Neuroscientists Uncover The Pain Source Of Fibromyalgia Fibromyalgia, a debilitating, chronic pain that runs from the neck to the shoulders to the lower back to the hips to the knees and affects millions of people world wide, especially women, is not an ‘imaginary illness’ scientists have discovered. Doctors were convinced that Fibromyalgia was more an imaginary and psychological disorder than an actual physical ailment. Breakthrough research shows that the illness is not imaginary and is actually caused by an excess of nerve fibers in the blood vessels. Fibromyalgia actually means “pain in connective tissue and muscles” and people who suffer from the illness report a variety of symptoms that occur at the same time: body pain, headache, sleeplessness, stomach problems and stiffness. Fibromyalgia symptoms American neurologists made the discovery when they tested the hands of non-sensory individuals by pricking a needle into their skin. They then repeated that process with people who claimed to suffer from Fibromyalgia and found that an exaggerated amount of a specific nerve vessel known as ‘Arterial Venules (AV)’ responded to the pricking. Up until this discovery, scientists were convinced the AVs were strictly responsible for controlling blood flow in the blood cells. But now the researchers know that there is a direct link between the nerve endings and widespread body pain. The study also explains why people suffering from Fibromyalgia have extremely oversensitive hands and other tender areas on the body. Thanks to the breakthrough discovery, scientists are now hopeful they can develop treatment and possibly a cure for the illness. Source: Pain Medicine, May 20, 2013. By Phillip J. Albrecht PhD, Quanzhi Hou MD PhD, Charles E. Argoff MD, James R. Storey MD, James P. Wymer MD PhD, and Frank L. Rice PhD. Integrated Tissue Dynamics, LLC, Rensselaer, New York, USA; Center for Neuropharmacology & Neuroscience, Albany Medical College, Albany, New York, USA.
 

Neurobiology Underlying Fibromyalgia Symptoms

Review Article

Neurobiology Underlying Fibromyalgia Symptoms

1Alan Edwards Centre for Research on Pain, McGill University, 3640 University Street, Room M19, Montreal, QC, H2A 1C1, Canada
2Department of Neurology & Neurosurgery, McGill University, 3640 University Street, Room M19, Montreal, QC, H2A 1C1, Canada
3Department of Anesthesia, McGill University, 3640 University Street, Room M19, Montreal, QC, H2A 1C1, Canada
4Center for Neurosensory Disorders, University of North Carolina, CB No. 7280, 3330 Thurston Building, Chapel Hill, NC 27599, USA

Received 27 April 2011; Accepted 23 August 2011

Academic Editor: Muhammad B. Yunus

Copyright © 2012 Marta Ceko et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Fibromyalgia is characterized by chronic widespread pain, clinical symptoms that include cognitive and sleep disturbances, and other abnormalities such as increased sensitivity to painful stimuli, increased sensitivity to multiple sensory modalities, and altered pain modulatory mechanisms. Here we relate experimental findings of fibromyalgia symptoms to anatomical and functional brain changes. Neuroimaging studies show augmented sensory processing in pain-related areas, which, together with gray matter decreases and neurochemical abnormalities in areas related to pain modulation, supports the psychophysical evidence of altered pain perception and inhibition. Gray matter decreases in areas related to emotional decision making and working memory suggest that cognitive disturbances could be related to brain alterations. Altered levels of neurotransmitters involved in sleep regulation link disordered sleep to neurochemical abnormalities. Thus, current evidence supports the view that at least some fibromyalgia symptoms are associated with brain dysfunctions or alterations, giving the long-held “it is all in your head” view of the disorder a new meaning.

1. Introduction

In order to examine the neurobiology underlying the symptoms of fibromyalgia, we must first determine what those symptoms are. Until recently, fibromyalgia (FM) was diagnosed based on the ARC1990 criteria [1], which were widespread pain in combination with tenderness at 11 or more of 18 specific tender point sites. The provisional ACR 2010 FM diagnostic criteria [2], suggested as an alternative method of diagnosing FM, do not require the presence of tenderness, but rather include a list of several other symptoms, including fatigue, unrefreshing sleep, and cognitive symptoms, as well as a mix of some other symptoms that could include headache, depression, and lower abdominal pain/cramping. The hallmark symptom is still widespread pain, and a diagnosis of fibromyalgia requires this symptom. However, a patient must also have some of the other symptoms that are common among FM patients in order to reach a composite score that would lead to a diagnosis of FM. In addition to clinical symptoms that make up the diagnosis of FM, experimental studies have identified a number of other abnormalities in FM patients, including increased sensitivity to multiple types of painful stimuli, increased sensitivity to other sensory modalities, and alterations in pain modulatory mechanisms. Further, neuroimaging studies have found functional, anatomical, and neurochemical differences in the brains of FM patients compared to healthy control subjects. Most of the clinical symptoms associated with FM have not been systematically studied in the experimental setting, but there are a number of studies that have provided an objective evaluation of the altered cognitive functioning and sleep disturbances reported in FM patients. Thus, this paper will focus on the experimental evidence related to FM symptoms and connect these perceptual and cognitive signs to abnormalities observed in the brains of FM patients.

1.1. Altered Pain Perception in FM Patients

The hallmark symptom of FM is widespread ongoing musculoskeletal pain. In addition, FM patients have been distinguished from other patients with widespread pain syndromes primarily by the presence of tenderness that has been assessed clinically by finding pain evoked by 4 kg manual pressure in at least 11 of 18 defined tender points. This tender point concept was not based on an understanding of the underlying pathophysiology, but rather on empirical observation. Thus, although the ARC-90 diagnostic criteria provided an important uniform tool for defining the FM syndrome, they did not validate the tender point concept, due to the circular evidence on which the criteria were based [3]. In fact, much evidence indicates that tender points are just sites normally more sensitive to pressure pain in all individuals [47] and that FM patients have an increased pressure sensitivity at non-tender-point sites as well [8]. Accumulating evidence now shows that FM patients have increased sensitivity to many types of painful stimulation, including pressure at non-tender-point sites [9], heat and cold pain [6,1014], electrical stimulation [6], and intramuscular hypertonic saline injection [15]. Despite the plethora of evidence for hypersensitivity to painful stimuli, there is less evidence that FM patients are more sensitive to innocuous somatosensory stimuli. Detection thresholds for tactile and electrical stimuli are not altered in FM [61213], but Hollins et al. [16] found that FM patients rated innocuous pressure as more intense than did healthy controls, although the effects in the innocuous range were weaker than in the noxious range. The evidence for changes in cool or warm detection also is mixed, with most investigators finding no differences between FM and controls for heat [610] or cold [1012], whereas one study found FM patients to have reduced heat detection thresholds [12], and one study found patients to have reduced cold detection thresholds [6]. Thus, it appears that the altered sensitivity within the somatosensory system is more profound in the noxious range than in the innocuous range.

1.2. Evidence for Generalized Hypersensitivity to Unpleasant Stimuli

The hypersensitivity of FM patients to painful stimuli has led some investigators to propose that fibromyalgia involves a hypervigilance to pain and pain-associated information [1719]. However, there is now evidence that the hypersensitivity to unpleasant stimuli extends beyond the somatosensory system, which has led to the hypothesis that there is a generalized hypervigilance for sensory stimuli in FM [162021]. A few studies have examined the sensitivity of FM patients in modalities other than pain and found perceptual amplification. FM patients have been shown to have decreased tolerance of unpleasant noise [20] and increased sensitivity to loud unpleasant auditory stimuli that parallels their increased pressure pain sensitivity [22]. Similarly, FM patients perceive unpleasant olfactory stimuli to be more intense and more unpleasant than do matched control subjects [23]. On the other hand, when pleasant odors were tested, FM patients and controls perceived the odors as equally intense, consistent with another evidence that the hypersensitivity across perceptual modalities may be confined to stimuli in the unpleasant range [24]. Nevertheless, for pleasant odors, although FM patients did not rate them as more intense, they did evaluate the pleasant odors as less pleasant than did control subjects. Further, a range of auditory stimuli were rated as more intense by FM patients than by controls, and auditory stimuli rated as mildly pleasant by healthy subjects were rated as somewhat unpleasant by FM patients [16]. The finding of hypersensitivity in multiple modalities of stimulation, particularly for unpleasant stimuli, suggests that the evoked pain sensitivity of FM may be related to an altered hedonic appreciation for sensory stimuli, rather than to peripheral tissue abnormalities.

1.3. Other Phenomena Related to Altered Pain Perception

Other types of evidence from experimental pain studies in FM patients support the idea of a centrally mediated up-regulation of nociceptive activity in the CNS. A central pathophysiological process that appears to be disturbed in FM patients is the “windup” of central nociceptive processing of C-fibre input to the spinal cord, resulting in the perceptual phenomenon of temporal summation of pain. Windup of nociceptive activity is dependent on activation of the NMDA receptor complex in the spinal cord by input from C-nociceptors [2526]. Some FM patients show increased temporal summation of pain and increased aftersensations at the termination of noxious stimulation [27]. These enhanced responses could be related to one or more of several possible factors: (1) an ongoing peripheral source of input from C nociceptors other than the applied stimulus; (2) sensitized NMDA receptors on central nociceptive neurons; (3) abnormalities in descending modulation; (4) abnormal processing at supraspinal levels. Evidence of increased sensitivity in multiple sensory modalities suggests that ongoing C-nociceptor input cannot alone account for FM symptoms, indicating that there probably also are either sensitized NMDA receptors, abnormalities in modulatory systems in the brain, or abnormal sensory processing at spinal or supraspinal levels. Increased sensitivity has been demonstrated at the spinal level in FM [11]. Staud et al. [28] showed that an NMDA inhibitor reduced temporal summation in both healthy people and FM patients, suggesting that NMDA receptors probably are not sensitized in FM. On the other hand, experimental evidence shows that there are abnormalities in pain modulatory systems in FM patients that could account for altered temporal summation and other putative spinal effects.

1.4. Altered Pain Inhibition in FM Patients

For hundreds of years, clinicians have known that pain inhibits pain, a phenomenon termed “counterirritation.” More recently, a physiological basis of this phenomenon has been identified; the application of noxious stimulation activates an endogenous analgesic system involving supraspinal descending control of dorsal horn nociceptive activity. This system is termed “diffuse noxious inhibitory control” or DNIC and its physiological basis in the spinal cord has been studied extensively in anesthetized animals [2930]. Nevertheless, when competing noxious stimuli are presented in conscious humans, other systems that modulate pain, such as distraction, also are probably in effect, so that care must be taken in inferring that perceptual effects are due to DNIC. Accordingly, a group of interested researchers has suggested that the term “conditioned pain modulation” be used in humans studies to avoid the mechanistic implication [31]. Studies that have examined conditioned pain modulation in FM patients show that conditioning stimuli that produce an analgesic response to experimental pain stimuli in healthy control subjects fail to have an effect on FM patients [133234]. One of these studies controlled for the effects of distraction and habituation and found a similar lack of conditioned pain modulation in FM patients [33], suggesting the possibility that the DNIC system is in fact impaired in these individuals. Alternatively, DNIC and other descending inhibitory systems could be activated by the widespread pain of FM, and the failure to demonstrate DNIC in FM could represent a ceiling effect in which these activated systems cannot be further engaged by the experimental manipulations [8]. In addition, distraction can have a powerful pain-inhibiting effect [3539], and some researchers have suggested that FM patients have altered attentional focusing, with a hypervigilance to unpleasant stimuli (see discussion above).

2. Other Symptoms of FM

2.1. Altered Cognitive Function in FM Patients

In addition to pain, many patients with fibromyalgia complain of problems with memory and concentration, often referred to as “fibrofog” [4043]. This clinical symptom has received a large amount of experimental study, and studies using objective cognitive tests substantiate patients’ subjective reports of cognitive dysfunctions, most commonly related to speed of information processing, attention, and memory [4356]. The most robust deficits in tests of memory and attention have so far been observed in paradigms involving a prominent distraction from a competing source of information, wherein FM patients are less capable than healthy controls to retain new information when rehearsal is prevented by a distraction [495057]. Milder deficits have been observed in memory free of distraction at encoding [43444849515859]. FM patients frequently display greater impairments in the ability to actively retrieve past episodic events in the absence of a cue (free recall) than on recognition tests, which serve to evaluate the retrieval of remembered information and are more resistant to the effects of impaired attention and concentration [43444851]. It has thus been proposed that memory impairments in FM are more highly related to attentional factors that modulate the efficiency of memory functioning than to primary memory processes per se [486061]. Thus, the inability to manage distraction seems to be a particular problem in fibromyalgia patients and is reflected in patients’ reports of difficulty concentrating and dealing with complex, rapidly changing environments [61] and by memory tests showing performance decrements in the presence of distraction. Impaired cognitive performance is evident even after controlling for anxiety and depression and the influence of medications that might affect cognitive functioning [43505258]. Another area of cognitive functioning that has been shown to be abnormal in FM is that of emotional decision making [6263]. A similar deficit has been shown in chronic back pain patients, suggesting that this is not unique to FM [64].

2.2. Sleep Disturbances in FM Patients

Many FM patients complain of unrefreshed sleep. Several laboratory studies using objective measures of sleep physiology such as EEG substantiate these reports by showing disordered sleep architecture in FM patients, including delayed onset to sleep, altered sleep stage dynamics, and reduced slow wave sleep (deep sleep) and rapid-eye movement (REM) sleep [6568]. The intrusion of EEG frequencies characteristic of wakefulness (alpha waves) in the deep non-REM sleep (delta waves) seems to be a prominent feature of the nonrestorative sleep of FM patients [656971]. Further, patients with FM often have fragmented sleep resulting from periodic intrusions such as involuntary limb movements (restless legs), sleep apnea, and arousal disturbances [687274]. Although FM patients tend to report greater disturbances in sleep duration and quality than shown in laboratory studies, and their subjective reports correlate better with the severity of clinical symptoms [75], objectively measured sleep disturbances have been associated with pain and subjective daily sleepiness in several studies [6768,7173].

3. Brain Changes That Could Underlie Symptoms

3.1. Neural Basis of Pain Amplification and Altered Pain Modulation

Functional brain imaging studies support psychophysical findings of increased pain perception in FM, in that there is an augmentation of sensory processing throughout pain-related brain regions [97681]. This is important, since laboratory findings of increased sensitivity could be interpreted as a reporting bias, rather than evidence of increased activation in pain pathways. The functional imaging studies have found that fibromyalgia patients show significantly more activity in response to pressure and thermal stimuli compared to controls in a number of brain regions. Increased activations were observed not only in limbic structures, but also in brain regions involved in sensory-discriminative processing, such as primary and secondary somatosensory cortices, which supports the view that neural responses to afferent signals are amplified in fibromyalgia.

Although the increased pain-evoked brain activations corroborate patients’ reports, the correlation between increased brain activity and increased pain perception does not explain how the afferent signal is amplified. As discussed above, there is psychophysical evidence of dysfunctions in pain modulation as well as pain perception. There is now much evidence that the activation of descending control circuitry is involved in pain modulation and that this circuitry includes parts of prefrontal, cingulate, and insular cortices [2336378283]. A number of anatomical imaging studies in FM patients reveal decreased brain gray matter in these regions [8490]. Although the cellular basis of decreased gray matter in FM patients is not known, it is possible that due to neuronal loss, decreased dendritic arborisation, or changes in glial activation, pain inhibitory systems do not work in FM patients as well as in healthy individuals.

Consistent with the idea that pain modulatory systems may be disturbed in fibromyalgia are data showing that some FM patients have abnormalities in neurochemical systems involved in pain control, including the forebrain opioid and dopamine systems. A positron emission tomography (PET) competitive binding study using the D2/D3 receptor antagonist [11C] raclopride showed that striatal dopamine is released in response to painful muscle stimulation in healthy subjects, but not in FM patients [1591], which might partially explain the increased sensitivity of FM patients to the painful muscle stimulation. For the opioid system, investigators using PET found that FM patients had decreased binding potentials at rest for the exogenously administered 𝜇-opioid receptor agonist carfentanil in several brain areas, including the ventral striatum, the anterior cingulate cortex, and the amygdala [92]. These areas are implicated in pain and its emotional modulation, and correspondingly, the binding potentials showed a negative relationship with the magnitude of affective pain scores relative to the sensory scores. Although results of this study do not tell us whether levels of endogenous opioids were increased or whether receptor availability was decreased, the findings support the notion that disturbances in the opioidergic system might be related to the increased pain sensitivity in fibromyalgia. For both dopamine and opioids, the ongoing widespread pain of FM could lead to a tonic activation within these systems and thus be a main factor in altering receptor availability and associated responsiveness to externally applied painful stimuli.

3.2. Neural Basis of Cognitive Symptoms

It is well known that cognitive capabilities such as attention and memory functions decline continuously across the adult lifespan [93], which, together with findings of accelerated age-related decline of brain gray matter observed in FM patients [84], suggests that there may be a relationship between gray matter reductions in FM and cognitive deficits in these patients. Two recent studies have linked FM to impaired emotional decision making [6263]. Anatomical imaging studies have reported that FM patients have decreased gray matter in the medial prefrontal and insular cortices [848589], areas implicated in emotional decision making [9499]. Together, these data suggest a possible association between gray matter loss and emotional decision making in FM. One study has directly examined the relationship between performance on working memory tasks and gray matter in FM patients and found that an individual’s performance was positively correlated with gray matter values in medial frontal and anterior cingulate cortices, thereby providing direct evidence for an association between altered working memory and gray matter morphology in fibromyalgia [51]. Both of these brain regions, together with lateral premotor cortex, lateral prefrontal cortex, frontal poles, and posterior parietal cortex, are areas known to be related to working memory processes [100105]. In terms of the neurochemical abnormalities in FM discussed above, dopamine plays an important role for cognitive functioning. Multiple lines of evidence demonstrate the importance of mesocortical and striatal dopaminergic pathways in memory tasks, perceptual speed, and response inhibition (see [106] for review). Thus, there is an overlap between tasks in which fibromyalgia patients perform poorly and tasks that are related to dopamine functioning, suggesting that a dysfunctional dopamine system could contribute to the cognitive symptoms of fibromyalgia.

3.3. Neural Basis of Sleep Disturbances

While many studies have used EEG and related methods to show various aspects of disordered sleep physiology in FM patients, little is known about the neurobiology underlying these disturbances. Several neurotransmitters have been proposed to influence CNS hypersensitivity associated with sleep alterations. For example, inhibition of the CNS serotonin synthesis has been linked to insomnia and increased pain sensitivity [107]. Accordingly, in FM there is evidence for low serum and cerebrospinal fluid serotonin levels [108109]. Injecting amounts of substance P into the CNS of rats has been shown to reduce sleep efficiency, increasing latency to onset to sleep and provoking awakenings from sleep [110], and there is evidence for elevated cerebrospinal fluid levels of substance P in FM patients [111,112].

3.4. What Do the Psychophysical, Cognitive, and Neuroimaging Studies Tell Us about the Neurobiology Underlying FM Symptoms?

The wealth of experimental evidence showing that FM patients are hypersensitive to painful stimuli, as well as unpleasant stimuli from other sensory modalities, in conjunction with functional brain imaging data showing increased stimulus-evoked activation throughout nociceptive pathways, shows that the defining symptom of FM—increased pain—is in fact real and not just a response bias of the patients. The finding that perception is increased in multiple modalities speaks against the hypothesis that FM pain is due to an upregulation of peripheral nociceptive processes. Further, psychophysical evidence that descending modulatory systems are altered in FM patients supports the opposing idea that FM symptoms are at least in part caused by alterations in CNS processing of the pain signal, including a dysregulation of pain modulatory systems. Nevertheless, the apparent dysregulation within these systems could be caused and/or perpetuated by a tonic activation related to the presence of ongoing widespread pain, so that the systems are saturated and cannot regulate further in response to external stimuli.

Since similar descending control systems, including attentional and emotional regulatory circuitry, affect multiple sensory modalities [113119], a dysfunction (or saturation) in these systems could lead to the hypersensitivity in multiple sensory modalities. FM patients show reduced habituation to nonpainful tactile stimuli and increased cortical response to intense auditory stimuli, both of which have been linked to deficient inhibition of incoming sensory stimuli [120121]. Also in support of the idea of a central dysregulation or saturation of pain modulation are changes in the opioid and dopamine neurotransmitter systems, both known to be involved in hedonic regulation [122].

Finally, the findings that FM patients not only perceive themselves to have altered memory and concentration (“fibrofog”), but also in fact perform poorly on multiple cognitive tests, even when depression is excluded as a contributing factor, suggest that there are alterations in brain function. The anatomical brain imaging studies that show reductions in gray matter in frontal regions important for cognitive function further indicate that this common symptom of FM is based on altered brain function. Together, the experimental evidence provides strong support for the idea that FM symptoms are related to dysfunctions in the central nervous system. The cause of these changes cannot be deduced from the available evidence, as it is correlational in nature. Did long-term ongoing pain cause the changes or did the changes cause the pain? Without a relevant animal model or long-term longitudinal studies, we cannot answer these questions. Nevertheless, we can at least say that fibromyalgia is real and that it is associated with multiple changes in the brain.

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Day Fortyfive:

An illusive day production!

Warning you may find this post offensive, sorry in advance.

Today was FUBAR pure and simple.

I post this a few days after the fact as I spent some of the following days in the short stay mental ward at our local hospital, yes they released me as sane and simply blamed the extreme stress I am under, apparently this type of behaviour under extreme stress conditions is understandable, but defiantly not acceptable and deeply troubles me.

I have no idea how it happened, all I remember was hearing arguing from the kids and the phone ringing again, ring ring ring ring, please stop, please stop!

It could not have been much before 8am I was so tired from lack of sleep, I was awoken pretty much every night and morning by something, in fact every time I had slept for a couple of weeks or so, I still even today can’t remember having a full nights sleep.

I jumped up from sleep in a trance like state of tiresome anguish to an empty bedroom and immediately began to rip apart the furniture.

As I began to smash it viciously and ferociously into my body I repeatedly pounded my face into the headboard, the pain enhanced my strength as I pummelled my self some more till the wood splintered and broke, bruising my head and cutting it.

I remember pulling a wardrobe on me, the clothes sprung out and spread out around the room then floated down atop of me, as I collapsed downwards the floor was the only thing feeling pity for my soul.

Weakened by my outrageous ordeal I lay among the clothes pile whimpering in docile torment.

The kids and Shell only heard my tantrum and luckily did not witness it, this is not normal behaviour for me at all and after they left for school and I heard the front door slam there was a moment of silence that lasted some time, everything suddenly became clear I wiped the snot from my face that had dribbled on my hands and dressing gown and began to come to my senses.

As I looked around the room there was not really any damage, just a fucking mess to clean up later, I beat my hands on my head repeatedly in frustration, not only at the mess I had caused but the massive amount of stress I had inflicted on my family and half the street for that matter, and it still wasn’t even 08:30 yet.

In a heightened state of alertness I headed towards the bathroom, clutching my bleeding head in one hand and steadying myself with the other, I then sat on the toilet, lid down and cried.

It is hard to explain the thought process I had next as I seem to have been crying one minute and the next I had a razor blade in my hands and had cut both of my legs randomly in multiple directions, as I revived myself from a some kind of comatose state I noticed the blade had skin hanging from it and that blood had dripped down my leg to a small pool on the floor.

My legs stung like nothing I had felt before, my mind felt so very calm, like a feather floating in space, drifting meaninglessly into the void.

Most of the day I spent in a quantum silence licking my wounds in a corner like a cowering animal quivering in pity and shame.

Please forgive me for I have sinned!

Loving Kindness, Stu.

Blood Lust a poem that attempts to describe how I felt.

Day Fortythree:

RESENTMENT

Noun

his success led to resentment from critics: bitterness, indignation, irritation, pique, dissatisfaction, disgruntlement, discontentment, discontent, resentfulness, bad feelings, hard feelings, ill will, acrimony, rancor, animosity, jaundice; envy, jealousy

Resentment is often at the heart of conflict. It’s the kind of anger that says, “I don’t deserve this” and “you are wrong.” So it’s not just an emotion; it makes claims about how you think you deserve to be treated, and that someone has not complied with that expectation.

09:30

I was rudely awoken really early this morning by the telephone ringing, it had rung to the point of frustration, to that point where you knew that if you had only got up to answer it; it would have stopped already!

Shell and the kids had left for school it was about 8:30 am the first time it called, it then rang over and over till about 09:30 am, I got up, hobbled down the stairs and answered it to a dial tone.

It rang shortly afterwards it was Shell’s friend whom is undergoing a difficult break up, she wanted to speak with her urgently!

She asked me if she had woken me up, I grumpily replied YES, told her to call her mobile and promptly hung up.

I must admit I do care for Shell’s friend dearly but her relationship problems are causing background stress and problems with ours, this is mainly due to the worry it causes Shell and her friends stress rubs of onto her making Shell stressed out. She has been calling at really inconvenient times, not her fault I know, often in the middle of dinner, a family film, and more frequently interrupting us talking when the kids are asleep.

I couldn’t sleep last night, no nightmares or bad images, but the pain in my spine kept me tossing and turning in anguish, thwarting my rest, I remember looking at the clock on my phone, I keep it under my pillow; it said 04:53 am.

Having only a few hours sleep is not good for a FM sufferer, I am full of Fibro Fog today, my mind feels numb and cloudy and I am having a hard time concentrating on what the hell I am doing, yet alone what I’m saying.

My back hurts and feels like it is twisted, buckled, crushed and trampled, my ankles cause severe discomfort when I put weight on them and I have pins and needles down the left side of my body, emotionally, I am completely drained, my batteries are not depleted they have been completely removed, Apple Menu / Shut Down.

10:26

Shell made an unscheduled trip to the doctors this morning as she had cramps in her belly, she is okay thankfully but my anxt has been increased as the doctor made the conception dates closer to the affair date.

If I am completely honest this news terrorized my emotions and I freaked out, RED ALERT! Shields up!

For the first time since this happened almost six weeks ago, I threw everything in Shells face all at once, please forgive me my love, it pains me to see you cry.

I feel so terrible and bitter, how can I say I love her the way I do and still feel so much pain and resentment?

I know we can fix this, today I feel that it was me that broke a string on our bow of love and not the other way around.

Although it is not my fault what happened, I should not have been so mean and inconsiderate to your feelings today.

Afterwards you smiled at me and said lets start the day again and I am pleased that you think I am worth that, I thank you for being so strong, I am liking this new more positive and affirmative you it suits you beautifully.

Sigh, today I let my brain and my emotions get the better of me, there is no excuse for it what so ever!

Apologising after the fact when you have said some really unthoughtful and hurtful things seems pointless, how ever I did try really hard to explain to Shell how looking at the calendar and figuring out conception dates to date how far she is gone was extremely hard for me to deal with, I found out Shell had the affair on my daughters birthday I only just realised this fact to be the case and Darren had come down that weekend and both of them knew of the occasion.

In addition to this we have received contact from him twice in the last week, and from others chatting malicious chants of upsetting propaganda.

I know I acted harshly and said a lot things I really shouldn’t have, how does one control the tongue’s ravenous tone?

For the first time since this tragedy, I actually lost it, all down to pure resentment, and for that I am truly despondent!

I was not thinking about what I was saying, how much it hurt, or even who was listening, at one point I was crying and ranting to my self on my own in the front room in turmoil, in a tantrum of fear, I wandered around the room crying and dribbling on myself.

I guess there will be days like this and I am thankful that they have been very few and far between, I have counselling tonight with Relate and am going to ask them to concentrate on my emotional outbursts as it is these that are putting pressure on both us and our healing.

Shell’s Mum has been saying she is worried about me, she worries because she feels I am trying to hard, maybe I am but what more can I do?

I have to try harder, clearly as I am still having times where my emotional pain is passing on to others and tormenting them.

13:12

Shell made us both a Turbo and then went to pick up our son from School.

Apart from the turmoil this morning we have had a good day, the sun is shining once again and I am going to sit in it’s healing light and just be still.

I have learnt a very valuable lesson today, that we all must be responsible not only for our actions but also for our words.

15:54

Shell just sent me a text I know she won’t mind me publishing it’s contents.

Shell says:

I love you so very much, you are everything my heart desires, I thank you for staying with me and wish you happiness and joy.

I said:

Namaste my Queen, may the light of our love shine eternal.

17:00

My support worker from YOU has just left and I went through the events of the last month once again, it does not matter how many times I speak about what happened it hurts just the same, I wish I could simply erase it from my mind.

She has known Shell and I for about a year now and was surprised her self at what had happened, there wasn’t any thing really to say or to do except to arrange some things regarding our move and sort out some paperwork.

20:00

Appointment with Relate for my first counselling session!
I’ll write about how that went later, no doubt I will have to traumatise my self again explaining to the counsellor what’s up, but I know that this will help us heal.

21:49

Just got back from my appointment with Relate I had a cry and a chat about it with Shell for about forty five minutes, she is now relaxing in the bath so I have some time to share my first appointment experience.

Wow! that was tough.

I arrived for my first appointment to Relate (Relationship counselling) apprehensive and anxious, I booked in at reception and was greeted with a smile, I was asked to wait in a small waiting room off to the side, it was painted white, and was very clinical, it had half a dozen chairs, I hadn’t noticed at first and thought they was all red, except for the one I was sitting on as it was green in colour, trust me to pick the odd one ^^

Multiple informational brochures, advice leaflets and such adorned the walls, As my eyes met up with the paraphernalia I started to notice the subject lines of the said pamphlets.

Subjects such as Has your partner been unfaithful? Suffering from the effects of an Affair? etc…
It is a relationship counselling service, so of course one would expect them to have literature on such subjects, for me though each and every one of them popped out as though to taunt me, then I burst into tears.

It wasn’t long before the counsellor popped her head around the corner, assumed it was me as I was alone and we headed towards another room.

This is where the roller coaster of torment, emotions and hap hazard babbling began.
It is not that the counsellor made me feel uneasy or that I felt ashamed of being there but letting it all out made my chest hurt, and my breath became irate and obtrusive.

She calmly passed me a tissue from a nearby box and patiently awaited my conformity.
After I got myself together she began to ask me a series of questions some of which where extremely painful to think about not alone answer.

Because of my pharmaceutical addiction, previous violent behaviour, our relationship problems, death in the family and the fact we had been evicted from a home recently she suggested that to treat me for relationship counselling I must first or as well as have psychodynamic therapy, this requires me to see a GP and get refereed, hopefully my support worker can assist me in arranging this as I really want to make our relationship work but I must address my own mental health issues first and for most if we are to get anywhere.

Shell is going there the same time next week, hopefully she won’t be considered as mad as me so she can get immediate help, I on the other hand am going to have to wait a while on a waiting list of some months before getting any help at all.

Overall it was a tough experience but I did feel some form of peace as I left the building and headed home.
It was worth going, it was my first step, unfortunately for me the next time I get some counselling might be a while, and the counsellor did say I needed assistance to help myself and there is nothing wrong with that.

TTFN, Namaste!

Words are Weapons by Eminem

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Day Fortytwo:

I awoke this morning and Shell made me a mocha, we had a little light-hearted chat about the affair and baby dates as we held each others hands.

These conversations still fill me with anxt and pain, at least that is easing over time, looking at her so radiantly pregnant and glowing with life erased those demons from my mind and filled me with love and joy.

I had a little cry to myself then pulled my self together, Shell hugged me, looked right at me and told me she truly loved me and that she was sorry for hurting me so deeply, I cried some more, looked deep into her eyes, almost wanten, told her that I loved her and smiled sweetly.

We hugged for a while and just stared into each others eyes, It amazes me that after everything we have been through over the last seventeen years, half of my life almost, that we still love each other so dearly, so passionately.

I do not think that love is something we should try to understand, just feel. trying to understand love makes you ask questions like, Why do they love me? Why am I special? Who would want to love me anyway?

If you feel love, do not try to question or analysis it, just feel it, share it with your significant other, a friend or even a stranger; just a simple smile as you pass on by and go about your day.

I spent some time today reading a dads guide to pregnancy as before I have not really bothered to understand the process, as sad as that sounds I do not think I had enough emotional attachment, understanding and maturity.

This time around I am really trying to help Shell get through it both mentally and physically, she is almost forty now and it is about time I made that extra effort she deserves, I can honestly say that having two paths to walk one of hate and resentment and the other of love and light has not been easy, but I know in my heart that the path of love and light is the right one to follow and now I have made my choice the darkness feels distant and not so vociferous.

The landline has been ringing and ringing, I have ignored it as I just want to deal with my own troubles of mind and selfishly ignore everybody else’s just for one day, I sit in the sun absorb the healing light of the universe and heal some.

I have not done my turbo on time again, I think I will have to change that schedule as I seem to have them later in the day, time to get some pain relief (Cannabis), eat something and sit in the sun as yet again it is another absolutely gorgeous day!

13:59

Just realised the time, I have to wake up Shell as my son needs picking up from school, Nan saves the day again by offering to pick him up, thank you nanny, you are so wonderful.

14:24

Shell is making turbos; yippee, I will clean up afterwards, she has really noticed a huge difference drinking juice makes to your life, even after such a short time. Since she quit smoking just over five days ago now she has juiced everyday, her skin looks healthier and she seems to have more body-mind energy as do I, go go juice!

Once the kids are home from school, we hope to take a stroll down to the anti-smoking clinic for our weekly advice meeting.

15:22

I have just spent some time healing by sitting in the sun, I sat on the wooden decking in our garden, I closed my eyes, inhaled a few calm deep breaths, and let everything go from my mind.

Sitting there I could hear the noise and motion of the neighbours, building works, mowing of the lawn, cars and people passing by, it is fantastic how much more aware of the world you are when you just sit and listen.

In a moment of peace and bliss everything become still, I felt at one with nature, the world the universe.

I could still hear the hustle and bustle of life but it had become a distant white noise, I could hear loudly and clearly in my mind the sound of the wind as it brushed past my face, tickling my arms with its gesture, the song of the birds engaging in chatter.

It is moments like this although short that I know that life is love and love is life.

Nan just arrived with my son she picked him up from school bless her, time to make some tea I guess =P

A fellow blogger liked a post of mine and like you do I returned the visit, they had a video on their blog that is an incredible healing tool and extremely inspiring.

Here it is please visit the Alternate Economy blog.

Balanced Emotions

How TV Ruined Your Life

Television the drug of the nation.

TV has been running our lives for years with fear, millions of us think that this is reality, time to wake up.

We have not had any TV as such in our home for many months now, we do not have an aerial for free view, Virgin lmao well enough said about that, and we have a broken SKY dish on the wall.

Since about six months ago due to some problems with our provider we have not had access to any TV channels unless we use on demand services via the internet on our phones or pc’s, we have found that although we do spend a lot of time on our individual computers when we use the big screen it is more about family time now and it is not just on wasting electricity and impacting the environment.

It is funny just how much time you free up not watching the soaps and the news that are designed to keep us dumbed down and scared.

How TV Ruined Your Life part 1

How TV Ruined Your Life part 2

Free your mind

Free your mind

Day Fortyone:

What is with this timeline thing on Facebook, lol, it has reset all my shizzle on my profile so I had to go through it all again, what fun =)

Brilliant day so far again today, sun is shining and the weather has been great this week, Shell, Nan and I took a look at a house today and accepted it so it looks like we will be moving, it’s so exciting for all of us, the kids will get their own room, the kitchen is much bigger ooooh it’s so exciting, finally our own home XD.

It makes you feel all mushy inside.

Had my turbo, went for a short walk outside and did some emotional relaxation.

20:01

Nan has just left the building 😉 love my Nan she is the rock in our lives, she really helps us out when we are in dire need, no questions asked she is always there.

The kids are settling down and I am about to run Shell a bath we have had a productive day, after lasagna for Tea, the kids supped on a mixture of organic yogurt, bananas, orange, strawberry and organic dark chocolate, what a pain in the bum that is to grate with a cheese grater!

Not a lot to say about today, except it has been wonderful.

22:56

Shell and I sat down on the sofa and snuggled whilst we watched Heroes on Netflix, I was late running the bath as she was preoccupied watching the tele.

I ran my self a bath and chilled out to some healing painful emotions and bubbly bath, I do find this terribly calming, relaxing and certainly the thing to do if your suffer with pain, I try to do it daliy.

Shell is now in the bath and looks pregnant bless her, you can see the bump and her breasts are noticeably larger, she radiates at the moment and I love her more for it, she looks so beautiful.

Goodnight!

Day Thirtyeight:

The day of Serendipity

serendipity |ˌserənˈdipitē | noun

The occurrence and development of events by chance in a happy or beneficial way:
A fortunate stroke of serendipity | a series of small serendipities.

Today as a fellow blogger puts it is a Pajama day I am absolutely knackerd from the walking I have done this week every muscle in my body exudes pain.

I am not getting dressed today and am going to spend the day chill axing and enjoying music, although I am in  an immense amount of pain I feel calm and still, Shell gave me a back rub earlier and took a lot of the stress and tension from me, I really need her to show me that she loves me now, the images in my mind are withering my soul.

Having a baby should be the happiest time of our lives and I am trying so hard to make it that way, I wish whole heartedly that the baby is mine and although I know the chances are very high that it is, the doubt in my mind is tormenting me and making it very hard to let go off all the pain.

Shell has just washed up and gone to pick up our son from school life goes on.

No turbo or exercise today but I have managed to do my emotions training it does help a lot and I am learning to control my brain, not it control me.

Shell and I had a big argument last night and said a lot of things to each other we really shouldn’t have, I am not going to go into it because it all started form nothing and neither of us where to blame, sometimes shit just happens.

Today we are both much calmer and have got a lot of held back feelings out in the open the truth hurts but once it is out you can heal.

It is a shame that some people still want to see hatred, that is up to them, but I am trying to not only lick my wounds but remember why they are there in the first place, if karma exists I must have acted extremely harshly previously in my life, there is no way out of that.

I do hope the other family involved are doing okay and are coping since they removed me from Facebook I have not been able to read their status updates, perhaps this is a good thing as it hurts to think of anything to do with my situation.

I have spent a lot of hours looking into Sensory Acuity and have been doing exercises to prepare myself for the NLP course in May, keeping focus on this and the baby is what is keeping me strong, we are looking into a private scan to get the conception dates as this will really help all parties involved and allow us to start planning and enjoying our baby.

16:40

We did end up making our turbo’s yippee, and after we had some ryvita and Philadelphia cheese with salad, we both helped each other make and clean everything.

18:35

Shell is now asleep on the sofa, she cleaned the kitchen, I got dressed and we made turbo’s together, my son always wants some, want your kids to eat spinach and celery? drink turbo’s and they will love it.

Before she fell asleep I put on the new David Gilmour album On an Island and gently caressed and kissed her belly, these are the magical moments that will keep us strong, as we clutched each others hands we just closed our eyes and reminisced in the moment.

It is times like this that make both of us know that we can get through this and we are strong enough to fight the demons and follow the path of the light.

19:48

Shell has been a sleep a while now and the house has got dark I have just noticed the time and cooked up some dinner for the kids, only beans and toast as it was late and they had ice cream and bananas for dessert.

Everyones settled down now to a movie on Netflix.

So it’s 00:42 tomorrow if you will, I have spent about an hour or so crying and dribbling on my self the day went great today and almost nothing went wrong, after Shell had a bath I got highly emotional and just burst into tears and stayed that way for about three hours, as I quietly sat on my own in the dark until now feeling sorry for myself.

Loving Kindness, Stu.

Day Thirtysix:

I didn’t wake up today until about twelve o’clock, just couldn’t sleep last night at all, I got up and spent some time working on the proposal for the venus project, did about an hours meditation, and went to sleep listening to Paul McKenna‘s “Master Your Emotions“.

I awoke feeling rather happy and joyful today, the first thing I remember seeing was Shell’s smiling face, I kissed her and told her I loved her, we hugged a while and went down stairs.

It took me a good hour to get my act together today, the mornings take a good bit of positive mental attitude to push your self past the fatigue and pain but it’s easier for me than taking the Tramodol and becoming a Zombie for the day, how does that help my muscles get stronger?

I am still in an immense amount of pain in my back and shoulders the tingling worsens at night, it might be the case that this could be a normal effect of Fibromyalgia, a fellow Blogger reports similar feelings whilst laying on her back to.

I must confess that I feel great compared to how I was just a month ago the juice is really giving me the energy I need and the super foods are making a massive difference to my well-being and body mind.

I would not recommend stopping medications the way I did to anyone it is dangerous and could cause you some serious harm, but I am now 36 days in and it was worth it for me personally.

I can eat foods without stomach pains, I can use the bathroom regularly and have so much motivation, enthusiasm and energy since stopping pharmaceuticals.

The sun is shining and I feel great after making some turbos, albeit without the avocado as the ones I had went bad =/

Shell has gone to get the kids from school, she seems much happier today I am trying so hard to help out around the house and do as much as possible to comfort her.

I have just looked at the Hotel that the NLP scholarship is held in, wow!
It is lovely, may as well make a night of it, so I have enquired about staying there a few nights =)

Hasta mañana.

Day Thirtyfour:

Alicia Keys – Love Is Blind

Got an answer today from the NLP people informing me that I have been accepted on their 2 day scholarship programme, I am eagerly awaiting full confirmation and instructions to get started.

I will travel to London in May for a two day training session, it should be enlightening, entertaining and teach me a lot, I have been tested more than any man could ever dream of lately and am coping remarkably well considering.

Shell and I have a property to look at within walking distance of our current home, we live in private rented accommodation at the moment and this means that will have a more permanent home that we can make ours, unpack the boxes, decorate and settle down.

I have worked on the proposal for The Venus Project and they have had a meeting via team speak on it, I am waiting for the minutes to be typed up and published. I could not make the online conference as I was doing my Daddy bit at the Mother-in-laws.

Shell took a pregnancy test today and it came up positive, although we are both really scared as we are in our 30’s we are tremendously excited about the prospect of having a new member in the family, I said to her a few days ago jokingly I bet your pregnant only to find out that she is.

She also did a digital test that says it is 99% accurate she is pregnant and 92% it was within 14 days, thankfully that takes her past her affair with Darren, she promises they used contraception and I pray that is true because if the child was his it would be an even more fucked up situation than it is now, it will take three months before we can get DNA tests done to confirm anything, but in my heart I am sure it’s a girl and she is mine, my lil Andromeda Hope is what we will name her.

Whatever happens I will stand by her.

Personally I am certain she conceived on our night of light on Day Twentyfour:.

I am having to do some serious re-framing today and positive thinking is the only way I am going to get through the next few months.
We do have to confirm it with the doctors tomorrow, after all the tests are not always right, but after her doing two tests I have to say she is, how exciting!

Going to clean up the kitchen now and set up to make some Turbos as Shell, I and the kids are going to try to have some family time together this evening.

I am going to have to completely quit smoking although I have managed to get rid of all the medications, and haven’t taken any since I began this journey, I have smoked especially over the last few weeks.

I am only on three or four at the most per day and they are mainly cannabis for pain relief, but now Shell is pregnant we will both have to quit and that is that.

Emeli Sande “Maybe (Acoustic)” HD. Angel Studio Session

This is something very very special, Thank you Emeli for singing so beautifully and giving me the inner strength to carry on each and every day that I hear your voice.

it’s currently 04:29 I could not sleep, my mind is quite clear although I am somewhat tearful, listened to Emeli and then watched a two hour NLP video.

Loving Kindness, Loving Kindness, Loving Kindness, Namaste.