Tag Archives: rheumatoid arthritis

A little help from my (rheum) friends . . .

Some great pieces from my international colleagues lately!

Dr. Irwin Lim discusses the role of methotrexate therapy here and here. Thanks, Irwin, for your insights.

Also check out his recent video which helps me explain to patients why allopurinol may actually cause a gout flare.

Finally, let’s travel over to Ireland and check out the many videos by Dr. Ronan Kavanagh. Great work, Ronan! (Irwin I see you’re on clear.md as well – I think I’m going to leave the videos to you guys and I’ll keep to the written word). So pleased to be able to share and collaborate with rheumatologists all over the globe.

Photo: taken at the Highland Games in New Hampshire

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A Helping Hand

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“You HAVE to tell all your patients about this! It’s the BEST gadget I’ve ever tried – and believe me, I’ve tried dozens!” said my patient as she pulled this out of her purse the minute I walked into the exam room. She’s not a representative of the company in any way. In fact, the brand isn’t anywhere on the gadget. It’s a 6-in-1 tool that can open soda cans, bags, bottles, jars. Anyway, if you can find it, my patient says to snap it up (and wanted me to spread the word on the blog).

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RA Update

This is a nice article highlighting various experts’ opinions.

http://www.acpinternist.org/archives/2010/07/arthritis.htm

The Lazy Blogger Award

Is there a Lazy Blogger Award? Well, if not, I am officially giving it to myself. Congratulations, Doctors’ Rheum, you’ve been a really lazy blogger!!

However, I have been reading blogs and trying to comment here and there and really appreciating some new commenters on my older blog entries. Let’s just say we in New England aren’t used to long stretches of hot, humid air and I think my brain is melting like the dark chocolate in my cabinet. However, I can’t put my brain in the fridge to firm it up, so let’s hope the neurons fire better after this cold front, or with the approach of fall.

Anyway, did you see these articles? If not, these are some points of interest I’ve been collecting to share:

The New York Times’ Well blog featured Voices of Scleroderma. Most people I’ve diagnosed with this condition have never heard of it. Fortunately it is rare, but unfortunately the treatment options are limited. I did my fellowship at The University of Pittsburgh, with several outstanding faculty members doing both clinical and basic science research on scleroderma.

Cheers! Could you actually help prevent Rheumatoid Arthritis by drinking alcohol? The very day I saw this article come across my daily email briefing, a patient brought it in and said, “Hey, does this mean I can drink?” Well, if you’re on Methotrexate that answer is still going to be no, no and are you crazy? The article was an observational study that found arthritis was less severe in drinkers compared with nondrinkers. However, the article also notes,

“We would wish to point out that, at the moment, that our findings are preliminary, and would not recommend that patients drink alcohol with the specific purpose of treating their arthritis,” said Dr. James Maxwell, lead author of the study and a consultant rheumatologist at The Rotherham NHS Foundation Trust in England.

Finally, did you see that all those “toning shoes” may not be all that great for you after all? One of my co-workers, a DIE-HARD fan of the shoes, was very disappointed when I mentioned this article to her. If you’re out of shape, strapping on a new pair of shoes won’t magically get you in shape, just as a treadmill that serves mainly as a clothes rack isn’t doing much for your fitness. However, if the promise of extra toning inspires you to walk more, be my guest. I just think they look a little funny, but, then again, I’m not winning any fashion awards.

Talking RA

The New York Times Well Blog recently had a story on “voices of RA.” Perhaps the #1 arthritis question I get about RA is how to differentiate it from OA. I’m going to give you a very simplified answer. OA, or osteoarthritis, is “wear and tear” of the joints. Some people get it earlier in life than others, in some people it will progress faster than in others, but we all use our joints so we will all develop some wear and tear in them. RA, or rheumatoid arthritis, is an autoimmune disease with inflammation occurring in the lining of the joints. Many people are surprised to hear children can get RA. I have been a speaker for the Arthritis Foundation and recommend further reading on their site, www.arthritis.org.

Fish Oil for RA

1Korea Trip 177My daily briefing email from the ACR (American College of Rheumatology) led with a story on fish oil in RA. More info can be found on the Health Day and UK Telegraph sites. The actual article was published in the journal Nature 461, 1287-1291 (29 October 2009). This site requires a paid registration to read the article, entitled “Resolvin D2 is a potent regulator of leukocytes and controls microbial sepsis.” Sounds fascinating, huh? Well, I could get the full article from the hospital library tomorrow but I think I’ll be OK with the Editor’s Summary on Nature’s site:

Resolvins, locally acting factors derived from omega-3 fatty acids, have been recognized as inflammation-resolving mediators. Experiments in a mouse abdominal sepsis model now show that resolvin D2 (RvD2) inhibits neutrophil trafficking to inflammatory sites and decreases leukocyte interactions with endothelial cells in a nitric oxide-dependent manner. RvD2’s cellular and molecular actions translated to a dramatic increased survival. This work points to RvD2 as a potent anti-inflammatory agent and suggests new therapeutic approaches that do not compromise host defences.

So, what does this mean? Fish oils may have a beneficial effect on inflammatory conditions, like RA. It appears that this happens because a substance in fish oils stops white blood cells from sticking to the walls of blood vessels. The article specifically talks about fish oil, but the vegetarians among us will be interested in other sources of omega-3 fatty acids, like flax seeds, walnuts and chia seeds. Many of my patients take these supplements and they are fairly well tolerated, aside from the occasional “fish belching” that some experience. Apparently taking the supplements with meals can decrease it, although a certain family member of mine unfortunately hasn’t found a tolerable brand yet! I should emphasize that the conclusions have been that these supplements may help symptoms of RA and may be part of a comprehensive treatment plan. Certainly no one is suggesting this as a treatment or in any way disease-modifying.