Disability Information - Fibromyalgia & Chronic Fatigue Syndrome

General Information

Education & Classroom Accommodations

Michigan Resources, Support Groups, Listservs & Websites

National Resources & Websites

Articles Related to this Disability

Books & Videos

Personal Websites & Home Pages

Medical Information

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 General Information

FMS (fibromyalgia syndrome) is a widespread musculoskeletal pain and fatigue disorder for which the cause is still unknown. Fibromyalgia means pain in the muscles, ligaments and tendons--the fibrous tissues in the body. FMS used to be called fibrositis, implying that there was inflammation in the muscles, but research later proved that inflammation did not exist. Most patients with fibromyalgia say that they ache all over. Their muscles may feel like they have been pulled or overworked. Sometimes the muscles twitch and at other times they burn. More women than men are afflicted with fibromyalgia, but it shows up in people of all ages.

Fibromyalgia Resource Information Website

Fibromyalgia in Children

Excerpted from Fibromyalgia: A Comprehensive Approach by Miryam Williamson

http://www.mwilliamson.com/children.htm

Until recently, fibromyalgia was considered an adult disorder; children were thought not to get it. Then, in a study published in the Journal of Rheumatology in 1993, a team of doctors in Israel reported that 6.2 percent of 338 healthy schoolchildren between the ages of nine and 15 met the criteria for the fibromyalgia syndrome.

Juvenile Fibromyalgia and Chronic Fatigue Syndrome

http://members.aol.com/fibroworld/juvFM.htm

A new study concludes that children diagnosed with chronic fatigue syndrome (CFS) have significantly more optimistic prognoses than their adult counterparts.

Children With FM

http://tigihiggins.tripod.com/children.htm

FM in children often starts with a flu-like illness from which the child seems never to have fully recovered.  Sometimes, particularly in children before puberty, the ailment simply comes on gradually, without any obvious precipitating event.  Very young children may not remember a time without pain, and thus may not complain at all.

A brief guide for parents
http://www.fibromyalgia-associationuk.org/child_young.htm
The aim of this leaflet is to provide basic information about fibromyalgia and suggestions on management and coping skills. Parents and other care-givers can assist young people to manage a social life, continue with their education and plan for the future despite this troublesome condition. FMS affects children in different degrees but FMS is not life threatening.

WHY CHILDREN WITH CFS ARE OFTEN OVERLOOKED
by Rebecca C. Moore and Frank Albrecht, Ph.D.
http://home.bluecrab.org/~health/reb.html
In children, Chronic Fatigue Syndrome (CFS) -- it's also called Chronic Fatigue Immune Dysfunction Syndrome (CFIDS)-- is often incorrectly diagnosed by pediatricians and other primary care physicians, and often by specialists as well.

Abstract: Thirteen-Year Follow-Up of Children and Adolescents with Chronic Fatigue Syndrome
ImmuneSupport.com

http://www.immunesupport.com/library/showarticle.cfm/ID/3347/T/CFIDS_FM

OBJECTIVE: To describe the educational, social, and symptomatic outcome of children and adolescents with chronic fatigue syndrome 13 years after illness onset.

To The Newly Diagnosed Patient

Russell Rothenberg, M.D., Chair, Medical Advisory Board, National Fibromyalgia Partnership

http://www.fmpartnership.org/To%20The%20Newly%20Diagnosed%20Patient.htm

Fibromyalgia can be a confusing diagnosis both to the patient and to the treating physician. One of the principal missions of the National Fibromyalgia Partnership is to educate both patients and physicians about what is currently known about this disease. Hopefully, through education, patients will be diagnosed more quickly and be started on a therapeutic treatment program at an earlier stage in their disease.

Questions and Answers about Fibromyalgia

http://www.niams.nih.gov/hi/topics/fibromyalgia/fibrofs.htm

Fibromyalgia

Patient Education Institute

This is an interactive tutorial that requires Flash plug-in.

http://www.nlm.nih.gov/medlineplus/fibromyalgia.html

Fibromyalgia

Mayo Foundation for Medical Education and Research

Fibromyalgia is a chronic condition characterized by fatigue and widespread pain in your muscles, ligaments and tendons.

http://www.mayoclinic.com/invoke.cfm?id=DS00079

Fibromyalgia.com

http://www.fibromyalgia.com/home.htm

It is the purpose of our presence on the World Wide Web to disseminate information that is accurate and beneficial in improving the quality of life for those suffering from fibromyalgia.

Fibromyalgia (FMS) &Chronic Myofascial Pain (CMP)

http://www.sover.net/~devstar/

This site describes two medical conditions which often occur together: Fibromyalgia and Chronic Myofascial Pain.  Chronic Myofascial Pain was previously called Myofascial Pain Syndrome. 

Fibromyalgia: What it is and how to manage it

American Academy of Family Physicians

http://familydoctor.org/handouts/070.html

Where to Go When You Need Help

National Fibromyalgia Partnership

http://www.fmpartnership.org/documents/emerserv.pdf

Fibromyalgia (FM) is a challenge even under the best of circumstances. When it interferes with patients' abilities to support themselves and their families or pursue their chosen careers, it can be devastating.

Coping Tips To Help With Life Links

http://bcorsa.freeyellow.com/coping.html#coping

Fibromyalgia Research: Challenges and Opportunities

National Institute of Arthritis and Musculoskeletal and Skin Diseases

http://www.niams.nih.gov/hi/topics/fibromyalgia/fibromya.htm

Fibromyalgia is a chronic disorder characterized by widespread musculoskeletal pain, fatigue, and tenderness in localized areas of the neck, spine, shoulders, and hips called "tender points." People with this syndrome may also experience sleep disturbances, morning stiffness, irritable bowel syndrome, anxiety, and other symptoms. Available data suggest that the number of persons aged 18 and older in the United States with fibromyalgia is approximately 3.7 million. It primarily occurs in women of childbearing age, but children, the elderly, and men may also be affected.

Delivering on the Promise in Fibromyalgia

Arthritis Foundation

http://www.arthritis.org/research/research_program/Fibromyalgia/default.asp

The causes, underlying pathologic processes and optimal treatment of fibromyalgia are not yet well understood. There is increasing evidence that abnormalities of the nervous system involving heightened pain perception play a role in its development.

What's in a Name: Fibromyalgia versus Chronic Fatigue Syndrome (CFS)

Arthritis Foundation

http://www.arthritis.org/resources/news/news_fibro_cfs.asp

Fibromyalgia and chronic fatigue syndrome (CFS) share a number of symptoms, and the names are often used interchangeably in the medical literature.

The Scientific Basis for Understanding Pain in Fibromyalgia
Robert Bennett MD, FRCP
http://www.myalgia.com/Scientific%20basis.htm
Fibromyalgia is a clinical construct that has been developed, for the most part, by rheumatologists. It is a direct descendent of "fibrositis", a common misnomer (1) that was first coined in 1904 (2).  There are always problems inherent in defining a disorder in purely descriptive terms. Nevertheless the publication of the American College of Rheumatology's 1990 Classification Criteria for fibromyalgia (3) has been coincident with an impressive resurgence of research in this area. This article attempts to synthesize contemporary research findings.

Helpful hints from support group members
http://www.ncf.carleton.ca/fibromyalgia/helpful.htm

ACTION for CFIDS / M.E.
http://www.cfs-news.org/action.htm
Help to fight for the CFIDS / M.E. community! Promote awareness, campaign for change, and help to correct misimpressions in the media and by government officials.

FibroMyalgia Personal Support Centre
http://www.fmpsc.org/info/info.htm

Fibromyalgia, Chronic Fatigue Syndrome & Related Syndromes
http://www.geocities.com/HotSprings/Falls/8173/
I have created this web page to provide an extensive resource of information on FM, CFS and other related conditions. I hope you find this site helpful in your search for information or support.

Miss Kitty Fibromyalgia Center
http://www.fmscenter.com/index2.html
Support, info, stories and more about Fibromyalgia and related conditions. You can also share your own story.

WHO GETS FIBROMYALGIA?
http://www.ucdmc.ucdavis.edu/ucdhs/health/a-z/76Fibromyalgia/doc76risk.html
Studies report that between 1.3% and 2% of the general population meet the diagnostic criteria.

It's a Guy Thing: Men with Fibromyalgia
by Lisa Lorden
http://fmaware.org/patient/coping/men.htm
The relationship between Fibromyalgia (FM) and gender has been a source of confusion and controversy among researchers and patients alike.  Although FM is clearly more prevalent among women, the illness does afflict men as well.

Benefits For Children With Disabilities
Social Security Administration
http://www.ssa.gov/pubs/10026.html
This booklet is written primarily for the parents and caregivers of children with disabilities and adults disabled since childhood.

Financial Help Links for People with Fibromyalgia
http://bcorsa.freeyellow.com/coping.html#financial

Informative! Alternative And Supplemental Income For People With Fibromyalgia
http://www.managing-my-fibromyalgia.com/supplemental-income.html

Social Security Administration Ruling on Chronic Fatigue Syndrome
http://www.myalgia.com/SSA%20ruling%20on%20CFS.htm
The Social Security Administration (SSA) issued a ruling on April 30, 1999 which paves the way for severely afflicted persons with CFS to be classified as having a medically determinable impairment. This ruling provides guidance to disability claims processors for applying SSA policy to applications for Social Security Disability Income (SSDI) benefits that result from disability due to CFS. This does not imply that persons with CFS are automatically entitled to SSDI, but it should make it easier for severely afflicted CFS patients to granted benefits.

Social Security memorandum on fibromyalgia
http://www.myalgia.com/SSA%20memorandem%20on%20FM.htm

Disability Help Links
http://bcorsa.freeyellow.com/coping.html#disability

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 Education & Classroom Accommodations

Attending school with Fibro/CFS
Fibro/CFS Foothold
http://www.tertius.net.au/foothold/school.html

A list of things that you can do to help survive school.

CFIDS: EDUCATIONAL RIGHTS, RESPONSIBILITIES, AND OPTIONS
By Michelle L. Banks MS.ed
http://www.geocities.com/cfsdays/edu_rts.htm
This information will help to identify the child's unique learning style to see if the onset of CFIDS has in anyway altered his/her educational ability or performance.

GUIDELINES FOR SCHOOLS: UNDERSTANDING and ACCOMMODATING CFIDS/FMS CHRONIC FATIGUE AND IMMUNE DYSFUNCTION SYNDROME and FIBROMYALGIA SYNDROME
The National CFIDS Foundation
http://www.ncf-net.org/general/guidlines.htm

Chronic Fatigue Syndrome and School Success
http://www.ncfsfa.org/Patients/cfsschool.htm

 
A Cognitive-Behavioral Approach in the Treatment of Children and Adolescents Diagnosed with Fibromyalgia
Reported by Karin Amour
http://fmaware.org/patient/research/acr2001c.htm

Schooling/Educating Sick and Worn-out Kids
http://home.bluecrab.org/~health/sch/sch.html
Many children with chronic fatigue syndrome, fibromyalgia, and other debilitating illnesses can't attend school, or can attend only part-time. These children usually don't look sick, so school staff often thinks, "It's all in her mind," or, "There's really nothing wrong with her." Even if they recognize that the illness is real, staff may think the child is school-avoidant, that the family doesn't really want the child in school, that he or she exaggerates the amount of pain or discomfort, or that "He could do better if he tried harder."

Home, Hospital, and Other Non–School-based Instruction for Children and Adolescents Who Are Medically Unable to Attend School (RE9956)
AMERICAN ACADEMY OF PEDIATRICS, Committee on School Health
http://www.aap.org/policy/re9956.html
Homebound instruction is governed by federal and state laws, but implementation may vary not only from state to state, but also from one school district to another. It must be clear that homebound instruction is meant for acute or catastrophic health problems that confine a child or adolescent to home or hospital for a prolonged but defined period of time and is not intended to relieve the school or parent of the responsibility for providing education for the child in the least restrictive environment.

Americans With Disabilities Act: What Persons With Fibromyalgia Need to Know
National Fibromyalgia Partnership
http://www.fmpartnership.org/documents/Disabilact.PDF or http://www.fmpartnership.org/ada.htm  

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 Michigan Resources, Support Groups, Listservs & Websites

Fatigue and Fibromyalgia Clinic of Michigan

http://www.cfids.com/

Our clinic is dedicated to the treatment of  Chronic Fatigue Syndrome (CFS), Fibromyalgia (FMS), Candida (yeast), allergies, Multiple Chemical Sensitivities (MCS) and other related disorders. 

Fibromyalgia Michigan

http://www.chiropractor-finder.com/Fibromyalgia/Michigan/

Find fibromyalgia doctors fibromyalgia treatment for fibromyalgia FMS.

Michigan Head•Pain & Neurological Institute

http://www.mhni.com/faqs_other_disorders.html#top
3120 Professional Drive
Ann Arbor, Michigan 48104-5131

Telephone: (734) 677-6000

Livonia CFS/Fibromyalgia Support Group

http://www.geocities.com/LivoniaCFSFMS/

We meet at 7:00 at the Livonia Civic Center Library which is located at 32777 Five Mile Road in Livonia. Normal meeting days are the second Thursday of the month - NO DECEMBER MEETING. Please check meeting section for further information. We try to keep our meetings FRAGRANT FREE for those with multiple chemical sensitivities. Please avoid SCENTED PRODUCTS AND SMOKE just prior to attending. Thank you for your consideration.

Join the Fatigue & Fibromyalgia Clinic of Michigan mailing list

http://lb.bcentral.com/ex/manage/subscriberprefs.aspx?customerid=6141

University of Michigan Fibromyalgia Research

http://www.med.umich.edu/intmed/rheumatology/fmweb/

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 National Resources & Websites

The American Fibromyalgia Syndrome Association - http://www.afsafund.org/

Fibromyalgia Network - http://www.fmnetnews.com/index.html

http://www.fibromyalgia.com

National Fibromyalgia Association

http://fmaware.org/index.html

Our mission is to develop and execute programs dedicated to improving the quality of life for people with Fibromyalgia by increasing the awareness of the public, media, government and medical communities.

National Fibromyalgia Partnership, Inc. (NFP)
http://www.fmpartnership.org/FMPartnership.htm
Thanks to the generous support of a number of medical experts and the National Institutes of Health, the NFP has been able to offer quality educational materials and speaker presentations on fibromyalgia and related conditions since its inception.

The American Fibromyalgia Syndrome Association

http://www.afsafund.org/

AFSA is the only charitable organization whose primary mission is to seed research in FMS and CFS. We acknowledge that patient and physician education, public awareness and advocacy are all important ingredients in aiding the lives of people with FMS and CFS.

American College of Rheumatology (ACR)

http://www.rheumatology.org/

The American College of Rheumatology (ACR) is the professional organization of rheumatologists and associated health professionals who share a dedication to healing, preventing disability, and curing the more than 100 types of arthritis and related disabling and sometimes fatal disorders of the joints, muscles, and bones. Members include practicing physicians, research scientists, nurses, physical and occupational therapists, psychologists, and social workers.

Arthritis Foundation

http://www.arthritis.org/

The Arthritis Foundation is the only national not-for-profit organization that supports the more than 100 types of arthritis and related conditions with advocacy, programs, services and research.

Fibromyalgia Resource Center at HealingWell.com

http://www.healingwell.com/fibro/

Medical news, information, community message boards, chat, email, free homepages, books, links and more for patients, friends and family of patients diagnosed with Fibromyalgia.

Living With FM & MPS
http://www.tidalweb.com/fms/

FibroMoms

http://members.tripod.com/fibroark/
There are millions of women suffering from fibromyalgia, and other invisible illnesses. A huge percentage of these women are moms. Come to FibroMoms and connect with others who really understand the struggle of raising kids while coping with invisible illnesses.

Support Groups by State

http://www.fmscommunity.org/sptgrp.htm#us

Here you will find links to various Fibromyalgia support groups.

Clouds Online Support Group

http://pub144.ezboard.com/bcloudsonlinesupportgroup.html

Fibrofacts UK Discussion Board

http://www.hotboards.com/plus/plus.mirage?who=helenchambers

FibroMoms message board

http://members.tripod.com/fibroark/id35.htm

Fibromyalgia Message Board

http://www.ecolivingcenter.com/board/fibromalgia/index.html

Friends International Online FMS-CFS-Chronic Pain Support

http://pub123.ezboard.com/bsunshine35446

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 Articles Related to this Disability

Fibromyalgia and Sleep Deprivation - People with fibromyalgia often experience sleeplessness. In this three-part series, MARRTC explores causes and solutions to the problem, and what it's like to live one sleepless night after another.

Part One: Fatigue Can Be Dangerous

 
Part Two: Pills and Pillows

 
Part Three: A Sleepless Night Crawls By

Tired Children, Teenagers in Pain
Aging Healthfully Magazine
http://www.majidali.com/Vol%202%20No%201%20Tired%20Children.htm
A parent can ignore a child's unexplained tiredness only at peril. To blame a teenager's muscle pain (myalgia) on hormones is often a serious mistake. For a doctor to dismiss tired children and teenagers in pain simply because lab tests are negative is a grave error. Unexplained tiredness is oxygen deprivation in brain and other tissues. Muscle pain is oxygen deficiency in muscles. Those are the simple facts about tired children and teenagers in pain.

A Novel Holistic Explanation for the Fibromyalgia Enigma: Autonomic Nervous System Dysfunction
By Manuel Martínez-Lavín, M.D., Instituto Nacional de Cardiologia Mexico
http://www.fmpartnership.org/Lavin%20article.htm
This article discusses scientific evidence supporting the notion that all fibromyalgia (FM) features can be explained on the basis of autonomic (sympathetic) nervous system dysfunction. On this basis, a holistic approach for FM treatment is proposed.

Post-Traumatic Fibromyalgia: A New Paradigm
National Fibromyalgia Partnership, Inc.
http://www.fmpartnership.org/Post-Traumatic_FM2.htm
The brain is easily overwhelmed by head injury, viruses, severe stress, and even rape and abuse. When an injury to the brain occurs, it triggers a cascade of neurochemicals to protect the traumatized area. Unfortunately for the patient, such defensive actions by the brain can cause significant dysfunctions in the body, i.e., limited energy, poor sleep, impaired cognition, dysautonomia, and mood abnormalities, among others, and they also seem to prevent FM patients from maintaining the effects of rehabilitative treatments over the long-term.

Non-Allergic Rhinitis
By Tamara Liller, M.A.
http://www.fmpartnership.org/Rhinitis.htm
As a group, persons with fibromyalgia (FM) exhibit many similar symptoms: a chronic runny nose, a congested head, a throat-clearing cough, or a maddening postnasal drip. While a sign of allergic reaction in some, for most with FM it is not, for there is no immune reaction in the body (i.e., antibodies that are detected by skin testing) and very little itching or inflammation occurs in the eyes and nose, respectively.

Up The Down Staircase: Work & Fibromyalgia
http://www.fmpartnership.org/work-fm.htm
The following is a "Letter to the Editor", reprinted in the spring 2000 issue of Fibromyalgia Frontiers, which raises many important issues relevant to working individuals with fibromyalgia.

(A) Fibromyalgia, (B) Myofascial Pain Syndrome, (C) All of the Above
By Bernard E. Filner, M.D.
http://www.fmpartnership.org/filner.htm
Persons with chronic pain frequently see many practitioners in their quest for a diagnosis and relief from their symptoms. Unfortunately, this quest often resembles the story of the six blind men, each stationed at a different part of the anatomy and then asked to describe the elephant.

The Art of Drawing a Blank
http://www.fmpartnership.org/memory.htm
It is helpful to think about memory as consisting of three stages: (1) the acquisition of information, (2) the storage of information, and (3) the retrieval of information when it is needed. When we forget things, we tend to blame our retrieval powers.

Marge Cheston ... On Adjusting
http://www.fmpartnership.org/cheston1.htm
When I was finally diagnosed with fibromyalgia syndrome (FMS), I was amazed that there was actually a name to cover all those weird and widespread body happenings that I was experiencing.

Latest Research Findings on Pain and Fibromyalgia
Tiny gene changes means big differences in pain
NewScientist.com news service
http://www.myalgia.com/OFF%20Archives/comt%20and%20pain.htm
A new study by US researchers has linked differences in the way people withstand pain - both physical and emotional stress - to a gene which makes a protein important for brain chemistry.

Fibromyalgia and Sleep Deprivation: Fatigue Can Be Dangerous
By Nicholas Rummell
http://www.muhealth.org/~arthritis/articles/sep02/sleep.html
Judy Fry says her symptoms of sleep deprivation began long before she was diagnosed with severe fibromyalgia in 1983.

A New Approach to Fibromyalgia
Summarized by Robert W. Griffith, MD
The treatment of fibromyalgia is, for the most part, unsatisfactory. Maybe that's why sufferers often have a considerable degree of anxiety and depression. And while it's known that exercise has proven helpful in some studies in reducing tender-point pain, it's general effect on the poor mood in fibromyalgia subjects has been questionable. Now a Canadian study has been reported in Arthritis Care & Research that provides more conclusive results.

Exercise Therapy Improves Fibromyalgia
intelihealth.com
http://www.intelihealth.com/IH/ihtIH/WSIHW000/333/344/353014.html
(British Medical Journal) -- Prescribed graded aerobic exercise is a simple, cheap, and effective treatment for people with fibromyalgia (medically unexplained chronic muscular pain and joint tenderness), finds a study in this week's BMJ.

Exercise Can Ease Fibromyalgia
By Jennifer Warner, WebMD Feature
http://webmd.lycos.com/content/article/49/40037.htm

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 Books & Videos

Adolescence and Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: Journeys with the Dragon

Naida Edgar Brotherston, MSW, RSW Supervisor, Community Services Program and Coordinator, Program Evaluation, Calgary Women’s Emergency Shelter

http://www.haworthpress.com/store/product.asp?sku=2075&AuthType=2

Adolescence and Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: Journeys with the Dragon examines the firsthand experiences of four young women stricken with this stigmatized chronic illness and offers advice and support for the victims, as well as for their family and friends. The book focuses on the ways they cope with a stigmatizing chronic illness during adolescence and the impact it has on their lives. It offers a personal “guide to survival” that will appeal to adolescent patients and parents, and it provides a window into the psychosocial implications of illness that is well-suited to professionals.

A Parents' Guide to CFIDS: How to Be an Advocate for Your Child with Chronic Fatigue Immune Dysfunction

By David S. Bell, M.D., FAAP; Mary Z. Robinson, M.S.Ed.; Jean Pollard, A.S.; Tom Robinson, M.S., CAS; and Bonnie Floyd, M.A.

http://www.haworthpressinc.com/store/product.asp?sku=1829

This guide will assist you in understanding CFIDS, also known as Fibromyalgia (FM) and Myalgic Encephalomyelitis (ME), one of the most complicated illnesses in medical history. You will learn how to help your child overcome the major academic challenges of CFIDS and the socialization issues inflicted by being cut off from friends and peers at a critical stage of development.

The Best Of Fibromyalgia Frontiers, 1992-2000

National Fibromyalgia Partnership (NFP)

http://www.fmpartnership.org/BOFF.htm

A goldmine of quality information still highly relevant to persons with fibromyalgia.  62 articles on fibromyalgia & related conditions, symptom management, coping, and work & disability, plus 18 favorites from our "Ask the Expert" columns. 81/2"x11", softbound, 182 pages.

The Clinical Neurobiology of Fibromyalgia and Myofascial Pain: Therapeutic Implications

A Synopsis of the Plenary Sessions of the MYOPAIN 2001 Conference in Portland, OR

Edited by Robert Bennett, M.D.

http://www.fmpartnership.org/Clinical%20Neurobiology.htm

If you are a medical professional or someone with advanced medical knowledge and are seeking a reference that charts noteworthy advances in the study of the neurobiology of soft tissue pain and suggests promising paths for future inquiries, this publication is for you.

Fibromyalgia: A Resource Guide For Health Care Professionals (2002/2003 Edition)

National Fibromyalgia Partnership (NFP)

http://www.fmpartnership.org/Resource%20Guide.htm

This new guide contains a wealth of quality information for medical professionals.

From Whiplash To Fibromyalgia: A Painful Beginning That Doesn't End

By Mark Pellegrino, M.D.

http://www.fmpartnership.org/Whiplash.htm

In this latest book, From Whiplash to Fibromyalgia: A Painful Beginning That Doesn't End, Dr. Pellegrino offers an up-close and careful look at the mechanics of whiplash injuries from the moment of initial impact through the evaluation and treatment of sustained injuries. This discussion is a great boon for the lay reader who would otherwise find wading through the complex scientific and medical articles on the subject very tough going.

A Practical Guide To Persevering & Winning Your Chronic Pain/Fatigue Disability Case

By Scott Davis

http://www.fmpartnership.org/ScottDavisBook.htm

The National Fibromyalgia Partnership has compiled 11 articles authored by Mr. Davis which provide practical and up-to-date information for persons with FM and CFS who are considering filing for Social Security Disability.

When Muscle Pain Won't Go Away: The Relief Handbook for Fibromyalgia and Chronic Muscle Pain
Gayle Backstrom, Bernard Rubin

This new revised edition tells sufferers everything they need to know about fibromyalgia (FM), but can't find anywhere else. It will assist and educate the layperson in recognizing and treating FM--what it is, how to detect it, and whom to consult about it, all in simple, straightforward language. The authors cover the gamut of exercise, diet, drugs, and emotional considerations.

The Fibromyalgia Relief Handbook
Chet Cunningham

Fibromyalgia: Simple Relief through Movement
Stacie L. Bigelow

Targeting mostly women between the ages of thirty-five and sixty, Fibromyalgia Syndrome (FMS) is an often-misunderstood condition that causes muscle pain, fatigue, and numerous other symptoms. Exercise and physical activity are recognized as the most effective methods to relieve the symptoms, but few people, including medical practitioners, know how to exercise without actually exacerbating the symptoms. Written by a motivational health counselor, Fibromyalgia presents clear and specific advice on how to safely and effectively use movement to ease the pain of FMS. * The first book devoted to relieving FMS pain through movement * 15 drawings illustrate ways to safely reduce pain.

Handbook for Fibromyalgia and Chronic Muscle Pain
Gayle Backstrom, Bernard R. Rubin
This revised and expanded edition of When Muscle Pain Won't Go Away offers you hope for coping with FM and shows you how to get on with your life. With the assistance of Dr. Bernard R. Rubin, author Gayle Backstrom, a sufferer herself, provides the information you need to know about FM, including how it is diagnosed, basic symptoms and conditions, treatment options, pain-relieving exercises that are easy to follow, and effective coping strategies.

Fibromyalgia For Dummies
Roland Staud, Christine Adamec, Christine A. Adamec
This easy-to-use guide will help you identify fibromyalgia symptoms, find the right doctor, and develop a plan of care. You get up-to-date information on prescription and over-the-counter medications, as well as alternative therapies that will help you manage your pain while handling work and family life.

From Fatigued to Fantastic!: A Proven Program to Regain Vibrant Health Based on a New Scientific Study Showing Highly Effective Treatment for Chronic Fatigue and Fibromyalgia
Jacob Teitelbaum, Act (Editor)
From Fatigued to Fantastic! offers the most effective treatment plan to help people recover from these disorders, and will coincide with the publication of a groundbreaking study in the Journal of Chronic Fatigue Syndrome announcing the author's findings to the medical community.

Managing Pain before It Manages You, Revised Edition
Margaret A. Caudill, Herbert Benson
Like the foreword writer, Herbert Benson, MD, author of The Relaxation Response, Caudill (Dartmouth Medical School) is a physician who subscribes to complementary alternative medicine. She explains the mind-body connection, common chronic pain conditions, and self-help tasks. Worksheets include a pain diary. No data is given for the first edition. Annotation c. Book News, Inc., Portland, OR (booknews.com)

Fibromyalgia and Chronic Myofascial Pain: A Survival Manual
Devin J. Starlanyl, Mary Ellen Copeland, Christopher R. Brown
Fibromyalgia & Chronic Myofascial Pain Syndrome offers the first comprehensive patient guide for managing these conditions. You'll start by learning what FMS and MPS are, evaluating your own symptoms, and identifying the tender and/or trigger points that are crucial for treating them. The manual covers chronic pain, sleep problems, and other "internal affairs," shows you how you can use your mind to counteract physical symptoms and the numbing effects of "fibrofog," and provides an extensive set of healing tools - including information on the latest medications, a nutritional program, and tips for using bodywork and other less commonly known treatments. Its comprehensive survival strategies include suggestions for coping with family and work situations, getting support, and dealing with the health care system.

Fibromyalgia Help Book: A Practical Guide to Living Better with Fibromyalgia
Jenny Fransen, I. Jon Russell
A how-to guide that gives people with the disorder practical tools for effective management. Recommended for fibromyalgia patients, medical professionals who treat fibromyalgia, those seeking to understand fibromyalgia sufferers, and support groups.

Parting the Fog: The Personal Side of Fibromyalgia / Chronic Fatigue Syndrome
Sue Jones
This book is a thorough and candid description of what it is like to journey through life suffering from fibromyalgia/chronic fatigue syndrome. Sue Jones is able to speak both personally and directly to those of us trying to balance our everyday lives while feeling the physical and emotional pain of these syndromes. Her mixture of truth, hope, pain, and humor will have readers shaking their heads in agreement as she inspires us to face each day with hope. She assures us that "FM leaves plenty of room for hope."  The poetry that she includes is quite beautiful and certainly puts into words how some of us are feeling during our everyday trials and tribulations. It might not be a bad idea for some of our family, friends, and co-workers to browse through this enlightening book!

Muscle Pain: Understanding Its Nature, Diagnosis, and Treatment
David Simons, Mense

In recent years, massive amounts of data have accumulated on the components of pain pathways, and concurrently knowledge of muscle pain in the field of neurobiology has increased markedly. This book, a collection of much of this data, aims to serve as an overview of the many diseases and syndromes associated with muscle pain, and to combine the clinical view with new concepts based on neuroanatomic and electrophysiologic research. Topics covered include local and neuropathic muscular pain, mediated and postural muscle pain, central and centrally modified pain, myofascial pain caused by trigger points, and fibromyalgia syndrome. Heavily illustrated. Annotation c. Book News, Inc., Portland, OR (booknews.com)

Inside Fibromyalgia: With Mark J. Pellegrino, MD
Mark J. Pellegrino, David Schumick (Illustrator)

You already know how Dr. Pellegrino can help you with his understanding and sound advice. Now get Dr. Pellegrino's new healing prescription in his comprehensive 348-page book, Inside Fibromyalgia. From the newest medications to alternative therapies and everything in between, Dr. Pellegrino helps you develop a plan for healing today and tomorrow. Dr. Pellegrino's special understanding - what really works and what doesn't - comes from his own personal experience having fibromyalgia and is now yours with Inside Fibromyalgia. You get the most effective healing resource from Dr. Pellegrino - forward thinking medical expertise combined with empathy and understanding; just like a personal "consultation" with him.

The Fibromyalgia Supporter
Mark J. Pellegrino

Written for the loved ones (e.g., "supporters") of FM patients, this book helps to explain how it feels to have fibromyalgia and explores in a non-judgmental way how persons with fibromyalgia and their supporters can develop better relationships. Not only does it contain good discussions of the basics of fibromyalgia (i.e., symptoms, diagnosis, and treatment), it also provides insight and humor regarding the various types of "supporters" and their relationship to their partners. (Anadem Publishing, Inc., 1997, 82 pages, softcover.

All about Fibromyalgia: A Guide for Patients and Their Families
Daniel J. Wallace, Janice Brock Wallace

This edition provides the current understanding of the disease as well as the latest drug treatments—all laid out in clear and accessible language. As in the previous volume, the authors provide a detailed, yet clear explanation of the disease.

The Fibromyalgia Relief Book: 213 Ideas for Improving Your Quality of Life
Miryam Ehrlich Williamson, Foreword by Mary Anne Saathoff

"...explains ways to change diet through nutrition and supplements, incorporate exercise into one life, and improve moods and relationships."

Concise Encyclopedia of Chronic Fatigue Syndrome
Roberto Patarca-Montero

The Concise Encyclopedia of Chronic Fatigue Syndrome summarizes current knowledge about chronic fatigue syndrome (CFS) to help anyone working with CFS patients become familiar with recent developments and facts about this and related fatiguing disorders. The information presented here has been thoughtfully organized so that you will be able to easily access and become familiar with highlights of the most relevant topics." "Comprehensive and thorough, the Concise Encyclopedia of Chronic Fatigue Syndrome will give both health care professionals and the general public a greater awareness of this widespread and growing problem.

VIDEO - New Fibromyalgia Stretch Video

Produced by Dr. Sharon Clark

http://www.myalgia.com/Videos/OnlineOrderFormTapes.htm

This revised program from Dr. Clark takes into consideration the up to date information about central sensitization and fibromyalgia. The complete stretching program may be done while sitting.  Includes warm-up. This video follows four FM patients led by a professional exercise instructor - Janice.

VIDEO - Toning and Strengthening Video

Produced by Dr. Sharon Clark

http://www.myalgia.com/Videos/OnlineOrderFormTapes.htm

Under the guidance of Dr.Sharon Clark, the fibromyalgia fitness team performs exercises while standing, sitting and lying down.  Sections are divided so that participants can do one section, take a day off then do another section followed by a day off, etc.  Instructions for safely changing position and how to progress from beginner to more advanced are given.  Illustrations of each muscle group are provided, allowing exercisers to precisely identify the muscles to be worked.  There are fun-filled warm-up and warm-down sessions for you to do along with the entire FM exercise team. 

VIDEO - Aerobic Exercise Video

Produced by Dr. Sharon Clark

http://www.myalgia.com/Videos/OnlineOrderFormTapes.htm

This tape provides a complete aerobics exercise program for persons with fibromyalgia. It includes warm-up, aerobics, cool down and gentle stretching. Whether you are a beginner or advanced, there is an aerobic program for you.

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 Personal Home Pages

FibroFriends Network

http://www.fibrofriendsnetwork.com/

My name is Chris; I am a 33 year old male and was diagnosed with Fibromyalgia in Nov. of 1999. I decided to create this web site because I saw there was a need for others such as myself to have a resource which allowed them to learn about their condition as well as to express there feelings.

A Bit of Roly's world

http://www.geocities.com/roly42/
A site about myself, family, and how FMS affects our lives.

About Me and Fibromyalgia

http://www.geocities.com/daynauk2001/fibromyalgia.html
Read my story of having fibromyalgia and hypermobility syndrome, and living with it everyday. I am 19 years old and my sister also has it, she is 16. Also good useful realated fibromyalgia sites. Also a link so you can submit your own poem about fibromyalgia, or just read other peoples poems. CHAT ROOM AND DISCUSSION BOARD, FOR FMS AND/OR HMS.

Anne Red's Fibromyalgia Page

http://www.angelfire.com/mb/annered/fms.html
Anne Red's Fibromyalgia Page discusses FMS, some of the causes being researched, coping tips, ideas for things to help relieve the pain, links, survey and more.

Cojema's FMS Pages

http://www.geocities.com/cojema/fibro.html
My site has info on fibromyalgia, also photos of my family and pets, free card shops and other freebies, fibromalgia links and Bible Readings.

Critter's Fibromyalgia Center

http://crittersworld.tripod.com/fibro.html
HELLO, MY NAME IS RALPH, aka "CRITTER". I'M A 45 YEAR OLD MALE WITH FIBROMYALGIA. I AM ALSO A DESERT STORM VETERAN AND THINK THAT IS WHAT STARTED MINE.

Debbie's Fibro Story

http://www.angelfire.com/il/stillsinging/FibroStorypage2.html
This page has my story plus some info on fibro and some links to help find more info on Fibromyalgia. Also Arthritis, health info & links.

Desiree's Page

http://www.geocities.com/Heartland/Vista/7164/desiree.html

My site has several links on FMS and ADD. It also shows my story on FMS.

Fibro/CFS Foothold

http://www.tertius.net.au/foothold/index.html
Bek's site is for anybody with Fibromyalgia and/or CFS. It contains her 'Open Letter', a bookshelf of relevant books with reviews from sufferers, a journal of her personal battle with Fibromyalgia/CFS, and lots of information about surviving, coping, and even having a life!

Fibromyalgia and Caring Friends

http://members.tripod.com/~treasures/fms.html

Hello, my name is Margaret, and I am just one of many that suffer from FMS ( Fibromyalgia Syndrome. ) My story is much like many others that you may have seen on the Net.

Fibromyalgia and Me

http://www.geocities.com/goofy_carol/fibro/fibro2.htm
This page is the first of now many. As time goes on it's apparent we need more public awareness to find a cause and cure.

Jessica's World

http://www.angelfire.com/ut/jessthegoon/index1.html
This page is about me, my struggle with FMS/CFS. links to friends pages who also have these diseases, links to pages with more info and to support groups.

KokoBaby's Home

http://member.tripod.com/~KokoBaby/index.html
Personal site on my illnesses including Fibromyalgia & CFIDS. There are many other related illnesses that are discussed as well as many links to helpful information.

Managing My Fibromyalgia

http://www.managing-my-fibromyalgia.com/
The "Managing My Fibromyalgia" Web site chronicles the author's journey since 1978 with what is now called fibromyalgia. He shares his experiences, frustrations, insights, and tips with others who have this disabling disorder. Author maintains unique diary [Weblog] of his ongoing experience.

My Fibromyalgia Story

http://www.mountain-breeze.com/webmaster/fms/index.html
Tells my story about my fight with fms and also has links to other sites that have information on fms. My site also consists of over 500 recipes and link ware graphics.

My Life as A Fibromaniac

http://www.angelfire.com/wa/joanyle/fibro.html
This is a small web page i put together telling briefly of my life with fibromyalgia.

Petra's FMS Page

http://www.kjsl.com/~petra/fms.htm
The story of my life with Fibromyalgia, helpful links and tips.

My Life With CFIDS And Fibromyalgia

http://www.anneshomeontheweb.com/CFIDS4.html

My name is Anne. I am 37 years old. I am a native NY'er. I presently live on the East Coast of Central Florida. I have 3 children and I am divorced. I live with the devastating diseases called "Chronic Fatigue and Immune Dysfunction Syndrome" and "Fibromyalgia".

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 Medical Information

Diagnostic Criteria for Fibromyalgia and Chronic Fatigue Syndrome

 
FIBROMYALGIA SYNDROME (FMS)

For the most part, routine laboratory testing reveals nothing about fibromyalgia or chronic fatigue syndrome. However, upon physical examination, the fibromyalgia patient will be sensitive to pressure in certain areas of the body called tender points. To meet the diagnostic criteria, patients must have:

A. Widespread pain in all four quadrants of their body for a minimum of three months

B. At least 11 of the 18 specified tender points
(see diagram)

These 18 sites used for diagnosis cluster around the neck, shoulder, chest, hip, knee and elbow regions. Over 75 other tender points have been found to exist, but are not used for diagnostic purposes.
*The 18 Tender Point Locations for FMS
on "The Three Graces" Masterpiece.

While many chronic pain syndromes display symptoms that overlap with fibromyalgia, the 1990 ACR multi-center criteria study (published in the February 1990 issue of Arthritis and Rheumatism) evaluated a total of 558 patients, of which 265 were classified as controls. These control individuals weren't your typical healthy "normals." They were age and sex matched patients with neck pain syndrome, low back pain, local tendinitis, trauma-related pain syndromes, rheumatoid arthritis, lupus, osteoarthritis of the knee or hand, and other painful disorders. These patients all had some symptoms that mimic FMS, but the trained examiners were not foiled--they hand-picked the FMS patients out of the "chronically ill" melting pot with an accuracy of 88%. FMS is not a wastebasket diagnosis!

Although the above criteria focuses on tender point count, a consensus of 35 FMS experts published a report in 1996 saying that a person does not need to have the required 11 tender points to be diagnosed and treated for FMS. This criteria was created for research purposes and many people may still have FMS with less than 11 of the required tender points as long as they have widespread pain and many of the common symptoms associated with FMS. Commonly associated symptoms include:
 
fatigue
irritable bowel (e.g., diarrhea, constipation, etc.)
sleep disorder (or sleep that is unrefreshing)
chronic headaches (tension-type or migraines)
jaw pain (including TMJ dysfunction)
cognitive or memory impairment
post-exertional malaise and muscle pain
morning stiffness (waking up stiff and achy)
menstrual cramping
numbness and tingling sensations
dizziness or lightheadedness
skin and chemical sensitivities

 
CHRONIC FATIGUE SYNDROME (CFS)

Chronic fatigue syndrome is diagnosed using the CDC 1994 guidelines published in the Annuals of Internal Medicine 121(12):953-959.

To meet the criteria, patients must have:

A. Fatigue

Severe, unexplained fatigue that is not relieved by rest, which can cause disability and which has an identifiable onset (i.e., not lifelong fatigue). It must be persistent or relapsing fatigue that lasts for at least six or more consecutive months.

B. Four or more of the following symptoms:

impaired memory or concentration problems
tender cervical or auxiliary lymph nodes in neck region (note that they do not have to be swollen but just tender; this can be a problem for people with FMS who have tenderness in these areas as well)
sore throat (but may not show signs of infection)
muscle pain
multi-joint pain (but not arthritis)
new onset headaches (tension-type or migraine)
unrefreshing sleep (wake up in the morning feeling unrested)
post-exertional malaise (fatigue, pain and flu-like symptoms after exercise)
NOTE: Five of the above eight criteria relate to pain and are often present in FMS as well. For both the fibromyalgia and chronic fatigue syndrome criteria, patients should be evaluated for other problems that could cause pain and fatigue, such as low thyroid function, low iron stores, arthritis and many other medical conditions. If any of these problems are found and corrected, but the individual still meets the FMS criteria, these other disorders (FMS and CFS) are viewed as co-existing and deserving of special medical attention. Unfortunately, the CDC criteria excludes people with other medical problems such as hypothyroidism and lupus, but it is okay to have the tender points of FMS or a mild case of depression/anxiety.

As a patient, you are deserving of medical care if the CFS symptoms persist and you should pursue therapy options with your doctor. However, when it comes to research studies or prevalence figures determined by the CDC, you will not be included as a CFS patient if you have any other co-existing medical condition (other than FMS and mild depression/anxiety). On the other hand, FMS is viewed as a distinct clinical entity that stands on its own, regardless of whether a person has other medical problems. This may be one reason why the prevalence figures for FMS (2% of the general population) are so much higher than CFS (roughly 0.5% of the general population).
 

Questions to Ask a New Doctor

Fibro/CFS Foothold

http://www.tertius.net.au/foothold/doctor_questions.html

Seeing a new doctor is usually a harrowing experience, and people with CFS and FMS have the added worries of 'Will they believe me?' and 'Do they know anything useful about treating my problems?'. I am looking for a new doctor at the moment, and this is a list that I compiled before I started ...

Improving Doctor/Patient Communication Links

http://bcorsa.freeyellow.com/coping.html#communication

Symptoms of Fibromyalgia

http://members.tripod.com/fibroark/id26.htm

You may have all of these symptoms at one time or another, or only a few.

FIBROMYALGIA IMPACT QUESTIONNAIRE (FIQ)

http://www.myalgia.com/fiq.pdf

FIBROMYALGIA IMPACT QUESTIONNAIRE (FIQ) SCORING

http://www.myalgia.com/Paintools/FIQ%20scoring%20b.pdf

Purpose: The FIQ is an assessment and evaluation instrument developed to measure fibromyalgia (FM) patient status, progress and outcomes. It has been designed to measure the components of health status that are believed to be most affected by FM. The average FM patient scores about 50, severely afflicted patients are usually 70 plus.

Weekly Chart for use with FM / MPS / CFIDS / MS

By Paula Payne

http://www.tidalweb.com/fms/weeklypainchart10.pdf

Pain Scale for FM & MPS

http://www.tidalweb.com/fms/fm_pain_scale.shtml

I designed this pain scale as a tool to help the FM patient clearly communicate to his/her doctor the pain levels hat he/she is experiencing. Hope it helps! –Paula

My FibroJournal

http://members.tripod.com/fibroark/id39.htm

Suggested Causes and Treatments of Fibromyalgia

By Ian Anderson, B.Sc., DC

http://www.ncf.carleton.ca/fibromyalgia/anderson.htm

Fibromyalgia is no joke! It is estimated that up to 4% of the U.S. adult population has fibromyalgia.

Mercury Toxicity [Implications for Chronic Fatigue Syndrome and Fibromyalgia Patients]
by Paul Dunn, M.D., ImmuneSupport.com

http://www.immunesupport.com/library/showarticle.cfm/id/3084/T/Both/

The incidence of mercury toxicity is much more prevalent in the general population than even possibly many physicians realize. It affects many people from developing fetus to infants, children, and adults of all ages. Reports in the recent past have pointed out the possibility of mercury poisoning from leaking gas meters and other mercury containing devices like thermometers, thermostats, blood pressure manometers, barometers, and elemental mercury collected by hobbyists. The incidence of mercury toxicity is actually greater than would be expected from these sources alone.

Fibromyalgia IS reversible - but you must DETOXIFY

http://goldberg.getwebspace.com/fibromyalgia.html
"I have yet to see a patient whose overall health was improved, whose fibromyalgia did not improve as well." says Dr. Paul Goldberg in Atlanta, who has had great success with no-drugs nutritional methods, and with fasting and detoxification. Book extracts, patient letters, description of healing methods.

Fibromyalgia Medications

Arthritis Foundation

http://www.arthritis.org/conditions/DrugGuide/about_fibromyalgia.asp

Despite the prevalence of fibromyalgia, no drugs have been developed or approved specifically for its treatment. However, researchers are currently studying at least two drugs to treat the condition's multiple symptoms.

Fibromyalgia Tender Points Identified By the American College of Rheumatology in 1990

National Fibromyalgia Partnership

http://www.fmpartnership.org/documents/sidetable.PDF

Disorders that accompany FMS

http://members.tripod.com/fibroark/id28.htm

Fibromyalgia and Sjogren’s Syndrome
http://www.myalgia.com/sjogrens.htm
There has been an increasing realization and interest over the last few years that many patients with Sjogren’s syndrome have an additional problem in the form of fibromyalgia and some patients initially diagnosed with fibromyalgia also have Sjogren's.

Do I have lupus or Fibromyalgia ?
Robert Bennett MD
http://www.myalgia.com/lupus.htm
This is not an uncommon question that I get asked. Unfortunately some fibromyalgia patients are erroneously diagnosed as having lupus, a potentially dangerous condition that affects about 2 in every 1000 people.

Headaches Due to Myofascial Trigger Points
Devin Starlanyl, MD
http://www.tidalweb.com/fms/headache.shtml
There are many possible causes of headache. For people with the hyper aroused autonomic nervous system of FMS, sensitivity to noise, cold, heat and light can add to our headache woes.

Reactive Hypoglycemia (RHG): FM/MPS Perpetuating Factor
Devin Starlanyl, MD
http://www.tidalweb.com/fms/rhg.shtml
It is thought that up to 85% of people with FM could have this condition.

Managing Your Fibromyalgia

Karen Lee Richards, Co-Director NFA

http://fmaware.org/patient/coping/managingfm.htm

A disease like Fibromyalgia has a way of taking control of your life.  It can consume every ounce of your energy and every moment of your day if you don't learn ways to manage it.

Fibromyalgia and Exercise

American Academy of Family Physicians

http://familydoctor.org/handouts/061.html

One of the best things you can do if you have fibromyalgia is exercise.

Meditation

Arthritis Foundation

http://www.arthritis.org/resources/arthritistoday/2001_archives/2001_01_02_meditation.asp

Taken daily, it can untangle tension, fight fatigue and even lower your blood pressure. It can lift your spirits and help you find inner peace. What's more, it costs nothing, has no side effects and doesn't require medical help.

But I Can't Meditate!

Fibro/CFS Foothold

http://www.tertius.net.au/foothold/meditation.html

Since the 'Real Thing' didn't seem to be working, I went about finding some alternatives to meditation ... this is what I came up with.

Find a Rheumatologist

American College of Rheumatology

http://www.rheumatology.org/directory/geo.asp

This compilation is created and maintained by the ACR.

Treatment of Fibromyalgia

Robert Bennett MD

http://www.myalgia.com/Treatment/treatment.htm

Clinical Trials - Fibromyalgia

National Institutes of Health

http://clinicaltrials.gov/ct/gui/action/FindCondition?ui=D005356&recruiting=true

Genetics & Fibromyalgia
Researchers at Case Western Reserve University in Cleveland, Ohio, are seeking volunteers to participate in a study of genetics and fibromyalgia (FM) sponsored by the NIH National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS).  Study participants must be diagnosed with fibromyalgia and have at least one living family member (i.e., parent or sibling) who has also been diagnosed with FM. Several study locations are available across the country.

 
For more information or to volunteer, phone: (216) 778-4589 or email: ffs@darwin.epbi.cwru.edu or write: Fibromyalgia Family Study, Department of Epidemiology and Biostatistics, Case Western Reserve University, MetroHealth Medical Center, 2500 MetroHealth Drive, R252A, Cleveland, OH 44109.

Fibromyalgia information for health care specialists:

• What Your Rheumatologist & Primary Care Physician Should Know

• What Your Allergist/ENT Should Know

• What Your Dentist Should Know

• What Your Eye Doctor Should Know

• What Your Mental Health Professional Should Know

• What Your Neurologist Should Know

• What Your OB/GYN Should Know

• What Your Pharmacist Should Know

• What Your Physical Therapist Should Know

• What Your Surgeon Should Know

• What Your Urologist Should Know

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