Recently in Ciguatera

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Shauna Murray is an associate professor and ARC Fellow at the University of Technology, Sydney in the Climate Change Cluster C3 Centre where she researches microalgae that produce toxins that are eaten by fish and could end up on your dinner plate, giving you an illness like Ciguatera. Ciguatera fish poisoning can cause major problems with circulation, digestion, breathing and the nervous system. Shauna's work includes identifying where the microalgae are growing so that fishers can be warned not to take any seafood from those areas and prevent the spread of the illness.

Gurjeet Singh Kohli is a Research Associate studying the genes of the microalgae that cause Ciguatera with both Shauna at UTS and Bret Neilan UNSW. He has recently handed in his PhD thesis. I asked him why it was so difficult to make a test kit that detects the toxins that cause Ciguatera.

Sustainable Aquaculture Group UTS
What is Ciguatera Fish Poisoning?

Searching for Octopus bush

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Velvet Soldierbush / Heliotropium foertherianu...

Velvet Soldierbush / Heliotropium foertherianum / 紋羽の木(モンパノキ) (Photo credit: TANAKA Juuyoh (田中十洋))

structure of rosmarinic acid

structure of rosmarinic acid (Photo credit: Wikipedia)

As I wrote earlier, Heliotropium foertherianum or Octopus Bush is a traditional remedy for Ciguatera Fish Poisoning that was scientifically tested in assays last year as effective against the toxin. While it hasn't been through the clinical trials that would show that it was definitely effective, as a native Australian plant its listed as bush tucker, so its not toxic.

Given that its not toxic, I've discussed this with my doctor, and I'd like to try the remedy of Octopus bush leaves boiled up as a tea. I am concerned about what will happen in my body if the toxin is dislodged as described in the paper, but its the only treatment on offer. The researchers in France are interested that the active compound in Octopus bush is similar to rosmarinic acid which they know how to make, so they've patented the use of rosmarinic acid for treating Ciguatera Fish Poisoning. I'd like to interview them, I hope they speak English.

A fellow CFP sufferer on facebook is trying rosmarinic acid supplements that are extracted from Rosemary, because its available. My problem is that the amounts of rosmarinic acid in the supplements are tiny. I'm after a medically active dose.

So I'm looking for sources of Octopus Bush itself, as I'd rather try the remedy that was proved to work. In the best of all possible worlds I'd wait for the clinical trials to be initiated, funded and completed, and for all the medicinal interactions to be mapped. However I've been sick ten years, and I'm recovering from a really vicious relapse that's lasted 12 months.

I can't find any sales of this plant or its extracts after exhaustive searches, so I've written to the Royal Botannical Gardens and the CSIRO for help. They've directed me to the Australian Tropical Herbarium, and the Northern Territory Herbarium . I'll send my request, and keep eating the rosemary.

English: Tournefortia argentea (habit). Locati...

English: Tournefortia argentea (habit). Location: Kure Atoll, Near coast (Photo credit: Wikipedia)

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A traditional herbal medicine based on the Octopus bush has been found effective against Ciguatera fish poisoning in bioassay tests. The active ingredient Rosmarinic acid has been patented. Clinical trials are yet to be done, but its the most hopeful news for Ciguatera Fish Poisoning sufferers I've seen in the ten years I've been poisoned. The active ingredient actually seems to work against the action of ciguatoxins and also act to remove them from the body.

Deutsch: Ciguatoxin CTX2

Deutsch: Ciguatoxin CTX2 (Photo credit: Wikipedia)


Use of Rosmarinic Acid and the Derivaties Thereof to Treat Ciguatera- patent

Protective effect of Heliotropium foertherianum (Boraginaceae) folk remedy and its active compound, rosmarinic acid, against a Pacific ciguatoxin - Journal of Ethnopharmocology

Heliotropium foertherianum - wikipedia

Rosmarinic Acid - wikipedia

Reef Or Madness

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Reef or Madness from ilum - Julie Hollenbeck on Vimeo.

A 16 minute film about Ciguatera Fish Poisoning created By Julie Hollenbeck, Mark Newbill and Ray Trujillo, Jr.

Ciguatera, the most reported "seafood toxin illness in the world" that a majority of the planet has never heard of, infects hundreds of thousands of people a year, some of whose very will to live is tested by the devastating and debilitating chronic neurological affects of the fish-borne toxin.

"Reef or Madness" a short documentary film by University of Miami Marine Affairs and Policy students Julie Hollenbeck and Mark Newbill, that recounts the struggle of chronic Ciguatera sufferers who seek to regain some semblance of their healthy and productive lives following Ciguatera infection and the incapacitating symptoms that can last for years. While Ciguatera is a recognized medical illness, many marine toxin specialists have yet to agree on how long people may suffer with the symptoms of the fish poison, leaving long-term chronic sufferers to feel as if they're more crazy than sick. Their families and physicians wondering the same. "Reef or Madness" will give a "voice" to the sufferers of chronic Ciguatera, who face doubt, confusion and scorn from themselves, their families and friends as well as the medical and scientific communities.

If people knew that the fish they're about to eat is like playing Russian roulette with their health, they might think twice before taking that first bite.

This film was created for $143 using personal, leveraged and collaborative resources.
Marlie Productions, 2010 ©

Karaoke Therapy

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Location of two brain areas that play a critic...

Image via Wikipedia

I suffer from mild aphasia from chronic ciguatera fish poisoning. I reasoned that karaoke therapy might help my fluent or "mild" aphasia. A year after I started singing, I had big improvements in the quality of my speech, and the science has been published explaining why it worked, and why joining a choir may help me and other people who've suffered "mild" aphasia even more.

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Zombie Fish poison! Associate Professor Graham Nicholson from the department of molecular and medical biosciences in the faculty of science at the University of Technology, Sydney spoke with Ian Woolf about the tropical fish disease Ciguatera and the fish you eat to consume the poison.
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English: Spanish mackerel have yellow or olive...

English: Spanish mackerel have yellow or olive green oval spots across their bodies. (Photo credit: Wikipedia)

I'm often asked for a list of fish people shouldn't eat if they want to avoid the risk of Ciguatera Fish Poisoning. Here's the official list from 1999 (before Sydney fishing was banned) for Australia, none of which I have ever knowingly eaten.

From the 1999 Federal Government report by Leigh Lehane:

"The main fish species in Australia that have caused outbreaks of CFP are: 

narrowbarred Spanish mackerel (Scomberomorus commersoni) and other mackerel species,
coral trout (Plectropomus spp.),

flowery cod (Epinephelus fuscoguttatus),

barracuda (Sphyraena jello),

red emperor (Lutjanus sebae),

queenfish (Scomberoides commersonianus),

grouper (Epinephelus lanciolatus),

red bass (Lutjanus bohar),
trevally (Caranx spp.),

Maori wrasse (Chelinus trilobatus),

kingfish (Seriola spp.),
parrotfish (Scarus spp.),

chinaman fish/snapper (Symphorus nematophorus),

and paddletail (Lutjanus gibbus) (Mitchell 1976; Gillespie et al 1986; Fenner et al 1997)."

Karaoke Therapy

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I accidentally ingested neurotoxins from tropical fish in December 2002, on a locally delivered pizza. Amongst the bizarre Ciguatera symptoms was "Mild Aphasia", including changes to my voice. I sounded terrible. I wasn't able to convey emotions in the tonality of my voice, and I often slurred my words or went quiet. The professional speech therapists took two looks down my throat and told me they couldn't see me using my voice wrongly. So I've had to do the Mad Scientist thing and experiment on myself, after reading up on neurology and immunology and toxicology.

I figured that if singing activated a different part of the brain for people who stutter and helps them speak clearly, it may also help with my voice changes. A different neural pathway sounded like exactly what I need. Singing is all about conveying emotions in the changing tonality of your voice.

So I downloaded EvilLyrics and winamp, and sing along at home. I have a bad memory for lyrics, but with EvilLyrics downloading them and displaying them in front of me for every song; I could sing. Nobody had to hear me. Mysteriously, my voice was remarkably richer the next day.

Thus Karaoke therapy was born. I suspect the fact that I'm trying to match the singer's timing, pronunciation and inflection are part of what makes a difference. In primary school, I used to be part of a school choir. We sang at the Sydney Opera House. I think singing with another voice, gives feedback for me to make corrections to my singing.

It seems to give me the best results if I sing for up to an hour, as part of my preparing for sleep rituals. Too little time has less effect. If I miss it for too many days, then my voice reverts to poor, high montonal, and faint.

I'm experimenting further to see if I can refine it and get better results. Certainly listening to my mp3 radio pieces, the changes are clear.

I have no medical qualifications, I'm just giving myself technical support for a black box problem that the experts have given up on. This seems to work for me, I hope if you have suffered the same symptoms, that it works for you. If nothing else, Karaoke is fun!

Ciguatera follow-up

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In April 2004, Ian Woolf reported how the fish we eat in Australia can be contaminated with Ciguatera poison, one of the poisons used in Haiti along with puffer fish and toad poison to make real Zombies. In a Discovery follow-up, Ian asks what is being done to protect us from Ciguatera.


Ciguatera and bread sound bite

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Ciguatoxin aka CTX1B, a neurotoxin isolated fr...

Ciguatoxin aka CTX1B, a neurotoxin isolated from the marine dinoflagellate Gambierdiscus toxicus. (Photo credit: Wikipedia)

In April, Ian Woolf reported how the fish we eat in Australia can be contaminated with Ciguatera poison, one of the poisons used in Haiti along with puffer fish and toad poison to make real Zombies. In a Discovery follow-up, Ian asks what is being done to protect us from Ciguatera. Omega-3 enhanced bread could give you Ciguatera.

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Ciguatera in the bread??

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Ciguatera - what is being done to prevent the poison reaching us?(mp3)

Ciguatera is an illness you get from eating fish poisoned with ciguatoxins. Omega-3 enhanced foods use tuna oil as a nutritional supplement. What are the regulations and procedure that stop us being zombified by neurotoxins? How does the poison work in the nervous system?

Mild Aphasia

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My brain's speech processing centres were attacked by the ciguatera poisoned fish I ate on December 1st 2002, and it took me six months to be able to get together the concentration to write a radio script explaining my condition, and to read it on air at 2SER 107.3.
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Ciguatera and high altitude

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Ciguatera has the same effect on the lungs as high altitude! In the 29th May 2004 issue of New Scientist, there is a story called "Why your lungs might not cope with high altitudes", which describes High Altitude Pulmonary Oedema (HAPE), where the lungs fill with fluid at high altitudes in susceptible people. Researchers at the Centre Hospitalier Universitaire Vaudois in Lausanne have shown that the illness is connected with the efficiency of the sodium pumps in the cells lining lung alveoli air sacs. These rid the lungs of excess fluid by pumping sodium ions out, which draws water outside the lungs by osmosis. The Swiss team showed that the asthma drug salmeterol boosts the sodium pumps activity and halves the risk of HAPE. Ciguatera blocks sodium channels receptors and forces open calcium channels. This looks like the mechanism of pulmonary problems with Ciguatera poisoning and the failure of asthma drugs to help with breathing are tied to the way they act on the ion channel pumps. Chronic Fatigue Group - University of Glasgow Neurology of Ciguatera - Professor Pearn, University of Queensland So my lungs are filling with fluid when I have trouble breathing, but the asthma drugs can't get the sodium pumps to clear them, because the sodium ion receptor is blocked by the ciguatera toxin. Against my gastroenterologists' wishes, my GP has me back on antibiotics to fight the chest infection and fevers, after a month of non-treatment. The fact that I feel able to make a blog entry after two months of having trouble even reading the screen for more than ten minutes shows what a good move that was! The reading has slowed way down while I deal with the fevers. However I'm still working my way through Tuning The Brain , and my pile of New Scientist as they arrive each week.

Ciguatera from bread!

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I wanted to find out about the risk of Ciguatera poisoning from skipjack tuna oil used to supplement Omega-3 DHA bread and other flour products, so I contacted George Weston Foods. George Weston Foods are one of Australia's largest food manufacturers, responsible for popular brands in bread and baked goods, dairy, meat, cereals and animal feed. They are wholly owned by Associated British Foods, who operate in New Zealand, the United States, the United Kingdom, South Africa and Thailand. I was assured "Fish effected by Ciguatera Poisoning are usually fish that feed in warm ocean waters such as a reef. The tuna used in our product is caught using large fishing trawlers in the deep ocean and therefore poses a minimal risk of carrying the toxin." However, their tuna suppliers test for Ciguatera every three months. I figure this is to account for the fact that fish swim. Predatory fish swim over large distances. Testing once every three months obviously isn't safe enough, or I wouldn't have been poisoned. Ciguatera is very under-reported, in fact it took 18 months for me to be diagnosed. Many other people may be affected and not know what hit them. What are the regulations for testing? I'm waiting on a reply from Food Standards Australia to find out whether there are any regulations for Ciguatera toxin testing in place.

Ciguatera Zombie Poison

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In Haiti, Voudon sorcerers mix up Zombie making powder that works largely because of two nerve poisons found in the puffer fish used in the recipie. Ciguatoxin, which blocks the calcium electrochemical channels in nerve cells, and tetradotoxin which blocks the sodium channels.

Ciguatoxin is a water and fat soluble protein that isn't restricted to puffer fish, its also made by dinoflagellate protozoa - micro-organisms that attach themselves to algae that grow on dead, damaged or dying pacfic coral reefs. Small fish eat the toxin-salted algae, and are eaten by larger and larger predator fish. The poison is concentrated in each step up the food chain. By the time you get to big fish like the skipjack tuna used in fish oil supplements, or barramundi, coral trout, sea perch, mullet, cod, red snapper, and mackeral, (to name a few) that you may choose for your dinner table; there's enough poison not to make you a zombie, but to make you suddenly and dramatically ill.

I should know, it happened to me just over a year ago.

Nobody returns from Narrabri

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I graduated from my Applied Physics degree with Computing Science sub-major, and applied for a job as a scientific programmer with the Ionospheric Prediction Service in Chatswood.

I knew about the 11 year sunspot cyle, so they hired me as a solar astronomer instead, as a replacement for the incumbent astronomer who was tired of the simple life in the outback. I gave up on my patent office job interview, and accepted the post. I had two weeks to move there from Sydney.

They observe the sun from the Culgoora Observatory outside of Narrabri, and make predictions about what the sunspots will do, and how they will effect the ionosphere and its ability to reflect radio waves back to Earth, and hard radiation that will be experienced by satellites and astronauts during solar storms.
astroian<In exile at the Culgoora Solar Observatory in driest Outback Australia
during my short sojourn as an astronomer. Narrabri - you'll never leave

Narrabri is an interesting town to move to for a city boy. One main street, with seven pubs and two drive through bottle shops, and one RSL club. Two video hire libraries, no theatres or other eentertainment. No public transport, just a plane trip to Sydney or Tamworth. I couldn't afford a car.

I worked in Narrabri for nine months. I was diagnosed with Myalgic Encephalomyelitis (ME/CFS) by Professor Denis Wakefield there, and then months later, my back was permanently injured while following instructions from the supervisor at the IPS Culgoora Solar Observatory. Heavy lifting isn't usually in the job description of an astronomer.

I made this observation of a solar storm on the new Spectrograph:

My severe Chronic Fatigue Syndrome (CFS) symptoms improved dramatically this year and neither I, nor my doctor know why. Now they're getting worse, and again I have hypotheses, but I don't really know. So, as a scientist who may be soon gaining or losing quite a few abilities, I thought I should summarize what I took over the time my Chronic Fatigue Syndrome symptoms, particularly my energy, concentration, memory, arithmetic, and speech improved. (turns out I had Ciguatera poisoning)

Dr Jay Goldstein of the Chronic Fatigue Sydrome Institute has finally released his new book on how to treat the illness.

I was given Ventolin (generic name "salbutamol" or "albuterol") on the 4th January 2004 as first aid for a severe bronchitis attack on a trip to winter Canada, and had wonderful side-effects helping my Chronic Fatigue Syndrome. The better drug, I found, is Symbicort.

After one puff of Ventolin, I immediately heard a loud dizzying, ringing noise, and then my mind cleared.

This is wholly remarkable to someone who has suffered clouding of the brain by severe CFS or Fibromyalgia. To someone like me, who has suffered frequent attacks of mild aphasia and complete confusion for more than a year, this is like going from reading by the light of a randomly flickering LED clock, to switching on the room lights.

Chronic Fatigue Syndrome researcher Dr Jay Goldstein in his book Betrayal By The Brain talks about there being brain systems going wrong that are helped by vaso-constricting drugs, and other brain system problems that are helped by vaso-dilators. A bronchio-dilator like ventolin dilates the bronchial tubes by vasodilator action.

I was prescribed the preventative Symbicort, which is a powder inhaler containing anti-inflammatory budesonide and brochiodilator formoterol. The brain effects were more gentle than the Ventolin, but more substantial and longer lasting. I have massively improved concentration, and my aphasic symptoms are so well controlled that I am able to sit and write for hours or sit and talk for hours. I feel more energetic, and I have a sense of well-being that I suspect comes from the reduction in inflammation.

After two weeks of Symbicort and antibiotics, my bronchitis mostly cleared up. I still had a dry cough, so I visited a doctor, and explained about how much I like the side effects of the Symbicort. He doubled my dose, and wrote a report for my doctor at home.

On the double dose, I had energy and stamina. For the first time in eighteen months, I had been able to go out on walks for pleasure, without debilitating exhaustion. My technical skills came back to me, and I was able to work on a project with my father-in-law to set up his computer to transfer his old video cassette collection to DVD to save space. I worked without tiring for several days before I finally had the familiar CFS "crash" exhaustion and had to simply rest for a few days.

We returned to Sydney via London, and my wife and I walked for six hours a day all over London to see the sights for two days. My legs hurt from simple muscle-tiredness after a good work-out, rather than from inflammation.

Since returning to Sydney, I developed the common side effect of oral thrush from the Symbicort, and my doctor switched me to Ventolin. The Ventolin gave me my voice back and let my body get rid of the thrush. I did have some stamina on the Ventolin alone, and I could still talk, but it simply wasn't as good as the Symbicort.

I started to feel miserable, like you do with flu or CFS, and I wasn't feeling as bright as on the Symbicort. When I started getting the Mild Aphasia symptoms like biting my mouth when I ate, I decided I had to return to the Symbicort. I compromised by halving my dose to one puff twice a day to reduce the risk of hurting my throat, and used an inhaler spacer.

I felt better within twenty minutes. I stopped having to lie down to recover from my one big day out gathering interviews for the Diffusion radio show . I started writing my travel insurance claim, chasing up the money that Centrelink owe me, cleaning the flat, and registering with the
NSW Writer's Centre .

I was diagnosed with Chronic Fatigue Syndrome (CFS) in 1992, and have suffered various insults that have worsened things since then. I have suffered severe symptoms since November 2002, suffering Mild Aphasia and losing seventeen kilograms.

I think the oral thrush that hurts my throat is only caused by the dry powder inhaler, and my google searching has shown that there exist aerosol inhalers that have the same active ingredients budesonide and formoterol, including sinus sprays.

I intend to contact AstraZeneca who make Symbicort and see if they have any information about the drug as a treatment for CFS.

My gastroenterologist early last year told me that my severe CFS symptoms and my mild Aphasia seemed to him to be caused by a micro-organism that exposed my brain to a foreign protein causing inflammation. It makes sense then, that an anti-inflammatory drug should help me.

I'm not cured; I'm still disabled by CFS, but I'm feeling much, much better. I hope that I'm not an isolated case and that these drugs can be used to help relieve some of the symptoms of CFS and Fibromyalgia sufferers around the world.

CFS/ME Society of NSW
A Companion Volume to Dr. Jay A. Goldstein's Betrayal by the Brain: A Guide for Patients and Their Physicians

This is Day Nineteen of winter wonderland, and the air in every house and car is filled with little hairs and fluff that start me coughing up a lung, and the occasional stomach lining. There is no ventilation in winter in the Northern Hemisphere. With the Super-Senses afforded to me by the curse of hyperacuity of my sense of touch, I can count every dog hair and fabric fragment as it hits my lungs going in, and sometimes out.

Hyperacuity is experiencing the removal of the normal filters that remove noise from the signals your brain porcesses from your raw senses. Its usually caused by psychotropic drugs, hypnotic states, or brain inflammation. I've opened the Doors Of Perception, as Huxley called this, with meditation in the past, but sadly its inflammation thats cursed me at random times in the past 12 months, and the Doors are open so wide that I can't get them shut to get some sleep.

I've visited a Canadian 24-hour clinic, so I've been able to compare standards of medical care with my Australian experience. The 90 minute wait wasn't bad for a Monday lunchtime in winter. My Canadian doctor was only able to handle one symptom for the visit, and his objective was to eliminate life-threatening pneumonia as a diagnosis, as quickly as possible and get me out of there so more desperate souls could receive his aid. I'm embarressing everyone with the secondary stomach problem that was caused by literally gut-wrenching, convulsive coughing on my return to the house in Toronto. My responsibility is to hope quietly that it will heal on its own. I would have been able to get an Australian doctor to at least check out the tender points, and get a baseline on whether I've done myself an injury in an already troubled region.

I have full travel insurance, so I can pay for proper medical care, but that doesn't matter. Emergency rooms at hospitals are for life-threatened people only, anyone else will be resented as betraying their civil duties, and be justly punished by unpleasant day-long waits. I'm not dying yet. This I have had explained to me, and this I understand.

I've also had explained to me that the Docs in the Clinic are understaffed and over-worked, and I've seen this. I'm told that Canadian residents do have access to doctors who could actually treat you like a person instead of a symptom, but that these doctors don't see people unless there's a guaranteed commitment to a long-term relationship. Sort of like an arranged marriage.

I should have stayed in Buffalo, and tried out what the US medical system would make of a guy who isn't dying, but can pay to see a doctor. I was certainly in a culture where I was welcome to express my distress, without people dismissing me as a drama queen. I made a bad decision. In my defence, I had all the signs of recovery until I hit the indoor air pollution. I felt like I was trying to breathe the atmosphere of a different planet and failing miserably. Not on Pluto anymore.

Deep exhaustion and oxygen-deprivation caused brain fog, and my ability to think narrowed sharply. Between gasps and full-body spasms, I was still able to clearly express myself in short, witty sentences, to a group of people who had no idea I'd been feverishly ill for four days already. After attempts to solve my oxygen problem with air cleaning machines, postural changes, and drinks of water, I was no longer able to think of a remedy for myself, and only wished for death to hurry up, already.

So I expressed blunt doubts about my survival, and someone was able to suggest stepping outside into the cold night air to escape the indoor air pollution. I wiped my running nose, coughed up the other lung, and put my jumper, snow-boots, jacket, scarf, gloves and touk (to stop my ears freezing), and ventured outsite. I was feeling very foolish I hadn't thought of this traditional Canadian respiratory infection remedy for myself. I risked being told once again how upside-down and topsy-turvey my Australian expectations are.

There is a ray of light from out of this cloud of misery and snow. I've been exposed to vaso-dilators. Much later in the evening when all the people with cars who could drive me to a Clinic had gone home, secure in the knowledge that I only needed a quick trip out into the cold but clean night air to be able to sleep; I was offered a hit of ventolin for my tortured lungs to help me survive the night. It affected my brain a *very good* way. Back in High School, I remember seeing non-asthmatic kids in high school getting high from ventolin puffs.

This is what happened: I heard a loud dizzying, ringing noise, and then my mind cleared.

This is wholly remarkable to someone who has suffered clouding of the brain by severe CFS or Fibromyalgia. To someone like me, who has suffered frequent attacks of mild aphasia and complete confusion, this is like going from reading by the light of a randomly flickering LED clock, to switching on the room lights. Result!

Two weeks ago I was reading the patient's gloss of Dr Jay Goldstein's "Betrayal By The Brain" about his clinical research into Chronic Fatigue Syndrome and Fibromyalgia. He talks about there being brain systems going wrong that are helped by vaso-constricting drugs, and other brain system problems that are helped by vaso-dilators. A bronchial-dilator like ventolin is a vasodilator. I took my prescription bronchitis inhalor tonight, and I didn't experience the ringing in the ears, or get quite so quick an effect. However, what an effect! Not only does it help control my coughing and wheezing, but I've just written a book review, and a rather sizeable blog entry. I've only been prescribed a two week supply. My memory problems seem to remain unhelped, but my concentration and articulation are improved. Memory may simply take longer treatment.

I'll be reading Goldstein's book to see what else he suggests for people who respond the way I have, and planning to get some vasodilation drugs that work a little more long-term on my return to Sydney.

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