Enbrel definitely affects a woman's cycle somehow. When I started, even
though I had just gotten my period a week prior, I got it again. When I
stopped to try to conceive, I got my period again, even though I had just
gotten two weeks prior (I usually have 38-45 day cycles). My rheumy even
said some doctors are prescribing it for fertility.
Hi all,
Have anyone experienced that driving ON YOUR OWN for longer
distances...say 100kms and more causing P flareups!
Medasani
[Editor's Note: I think if driving is stressful for someone, then driving long
distances (or short distances in heavy rush hour big city traffic) can produce
significant stress which we all know is bad for ANY illness. So, yes, I think
it can, under certain circumstances, make things worse for P or PA. For many
years I routinely drove 125 miles (200 kms) to our weekend house, including
driving through NYC to get out of town and never had a flare that I would
attribute to driving but I was very used to driving daily into the heart of
midtown Manhattan in rush hour so not much fazed me. That's not true for most
people. It is also possible that you need to use sunscreen and moisterizer
before getting in the car. Kathy F.]
hi everyone,
ive been on enbrel for quite a while and a year ago i started having spotting
between periods then the spotting became heavier, i made all kinds of tests at
the gyn. office and everything was fine, that's why im wondering whether enbrel
has anything to do with it.
Thanks,
Ghaida, Kuwait
Dear Melissa, don't start worrying about all of this. Apparently your
doctor doesn't know you or how you feel. Nobody does but you. And all
this stress is just going to make your PA flare up worse than before. I
just go dx with PA and am in pain also but all they have me on is
methotrexate 2 tabs of 2.5. I folic acid tab and 500mg of hydrocodone
every 6 hours. I feel like crap being 37 years old having to walk around
with my cane like some old lady. And yes, I am depressed. All I did
yesterday was cry about being a burden on my family. I can't help how I
feel and neither can you. But this stress isn't doing me or you any
good.
I'm here if you need me. God Bless you. Beth W
That is tough, you should find another doctor. No
doctor in his right mind would not prescribe PT.
Hopefully you will feel better. Greg
I am sooooo angry its not even funny...... i was told tonight that (a) i
wont give you stronger pain meds, no real reason why not (b) I wont send you
for water physical therapy because of your psoriasis (like I can't put even
more lotion on to compensate for the chlorine????) and this is the one that
just angers me the most (c) Take an anti depressant and that should
help....whatever..... What a waste of time, money and effort.... I was so
disappointed and my husband who usually speaks up and supports me basically
said nothing and agreed with the doctor.... So great, I'lll just waste away
and die like this..... no problem, don't worry about me... I jsut can't walk
or sit or lie down for very long and don't have any quality of life left,
but that's ok, an anti depressant will cure it. Unbelievable!
Melissa
--
I can do all things through Christ which strengtheneth me Phil 4:13
Hi Niki,
I am sorry that I can't really answer your questions as I am even
newer to this than you. I just started MTX this past Friday night and
I did have to throw up one time that night. The rest of the weekend,
I was very tired, a little dizzy and nauseous at times, but not too
bad. I am interested in hearing more about the mouth sores though as
I have also developed this weekend some swelling in my lips and some
small cold-sore looking sores on my lips though I have never had cold
sores before. My lips basically look and feel like they are very
badly chapped or sunburned. Is this what your mouth sores were like
or has anyone had a similar experience?
I am also having to try this MTX b/c my insurance requires this be
tried before Enbrel which my doctor originally prescribed. Does
anyone know whether or not mouth sores and vomiting are enough reason
for the doctor to overrule the insurance decision?
Thank you,
Monica
[Editor's Note: Monica, mouth sores are one of the most common side effects
with MTX. They are fairly easy to prevent by taking folic acid every day.
This is available inexpensively over-the-counter if your rheumatologist has not
already prescribed it for you. I'd suggest you consider taking it immediately
but by all means call your rheumy if your have any doubts. The nausea and
dizziness may be readily controlled by taking Benadryl about a half hour or so
before you take MTX. For almost everybody, mild dosing with Benadryl is enough
to take the nauseous edge off. I am not your insurance agent so I can't really
speak for the insurance, but the side effects you mention from MTX are so easily
controlled that I do not think you should give up on it just yet. It can take
up to 8-10 weeks before you start to feel the benefits from MTX (and they can be
many). In addition, Enbrel has been shown to be MORE EFFECTIVE when taken with
MTX than when used alone so that is another reason to take folic acid and
Benadryl to counter-act these common MTX side effects. Kathy F.]
During the worst of my last flare, I was taking 2 Tramadol every 4
hours, with 2 Bufferin every 4 hours halfway in between. I'm down to 1
Tramadol at night only and no aspirin.
Tramadol worked very well for me.
regards,
sherry z
Wanda,
THhnk you for thinking of me. I'm doing great actually. I highly recommend
anyone limping around in pain like I was to get the surgery and don't be afraid.
It will set you free. From day one the pain in my hip has dropped from a 10 to a
3. Now it is not at all. I am in out patient therapy now. I am walking most of
the time without any assistant devices. I use a cane at times. I still limp but
that is because I still have to work on my muscles. My dh is funny because he is
so attentive it starts to get on my nerves. He leaves my mom notes so she knows
how to do things according to protocol as he calls it. My girls have been real
helpful too, they are just happy that my incision is just about healed up, that
made them sick. It is only 6 and a half inches long though so it's not bad. I am
having a big 30th birthday party on Feb.3 and I hope to not be limping as badly
by then so I can surprise everybody who hasn't seen me since my surgery.
Take care,
Shannon
dreimutter1957 <dreimutter1957@...
Hey girl, you're back! How did the surgery go and how are you feeling?
I've been thinking about you! Are you at home now, or at a rehab
center? How are your kids and dh coping? Wishing you a QUICK and
SMOOTH recovery!
Wanda
~Jeff and Shannon DeLazzer
"We can do no great things-only small things with great love."
-Mother Teresa
Hello,
I wanted to see what the average range of pain medications are. I am
currently on Talwin NX every 6 hours and its not cutting it... I'm
alternating 4 ibuprofin every 3 hours. I have been on vicodin, vicodin es,
percocet, and now the talwin. I am in a ton of pain and dont know what to
ask for next. At what point did your docs say "ok its time for pain med mgt
docs" and your gp be done with it? and what's the strongest meds your gp
gave you? Thanks
Melissa
--
I can do all things through Christ which strengtheneth me Phil 4:13
In a message dated 1/12/2007 5:43:56 P.M. Pacific Standard Time,
ladyspeed@... writes:
The ones I have
had on and around my eyes and on the back of my scalp have cleared up yet I
still itch even inside my eyes.
Hi KarenCorie...I had the lesions on my eyes once, and needed steroid drops
to clear them up vs. just oral prednisone...I would recommend seeing an
opthamologist that has experience with autoimmune complications...
Rachel
Basic story 2 years of feeling horrible and a dx of MCTD and probably
fibro, as rheumy didn¹t want to commit to RA with my positive but low RA
factor. Spent 2 years off and on plaquenil (did nothing but make me sick),
prednisone (did nothing but make me have panic attacks and feel like
squirrels were running around my brain), mobic, antidepressants and darvocet
for the pain. And tests, lots of tests. Finally in May of 06, I noticed
my newly pitted nails, showed them to rheumy, and presto! A dx of PA (I¹ve
had minor P on my elbows all of my life, but that¹s it) and he still wants
to throw fibro in there I¹m not so sure about that part. In May I started
on MTX and worked up to 15 mg/week + lots of folic as it was causing mouth
sores. It also pretty much knocked me on my butt for the whole day
afterward (and still does, though not as badly now). The MTX did not do
anything positive for me that I could tell. Finally in October, I basically
told rheumy I couldn¹t take it anymore. I was better than 2 years ago with
no meds, but not measurably so, and I¹m too young (37 now) to not even be
able to take my kids to the mall. I also have to work full-time, no choices
there 2 kids, 16 and 11, and hubby and I make about the same money, and
couldn¹t live on 1 salary plus, my insurance is good and cheap through my
work, and I need the income to pay for meds!
He started me on Enbrel (and kept me on the MTX and mobic). A little scary,
but also very promising, as I know a few people who have said it was life
changing, so it was worth the hassle, and fortunately I have great
insurance, that (once it was FINALLY approved) would give me a monthly copay
of $20. I jumped on it. At my 6 weeks later appointment, he asked was I
feeling a big difference, and truthfully I told him no. He seemed a little
dismayed at this, and I actually felt bad for saying that, but certainly
wasn¹t going to lie! He told me to give it some more time. It¹s been almost
6 weeks since that appointment, and I¹ve been on Enbrel for 11 weeks now.
Over Christmas break (2 weeks, as I work at a school), Ii felt great, felt
rested, had no major pain and took no pain pills for the entire break. I
was sure we had a huge breakthrough. Then I went back to work and after 2
days felt just like I had before Christmas. So now I¹m back in the same
boat.
I will say that I feel somewhat better than I did back in the fall. I have
more specific pain (I had told him the MTX did this less general ³I hurt
everywhere² and more specific ³this joint hurts² pain but still pain).
I¹m getting more sleep (Ambien CR is a dream!), and definitely taking less
pain pills than I was before, but I do still take some the pain is less
and more tolerable, so I don¹t always feel the need to medicate. I¹m still
tired all of the time, and 8 hours a night is never enough. I can¹t walk
long distances (or up hills), and just vacuuming the living room wears me
out. I wake up with pain and stiffness, and though the stiffness eases, the
pain does not always. After all the wonderful things I¹ve heard about
Enbrel, I was sure that I would feel much more like my former self by now,
though I¹m starting to forget how I felt ³before². I also know that
depression plays a part in this, and I¹m still taking ADs, and trying to do
yoga for some exercise and endorphins. Hubby can see some days that I¹m
getting ³depressive again², and tries to help, but our girls are a teen and
a pre-teen, and they don¹t get how hard it is for me.
So am I expecting too much too soon? Are there people out there for whom
Enbrel just didn¹t do it? And how long does it take to decide that? I¹m
going back to rheumy on Friday, and I want to be honest, and I¹m sure he¹ll
want to give it more time. So how much of my real life could I
realistically expect to regain? I was never a very active person, but going
to Target with my kids shouldn¹t be a major ordeal. I want to be
reasonable, but I also want to know if this is as far as I can expect to
get.
Niki in NC
http://www.knitnik.com
Hi Bobby,
You may be between a rock and a hard place now, but you
are not stuck. You have to quit beating yourself up over the
the remarks of stupid people. Some of these "doctors" get so
wound up in their self importance, they forget they are treating
real people with real problems. YOU know you have pain, and
until you get help to stop the progress of your disease, you can't
feel guilty for taking pain releivers. We all worry about adictions,
some of us have the gene that makes us prone to adiction but we
have to live. My son just had a hip replacement done, his doctor
prescribed oxycontin as well as another one I can't remember the
the name of. He said it was Vicadin with more narcotic and less
acetaminaphen. I voiced the possibility that he was already hooked
on pain relievers from the past 2 years and he told me not to worry.
When the time came they would control his dosage to ween him off
them. As it turned out, as the pain went away, he no longer needed
the meds and didn't take them any longer. The same can happen to
you when you find the right doctors and you start getting the right
DMARDS or biologics. Remember, what works for one doesn't
necessarily work for another. So far MTX works for me. I take
an occasional vicadin or an xtra strength Tylenol for pain.
I also am changing doctors and it is a pain to get reaquainted with
new people, but you have to do what you have to do. The guy at
that pain center didn't know you from Adam, but you could have been
behind a couple that were there only for drugs. I'm sure
you will find the help you need. God bless,
Janet in Ca
Can anyone tell me what the maximum dose is for methotrexate for our
once weekly dosing? I have looked in my nursing drug books and can
not find a straight forward answer to that question due to psoriatic
arthritis being an "unlabled use" for methotrexate.
Thanks for your help all.
Jason M
Wilton, IA
[Editor's Note: The traditional maximum dose is 25mgs a week. Kathy F.]
I really don't want to be the first one to post an "anti-Benadryl"
message, but since I was one of the people who suggested the benefits -
I can't help but post a link to a website with a complete description
of the drug. There ARE some negatives and some things to keep an eye
out for.
One other thing before the link... One of the afternoon talk show hosts
recently did a program that included people who had given their
children ADULT doses of Benadryl with tragic results. As with all drugs
this one has dangers too.
http://www.drugs.com/mtm/B/Benadryl.html
Based on you guys experience, which one is more
effective for clearing up the skin?
Thank you,
Monica
[Editor's Note: The results vary from person to person. Kathy F.]
Hi Brande,
What has your pharmacist suggested to you, if you wouldn't mind mentioning?
Don
in Boston
Brande <brandewood@...
Casey,
Thanks - you are so right! I have had several experiences where my
pharmacist caught a drug interaction that my doctor should have or
advised against taking certain supplements while on a certain
medication. I find talking to the pharmacists a lot more comfortable
most of the time.
My Mom, who has lived with Lupus for almost four decades, highly
recommends a close and friendly relationship with your pharmacist.
She says that doctors come and go with insurance changes, but your
pharmacist is there with you for the long haul!
Mine has been quite helpful in discussing alternative therapies - I
don't have insurance and for personal reasons, cannot take DMARDs - I
know they stem the progression of the disease, but it doesn't make it
any more possible for me to take them - so better to find something
that helps and improves my quality of life than to do nothing.
Thank you,
Brande
Fran,
Thanks for the reply. It is like being stuck between a rock and a hard
place. I know that I cant get thru the day without the MS Contin for the pain,
and
I know that I can't get thru the day, because I am addicted to the MS
Contin. I hate to complain, but it just wears you down. When I was misplaced by
Katrina, I went to a pain management guy in North Florida, he humiliated me by
calling me a drug addict, trying to get drugs, told me my doctors in New
Orleans were just drug dealers, gave me a 45 second exam, where he squeezed a
couple of joints and since I didn't scream, he made up his mind I just wanted a
fix. My Doc here even took the time during the aftermath of the storm to call
this guys and explain my injuries, before the appointment. Being the type
individual I am, I thought well maybe he is right, so I tortured myself for
days,
enduring pain and withdrawals, but then I got angry. So as you can see I
have not had the best of luck with Pain Management Docs, well there I go
venting
again. Anyway thanks for the chat, I understand.
Bobby
I saw my rheumy Friday. Got a script for Humira and now we'll have
to see whether my insurance will approve it and how long it will
take. The plan is to take it along with the MTX.
She also referred me to an ENT to find out what's going on with my
nosebleeds. She had me try doubling my folic acid to 2 grams for a
month, but that made no difference so now I'll see the ENT.
She switched me from folic acid to something called Metanx, which I
think is just another form of folic acid?
No sooner did I get home than the rheumy called to say my liver
panels are high again. Now I have to reduce the MTX again, plus hope
the approval for Humira comes quickly!
To add insult to injury, we are having rain and more is predicted
through the week. I ache like crazy with the rain.
Question: I am totally off all alcohol and am only taking 15 mg of
MTX. Should I be worried about my liver that my panels keep going
high even with such a low dose? Is the naproxen and tramadol also
affecting my liver?
thanks,
sherry z
Dear Bobby,
Ive taken MS Contin for several years and never had any problems with it.
I was lucky I guess. Im not trying to sound like a broken record, but I
would go to a pain management center and tell them just what you have
written in your email. There are many ways they can take you off of a
certain drug and still control your pain with another drug. MS Contin is
great for a break through pain medication, but it doesnt last long enough
to be taken as an only source of pain medication. (Unless your pain is
short term and not chronic, and from what you have written it sounds like
you are suffering with chronic pain.)
There are many types of long term pain medications that work on a time
release basis that hopefully would be able to ease you off of MS Contin
without going through withdrawal or having to suffer with a lot of pain.
You need a specialist though who knows just what to do in your situation.
Tell them that you have increased your medication to just control your pain
and now you are just afraid that you are addicted to it. Using narcotics
long term almost always causes physical addiction, but that isnt the same
as being a drug addict. I know it sounds like splitting hairs, but the
difference is without your pain you simply dont need your medication. I
know you stated that you need your drug to just get through the day now, but
are you sure that you arent taking it for pain? Even if you are physically
addicted to Ms Contin, they can help you either get off of it, or find you a
replacement that you wont need as much of and one that will hopefully
control your pain without over using it.
Certain medications are more addicting to certain people, so once again its
great to have someone who will work with you and try and find one that you
dont respond badly too.
Dont feel bad about your situation. It happens to a lot of people simply
because their doctors dont understand chronic long-term pain. I also cant
take the stronger PA drugs. Ive tried Humira and Enbrel and several others
and have almost ended up in the ER several times. Luckily, so far Ive been
able to take Arava and it has helped me quite a bit. I still worry about
side effects since I seem to have constant bladder infections, and suffer
with all kinds of skin rashes from time to time. Still it has helped me
over all so Im doing my best and getting my blood checked every 6 weeks.
Now not all pain doctors are wonderful. You may have to shop around first
to find one that you like and one that will work for you. When they are
good, they get really busy and sometimes dont have a lot of time to spend
with you. The good ones though always find the time, especially on your
first appointment to understand your problems and how to help you. Take any
X-rays and doctor reports or test you have to document your problems the
best you can. It helps the doctor to see on paper exactly what is the cause
of your pain, that way it helps to validate your problems. The main thing
is not give up and to not accept just living with pain. To me, thats not
living. Im not saying I dont have pain. Right now in fact, Ive got
arthritis in my shoulder and neck and it has been killing me for almost 2
weeks. Ive had several injections into trigger points, but I think next
time Im going have the joint itself injected. I can hardly sit up for more
than 10 minutes so typing this email has been rough. I just hate to read
about people suffering in ways that can be avoided.
I hope you find some help out there and dont get discouraged. You arent
alone and this happens to so many of us because so many doctors just dont
know how to handle pain. Most of them just want to ignore it and hope you
wont bring it up again. Let me know if I can help in anyway. Take care
and hang in there.
Fran from Florida
LOL! Even a large overweight man could stand on my table. It's made
from 100-year old heart pine that was salvaged when an old hotel was
demolished. It was once the FLOOR of the hotel!
Unfortunately, it's too large and heavy to move around to use as a
ladder - too bad!
I'm going to thank my hubby right now, by the way.
best to all,
sherry z
In a message dated 1/12/2007 8:29:27 A.M. Eastern Standard Time,
remshotpurpleparis@... writes:
my bosses are worried about me but what can you do if you can't perform what
they need. I talked to them and they want me back. I told them that some one
will get mad if I can't pull my weight, but she said they better leave me
alone.
Have you discussed with your HR folks about another position within the
company? Good workers are hard to find and companies do not want to lose them.
See what's available. Explain your concerns about fulfilling your present
duties and also how you feel it may not sit will with co-workers. I've seen
jobs created to accommodate a good worker no longer able to do present duties.
Peace and Hugs,
Sandy swOhio
PSORIATIC ARTHRITIS NEWS AND VIEWS
VOLUME- 6 ISSUE- 15
December 30, 2006
PSORIATIC ARTHRITIS MEDICAL NEWS
CHRONIC FATIGUE SYNDROME CAMPAIGN LAUNCHED
U.S. health officials stress disease is real, though treatments remain
elusive
By Amanda Gardner - HealthDay Reporter
(HealthDay News) -- U.S. health officials recently launched a major campaign
to increase awareness of chronic fatigue syndrome, an illness that has
labored under an intense level of controversy.
"This disease has been shrouded in a lot of mystery. Sometimes people
question if it's real or not real," Dr. Julie Gerberding, director of the U.S.
Centers for Disease Control and Prevention, said at a news conference. "We hope
to help patients know they have an illness that requires medical attention and
help physicians be able to diagnose the illness, and be able to validate and
understand the incredible suffering that many people and their families
experience in this context."
The campaign will consist of public service announcements, brochures, and a
"tool kit" for health-care professionals and a photo exhibit called "The Faces
of Chronic Fatigue Syndrome," which will travel to cities across the country
throughout 2007.
"We hope this will be a turning point in the public's awareness of the
disease as well as in health-care professionals' ability to diagnose and treat
it," Kim McCleary, president and CEO of the CFIDS Association of America, said
at the news conference.
"This launch is so important to increasing understanding of this illness,"
added Dr. Nancy Klimas, of the University of Miami Miller School of Medicine.
"Historically, lack of credibility of this illness has been a major stumbling
block."
According to Dr. William Reeves, of the CDC's National Center for Infectious
Diseases, the level of impairment experienced by people with chronic fatigue
syndrome is comparable to that of multiple sclerosis, AIDS, end-stage renal
failure and chronic obstructive pulmonary disease.
One CFS patient, Adrianne Ryan, said that sometimes taking a walk or a
shower was too much, and resulted in her collapsing for weeks afterwards. Ryan
is
a former marathoner.
Doctors still don't know what causes CFS or how to treat it successfully,
but more than 4,000 studies over the past two decades show definite underlying
biological abnormalities, said Dr. Anthony Komaroff, of Harvard Medical
School.
"This is not an illness that people can imagine they have. It's not a
psychological illness," he said. "That debate, which has raged for 20 years,
should
now be over."
Among other things, Komaroff pointed out, the brain hormone systems of
people with CFS are different than those without the disease. Brain functioning
is
also impaired and cells' energy metabolism seems to be compromised.
Analyses of the activity levels of 20,000 genes in people with CFS have
found abnormalities in genes related to the part of brain activity mediating the
stress response, Reeves said.
Some 1 million Americans suffer from the disease. Women are affected at
about four times the rate as men and non-white women are affected more than
white
women. The disease can affect any age and demographic but is most likely to
strike when a person is 40 to 59 years of age.
According to a large study conducted in Wichita, Kans., only half of people
with CFS have consulted a physician and only 16 percent have been diagnosed
and treated, although studies have shown that those who get appropriate care
early in the illness have better long-term results. A quarter of people with
the disease were unemployed or receiving disability, with the average affected
family foregoing $20,000 annually in income. That amounts to $9.1 billion in
lost income and wages for the U.S. economy as a whole, the study found.
While there's reason to be happy with advances in the basic scientific
knowledge of the disease, Klimas said she was less happy with advances in care.
Over the past 20 years, she said, she has treated more than 2,000 people with
CFS who were "angry and defiant, frustrated, trying to convince physicians,
friends and families that this was a real illness."
"We need much more work to understand the biological underpinnings and
translate this into clinical practice," she said. "At the same time, there are
effective strategies we can use right now, treatments that do help and help
significantly."
Visit the U.S. Centers for Disease Control and Prevention (_www.cdc.gov_
(http://www.cdc.gov) ) for more on chronic fatigue syndrome.
SOURCES: Nov. 3, 2006, teleconference with Kim McCleary, president and CEO,
CFIDS Association of America, Charlotte. N.C.; Julie Gerberding, M.D.,
director, U.S. Centers of Disease Control and Prevention, Atlanta; William
Reeves,
M.D., National Center for Infectious Diseases, CDC, Atlanta; Anthony Komaroff,
M.D., Harvard Medical School, Boston; Nancy Klimas, M.D., University of
Miami, VA Medical Center; Adrianne Ryan, CFS patient Copyright Ā© 2006
ScoutNews,
LLC. All rights reserved.
*******************************************************
SCIENTISTS HOPE BODIES CAN FIGHT CANCER
Scientists are investigating new strategies to harness the human body's own
immune system to fight skin cancer.
LONDON (AP) -- In a departure from the standard chemotherapy treatments,
which flood patients with toxic chemicals to kill cancer cells, doctors are
trying to provoke the body's natural defenses to do the same thing. Two such
techniques to combat melanoma were reported in papers presented this week in
Prague at a European cancer research meeting.
The strategies are the first attempts to suppress the body's T-regulatory
cells, which normally keep the immune system in check. In cancer, oncologists
theorize that it may be helpful for the immune system to remain active, thereby
unleashing it on the cancer.
"This is a fundamentally different approach to treating cancer," said Dr.
Alexander Eggermont, professor of surgical oncology at the University of
Rotterdam, Netherlands, the conference's chairman. Eggermont was not connected
to
either of the skin cancer research papers.
While the research is still preliminary, the scientists' novel approach to
attacking cancer has already produced some promising results.
In a paper presented by Dr. Jason Chesney of the JG Brown Cancer Center in
Kentucky seven patients with advanced skin cancer were given a drug combination
of diphtheria toxin and interleukin 2, intended to knock out the body's
T-regulatory cells. In five of the seven patients, tumors shrank or remained
stable.
By wiping out the T-regulator cells, the drug prevented the immune system
from shutting down, thus priming the body to mount a continuous attack against
cancer, Chesney explained.
"This is a landmark study," said Dr. Anna Pavlick, director of the melanoma
program at New York University, who was not involved in the study. "What it
shows is that by suppressing T-regulatory cells, we can take the brakes off a
patient's immune system."
Though Pavlick says it's too early to change how patients are treated based
on Chesney's study alone, she believes the methodology merits further
research.
"It's like having permanent chemotherapy," said Chesney. "You're inducing
your own immune system to stick around and keep this cancer from growing."
Advanced melanoma is a devastating disease for which there is no effective
treatment. The average life expectancy is about nine months, and less than 20
percent of patients survive more than two years after diagnosis.
In another study presented Wednesday, Dr. Jeffrey Weber, a professor of
medicine at the University of Southern California in Los Angeles, described how
he and colleagues were able to block a protein on T-regulatory cells, thus
inhibiting them enough for the immune system to attack cancerous cells. Patients
were given shots of an antibody aimed at the T-regulatory cells. Out of 25
patients tested, 24 are alive after 17 months, and three are free of cancer.
If this strategy of manipulating the immune system proves successful, the
whole framework of cancer treatment might be changed. Until recently,
chemotherapy was thought to be the best way to eliminate tumors. Yet while
chemotherapy certainly reduces the size of tumors, it cannot prevent their
recurrence,
and is only a short-term solution.
"If we can change the rules of the game by keeping the immune system active,
we might be able to prevent tumor regrowth," said Eggermont.
Allowing the immune system to run wild does not come without risk; doctors
admit it could lead to autoimmune diseases including hepatitis, colitis or
dermatitis. Still, most say those conditions are manageable, and are outweighed
by the prospect of beating skin cancer.
Earlier this year, scientists at the U.S. National Cancer Institute used a
similar technique, turning regular red blood cells into cancer-killing agents.
That involved genetically engineering red blood cells in a laboratory and
artificially producing billions more of them before re-injecting them into
patients.
However, the strategies employed by Chesney and Weber are far more
straightforward, as they don't involve genetic manipulation in a laboratory.
Both Chesney and Weber say it will be years before their strategies are
sufficiently tested to know if they work on a wide scale. Nevertheless, if their
hypotheses prove correct, they could also be applied to other types of cancer
in which T-regulatory cells are known to play a role, such as breast, kidney,
or esophageal cancer.
"This is how successful therapies get started," said Dr. Rick Bucala, a
professor at Yale University's School of Medicine. While Bucala says that it
would be "highly significant" if the immune system could be effectively used
against cancer, he cautioned there was still too little data. "Nothing in
science
is meaningful until it's been replicated."
Copyright 2006 The Associated Press. All rights reserved.
*****************************************************************
BACK SURGERY OFTEN NO BETTER THAN WAITING
Study: Patients improved after two years, even without operation
The Associated Press
CHICAGO - Two big government-funded studies on back surgery for painful
herniated disks show no clear-cut reason to choose an operation over other
treatment.
The pain and physical function of the patients, who were suffering from a
condition called sciatica, improved significantly after two years whether or not
they had surgery. However, neither strategy offered complete relief.
The results indicate patients should choose which treatment they get for the
ailment, the researchers said.
āIn back surgery for this particular condition, thereās actually a
choice,ā
said lead author Dr. James Weinstein of Dartmouth Medical School. āIf you
donā
t want the risk of surgery, you can do watchful waitingā and still get well.
The condition involves disk cartilage bulging between vertebrae in the lower
spine and pressing against a nerve. It can cause excruciating burning pain
called sciatica, radiating from the lower back into the legs; patients often
have difficulty walking.
About 250,000 Americans have disk surgery for sciatica each year, while
another quarter-million instead choose physical therapy, painkillers or rest
until they feel better. The surgery costs about $6,000, Weinstein said.
The findings, published in Wednesdayās Journal of the American Medical
Association, are the first from a big government-funded research project on
spine
surgery. Patients were treated at 13 spine centers in 11 states.
One study involved 472 patients aged 42 on average that were followed for
two years after being randomly assigned to surgery or noninvasive treatment,
which included education, physical therapy or painkillers. Surgery involved
removing part of the bulging disc in a standard operation often done on an
outpatient basis.
Patients in both groups had much-improved scores on measures of pain,
physical function and disability during periodic evaluations; differences
between
the groups werenāt statistically significant.
Ninety-five percent of surgery patients had no complications, but 4 percent
required a second surgery within a year.
In the other study, the researchers followed for two years 743 patients who
chose surgery or other treatment. It found a clearer advantage to surgery,
including quicker relief in the first months. After three months, 82 percent of
surgery patients reported major improvement, compared with 48 percent of
nonsurgery patients. Those differences shrank over two years, however, and the
researchers said the self-reported results should be interpreted cautiously.
In the randomized study, many patients didnāt stay in their assigned group:
Almost half those assigned to noninvasive treatment ultimately had surgery,
and more than one-third of those assigned to surgery ended up choosing less
invasive treatment instead.
That patient crossover makes drawing conclusions tricky and may account for
surgery showing no superiority over other treatments, Weinstein said.
No one in either study developed a rare but feared disabling condition
called cauda equina syndrome, which should ease the minds of patients and
surgeons, said Dr. Eugene Carragee of Stanford University Medical Center.
āSometimes people with mild sciatica have elected to go ahead with the
surgery in order to avoid a theoretical neurological catastrophe,ā but now
patients can avoid surgery with a realistic expectation that theyāll feel
better in
a year or two, said Carragee, who was not involved in the research.
The study shows how tough it is to find scientific evidence that back
surgery works better than other treatments.
For one thing, patients willing to be randomly assigned to surgery are
probably different than most patients; their pain could be less, for example,
making them more inclined to roll the dice and be assigned to treatment other
than surgery.
Another problem: Most surgery studies have no placebo group to rule out the
benefits that come with patientsā faith in surgery.
Using sham surgery as a placebo, in which patients have incisions but no
real treatment, raises ethical questions, but has been done in some research ā
and some patients say they feel better.
āItās critical that we evaluate the real role of surgery in peopleās
lives,ā
said Dr. David Flum of the University of Washington. āStudies like this
that donāt have a placebo arm make it very difficult to figure out how much of
the effect is the operation versus the patientsā and the surgeonsā hopes for
the operation.ā Ā© 2006 The Associated Press. All rights reserved.
********************************************************
SIX TIPS TO PRO-ACTIVELY REDUCE SAD
The winter season can be a busy and joyful time of year. But for many,
changes in light and temperature combined with the stresses of holiday events
and
heightened expectations can increase anxiety and cause depression. Seasonal
Affective Disorder (SAD) is a mood disorder associated with depression
episodes and related to seasonal variations in light. Andrea Rogers, Supervisor
for
Intensive Outpatient Programs in the Department of Psychiatry at
Cedars-Sinai, offers warning signs and suggestions to combat seasonal affective
disorder
this Holiday season.
"As Seasons change, there is a shift in our "biological internal clocks" or
circadian rhythm due partly because of changes in sunlight patterns," says
Rogers, "These changes combined with the stresses of Holiday travel, sensitive
family dynamics and managing expectations can build a recipe for depression
during the winter months. Juggling these variables can be challenging and can
make it difficult to enjoy the joys of the season."
According to the National Mental Health Association, the most difficult
months for SAD sufferers are January and February, and younger persons and women
are at higher risk.
Melatonin, a sleep-related hormone secreted by the pineal gland in the
brain, is produced at increased levels in the dark. Melatonin also may cause
symptoms of depression. When daylight savings time ends, and it begins getting
dark earlier in the day, production of the hormone increases, which may cause
depressive episodes. These biological variables mixed with environmental
conditions such as cold weather, emotional reactions to holidays and anxiety can
create a recipe for depression that can cast a "blue" cloud over the holiday
season.
Phototherapy or bright light therapy has been shown to suppress the brain's
secretion of melatonin. The device most often used today is a bank of white
fluorescent lights on a metal reflector and shield with a plastic screen. For
mild symptoms, spending time outdoors during the day or arranging homes and
work places to receive more sunlight can be helpful.
Six tips to pro-actively reduce or eliminate environmental stressors and
symptoms of SAD:
Let go of the past! The holidays bring out the "traditionalist" in most
people, and many of us are caught up in trying to make the holidays just like
years past. The reality is, every year brings about new circumstances, surprises
and colorful characters who are bound to "rock the boat" during your
"perfect" holiday celebration. "Reduce your anxiety about holiday traditions by
acknowledging your opportunity to maximize your current circumstances to build
new traditions, build on old ones, and abandon unrealistic expectations." Says
Rogers
Pace yourself. Unlike any other time of year, the holiday season is a time
of celebrations, family gatherings, winter activities and entertaining
visitors. These variables added on to an already busy lifestyle can cause
unnecessary
anxiety and hopelessness when projects begin "falling through the cracks".
The key to managing additional responsibilities and social commitments during
this time is to pace yourself and organize your time. Make a list and
prioritize your most important activities. Accept help, and allow for quiet
time at
regular intervals.
Acknowledge your feelings. The holiday season does not automatically banish
reasons for feeling sad or lonely. If you have experienced the loss of a loved
one, are far from family and/or friends, or are generally affected by
changes in weather and light, it is OK to acknowledge that these feelings are
present - even if you choose not to express them.
Don't drink too much! Excessive drinking only perpetuates anxiety and
depression. If you are prone to depression around this time of year, keep your
alcohol intake to a minimum.
Create a support system. Spend time with people who are supportive and care
about you. If that isn't your family, then spend this time with friends. If
you are far from home or alone during special times, make a proactive effort to
build new friendships or contact someone you have lost touch with.
Seek treatment. Sometimes, SAD can get the best of us, even when
pro-actively reducing stressors. If you are experiencing symptoms of depression
during
the winter months that are uncommon for you any other time of year, contact a
mental health professional who can provide counseling and treatment to help
you "weather the storm."
This information has been provided with the kind permission of Cedars-Sinai
Medical Center, Los Angeles, California.
************************************************
BOOST YOUR SELF-ESTEEM AND YOUR HEALTH
A lack of confidence, a reluctance to trust your instincts, and treating
yourself badly could be signs that it's time to improve your self-image.
'Try a Little Tenderness'
How can you improve your self-esteem and develop a more realistic opinion of
yourself?
Each day, do one thing to take care of yourself
Replace a junk-food snack with a piece of fruit; take a 10-minute walk at
lunchtime; floss your teeth.
Talk to yourself as you would to a friend
Replace your usual self-criticism with words of encouragement. Instead of "I
never do anything right," try "I do many things well."
Start a brag file
Take credit for your accomplishments no matter how small.
Spend time with people who make you feel good
You donāt have to avoid constructive criticism from supportive friends, but
avoid people who only want to tear you down.
Take on a new challenge and reward yourself when you reach your goal
Start small, with easily reachable goals. Then work up to greater challenges.
Exercise regularly
Activity is good for physical and emotional health. Aim for 30 minutes of
moderate-intensity exercise five or more days a week.
If these self-help measures don't work, consider getting professional help
from a qualified therapist or counselor.
You won't find it down an aisle of the supermarket or in a bottle in your
medicine cabinet. Your doctor can't prescribe it and you canāt buy it for
your
birthday. But without it, you could be more susceptible to the common cold
and more vulnerable to depression, heart disease and drug and alcohol abuse.
It's self-esteem, a reflection of how much you value, appreciate and approve
of yourself. A healthy self-esteem means you like yourself, believe you
deserve love and happiness, and feel confident in what you can accomplish.
But if you're plagued by low-self esteem, chances are you have an inner
critic living rent-free in your head, one that whispers (or shouts), "I'll
always
be alone," "I'm stupid and boring," "I'm useless."
Regular verbal beatings such as these, along with a lack of confidence, a
reluctance to trust your instincts and opinions, and treating yourself badly
could be signs that it's time to improve your self-image. Think a little more
Donald Trump and a little less Woody Allen.
"What's (Self) Love Got To Do With It?"
Besides making you feel worthless and unlovable, low self-esteem is
hazardous to your health. The negative emotions or moods it triggers, such as
anxiety
and depression, can increase the risk for heart disease. How? They wear down
the emotion-sensitive immune system and are associated with increases in
inflammation, which has been linked to heart disease.
Low self-esteem can raise blood pressure and lead to unhealthy behaviors
such as smoking, excessive drinking and avoiding social contact.
Low self-esteem can sap your motivation to take care of yourself. If you
don't like yourself very much, blowing off steam with a six-pack after a bad day
looks a whole lot more appealing than jogging six miles. Studies have shown
that people with high self-esteem are more likely to exercise regularly.
"Don't Worryā¦Be Happy"
A healthy self-esteem is an important key to positive emotional states.
That's what experts call joy, contentment, feeling relaxed and gratitude. These
positive states help buffer you against stress and they contribute to
emotional and physical well-being.
Shakespeare was onto something when he wrote "Mirth and merrimentā¦bars a
thousand harms and lengthens life." Modern science is beginning to confirm the
Bard's wisdom. Here are some recent findings linking positive emotions to good
health:
Laughing and coping by using humor improved immune function and increased
the level of an immune system protein, the body's first line of defense against
colds.
Positive emotions reduced the readmission rate of people hospitalized with
heart disease.
Optimism (having a positive outlook and being able to bounce back from bad
events) cuts the risk for heart attacks by half and has been linked to better
recovery from heart bypass surgery.
Positive emotions help counteract the bodyās reaction to stress.
Positive emotions produce more flexible, creative and efficient thinking.
Positive emotions are associated with better sleep.
āTry a Little Tendernessā
***********************************************************
EXERCISE AND CALORIE CUTTING LOWER DIABETES RISK EQUALLY
By Neil Osterweil, MedPage Today Staff Writer
Reviewed by Zalman S. Agus, MD; Emeritus Professor at the University of
Pennsylvania School of Medicine.
Eat less? Exercise more? For diabetes prevention, it's a toss up.
Decreasing caloric intake and increasing activity are equally effective at
improving glucose tolerance and insulin sensitivity, reported researchers here.
"Both diet and exercise provide profound benefits to reduce the risk of
diabetes," said Edward Weiss, Ph.D., of Saint Louis University, and colleagues.
"Both those who restrict calories and those who exercise benefit from weight
loss."
"We thought exercise probably would produce greater benefits," Dr. Weiss
said. "But both of these are providing beneficial health improvements."
In a year-long study, Dr. Weiss and colleagues evaluated nonobese, healthy
adults in their 50s who were part of a longevity study. The participants were
at the high end of normal in terms of body mass index.
The investigators wanted to see whether energy expenditures achieved through
exercise could both produce weight loss and further improve glucose
tolerance and insulin action through mechanisms independent of weight loss.
They enrolled 46 sedentary men and women from the ages of 50 to 60 with BMIs
of 23.5-29.9 kg/m2. The participants were randomly assigned to either 12
months of exercise training or 12 months of calories restriction (18 in each
group).
The remaining 10 participants were assigned to a healthy lifestyle
intervention as controls. The intervention consisted of advice for a healthy
diet if
requested, plus free passes to an offsite yoga facility to use at their
option, although few took advantage of the classes or advice, the investigators
noted.
All participants underwent oral glucose tolerance tests at baseline and at
12 months to measure insulin sensitivity and areas under the curve for both
glucose and insulin. The investigators also measured the glucoregulatory factors
adiponectin and tumor necrosis factor Ī±, and used dual-energy x-ray
absorptiometry to measure fat mass.
Members of the caloric restriction group met weekly with a dietitian who
helped them with individual meal plans, portion-size reduction, and substitution
of low-calorie density foods for high-calorie ones. The goal was a 16%
reduction in calorie intake for the first three months, and a 20% restriction
for
the remainder. The dieters were monitored with food diaries and with the
doubly labeled water test, a measure of metabolism.
The exercise group members met weekly with an exercise trainer and had open
access to a fitness center. They exercised for 60 to 90 minutes daily and
tracked their progress on a heart-rate monitor that also recorded calories
burned.
"As they got fit, the treadmill could be speeded up," Dr. Weiss said. "They
could exercise on a steeper grade and they could burn more calories. All of
them learned very quickly the most efficient way to burn more calories was
through cardio. If they pushed themselves, the numbers added up quickly."
The authors found that while the exercisers had more rapid results, there
were no significant differences in energy deficits between the exercise and diet
groups at one year, as shown by changes in body weight and fat mass.
In both the exercise and caloric restriction groups the insulin sensitivity
index increased and the glucose and insulin areas under the curve decreased
from baseline to the end of the study. There were no significant differences
between exercisers and dieters. Among controls, however, insulin sensitivity,
glucose, and insulin measured remained unchanged at one year.
In addition, there were "marginally significant" increases in adiponectin,
and decreases in the ratio of TNF-Ī± to adiponectin among the exercisers and
calorie cutters, but not among controls.
The authors concluded that "weight loss induced by exercise training or
calorie restriction improves glucose tolerance and insulin action in non-obese,
healthy, middle-aged men and women. However, exercise-induced weight loss does
not appear to be greater than that induced by calorie restriction."
Dr. Weiss said that it's still not known whether the combination of exercise
and caloric restriction will be able to provide greater benefits that either
intervention alone. The research was funded by the National Institutes of
Health.
Primary source: American Journal of Clinical Nutrition
Weiss EP et al. "Improvements in glucose tolerance and insulin action
induced by increasing energy expenditure or decreasing energy intake: a
randomized
controlled trial." Am J Clin Nutr; 84: 1033 Ā© 2004-2006 MedPage Today, LLC.
********************************************************
NEW CLUE TO RED WINEāS HEART PROTECTION
Grapes from southwest France contain higher levels of healthy ingredient
Reuters
NEW YORK - Scientists in the U.K. have identified āoligomeric procyanidinsā
as the likely ingredient in red wineās polyphenols that contributes to heart
health and longevity. And some red wines contain more procyanidins than
others.
In the journal Nature, Dr. Roger Corder, from Queen Maryās School of
Medicine and Dentistry in London, and his associates note that not everyone
agrees
that red wine actually possess heart-healthy properties, which they say may be
due to the complexity and variability in the constituents in different wines.
To look into this issue, the investigators cultured human blood vessel cells
and exposed them to 165 different wines to identify the polyphenols with
most potent effects on blood vessels.
They found that procyanidins suppress production of a protein called
endothelin-1 that constricts blood vessels. High-performance liquid
chromatography
identified oligomeric procyanidins as the specific phenolic constituent
responsible for this effect.
People living in Nuoro province, Sardinia, and southwest France have higher
than normal average longevity. And wines from those regions, Corder and
colleagues found, had a 2- to 4-fold higher inhibitory effect on endothelin-1
and
significantly higher oligomeric procyanidin levels than wines from Australia,
Europe, South America, the US, and Sardinia.
Corder and his associates maintain that traditional wine-making methods and
use of the flavonoid-rich grape Tannat commonly grown in southwest France
result in high levels of oligomeric procyanidins in the local wine.
The researchers are hopeful that further investigation of oligomeric
procyanidins-rich wines and foods will provide insight into how blood vessel
function might be optimally maintained. Copyright 2006 Reuters Limited. All
rights
reserved.
*******************************************************
FDA HALTS SALES OF SOME LEG CRAMP DRUGS
Unapproved quinine medicines pose serious risks, agency says
The Associated Press
WASHINGTON - Companies have 60 days to stop selling unapproved prescription
drugs made with quinine and dispensed by the millions each year.
The new Food and Drug Administration order, released Tuesday, applies to the
roughly eight companies that make and sell the drugs, most commonly
prescribed to treat leg cramps. It does not affect the single FDA-approved
quinine
drug sold to treat some types of malaria.
That FDA-approved medicine, heir to a traditional use of the drug that dates
to the 1800s, today accounts for just one-half of 1 percent of the estimated
4 million annual prescriptions written for quinine drugs. Doctors prescribe
the vast majority of the drugs for leg cramps, a use that the FDA warned
patients and doctors could pose serious safety risks.
Many unapproved quinine drugs donāt bear warnings of those risks, including
the toxic effects of even a slight overdose, agency officials said.
Since 1969, quinine drugs have been linked to 665 reports of serious adverse
events, including 93 deaths, according to the FDA.
Many of the unapproved drugs now sold entered the market before later
changes to federal law that now require medicines to be tested for safety and
effectiveness before gaining FDA approval. The FDA estimates that the several
hundred unapproved drugs on the market account for about 2 percent of
prescriptions written each year.
Messages left with Watson Pharmaceuticals Inc. of Corona, Calif. and Ivax
Corp. of Miami, now part of Israelās Teva Pharmaceutical Industries Ltd., were
not immediately returned.
The companies are among the eight that the FDA said have made or sold
unapproved quinine products. The agency added that some manufacturers already
have
stopped selling the drugs; it wasnāt immediately clear if the two companies
were among them.
Also Tuesday, the FDA said interstate shipments of unapproved quinine drugs
must cease within 180 days.
Ā© 2006 The Associated Press. All rights reserved. Ā© 2006 MSNBC.com
********************************************************
HEARTBURN DRUGS LINKED TO HIP-FRACTURE RISK
Nexium, Prilosec may make it harder for body to absorb calcium, study says
The Associated Press
CHICAGO - Taking such popular heartburn drugs as Nexium, Prevacid or
Prilosec for a year or more can raise the risk of a broken hip markedly in
people
over 50, a large study in Britain found.
The study raises questions about the safety of some of the most widely used
and heavily promoted prescription drugs on the market, taken by millions of
people.
The researchers speculated that when the drugs reduce acid in the stomach,
they also make it more difficult for the body to absorb bone-building calcium.
That can lead to weaker bones and fractures.
Hip fractures in the elderly often lead to life-threatening complications.
As a result, doctors should make sure patients have good reason to stay on
heartburn drugs long term, said study co-author Dr. Yu-Xiao Yang of the
University of Pennsylvania School of Medicine.
āThe general perception is they are relatively harmless,ā Yang said. āThey
often are used without a clear or justified indication for the treatment.ā
Some people find relief from heartburn with over-the-counter antacids such
as Tums, Rolaids and Maalox. For others, these medicines do not work well.
Moreover, heartburn can be more than a source of discomfort. People with chronic
heartburn can develop painful ulcers in the esophagus, and in rare cases,
some can end up with damage that can lead to esophageal cancer.
Dr. Sandra Dial of McGill University in Montreal, who was not involved in
the study but has done similar research, said patients should discuss the risks
and benefits with their doctors and taper off their use of these medicines if
they can.
Nexium, Prevacid and Prilosec are members of a class of drugs known as
proton pump inhibitors. The study found a similar but smaller risk of hip
fractures for another class of acid-fighting drugs called H2 blockers. Those
drugs
include Tagamet and Pepcid.
The study, published in Wednesdayās Journal of the American Medical
Association, looked at medical records of more than 145,000 patients in
England,
where a large electronic database of records is available for research. The
average age of the patients was 77.
The patients who used proton pump inhibitors for more than a year had a 44
percent higher risk of hip fracture than nonusers. The longer the patients took
the drugs, the higher their risk.
The biggest risk was seen in people who took high doses of the drugs for
more than a year. That group had a 2Ā½ times greater risk of hip fractures than
nonusers.
Yang said that for every 1,262 elderly patients treated with the drugs for
more than a year, there would be one additional hip fracture a year
attributable to the drugs. For every 336 elderly patients treated for more than
a year
with high doses, there would be one extra hip fracture a year attributable to
the drugs.
Dr. Doug Levine of AstraZeneca PLC, which makes Nexium and Prilosec, said
the study does not prove that proton pump inhibitors cause hip fractures. It
merely suggests a potential association, he said, adding that doctors need to
monitor their patients for proper dosage and watch how long they take the
drugs.
Dr. Alan Buchman of Northwestern University, who was not involved in the
research, said the study should not change medical practice, since doctors
already should be monitoring the bone density of elderly people taking the drugs
and recommending calcium-rich diets to all patients.
āMost people are not taking enough calcium to start with,ā he said. He also
wondered if a similar result would have been found in a sunny climate,
because vitamin D from sunshine helps with calcium absorption.
Also, Buchman said it not known whether the acid-fighting drugs prevent
esophageal cancer. He said the risk of esophageal cancer has been exaggerated in
the marketing of these drugs.
āI think the risk has been overplayed and scared the community,ā Buchman
said.
Heartburn medicines are heavily advertised in āAsk your doctor about ...ā
commercials in this country, particularly during the evening news.
Nexium is the second-biggest-selling drug in the world, behind the
cholesterol medicine Lipitor, with global sales totaling $4.6 billion last year,
according to IMS Health, which tracks drug sales.
Yang and his co-authors disclosed in the paper that they have worked as
consultants and received speaking fees from companies making acid-fighting
drugs.
The study was funded by the National Institutes of Health and the American
Gastroenterological Association/GlaxoSmithKline Glaxo Institute for Digestive
Health.
Men in the study had a higher drug-associated risk of hip fracture than
women, possibly because women may be more aware of osteoporosis and may get more
calcium in their diets, Yang said. He plans more research on whether
calcium-rich diets or calcium supplements can prevent the problem.
Ā© 2006 The Associated Press. All rights reserved. Ā© 2007 MSNBC.com
*********************************************************
RESEARCHERS FORESEE IMAGES THAT PROVE PAIN
(The New York Times News Service)
Researchers foresee a day when people tortured by chronic, unexplained pain
will be able to prove that they really hurt -- evidence that could help
sufferers be taken more seriously and could even lead to better treatments.
Recent studies suggest that prolonged, ongoing pain leaves a signature in
the brain that can be detected using advanced imaging techniques.
In other work, researchers at Massachusetts General Hospital and elsewhere
have found that excruciating nerve damage can be detected in bits of skin the
size of a pinhead. And genetic tests may someday prove useful, researchers
believe: Certain genes appear to be linked to lower pain thresholds and a
tendency to develop chronic pain.
Most of the research remains years from helping patients, but as it comes to
fruition, "what it means is that no longer can they say, 'it's all in your
head,"' said Jim Broatch, who leads an advocacy group for people with a
specific chronic pain disorder.
Clinical proof of pain could make an enormous difference for patients -
emotionally, with unsympathetic relatives and colleagues, and legally, in
battles
with insurers and employers, researchers say.
And as science uncovers more of the objective signs of pain, that knowledge
may help with diagnoses, treatment, perhaps even the development of drugs,
they say.
Late last month, German researchers reported that they had turned up
microstructural changes in the brains of people who had suffered for years from
lower back pain.
The study of 40 patients, presented at the Radiological Society of North
America conference in Chicago, used a type of brain scanning called Diffusion
Tensor Imaging, which can detect long-term changes in the nerve pathways in the
brain.
The scan identified three areas involved in pain processing that showed
signs of heightened activity. It was as though pathways that had started as
single-lane roads had been expanded into four-lane superhighways, as more and
more
signals traveled along them, said researcher Juergen Lutz.
"With these objective and reproducible correlates in brain imaging, chronic
pain may no longer be a subjective experience," Lutz said in a press release.
Other work focuses on the theory that people who have chronic pain may have
something wrong with their pain-killing system.
Last month, University of Michigan researchers reported findings that
patients with fibromyalgia, a chronic pain disorder, have abnormally low levels
of
natural opiate-like painkillers in parts of their brains.
The study, presented at a rheumatology conference, "also just validates that
these people are in pain," said researcher Richard E. Harris.
"They're trying to turn on their analgesic system but it's not enough to
reduce the pain."
Brain imaging of pain is still too experimental for clinical use but that is
coming, Harris said. "I'd say it will probably be five or 10 years until we
can have a patient walk into a doctor's office and say, 'I have pain,' and the
doctor says, 'I want to refer you out to a specialist who does imaging to
verify that or find out where your pain is located,"' whether in the brain,
spinal cord, or elsewhere, he said.
Proving the presence of pain through genetic testing is probably even longer
away, Harris and others said. Several studies have established a link
between a gene known as "COMT" and pain disorders, including one that can affect
the jaw; a mutation in that same gene seems to predispose people to low
pain-killing opioid activity in the brain and low pain thresholds, published
research suggests.
Other work is much further along. At Mass. General, for example, Dr. Anne
Louise Oaklander is already measuring "the objective correlates of pain" by
counting the numbers of pain-sensing nerve endings in tiny skin samples from
patients with unexplained pain. Paradoxically, patients with previously
unexplained pain tend to have fewer such endings.
Such skin biopsies allow researchers to diagnose "small fiber neuropathies,"
the nerve damage that is sometimes a side effect of diabetes and other
diseases. The nerve endings are so tiny that they have been largely invisible,
Oaklander said, but skin biopsies are "opening a window into the pain system,
allowing us to see when it is damaged."
Oaklander's work recently helped a college athlete who suddenly began
experiencing an unbearable burning sensation in his palms and on the soles of
his
feet, according to a paper slated for publication in the February issue of the
journal Anesthesia & Analgesia.
Greg Palladino, a lacrosse goalie at Southern New Hampshire University, was
on a team trip to Bermuda last year when he began suffering a pain that only
submersion in ice would alleviate. It was as though broken glass were running
through his veins, he told his doctors.
He returned home and was treated repeatedly at area hospitals for weeks.
Despite extensive tests, the doctors were baffled, said Palladino's father,
Steven. Drug after drug failed to help, and he lost 55 pounds in a matter of
weeks.
When Oaklander was called in, she did a skin biopsy that showed conclusively
that Palladino's "erythromelalgia" -- his red, burning appendages - stemmed
from severe damage to small nerve fibers that apparently came on because of
an auto-immune reaction. For some reason, his body had started attacking its
own nerve cells.
The biopsy gave doctors the confidence to put Palladino on enormous doses of
steroids to stop the auto-immune attack, and he has almost completely
recovered, his father said.
Palladino was - in a way -- lucky that he had tissue damage that could be
detected; many patients, Oaklander said, have very real pain that is caused by
undetected problems in their nervous system, afflicting them with "an
invisible disability that leaves no traces."
"It's a wiring problem," she said. "It's like when your oil light on your
dashboard goes on, and you think, 'My car must be low on oil,' but you pull over
and check your oil and it's fine, and you realize it's an electrical
problem. These are people who have electrical problems in their pain system,
and
their neurons are firing as much as if they had a broken leg, only their leg is
fine."
For patients with chronic unexplained pain, the lack of physical proof of
their suffering compounds it, pushing some as far as suicide.
"You feel like you're malingering, you feel like you're crazy," said Mary
Beth Ludington, patient representative for Jim Broatch's group, the Reflex
Sympathetic Dystrophy Syndrome Association, which helps people with pain
disorder. "I used to feel like a wimp until I was diagnosed. Then it was,
'Hallelujah! I'm not crazy and I'm not a big wimp! There's a reason for this,
and a
name.' It really validates the suffering that a lot of people go through."
Copyright 2006 The New York Times News Service.
**************************************************
Editorās note: In 2007, I will be reducing the number of newsletters to once
a month. When news items are especially heavy I will, on occasion, publish
an additional newsletter as warranted. I have certainly enjoyed bringing you
ā
the newsā during 2006 and hope that it has been helpful to you.
Good Health to All,
Jack Nicholas
Newsletter Editor
_Cornishpro@..._ (mailto:Cornishpro@...)
Issue 2006- 15
12/30/06
If you no longer have a choice, you might want to do some research
to see if there are any versions out there that would permit
swimming on a regular basis.
If you have a Broviac or Hickman catheter implanted in your chest or
a PICC line implanted in your arm, swimming would not be allowed.
There is a device that is implanted in the subclavian vein
completely, underneath the skin of your right or left chest if
possible. Swimming WOULD be allowed with that device, since it is
completely enclosed under the skin. The problem is if you are afraid
of needles, since every time you are given the infusions, they must
insert a special needle into the center of the port through the skin
above it. Also, with this device, if your docs are hoping to be able
to draw blood from it....sometimes you are able to do so with this
device and sometimes not....with the peripheral and central line
catheters you are always able to draw blood. Another thing to
consider, is that if for some reason your venous anatomy is
difficult (really tiny veins, "twisty" and rolling type veins, etc.)
they may not be able to use the venous internal port because of
physical reasons and may be forced to insert one of the external
catheters instead. (At the childrens hospital, they were able
sometimes to insert the port abdominally instead of in the chest in
little kids, but that option wouldn't be feasible in an adult
because of weight issues causing pressure on the port and possible
dislodgement of the IV infusions and infiltration and so on.)
Hoping things work out for you!
Wanda
Casey,
Thanks - you are so right! I have had several experiences where my
pharmacist caught a drug interaction that my doctor should have or
advised against taking certain supplements while on a certain
medication. I find talking to the pharmacists a lot more comfortable
most of the time.
My Mom, who has lived with Lupus for almost four decades, highly
recommends a close and friendly relationship with your pharmacist.
She says that doctors come and go with insurance changes, but your
pharmacist is there with you for the long haul!
Mine has been quite helpful in discussing alternative therapies - I
don't have insurance and for personal reasons, cannot take DMARDs - I
know they stem the progression of the disease, but it doesn't make it
any more possible for me to take them - so better to find something
that helps and improves my quality of life than to do nothing.
Thank you,
Brande
Dear Lisa and Cornth1313,
Both of your emails really got my attention. First of all, Ive been in
pain management now for over 6 years and have no doubt it saved my life many
times over the past years. Like anyone who doesnt have a drug problem, I
never wanted to be put on narcotic medications, but I soon learned that my
life really depended on it.
For me, everything Cornth1313 said in his email made perfect sense. The
long-term stress of chronic pain disrupts your life, your health and your
ability to even cope with day-to-day problems. The thought of toughing it
out no longer makes any sense and is actually dangerous. The longer
chronic pain goes untreated, the worse it gets and the harder it becomes to
ever control it. Ive learned a lot about it over the years and by dealing
with professionals who understand pain I have always treated with respect
and compassion. No one has ever doubted my pain or ever accused me of
taking too much medication or abusing my medications. I think with time and
more education, people will finally understand pain control one day. It
will make it so much easier for everyone and hopefully take the stigma off
of all of us who have to use pain meds.
Lisa, using Vicoden could possibly be one of your pain problems. Its not a
really good long-term pain medication. For one thing, it causes you to go
up and down and can cause highs and lows, which isnt good for your body.
Being on a time released pain medication makes more sense since you never
experience those highs or lows and your pain is hopefully under constant
control. Of course, things dont always go as well as everyone hopes and
pain can be unpredictable. So I also have a break through pain medication
if I need it in between my regular doses. If I were you, I'd go a pain
management doctor ASAP. What do you have to lose, except the pain and
misery?
Also as far as the fatigue you are experiencing, I take a wonderful drug
called Provigil, which is normally used for sleep problems. It keeps me
awake during the day and helps tremendously with the horrible body fatigue.
My daughter who has suffered with severe ibromyalgia for almost 10 years
feels it has saved her life. Before, the fatigue stopped her from leading a
normal life and she had many days a week that were lost to fatigue. Since
going on Provigil, she has almost finished college and feels like for the
first time she might be able to work full time when she gets out. Hopefully
your doctor has heard of it and wont have any problems prescribing it for
you. So far I havent had any side effects and Ive been on it now for over
18months. I hope you have the same benefits from Provigil that I get and
your doctor doesnt have a problem prescribing it yet. Certain areas of the
country seem to be more up to date on this drug and its safety while using
it on a regular basis.
Like you Lisa, Im also on steroids and I worry about those 10 times more
than I do any of my pain medications. First of all, the side effects are
horrible and the longer you are on them, the more damage that is done to
your body. For me though, I cant get below 10mg due to my asthma and
arthritis.
As far as not liking yourself or hating yourself due to taking pain
medications, it makes me wonder if someone else is putting pressure on you
to quit or making you feel bad for having to use narcotics? You dont look
down on someone for taking Enbrel or Humira do you? To me pain control is
just as important and helps me function since PA drugs only work part of the
time, and for some of us not at all. I think you are being way too hard on
yourself for needing pain medication. Im one of those people who have a
lot of guilt issues and so I can understand how you can feel bad about
yourself at times. I had a real hard time at first when I got sick. I
couldnt work anymore, and I felt like I was letting my husband and my girls
down all the time since I couldnt do anything at home either. I still
dont drive anymore, I still dont work either (my husband and I worked
together in our family business before all of this hit me) and I still have
issues on feeling guilty at times. But I dont have any guilt problems with
my medication. I wish I didnt need so many drugs to survive, but Im glad
they are available for me while I do need them.
One other point and then Ill end this long email. At almost all pain
management clinics, they have psychologists on hand to help you deal with
guilt, and other problems that come about from dealing with chronic pain.
Hopefully if you find a good clinic, you can get some support on several
levels. I know it helped me to have someone to talk to about all the
changes that I have gone through in my life.
Anyway Lisa, good luck and thanks again Cornth1313 for such a great email.
Fran in Florida
Hi Everyone,
I have been on Prednisone for close to 2 yrs now. I take between 2.5 mg to 5
mgs. The last time I was at my RD's he mentioned that the Prednisone--after
he diagnosed PA--would help clear up the Psoriasis lesions. The ones I have
had on and around my eyes and on the back of my scalp have cleared up yet I
still itch even inside my eyes. Does anyone else have this problem? And is
there anything that can be done to help this?
Thanks in advance for any help with this.
Hugs,
KarenCorie
--
SPEEDY :-)
Meds:
MTX 15 mg; Prednisone 5mg; Leucovorin 5 mg; Armour Thyroid 60 mg
Supporters:
MSM; DHEA 25 mg; Omega3 fish oil 8 daily; Vit. C; Vit. D; B-Complex; Vit
B-12;
Lithium Ortate; Osteo Comlex; Glucosamine & Chondroitin; and Essential
Minerals, AND CALCIUM 1500 mg
"Love endures all things."
great MSN animations:
http://groups.msn.com/TheAbyssOfAnimation/
Dear Lisa,
Your message touched me. I too worried about becoming addicted to
narcotics for my pain. My dr. told me to not worry about it because
I would be addicted to some drug or other before I died. That made
me mad until I discussed it with a friend of mine who happens to be
a nurse. She told me to take the vicoden as directed by my dr.,
whether I was in pain at the time or not. She explained that you
have to build up enough of the drug in your system to keep the pain
in check. Waiting until you are in pain is too late. The drugs may
not be able to bring your pain level back down to something
manageable. Chronic pain makes me depressed and depression adds to
my pain and makes my body exhausted from fighting it and the
exhaustion comes from the same PA that causes the chronic pain. So
it is one big FAT rut that we're stuck in. Drugs are necessary to
help us continue to function in whatever capacity we have left. And
the biggest thing is the fact that pain makes your blood pressure go
up and who needs a heart attack or stroke on top of everything else?
So what if I walk around in a fog all the time? At least I can't
see well enough to tell if it's the drugs or the disease that's
making me blind and at least I don't care as much that life is just
not fair.
Hey! Thirty-five years ago I would have considered this as "cool"!
Take care,
Sib
i can't understand why that would be a rheumatologists first choice for a 5
year old . but I would get another opinion. Doesn't sound quite right to me.
cathy from ma
Hello,
I could use some advice. My daughter's rheumy is talking about
putting my 5 year old daughter on MTX at our next visit. I hear such
horrible things about the side effects. Has anyone in this group
started taking it at such a young age? How do you deal with the side
effects in a child. Is it too early to start? Should a different
medicine be tried first. I know it's probably a necessary evil, but
she is my baby after all.
I am also on Lyrica and this is the only drug that helps the pain in my back
from the herniated disc. More people should be aware of it.
Heather
Ontario
HI Misti!
You have come to the right place! You are welcome
here and we accept you and your PA! I understand about
losing the husband and the job my marriage was only 8
years and the job was 10 but it was very hard
emotionally. You could be having some depression going
on with everything else. Talk to your Doctor about it
there is a test that you can take to see if there is
some depression or not. If so don't be scared of
taking something for it, believe me I take 60mg. of
Cymbalta, 80mg. Prozac and 20mg of Buspar, plus 1mg
kloponin 4 times daily. I have felt sorry for myself
since I was Dx. in 2004. It has been a long time but I
have finally realized that I can still have a life! I
just have to know my limits on what my body can do and
there are men out there that will love you for WHO you
are and not WHAT you can do or not do. I thought I had
found mine but, having spent a lot more time with him,
even though I am sick I still demand respect and he
can't seem to stop helping out the ex girlfriend so
now he has another ex! I know that if God intended me
to be alone I can be happy and if somewhere down the
line I find somebody I can still be happy. As long as
I am happy with me! Right now we have to get you to
that point of where you are happy with WHO YOU are,
believe me YOU ARE SOMEBODY!!! The soon to be ex
doesn't realize what he has it takes a very strong
person to handle PA and still live each day as
"normal" as possible. It is his mistake, as far as the
job you should be able to get SS disability, I did. So
being a stay at home Mom has really brought my son and
I a lot closer and I have realized that nobody sick or
healthy is guaranteed tomorrow, if you have a higher
power call on him for help and learn to lean on him
according to the bible that is what he WANTS us to do
anyway, he is our father and who better could we lean
on? I so hope to hear from you again soon and you are
in my prayers like everyone else here,
By the way....... has anyone heard from Mike
lately?? If you are reading this I am thinking about
you and your zoo!! Sharon
Lisa,
This might be a little late because I haven't been on
for a few days but I wanted you to know that I can not
take any of the new meds either. I also have chronic
fatigue, and pain with swelling of the joints and the
bottom half of my spine is fused together now. I know
how you are feeling. I am taking Lyrica for the nerve
pain which is like celebrex without so many side
effects according to my Doc. I am on a narcotic, only
it is physically addicting not mentally and it is
Advanza. It is time released and it helps all day
long. When you go to bed at night try doing relaxing
things like taking a warm bath, some say warm milk
helps them sleep. Just whatever makes you relax try
everything you can think of that might help you. I had
my thyroid taken out too, several years ago. I hope
the xanax helps you, also try other relaxing methods.
You are always welcome to vent here that's what we are
here for each other because all of us know how we are
all feeling, and we learn from each other also. You
are in my prayers Lisa I hope you find relief soon.
You can have a full life, like you mentioned just
don't overdo it, listen to your body it will let you
know so much about yourself you will be amazed. Once
you know your limits, then the sky is the limit
again!!! I have realized in the few weeks that we can
have a life once I got over feeling sorry for myself.
It took me 3 years don't let it take you that long!!
You have found a wonderful group of friends here, one
of our best cheerleaders right now is really having it
rough her name is Betz, I pray for her like I will for
you.
Sharon
My late DH had a port to deliver his chemo. My mother had one put
in a couple of years ago after a midnight visit to the ER. Her
viens are so scarred from years of illness that it took almost ten
hours to get access so they could give her any medication.
Once the port is in place and the small cuts have healed you
probably won't have a bit of trouble. the port lies under the skin
and the stick to access it is just hitting a target with a dart to
deliver meds or draw blood.
They do have to be heprin flushed once a month, but if you are
already on Remicade, they will do that when you have your
infusions.
DH insisted that hospital staff use the port for blood draws. This
is not their usual procedure so some staff is reluctant to do this.
he had to get insistent about it a couple of times, but he always
won in the end....
Giving Benadryl to counter reactions to meds isn't unheard of. I
had to take amphitericin for a fungal lung/blood infection a few
years back. This stuff is notorious for causing SEVERE, UGLY, and
DANGEROUS reactions. The medical community finally figured out that
if they gave a nice dose of Benadryl before the infusion, that the
reactions were much reduced. I'll take a few hours of drowsy over
shaking so much that the bed rattles any day!
It may be that the reactions to MTX aren't that horrible, and, since
Benadryl is an antihistamine, it is a 'non-sanctioned' use. So your
Dr can't recommend it...
I wish the chair was an option, but the job requires moving constantly. Plus I
have nothing else to go to. I have no qualifications to work in an office or
anything like that. Besides, I've filled out a lot of application for office
jobs and no luck in landing one. They all say they'll call. I call and it
doesn't do any good. Still nothing. I have the best insurance where my husband
works at Mohawk. It's the GOLD plan and it's the best they have, but my bosses
are worried about me but what can you do if you can't perform what they need. I
talked to them and they want me back. I told them that some one will get mad if
I can't pull my weight, but she said they better leave me alone. So, we'll see.
I have an appt with my family doc in the morn and one with my orthoped on Jan
16. Just hang in there with me. Don't give up on me. I really need you guys.
Just reading your posts makes me think about a lot of things. Love Beth
[Editor's Note: Beth, I don't know exactly what you do, but have you considered
purchasing, through insurance or otherwise, an electric scooter or wheelchair?
Many of them come fitted out with large baskets if you need to transport things
like files and such. They fit in extremely narrow spaces. You might be able to
use this on the job and instead of being slower than the others, you could,
potentially, do your job even faster. Another thought is to look around your
area and see where the jobs are. What industries or companies are growing?
What kind of help do they routinely need? You might be able to take a night
course that would train you to do some other kind of work that IS inside an
office (e.g. medical transcription, receptionist, telephone orders, insurance
associate, etc. You might have to take a cut in pay initially if you switch
careers, but it would give you a future and it might provide more pay than
disability. Don't worry. We'll hang in there with you. We won't give up.
Kathy F.]
dreimutter1957 <dreimutter1957@...
I'm going to be able to do my job. I have a
stand up job and have to use my hands constantly.
Beth, you probably need to speak with the management at your job. By
law, your employers must give you REASONABLE accomodation to enable
you to perform your duties. As Kathy said, see if they can give you a
tall chair or something to sit on if that would help. That certainly
falls under the heading of reasonable accomodation. Also, along with
the Methotrexate, physical therapy helps a LOT to maintain flexibility
of joints, hands, and so on. And many of us here use one of the
biologics, like Enbrel or Humira or Remicade along with the
Methotrexate because both together seem to work better than either
alone.
I would say applying for disability should be your last resort; my dh
was one of the lucky ones who got his disability (for a refractory
seizure disorder) on the first try, but most people are denied at
least once and have to resort to hiring a disability lawyer to get
accepted. When you DO get disability, you get only about 3/4 of what
your pay was at the MOST.....it's not a whole heck of a lot of money
to live on. If we had to live on dh's disability income alone, we
would be homeless, to put it bluntly. Plus, after you've been on the
disability for 6 months, then Medicare kicks in, and they deduct
premiums for the Part A and Part B and for the Medicare prescription
plan you choose.....(and most of the Medicare prescription plans are
really awful, with the donut hole gap and limiting the drugs you can
have to what's on their formulary and stuff.)
Another thing you may want to do is make a list of your
accomplishments and see if there is another type of employment you
could do that would be less physically demanding....that's what I did.
I did have to be on medical leave from my job (paid as short-term
disability) for 6-9 months when I was first diagnosed. I worked as an
RN in a teaching hospital, and my PA showed up as psoriatic
spondyloarthritis. It also affected my hip terribly. Before starting
the Methotrexate, I could barely walk.....had to hobble about my house
using two canes.....can't exactly charge up and down the halls taking
care of 28 or so patients in that condition! After about 6-9 months on
the Methotrexate, I was able to walk short distances without any canes
but had a bad limp......I had to leave hospital nursing and switch to
office nursing which is far less physically demanding. Since then,
I've had a hip replacement and started Enbrel and am doing TONS
better. I still wouldn't be able to do hospital nursing, I don't
think, though.....lifting and moving immobilized patients about would
DEFINITELY kill my back. In the office, the patients climb up on the
exam tables themselves.....I don't have to lift them :)
Wishing you improved health SOON.
Wanda
[Editor's Note: Great post, Wanda. You've provided a number of wonderful
suggestions as well as an inspiring testamonial. Kathy F.]
Hey girl, you're back! How did the surgery go and how are you feeling?
I've been thinking about you! Are you at home now, or at a rehab
center? How are your kids and dh coping? Wishing you a QUICK and
SMOOTH recovery!
Wanda
CM Pete,
I am so happy for you that you can now straighten your right leg. That must
give you an amazing amount of relief, especially when you realize the medicines
are doing their job. I was also diagnosed in September. I am on Arava. I
started to notice that my medicine was working around mid December. I actually
woke up in mid December three days in a row almost totally pain free. This week
has also been a prettty pain free week. Since mid December, I have been able to
change my anti-inflammatories from Arthrotec(which is very strong) to one Aleve
a day, if I even need that. This week, I haven't even needed Aleve. For me,
the biggest difference has been in my feet. I used to limp every morning, now
my feet are almost 100% better. My hands still have some soarness and a little
swelling, but it is very tolerable. I hope you continue to feel better,
especially with your frozen shoulder.
Julie from FL.
CM Peterson <cmquilts@...
Yesterday, for the first time since July, I could
straighten out my right leg!!
I was dx'ed in September, I am on MTX, Humira, and
Celebrex. I've had one severe flare and another
mini-flare since then.
I was doing stretching exercises at my desk and
realized that my leg was straight! It has been so
long, I forgot that it could happen....
At any rate, this is a commercial for 'hang in there'.
Sometimes you just need to let the meds build up in
your system to get the FULL effect.
Now if I could just get the shoulder to un-freeze.
CMPete
Quilts With Poodle
'.....now times are rough and I've got too much STUFF!!'
J.D. Buffett
I have a blog now!! And there is ACTUALLY stuff on it!
http://cmpetequiltspoodle.blogspot.com/
I have done some research, Casey. This site was founded in 1998. On
Feb 19, 1999, the first post touting the benefits of taking Benadryl to
ease nausea from MTX was posted. There have been 191 posts since then
with "Benadryl" in the heading and while I have not re-read every one,
I can never remember seeing a single post that did anything other than
tout its benefits. Perhaps people didn't respond to your post because
they were busy or we may have had a discussion on that very topic just
before you joined. I can't recall seeing a single post that was
against taking Benadryl to ease any adverse MTX symptoms. Given that
we have a constant churn of new members, please continue to extol the
benefits of Benadryl whenever you see a newbie struggling with nausea
from MTX.
Kathy F.
Researchers at the Mayo Clinic have produced a new breed of transgenic mice
with autoimmune responses similar to human RA patients and increased
incidence of the disease in females. Featured in the January 2007 issue of
Arthritis & Rheumatism, this humanized mouse model may be valuable for not
only studying sex differences in RA, but also for understanding why women
are particularly vulnerable to autoimmunity and for developing future
therapeutic strategies.
IF YOU KEEP DOING WHAT YOU'VE ALWAYS DONE, YOU WILL GET WHAT YOU'VE ALWAYS
GOTTEN
Maraika Mason
Degenerative Disease Resourced Information
Clin.Nutrition
www.4betrhealth.com
Get A Good Start In 2007: Ring In The New Year With FoodFit's Seven Steps
For Healthy Living
As the holidays come to a close and regular routines start again, it can be
difficult to find time to stay true to New Year's resolutions. Recently
acquired by FoodFit, a healthy eating and active living Web site, consulted
nutrition, health and fitness experts to come up with seven simple steps to
take for better health in the New Year.
"The New Year is a crucial time for establishing healthy lifestyle habits,"
said Ellen Haas, FoodFit.com's Founder and President and former
Undersecretary of Agriculture for Food, Nutrition and Consumer Services.
"Follow these tips to help incorporate the two basics of a healthy diet --
balance and variety -- into your everyday routine."
The Seven-Step Plan:
1. Start Early -- Eat Breakfast
A breakfast high in fiber and carbohydrates but low in fat gets your
metabolism moving faster.
If you are pressed for time, grab a banana or a bag of dry cereal.
2. Size it up -- Keep Portion Control in Mind
Be sure to read the food label. Many snacks are sold as single servings but
actually provide two servings or more.
Substitute one or two "first course" dishes for the main; you'll get a
variety of tastes without huge portions.
3. Plan Ahead -- Prepare Healthy Snacks
Have a corner in the fridge for good-for-you munchies.
Wash some carrots or celery sticks, cherry tomatoes, peppers, shelled peas,
strawberries, and blueberries.
4. Small Changes Can Make a Big Difference to Your Waistline.
Choose low fat. Switching to 1% or skim milk from 2% cuts the fat by at
least half.
Eat your fruit instead of drinking it.
5. Every Step Counts -- Fit Fitness in Throughout the Day
Balance on one foot while brushing your teeth and the other while combing
your hair.
Take a walk every day.
6. Remember the Basics -- Follow the Three Rules for Healthy Eating
Expand the variety of foods in your diet.
Add more fruits, vegetables and whole grains to the foods you already eat.
Select more lower-fat food choices.
7. Treat Yourself
Pick a day or two in the week and have a treat that is planned, such as a
dessert or entree that you especially enjoy.
Try meditating, yoga or an old-fashioned nap.
IF YOU KEEP DOING WHAT YOU'VE ALWAYS DONE, YOU WILL GET WHAT YOU'VE ALWAYS
GOTTEN
Maraika Mason
Degenerative Disease Resourced Information
Clin.Nutrition
www.4betrhealth.com
Yesterday, for the first time since July, I could
straighten out my right leg!!
I was dx'ed in September, I am on MTX, Humira, and
Celebrex. I've had one severe flare and another
mini-flare since then.
I was doing stretching exercises at my desk and
realized that my leg was straight! It has been so
long, I forgot that it could happen....
At any rate, this is a commercial for 'hang in there'.
Sometimes you just need to let the meds build up in
your system to get the FULL effect.
Now if I could just get the shoulder to un-freeze.
CMPete
Quilts With Poodle
'.....now times are rough and I've got too much STUFF!!'
J.D. Buffett
I have a blog now!! And there is ACTUALLY stuff on it!
http://cmpetequiltspoodle.blogspot.com/
Ann: I wouldn't be scared of the port itself. I think, implanting the port is
routine. What goes into the blood, that what would scare me most.
Wish you feel better.
Kevin
[Editor's Note: Kevin is right - the implanting of the port is a simple matter.
As long as you follow instructions for keeping the catheter clean, there should
be no reason to fear an increased risk of infection. Swimming, however, will
most likely be off-limits so if you have a choice about whether or not to have
one implanted, your love of swimming will be a factor in your decision. If you
no longer have a choice, you might want to do some research to see if there are
any versions out there that would permit swimming on a regular basis. Kathy F.]
Ann Christmann <fetchinn@...
Pleas Help, I am so scared
HI I have suffered for over 20 years, with PA and then had Breast cancer thrown
into the mix.
I take Mobil, Folic acid, remicade Iv every 6 weeks, and Gama goblin Iv every 3
weeks, I was on zithromax for almost two years, developed a colon infection, and
had to get on vancomycine to cure that, It is always something. I had one
infection after another, 13 abeccessed teeth, strep sinus infection, requiring
surgery, until i got on Gama goblin, and my skin color was so yellow and my legs
and arms were so infected! I lived sitting in hot tubs, when tub was not
available I would use a hair dryer on my skin. I could not walk up stairs. Did I
ever get restless legs, butr we have concluded that may be caused from the
bendryal, when the give me iv benadraly, it is put in to fast it drives me nuts
So I started the new medicinces and joined a water therapy class, finally i was
able to walk in and out of the pool, after much persistence I am working out 3
to four days a week, pain or no pain.I was originally put on predisonee to clear
my skin and my arthritis, all i have to show for that is a buffalo hump that is
not going down., and type 2 diabetis.
My new delimina, you all know remicade can hurt our immune system and cause
infections-well having tried 3 days with 6 sticks one day 2 the next, they want
to place a poirt in my artery so they can access it for all my blood draws and
infusions. Does anyone have any feelings about this and infections It is rather
scarey for me.l I have two implants from the double masectomy under the muscle,
My rheummy is worried about infections with Remicade? Anyone have any feed back
for me?
My rheummy, internist, Infectious disease, and my hemotologist oncologist all
work well together, and does the dermey, now this adds another doctor to the
mix, a surgeon.
Hugs
Ann
P.S. Does the port limit you I am an out door girl, i have heard it is hard to
wear a seatbelt over it, I like to swim in fresh and salt water, and sun bath a
little, cause that seems to help the skin on my arms and legs, and i exercise
with circuit weights at the local health club , .
karencorie66 <ladyspeed@...
Welcome to the group. I'm sorry to see you share the same diagnosis.
But glad you found the group. I know it has been the help I was
looking for.
I can't really help you on the employment thing since I haven't been
employed over 7 years due to this. I am not able to stay focused due
to the pain and brain fog. I find at times I can't even spell the
easiest of words.And my fatigue levels are soaring high.
I hope you can receive some answers from the other members here. I was
offically diagnosed with this disease about a week ago even though I
was diagnosed with an inflammatory arthritis that was like RA at age
12, and I just joined the group myself.
I hope you can achieve a controlled state with your disease quickly.
Hugs,
KarenCorie
Pleas Help, I am so scared
HI I have suffered for over 20 years, with PA and then had Breast cancer
thrown into the mix.
I take Mobil, Folic acid, remicade Iv every 6 weeks, and Gama goblin Iv every
3 weeks, I was on zithromax for almost two years, developed a colon infection,
and had to get on vancomycine to cure that, It is always something. I had one
infection after another, 13 abeccessed teeth, strep sinus infection, requiring
surgery, until i got on Gama goblin, and my skin color was so yellow and my
legs and arms were so infected! I lived sitting in hot tubs, when tub was not
available I would use a hair dryer on my skin. I could not walk up stairs. Did
I ever get restless legs, butr we have concluded that may be caused from the
bendryal, when the give me iv benadraly, it is put in to fast it drives me nuts
So I started the new medicinces and joined a water therapy class, finally i
was able to walk in and out of the pool, after much persistence I am working out
3 to four days a week, pain or no pain.I was originally put on predisonee to
clear my skin and my arthritis, all i have to show for that is a buffalo hump
that is not going down., and type 2 diabetis.
My new delimina, you all know remicade can hurt our immune system and cause
infections-well having tried 3 days with 6 sticks one day 2 the next, they want
to place a poirt in my artery so they can access it for all my blood draws and
infus