As promised: Notes on osteoarthritis - do you have it?

The Osteoarthritis checklist:

1. age > 40  ____

2. female     ____

3. overweight to obese ____

4. pain in knees on standing and prolonged walking ____

5. hand most peripheral joints painful and growing knobs ____

6. neck and lowback pain ____
7. experienced pain in the above joints for more than 3 months _____


Two sets of hands of 2 females
first degree cousins

8. a close relative positive for the checklist? _____

There it is. Check, check, check, check for 4 or 5 items?

Osteaorthritis is the most common joint disease that affects man (dinosaurs were shown to have this arthritis!). From the above check list, one sees that it is an arthritis of the middle aged to the elderly, mostly women (men, too), and causes pain during use, in specific sites. It can be inherited, and is shown to affect the hip joints less in Asians than in Caucasians.

Good news!

Come in for consult early. The rheumatologist and physiatrist can be the best starting points (surgery can be avoided, you know):

1. There are safe ways to control pain:

                physical therapy consisting of appropriate exercises and muscle strengthening
                occupational therapy with appropriate foot wear prescription
                weight loss
                low doses of paracetamol

    2.   There are ways to control deformities:
              
                occupational therapy consisting of
                     lifestype adaptation techniques, for example 
                        special ways to   open doors, carry objects etc
                splints if deformities have set in

    

Notes on a "new year"

 Even if it is just another day,

labeling it with the start of a set of numbers

makes it sound so different, so hopeful.

It is a wonder that just by doing that, we can feel that we are facing a new

 --hmmm well, something.

It's amazing how the mind and feelings respond to numerical suggestions,

in such a hopeful note!

Remember, it is just another day -

the new year is a tomorrow we experience day in and day out.

Let us make January 1, 2012 a special tomorrow

and like every tomorrow, know what we Hope -

Romans 5:2 !

Blessed tomorrow, and tomorrow, and tomorrow...

Arthritis tid bits

 Arthritis:   

Take the test:
1. Who painted this piece?

Answer: _______________

2.What arthritis was thought
to have afflicted this great painter?

Answer: _________________________________________

For the tid bits now....

• common in the elderly - osteoarthritis
• common in middle aged men - gout
• common in middle aged women - myofascial pain syndrome, fibromyalgia
• common in children - growing pains of childhood, juvenile idiopathic arthritis
• common in promiscuous males/females - infectious arthritis, reactive arthritis
• common among those with Turkish and Japanese descent - Behcet's Syndrome
• common among ethnic Chinese and European descent - ankylosing spondylitis

Watch for further posts on these conditions or look them up!

What precipitates a gout attack

Gout has been called the "king of diseases" (due to the extreme pain and disability like no other that it causes) and the "disease of kings" ( due to many a royalty who did have this arthritis). The source of such descriptions I cannot trace currently, but if I am not mistaken, these still appeared in the 9th edition of an important medical book, c1981. The most recent edition of the same, 18th ed., no longer carries such description (shame).

And while excessive intake of most food (red meat, alcohol, shellfish and innards) is the popular cause of such debilitating arthritis, there are other known precipitants in susceptible individuals, that should be checked and removed or replaced, if ever very necessary. There are 3 important ones that are commonly taken and many times necessary:

1. low dose aspirin (dose given as blood thinner to prevent heart attacks)
2. antihypertension drugs containing hydrochlorothiazide ( as a single agent or combined with other drugs for hypertension, prefixed or suffixed in many preparations as "plus" or "co" )
3. anti tuberculosis medicines

Tips on what to do:

1. The heart specialist can replace your low dose aspirin with other blood thinners ( please, only  if you have the real severe, exquisitely painful joint in  gout -usually the big toe, andkle and knee- not any body ache or pain!) 
2. Your doctor can also change your antihypertensive medicines to replace the hydrochlorothiazide part (which is a good drug for hypertension and can be used in non-gouty individuals, of course)
3. Your rheumatologist together with your infectious disease or family doctor can modify your anti tuberculosis medicines.

Sleep lack and arthritis - any link?

Yes indeed, there is. Have you ever gone through night or nights without sleep, or a jet lag perhaps and got aches all over, aside from feeling heavy, and feverish? If you haven't, you must be the exception- contact me!

It is now known that the sleep wake cycle (meaning sleeping nights and awake daytime, not the other way around please) directs special hormones and blood elements called cytokines, to switch on and off important brain centers and specialized organs, to create a refreshed state - this, usually after a night sleep of 7-8 hours. Short of this, (which most of us have), these blood elements direct what is known as "sickness behavior" -fatigue, pain, reduced activity, depressed mood, decreased sexual behavior and a string of other disorders.

Ever wondered why when you should just go on and sleep after a grave yard shift, you can't because of muscle and joint pains? This is part of the sickness behavior. Sustain the wakefulness another day or for several more days, the sickness behavior can blow up into actual illness - inflammation of joints, blood vessels, and other organs. In fact, after a night of lack of sleep, the blood examination CRP, can be elevated, and this has been traced to higher risk for heart attacks, among others.

Sleep  is the periodic suspension of consciousness during which the powers of the body are restored. (Mirriam-Webster)

Sleep equals restoration- simple and fair enough!

If you are in a sleep predicament:

1. Go see the sleep specialist (a pulmonary internist, a neurologist or an ENT specializing in sleep)
2.  "have to" shift that shift - dont get stuck in the graveyard one
3. Insomniac? Check your sleep environment - flickering tube light, laptop light, must be replaced with a yellow steady light of the old fashioned incandescent bulb and a good book (added personal endorsement here)
4. Block off that noise (snoring significant other needs # 1 and for the neighbor karaoke-ing, ear plugs, you can find good ones in Handyman or Ace...)
5. Warm glass of milk? - some do with coffee ??? or tea ...

  

clip art, Windows

Go get enough sleep!

Rheumatism in December - Is rheumatism (arthritis) seasonal?

Is rheumatism (arthritis) seasonal?

Not really.

There are aches and pain in and around joints or in muscles that are related to unaccustomed activity. Take these cases:
- 56 year old female, hospital worker (mostly seated in the lab), complains of heel pain about 3rd week of December. Her heel is tender to pressure, in the sole more so.
- 65 year old lady has swelling of theleft knee in the first week of December, and remembered the same condition some years back during the holy week.

Common to the 2 cases are gender and age group and one other fact, which many times, could be missed during the doctor visit - both had spent an average of 5 hours doing Christmas shopping, and for the second case, walking in a religious procession for at least 3 hours.

Does this feel familiar? Here are some tips to avoid this bane:
1. Check out those shoes. Get into a comfortable soft soled footwear, with enough arch support (or buy one during the shopping)
2. Have regular rest periods during the outing - clue is don't wait for discomfort in the calf muscles before finding a seat, so this should be about every 30 min for some, 45 min or even 1-2 hours for the younger ones.
3. Cold packs around the ankle area can help after a long shopping walk - just for 10 minutes, while putting up feet to rest.