Don’t write off that tingling sensation in your hands and feet. If you have diabetes, it may be a sign of neuropathy.
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Rheumatoid Arthritis (RA) is a tricky disease.
No one knows what causes it, but while there isn’t yet a cure for the autoimmune disease, it can be treated. Arthritis is an extremely common problem but not all forms of arthritis are alike.
Just as symptoms of RA can vary, medical treatments can vary, but the important thing to know is that over the last 20 years the treatment of RA has changed dramatically with the approval of many new, highly effective drugs.
These can help slow or stop joint damage, minimize disability, and reduce inflammation, pain and swelling. Lowering, stress, eating a healthy diet, quitting smoking, and getting enough rest are all suggested lifestyle changes.
Some medicines are taken by mouth, while others require regular injections; these drugs are highly effective, but do have side effects. Thus, it’s essential to get a proper diagnosis from a doctor who specializes in rheumatic diseases, understands all the different causes of arthritis—in adults and children—and has experience with the new drugs, advises John O’Shea, M.D., scientific director at the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS).
“RA and other autoimmune diseases don’t just affect the joints, they cause inflammation throughout your body,” Dr. O’Shea says.
The main goal in treating RA is to reduce inflammation and pain, stop more joint damage, and to be able to function normally.
“We now have better treatment therapies to keep you safe, as well as clinical studies that specifically look at inflammation,” Dr. O’Shea adds. The RA drug tofacitinib, approved for the treatment of RA in 2012, targets a protein that was discovered in the early 1990s by O’Shea and his colleagues.
Dr. O’Shea and his team at NIAMS are studying the molecular and genetic basis of rheumatoid arthritis and other inflammatory diseases in an effort to identify potential strategies for future therapies.
Researchers are also studying the natural history of the disease in children and adults to understand more fully how RA progresses and impacts people’s lives.
In addition, NIAMS researchers are collaborating with investigators outside of NIH to explore whether people with RA who are in remission (no symptoms of the disease) while taking TNF inhibitors are at risk of having symptoms come back if they stop taking the medicine.
Another study funded by NIAMS focuses on RA patients with inflammation in the blood vessels and heart tissue, which can eventually lead to heart disease.
“People who have rheumatoid arthritis have a 50 percent increase in chance of experiencing a stroke or heart failure,” says Joan Bathon, M.D., chief of the division of rheumatology at Columbia University Medical Center in New York.
Known as the TARGET study, the clinical trial aims to see if treatment of arthritis in individuals with RA will also reduce inflammation in blood vessels. Inflammation in blood vessels is believed to be an early predictor of atherosclerosis (hardening of the arteries) which leads to heart attacks and strokes. If RA medications reduce inflammation in blood vessels, this may reduce future chances of heart attacks and strokes. “We want to aggressively treat rheumatoid arthritis, to see if it will help the heart,” Dr. Bathon says.
Joining a clinical study such as the TARGET study will help researchers find a cure more quickly. There are 30 sites in the U.S. focusing on the TARGET study, with more to come soon.
“We have a lot of treatments, but none of our treatments cure the disease,” Dr. Bathon says. “In lieu of a cure is prevention of related complications from the disease. RA is treatable. We’re focusing on outcomes right now and getting people with RA back on track.”
The bottom line: If you have symptoms of rheumatoid arthritis, early diagnosis is essential. It is critical to get aggressive treatment as early as possible to help slow RA and help prevent permanent joint damage.
Mayo Clinic cardiovascular surgeon, Joseph Dearani, M.D., talks about the diagnosis and treatment of Ebstein’s anomaly. Visit http://www.mayoclinic.org/diseases-conditions/ebsteins-anomaly/home/ovc-20199183?mc_id=global&utm_source=youtube&utm_medium=sm&utm_content=cardiacanomalyheart&utm_campaign=mayoclinic&geo=global&placementsite=enterprise&cauid=10394 for more information on Ebstein’s anomaly or to request an appointment at Mayo Clinic.
Ebstein’s anomaly is a congenital heart defect that can differ from patient to patient. An Ebstein’s anomaly patient who is highly symptomatic can require urgent surgery as a newborn while others may not know they have this condition until late into adulthood. However, with advances in prenatal ultrasounds, this diagnosis can oftentimes be made prenatally. The timing of surgical treatment for Ebstein’s anomaly can vary depending on severity of the diagnosis as well as other compounding factors such as a hole in the heart or cyanosis.
The ultimate goal of surgical treatment for Ebstein’s anomaly is to repair the native tricuspid valve. If the tricuspid valve is too abnormal to repair, replacement is also an option. Patients who have undergone tricuspid valve repair or replacement for Ebstein’s anomaly require continuous followup for things such as irregular heartbeats, arrhythmias, recurrent tricuspid valve problems, and ventricular function abnormalities.
Multiple sclerosis, or MS, is a chronic disease that affects the central nervous system (the brain and spinal cord). A patient’s clinical course is difficult to predict.
It damages myelin, a substance that wraps around nerve fibers and helps protect them.
Damaged myelin exposes our nerve fiber and disrupts key communication between our nervous system and brain. This creates pain, coordination issues, vision problems, and more.
MS is considered to be an autoimmune disease, in which your immune system mistakenly attacks healthy cells in your body.
Multiple sclerosis signs and symptoms appear in many ways. They can range from minimal to disabling, depending on how much nerve damage there is and which nerves are affected.
The majority of MS patients are mildly affected, but in the worst cases, MS can make a person unable to write, speak, or walk.
MS symptoms usually appear in people between ages 20 and 40 and can include the following:
Check with a health care provider if you experience any or some of these symptoms and suspect it may be MS.
Some people with MS do well without therapy, and in some cases, medications can have serious side effects. Some have major risks, which requires close monitoring. Unfortunately, MS can worsen slowly enough that patients are not always aware of it, and this can happen in the absence of new lesions in the brain or spinal cord.
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Olympian gymnast Gabrielle Douglas reveals the grueling details of her daily workout, how she mentally prepares for competition, and the foods she eats to stay charged.
Discover how Olympic athletes stay fit. Plus, get food and fitness tips for the everyday Olympian.
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Mindful Living is a four-week course offered at Mayo Clinic to patients and caregivers taught by Teri Pipe, Ph.D., Director of Nursing Research and Innovation at Mayo Clinic in Arizona and Interim Dean of ASU’s College of Nursing and Health Innovation. The course incorporates mindfulness techniques to help participants better cope with stress.
In the following video, Dr. Pipe will explain how the concept of Mindfulness works and ways to achieve it.
Emmy-winning ‘American Ninja Warrior’ host opens up about health, career, and NIH research
Photo: courtesy of NBC.
Matt Iseman was trained as a doctor, but he is known to many as a comic, first winner of the “New Celebrity Apprentice,” and host of the hit TV show “American Ninja Warrior.” He is also one of millions of Americans living with arthritis and has been an advocate for more research into the condition. He spoke with NIH MedlinePlus magazine to talk about his experience and what drives him to success.
I was diagnosed Christmas of 2002. When I was told I had rheumatoid arthritis (RA), the first thought I had was relief. People are always shocked when they hear that. But it had been 18 months that I had been having symptoms—18 months when my body and my life were falling apart.
I had just turned 30 and my symptoms started with pain in my right index finger and then spread to my feet, back, and neck. I was always exhausted and often sleeping up to 14 hours a day. I had been an athlete all my life, but couldn’t work out at all and eventually gained 55 pounds. I saw a range of doctors, but no one could tell me what was wrong.
When I was finally told I had RA, I was relieved because I knew there was something I could do about it.
I’m walking proof of the importance of research like that done by NIH.
The good news is when I started treatment (with a biologic medicine that helps reduce inflammation), it gave me my life back.
That is why I have been a passionate advocate, working with groups like the Arthritis Foundation to let others know that there is hope. Despite the fact that I am a doctor and understood the disease, I didn’t know anyone who had it. Many who are newly diagnosed go online and see the worst-case scenario.
I want them to see me, someone who won “Celebrity Apprentice,” who hosts “American Ninja Warrior,” and travels the country doing stand-up comedy. I love sharing my story. There is hope. This is a disease you can lead a full life with.
I used to play basketball, but I haven’t played basketball or run since I was diagnosed. I like to tell people that whatever you are dealing with, don’t focus on what you can’t do, focus on what you can do. You will be amazed at what you can accomplish.
I have discovered yoga and pilates. They are terrific for building strength and flexibility. If you are dealing with RA, the saying goes “motion is lotion.” The more you move the better you feel and the better your vitality.
Laughter has always been key for me, particularly when I was down before I was diagnosed. Stand-up comedy really saved my life at that point. No matter how bad I felt, I did stand-up comedy, laughing and making others laugh. Taking care of yourself physically and emotionally is key. And laughter is such a great tool.
No one does it alone. We talk about that on “American Ninja Warrior” and I talk about arthritis.
When you are newly diagnosed, your doctor, your nurse, and your family are going to talk to you. But it is also important to talk to someone who is going through or has been through what you are. Join a group to share stories and tips about living with RA.
I’m it. I’m walking proof of the importance of research like that done by NIH. The medication I’m on was discovered just four years before I was diagnosed.
We would not have advancements like this without the research supported by NIH. We need to make sure that researchers have the funding to develop even better treatments and one day find a cure.
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Lupus patient shares organ donation experience with mother
Photo: courtesy of Alison Lee.
Alison Lee is a fighter. She has fought lupus, kidney failure, and cancer—all in just 35 short years.
Alison was diagnosed with lupus at 16 years old. Lupus is a disease in which your immune system attacks your healthy cells and tissue by mistake. Lupus may affect the kidneys and can lead to kidney failure.
However, Alison didn’t experience serious lupus symptoms until she was in her mid-20s, when she started to have anemia (or lack of red blood cells), shortness of breath, and heart issues.
At that point, she was living in New York City and doing things many other 20-somethings do: working, hanging out with friends, and enjoying life.
But things got worse in 2014 when her lupus started to damage her kidneys. She remembers feeling fatigued and very weak.
“When going to dinner with my friends a few blocks away, I would need to stop and take a break and sit on a bench because I couldn’t walk three blocks,” Alison said.
She also noticed decreased urine output. Her kidneys started to fail. She remembers feeling fatigued and going in and out of the hospital.
“I would go through an entire day at work without having to pee at all. I knew something was going on,” Alison said.
Finally, in 2014, she decided to leave her job because she felt so sick. In 2015, she started kidney dialysis because her kidneys were unable to work well enough to keep her healthy.
“Because my heart had been struggling for so many years, my doctors said it wouldn’t be able to handle a kidney transplant,” Alison said.
“Dialysis was really difficult for me. At the beginning it was like a full-time job because you need to drain and refill the fluid every four to six hours. It was difficult to have a normal life,” she added.
However, the dialysis improved Alison’s health dramatically.
After six months on dialysis, she was healthy enough for a transplant. She had a transplant evaluation and asked family members to be tested to see if any of them would be good potential donors.
Alison was one of the lucky ones when it came to finding a donor. Her mom, sister, and brother all offered to donate.
“Of course, my mom being my mom said she would donate,” Alison said.
Her mom wouldn’t have it any other way. “My mom is so selfless, and she has helped me throughout all of my health issues in the past,” Alison added.
Despite her fears, Alison said the excitement about the future outweighed her concerns about the surgery.
“The whole transplant experience was straightforward and easy. The hospital wanted to make sure I understood everything that was happening with the transplant and also post-transplant,” Alison said. “I was more excited about the prospect of the future than scared about the procedure.”
After surgery, Alison woke up and had to pee a lot, which was a good sign. It meant her kidney was working well. Her blood work was also positive.
Alison’s mom, who was in her sixties at the time, also did well. She was back up and helping take care of Alison during her recovery just three days after surgery.
While the transplant surgery was straightforward, Alison’s recovery wasn’t easy.
About a month after surgery, she discovered a lump growing behind her ear. She ended up contracting lymphoma, a cancer of the lymph nodes. While very rare, a drug Alison needed to prevent rejection of her transplant allowed a slow-growing lymphoma she had before the transplant to transform into a more aggressive lymphoma.
“It’s not common, but I had some history of a slow growing lymphoma in my past, so they knew this was a risk. Coupled with my recovery from transplant, I also had to go through the biopsy and the chemo treatment that I did for about four months,” Alison said.
Despite the difficult battle of recovery coupled with chemotherapy, Alison’s positive attitude and family helped her each step of the way. An unexpected benefit from her chemo was decreased rejection of her transplanted kidney. “The chemo was surprisingly beneficial for my transplant. I was given lots of fluid which helped to keep the new kidney hydrated. Also, the chemo itself essentially killed my immune system, preventing it from attacking the new kidney,” Alison said.
Alison is in remission but still deals with related health issues. She works closely with the Lupus Research Alliance, focusing on patient advocacy and sharing her story and message of hope with others. She recommends other people struggling with health issues find a support group or organization.
“It’s good for me to interact with other lupus patients. It helps me to feel more comfortable with my disease,” Alison said.
Alison also works part time and carves out time to travel and enjoy the little things. She recently traveled to Mexico for a yoga retreat.
“I think a positive attitude is really important,” said Alison. “Even through all of this, I’ve never felt like I was dying or wasn’t going to survive. Each issue just becomes another bump that I have to get through until things will get better.”
Migraine visual aura spoils a summer afternoon. To learn more, visit http://mayocl.in/2yXjlvh.
When you think about arthritis and its associated swelling and joint pain, you likely relate the problem primarily with the elderly. However, statistics are clear it is not just the oldest (and wisest) among us who suffer from arthritis; there’s a whole range of problems under the Juvenile Arthritis (JA) umbrella negatively impacting the lives of kids, according to the Arthritis Foundation.
July is Juvenile Arthritis Awareness Month, a month dedicated to increase awareness about the early signs and symptoms of juvenile arthritis and to increase the focus and expand resources for the fight against JA. The campaign was initiated by the Arthritis Foundation and targets a condition that currently affects 300 000 children nationwide, making it one of the most common childhood diseases in the US.
The word “arthritis” means joint inflammation in Latin, but juvenile arthritis can impact eyes, skin and the gastrointestinal tract. The disorder takes on a large variety of forms, and researchers and doctors alike are working to better understand the key differences and how varying approaches can help.
Juvenile arthritis (JA) is not a disease in itself. Also known as pediatric rheumatic disease, JA is an umbrella term used to describe the many autoimmune and inflammatory conditions or pediatric rheumatic diseases that can develop in children under the age of 16.
Although the various types of juvenile arthritis share many common symptoms, like pain, joint swelling, redness and warmth, each type of JA is distinct and has its own special concerns and symptoms. Some types of juvenile arthritis affect the musculoskeletal system, but joint symptoms may be minor or nonexistent.
Three classifications of juvenile arthritis exist: juvenile rheumatoid arthritis (JRA), juvenile chronic arthritis (JCA), and juvenile idiopathic arthritis (JIA), of which, juvenile rheumatoid arthritis is the most common. The classification is made based on symptoms, number of joints involved and the presence of antibodies in the blood
According to the Arthritis Foundation, JA can do more than cause joint discomfort in young people. While many types of JA share commonalities like swelling, “each type of JA is distinct and has its own special concerns and symptoms”, it notes.
For example, some versions of JA don’t fall under the classic definition of arthritis at all; the problem can affect the eyes, skin (Juvenile dermatomyositis) and digestive system as well, according to the foundation.
While some children may not express any pain from the disease, their actions can speak for themselves. The National Institute of Arthritis and Musculoskeletal and Skin Diseases notes that JA often targets the knees and feet, creating a telltale limp in junior’s walk.
The source also notes that the problem is usually worse first thing in the morning or after a nap, when the joints have a chance to stiffen. Keep an eye out for any strange walking patterns of your child, especially if you can’t recall any recent accidents that would contribute to the limping.
While many diseases are passed down from one parent or both, The National Institute of Arthritis and Musculoskeletal and Skin Diseases notes that it’s “very rare” for more than one family member to have JA.
That being said, children who have another family member who has JA are at “slightly increased” risk of developing the problem. Since JA is largely an autoimmune disease (when you immune system mistakenly attacks healthy cells), families with a history of autoimmune diseases such as Multiple Sclerosis or Thyroid inflammation may be at higher risk.
According to HealthCentral.com, Juvenile Arthritis affects more girls than boys, and is likely to develop from ages 2 to 4 or during the adolescent/teen years (but under the age of 16).
While there doesn’t seem to be any solid statistics for girls versus boys when it comes to JA cases, KidsGetArthritisToo.org notes that the most common form of JA is mild oligoarthritis (affecting fewer than five joints) that is usually found in girls aged 8-or younger.
Apparently arthritis and other rheumatic conditions (collectively known as AORC) in youth has accounted for deaths in the U.S., according to statistics from the Centers for Disease Control and Prevention (CDC). The source notes that between 1979 and 1998, there were roughly 50 deaths per year (of children younger than 15) attributed to the diseases.
The slightly better news is that during this roughly 20-year period, the death rate related to AORC diseases fell 25-percent from 1.2 deaths per million to 0.9 deaths per million, according to the CDC. These deaths are more common among females than males, according to HealthLine.com, which paints a somewhat bleaker picture regarding JA mortality rates.
At this moment, there is no cure for juvenile arthritis. The custom approach to the disorder is to control pain levels, reduce inflammation and maintain mobility, while in more extreme cases surgery is the only possible solution to prevent further joint damage. Many treatment plans are based on proper medication, therapeutically physical activities, eye care and healthy eating.
The treatments used for Juvenile Arthritis focus on improving quality of life for young people. In some cases, pain medication is the solution, but in some cases anti-inflammatory drugs (NSAIDS) are used. Doctors may also prescribe DMARDs, a family of drugs that are designed to slow the progression of the juvenile arthritis. Chemotherapy drugs have also been used to battle JA, although in lower doses than when treating cancer patients.
Physical therapy may also be part of the treatment plan to help maintain your child’s flexibility and maintain muscle tone. Probably the most important component of any plan is the way in which all measures are customized for a child’s daily schedule in order to affect the quality of life as little as possible.
No known cause has been pinpointed for most forms of juvenile arthritis, nor is there evidence to suggest that toxins, foods or allergies cause children to develop JA. Some research points toward a genetic predisposition to juvenile arthritis, which means the combination of genes a child receives from his or her parents may cause the onset of JA when triggered by other factors.
Each of the different types of JA have their own set of signs and symptoms. You can read more specifics about the diseases by following the links above, and by visiting the Arthritis Foundation’s website dedicated to pediatric rheumatic diseases, KidsGetArthritisToo.
The most important step in properly treating juvenile arthritis is getting an accurate diagnosis. The diagnostic process can be long and detailed. There is no single blood test that confirms any type of JA. In children, the key to diagnosis is a careful physical exam, along with a thorough medical history. Any specific tests a doctor may perform will depend upon the type of JA suspected.
An important part of JA treatment is teaching chidlren the importance of following the treatment prescribed by their healthcare team. Self care also involves helping the child address the emotional and social effects of the disease. Self management encompasses the choices made each day to live well and stay healthy and happy.
You’ll probably first bring your symptoms to the attention of your family doctor, who may refer you to a rheumatologist — a doctor specializing in the treatment of arthritis and other diseases of the joints, muscles and bone. Because JA can affect many organ systems, you may need to see a variety of medical specialists.
To get the right help, find a rheumatologist or other physician who knows how hard it is to endure a disease so few understand and can truly help. Go to HealthLynked.com today to build a Free patient profile and begin communicating there with those who will collaborate on your wellness.
DISCLAIMER: The information on this site is not intended or implied to be a substitute for professional medical advice, diagnosis or treatment. All content, including text, graphics, images and information, contained on or available through this web site is for general information purposes only. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website. The opinions expressed in this column are not those of HealthLynked Corp and are intended to spark discussion about issues pertaining to health and wellness.
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