HOW TO TALK TO YOUR DOCTOR ABOUT THIS AND A QUESTIONNAIRE
 
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Again, let me say that I am not a doctor and I can neither diagnose nor prescribe. I am a genealogist with a scientific bent and a patient ADVOCATE. I can tell you about my illness and the way that I dealt with it. It is up to you to decide for yourself your course. I encourage you to read and complete the following questionnaire, but first a word on HOW to present this to your own doctor.
 
In order for your doctor to listen to you, you must talk to him about yourself and your problems and he must listen to you. I have been told that doctors listen to the first 23 seconds of what patients say. So you must be quick and you must make a strong statement. Here is one that you can practice before a mirror or a family member that may be of some help.
 
Dr.______ I am a genealogist and I have been researching my family tree. I have found that I have ancestry from a fascinating group of people called Melungeons in one (or more) of my family lines.  The Melungeons have a Mediterranean ancestry.  Many Melungeon descendants are finding that they have one or more inherited Mediterranean illnesses. I have found what is thought to be a rare disease in America that fits many of my symptoms through this research.  ONE of the symptoms of this disease is 'fibromyalgia.' I want you to consider giving me a trial course of the medicine for this illness. I have been told that the med is not harmful taken for 30 days even if I do not have the inherited illness, and I will know within that time period whether or not it will help me. I know of about TWO HUNDRED (200) people with this ancestry who have tried the meds in the last two years and who are receiving help and feeling better. I also want to feel better and I know that you want me to feel better too! The medicine I want to try is called colchicine and the inherited illness is called Familial Mediterranean Fever. I need a prescription for 0.6mgs of colchicine to be taken twice a day for 30 days. If this does not help me, I will tell you and stop taking the medicine. I think it will help and I want to try it.
 
If your doctor laughs at you, hold up your hand in the stop position and say  ‘Stop laughing. Do not laugh at me!’ I am serious about this and I want to try the medication.  Hand him the document you have copied from Medscape, entitled Fibromyalgia in familial Mediterranean fever. Each time your doctor says something there after, say “I am serious about this and I want to try colchicine.” You may also say, “I have tried every other medicine you have given me without any improvement. I want to try colchicine.” You may also then show him the questionnaire and ask if he would like to go over it with you. (Colchicine is pronounced Coal-chuh-seen.)
 
If he does not listen, you might want to consider going to another doctor. I went to three others before I found one who understood that I take the lead in my own health care; that I listen to the doctor and ask questions and then make up my own mind about what is happening to me. Although my doctor told me that he didn’t think I had this illness, he agreed to give me a trial of the med. It is working. I have not had to take an anti-inflammatory for about a year now, except for an occasional headache. My doctor and I are both pleased.
 
Some folks are reporting that it is easier to tell the doctor that a sibling or parent has just been diagnosed with this illness and since they had similar symptoms, they want a trial of the med too. It seems to be working since all have taken colchicine and are improving. I am not advocating this, just telling you what has been used.
 
I also suggest that you take someone with you, preferably a male if he will go. Doctors listen to men better than they do women and because you may be nervous, having a hubby or friend with you will help you to be more calm and collected and able to remember all the things that you wanted to talk with your doctor about.  And if he has lived with you and seen your pain, he will be able to verify for the doctor that these symptoms are accurate. While I would prefer this not to be necessary, it does work for some doctors.
 
Note that the MAIN SYMPTOMS OF Familial Mediterranean Fever of the kinds
that they have discovered are:
 
1. FMF is periodic/recurrent
 
2. Periodic fevers of 101-103, with chills and possibly night sweats. (THIS IS IMPORTANT!!! You might want to take your temperature at the same time each day for a month to get your normal temp. Mine is about 95.6 to 97.5, so if I have a 98.6 temp I have a fever. Record the temperature to take with you to your doctor. If on any day that you are taking your temperature, you feel at a different time that you might have a fever, take your temperature then as well and note any difference. )
 
3. Depression
 
4. Skin rash - prickly heat type rash anywhere on body, but also another kind on legs and one of the ankles. See: http://images.google.com/images?q=erysipelas&ie=ISO-8859-1&hl=en&btnG=Google+Search
SCROLL down to the picture of a foot ankle w/ this written under it:
padeh.net/Erysipelas.JPG Take a look at the next picture beside it as well, clicking on the pictures to enlarge them.
 
5 hereditary
 
6. Acute short-lived painful bouts of stomach pain (may be followed by
Diarrhea) and frequently misdiagnosed as appendicitis, kidney, gallbladder
problems.)
 
7. Pleuritis, inflammation of the lining of the body cavities, which in the
acute stage may produce stabbing pain in the right side or of the chest
(mine started there and spread throughout my stomach or I had problems with
chest pain, breast bone pain.)
 
8. A short dry cough
 
9. Muscle and joint pain frequently diagnosed as fibromyalgia and either osteo OR rheumatoid arthritis
During a crisis of FMF, the RA Factor rises just as it does with Rheumatoid Arthritis.
 
10.  Nephropathic amyloidosis (can lead to kidney failure)
 
11. Infertility and pregnancy loss more common.
 
These are the most important symptoms that you must stress to your doctor if you
are to get this diagnosis and IF you have any or all of them. The other
symptoms that are in this chart are the secondary symptoms that I suffered
with this illness. Print out the following questionnaire and answer it.
 
    The following is a list of symptoms associated with Familial
Mediterranean Fever. Please take a few minutes to read through the list and
then go back and place a check mark in the yes or no columns for each
symptom you feel that you have either NOW or had in the PAST.  Write a brief
description below each symptom you have marked, including WHEN you
experienced the particular symptom and its DURATION.  Please take this list
with you when you see your physician to ensure that you don't forget to
mention any of the symptoms you have been experiencing. Make two copies of
this so that you can give one to your doctor after you have talked to him
about these things, and still have a copy for yourself.  Start copying the
questionnaire from this point.
 
GENERAL QUESTIONS ABOUT YOUR HEALTH:
Your doctor needs to know this information about you.
A. Are you working? 
1. Are you now working? YES ___ NO ___
2. If not, could you work all day, five days a week, year round?  YES ___ NO___
3. Did problems with your health stop you from working? YES ___ NO ___
4. When did you stop working if so?   month, ____day, ____ year___
B. Activities of Daily Living: Consider a month to be 30 days.
1. How many good days a month do you have when you feel well and complete all living and home care activities? Number of days ____
2. How many fair days do you have a month where you can function, but have serious difficulty doing so, and fail to complete some living and home care activities? Number of days_____
3. How many bad days do you have where you function poorly or not at all and fail to complete most living and home care activities. Number of days ____
 
FAMILIAL MEDITERRANEAN FEVER SYMPTOMS QUESTIONNAIRE
(FMF)
 
SYMPTOMS:
1. My symptoms have been recurring periodically for many years.
___yes ___no
    These symptoms are growing worse and I have been given MANY different
diagnoses.
___yes ___no
 

2. I have had periodic, recurrent fevers of 101-103 degrees. ___yes ___no
    (Think about the flu and cold symptoms you may have suffered. Could it
have been something else?)
 

3. I have had chills and/or night sweats. ___yes ___no
 

4. I have had acute, short painful bouts of stomach pain over the years
going
as far back as childhood..
    ___yes ___no   (See # 5)
 
 
 
5. I have been diagnosed with:  Appendicitis        ___yes ___no
                    Kidney stones       ___yes ___no
                    Gall stones         ___yes ___no
(2)     Ulcers          ___yes ___no
        Other, describe ___yes ___no
    Were any of the above diagnoses proven true?        ___yes ___no
(Please list which ones, noting any surgeries you have had for these
problems.)
 
 
 
 
 
6. I have been treated for kidney problems (inflammation, infections,
stones,
etc.) ____yes ___no
      I have been diagnosed with Nephropathic amyloidosis (can lead to
kidney failure)       ___yes ___no ___ don't know
 

7. I have had stabbing pains in my chest cavity or breast bone area which
were NOT connected to heart problems. ___yes ___no    (See number 8)
 
8.I have been diagnosed with:   Bronchitis      ___yes ___no
                Asthma      ___yes ___no
                Pneumonia       ___yes ___no
                Pleurisy        ___yes ___no
                Collapsed lung      ___yes ___no
     Costochronditis   _____ yes  ____no 
Relapsing Polychondritis  ______yes ________no
 
  Where any of these found to be actual problems?   ___yes ___no  (Please
list which ones.)
 

9. I frequently/periodically have unexplained swollen lymph nodes? ___yes
___no
 

10. I have or have had a short dry cough.  ___yes ___no       Duration:
_________
 

11. I have or have had skin rashes periodically. ___yes ___no    Number of
years:  _______
      Do you or any members of your family suffer with VITILIGO or loss of
pigmentation (skin coloring?)___yes __no
 

12. I have suffered with depression ___yes ___no     Age at onset of
symptoms: ______
Number of years duration: _________
      If you have taken antidepressants, please list which ones.
 
 
 
(3)
13. I have had problems with infertility and/or pregnancy loss. ___yes ___no
 
 
 
14. I have had severe muscle and joint pain for many years. ____yes ___no
      How many years? ____  My pain seems to move from joint to joint.
____yes ___no
      (See number 15.)
 
 
 
15. I have been diagnosed with:     Osteoarthritis          ___yes ___no
                    Rheumatoid arthritis        ___yes ___no
                    Fibromyalgia            ___yes ___no
                    Chronic fatigue syndrome    ___yes ___no
                    Costochronditis        _____yes _____no
                    Lupus                            ____yes ______no
                    MS                                ____yes _____no
                    MD                      _____yes ____no
      Relapsing Polychondritis ____yes ____ no
 
                              Any other fairly rare disease _____yes _____no
                              Name the illness ___________________________
    Normal pain medicines (aspirin, ibuprofen) and other anti-inflammatories
do NOT help my pain or just slightly dull it. ____yes  _____no
 

16. I have morning stiffness. ___yes ___no
 
17. I have muscle weakness, for example getting up out of a chair or bed.
__yes ___no
 

18. I have suffered from anxiety. ___yes ___no    Number of years:  ________
      Please list any medications that you have taken for this.
 

19. I have suffered with confusion or disorientation. ___yes ___no
 

20. At times I have difficulty concentrating. ___yes ___no
 

21. At times I have experienced dizziness/light headedness. ___yes ___no
 

22. At times I suffer from memory loss, such as not remembering a word you
are sure you know, or forgetting the name of a relative or close friend.
___yes ___no
 

(4)
23. I have SEVERE fatigue. ___yes ___no
      Give several examples of when, where and how you have fatigue. (Do you
need assistance with household chores? What kind and how often? What happens
when you try to do things you used to do?)
 
 
 

24. I have headaches. ___yes ___no  Frequency: _____________ (Please list
whether these are tension headaches, sinus, migraine or cluster in your
description.)
 

25. I have mood swings and/or am irritable. ___yes __no
 

26. I do not sleep well nor do I feel refreshed upon arising. ___yes ___no
      Have you been to a sleep clinic?  ___yes ___no  When?___________
      What was the diagnosis?
 

27.  I am absolutely unable to exercise. ___yes ___no (This means you are
NOT ABLE to exercise, not that you just don't like to or can't find the time
to exercise.) What happens to you if you try to exercise? Can you clean your
house regularly or do you require assistance?
 
 
 
 
 
28. I have a reduced sex drive. ___yes ___no
 

29. I know that I have ancestry from the Mediterranean areas such as Spain,
Portugal, Italy, Greece, Turkey, or Jewish or Arab ancestry, or Moorish
ancestry. Or any other ancestry from around the Mediterranean. ____yes ___no
 
30. I know that I have Melungeon ancestry from the areas around
NC/VA/KY/TN/WV.
      ___yes ___no
      List common surnames that you believe have a Melungeon ancestry if is known. 
See:  http://mywebpages.comcast.net/sparkys9/melungeons.html
 

31. I have the following physical characteristics which are known to be
connected to Melungeon ancestry:
    A.      Back of Head                             Ridge: ___yes
Bump: ___yes
            \lllllllllllllllllllllllll/
 
     ears ( ___x___ ) ears      x marks the bump's location
               \valley /                the ridge is the line __ shown
                 \      /  neck
                 /      \__shoulders
 
The `bump' is called an Anatolian bump and originates in the Anatolian
region of Turkey ONLY.
The ridge, which is an enlargement of the base of the skull, is called a
Central Asian Cranial Ridge and is found in the areas of Central Asia ONLY.
These traits are found in the descendants of those who lived there.
Melungeon descendants have these characteristics in at least 75% of the
time.
 
B. Asian Shovel Teeth:
    The backs of the first four upper and lower teeth are differentiated in
descendants of Northern European descendents and those of the Mediterranean,
Native American and Melungeon descendants.
Side view of teeth:
 
Northern European teeth                               Asian Shovel Teeth
     \l                                                               )/
 
Asian Shovel Teeth also have a ridge at the gumline. Think of adding an L to
the top of the ) so that the end of the bottom part of the L touches the top
of the ).___yes ___no
 
C. Asian eyefolds.
     Native Americans, Asians and Melungeon descendants may have an
eyefold.This is rather difficult to describe.  At the inner corner of the
eye, the upper lid attaches slightly lower than the lower lid. That is to
say that, it overlaps the bottom lid.  If you place your finger just under
the inner corner of the eye and gently pull down, a wrinkle will form which
makes the fold more visible.  Some people call these eyes, "sleepy eyes,
dreamy eyes,
bedroom eyes." Many Indian descendants also have these kinds of eyes.
 
   Asian Eyefold:  nose /-    0    >  Northern European eye <    0    >
                                ^ place your finger here.            Asian eyefold? ___yes ___no
 
D. Skin Coloring:
     Some Melungeon descendants may have very dark skin tones or have a
reddish, coppery cast to their skins.Vitiligo or loss of pigmentation of the
skin may run in these families. Is your skin coloring darker than what is
considered the 'norm' for European skin tones?   ___yes ___no
                           Vitilgo? Yourself? ___yes ___no   Family ___yes
___no
 
E. Some Melungeon families are known to have 6 fingers or toes. Do you or
anyone of your family have this physical characterisic?
               Yourself? ___yes ___no    Family? ___yes ___no
 
 
 

 
 
The MELUNGEON HEALTH EDUCATION AND SUPPORT NETWORK:
http://www.melungeonhealth.org

Melungeon Printed Resources:
http://melungeonhealth.org/resources.html

ONE HUNDRED and SIXTY-NINE Melungeon and associated websites:
http://melungeonhealth.org/websites.html

A Melungeon mailing list that is family friendly - send an e-mail to:
Melungeons-subscribe@topica.com

Melungeon Definition:
http://www.geocities.com/mikenassau/definition.htm
Also includes several urls.

Melungeon Information and Common Surname List:
http://sparksgenealogy.com/melungeons.html

Diagrams of physical characteristics
http://melungeonhealth.org/info.html

Fibromyalgia in YOUR family? Inherited? Maybe!!
http://www.holisticonline.com/Remedies/CFS/fib_causes_nancy.htm
http://www.geocities.com/bourbonstreet/inn/1024/DNAannouce.html

Sparks Genealogy: http://SparksGenealogy.net
(Select: Index/Nancy's Corner/The Melungeon Connection)
(Select: Index/The Melungeon Media Release)

Searching SPARKS, HAGER, JAYNE, RAMEY/REMY, COLLINS, MUSICK, WALKER, PORTER
                MAYO, CAREY/CARY NAPIER,QUEEN, PERDUE, KELLEY, LETT,


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