Smoking and Rheumatoid Arthritis
Posted by admin in Rheumatoid Arthritis on December 23, 2011
Rheumatoid Arthritis
Rheumatoid arthritis is more than a disease of the joints. It is a chronic condition affecting the whole body. In this article I’m going to consider rheumatoid arthritis and especially its possible link and association with smoking. For the benefit of those not familiar with the condition I’ll add some introductory material, so bear with me.
The Science Bit
Well, as the name suggests, rheumatoid arthritis is an arthritic condition. The other common form of arthritis is termed osteoarthritis. Osteoarthritis is due to wear and tear on the joints and is often a disease of old age. Rheumatoid arthritis differs in many respects from osteoarthritis. First off, it can occur at any age. Its onset is often sudden and symptoms such as joint pain are common. The disorder causes joint inflammation and is progressive. If unchecked it damages and destroys joints. It is relatively common and affects about 1% of the population. The cause is really not known, but there seems to be a genetic component which interacts with environmental factors. Rheumatoid arthritis is an auto-immune disease. In auto-immune immune disorders, the immune system goes ‘haywire’ and starts attacking normal healthy tissue. In addition to joint damage this condition is often associated with fatigue and a general feeling of ‘being unwell’
Smoking and Rheumatoid Arthritis
So what has all this to do with smoking? A Swedish study has found that smoking is an important risk factor in developing the disease. Other factors are important, of course. For instance, women are more prone to the disorder than men; it is more common in the 40 to 60 age group and there is often a family history. Workers at the Karolinska institute in Stockholm looked to see if there was a link between rheumatoid arthritis and smoking. Their research found that heavy smokers, who smoked for at least 20 years, were two and a half times more likely to contain an antibody closely associated with the condition and especially with a severe form of the disease. The researchers concluded that smoking may account for 35% of cases where the antibody is present and 20% of cases overall. It is thought that smoking, particularly heavy smoking, acts as a trigger for the disease in those who already have a genetic predisposition. Read the rest of this entry »
Osteoporosis? 5 Ways Your Doctor May Not Have Mentioned to Strengthen Your Bones
Posted by admin in Osteoporosis on December 23, 2011
Bone health is a growing problem in today’s toxic society. Some are diagnosed with osteoporosis. Some with osteopenia, which is considered a “pre” osteoporosis. The vast majority of patients with these diagnosis are given a prescription for Fosomax or Boniva or Actonel.
The use of medications to treat osteopenia is completely out of line with all the guidelines used for treatment of lower bone mass. Someone with osteopenia is still at a very low risk of suffering a fracture, although it is clear that they are on a trajectory towards losing too much bone. If someone is at a very low risk of a fracture, if we medicate this person, they will likely be taking this class of drugs for an extended period of time. Recent research suggests that, after 3-5 years, because this class of drugs interferes with normal bone turnover, patients will now be at increased risk of fractures in other bones besides the hip and spine.
For most of our history, we have viewed bone as an inert tissue that is used to provide support for the body, attach muscles to for movement and act as a source of calcium when blood levels drop. This view has changed dramatically in the past few years.
We now understand that bone is an integral tissue that is involved in the regulation of body composition and actually produces a hormone called that protects against diabetes. When bone is healthy and building, the cells that build bone, called osteoblasts, produce the hormone osteocalcin. Absolutely astonishing information that is changing the way we view bone.
To further complicate the picture, gastrointestinal health also interacts with bone. When the gut becomes stressed (psychological stress, poor diet, drugs to treat acid reflux or heartburn, etc..) the enterochromaffin cells lining the gut produce more serotonin. Yes–serotonin, that “feel good” hormone that we think of when we think depression and Prosac and Paxil and Zoloft. Many do not realize that over 2/3 of the body’s serotonin is actually derived from the gut.
So, more stress on the gut produces more serotonin. This serotonin then affects the activity of the osteoblasts in bone, slowing their activity and slowing bone building. Read the rest of this entry »
Achieving Chronic Pain Relief With Spinal Cord Stimulator Implants (SCS)
Posted by admin in Chronic Pain on December 23, 2011
Spinal cord stimulation, otherwise known as SCS, uses electrical stimulation to provide pain relief of the back, neck, legs, and arms. It is believed that electrical impulses will inhibit pain sensations from being received by the brain. SCS candidates include patients who are suffering from chronic pain and for whom conservative treatments have failed or potentially surgical treatment has not given substantial relief.
Prior to having a final implant placed with a spinal cord stimulator, the patient will need to undergo placement of a trial implant first. The doctor will sterilize and numb the area of the back under concern and an epidural needle is placed. Once the epidural needle has reached the spinal canal, a catheter is placed through the needle.
The patient is not completely anesthetized for this trial implant procedure. The reason is that the doctor needs to ask the patient at which point of placement the patient achieves adequate pain relief of the area suffering from chronic pain. Once the catheter is in the position for relieving pain best an external power supply and programmer is attached which supplies power and will allow the patient to wear it for 5 to 7 days.
During the week that the trial implant is placed, the patient will keep a journal detailing exactly how much pain relief is achieved from the trial. If the implant achieves adequate pain relief (such as over 50%), the patient may move on to a final implant. Regardless, the trial implant is removed in the office at about a week’s time.
The permanent implant is placed under sedation and often times general anesthesia. Through a small incision in the lower back, the surgeon will perform a small laminectomy or laminotomy, which means a little bit of bone overlying the epidural space is removed. At that point the paddle lead is able to be placed into the epidural space and positioned appropriately in the center for pain relief. Read the rest of this entry »