit Hyperactivity Disorder http://www2.chadd.org/

About AD/HD & ADD

Topics in this section:

About AD/HD & ADD

Attention-deficit/hyperactivity disorder (AD/HD) is one of the most common neurobehavioral disorders. It is usually first diagnosed in childhood and often persists into adulthood. AD/HD is a chronic disorder that can negatively impair many aspects of daily life, including home, school, work, and interpersonal relationships.

Because it is a lifespan disorder that impacts so many areas of an individual's daily functioning, AD/HD is a serious public health issue.

The National Resource Center has partnered with the National Alliance for Hispanic Health to produce an introduction to AD/HD in children. This is available in both English and Spanish.

Other Web Sites:

AD/HD Global Network (AGN)
The AD/HD Global Network is a non-profit international foundation that seeks to support AD/HD advocacy groups and/or individuals by serving as an information and referral resource, and by providing global AD/HD training and consultancy.
Centers for Disease Control and Prevention (CDC/NCBDDD)
AD/HD information page at CDC's National Center on Birth Defects and Developmental Disabilities
CDC and Child Development
CDC's Child Development page with information about major projects and activities, public health issues in child development, child development milestones, and Positive Parenting Tips sheets
CH.A.D.D. Canada
CH.A.D.D. Canada is a charitable organization that aims to help support, educate, and ultimately better the lives of individuals with ADHD, and those who are for them.
Mental Health America (formerly National Mental Health Association)
General information on mental health issues and resources.
NICHQ
The National Initiative for Children's Healthcare Quality (NICHQ) is an education and research organization dedicated to improving the quality of health care provided to children. NICHQ's mission is to eliminate the gap between what is and what can be in health care for all children.
The REACH Institute
REsource for Advancing Children's Health (REACH) was founded to accelerate the acceptance and effective use of proven interventions that foster children?s emotional and behavioral health.

Citizen Advocates for Foster Children’s Rights http://clcmn.org/

What is Foster Care?
Foster care is the temporary placement of children and youth with families outside of their own home as a result of abuse or neglect. The goal is to provide a safe, stable, nurturing environment.

Foster Child Bill of Rights

Ratified in Congress Hall, Philadelphia
Saturday, the Twenty-eighth of April, Nineteen Hundred and Seventy Three

Reaffirmed during the National Focus on Foster Care Conference, Norfolk, Virginia

Wednesday, the Fourth of May, Nineteen Hundred and Eighty Three

Even more than for other children, society has a responsibility, along with parents, for the well-being of children in foster care. Citizens are responsible for acting to insure their welfare.

Every child in foster care is endowed with the rights inherently belonging to all children. In addition, because of the temporary or permanent separation from, and loss of, parents and other family members, the child requires special safeguards, resources, and care.

EVERY CHILD IN FOSTER CARE HAS THE INHERENT RIGHT:

Article the first
....to be cherished by a family of his own, either his family helped by readily available services and supports to resume his care, or an adoptive family or, by plan, a continuing foster family.
Article the second
....to be nurtured by foster parents who have been selected to meet his individual needs, and who are provided services and supports, including specialized education, so that they can grow in their ability to enable the child to reach his potentiality.
Article the third
....to receive sensitive, continuing help in understanding and accepting the reasons for his own family's inability to take care of him, and in developing confidence in his own self worth.

Article the fourth
....to receive continuing loving care and respect as a unique human being...a child growing in trust in himself and others.

Article the fifth
....to grow up in freedom and dignity in a neighborhood of people who accept him with understanding, respect and friendship.

Article the sixth
....to receive help in overcoming deprivation or whatever distortion in his emotional, physical, intellectual, social and spiritual growth may have resulted from his early experiences.

Article the seventh
....to receive education, training, and career guidance to prepare for a useful and satisfying life.

Article the eighth
....to receive preparation for citizenship and parenthood through interaction with foster parents and other adults who are consistent role models.

Article the ninth
....to be represented by an attorney-at-law in administrative or judicial proceedings with access to fair hearings and court review of decisions, so that his best interests are safeguarded.

Article the tenth
....to receive a high quality of child welfare services, including involvement of the natural parents and his own involvement in major decisions that affect his life.

Fibromyalgia Foundation http://www.fmaware.org

Section Graphic Fibromyalgia

Fibromyalgia

What is fibromyalgia?

Fibromyalgia (FM) is a chronic pain illness characterized by widespread musculoskeletal aches, pain and stiffness, soft tissue tenderness, general fatigue, and sleep disturbances. The most common sites of pain include the neck, back, shoulders, pelvic girdle, and hands, but any body part can be affected. Fibromyalgia patients experience a range of symptoms of varying intensities that wax and wane over time.

Who is affected?

It is estimated that approximately 3-6% of the U.S. population has FM. Although a higher percentage of women of all ages and races are affected, it does strike men and children. Because of its debilitating nature, fibromyalgia has a serious impact on patients' families, friends, and employers, as well as society at large.

What are the symptoms?

FM is characterized by the presence of multiple tender points and a constellation of symptoms.

Pain
The pain of FM is profound, widespread and chronic. It knows no boundaries, migrating to all parts of the body and varying in intensity. FM pain has been described as stabbing and shooting pain and deep muscular aching, throbbing, and twitching. Neurological complaints such as numbness, tingling, and burning are often present and add to the discomfort of the patient. The severity of the pain and stiffness is often worse in the morning. Aggravating factors that affect pain include cold/humid weather, non-restorative sleep, physical and mental fatigue, excessive physical activity, physical inactivity, anxiety and stress.
Fatigue
In today's world many people complain of fatigue; however, the fatigue of FM is much more than being tired. It is an all-encompassing exhaustion that interferes with even the simplest daily activities. It feels like every drop of energy has been drained from the body, which at times can leave the patient with a limited ability to function both mentally and physically.
Sleep problems
Many fibromyalgia patients have an associated sleep disorder that prevents them from getting deep, restful, restorative sleep. Medical researchers have documented specific and distinctive abnormalities in the Stage 4 deep sleep of FM patients. During sleep, individuals with FM are constantly interrupted by bursts of awake-like brain activity, limiting the amount of time they spend in deep sleep.
Other symptoms
Additional symptoms may include: irritable bowel and bladder, headaches and migraines, restless legs syndrome (periodic limb movement disorder), impaired memory and concentration, skin sensitivities and rashes, dry eyes and mouth, anxiety, depression, ringing in the ears, dizziness, vision problems, Raynaud's Syndrome, neurological symptoms, and impaired coordination.

How is it diagnosed?

Currently there are no laboratory tests available for diagnosing fibromyalgia. Doctors must rely on patient histories, self-reported symptoms, a physical examination and an accurate manual tender point examination. This exam is based on the standardized American College of Rheumatology (ACR) criteria. Proper implementation of the exam determines the presence of multiple tender points at characteristic locations.

It is estimated that it takes an average of five years for an FM patient to get an accurate diagnosis. Many doctors are still not adequately informed or educated about FM. Laboratory tests often prove negative and many FM symptoms overlap with those of other conditions, thus leading to extensive investigative costs and frustration for both the doctor and patient. Another essential point that must be considered is that the presence of other diseases, such as rheumatoid arthritis or lupus, does not rule out an FM diagnosis. Fibromyalgia is not a diagnosis of exclusion and must be diagnosed by its own characteristic features.

To receive a diagnosis of FM, the patient must meet the following diagnostic criteria:

Widespread pain in all four quadrants of the body for a minimum duration of three months
Tenderness or pain in at least 11 of the 18 specified tender points when pressure is applied

What causes fibromyalgia?

While the underlying cause or causes of FM still remain a mystery, new research findings continue to bring us closer to understanding the basic mechanisms of fibromyalgia. Most researchers agree that FM is a disorder of central processing with neuroendocrine/neurotransmitter dysregulation. The FM patient experiences pain amplification due to abnormal sensory processing in the central nervous system. An increasing number of scientific studies now show multiple physiological abnormalities in the FM patient, including: increased levels of substance P in the spinal cord, low levels of blood flow to the thalamus region of the brain, HPA axis hypofunction, low levels of serotonin and tryptophan and abnormalities in cytokine function.

Recent studies show that genetic factors may predispose individuals to a genetic susceptibility to FM. For some, the onset of FM is slow; however, in a large percentage of patients the onset is triggered by an illness or injury that causes trauma to the body. These events may act to incite an undetected physiological problem already present.

Exciting new research has also begun in the areas of brain imaging and neurosurgery. Ongoing research will test the hypothesis that FM is caused by an interpretative defect in the central nervous system that brings about abnormal pain perception. Medical researchers have just begun to untangle the truths about this life-altering disease.

How is fibromyalgia treated?

One of the most important factors in improving the symptoms of FM is for the patient to recognize the need for lifestyle adaptation. Most people are resistant to change because it implies adjustment, discomfort and effort. However, in the case of FM, change can bring about recognizable improvement in function and quality of life. Becoming educated about FM gives the patient more potential for improvement.

An empathetic physician who is knowledgeable about the diagnosis and treatment of FM and who will listen to and work with the patient is an important component of treatment. It may be a family practitioner, an internist, or a specialist (rheumatologist or neurologist, for example). Conventional medical intervention may be only part of a potential treatment program. Alternative treatments, nutrition, relaxation techniques, and exercise play an important role in FM treatment as well. Each patient should, with the input of a healthcare practitioner, establish a multifaceted and individualized approach that works for them.

Pain management
Over-the-counter pain medications, such as acetaminophen or ibuprofen, may be helpful in relieving pain. The physician may decide to prescribe one of the newer non-narcotic pain relievers (e.g. tramadol) or low doses of antidepressants (e.g. tricyclic antidepressants, serotonin reuptake inhibitors) or benzodiazepines. Patients must remember that antidepressants are "serotonin builders" and can be prescribed at low levels to help improve sleep and relieve pain. If the patient is experiencing depression, higher levels of these or other medications may need to be prescribed. Lidocaine injections into the patient's tender points also work well on localized areas of pain. An important aspect of pain management is a regular program of gentle exercise and stretching, which helps maintain muscle tone and reduces pain and stiffness.
Sleep management
Improved sleep can be obtained by implementing a healthy sleep regimen. This includes going to bed and getting up at the same time every day; making sure that the sleeping environment is conducive to sleep (i.e. quiet, free from distractions, a comfortable room temperature, a supportive bed); avoiding caffeine, sugar, and alcohol before bed; doing some type of light exercise during the day; avoiding eating immediately before bedtime; and practicing relaxation exercises as you fall to sleep. When necessary, there are new sleep medications that can be prescribed, some of which can be especially helpful if the patient's sleep is disturbed by restless legs or periodic limb movement disorder.
Psychological support
Learning to live with a chronic illness often challenges an individual emotionally. The FM patient needs to develop a program that provides emotional support and increases communication with family and friends. Many communities throughout the United States and abroad have organized fibromyalgia support groups. These groups often provide important information and have guest speakers who discuss subjects of particular interest to the FM patient. Counseling sessions with a trained professional may help improve communication and understanding about the illness and help to build healthier relationships within the patient's family.
Other treatments
Complementary therapies can be very beneficial. These include: physical therapy, therapeutic massage, myofascial release therapy, water therapy, light aerobics, acupressure, application of heat or cold, acupuncture, yoga, relaxation exercises, breathing techniques, aromatherapy, cognitive therapy, biofeedback, herbs, nutritional supplements, and osteopathic or chiropractic manipulation.

What is the prognosis?

Better than ever before! The efforts of individuals, support groups, organizations and medical professionals to help improve the quality of life for people with FM are starting to pay off. Better ways to diagnose and treat FM are on the horizon. The symptoms of FM can vary in severity and often wax and wane, but most patients do tend to improve over time. By actively seeking new information, talking to others who have FM, re-evaluating daily priorities, making lifestyle changes, and working hard to keep a hopeful attitude, the FM sufferer can become the FM survivor!

Institute for Attachment and Child Development http://www.instituteforattachment.org/

What is attachment disorder?
An attachment disorder is a condition in which individuals have difficulty forming loving, lasting intimate relationships.

Attachment disorders vary in severity, but the term usually is reserved for individuals who show a nearly complete lack of ability to be genuinely affectionate with others. They typically fail to develop a conscience and do not learn to trust.

Children with healthy attachments to a loving caregiver ...

Feel secure and loved
Can attain their potential
Can develop reciprocal relationships
Develop a conscience
Cope with stress and anxiety
Become self-reliant

Children who do not have healthy attachments with a loving caregiver . . .

Do not trust caregivers or adults in authority.
Have extreme control problems, manifested in covertly manipulative or overtly hostile ways.
Do not develop a moral foundation: no empathy, no remorse, no conscience, and/or no compassion for others.
Lack the ability to give and receive genuine affection or love.
Resist all efforts to nurture or guide them.
Lack cause and effect thinking.
Act out negatively, provoking anger in others.
Lie, steal, cheat, and/or manipulate.
Are destructive, cruel, argumentative and/or hostile.
Lack self-control - are impulsive.
Are superficially charming and engaging.

The process of developing healthy attachments can be disrupted by...

Abuse, neglect, abandonment, multiple changes in caregivers, foster care, adoption, painful illness, exposure to alcohol/drugs in utero, maternal depression, and/or inconsistent day care.

Parents of Children with Attachment disorder frequently . . .

Feel isolated and depressed.
Feel frustrated and stressed.
Are hypervigilant, agitated and have difficulty concentrating.
Are confused, puzzled and obsessed with finding answers.
Feel blamed by family, friends, and professionals.
Feel helpless, hopeless, and angry.
Feel that their family's problems are minimized by the helping profession.

Lupus Logo Lupus http://www.lupus.org/newsite/index.html

about Lupus

Lupus is a chronic inflammatory disease that can affect various parts of the body, especially the skin, joints, blood, and kidneys.

Introduction to Lupus

Lupus is an autoimmune disease that can affect various parts of the body, including the skin, joints, heart, lungs, blood, kidneys and brain. Normally the body's immune system makes proteins called antibodies, to protect the body against viruses, bacteria, and other foreign materials. These foreign materials are called antigens.

In an autoimmune disorder like lupus, the immune system cannot tell the difference between foreign substances and its own cells and tissues. The immune system then makes antibodies directed against itself. These antibodies -- called "auto-antibodies" (auto means 'self') -- cause inflammation, pain and damage in various parts of the body.

Inflammation is considered the primary feature of lupus. Inflammation, which in Latin means "set on fire," is characterized by pain, heat, redness, swelling and loss of function, either on the inside or on the outside of the body (or both).

For most people, lupus is a mild disease affecting only a few organs. For others, it may cause serious and even life-threatening problems. Although epidemiological data on lupus is limited, studies suggest that more than 16,000 Americans develop lupus each year.

The Lupus Foundation of America (LFA) estimates between 1.5 - 2 million Americans have a form of lupus, but the actual number may be higher. More than 90 percent of people with lupus are women. Symptoms and diagnosis occur most often when women are in their child-bearing years, between the ages of 15 and 45.

In the United States, lupus is more common in African Americans, Latinos, Asians, and Native Americans than in Caucasians.

Lupus: an online tutorial

The National Library of Medicine has created an excellent online tutorial which provides a comprehensive overview of the disease, symptoms, health effects and treatments.

Multiple Sclerosis Society http://www.nationalmssociety.org/

Living with MS

For People Newly Diagnosed

If you or someone close to you has recently been given a diagnosis of multiple sclerosis, you probably have a lot of questions and concerns. Or, you may be feeling so overwhelmed by the diagnosis that you aren’t sure what kinds of questions to ask. The National MS Society has developed programs to give you the information and support you need to live comfortably and confidently with this change in your life.

	Knowledge Is Power An at-home educational series for people newly diagnosed with MS

An Introduction to MS

	Living with MS Addresses questions frequently asked after diagnosis of MS is received-from possible causes to advice on coping

Reach Out for Care

866.AFA.8484 (toll-free)

Introduction

Alzheimer's and the brain

The role of plaques and tangles

History

All About Diabetes

Major Types of Diabetes

Learn About Arthritis

What is Arthritis?

History of the CASA Movement

About AD/HD & ADD

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Other Web Sites:

Foster Child Bill of Rights

Introduction to Lupus