Fibro Fog.. What is it and why …

Fibro Fog

Sleep, brain dysfunction likely culprits for cognitive difficulties associated with fibromyalgia.

Fibro fog – also known as fibromyalgia fog and brain fog – is a term commonly used for the cognitive difficulties that can occur with fibromyalgia.

What is Fibro Fog?

“My patients tell me that fibro fog feels like they’ve been taking cold medicine constantly,” says Rob Keenan, MD, MPH, assistant professor of rheumatology at Duke University School of Medicine. “They have difficulty concentrating, finding words, holding conversations, feeling alert and remembering things.”

According to a 2015 review in Rheumatology International, some patients report that the loss of mental clarity can be even more devastating than the pain and fatigue associated with fibromyalgia. Fibro fog can manifest itself in different ways in different people but some of the most common symptoms include:

  • short term memory loss
  • misplacing objects
  • becoming easily distracted
  • forgetting plans
  • difficulty carrying on conversations
  • inability to remember new information

Although cognitive difficulties have sometimes been thought of as “all in a patient’s head,” a 2015 study in Arthritis Care and Research found that fibro fog is a real issue. In a study of 60 individuals – 30 with fibromyalgia and 30 without fibromyalgia – researchers found various impairments of attention and memory in fibromyalgia patients when compared with healthy controls. What remains unclear is what is causing the cognitive challenges.

Sleep Better, Feel Better

Though the cause of fibromyalgia fog is still up for debate, many physicians and researchers theorize that fibro fog could be related to poor sleep.

“The first thing I ask my patients is how well they’re sleeping,” says Dr. Keenan. “Most will tell me that they’re waking up several times during the night or lying awake for hours. Goal number one becomes getting them to sleep well, which can help them feel sharper, as well as help them better deal with pain.”

Dr. Keenan often tackles sleep issues using a combination of tactics.

“I often prescribe patients amitriptyline (Elavil), which helps people reach the level of restorative sleep they’re often missing with fibromyalgia,” says Dr. Keenan. “I also recommend that they get as much activity during the day as they can handle, whether it’s walking 50 feet down the street or getting into a warm pool to exercise. Good sleep hygiene also is important.” 

Is the Brain to Blame?

Though better sleep has many benefits, some studies show there are simply different things happening in the brains of people with fibromyalgia. In one study, brain scans showed that from time to time, people with fibromyalgia do not receive enough oxygen in different parts of their brain. One possible reason is that part of their nervous system is off-kilter, causing changes in the brain’s blood vessels.

Additional research – though not on fibromyalgia specifically – showed that chronic pain may affect the brain. Functional MRI found that in people with chronic pain, a front region of the brain mostly associated with emotion is constantly active. The affected areas fail to shut off when they should, exhausting neurons and disturbing the balance of the brain as a whole.

A 2013 review in Current Pain and Headache Reports on cognitive impairment in fibromyalgia patients confirmed that the jury is still out on the exact cause of fibro fog. However, it did report that patients may see some cognitive improvement with a combination of physical activity, cognitive-behavioral therapy and medication.

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Sometimes I honestly wish i never heard of the word’s……..

Sometimes I honestly wish i never heard of the word's

  • Fibromyalgia
  • Fibro Fog
  • CRPS Type II
  • Rheumatoid Arthritis
  • Diabetes Type 2
  • Paget's Disease.

If I didnt then I would be living a normal life, doing normal things, and just outright enjoying everything. I would love to have just 1 day, 1 full day of not having to deal with any of it. just to remember what it feels like to be normal again.

I could do work to my house, without begging my body to make it through this day, so I can do more the next.  I could work in my yard, and garden, without praying i can make it through this day. and finish before my body shuts down again.  I could take walks, or ride a bike, go camping, make plans for the days and weeks to come, without having to cancel those plans.

Some think its a all in my head thing, some think I just dont want to do it. others just don't care to hear about it. but if they had just 1 half a day with exactly what i deal with on a ongoing basis,  then maybe they would understand, and instead of ridicule, or the words "thats bullshit" come out of their mouths or in their heads thinking of it. a little more comfort would be offered, and a little more understanding would be given.  

The Daily hell is always there for me, its real, the uncertainly from day to day of how will I feel?, what will I be able to do? can I do just a little bit and finish a project? that is what i deal with each day. 

I honestly wish i never heard of the word's……………

Common Errors and Oversights – Trackplanning

So you’re tired of watching your train go around an oval, and you’re ready to design the ultimate layout — one whose trackplan alone will make the model-railroading magazines fight for the rights to your article. A plan so good that you’ll never have to revise it or improve it. Sounds good to me! But if you haven’t done much trackplanning, how do you know your grand ideas will work? I’m not here to tell you how to do it, but how not to do it.

Trackplanning is a skill that improves with experience, which comes from making mistakes, and that can include other people’s mistakes. Why make the same errors that others have already made? This article is a partial list of the most popular trackplanning goofs. If you heed this advice, you can at least be sure that your mistakes will be original.

Mechanical problems are physical errors that will keep the layout from working properly. The most common ones are:

  • Curves tighter than they need to be. This is a questionable way to fit more track into your space. Okay, you’ve run tests, and all your engines and cars will run on a tight curve. The problems here are that (a) just because it runs doesn’t mean it looks right, and (b) what will you do on the day you bring home something new, long and gorgeous, then discover that won’t quite make it around your curves? Make your minimum radius a little bigger than it absolutely has to be, and you’ll have no regrets later.
  • S-curves. John Armstrong covered this train-killer in detail in his excellent book, Trackplanning for Realistic Operation. If you don’t own a copy, get one. In brief: s-curves tend to sneak into the best plans, they can be murder to fix if you don’t get them early in the game, and if you don’t eradicate or minimize them, your trains will not stay on the rails.
  • Track too close to the edge of the table. It’s tempting to push the limits of your benchwork in order to squeeze in a little more track. But you’ll regret it the first time a train takes The Big Dive. It might be a stray elbow, an inadvertent jolt to the benchwork, the aftermath of a simple derailment, or a 1:1-scale earthquake if you live in California, but if there’s nothing stopping an engine or car from going down, then down is the direction it will go until something stops it (like the floor). Those stray elbows will also play havoc with your carefully ballasted track. And it’s a fact that trains look longer if they sometimes move behind trees and structures, which is impossible if there’s no room for trees and structures between the track and the table edge. You’ll be happier in the long run if you give up a little track space along the edges, both for scenery and for safety.
  • Overly-optimistic turnout "templates." This mistake will never derail a train, but it has derailed many a track plan. Put simply, it means your pencil-and-paper plan hasn’t allowed for the fact that the curved leg of a turnout is a lot broader than you think. I’ve seen hand-drawn plans where the turnouts almost looked like right angles. Then you try to convert the plan into roadbed and rails, and you’re dismayed beyond words that it won’t fit. No harm was done, but a lot of effort was wasted. Measure samples of the actual turnouts you’ll be using, before you start, and you won’t have to start over.
  • No tangents for coupling & uncoupling. This one is so commonplace, even in published plans, that I suspect that very few trackplanners do much switching. All couplers, in all scales, work better on straightaways and very gradual curves than they do on hairpins. Automatic uncoupling just doesn’t work on curves. Yes, you can do it manually, but it’s still a lot harder than on straight track. Trying to couple on curves is even more difficult. If your yards and industrial parks are for switching and not for show, make sure they have straight sections where the action takes place, or you may soon give up on switching altogether.
  • Grades too steep. The sight of trains straining upgrade and crossing over other trains on bridges has strong visual appeal. As hobbyists, we tend to minimize the "straining" part. But a 2% grade can cut your engine’s effective pulling ability by half or more. Add the extra effort needed to pull around the curves we usually put our grades on, and it’s a wonder our engines ever reach the summit. Downgrades add their own complications; the engine will buck and race as it tries to hold the cars back, and I’ve seen at least one train jump the tracks because the weight of the cars trying to roll downhill was greater than gravity’s ability to keep them on the rails. If you don’t have room for a grade that your trains can handle, you may be better off keeping the layout flat.
  • Benchwork the wrong height. This usually means it’s too low. Bending over to work on a low layout will give you back trouble, and wiggling beneath it to work on the wiring will give you a bad attitude toward model railroading in general. Also, trains look better at eye level, and how many model railroaders have an eye level of three feet? Unless you’re constrained by double decks or similar restrictions, a permanent layout shouldn’t be lower than 42", with 48" a better height; some will go even higher. But don’t go too high, or the layout will be equally uncomfortable to work on, and you’ll drastically reduce the area you can reach. If you have frequent visitors, keep their heights in mind, too — children and vertically-challenged adults don’t get much enjoyment from a layout that’s too tall for them to see.
  • Biting off more than you can chew. This means you’ve designed a layout that you don’t have the resources to build. Those resources can be money, time, or energy, but if you don’t allow for ways to get a small part of the layout working, you’ll probably lose interest before you can finish the whole thing. Better yet, if this is your first "real" layout, start small. Build a layout that doesn’t fill your entire space; use it as a chance to hone your techniques for track laying, scenery, and wiring. You may find that the small layout is all you need, or all you can handle. If so, great! There’s no rule that says a layout has to be huge to be fun. But if you still want to build The Big Dream, you’ll do a much better job of it if you’ve constructed one or two "practice" pikes first.

Access problems are issues of not being able to reach things. Everything works as planned, but the humans can’t interact with the layout properly. This kind of problem results in a layout that doesn’t get enough maintenance, starts to act balky, and gets abandoned because it’s more frustrating than fun.

  • Too much hidden track. The issue here is track cleaning, which is hard when you can’t see or reach the track. The hidden sections will get dirtier than they should, which results in stalled trains. Some hidden track is often a good thing for a track plan, but make a way to get to it easily, both for cleaning and for retrieving the inevitable derailed cars.
  • Turnouts in tunnels. Some swear by them, some swear at them. Turnouts are tricky critters under the best of circumstances. Hide one in a tunnel, and you multiply the problems of cleaning and maintenance, and perhaps add the excitement of not knowing for sure if it’s thrown the right way as a train approaches. The consensus is that turnouts in tunnels can work if there’s no other way to make your plan fit, but there are no guarantees. For a beginner planning his/her first layout, they probably are not a good idea.
  • Operator can’t reach what he needs to reach. I did this to myself as I planned my own Big Dream. An industrial park was serviced by a long passing siding. One end of the siding was close to where I’d stand while doing the switching, but the other end was four feet away — far out of reach, unless I walked all the way around to the other side of the peninsula. How could I uncouple a car I couldn’t reach? Could I even read a car number from that far away? And forget about throwing a manual turnout from that distance. Mentally put yourself in each place where a train operator must stand to do his/her work, and verify that everything needed to do the job is close enough.
  • Benchwork too wide. Don’t kid yourself here — we aren’t talking about how far you can reach to get a fingertip onto something. We’re talking about how far you can reach to manually uncouple two cars, solder a wire to a rail, or adjust the throw rod of a turnout. For most people, at typical layout heights, that’s about two feet, and your reach gets shorter as the layout gets higher. Don’t plan on climbing onto the benchwork to fix things; even if you make it strong enough to hold your weight, you won’t want to kneel on your finished scenery just to clean your track. Pop-up access holes can be a solution, but will your knees be up to the challenge twenty years from now? The best answer is either benchwork that is two feet wide or less, or benchwork that can be reached from both sides. Remember: if you can’t reach it, you can’t maintain it, and if you can’t maintain it, trains won’t run on it.
  • Aisles too narrow. This one is a judgment call, based on how you expect to run your railroad. If you’re a lone wolf with few visitors, you can probably get away with aisles less than two feet wide (assuming your waist is less than two feet wide and will stay that way). If you expect guests, or if your layout is meant for more than one operator, experts will strongly suggest giving up some train-table space in exchange for some people space. Three feet is about the minimum width for two people to pass each other without being very good friends. An access aisle doesn’t have to be full width, but your main viewing areas should be at least that wide.
  • Problems entering the train room. How do people get to your layout? Duck-unders will work, as long as you and your operators and guests suffer from no back or leg ailments. Lifting, dropping, and swinging bridges pose no limits to access, but they add construction, tracklaying and wiring problems. Check the published plans of the big, successful layouts; almost all of them are walk-in designs. Why? Because the simplest solutions are often the best.
  • Human-traffic bottlenecks. Say you want a long mainline, and you can fit another loop of track into your space if you shrink an aisle at one point. Will it work? If the shrunk portion is smack in the middle of a high-traffic area, the answer is "no," because people won’t be able to pass freely through the one area where they’ll do the most passing through. Don’t short-change the aisle space around the places where operators must stand to do their work. Also give space around the interesting areas where spectators will gather and linger — engine facilities, industrial parks, long bridges, and tunnel portals. And never make a dead-end aisle too narrow for two people to pass comfortably, or people may get trapped at the end, waiting for someone else to move so they can escape.
  • Walk-around control issues. Tethered walk-around throttles are a great way to enjoy the trains and to troubleshoot distant track problems. If you intend to take advantage of them, make sure to allow for them in your plan. Are there enough jacks for the throttles? Are they in convenient locations? Will two operators get their cords tangled as they follow their trains around the layout? If your throttles can’t be unplugged, are they placed so you can reach all the important parts of the pike? Will a cable block other people’s access to an aisle? Mentally map out where the throttles can go, where they should go, and how they will affect human traffic.
  • No workspace. It’s so tempting to fill your train space with nothing but trains! And the benchwork is a convenient place to work on projects, as long as the benchwork is just bare wood with a few tracks on it. But once the scenery is down, where will you assemble your kits and lubricate your locomotives? Be wise and leave some room for a workbench or desk in the train room. If your benchwork is tall enough, you can fit the work area partially beneath the layout — you’ll be sitting down to work anyway.

Visual problems are issues of the layout’s appearance. Everything works, but it doesn’t quite look right. This kind of mistake usually goes unrecognized for a while, causes mild annoyance when it’s discovered, and keeps you from really being pleased with the layout from that day forward.

  • Missing Christmas tree. In other words, your plan consists of loops of track that go around and around… and around. Maybe you need two or three separate loops for multi-train action, or a twice-around for a long mainline. Maybe you really like watching trains in orbit. But if the looping is too obvious, you’ll never convince anyone that you’re running anything but a toy train set that ought to have a Christmas tree in the middle. There are many ways to visually break up a race-track: scenery or structures between the tracks, tunnels, track at varying heights, gentle curves instead of parallel straightaways, spur tracks into the middle of the layout. The idea is to make each loop look like it’s in its own scene, somehow separate from the other tracks, and to minimize the fact that each track connects back onto itself.
  • Too much track along the edge of the table. If most of your mainline runs parallel to your table edge, it looks just like the oval of track on the 4×8 that you’re trying to get away from — toylike. Let the track undulate in gentle curves (like the prototype does), or set the whole mainline at a slight angle to the benchwork.
  • Not enough room for the scenery. This is especially hard to avoid on small layouts. Do your buildings fit between the tracks? Did you allow for the width of the roadbed before you said "yes" to that question? And how do your miniature workers get to each building — is there room for a road that leads to it? It’s also easy to not leave room for vertical scenery. Suppose you have two tracks next to each other, one low and one elevated. How do you join them scenically? A retaining wall? A rock cliff? Do retaining walls or rock cliffs make sense in the area you’re trying to model?
  • Undersized structures. It’s tempting, especially on a small layout, to fit in more industries by reducing their size. Yes, there’s such a thing as selective compression. But when your factory is barely bigger than the boxcar next to it, it will look decidedly odd. You’ll also have a problem convincing anyone that such a small industry could fill a boxcar a day for your railroad. One or two decent-sized industries will look a lot better, and you can spot several cars on their spurs at once to generate as much traffic as a bigger number of smaller industries could do. Building flats are a great way to pull this trick off.
  • Clashing scenery types. We sometimes want to put too much on our layouts, without considering how the various elements will look next to each other. This was beautifully illustrated in the Atlas book, Seven Step-by-Step HO Railroads. Thaddeus Stepek drew a picture of track running across a pond on a viaduct. Half of the pond was liquid, with sailboats; on the other side of the viaduct, it was frozen, with skaters. Nearby, a lone mountain rose straight out of the plains, and a tunnel ran through it instead of going around it. These are extreme examples, but the problem is real. If you absolutely have to have radically different locations or seasons on the same layout, it can be done with scenic dividers or carefully planned transitions. Skimp on the planning here and, to paraphrase the Atlas book, "you can decorate your layout so it would look better if you hadn’t."
  • Trying to include everything. Wouldn’t it be nice if you had enough room to model the entire coal industry, from mines in the hollers to the seaports? Or the whole Pennsy four-track mainline from New York to Chicago? I have yet to see or meet anyone who had that kind of space. It’s tempting to try to have a little of everything, but if New York is only ten feet away from Chicago on your pike, you’ve strained believability beyond the breaking point. And if your New York and Chicago are the size of Podunk and Jerkwater, forget it. As with scenery types, you can do it with careful use of scenic dividers. But for a first layout, you’ll be much better off if you choose one or two scenes of reasonable size.
  • Features you don’t need. Is a model railroad still a model railroad if it doesn’t have a yard, a roundhouse and turntable, a mountain with tunnels, and a river with bridges? Of course it is, but you wouldn’t guess it by looking at a lot of published plans. We tend to assume that every pike must have these features, and a few others you can probably think of. If your kind of railroading needs them, then use them. But these space-eaters can devour your layout, crowding out other features that might be more important to you. Look at every major aspect of your plan and ask yourself: does my railroad need this? How would it suffer if I didn’t have it? Would I be happier if I omitted it in favor of something I like better?

Operational problems are errors in planning how the trains will run. There’s nothing wrong with the plan or the way it looks. But when you try to go beyond toy-train running and do something realistic on your new layout, you discover that it can’t be done.

  • Not enough sidings or crossovers. This becomes a problem when you try to run more than one train. With only one siding, one train can run while another waits, and that’s it. With two sidings, the second train can try to dash from one siding to the other before the first train gets there. Once you have three or more sidings, the second train can actually do more running than waiting. Similar issues arise with double track and crossovers. Here, the problem is whether a train running in either direction can use the wrong main as a passing siding. Also be sure that a train running in either direction can get to all sidings, spurs, and yards. Trace out your routes in advance to see if the trains can do all that you might ever want them to do.
  • Overly-cramped yards. At a bare minimum, a yard needs an arrival track for incoming trains, sorting tracks for rearranging cars, and a departure track for trains heading out. These functions can be combined if need be. The question is, are there enough tracks to do all that your yard is meant to do? If the switcher is constantly tripping over itself trying to do its work, you may need a thoroughfare track from one end of the yard to the other. A drill track (so the switcher can work without fouling the main line) is always a good investment. You can also add space by lengthening the yard tracks; bending them at a super-gentle curve may let you stretch them without causing other problems. If all else fails, you may have to reduce the amount of work that your yard is expected to perform. Anything is better than a yard where no one wants to work because it’s an exercise in frustration.
  • Excessively difficult switching. Some people really like switching puzzles, with multiple switchbacks and short tail tracks. You won’t see many of these in real life, because railroads don’t like complications unless there’s no other way to get a job done. In miniature, they can be fun. But not everyone likes switching puzzles, and sometimes even the greatest Timesaver fanatic gets tired of planning every move five steps in advance. When this happens, the switching puzzle becomes nothing but scenery — track that nobody uses because it’s such a pain in the neck. One such puzzle is probably enough for most layouts. For the rest of your yards and industries, keep it simple, like the prototype does.
  • Gratuitous reversing connections. If you look at older track plans, you’ll see many reverse loops and wye connections. The articles that describe them take it for granted that being able to turn a train around is a good and necessary thing. Why? Real railroads don’t turn trains around just so they can go back the way they came. If your staging scheme can use such a turnaround, or if you need a wye for turning engines and single-ended equipment, by all means use one. But wyes and reverse loops eat up a lot of real estate. Don’t clutter your layout with track that doesn’t serve a purpose, just because somebody else says you ought to have it.
  • Not enough for the trains to do. What do trains do? They pick up passengers and deliver them, they pick up many different types of freight and deliver it, they roll along the mainline, they meet and pass other trains on sidings, they interchange cars with other railroads, they get rearranged in yards, they get serviced on rip tracks while the engines are maintained in roundhouses and engine shops, they maintain the track with special MOW equipment… the list goes on. How many of these actions can your trains perform on your layout? If you’re content watching trains go around and around, it doesn’t matter. But if you want more out of this fascinating hobby of ours, then don’t limit your options. The more things your trains can do, the more enjoyment you and your friends can get out of the layout. Don’t try to pack everything in, of course, but any layout can perform at least two or three of the above without any compromise.
  • No place for traffic to come from or go to. If you’re modeling the ATSF, how did that Penn Central boxcar get onto your layout? Railroads derive much of their income from interchanging with other roads, and we can derive much action and realism the same way. An interchange can be as simple as a spur that leads off the edge of the layout to an imaginary Someplace Else, or as elaborate as dedicated staging tracks with trains from "the other railroad." Interchange is one of the keys to realistic operation, and it’s a very simple way to expand your railroading options.
  • Insufficient staging. For flexible operations, few things improve a layout like staging tracks — hidden sidings or spurs where trains can come from and go to. On a mundane level, they let you run a different train without resorting to the 0-5-0 switcher. On a deeper level, you can simulate the comings and goings of trains on a real railroad. The trouble with staging is that, once you start using it, you come up with more and more uses for it, and you run out of tracks. If you can find the room, plan on at least twice as many staging tracks as you think you need. It’s easier to install them at the start than try to fit them into a finished pike, and I’ve never heard anyone complain that he had too much staging.

As you browse this list, I’m sure you’ll think of other problems that might arise, or that have arisen in your own modeling past, which I neglected to mention. That’s great — it means this article has started you thinking about how to avoid trackplanning problems. An ounce of prevention goes a long way, even if the ounce is reduced to Z scale. And you’ll enjoy your layout a lot more if it’s free from basic problems at the outset. Keep 'em running!