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Sisters I Need Help! About Immune System After Hyst. Sisters I Need Help! About Immune System After Hyst.

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Unread 04-04-2003, 03:11 AM
Sisters I Need Help! About Immune System After Hyst.

Surgery can take a huge toll on our bodies as can living w/Chronic pain You have been thru soo very much
After my Hyst I had 2 additional surgeries within 3 months & since then I have developed several pain syndromes & seem to be sick everytime I turn around. I get a sore throat every few weeks but I do have FMS/CFS & this is a common symptom. Here is some info that explains what pain can do & some on FMS/CFS:


Managing Chronic Pain:

Additional Resources for Patients and Patient Advocates:

Battling Back: Overcoming the Undertreatment of Chronic Pain:

Questions You Should Ask About Pain & Pain Treatment:

Pain Management:

Pain Clinics - a personal view:

Women and Pain:

Fibromyalgia and Chronic Fatigue Syndrome Clinic:

Living with FMS:

Diagnosis of chronic fatigue syndrome:

Fatigue Takes a Special Toll on Women:

The experience of being in a state of uncontrolled pain is horrible, frightening and a medical emergency. However, to those not experiencing it, including health care professionals, extreme pain is often not considered important enough to require immediate action. After all, pain is not going to kill you. Or is it?The experience of being in a state of uncontrolled pain is horrible, frightening and a medical emergency. However, to those not experiencing it, including health care professionals, extreme pain is often not considered important enough to require immediate action. After all, pain is not going to kill you. Or is it?


It turns out that healing is actually delayed when pain caused by tissue damage is not relieved. A number of studies suggest that uncontrolled pain has an adverse effect on our immune system. Continuous pain also appears to lower our body's ability to respond to stressful situations such as surgery, chemotherapy, and psychological stress.

Far-reaching consequences can also result from pain due to damage to a nerve (neuropathic pain). This type of unrelieved pain seems to cause changes in the nervous system that contribute to the development of chronic pain long after the damage to the nerve has healed.

A very interesting study linking pain relief and prolongation of life was done by a surgeon who operated on patients with pancreatic cancer. In half the patients that he operated on, he injected alcohol into the nerve that transmits pain signals from the pancreas to the brain. This destroyed the nerve and reduced the pain caused by the pancreatic cancer. In the second group of patients he injected a simple salt solution into the nerve, which does not harm it, allowing the pain signals to continue. Interestingly, the patients who had the nerve destroyed not only had lower pain scores, but also lived much longer than the patients who still suffered uncontrolled pain through their intact nerve.

Although this was a small study, hopefully larger studies will be done to investigate the effect of pain control on length of survival. Certainly, we already know that controlling pain helps to provide enjoyment and peace to those who are living with a life-threatening illness.


Before discussing the details of pain control, it is important to understand that having trust in your health care team is essential for good pain management. To establish this trust, you need those around you, especially your health care team, to believe that your pain is what you say it is, not what they think it is. This is the key that will allow you and your health care team to work together to help you deal with the pain.

Also, it is very helpful to get an explanation for the pain - what is causing it, and why it is occurring. The unknown pain always hurts more than the known pain. Indeed, knowing the source of the pain is one of the first steps in being able to control it.

Being able to talk about the pain will also help you to cope better: how it affects you, and how you feel about what is causing it. As well, it is crucial to be able to discuss other issues in your life, either with people around you or a member of your health care team. If you are worried about relationships, spiritual issues, your future health, finances or other issues, your pain will be magnified.
Fatigue Worst Hysterectomy Side Effect:

A disturbing percentage of women are struck by "debilitating" fatigue following a hysterectomy, according to a new survey. And in many cases, their doctors don't appear to be treating the cause of their problem.

The national survey of 300 women suggests that fatigue is the most common and long-lasting side effect of a hysterectomy, or the surgical removal of the uterus. The findings were presented this week at the joint annual meeting of the American Society for Reproductive Medicine and the Canadian Fertility and Andrology Society in Toronto.

Roughly 600,000 hysterectomies are performed every year in the United States, making it the most common non-pregnancy-related surgery for women. But according to Dr. R. Jeffrey Chang, the president-elect of the American Society for Reproductive Medicine, 74 percent of women who responded to the survey said that they had experienced unbearable fatigue, and that on average it lasted for 10 weeks after their surgery.

Thirty-seven percent reported that weariness interfered with their recovery more than other side effects, such as pain (which lasted, on average, for 4.5 weeks), sexual dysfunction, and hot flashes. And the effects of fatigue went beyond the physical: 55 percent reported difficulty in caring for their families, and half said that it delayed their return to work, placing them under financial strain.

Patients need expectations

"I try to have my patients fully comprehend the impact of the surgery," says Chang. In the last 20 years, he says, the time that women spend in the hospital following a hysterectomy has shrunk from four to five days to one to two days. "My tendency is to tell patients that when you leave the hospital the air is going to feel a little heavier. People have to remember these things, and if they do that, their expectations of recovery will be far, far more accurate.

"Remember, when a patient goes through surgery, you go through an anesthesia. You go through the trauma of the surgery itself. And then you have to have pain medication. All of those things -- to mention a few -- come together to create this picture."

Patients need some time for tissues to heal, which will bring on fatigue.

The disquieting figures presented in this study are made worse by the fact that for many of those women, such suffering isn't necessary. According to Chang, one of the most common causes of fatigue is anemia, a condition in which low levels of red blood cells don't provide enough oxygen to body tissues. Thirty-nine percent of the women in the survey reported that they had been diagnosed as anemic before or after their surgery, and 13 percent said that their surgery was postponed due to anemia. But only 15 percent of women with anemia said they were receiving prescription treatment to correct it.

Even if a woman is only marginally anemic prior to her surgery, and is being treated to bring up her red blood cells count due to blood loss from uterine bleeding, the blood loss during her surgery may push her red blood cell count so low that she becomes severely anemic. The logical step would be to start her on iron supplements, but according to Chang, "it turns out that that's not the case, according to the study. Not all women receive that therapy. And we don't know why that interaction fails to happen."

More than two-thirds of the women said that their doctor had told them little or nothing about anemia treatments, and just over half of the fatigued respondents did not recommend any treatment. However, 43 percent of the women said that they hadn't brought up their fatigue with the doctor, and a staggering 91 percent assumed that they would simply have to live with it.

"It may well be that patients aren't talking to doctors and doctors aren't talking to patients," says Chang. "We implore patients and physicians to talk to each other. If we were able to restore blood [iron] levels faster, we may have a reduction in the fatigue."

Wirthlin Worldwide, a research organization, conducted the survey in June.

What To Do

If you are about to or have recently undergone a hysterectomy, and you're experiencing major or lasting fatigue, talk to your doctor about it. There may be a treatment option for you.'s%20Health/posthyst.htm

Identifying Fibromyalgia:
Q: How do I know if I have fibromyalgia?

A: Fibromyalgia is a hodgepodge of symptoms characterized by mild to extreme discomfort emanating from skeletal muscles and soft tissue throughout the body. It is also referred to as myofascial pain and can encompass other disorders, including temporomandibular joint pain (TMJ).

Over the years, fibromyalgia has had a number of medical labels: muscle hardening, muscular rheumatism, fibrositis, myofascitis, myogelosis, and interstitial myofibrositis. The terms fibromyalgia and myofascial pain often are used interchangeably, but they are not identical twins. Myofascial pain is the umbrella term, and fibromyalgia is a specific kind of pain that encompasses widespread symptoms in muscles throughout the body.

The centerpiece of this disorder involves tender areas of muscle and trigger points (small areas of muscle that cause pain in a distant area when they are pressed). Trigger points are often associated with tender, hard knots within muscle tissue but are not always tender themselves. Trigger points and tender points often are confused, but they are not the same thing.

As with many pain conditions, there are no laboratory tests to diagnose this pain. For years, patients have been complaining to their doctors about achy pain in their muscles that comes and goes, moves around their bodies, and produces fatigue. Yet the shifting character of the condition, seemingly vague symptoms that come and go, and undetectable causes have confounded successful treatment.

In 1990, doctors with the American College of Rheumatology developed specific criteria for diagnosing fibromyalgia. To be diagnosed with it, a patient must have widespread pain and clear signs of muscle tenderness at eleven of eighteen identified spots on the body. The scientist who first spotted these clumps within muscle described them as feeling like "rubbery Rice Krispies."

Lodged within a taut band of muscle or neighboring tissue, they are tight knots. When pressed, they are unusually tender. When pressed hard, they may cause the whole muscle to twitch or a person to flinch, which is known as a jump sign. They frequently congregate in one area of the body, such as in the neck, shoulder, or back, and radiate discomfort to neighboring muscles. If you have had occasional knots in your muscles, like a kink in the neck, you may have had what is called latent trigger points because they can radiate pain but quickly disappear.

The underlying cause of trigger points is frequently a mystery. They can crop up after an injury or disease, from repetitive motion (like lots of lifting or a repeated sports motion), or for no apparent reason.
It has become increasingly clear that fibromyalgia (FMS) and several other chronic conditions, such as chronic fatigue syndrome, myofascial pain syndrome, headaches, irritable bowel syndrome, restless legs syndrome, primary dysmenorrhea, temporomandibular pain and dysfunction syndrome and female urethral syndrome are similar conditions. Gulf war syndrome is quite similar to FMS, and chemical sensitivity has not been well defined. A number of controlled studies show that these syndromes are associated with each other, and many of them are present in the same patient. In 1984, we had proposed that these syndromes have overlapping features and are unified by a common pathophysiologic mechanism which was not well understood at that time (Yunus MB, Comprehensive Therapy 1984; 10:21-28). Subsequently it became evident that the binding glue for these common conditions is a neuroendocrine aberration that is generally different from those found in psychiatric conditions (Yunus MB, Bailtieres Clin Rheum 1994; 8: 811-37). Recent research suggest, as well reviewed by Bennett (Bennett RM, Mayo Clin Proc 1999; 74:385-98), that more specified neuroendocrine abnorn1ality may well be central sensitization which is likely to be the common biopathophysiological binder of these overlapping illnesses.

Although some members of the above mentioned overlapping group of syndromes may indeed show central sensitization in response to a peripheral afferent input, it is equally possible that the central nervous system is intrinsically sensitive, even in the absence of a noxious stimulus in the peripheral tissues, in these conditions. An appropriate nomenclature for this group of syndromes has therefore been suggested to be "Central sensitivity syndromes" or CSS (Yunus MB, Journal of Indian Rheum Association, in press). The concept of central sensitization/central sensitivity and the available evidence for central sensitivity for several members of CSS will be discussed.

Central sensitization is related to central nervous system (CNS) neuroplasticity, which involves transsynaptic, cellular, molecular, membrane, and neurochemical changes in the central neurons of the spinal dorsal horn and supraspinal structures, in response to a peripheral stimulus. Such changes lead to central sensitivity with an exaggerated and prolonged response to a painful stimulus, increased receptive field, wind-up or summation effect and painful response to an otherwise non-noxious stimulus (such as touch). Central sensitization/ sensitivity is determined by other CNS factors, e.g., neurohormonal interactions and cerebral cognition.

Central sensitivity and related neurohorn1onal aberrations in FMS are suggested by persistence and spread of dysesthesia following a non-noxious electric stimulation, hyperexcitability with temporal summation to repeated electric stimulation, increased amplitude of cerebral event- related potential evoked by CO21aser stimulation, a decreased regional blood flow to thalamus and caudate nucleus, and an aberrant HPA axis. In chronic fatigue syndrome, there is widespread lower pain threshold in muscles by electric stimulation, as compared with normal controls. HPA axis abnormalities as well as brain neuroimaging studies also support that CFS is a disease of CNS.

Patients with irritable bowel syndrome (IBS) have multiple tender points as well as heightened visceral sensitivity with amplification and spread of pain in response to noxious stimuli. Cerebral neuroimaging in IBS also suggest a central dysfunction of nociception. Central sensitivity in tension-type headaches is evidenced by a widespread distribution of pain as well as a qualitative difference in pain following a peripheral noxious stimulus. The role of central mechanisms in migraine is suggested by an involvement of hypothalamus, serotonin, excitatory amino acids, central trigeminal pathways and cerebral events. Nicolodi et al examined existing data and concluded that hyperalgesia related to CNS neuroplastic changes are crucial for both migraine and FMS (Niclodi et al, Cephalgia 1998; 18 (suppI21): 41-4). With regards to myofascial pain syndrome, Bendtsen et al have demonstrated qualitatively altered nociception in this condition, suggesting aberrant central pain mechanism (Bendtsen et al, Pain 1996; 65 :259-64 ).

Several characteristics are shared by the CSS members, e.g., pain, hyperalgesia, poor sleep, fatigue, a response to a centrally acting drug, and an absence structural pathology in the tissues. The usual laboratory tests or X-rays which are useful for detecting classic pathology are normal in CSS. However, neurohormonal and newer brain imaging studies are abnormal in CSS diseases, but these abnormalities are generally different from those seen in psychiatric conditions. Thus CSS does not fit the traditional dichotomy of structural pathology or psychiatry, but a third" paradigm of central sensitivity/ neurohormonal dysfunction. It is, however, important to recognize that the boundaries between these three paradigms are not rigid and that there are some overlaps between them. For example, subgroups of rheumatoid arthritis as well as FMS have a psychological/psychiatric component, and FMS may be associated with, or triggered by, diseases of structural pathology, such as RA and systemic lupus erythematosus, as well as trauma. The diseases of these three chronic disease paradigms can be satisfactorily explained only by a biopsychosocial model. The boundaries between the so-called organic and functional disorders are more artificial than real. For this reason, I often use the tenus 'disease' and 'illness' synonymously.

The CSS members are probably the commonest conditions as a group for which a patient consults a physician for their immense suffering. Greater academic and clinical interest as well as an increased level of research funding are strongly warranted for these real illnesses.
Why is chronic pain more common in women?

At a conference co-sponsored by the Society for Women's Health Research, Georgetown University Medical Center rheumatologist Daniel Claw said women are more sensitive to pain. Claw added that certain autoimmune disorders such as lupus and pain amplification syndromes turn up more frequently in women.
Pain hits women especially hard because of the insomnia, fatigue, loss of appetite, muscle atrophy, and depression that goes along with many such disorders, says James Campbell, a professor of neurosurgery at Johns Hopkins University in Baltimore.
For years scientists have debated the relative importance of brain function, genes, and hormones in causing contrasting pain sensations among men and women. "There is a definite need to better understand all the neurophysiological and psychosocial factors in how we experience pain," says Fillingim. Scientists believe the brain circuitry that regulates pain response and relief differs in women and women.
Women are Wired DifferentlyWomen's hypersensitivity is partly because their brains are wired differently, says Jeffrey Mogil, an assistant professor of psychology at the University of Illinois at Urbana-Champaign.
In research on mice and rats, Mogil and his colleagues implicated a sex-specific gene. The unidentified gene(s) in this region accounts for up to 25% of the trait difference seen in female mice but not males. They also pinpointed a region of a mouse chromosome that contains a gene affecting pain sensitivity only in males.
"More and more it looks like there's actually different systems in men and women...that the physiology must differ by a protein being involved in a neural circuit in one case and not in the other," Mogil says.
Women are more sensitive to the same sensations and less tolerant than males in part because brain chemistry ebbs and flows with the menstrual cycle. New evidence suggests that certain women patients who experience more severe premenstrual pain symptoms may be hypersensitive in other ways.
Fillingim was amazed by how many patients he treated for TMJ had experienced early, painful periods. "They were out of whack from puberty," Fillingim says.
Hormones Linked to Painful DisordersHormones have been linked to other painful disorders such as rheumatoid arthritis, irritable bowel syndrome, and fibromyalgia. With such conditions as migraines and TMJ, the prognosis doesn't necessarily improve with age.
A study published in the April 2001 issue of Pain suggests that hormone replacement therapy can actually aggravate TMJ even in healthy menopausal women who are subjected to provocation. "The women on HRT reported being more pain-sensitive than those who were not," says Fillingim, who headed the study.
"If a woman with osteoarthritis starts HRT and notices that her pain is getting worse, she should consider getting off the drug, taking a lower dose, or switching to another alternative to see if (it is) responsible," he says.
From arthritis to migraines, scientists are also finding sex differences in how men and women respond to the pain of common diseases and disorders:
Arthritis: Daily logs kept by 71 arthritis patients showed that women experienced significantly more severe pain. According to Keefe, who was principal investigator on the project, women are also more likely to relax, air their emotions, seek distractions and emotional support to cope. "Men don't show their feelings and don't seek out assistance as readily as women. That may very well be what's going on in this case," Keefe says.
Cardiac Disease: Premenopausal women have higher rates of false-positive chest pain syndromes, while postmenopausal women have relatively high rates of asymptomatic or silent heart disease, says Debra Judelson, MD, medical director of the Women's Heart Institute in Beverly Hills, Calif. and former president of the American Women's Medical Association. "Women are more likely to have high blood pressure and diabetes as complicating medical problems which can change the way they experience pain," Judelson says. "They also have more abdominal, shoulder, and neck pain, shortness of breath, back discomfort, vomiting, fatigue and nausea as opposed to chest discomfort seen in men." The bottom line: up to a 40 percent higher mortality rate in younger women under 50 with heart disease than men. "Whatever symptoms they experience are not recognized as a cardio problem in the emergency room, which contributes to delays in seeking help or getting treatment," Judelson adds.
Migraine Headaches: Boys have more migraines than girls until puberty when hormones begin kicking in. Women are three times more likely to experience migraines than men beginning at puberty when hormone fluctuations kick in. They seem to strike whenever estrogen, the neurotransmitter serotonin, and beta endorphins are low. Several studies concluded that migraine in women of childbearing age dramatically boosts the risk of ischaemic, not haemorrhagic stroke. Women who use oral contraceptives, have high blood pressure, or smoke are at greatest risk of ischaemic stroke associated with migraine.
Opioids More Effective in Women
Scientists believe that learning about sex differences in pain may require rethinking how much medication to give people based on their sex. A 2001 study found that women patients with myocardial infarction (heart attack) were less likely than men to receive aspirin in the first hour of care than men.
Evidence suggests men and women respond differently to certain drugs, including analgesics used to treat pain. Campbell indicated that one study found that for back pain, male physicians prescribed higher doses of pain medication while female physicians upped pain medication for women. As the founder of the American Pain Society, Campbell urges more, not less, prescribing of painkillers to those in need.
Despite the fact that painful problems disproportionately strike women, the bright side is that a class of pain relievers called opioids are more effective in women although Campbell insists that their effects vary with the menstrual cycle.
To get pain relief, he insists, often calls for a variety of treatments, not a single solution. "The bottom line is helping that person relieve the level of pain and suffering, sleep, and function for daily living." Claw agrees. He prescribe medications that act on neurotransmitters, exercise, and cognitive therapy.
Chronic pain is pain that lingers after the normal healing process is complete. Usually pain that last longer than six weeks is considered chronic pain. There are many causes of chronic pain; some is due to injury or damage to nerve fibers (neuropathic pain); some due to diseases, shingles (Herpes Zoster), diabetes; some is due to trauma, such as injury, surgery, or amputation; it can also occur without disease or a known injury. This can happen in part, because the nervous system, which sends messages, can undergo rewiring and short circuits, which can obscure the initial or underlying cause of the pain. Chronic pain can range from mild, to severe, to disabling and can last from a few weeks or months to many years. Usually emotional and psychological components develop. These are sometimes significant and cause behavioral changes in the individual including, sadness, anger, and depression. Over time, a sense of helplessness to control the pain can lead to "pain behavior", which can become habitual crutches, that can undermine your ability to effectively manage the pain. Chronic pain can exact a toll on the individual, the family, the work place, and the health care system.
Millions of people world wide seek treatment for chronic pain every year. On occasion certain medications, nerve blocks or physical therapy can make a big difference, however, in most cases a multiple-part approach to ending the downward spiral of chronic pain is required. Reversing this spiral is now commonly referred to as pain management. Pain management includes, not only medication, but also a comprehensive plan of relaxation, exercise and behavioral change. There is no magic bullet for relief of chronic pain. Managing pain is not about making the pain disappear, it is about keeping pain tolerable and there are several ways to accomplish this.
Keep a Pain Journal: Record the various activities and therapies that reduce or alleviate your pain. A journal also helps track the ebb and flow of pain, so you are aware of them and know when the pain worsens and how to ease it.

Get Started on an Exercise Program: Exercise improves overall fitness, increases strength and flexibility and can reduce the risk of further injury and helps control pain.

Balance Your Life: Find a healthful balance of activities, which should include work time, exercise, recreation, hobbies, relaxation, rest and socialization with family and friends. This balance can ease pain and elevate your mood.

Medications: All medications have side effects and there are toxic risks with all medication. So which medication to use and when to use one for chronic pain is very complex.

Complementary Medicine: Unconventional therapies used (yoga or Tai Chi), which promote physical strengthening are safe and sensible when combined with exercise, diet and treatments prescribed by your doctor.

Alternative Medicine: This therapy is used instead of, or in conjunction with, traditional medical care, including homeopathic or naturopathic practitioners. The Food and Drug Administration do, not regulate herbal medications, while they may be beneficial; they may also be toxic and may interfere with prescription medication. Take with care.

Some Tips to Help in Managing Chronic Pain
Write yourself a contract: Pledge to yourself that you are committed to managing your pain.
Keep your home environment healthful: Remove all items from your home that might lure you into unhealthy habits. Your home should reflect your positive active attitude.
Set goals for pain management: Set specific goals to address your greatest pain problems.
Monitor your progress: Prepare some type visual aid or chart to display your progress.
Accept support: Support of family, friends and physician will help you keep going on track on difficult days.
Team up with your doctor: Your doctor can work with you to overcome obstacles, keep him/her posted on your progress.
Plan each day: Schedule your exercise, relaxation, rest, work. Make a list of things to do in order to accomplish your goals.
Stay positive: Think that you will control the pain. Keep your spirits up, this will help to maintain your ability to overcome and manage pain.
Reward yourself: If you treat yourself to something enjoyable, when you reach a goal, it will reinforce a positive attitude.
Study links endometriosis with autoimmune, hormone and allergic diseases:
Study links endometriosis with autoimmune, hormone and allergic diseases

LONDON (AP) — Women with endometriosis — a leading cause of infertility in which tissue from the womb lining grows elsewhere in the body — are much more likely to suffer from rheumatoid arthritis, lupus, chronic fatigue syndrome, fibromyalgia and allergies, new research has found.

The study, published this week in the journal Human Reproduction, is the first to document something that has been noticed by many women with the painful disorder.

The researchers urged doctors to look for the other diseases in women when diagnosing endometriosis, which afflicts between 8 % and 10% of women of childbearing age.

The cause of endometriosis, as well as of the other diseases, remains unknown.

The new research suggests an immune system abnormality may underlie all these conditions, said Warren Nothnick, a University of Kansas professor of obstetrics and gynecology who was not connected with the study.

"What is the underlying factor, the commonality, between all of these diseases? If we can find out what the one factor is, or group of factors, we can target that and hopefully come up with a way to treat not only the endometriosis, but also some of the other diseases," Nothnick said.

His own work, as well as that of other scientists, suggests that the malfunctioning of certain immune system chemicals called cytokines may be a common link.

Assuming endometriosis occurs before the other diseases, it may also be possible one day to spare women with endometriosis from developing some of the additional diseases, Nothnick said.

The study, conducted by scientists at the U.S. National Institute of Child Health and Human Development, George Washington University and the Endometriosis Association, involved 3,680 women with endometriosis.

The scientists found that 20% of the women had more than one other disease. A third of the women who had other diseases had fibromyalgia or chronic fatigue syndrome, and some of those women also had other autoimmune or hormone diseases.

Chronic fatigue syndrome was more than 100 times more common than among the general U.S. female population.

Hypothyroidism, which involves an underactive thyroid gland and causes mental and physical slowing, was seven times more common.

Fibromyalgia, which is characterized by widespread body pain and tiredness, was twice as common among the women with endometriosis.

Autoimmune inflammatory diseases — systemic lupus, rheumatoid arthritis and multiple sclerosis — also occurred more frequently than normal.

Rates of allergic conditions were higher, too. While allergies occur in 18% of U.S. women, they occurred in 61% of the women with endometriosis. The rate climbed even higher if the women had additional diseases.

The study also confirmed previous findings that there is typically a 10-year gap between the time women first get the pelvic pain and the diagnosis of endometriosis.

The most common symptom of endometriosis is pain, especially excessive cramps during menstrual periods or pain during or after sex. Infertility occurs in about 30 to 40% of women with endometriosis.

Endometrial tissue outside the uterus responds to the menstrual cycle similarly to the way it responds in the uterus. At the end of every cycle, when hormones cause the uterus to shed its endometrial lining, endometrial tissue growing outside the uterus also breaks apart and bleeds.

However, unlike menstrual fluid from the womb, which is flushed from the body during menstrual periods, blood from the misplaced tissue has no place to go. Tissues surrounding the area of endometriosis may become inflamed or swollen.

It is one of the most complex and least understood gynecological diseases and, despite many theories, the cause remains unknown.

One theory is that during menstruation some of the menstrual tissue backs up through the fallopian tubes into the abdomen, where it implants and grows.
. The emotional toll of chronic pain also can become part of a vicious cycle. Anxiety, stress, depression, anger and fatigue interact in complex ways with chronic pain and may decrease the body's production of natural painkillers; moreover, such negative feelings may increase the level of substances that amplify sensations of pain, worsening the spiral. Even the body's most basic defenses may be compromised: There is considerable evidence that unrelenting pain can suppress the immune system. Because of the mind/body links associated with chronic pain, effective treatment may require addressing psychological as well as physical aspects of the condition.

Any pain that lasts longer than six months is defined as chronic. The syndrome may include weakness, numbness, tingling, or other sensations, along with sleeping difficulties, a lack of energy, and depression. Some common forms of chronic pain are:

Continuing muscle pain, accompanied by cramping, soreness, swelling and muscle spasms or stiffness.
Lingering back pain, which may be sharp or aching, constant or intermittent, localized, radiating or diffuse.
Enduring joint pain, with tenderness and a sensation of heat in the affected area as well as radiating pain and a restricted range of motion.

The causes of chronic pain are exceedingly diverse. One frequent factor is the development of any of a number of conditions that can accompany aging and may affect bones and joints in ways that cause chronic pain. Other common reasons for persistent pain are nerve damage and injuries that fail to heal properly.

Disease can also be the underlying cause of chronic pain. Rheumatoid arthritis and osteoarthritis are well-known culprits, but persistent pain may also be due to such ailments as cancer, multiple sclerosis, stomach ulcers, AIDS and gallbladder disease.

In many cases, however, just what the source of chronic pain is can be a very complex and even mysterious issue to untangle. Although it may begin with an injury or illness, continuing pain can develop a psychological dimension after the physical problem has healed. This fact alone makes pinning down a single course of treatment tricky, and it is why doctors and other healers often find they have to try a number of different types of curative steps.

Many people suffering from chronic pain are able to gain some measure of control over it by practicing mind/body techniques on their own. But others may need professional help. For them, pain clinics — special care centers devoted exclusively to dealing with intractable pain — are often the answer. Some pain clinics are associated with hospitals and others are private; in either case, both inpatient and outpatient treatment are usually available. The length of a full treatment program can vary from several weeks to several months.

Pain clinics generally employ a multidisciplinary approach, involving physicians, psychologists, and physical therapists. The patient as well should take an active role in his or her own treatment. The aim in many cases is not only to alleviate pain but also to teach the chronic sufferer how to come to terms with pain and function in spite of it.

Various studies have shown as much as 50 percent improvement in pain reduction for chronic pain sufferers after visiting a pain clinic, and most people learn to cope better and can resume normal activities.

Immune Problems:

In most people, most of the time, the immune system does its job efficiently, but problems in its response to the environment are common. An overactive immune system, for example, results in autoimmune disorders. In these cases, for reasons that aren't clear, the immune system mistakes normal, healthy tissues for foreign invaders and attacks them. Examples of autoimmune disorders include rheumatoid arthritis, multiple sclerosis, lupus, Type 1 diabetes, scleroderma (skin hardening) and myasthenia gravis (destruction of muscle proteins). Researchers suspect that chronic fatigue syndrome and amyotrophic lateral sclerosis may be autoimmune diseases as well.

Another type of immune error occurs when the system overreacts to something harmless, as with allergies. In the case of hay fever, for example, the immune system mistakes pollen for a dangerous invader and marshals a powerful and sometimes deadly response.

The opposite occurs when the immune system fails to respond adequately, resulting in immunodeficiency diseases. AIDS is perhaps the best-known example; other immunodeficiency disorders are inherited, extremely rare, and potentially fatal.

For people who are generally healthy, it's possible for the immune system to become temporarily depressed. When this happens, fighting pathogens becomes more difficult, and as a result, your body becomes more susceptible to infections, which hit you harder and stay with you longer than they would otherwise.

In general, problems with immune problems manifest a tendency to catch colds, the flu and various other infections more frequently than usual; to get easily tired; or to develop allergies. For specific symptoms of immune system disorders, see AIDS, Allergies, Arthritis, Asthma, Chronic Fatigue Syndrome, Diabetes, Hay Fever, Lupus, Multiple Sclerosis, and Sarcoidosis.

Among the things that can temporarily weaken the immune system are environmental toxins (see Environmental Poisoning), stress, poor diet, lack of exercise and sleep, and abuse of alcohol and tobacco. Over time, these factors can have a long-lasting debilitating effect on your immunity. Studies have also shown that emotional stress, ranging from such everyday events as a disagreement to such dramatic ones as the death of a spouse (see Grief), can affect immune functioning. Certain medications (especially corticosteroids and anticancer drugs), radiation therapy and -- some researchers believe -- an overdependence on antibiotics can also adversely affect your immune system.

Scientists believe that autoimmune diseases may result from a combination of genetic, molecular, cellular and environmental factors. Any enduring illness, but particularly cancer, diabetes or kidney disease, can weaken your body's immune defenses.

People born with inherited defects in their immune systems, such as a decreased number of lymphocytes (a type of white blood cell that, among other functions, produces antibodies), suffer from serious immunodeficiencies that make them extremely vulnerable to infection. Diminished immune functioning can also result from such events as having your spleen surgically removed, being born without the thymus gland or having to take immune-suppressing medication following organ transplant surgery.

Diagnostic and Test Procedures
To check for impaired immune functioning, your doctor may administer a number of tests. An immunoelectrophoresis test detects lower-than-normal levels of various antibodies. Another test, known as antigenic stimulation, determines whether your body is able to produce certain antibodies. Your doctor may also test for the effects of an impaired immune system: A thyroid function test, for example, will reveal an underactive thyroid (see Thyroid Problems), and X-rays can reveal pneumonia or sinusitis.

Boosting your immunity may involve altering your eating and exercise habits. Your doctor may refer you to a nutritionist and a physical therapist for specific guidelines.

Conventional Medicine
Your doctor may discuss with you any stressful events or situations that are adversely affecting your health and suggest making necessary lifestyle changes. The first step your doctor may suggest is to actively stimulate your immune system with vaccines;if that fails, he may try injections of gamma globulin, a blood derivative product that may also work to normalize your immune system.

For people with serious, inherited immunodeficiencies, antibody injections, tissue or bone marrotransplantation, and long-term courses of antibiotics may control the problem.

Medical researchers are uncertain of exactly how the malfunctioning of your immune system known as autoimmunity works. For autoimmune disorders your doctor may suggest nonsteroidal anti-inflammatory drugs (NSAIDs), corticosteroids or other, more powerful, immunosuppressive medications, depending on your particular ailment and its severity.

If you suffer from allergies, your doctor may suggest a variety of environmental controls to avoid the substances causing your system to overreact. If that proves insufficient to relieve your symptoms, medications such as antihistamines, decongestants or inhaled corticosteroids may be advised. The third step in controlling overactive immunity is a series of allergy shots, or immunotherapy, to desensitize your system so it can react normally.
Big ((((hugs)))) Sadly Pls speak with your Dr about your concerns, there are ways to help boost your immune system. He may also need to run some further testing to see if there is something else contributing you your symptoms...Good Luck... pls keep us posted...(((hugs)))
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