Fibromyalgia Case Studies: September - November, 2005

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Sent to us on 9/28/05
1. Age of onset of symptoms:
Diagnosed at 43 (probably had symptoms for 4-5 years before that).

2. How long have you had fibromyalgia?
A little less than 2 years.

3. Where did you grow up?
Born in Mumbai, India. Grew up in Union, NJ since age 9

4. Where do you live now? Live in South Brunswick Township, NJ since age 27.

5. Were you exposed to pesticides?
Probably...in the yard. Have always suffered from allergies (to dust and chemical sensitivity)

6. Do you have any personal theories about what brought this on?
Prolonged periods of stress (with no down time from the stress). Did the work of four people in the telecom industry for about 3-4 years as they continued to do more with less people. As they downsized, I was consistently being "put down" and "accused" of not doing my job properly (only in one particular job). Was force adjusted and on the last day rehired by another group because of my track record and placed in another "high stress" job - all of this combined triggered the fibromyalgia where my muscles "locked up."

7. What were your symptoms?
I completely locked up (my muscles and a lot of pain all over my body...I could not move or get out of bed). I have had pain all over my body (muscular, joints, back, neck, shoulders, hands calves, upper arms, neck, sciatica). No numbness, occasional tingling which goes away.

8. Were you diagnosed with something else before fibromyalgia?
No, I was not diagnosed with anything else (other than ulcerative colitis, when I was 26 years old (before marriage) - which I reversed/eliminated with homeopathic treatment after my second son was born- and am on no meds for that either anymore.) I had been complaining of fatigue for several years (after the birth of my second son), since 1992. I was in physical therapy for "muscle spasms" almost 5-6 times for almost 2-4 months at a time. Each year, the pain was in a different area of the body (neck, lower back, shoulders, etc.). This went on for about 6 years... until I completely locked up a couple of years ago (and then it was diagnosed - I asked to go to a rheumatologist for a second opinion and she too ran some tests that eliminated other things and confirmed the diagnosis). She prescribed muscle relaxants and pain killers (and they helped while I was in the "crisis" mode of being locked up - - but I came off the meds within two months.

9 . What supplements, medications or alternative practices have helped?
* Meds: do not help (create more side effects)
* Alternative practices that help: Yoga, accupuncture, physical therapy and exercise
* Supplements: Kirkland brand High Energy Vitamins, Magnesium
* Herbal Detoxification: Garden of Life Fungal Defense, Herbal Detox teas made with Black Walnut Hull & Wormwood (use with caution and not for more than 5 days - eliminated joint pains)

Additional Comments: Tests for candida and other bacteria that are not normally tested for by allopathic doctors are important to get done (the AIMS Clinic in East Brunswick, NJ conducts such tests). Of course, these are not usually covered by insurance (depends on the plan).

Fibromyalgia seems to have a better response when alternative (more holistic) therapies are used and it takes time to "undo" the damage that has accumulated. My experience shows that by avoiding drugs, you can recover faster (and reverse fibromyalgia. Here's what I did:

I turned to yoga (very low impact, what seniors and bedridden people might do). With that circulation in the muscles improves and toxicity is also expelled. I started doing yoga everyday and my mom's friends started giving me massage every few days to reduce the tightness all over my body...both combined helped me to come off the medication. Yoga reduced the pain for about 8-10 hours!. After 1 - 1 1/2 years of exercise, I started looking at diet/nutrition/detoxification. The pain never completely went away until I started acupuncture treatments. I am still fighting the fatigue - but now feel confident that I will be able to find some herbal alternatives to help that as well.

With pain often depression accompanies it, and it is imperative to keep reading positive things and to recognize that adding B vitamins can ease the depression also instead of medication (taking an increased amount for some period of time to ease the depression will not hurt anyone.). Understanding that all this is the body's response to stress and being "objective" so that you can get the strength to recover is important. If it took us so long for these things to manifest in the body, why do we shortchange the "healing power that rest" provides to the body to allow it to recover again (of course, we need to give the body the beneficial things it needs to recover - proper diet, yoga/exercise, rest, vitamins/herbs that will help, etc.). These are all "common sense" things that we have devalued. It is my belief that a "quick fix" (drugs) are not the answer. In our fast-paced society, we have forgotten the basics that is the knowledge of the past (and we need to rediscover all that again)!

Diet is very important (avoid milk, sugars and refined products). I believe the candida diet helps to give your whole immune system a break so that it can heal natrually. Detoxification with herbs is also important to get rid of the toxins that have accumulated in the body (no side effects with these). If there is depression, add B vitamins to combat it and also read positive materials and keep in the company of positive and supportive people. Remember that thoughts are temporary and can change (do not give them importance as they will change eventually!) Be strong internally....you can reverse this condition. Do not underestimate the healing power of REST. The body lets you know when you need it (just listen!) High energy vitamins and supplementation of magnesium helped me as well. Accupuncture helps to get rid of pain and restore energy flow to help it get balanced (pick someone good!) Deal with your emotions and let go of whatever you are holding on to. Be good to yourself. Forgive yourself and others around you and see the power of healing (be receptive) change your condition. I was diagnosed almost two years ago, came off all medication within two months after beginning yoga. Turning to natural alternatives has improved / practically reversed this condition. I can now think about going back to work. Find a good naturopathic doctor who has worked with fibromyalgia."

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Sent to us on 10/5/05
Name: Carol
Sex: Female
Age at Onset: aprox. 37 years old
Born: Detroit, Michigan, United States
Live now: Wahiawa, Hawaii, United States
How long since diagnosis? 3 years
Pesticide Exposure: limited / weed killers, grass fertilizer, bug sprays
Prior Medical History: Graves' disease (hyper-thyroidism) treated with radiation, ablation therapy
Theories about how the disease came about: Very stressful lst marriage which resulted in divorce. Graves' disease. Very physical job as a sales merchadiser for 6 months-about 1 month into the job the headaches & muscle spasms started & haven't stopped yet and that was 7 years ago.
What has helped? Malic acid/magnesium (too soon to be sure yet), massage therapy, yoga
What makes the condition worse? stress & physical exertion
What is your line of work? Was a sales merchandiser/ can't work now

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Sent to us on 10/12/05
Name: ARLENE
Sex: FEMALE
Age at Onset: 59
Born: CHICAGO, IL
Live now: CREST HILL, IL
How long since diagnosis? 6 WEEKS
Pesticide exposure: NOT THAT I KNOW OF....
Prior Medical History: HIGH BLOOD PRESSURE, THYROID, EDEMA, HIGH CHOLESTEROL
Theories about how the disease came about: SEVERE STRESS AND DEPRESSION SEEMED TO HAVE BROUGHT THIS TO A HEAD. I
HAVE BEEN SUFFERING FOR OVER TWO YEARS PUT DID NOT KNOW WHAT WAS CAUSING MY SYMPTOMS. WHEN THE SEDIMENTATION RATE IN MY BLOOD COUNT REMAINED VERY HIGH MY DOCTOR SENT ME TO A RHEMATOLOGIST, I AM ON A LOW DOSE OF PREDNISONE BUT DO NOT
SEEM TO HAVE MUCH RELIEF. THE ONLY THING THAT HAS HELPED SO FAR HAVE BEEN WEEKLY ACCUPUNCTURE.
What has helped? ACCUPUNTURE
What makes the condition worse?: STRESS
What is your line of work? INSURANCE

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Sent to us on 10/12/05
name: Kathy
sex: Female
age at onset: 34
born: Rochester, New York USA
current city: Spokane, WA USA
how long since diagnosis: one month
pesticide exposure: N/A
prior medical history: I have PCOS, arthritis in my lower back
theories: I was struck by lightning when I was 20 and it caused some nerve
damage, but over the years I regained my feeling. Other than that, I do not know what has caused my condition.
what has helped: At this time, I'm just trying Hydr. Perox and Apple Cider. I'm also going to be starting Aquatic Therapy.
what makes condition worse: Just waking up, sitting for long time, extended activity/walking, sitting too long
work: Executive Assistant/HR Analyst

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Sent to us on 10/19/05
name: Tania
Sex: Female
born: Australia
Age at Onset: 29 years
How long since diagnosis: 8 Years
Current City: adelaide 38 years
Have you always exercised? Yes very much so. Used to play state netball, tabletennis, basketball and gymnastics. Now only walking and swimming. Yes, competitive exercise or harsh exercise exacerbates symptoms rapidly.
Pesticide Exposure: no
Prior Medical History: Diagnosed with Hashimoto's thyroidism (underactive) six months after the birth of my son. (January 97). Shortly thereafter, diagnosed with fibro.
Theories: Possibly from the birth of my son and supposedly having a low thyroid during the course of my pregnancy; or, they say, from a broken nose in 1983; or, possibly hereditary (mum has slight symptoms). They think moreso from the birth of my son and having a low thyroid and not depicting the low thyroid for six months after having him.
What has helped: Thyroxine Sodium 250 mcgms.daily; 1/2 Cipramil daily; 1/2 Naprosyn 750SR daily; Sandomigran 1 nightly; Capadex occasionally; Crampeze for muscle cramps during the night.
What Makes Condition Worse: Stress, excessive exercise, most types of weather and doing too much during the day.
Work: office work

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Sent to us on 10/27/05
Name: Cassandra
Sex: Female
Age at onset: 33
Born: Sun Valley, California
Current city: Simi Valley, California 11 years
Exercise History: Very active, walking, hiking, water sports, other sports. I am unable to exercise now except for walking. Exercise exacerbates the pain.
How long since diagnosis: 2 years
Pesticide exposure: Raid, flea sprays etc.. Household stuff
Prior medical history: Two herniated discs, T-7 & L-5. One ruptured disc L-4. Syringomyellia.
Theories: No clue, my doctors say it was the back injury but there is no substantial proof that the two are related. Could have been high stress for a long period of time, approx. the last 5 years. Do people have long or short bouts with this?Sometimes I can go for 4 months and only suffer from pain in my legs and back, then I wake up and feel like a house is parked on my body. I hurt everywhere, constantly, I'm totally
exhausted,numbness in arms and hands, I can't sleep etc..., it can last for a month or so or can go on for 3-5 months.
What has helped: Nothing yet. Tried accupuncture, physical therapies (i.e. pool etc..), massage therapy, full body adjustments from Chiropractor, herbal supplements, pain medication etc...
What makes condition worse: Stress, exercise.
Work: Managerial (high stress, high activity and very long hours)

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Sent to us on 10/27/05
name: Bobbie
sex: female
age at onset: In my 40's
born: Arkansas, USA
current city: Arkansas, USA 10 years- before that 16 1/2 years at previous residence
exercise+history: Haven't really been physically active..have walked some for my health..but exercise seems to make the muscles hurt more..sometimes I feel better, but that is rare
how long since diagnosis: almost 6 years
pesticide exposure: Not known...drank some kerosene when I was a baby 18 months old, but could have been exposed to weed killers, insect killers...
Prior medical history: Yes, hypertension, IBS, GERD, heart murmer, arthritis in neck and shoulders, also, in knees, depression, menopause,
Theories: I believe that my having pneumonia in March 2000 aggravated some symptoms I had already had in years past. I was also under a lot of stress during this time...so I feel that the illness combined with stress is what really hit me with symptoms..before that, the symptoms had been few and far between, but I can remember having some of the isolated symptoms over a period of 10 or 15 years...my sister was diagnosed about 30 or 35 years, with her symptoms stemming from childhood...
What has helped: I take a lot of supplements, but am not sure it has helped a lot..I take Tylenol PM at night to help pain and help sleep; Calcium with Magnesium, Omega 3 Fish Oil, Green Tea Caps, tried osteopathy, also have tried Juice Plus, physical therapy.
What makes condition worse: stress, definitely, and rain and humidity, cold temps
Work: Office work...in a hospital

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Sent to us on 10/27/05
name: Jean
sex: female
age at onset: 27
born: Idaho Falls, Idaho USA
current city: Marysville WA USA 16 years
exercise+history: Very weight conscience--running, biking, hiking, walking, workout machines, gym membership, etc., etc. Now have to be very careful not to overdo it--can walk 2.5 miles but not everyday
how long since diagnosis: 8 months--been sick for 22 years
pesticide exposure: nothing out of the ordinary--normal suburban life with yard and gard
prior medical history: Bipolar II
theories: I believe Fibro is a type of massive system failure of the endocrine system beginning in the hypothylamus and affecting the thyroid, pituitary and adrenals. That in turn causes other systems to malfunction. Also seems to be a serious problem with nutrients not being absorbed at the cellular level in spite of normal blood tests. Currently researching how to remove lactic acid from my system hoping it will decrease flare-ups.

Vital question missing (in the questionaire) is 'how long have you had Fibro, and when were you diagnosed? I've had it since I was 27--22 long years--emerged slowly at first but has accelerated in past 10 years--took 6 years to get diagnosed and even then, I asked the Rheumotologist to evaluate me for it after putting the pieces together myself. He sent me for a sleep study resulting in a CPAP machine--that's the only thing the medical profession has helped me with other than allowing me to purchase my other meds!!! Time to figure out what I can do to help myself.
what has helped: MSM, malic acid, CoQ10, increased salt intake--drink salt water, CPAP machine for sleep apnea, Klonopin and Benedryl promote stage 4 sleep, working on uping intake of magnesium, B12 among other vitamins/minerals/amino acids, etc. Also on thyroid hormone--blood tests normal but have subclinical hypothyroidism; Capzasin HP rub for pain along with trigger point massage done with large handheld massager sold at large departments stores--made a huge difference in pain--seldom have to take pain meds
what makes condition worse: stress, mentstration, change in weather, lack of sleep, overdoing it
work: accountant

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Sent to us on 10/29/05
Name: Josie
Sex: female
Age at onset: 50
Born: Ohio
Current city: NC
How long since diagnosis: 4 years
Pesticide exposure: unknown pesticide exposure
prior medicalhistory: osteoarthritis, lumbar scoliosis, carpal tunnel syndrome.
Theories: My symptoms and diagnosis occured after a whiplash injury.
I believe an acute, stressful injury sets off the immune system causing an "overkill" when reacting to the release of histamines, and platelets at the injury site. This in turn, creates havoc in the total body system. I feel the immune system has gone awry. Instead of repairing the tissue/injury, the immune system has attacked it, as well as other areas of the body erroneously recognizing these areas as foreign substances. Sort of like a short circuit in our system. I feel a vital question would be "Did you have any injury or trauma prior to your diagnosis of fibromyalgia?"
what has helped: Ultram, yoga, heat therapy, relaxation therapy.
what makes condition worse: cold weather, humidity, lack of sleep, lying in bed too long, stress.
work: RN

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Sent to us on 11/5/05
Name: Lisa
Sex: Female
age at onset: 50
born: Evanston,IL USA
current city: Phoenix, AZ USA
how long since diagnosis: 1 year
pesticide exposure: NO
prior medical history: Irritable bowel syndrone, degenerative arthritis of spine, lots of back pain and most recently, joints, esp. knee, hips, ankles, neck, thumbs, the usual trigger points. Actually, it is complete body pain.
Theories: I was pretty convinced that my sudden inabillity to walk was due to degenerative arthitis. Spinal stenosis etc. Confirmed with MRI. MS was ruled out although I do have a white spot on my brain???From what? No other plaques. To this day I have trouble with balance, my legs and feet are constantly numb with tingling sensations. Muscle pain, Sometimes I am numb up to my waist. No doctor can figure this out. It was about a year ago I began experiencing extreme pain all over my body. fatique etc. Well Fibromyalgia was diagnosed. I think it is caused by the body being completely shut down with a bad immune system. Possibly the good ole virus. We all need to cleanse the body. I am suffering terribly and will try just about anything to help me with this condition. I am disabled because of it.
what has helped: So far, I have started on quite a few nutritional supplements. To begin with a bowel cleanse. I just started that too. The others I am on I can't judge just yet, it has only been a month. However, I would like to try the ACV, just don't want it to hurt my teeth..could keep you posted....
what makes condition worse: stress, rain, humidity, exercise, lack of sleep
work: NURSING

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Sent to us on 11/5/05
name: Cindy
sex: female
born: New Albany, IN USA
current city: Clarksville, IN USA
age at onset: 44
how long since diagnosis: 3 years
pesticide exposure: Only on rare occasions when spraying home for spiders, ants, etc.
prior medical history: Hashimoto disease, hypermobility syndrome, general anxiety disorder, systemic lupus, acid reflux disease
Theories: Years of chronic stress, dental hygiene career (constant cramped working position with muscles in a constant state of contraction), type A personality (meaning always being on edge, trying to be perfect, anxious about almost everything)
what has helped: yoga, low impact aerobics, stretching, massage therapy, chiropractic therapy, acid cider vinegar capsules, baking soda water, apple cider vinegar baths, or just hot baths, talking to people, laughing, deep breathing, meditation what makes condition worse: stress, rain, lack of exercise and stretching, lack of socializing, fear of never recovering, thought of never going back to work, feeling useless
work: Dental Hygiene

(Sent to us on 11/7/05)
name: Anglia
sex: Female
age at onset: 42
born: Foxworth, Mississippi
current city: Foxworth, Mississippi
how long since diagnosis: 6 years
theories: no
pesticide exposure: no
what makes condition worse: rain, humidity, doing any kind of bending, sitting for more than 20 minutes
work: Nursing Aide

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( Sent to us on 11/09/05)
name: Wendy Jo
Sex: Female
born: Idaho Falls
current city: shelley id usa
age at onset: 14
how long since diagnosis: 16 years
exercise history: yes. farm labor, circuit training when I can tolerate it.
how many years in current city: 36 yrs
prior injuries: rape
pesticide exposure: nke
prior medical history: pcos, depression
Theories: Rape was the starting factor. Pattern i see is the stress factor that is apparent on the cases i read above.
what has helped: ambien, trazadone, t/3 for pain, amitryptaline
what makes condition worse: menstral cycle, fluctuations in temp, stress.
work: dental assistant

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( Sent to us on 11/10/05)
sex: female
age at onset: 45
born: Big Stone Gap VA
current city: Big Stone Gap VA
how long since diagnosis: 4 years at least
pesticide exposure: None
prior medical history: High Cholesterol
what has helped: She has been taking ACV for a few weeks now, and already has more energy and feels much better.
what makes condition worse: Stress
work: Unemployed

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10/7/2005:
age at onset: aprox. 37 years old
born: Detroit, Michigan, United States
current city: Wahiawa, Hawaii, United States
how long since diagnosis: 3 years
name: Carol
pesticide exposure: limited / weed killers, grass fertilizer, bug sprays
prior medical history: Graves' disease (hyper-thyroidism) treated with radiation
ablation therapy
sex: Female
theories: Very stressful lst marriage which resulted in divorce. Graves' disease. Very physical job as a sales merchadiser for 6 months-about 1 month into the job the headaches & muscle spasms started & haven't stopped yet and that was 7 years ago.
what has helped: Malic acid/magnesium (to soon to be sure yet), massage therapy,
yoga
what makes condition worse: stress & physical exertion
work: Was a sales merchandiser/ can't work now

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10/9/2005:
age at onset: 35
born: San Francisco, California USA
current city: Petaluma, California USA
how long since diagnosis: 10 years
name: Darcey
pesticide exposure: Yes, many! I lived in Brentwood CA prior to diagnosis. They spray everything.
prior medical history: No
sex: female
theories: Being physically and verbally abused for several years just prior to developing fibromyalgia is a theory, especially since stress worsens my symptoms dramatically.
what has helped: Staying away from refined foods. MSG tends to aggrevate. The Bowen Technique helps immensely.
what makes condition worse: Stress mostly
work: Electronics Technician

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10/15/2005:
age at onset: 26
born: Spokane, WA
current city: Olympia, WA
how long since diagnosis: 7 years
name: Tina
pesticide exposure: yes. Don't know. Know my dad used diazanine on home grown onions.
prior medical history: Multiple food and environmental allergies, scholiosis, sciatica, chronic yeast infections, genital herpes
sex: female
theories: Grew up in alchoholic home and stayed in abusive relationship for three years. Also, just stress of overly being overly busy with high school activities and being high achiever. In college, way too much stress of school working two jobs, being in unhealthy relationships etc. Now happily married but noticed symptoms big time after birth of second child.
what has helped: acupuncture during pregnancy helped with sleep/depression, yoga helped with back pain, Paxil and Nortriptaline, although am going off Paxil now and am using just 10mg of Nort. for sleep. Apple cider vinegar does help temporarily for pain and fatigue. Just started MSM and am noticing normal bowel movements (no more constipation). Am taking Cytomel T3 and has been helping with memory, pain and fatigue. Am going to try Armour to see if it works any better. Also am on Nystatin for internal yeast. Also am taking acidopholus and
magnesium citrate.
what makes condition worse: stress, lack of sleep,
work: elementary teacher

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10/17/2005:
age at onset: 15
born: Macon, MO, USA
current city: St. Petersburg, FL, USA
how long since diagnosis: 3 months
name: Suzanne
pesticide exposure: maybe, I grew up on a farm
prior medical history: Depression, Anxiety, chemical sensitivity
sex: Female
theories: i think chemicals and food additives combined with sedative,fast paced lifestyles, and lots of stress, perhaps cause fibromyalgia, i definitely think that our bodies aren't strong enough to combat all of these things.
what has helped: no milk, processed foods, white sugars, lots of exercise (the right kind) slower paced environment.
what makes condition worse: stress, rigorous physical activity, lack of exercise
work: Engineering Technician

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10/19/2005:
age at onset: 20
born: Grand Manan Island,New Brunswick,Canada
current city: Parrsboro, Nova Scotia, Canada
how long since diagnosis: just diagnosed, finally!!
name: Linda
pesticide exposure: no
prior medical history: gall bladder removed, ulcer, high blood pressure, high colestrol
sex: Female
what has helped: extra fiber helpes regulate bowels, rest sometimes helps pain
working through the pain keeps me moving-or I couldn't move at all.
what makes condition worse: stress, humidity,some types of movement
work: Factory work, home care

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11/3/2005:
age at onset: 53
born: Spartanburg SC USA
how long since diagnosis: 8 yrs
name: Bobby
pesticide exposure: no
prior medical history: yes Severe Depression
sex: male
theories: NO I have no energy.Dont want to do anything. cant do anything, was very active before.
what has helped: pain medicines
what makes condition worse: walking or sitting for over 20 MIn
work: Captain-- Prison

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11/13/2005:
age at onset: 51
born: grove city. pa., usa
current city: butler,pa.,usa
how long since diagnosis: 3 months
name: janet
prior medical history: rhuemantic fever, measles, mumps as a child. pulled muscles, cysts in my breasts, fybroid tumor in uterus, mild diabetes, major acid indigestion. general malaise, aching in muscles of legs, retinal bleed of right eye
sex: female
theories: stress changes in my personal life
what has helped: malic acid and magnesium magnetic therapy, massage, small dose of lithium
what makes condition worse: stress, fatigue
work: nursing

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11/14/2005:
age at onset: 31
born: Prague, OK Lincoln
current city: Dale, OK Pottowatomie
how long since diagnosis: 10 years
name: Lisa
pesticide exposure: no
prior medical history: 2 C-sections
sex: female
theories: I hate the fibrofog. I cannot lose weight. I get very depressed. I hurt and am tired most of the time. I taught myself in my teen years playing sports to block some pain. I have to work...no choice, so tired or not, off to work I go. My family life suffers, though. I can't seem to keep up with my housework, and I crash or just get cranky when I'm home. Probably because of the effort and energy it takes to teach primary children. It seems everything mentioned that is bad for us to eat is what I crave. Milk, sugar (particulary chocolate), and bread foods are all I want to eat. Nothing else sounds even remotely good to me. I hate taking my anti-depressants and anxiety meds. that my doctor put me on. No one told me that it was almost impossible to get off. Side effects are BAD! I just wish someone would take the time to research this problem and help us. Sigh!
what has helped: yoga
what makes condition worse: stress, change of schedules, no down time
work: teacher

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11/16/2005:
age at onset: 52
born: London, UK
current city: Dorset, UK
exercise+ history: Yes, Took additional course of exercise this year - lost a stone in weight. Did not resolve pain, but didn't make worse and the increased energy helps me cope
how long since diagnosis: 1 year
how many years in current city: 12 years
prior injury: decorated house for 3 days
pesticide exposure: Yes PCB's sheep dip etc but many years ago prior medical history: none, I have low cholesteral and all blood tests are clear for diabetes, rhumatic markers etc
sex: Female
theories: Yes - Over exercise during decorating which went on for 3 days. This co-incided with coming of HRT the month before. I think it was a combination of hormone change and physical body stress. Up until then I had had a perfect sleep pattern, since I have been in too much pain to get a good nights sleep. I am not depressed, I am otherwise in good health.There does seem to be a pattern of trauma linked to hormonal change. This may
explain why women are more at risk.
what has helped: have taken St Johns Wort which did help was relieved of symptoms for a whole week. I have reduced alcohol intake and caffine. In fact the reduction in caffine and substituting water did co-incide with a reduction in pain.
what makes condition worse: Weather - cold and damp, lack of sleep, winter nights
work: web developer

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