Health News Blog provides coverage of current health news.

RHEUMATOID ARTHRITIS AND PRACTICAL MATTERS  There’s no getting around the fact that rheumatoid arthritis (RA) can interfere with a person’s ability to work. Stiffness, pain, decreased mobility, and fatigue present problems for someone whose employment involves an eight-hour workday. We have already mentioned that people with RA often find it helpful to talk with their employers about arranging for increased flexibility in work hours and creating an arthritis-friendly workplace. These modifications can help a person with RA avoid having minor flare-ups interfere with work. Another possibility is a job-sharing program, in which two people each work halftime to fulfill the duties of one full-time job.We stress the fact that persons with RA are differently abled and that with creative planning, flexibility, and understanding a person with RA often can continue in his or her job. This is what many people would prefer to do; but sometimes, despite a person’s best creative efforts, it is not possible to continue being employed as before. This is particularly true for people with a physically demanding job that requires repeated use of inflamed joints.A person with RA who is having problems at work would be well advised to discuss the situation with his or her doctor and social service worker. If the best decision seems to be to make a change, the person might consider pursuing another form of employment, making arrangements with his or her employer to change jobs within the same company (or to change the description and duties of the present job), or applying for disability benefits. This decision, of course, is highly personal. The choice you make depends on your work experience, education, age, financial responsibilities, degree of arthritis involvement, and the advice of your health care team.*116/209/5*

CORTICOSTEROIDS FOR TREATMENT OF RHEUMATOID ARTHRITIS (RA): CORTICOSTEROID INJECTIONSIn RA it is common for one joint to become more swollen than others or to lag behind the others in improvement. An injection of corticosteroids directly into the joint will decrease the pain, warmth, and swelling in the joint that is giving the person the most trouble. The beneficial effects generally last four to six weeks.This is a frequently performed and effective procedure that is generally safe and well tolerated. Before the injection is administered, the skin is generally numbed with a local anesthetic. (Be certain to warn your doctor if you have ever had a reaction to local anesthetics such as Novocain or Xylocaine.) A needle is then introduced through the skin and into the joint, into which the corticosteroid is injected.The side effects of the small amount of corticosteroid injected into the joint are minimal. If a given joint is injected no more frequently than every four months, adverse effects from the corticosteroid itself are unlikely.Corticosteroid injection into the same joint more frequently than every four months, however, may cause joint damage. In fewer than 5 percent of patients the injected corticosteroid can actually increase inflammation for a short period. This is known as a post-infection flare. Although uncomfortable, the inflammation will decrease within two to three days. It is impossible to tell in advance of the injection whether a particular individual will suffer this side effect.Occasionally, a dimple in the skin or a mild change in skin color will be noticed at the site of injection. These skin changes will almost always disappear with time.As with any procedure, complications related to the procedure itself can arise. Care must be taken to avoid injuring surrounding tendons or other structures. Sterile technique is required to prevent the possibility of introducing bacteria and infection into the joint. Experienced physicians, generally rheumatologists or orthopedic surgeons, take exceptional care to avoid these complications.*106/209/5*

IMMUNOSUPPRESSANTS FOR TREATMENT OF RA (RHEUMATOID ARTHRITIS): METHOTREXATERheumatrexTablet size: 2.5 mgUsual dose: two to six pills all on one day per week or in one weekly injection Effective within: three to eight weeksMethotrexate was used initially in the 1940s to treat people with leukemia and is still frequently taken in very high doses as an anticancer drug. It later became widely used as treatment for severe psoriasis and a form of arthritis associated with this skin condition. Since the early 1980s its use in the treatment of RA has skyrocketed.The marked increase in this drug’s popularity for RA treatment has many explanations. First, it becomes effective more rapidly than the other DMARDs: improvement is sometimes noted within two weeks of the first use. Second, it is possibly the most effective medication available. It is as effective as injectable gold or penicillamine, previously believed to be the most effective pharmaceutical treatment for RA. Third, it is very convenient in that it can be taken once a week if tolerated.*96/209/5*

Nutrition is a relatively new science, barely 30 years old. It has already made impressive gains in knowledge. But we have only scratched the surface. In coming years nutritionists will discover and identify many new vitamins and other nutritional factors which will play an important role in your health.

Therefore, one who does not suffer from any specific disease or deficiency but who is interested in food supplements for prophylactic or preventive reasons—that is for health protection —should not take any vitamins, minerals, or other isolated factors. But he should use natural food supplements, such as brewers yeast, kelp, bone meal, rose hips, cold-pressed vegetable oils, cod liver oil, wheat germ oil, etc. These are all natural, unrefined foods, rather than isolated vitamins or minerals. When you take them you will be benefiting not only from all the known vitamins and other nutritional factors, but also from all the unknown, as yet undiscovered, factors. Moreover, in such natural food supplements all the vital factors are present in their naturally balanced combination. This is important for two reasons. First, this will assure their full biological activity and maximum assimilation. Second, it will prevent overdosage which, as in the cases of vitamins D, A, and certain vitamins of the B-complex, could be quite dangerous.

The above remarks are made in reference to relatively healthy people. In the case of disease, however, the use of isolated vitamins and other nutritional factors could be not only justified but, in many cases, absolutely essential.

*50\176\2*