I’ve read that the Canadian supply of H1N1 vaccine is to contain an adjuvant which is a chemical that increases the immune system response to a vaccine. Apparently, they can use less vaccine if mixed with an adjuvant. Will the H1N1 vaccine be safe for people with RA taking methotrexate and biologics such as Enbrel? Should we have the vaccine with the adjuvant or without the adjuvant if such a vaccine is available.
As a general rule, patients on biologics cannot receive live vaccines. They can receive dead vaccines if there are no other conta-indications in their specific case. The flue vaccine should be a dead vaccine.Do ask your physician if there are other reasons, however, why you should not receive it.
Answered on: October 19, 2009
I have been told that a bone in my right hip joint is fused. I am concerned that it could happen to the other joints. How long does it take for the fusion to occur in ankylosing spondylitis? Is it weeks, months or years?
Ankylosing spondylitis affects the sacroiliac joints which may become fused as you describe. This does nor occur in all patients and it is a process which evolves over years. There may be inflammation in the hips, shoulders and other peripheral joints with cartilage destruction as one sees in rheumatoid arthritis. We now have medications (biologics) to better control this disease and help our patients.
Answered on: October 13, 2009
I was diagnosed with juvenile rheumatoid arthritis when I was 13 months old. I’m now 25 yrs old. Most of my joints are affected – this along with my small physical frame and high metabolism make me appear thin and weak. I would really like to gain muscle mass and fill out my thin limbs, but since my joints don’t allow me to lift heavy weights or do other physical exercises such as push-ups, I don’t know how. Do you have any suggestions for the type of diet and exercises I can implement?
Exercise must take into account the degree of inflammation and of destruction in the joints of each individual patient. It cannot be suggested on the web without a proper knowledge of your particular case. I suggest you discuss diet and exercise with your rheumatologist and ask for referral in your community as and if needed.
Answered on: October 05, 2009
Is it possible to have arthritis in the sternum? I feel something at the junction of the sternum and a rib. X-rays of my ribs only show that my back is not straight. I was treated with cortisone for two years for polymyalgie rheumatica.
It is possible to have costochondritis, which is a localised inflammation at the junction of the rib cartilage. One must then avoid arm movements such as the action of rowing. If anti-inflammatory medications are not sufficient, a steroid infiltration can be performed in the affected area.
Answered on: September 28, 2009
My brother is 48 and has severe arthritis. He is in so much pain and has tried all available medicines. It is getting urgent. I wondered if I can donate stem cells or anything else that would improve his health.
You can give your brother love and support but you cannot take away his disease or treat it. He should see his rheumatologist rapidly if he is in such pain, and together they can work out a treatment plan. You have not given any details about his arthritis. I cannot be more precise. Do go back to the rheumatologist and ask for his help.
Answered on: September 21, 2009
I was diagnosed with fibromyalgia and osteoarthritis in 2000. Is there a possible connection between either of these ailments and symptoms that include a sore throat, swollen glands, canker sores, coughing and bladder incontinence?
Irritable bladder can be found in association with fibromyalgia; however, I see no link with your other problems or symptoms.
Answered on: September 14, 2009
Are you aware of the concept of niacin deficiency and the administration of niacinamide as a treatment for osteoarthritis? I’ve read this was something developed by Dr. Kauffman in the 1930s. Is it something that is relevant today?
Fifty years ago, Kaufman reported that high-dose niacinamide was beneficial in osteoarthritis and rheumatoid arthritis. A recent double-blind pilot study was published by Jonas WB and collaborators from the Office of Alternative Medicine of the U.S. National Institutes of Health on the effect of niacinamide in osteoarthritis in 72 patients for 12 weeks (Inflamm Res. 1996 Jul;45(7):330-4). The authors concluded that “Niacinamide improved the global impact of osteoarthritis, improved joint flexibility, reduced inflammation, and allowed for reduction in standard anti-inflammatory medications when compared to placebo. Pain levels did not change but those on niacinamide reduced their anti-inflammatory medications by 13%”.
I agree with the authors that “More extensive evaluation of niacinamide in arthritis is warranted.”
Answered on: September 08, 2009
Are the risks of having an arthritis flare-up higher during menopause and pre-menopause? Thank you on behalf of all women living with rheumatoid arthritis.
Menopause occurs on average around the age of 50. Half of people over 40 show radiologic signs of osteoarthritis. Many also start to display clinical symptoms of this disease at this time. The cause of rheumatoid arthritis is still unknown. RA mainly affects women of childbearing age, but flare-ups can occur at any age.
Answered on: August 17, 2009
Are there any scientific studies to backup the claim that “vibration plate therapy” devices offer up relief of arthritis pain? They’re suggesting relief can be had by standing on these platforms for 10 minutes 3 or 4 times per week.
Some effects of low frequency vibratory exercises on bone (for example, reducing the risk of bone fracture in osteoporosis compared to walking) has been studied. However, I am not aware of equivalent controlled studies on the pain of arthritis though some benefit may exist on postural control of muscle.
Answered on: August 10, 2009
Use of anti-inflammatories for 10 years has recently been causing me stomach problems. Are you aware of any recent testing about the benefits or harm in taking shark cartilage for osteoarthritis?
Oral administration of chondroitin sulfate (CS) is widely practiced for the treatment of osteoarthritis, although the efficacy of this treatment has not been well established by clinical studies. A reason for the inconsistency of the results may be the quality of the CS preparations, which are commercially available as dietary supplements such as the shark cartilage you mention. More research is needed.
Answered on: August 03, 2009
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