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Insider Arthritis Tips Newsletter October 2010
October 15, 2010

""When you find yourself stressed, ask yourself one question: Will this matter five years from now? If yes, then do something about the situation. If no, then let it go."

-- Catherine Pulsifer, writer

Here's more arthritis news from this past month...

Cartilage Cell Transplant May Benefit Certain Patients With Knee Osteoarthritis
Janice Lloyd writing in USA Today, reports that autologous chondrocyte implantation (ACI) may delay knee replacements for certain patients with osteoarthritis.
ACI "requires two operations, followed by a lengthy recovery, and physical therapy," however, and "for 12 to 18 months, the new cartilage cells need to heal and harden." Meanwhile, "patients wear a leg brace and use crutches for several months. They can run after a year and pivot several months later."
To date, the procedure has a 92% success rate and is not suitable for patients who are obese.
Dara Torres, the Olympic swimmer, had this done, and says, “ it's the toughest rehab she has ever faced.”
In an accompanying editorial, Riley Williams, a surgeon at the Hospital for Special Surgery in New York., said, “People who need knee replacements can scratch this cartilage repair surgery off their list. If you have one, maybe two areas of isolated cartilage loss, then you are a candidate," says Williams.
"If you have it on one side of the knee, the meniscus is gone, and clearly the environment of the knee has shifted toward the degenerative, then we can't help with this kind of surgery."

Comment: Cartilage implants are good for localized defects but aren’t practical for osteoarthritis.

RA May Raise Complication Risk After Ankle Replacement
An article in HealthDay quoted a study showing rheumatoid arthritis is associated with an increased risk for major complications for patients who have undergone ankle replacement.
The research was published in the Journal of Bone & Joint Surgery. The researchers found that female sex, a history of corticosteroid use, and underlying inflammatory arthritis were associated with higher risk.
Among those needing additional surgery for major complications, underlying rheumatoid arthritis was the only significant risk factor, incurring a 14-fold risk.

Comment: This is another example of the systemic effects of this potentially devastating disease.

Disco Star Beats Knee OA
Gloria Gaynor, the Queen of disco has struggled with osteoarthritis knee pain since 1984. Ms. Gaynor, who says she is a "survivor," was diagnosed with OA of the knee over 25 years ago.
She tried numerous treatment options to manage the pain including exercise, various non-drug therapies, simple pain relievers and finally hyaluronic acid (HA) therapy.
Ms Gaynor, who had major hits with “Never Can Say Goodbye” and “I Will Survive”, is the national spokesperson for Euflexxa, a hyaluronic acid viscosupplement.

Comment: Time to get out my polyester jumpsuit, my gold chains, and platform shoes…

Pfizer Arthritis Drug Worked Too Well
An experimental arthritis drug from Pfizer reduced pain more than researchers thought. Apparently, it reduced pain so well That some patients overused and damaged their joints.
Bone destruction developed in 16 of 6,800 patients taking the medicine, tanezumab, as part of a research program, requiring joint replacement for the affected knee, hip or shoulder, according to an article in the New England Journal of Medicine. Pain-free patients may have put excessive pressure on their joints because they weren’t getting natural pain signals to take it easy, s aid the lead researcher, Nancy Lane.
Tanezumab, a nerve growth factor inhibitor, was considered one of Pfizer’s most promising compounds in development. The FDA has put a halt on studies in osteoarthritis Involving tanezemab.

Comment: When it comes to pain…You know… sometimes you can too much of a good thing it seems. Having been one of the investigators for this compound, though, I think it worked very well and our patients were sorry to have to leave the study.

Bad Gene Causes Severe Osteoarthritis.
Robert Preidt, in HealthDay, reported that, according to a study to be presented at the World Congress on Osteoarthritis, researchers have identified "genetic factors that may predict severe osteoarthritis." In an "analysis of data from 1,154 osteoarthritis patients who were followed for up to 11 years," investigators "found that those with X-ray evidence of knee arthritis who had a specific pattern of genetic variations on a gene located on chromosome 2 were nearly twice as likely as other patients to develop severe osteoarthritis.
The gene variants were detected on the interleukin-1 receptor antagonist (IL-1Ra) gene, which modulates many of immune and inflammatory responses in the body," the study found.

Comment: Very interesting stuff. The more we find out about why these diseases occur, the better our chances for finding good treatments. I think these findings may explain why some patients with severe osteoarthritis seem to respond to drugs that block interleukin –1.

Anger Increases Pain in Women
Bill Hendricks in WebMD Health News reported on a study showing negative emotions such as anger and sadness increase pain in both women who suffer from fibromyalgia and in those who don’t, according to a new study.
Researchers in the Netherlands conducted experiments on a total of 121 women, 62 with fibromyalgia, a chronic pain condition, and 59 who don’t have the disorder. Both groups were asked to recall a neutral situation, then recall anger and sadness-inducing conditions.
The effects of these negative emotions on pain responses were measured. The participants were also subjected to electrical pain induction, where they pressed a button when they felt an electrical current and again when it became painful and once again when intolerable.
The researchers found that women with and without fibromyalgia indicated increased pain in response to both anger and sadness. A greater emotional reaction was associated with a greater amount of pain response.
“Emotional sensitization of pain may be especially detrimental in people who already have high pain levels,” says Henriet van Middendorp, PhD, of Utrecht University in the Netherlands, one of the authors of the study which appeared in the journal Arthritis Care and Research..

Comment: I don’t think these findings are surprising. Most of us know that our emotions always play into how we feel. And it’s not just women!

ASU supplement slows osteoarthritis
Mitchell Zoler reporting in the Rheumatology News described a study where the dietary supplement avocado soybean unsaponifiables over three years led to a modest but statistically significant reduction in x-ray progression in a placebo-controlled study of 345 people with symptomatic osteoarthritis of the hip.
The study was reported at the European League Against Rheumatism meeting by Dr. Emmanuel Maheu , a rheumatologist at the St. Antoine Hospital in Paris. ASU is felt to inhibit the effects of interleukin 1, a protein that promotes inflammation in osteoarthritis. The supplement is an avocado and soybean extract available in a 300mg softgel.

Comment: Just mix some soy sauce in with your guacamole... yuck!


A quick notice:

We have a new practice website. The address is:

Lots of good info and a weekly video blog with news three times a week.


This month we’re having a special on Myorx, a soothing topical arthritis cream that contains omega-3 fatty acids. Very effective for those pesky aches and pains. The regular price is $16.00 a jar. This month, take $5.00 off and get it for only $11 a jar plus S&H. The reason? We had a double shipment come in that we weren’t expecting so we’re overstocked. So right now we have too much …but this announcement is going out to both our subscribers here as well as to our practice patients so I expect a big rush since it’s so popular. You can order by going to the practice website or by calling the office at (301) 694-5800 during regular hours Eastern Time.


Wei's World October 2010

I like to fish. When I was a boy, my father used to take my brother and me on fishing outings. I still remember catching my first fish when I was five. It was a real thrill.

Some of my fondest memories revolved around those little fishing excursions we would make to the local reservoir. Occasionally, we would travel to the Jersey shore for a day trip fishing in the bay.

But most of our fishing was fresh water. The reservoir had bluegill, crappie, and carp. Many people think of carp as a garbage fish. But the water in the reservoir was clean and the carp were beautiful. In China, carp are considered a delicacy. After our fishing trips, it was always my mom who had to clean the fish. Now I understand why she never looked particularly happy when we brought these fish home.

Another fishing memory … my brother would always catch more fish than me. Always. We would change places, switch our bait, even switch fishing rods. Didn’t matter. He would still catch more than me. He had … and still has that knack. I swear… he probably could catch fish in a toilet!

I tried introducing fishing to my kids. It doesn’t seem to have caught on with any of them. I mean, they could take it or leave it. Not me. I still love to fish.

One summer, about five years ago, I took my dad and one of my sons with me to Northern Ontario. We went fishing for walleye and northern pike. It was a real thrill. We had to take a float plane to the lake. I took a photo of my son helping his grandfather walk down the dock after we landed. My dad caught a trophy walleye and we had it mounted. Even though his memory is fading fast, he still remembers that trip. He calls it the “trip of a lifetime.” And it truly was.

Nowadays, I still enjoy fishing. When we go to the Outer Banks of North Carolina, I love to surf fish. Sometimes I catch fish… and other days I don’t. I don’t really care. Being out there, with the blue sky and the birds, it’s a feeling that’s hard to beat. On the days when I have the luck to run into a school of fish, I’ll catch a lot of them and we’ll have a fish fry.

Between the bait, the rigs, and the license, it probably costs about $95 a pound for the fish I catch. My wife teases me about that. And that’s okay.

Many people who know me find it hard to believe I love fishing so much because I have a Type A personality. But I guess that’s why I really like fishing. It’s one of the few times I’m totally relaxed.

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