Question of the month
month we are able to respond to 2 of our readers questions.
this months answers we turn to Dr. Monique Camerlain who has more than
30 years of experience in rheumatology. Dr. Camerlain is the author of
approximately 100 articles and some 200 medical presentations.
S. Attwater, United States...
"My mother has RA and has
been put on the waiting list for a double hip replacement. The wait is
about one year long and she is suffering with a lot of pain. Can you
suggest anything for the pain?"
It is unfortunate that the
medicare system permits a person in your mother's condition to suffer
so long in pain. Furthermore the delay leads to other problems such as
muscle wasting, osteoporosis, excess stress and possible damage to
other joints compensating for the hips, clots in leg veins, skin
ulcers, psychological distress and depression and care-giver burn-out.
Request that your mother be
put on a waiting list for the surgery. Get any help you can to move her
up on the list. Write your health minister and local MP and MPP to
voice your concerns.
Physiotherapy will teach
joint protection, muscle strengthening and range-of-movement exercises,
pool therapy and use of walking aids such as forearm crutches.
Occupational therapy will help modify environment to protect hips eg
raised chairs and toilet seat, dressing and washing aids
The most effective and best
tolerated nonsteroidal antiinflammatory drug should be used on a
regular basis. They may be more effective in a suppository form
overnight. Analgesics should also be used--sometimes regular doses of
long-acting narcotics are needed. Acupuncture may help. Injection of
the hip joints with cortisone under radiological or
ultrasound guidance may be effective and may need to be repeated.
Maximum control of the rheumatoid arthritis is also important because
some of the hip joint pain may be due not only to damage but
to inflammation. Measures to counteract osteoporosis are also advisable.
M. Ginger, New Zealand...
"I find that
cutting out dairy helps reduce the frequency and severity of pain. Do
dairy and other foods play a role in Sjogren's syndrome? "
It is estimated that up to 5% of patients with
various forms of arthritis may worsen with certain foods. There is
nothing specific about Sjogren's Syndrome. The commonest foods
implicated in worsening rheumatoid arthritis-like conditions include
dairy products; wheat, corn, beef; and tartrazine dyes. There are few
good studies on this subject and they are difficult to do in a rigorous
A good study in an
individual patient with rheumatoid arthritis worsened by dairy products
is described in the following article: Panush RS, Stroud RM, Webster E:
Food-induced (allergic) arthritis. Inflammatory arthritis exacerbated
by milk. in the journal called "Arthritis and Rheumatism" , Volume 29,
pages 220-226 in the year 1986.This article describes a patient
diagnosed with rheumatoid arthritis who worsens after eating dairy
products. The patient was better off dairy products but worsened on 4
blind challenges with milk products but not with other foods or
placebo. Symptoms peaked 24 to 48 hours after each dairy challenge and
then resolved by 3 days. These flare-ups were associated with
immunologic hypersensitivity to milk as measured by tests of cellular
and antibody immunity.
dairy products definitely helps and ingesting them definitely worsens
your joint symptoms, then avoid eating them. However, make sure you
supplement your diet with adequate amounts of calcium and vitamin D.
great health & good fortune,
Map | CONTACT
USReturn from "Ask The
Editor" to the September Newsletter