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Which Oil Supplements Work For Rheumatoid Arthritis... And Which Don’t!
“Your food shall be your remedy. Let food be your medicine and let medicine be your food…”These words were uttered by Hippocrates.With all the emphasis on natural remedies Read more...
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Arthritis
Doctor… I Have Rheumatoid Arthritis And I’m Short Of Breath. What’s Going On?
Rheumatoid is a chronic, progressive, systemic, autoimmune condition for which there is no known cure. It is a common disorder affecting approximately 2.1 million Americans.
While it is technically a form of arthritis, rheumatoid is a true systemic disease in which multiple organ systems can be affected.
Among these are the skin with vasculitic ulcers, eyes leading to scleritis or episcleritis (inflammatory eye disease), glands that make saliva and tears leading to dryness of the eyes and mouth, lymph nodes sometimes causing lymphoma, cardiovascular system leading to early heart attack and stroke, and the lungs.
Lung involvement can take multiple forms. Rheumatoid can cause pleurisy (inflammation of the lining of the lungs), nodules within the lungs, pneumonia, inflammation of the small airways (bronchitis and bronchiolitis), and inflammation of the lung tissue. This latter condition is called interstitial lung disease.
Patients with rheumatoid are examined clinically and sometimes interstitial lung disease is a finding that is picked up on physical examination.
Prior to starting drugs such as TNF inhibitors (Enbrel, Humira, Remicade), a chest x-ray is also obtained and sometimes interstitial lung disease is found then. However, chest x-ray is not very sensitive for picking up interstitial lung disease early.
A recent study found some disturbing evidence that oftentimes patients with rheumatoid may have subclinical interstitial lung disease. This means that the lung disease is there without any symptoms.
The researchers found that “preclinical interstitial lung disease detected by high-resolution computed tomography is prevalent and progressive in patients with rheumatoid arthritis.” (Arch Intern Med 2008;168:159-166). High resolution computerized tomography is a fine detail CAT scan technique.
The
prevalence of asymptomatic interstitial lung disease in rheumatoid is unknown. The authors of the study said, though, that “given the availability of new therapeutic options, early identification and treatment may improve outcomes.”
The authors recruited 64 patients with rheumatoid without shortness of breath or cough and 10 with rheumatoid and pulmonary fibrosis (interstitial lung disease).
High-resolution computed tomography identified preclinical interstitial lung disease in 21 of the asymptomatic patients (33%).
Pulmonary function tests such as air flow and lung volumes which measure lung function were normal in the interstitial lung disease patients at baseline, but gas exchange (the ability to transfer oxygen into the lungs and get rid of carbon dioxide out of the lungs) was impaired in patients with no interstitial lung disease.
During a mean follow-up of 2 years, repeat scanning showed disease progression in 12 subjects with preclinical interstitial lung disease and in 6 subjects with pulmonary fibrosis; the rate of change was low and similar in the two groups.
"In this cohort of patients with rheumatoid arthritis, preclinical interstitial lung disease is prevalent and progressive," the authors stated.
They also wrote: "The natural history of disease resembles that of pulmonary fibrosis, and high resolution computed tomography is more sensitive than pulmonary function test measurements in detecting early progression of preclinical interstitial lung disease."
Two thirds of patients with lung disease and less than one quarter without lung disease had a history of smoking, and the mean number of pack-years smoked was significantly higher in the lung disease group. Therefore, the authors say, clinicians should recommend that patients with rheumatoid should stop smoking.
The scientists concluded: "High resolution computed tomography may be indicated to identify early preclinical ILD in patients with RA whose physical examinations reveal crackles."
Author’s note: I agree with these findings and always send patients for a CAT scan of the lungs if I detect crackles on physical examination. The presence of lung disease is also a prompt to become more aggressive with treatment.
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Online Compulsive Overeating Counseling
Online compulsive overeating counseling is one way that a person can seek help for a food addiction problem that actually grips many people who may be obese or may have a nearly normal weight.<div class="feedflare">
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Weight Loss Supplement Program
Many dieters turn to a weight loss supplement program as a way to jump start efforts to shed extra pounds.<div class="feedflare">
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What Causes Arthritis
In order to understand what is arthritis, it is helpful to understand that this disease encompasses over 90 different medical conditions within the same term.<div class="feedflare">
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Weight Control Surgery
Turning to weight control surgery is often a last resort for those who have tried to loose pounds through other methods.<div class="feedflare">
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Gastric Lapband Surgery
Gastric lapband surgery can be the answer for many people who have been fighting obesity for years.<div class="feedflare">
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Obesity Treatment Center
An obesity treatment center may be the last stop for a person who has tried for years to lose weight.<div class="feedflare">
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Stomach Banding Surgery
Stomach banding surgery is one of the options that those who are obese have that can dramatically reduce a person's weight.<div class="feedflare">
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Treatment For Binge Eating
Treatment for binge eating is available for persons who struggle with food addiction disorder issue.<div class="feedflare">
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Morbid Obesity Surgery
Bariatric or morbid obesity surgery may be required for someone who needs to lose a great deal of weight.<div class="feedflare">
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Symptoms Of Generalized Anxiety Disorder
Symptoms of generalized anxiety disorder (GAD) are more than just a feeling of anxiousness just before a deadline passes or a traumatic situation resolves itself.<div class="feedflare">
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Mini Gastric Bypass Surgery
The option of mini gastric bypass surgery may be a viable one for anyone who is considering a less invasive, but still effective, form of bariatric treatment.<div class="feedflare">
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How To Control Emotional Eating
Binge eaters may learn how to control emotional eating through psychological counseling and reprogramming self-image attitudes.<div class="feedflare">
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Compulsive Eating Treatment
A successful compulsive eating treatment deals with the underlying causes of food disorders.<div class="feedflare">
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Eye Exercises To Improve Vision
Many websites and other advertisements offer eye exercises to improve vision for the person who is willing to undergo a regimen of therapies.<div class="feedflare">
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Tummy Tuck Financing
A tummy tuck financing agreement may lead to a slimmer appearance, but it can also lead to a host of other problems and will definitely slim down a person's wallet in the long run.<div class="feedflare">
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Parkinson's Disease Support Groups
Parkinson's disease support groups can help a person cope with the physical and emotional changes caused by the illness.<div class="feedflare">
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Gastric Bypass Financing
There can be many challenges to obtaining gastric bypass financing including difficulties in dealing with insurance restrictions as well as finding outside lending opportunities.<div class="feedflare">
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Treatment For Eating Disorders
The successful treatment for eating disorders hinges entirely on the skill and knowledge of a team of medical professionals: mental health, medical, registered dieticians, and family counselors.<div class="feedflare">
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Cataract Eye Surgery
When someone goes for cataract eye surgery, he often wonders what the surgeon will do and if the procedure is painful.<div class="feedflare">
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Diabetic Retinopathy Symptoms
Almost every person who has diabetic retinopathy symptoms can avoid significant vision loss with good diabetic retinopathy treatment.<div class="feedflare">
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