In a recent blog I mentioned my yearly optometrist screening and how I was referred out for glaucoma testing.  When you peruse the internet you'll immediately find:

Glaucoma tests are a group of tests that help diagnose glaucoma, a disease of the eye that can cause vision loss and blindness. ... The extra fluid causes an increase in eye pressure. Increased eye pressure can damage the optic nerve. The optic nerve carries information from the eye to the brain.

But that wasn't the most important concern on my list while speaking to the specialist.  I was remembering a short jaunt ago's visit for pupil dilation.  It was not a great experience to say the least.  The most prominent memory being that my eyes were burning for sometime while drops were put in, during the testing, and for a time afterwards.  I placed emphasis on the fact that it is due to over active nerve pain by nature from the fibromyalgia.  It was not a pleasant experience to say the least.  So it was only natural that I would be a bit apprehensive pertaining to my upcoming screening that could include many various tests in one sitting that would need several dilation eye drops. 

​There are several types of glaucoma. The main types are:

• Open-angle glaucoma, also called primary open-angle glaucoma. This is the most common type of glaucoma. It happens when the fluid in the eye doesn't drain properly from the eye's drainage canals. The fluid gets backed up in the canals like a clogged sink drain that gets backed up with water. This causes an increase in eye pressure. Open-angle glaucoma develops slowly, over a period of months or years. Most people don't have any symptoms or vision changes at first. Open-angle glaucoma usually affects both eyes at the same time.
• Closed-angle glaucoma, also called angle-closure or narrow-angle glaucoma. This type of glaucoma isn't common in the United States. It usually affects one eye at a time. In this type of glaucoma, drainage canals in the eyes get covered up, as if a stopper was put over a drain. Closed-angle glaucoma can be either acute or chronic.
  • Acute closed-angle glaucoma causes a rapid increase in eye pressure. It is a medical emergency. People with acute closed-angle glaucoma can lose vision in a matter of hours if the condition is not treated promptly.
  • Chronic closed-angle glaucoma develops slowly. In many cases, there are no symptoms until damage is severe.

Why do I need glaucoma testing?If you have open-angle glaucoma, you may not have any symptoms until the disease becomes severe. So it's important to be tested if you have certain risk factors. You may be at higher risk for glaucoma if you have a family history of glaucoma or if you are:

• Aged 60 or older. Glaucoma is much more common in older people.
• Hispanic and aged 60 or older. Hispanics in this age group have a higher risk of glaucoma compared with older adults with European ancestry.
• African American. Glaucoma is the leading cause of blindness in African Americans.
• Asian. People of Asian descent are at higher risk for getting closed-angle glaucoma.

Closed-angle glaucoma can cause sudden and severe symptoms. If not treated promptly, it can cause blindness. Symptoms include:

• Sudden blurring of vision
• Severe eye pain
• Red eyes
• Colored halos around lights
• Nausea and vomiting

If you have any of these symptoms, seek medical help right away.
What happens during a glaucoma test?Glaucoma is usually diagnosed with a group of tests, commonly known as a comprehensive eye exam. These exams are most often done by an ophthalmologist. An ophthalmologist is a medical doctor who specializes in eye health and in treating and preventing eye disease.

A comprehensive eye exam includes:

• Tonometry. In a tonometry test, you will sit in an exam chair next to a special microscope called a slit lamp. Your ophthalmologist or other health care provider will put drops in your eyes to numb them. Then you'll rest your chin and forehead onto the slit lamp. While you are leaning into the slit lamp, your provider will use a device on your eye called a tonometer. The device measures eye pressure. You will feel a small puff of air, but it won't hurt.
• Pachymetry. As in a tonometry test, you'll first get drops to numb your eye. Your provider will then use a small device on your eye called a pachymeter. This device measures the thickness of your cornea. The cornea is the eye's outer layer that covers the iris (colored part of the eye) and the pupil. A thin cornea may put you at higher risk for getting glaucoma.
• Perimetry, also known as a visual field test, measures your peripheral (side) vision. During perimetry, you'll be asked to look straight ahead at a screen. A light or image will move in from one side of the screen. You'll let the provider know when you see this light or image while still looking straight ahead.
• Dilated eye test. In this test, your provider will put drops in your eyes that widen (dilate) your pupils. Your provider will use a device with a light and magnifying lens to look at your optic nerve and check for damage.
• Gonioscopy. In this test, your provider will put drops in your eyes to both numb and dilate them. Then your provider will put a special hand-held contact lens on the eye. The lens has a mirror on it to let the doctor view the inside of the eye from different directions. It can show if the angle between the iris and cornea is too wide (a possible sign of open-angle glaucoma) or too narrow (a possible sign of closed-angle glaucoma).

Will I need to do anything to prepare for a glaucoma test?While your eyes are dilated, your vision may be blurred and you'll be extra sensitive to light. These effects can last for several hours and vary in severity. To protect your eyes from bright light, you should bring sunglasses to wear after the appointment. You should also make arrangements for someone to drive you home, as your vision may be too impaired for safe driving.
What do the results mean?Your ophthalmologist will look at the results of all your glaucoma tests to figure out whether you have glaucoma. If the doctor determines you have glaucoma, he or she may recommend one or more of the following treatments:

• Medicine to lower eye pressure or cause the eye to make less fluid. Some medicines are taken as eye drops; others are in pill form.
• Surgery to create a new opening for fluid to leave the eye.
• Drainage tube implant, another type of surgery. In this procedure, a flexible plastic tube is placed in the eye to help drain excess fluid.
• Laser surgery to remove excess fluid from the eye. Laser surgery is usually done in an ophthalmologist's office or outpatient surgery center. You may need to continue taking glaucoma medicines after laser surgery.

If you've been diagnosed with glaucoma, your ophthalmologist will probably monitor your vision on a regular basis.

I was fortunate enough to get into an office that houses a good team.  They were very explanatory through all the testing.  Best of all, I was informed immediately that these tests would not hurt.  It was standard procedure to begin with "numbing drops" before any actual dilation drops were utilized.  What a relief that was!  Deep breathing was less accelerated after hearing this.  

Luckily there was no definitive diagnosis of glaucoma for me.  But, the optical nerve was enlarged and must be monitored yearly to ensure there is no degeneration of the nerve that will result in glaucoma. 

I encourage you to keep up with yearly eye screenings.  You never know what is going to pop up on these routine medical tests that can result in preventative maintenance.    

People often write me wondering what can they do for a sweet craving while Paleo dieting?  This one is top on my list.  It is sweet and contains the antimicrobial aspects that a coconut can harbor.

Give this one a try today, you won't be disappointed.  On a positive note, these can be whipped up in minutes!

6 apples
1 cup unsweetened coconut flakes
cinnamon to taste

Remove core to 1/2 inch of the bottom of the apples.

Place in Air Fryer basket.

Fill cores with coconut flakes and sprinkle with cinnamon.

​Bake at 360 degrees for 10-12 minutes.

For all those on the Paleo regime, I humbly submit this tantalizing recipe for your enjoyment.  Packed with pure protein, your body will be sure to absorb the proper nutrients to keep you going for hours.

16 chicken tenderloins

Dry Mix

1½ cup almond meal
2 teaspoons ground pepper
1 tablespoon Italian seasoning
1 cup unsweetened coconut flakes
1/2 cup flaxseed meal

Egg Wash:

2 large eggs

Directions

Preheat the air fryer to 400 degrees F (200 degrees C) for 5 minutes.

Meanwhile add almond meal to one bowl. Beat together eggs, ground pepper in a separate shallow bowl for the egg wash. Combine flaxseed and coconut flakes in a third shallow bowl for the crust.

Dip each chicken tender into the almond mix, shaking off excess spice. Dip into egg wash, draining excess, and dredge through the crust mixture. Repeat steps for each tender.

Place crusted chicken tenders into the air fryer basket and cook on high for 6 minutes. Turn tenders and cook for another 6 minutes until chicken is cooked through and coating is crisp.

​A cash-strapped puppeteer returns home for the holidays and gets caught up in a treasure hunt with her paintball-obsessed best friend, her tango-dancing grandmother, and a childhood sweetheart.

​This anthology series showcases the stories, memories, and inspirations behind the singer's most beloved songs.

​A medieval knight is transported to the present day, where he falls for a high school science teacher who's disillusioned by love.

​Teenagers Kara and Jessie strike up an unlikely friendship while sitting next to each other on a plane that's bound for the heartland. Forced to spend the holidays in the same small town with relatives that they've never met, the girls devise a plan to switch places for Christmas. Jessie soon finds herself living lavishly with Kara's wealthy grandparents, while Kara starts to bond with Jessie's fun, quirky grandmother and the most genuine, modest family that she's ever known.

​After her husband ends their marriage, Kate embarks on a solo second honeymoon in Africa. There, she and Derek, a pilot, rescue a baby elephant. While nursing the elephant back to health, Kate discovers how much she loves her new surroundings.

​Nothing says breakfast like pancakes.

Anyone who is required to eat a grain-free and/or dairy-free diet, can tell you it’s the breakfast item they miss most of all.

We did a whole foods cleanse in January, and it took all my willpower to stay away from some of my favorite breakfast dishes.

1 large ripe bananas
1 large egg
1 teaspoon of any nut butter
Coconut oil for frying

Preheat a non-stick skillet over medium heat. 

Place the bananas, eggs, nut butter, and 2 pinches of salt in the blender. Puree until smooth. The batter should be thick, but pourable. 

Brush the skillet lightly with coconut oil. Pour in a 3-inch circle of batter. Shake the skillet gently to spread the batter into a 4-inch circle. Cook for 2-4 minutes until the bottom of the pancake is golden-brown and the edges are firm. 

Flip gently with a flexible spatula, and continue cooking another 2-4 minutes.

These Grain-Free Chocolate Coconut Cookies are vegan, 1 bowl, 8 ingredients and everything you want in a cookie. Crispy edges, fudgy and chewy center and the very definition of decadence! Truly hard to believe they are grain-free, vegan, gluten-free, Paleo, and ready in 20 minutes!

7 pitted dates
3/4 cup almond flour
1/3 cup unsweetened shredded coconut
1/4 cup coconut flour
1/4 teaspoon salt
2 tab coconut milk
1 egg
1 cup cacao nibs


Preheat an oven to 350°F  and line 2 sheet pans with parchment paper.

Combine dates and coconut milk in food processor. Pulse until crumbs.

Pour in the oil, egg, and chocolate chunks. Stir well until a very thick, almost stiff batter forms. It will be very sticky. You probably don't want to taste the batter. No, you don't. It will be hard to stop eating it.

Use a cookie scoop or form round shapes with 2 tablespoons worth of dough. It will be a little sticky to roll into balls with your hands, but does OR just form the shapes on the pan pressing them down to 1/4 - 1/2 inch thick and smooth the edges into a round shape after dipping your fingertips in water. Place each cookie 2 inches apart. I did 6 at a time on the pan.

Bake for 10 minutes. They should have spread nicely and puffed up. I found 10 minutes to be perfect in my oven with crispy edges and a chewy moist center. Your oven may vary, but I would warn to not overbake them too long or it can dry out the centers. Cool on the pan for 10 minutes before moving to cooling rack. Makes 1 dozen. These will soften by the next day, but it's not like they will last that long anyways, who are we kidding.

I went for my annual eye exam recently to update my lens prescription.  I am so grateful that I've signed on to a simple vision plan to ensure my vision stays acute.  For the last several years, there has been always smooth sailing.  I go in.  And 10 minutes later I'm out with a new script.

This time was different.

It first began with a bit more length to my usual examination. As I was propped up on the phoropter, she had took a bit more time to ensure my prescription was accurate.  Then when she utilized the slip lamp, which allows a 3-D projection of the inside of my eye including the optical nerve, she waved it back and forth numerous times.  I took a deep breath.  What could it be now?

"I'm concerned that your optical nerve has changed.  I'd like you to get a more thorough study with an ophthalmologist just to make sure.  It may be nothing," she stated.  

"Nothing?!" I thought.  "It is always the beginning of something with fibromyalgia," I added.

I immediately went home and began searching correlations concerning fibromyalgia and optical nerve damage.  It may come as a surprise to you, but there is a connection here, too.  After all, we are dealing with sensitivities in the central nervous system.  

Research published in 2015 and 2016 suggests there may be connection with glaucoma and fibromyalgia.
.
Fibromyalgia is widely believed to be a condition of the central nervous system, which includes the brain and spinal column. It also includes the eyes and the structures that help our brains interpret what we see.
Chief among these structures is the optic nerve, which is similar to a cable made up of many smaller fibers. Among them is a layer of nerves called the retina nerve fiber layer (RNFL).

Those nerve fibers are of special interest to researchers because of other recent work that's uncovered dysfunction of the small nerve fibers. It suggests that, in people with fibromyalgia, small-fiber neuropathy (nerve damage) may be responsible for at least some of the pain.

In two studies, Spanish researchers have also discovered evidence of neuropathy in the small fibers of the eye.

Blood-Flow Problems

In the study published in 2015, researchers looked at blood flow to the optic nerve and the RNFL. Blood flow, also called perfusion, is hypothesized to be irregular in several regions of the brains of people with fibromyalgia.

Researchers examined and took photographs of the eyes of 118 people with this condition plus 76 healthy people in the control group.

The photos were then analyzed with special software. The researchers concluded that the fibromyalgia eyes did in fact show low perfusion rates in several sectors, but the only significant difference was in certain RNFL.

Optic Nerve Thinning

The study published in 2016 built on that research, involving many of the same researchers. This time, they included 116 people with fibromyalgia and 144 in the control group.
They found:

• A significant decrease in the RNFL in fibromyalgia compared to controls
• A thinning of multiple structures in the eye
• Greater optic nerve thinning in those with severe fibromyalgia than in those with a milder case
• Greater optic nerve thinning in subgroups without depression than in those with depression

Neurodegeneration

Before now, fibromyalgia has been considered non-neurodegenerative, meaning that no biological structures were being damaged or destroyed as they're known to be in other neurological diseases such as multiple sclerosis or Alzheimer's disease.

However, this research suggests that fibromyalgia may, in fact, involve some neurodegeneration in structures inside the central nervous system.

This, combined with earlier research on small nerve fiber damage in the skin, could mean that the degeneration is not confined to the central nervous system but may extend to the peripheral nervous system, which includes the nerves in the limbs, hands, and feet.

The Relationship Between Fibromyalgia, the Optic Nerve, and Neurodegeneration

Fibromyalgia has always posed problems for doctors. We have pain, but no obvious cause. If this research is accurate, which we won't know until it's been replicated, it could mean that our pain comes from a very understandable source. After all, neuropathic pain has been recognized for a long time. Suddenly, it makes our "mysterious" pain not mysterious at all.

On the other hand, it opens new doors for questioning. If we have damaged nerves, then why? What is causing the damage?

Possible candidates could include autoimmunity, which would involve the immune system going haywire and attacking the nerves as if they were bacteria or viruses, and problems with how the body uses substances that grow or maintain nerves.

Researchers have long speculated about possible autoimmunity in fibromyalgia, but so far we don't have solid evidence pointing toward it. Now that researchers have discovered actual damage, they may gain better insight into where to look for autoimmune activity. They may also be able to pinpoint shortages or inefficiencies in how nerves are maintained.

When it comes to diagnostic tests, it's too early to say whether abnormalities in the eye could lead to a more objective test than we currently have. If so, it would be a major advancement in how fibromyalgia is detected.
Because the thinning was worse in more severe cases, it could provide a marker for doctors to monitor treatments as well as progression.

It's also possible that these discoveries could lead to targeted treatments.
​
We won't know the full impact of this research for some time, as any advancement in diagnostics and treatments would have to come after further research either confirms or contradicts these findings.

Next article will detail more information on the the specifics of glaucoma.  In the meantime, get an eye exam. As the years pass, more is known about the correlation fibromyalgia plays in the CNS.

A sweet treat here and there is nice.  Our little ones deserve it too!! This is an almost allergy free recipe (no eggs, no gluten, no dairy, no nuts) that you can safely offer to your little ones satisfying their sweet palate without the side effects of refined sugars. 

I usually use chickpea flour for flat breads or crackers, but it’s great for baking too! As it doesn’t contain gluten, don’t expect the muffins to raise too tall, they will create a nice hill, not a mountain ?
From a nutritional point of view chickpeas (and so chickpeas flour) are a great source of folate, iron, protein, zinc, manganese and calcium, all elements that help your baby’s body development and straighten his/her immune system.

2 1/4 cups chickpea flour
2/3 cup natural sugar
2 eggs
7 Tbsp butter
1 cup milk
4 tsp baking powder
1/2 tsp salt
2 tsp vanilla extract
1 1/2 cups frozen blueberries

In a bowl add all the wet ingredients.  Mix well. Set apart.

In a separate bowl add the chickpea flour, sugar, and baking powder. Mix.

Gently combine the dry ingredients into the wet ones.

Add the frozen blueberries at the end. Mix.

Fill a cupcake tin with the mix.

Bake to 400F/180C for 20/25 min.
​
As there is no gluten involved, don't expect the muffins to rise like a mountain, they will look more like a plateau.

There's new research that the fascia, connective tissue which binds the muscles, causes the muscle pain in fibromyalgia.  This is not a new idea.  In fact, 1904 a physician proposed that inflammation of "white fibrous tissue" that surrounds the muscles was the source of fibromyalgia pain then called fibrosis or chronic rheumatism.  Many fibromyalgia sufferers further these studies by stating, "It hurts on the outside of my muscles not the inside." 

Fascia is connective tissue fibers, primarily collagen, that form sheets or bands beneath the skin to attach and separate muscles and other internal organs. Fascia are classified according to their distinct layers, their functions and their anatomical location: superficial fascia, deep (or muscle) fascia, and visceral (or parietal) fascia. Like ligaments and tendons, fascia are connective tissues, containing closely packed bundles of collagen fibers. Fascia are consequently flexible structures able to resist great tension forces until the wavy pattern of fibers has been straightened out by the pulling force. These collagen fibers are produced by the fibroblasts located within the fascia.

Fascia are similar to ligaments and tendons as they have collagen as their major component. They differ in their location and function: ligaments join one bone to another bone, tendons join muscle to bone, and fascia surround muscles or other structures. This connective tissue around muscle is highly sensitive to pain. In fact, the fascia is about as sensitive to pain as our skin. Needles inserted into the thick outer layer of fascia surrounding the muscle hurt more than needles poked into muscle tissue itself.

The cells of fascia direct the repair process of muscle by secreting more collagen, or "goo" that attracts immune cells to the area of damage.  The muscle tissue and especially the surrounding fascia is continually engaged in a process of damage and repair.  Fibroblasts are continually repairing the collagen network in which they live, just like a spider repairs its web.  Excess collagen and scar tissue can result.  This is why some massage therapists will say to their patients, "You're fascia feels tight and thick."

People with fibromyalgia often say their muscles feel "bruised" similar to muscle soreness.  One study found that an increase in collagen to the fascia may be the culprit.  Comparing specially stained muscle biopsies, researches described a "slight, but significant, increase in collagen surrounding the muscle cells of the fibromyalgia patients."

Chronic activation of the flight-or-flight response may be promoting tension in the fascia of the muscles and lead to tissue damage.  Studies show elevated pressures inside the muscles of fibromyalgia may reflect a flight-or-flight nervous system.  Muscles and fascia may be constantly tensed in fight-or-flight mode and more prone to injury and damage than just from our usual daily activities.  

Fascial dysfunction and inflammation may be the cause of wide-spread muscle pain in fibromyalgia.  Excess tension in the fascia due to activation of the fight-or-flight system may lead to excessive tissue damage, similar to over-exercised muscles.  Too boot, lack of sleep, a critical time for body tissue repair and remolding, does not provide adequate repair time for strained and damaged fascia.