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Insider Arthritis Tips July and August 2015
July 15, 2015

“Logic will get you from A to B. Imagination will take you everywhere.” - Albert Einstein

Does running increase the risk of knee osteoarthritis… next

Running history doesn’t contribute to knee OA

Jeff Evans writing in Rheumatology News reported on a study presented at the American College of Rheumatology national meeting. A history of running doesn’t contribute to increased risk for knee OA and may even be protective. They study drew from data in the Osteoarthritis Initiative. Both knee pain and x-ray changes were less frequent in runners than in non-runners.

Comment: Finally… some good news if you’re a runner.

So… when is the time right for a knee replacement…

Study: 30% Of TKA Patients Experience Rapid Disease Progression, Worsening Of OA Symptoms In Two Years Prior To Procedure.

Pam Harrison writing in MedPage Today reported that research published in Osteoarthritis and Cartilage suggests that nearly “30% of patients who undergo total knee arthroplasty (TKA) experienced rapid disease progression and worsening of osteoarthritis (OA) symptoms during the 2 years leading up to the procedure itself.” Researchers found that “during the 2 years prior to TKA, worsening by at least one Kellgren and Lawrence (KL) grade occurred in 27.4% of surgical knees from the Osteoarthritis Initiatives dataset compared with 6.6% of matched nonsurgical knees.”

Comment: Basically, if you need a knee replacement, you’ll know.



A side effect of a popular pain killer…

Opioid Linked to Low Blood Sugar

Kristina Fiore writing in MedPage Today reported the mild opioid tramadol was associated with an increased risk of hospitalization for hypoglycemia, researchers reported.
In a case-control study, the use of tramadol was associated with a 52% higher risk of hospitalization for hypoglycemia compared with codeine, Samy Suissa, PhD, , of McGill University in Montreal, and colleagues reported in JAMA.

Comment: Interesting fact that I wasn’t aware of…



Organs on a chip…

Researchers Developing “Organs-On-A-Chip.”

Richard Harris reporting in NPR commented that researchers are developing “organs-on-a-chip” that “are designed to test drugs and help understand the basics of how organs function when they are healthy and when they are diseased.” The blog added, “‘There’s going to be a brain-on-a-chip, liver, heart and so on,’ says Danilo Tagle, who coordinates this overall effort at the National Center for Advancing Translational Sciences,” part of the NIH. Altogether, “it is funding development of 10 organ systems.”

Comment: This will help speed up drug development I hope



An epidemic that will break the bank…

$87 Billion Dollars For Total Knee Replacements by 2030?

Reported in Blood Cure… We have an epidemic of knee arthritis in the United States with over 10 million affected Americans. Many treatments are prescribed with variable efficacy for this common problem. When all else fails, knee replacement is often recommended. This procedure is overall highly successful but also expensive.

In 2009, the CDC reported the estimated costs of knee replacement in the US to be $28.5 billion dollars. Published reports suggest there will be a need for almost 3.5 million knee replacements in the United States by 2030. At a conservative total cost of $25,000 per surgery, that translates into $87 billion dollars. So, the projections suggest the costs will triple over the next 15 years.
That is $87 Billion Dollars just in the United States to treat end-stage knee arthritis. That is just the cost of knee replacements. It does not include other surgical or non-operative costs. It also doesn't include treatment of other potentially arthritic joints such as the hip or shoulder.

 Comment: Obviously there is the need to find a better solution. Biotherapies such as stem cells are the areas where we need more progress.



What can the mind do for muscles?

The power of mental visualization in maintaining real-life muscle

by Stacy Brooks

Stacy Brooks writing in Medical Xpress reported researchers at the Ohio Musculoskeletal and Neurological Institute (OMNI) at Ohio University have found that the mind is critical in maintaining muscle strength following a prolonged period of immobilization and that mental imagery may be key in reducing the associated muscle loss.

Brian C. Clark and colleagues set out to test how the brain's cortex plays into strength development.
"These findings suggest neurological mechanisms, most likely at the cortical level, contribute significantly to disuse-induced weakness, and that regular activation of the cortical regions via imagery attenuates weakness. Their findings were published in the Journal of Neurophysiology.

Comment: The most powerful organ in the body is the brain.


Fat… how does that help your knees?

Fat-derived stem cells effective for osteoarthritis

Recent advances in tissue engineering have pointed towards the fact that adipose tissue may be a richer source of adult stem cells than other sources. In addition, they have a mixed population of multipotent and regenerative cells that may be more effective from a tissue repair point of view. These cells have been shown to modulate inflammation, increase the formation of blood vessels, and repair connective tissue. A recent Korean study demonstrated cartilage repair using second look arthroscopy at two years following adipose stem cell treatment.

Comment: Adipose derived stem cells are intriguing. I know my female patients are interested since a liposuction is required to harvest enough fat for stem cell procedures.


This next piece is highly unusual…

Cannabinoid Receptor Agonist May be Beneficial for Rheumatoid Arthritis

Rachel Lutz writing for HCP live reported a treatment that targets the CB2 cannabinoid receptor may be an effective treatment for rheumatoid arthritis and synovitis, according to research published in BMC Musculoskeletal Disorders.
A collaborative team of researchers from the United Kingdom investigated cannabinoid receptor isoform CB2 as a target for treatment for rheumatoid arthritis while reviewing current treatments available to patients. Anti-inflammatory effects were detected and might work together with existing therapies.

Comment: Far out!

Sugar water injections. Hope or hype… next

Evidence Supporting Efficacy Of Prolotherapy To Treat Chronic Joint, Muscle Pain Is Limited.

Corey Carson writing in the Washington Post reported that “prolotherapy, a treatment for chronic joint and muscle pain that involves injecting patients with becoming increasingly popular, even though evidence supporting its efficacy is limited.” The treatment involves “the injection of a non-active substance, most often dextrose, into an injured tissue to stimulate inflammation and trigger the body’s natural healing response.” Studies suggest that the treatment “may be effective for some parts of the body and not effective for others.” There is limited support for use of prolotherapy for ligament and tendon overuse injuries of a chronic nature.

Comment: Not sure what to say. I know two physicians who are experts in this method and according to them it works well. Using platelet rich plasma – PRP- might be a better- albeit more costly- method of treating tendon and ligament issues.

Sea Gold It’s the purest form of Omega-3 fish oil available. 


Research studies show that Omega 3 fish oil health benefits are downright amazing.  Getting more Omega 3 fish oil is one the best things you can do for your health.  And Sea Gold is the purest, most effective dietary fish oil manufactured.  Omega-3 fish oils have been shown to be a remarkably effective and safe treatment for the inflammation of arthritis. 


Omega-3 fish oils have been recommended by more rheumatologists than any other dietary supplement for the control of the inflammation that accompanies rheumatoid arthritis, psoriatic arthritis, and other forms of inflammatory arthritis.  Studies show that supplementation with fish oils can markedly reduce morning stiffness and the number of painful joints for people who have rheumatoid arthritis.


You'll feel happier and be so much healthier through the benefits of Omega 3 supplements, such as Sea Gold.


·         Lower blood pressure.

·         Reduce triglycerides.

·         Improve your memory and energy levels.

·         Reduce your stress and fatigue.

·         Reduces breast, colon and prostate cancer.

·         Live a strong healthier life!

·         Reduce your risk of arthritis, heart attack, stroke, and sudden death.

And now it's time to put all these Omega 3 fish oil health benefits to work by eating more oily fish and taking quality fish oil supplements every day.


Buy 2 and Get 1 Free….


This offer is available only thru August 2015.  Call our office at 301-694-5800 to speak with our product specialist. 

Raspberry-Cream Cheese Muffins


  • 1/3 cup butter, softened
  • 1 1/2 cups sugar
  • 1 1/2 teaspoons vanilla extract
  • 2 large egg whites
  • 1 large egg
  • 2 cups all-purpose flour
  • 1 teaspoon baking powder
  • 1/4 teaspoon baking soda
  • 1/2 teaspoon salt
  • 1/2 cup low-fat buttermilk
  • 2 cups fresh or frozen raspberries
  • 1/4 cup finely chopped walnuts
  • 2/3 cup (5 ounces) 1/3-less-fat cream cheese, softened


Preheat oven to 350°. Combine cream cheese and butter in a large bowl. Beat with a mixer at high speed until well blended. Add sugar; beat until fluffy. Add vanilla, egg whites, and egg; beat well. Lightly spoon flour into dry measuring cups; level with a knife. Combine flour, baking powder, baking soda, and salt. With mixer on low speed, add the flour mixture and buttermilk to cream cheese mixture, beginning and ending with flour mixture. Gently fold in raspberries and walnuts. Place 24 foil cup liners in muffin cups. Spoon batter evenly into liners. Bake at 350° 25 minutes or until a wooden pick inserted in center comes out clean. Remove from pans; cool on a wire rack.

6 Unusual Signs of Dehydration

Everyday Health

  • Dehydration, which occurs when the body has insufficient water and other fluids to function properly, can lead to blood clots, seizures, and other potentially fatal complications. Here are six surprising indicators that you might be dehydrated.
  • Bad breath. Saliva has antibacterial properties in it, but dehydration can prevent your body from making enough saliva.
  • Dry skin. A lot of people think that people who get dehydrated are really sweaty; but as you go through various stages of dehydration, you become very dizzy and you don’t have enough blood volume so you get very dry skin.
  • Muscle cramps. The hotter you get, the more likely you are to get muscle cramps, and that’s from a pure heat effect on the muscles. As the muscles work harder and harder, they can seize up from the heat itself. 4. Fever and chills. If your body is severely dehydrated you may experience symptoms like fever or even chills. Fever can be especially dangerous. Seek immediate medical help if your fever rises over 101°F.
  • Food cravings, especially for sweets. “When you’re dehydrated, it can be difficult for some nutrients and organs to release some components of your energy stores resulting in food cravings. While you can crave anything from chocolate to a salty snack, cravings for sweets are more common because your body may be experiencing difficulty with glycogen.
  • Headaches. The brain sits inside a fluid sack that keeps it from bumping against the skull. If that fluid sack is depleted or running low because of dehydration, the brain can push up against parts of the skull, causing headaches.

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Healing Essential Oils

Natural Health
Elizabeth Barker ~ 6/2/2014

  • TEA TREE - This antibacterial, antiviral oil helps knock out yeast infections.
  • CASSIA (CINNAMON) BARK - Traveling to a foreign country? The antiviral effects of cinnamon bark guard against diarrhea, E. coli, and salmonella. To help prevent food-borne disease, take one drop of cinnamon bark oil in a cup of water several times a day.
  • PEPPERMINT - A pain-reliever and digestive stimulant, peppermint can tame headaches and ease constipation. Apply two drops to your temples or the back of your aching head. For digestion, dispense one drop in a cup of water, then drink.
  • EUCALYPTUS - Soothing to the respiratory system, this antiviral oil helps with colds, coughs, and sinus infections. Dab a few drops on the tops of your feet. Your veins transport the oil up to your lungs in less than 30 seconds.
  • HELICHRYSUM (IMMORTELLE) - This "emergency oil" can stop bleeding on contact and acts as an instant analgesic for gashes and wounds. Apply one or two drops directly on the wound. In about a minute or two, the pain will be gone.
  • RED MANDARIN - Able to trigger the release of gas, this antispasmodic is strong enough for adults with constipation. Combine three drops of red mandarin oil with one drop of peppermint, and apply to your abdomen when you're bloated.
  • SPRUCE - White spruce is a natural antihistamine provides relief from congestion, runny nose, and itchy eyes. Apply one or two drops to the top of each foot. Or put a drop in each palm, rub your hands together, and cup them over your nose and mouth.

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Your Role as a Patient: What You Can Do

Arthritis Today

  1. Succeeding with a chronic illness involves more than just following doctor’s orders. If you’re willing to work at it, these five habits will ensure you live successfully with arthritis:
  2. Learn all you can. - Knowledge is power. Read everything you can, and locate trusted sources of news and information (online or offline); find out where exercise classes are being held in your community; and ask lots of questions – of your doctor, your physical therapist and other health-care providers.
  3. Pay attention to your emotions. - Living with a chronic condition such as arthritis ups your chance of developing depression. Warning signs include constant tiredness, lack of appetite, trouble making decisions, disrupted sleep and feeling worthless. To head off depression, develop a network of family and friends who raise your spirits and can help you keep active.
  4. Make your doctor your partner in care - You’re more likely to find success if you and your physician make informed decisions together. Make sure your doctor spends time with you discussing treatment options and answering all your questions. Talk about ways to improve your functioning, such as losing weight, becoming more active or reducing stress. Don’t be embarrassed to talk to your physician about anything, including admitting when you haven’t followed her advice. Agree to disagree when the two of you have different opinions – and keep talking about it.
  5. Take action. It’s natural to be unsettled and upset after being diagnosed with arthritis or a related condition. But those who live successfully with chronic illness accept that their diagnosis is here to stay and they quickly start thinking about how to adapt their lives. Look at what you can do and what you may need to change (whether it’s activities, diet, exercise or stress level). Make a plan (with your doctor) and write it down. Talk to family and friends about the changes you’ll need to make. Letting others know about your plan can help you stick with it.
  6. Invest in yourself. You don’t have to give up the life you had before you were diagnosed, but you may have to put that plan you made into action. It’s not surprising to hear that the most successful patients are the ones who made changes, such as exercising more, losing weight and eating more nutritious meals. Recognize your responsibility – and ability – to take good care of yourself in order to live healthfully. Make sure your goals are realistic, even if they involve only small steps right now. Enlist family and friends to help you make healthy changes, and monitor your own behavior frequently.

Wei's World

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Why Philanthropy?

Nathan Wei, MD, Rheumatology, 12:51PM Jun 3, 2015


On May 28th, I had the pleasure of attending graduation exercises for the Class of 2015 at the Sidney Kimmel Medical College of Thomas Jefferson University. Four years ago my wife and I set up a scholarship fund in my mother's memory and the first recipient of that scholarship, Christine Chang, MD, was one of the graduates. It was a memorable occasion. And it was particularly special for me because it was the 40th anniversary of my graduation from Jefferson. One touching moment occurred when the Hippocratic Oath was administered and all of the physicians in the audience were asked to join in.


When Judy and I made the decision to create the scholarship, it was done because my mother was a driving force in my becoming a doctor and also attending Jefferson. When we established the scholarship, however, we had no idea we would receive far more than we had given. Christine has become a "daughter" to us and we have been so proud of her accomplishments. In addition, we've become acquainted with her family. Her Mom and Dad are hard-working immigrants much like my parents were.


So... back to the graduation. Mr. and Mrs. Kimmel were in attendance. When the renaming of Jefferson to the Sidney Kimmel Medical College took place, there was grumbling and controversy among some graduates as to whether this was appropriate. The naming of medical institutions, however, is not new, and I personally could not see a downside. In fact, Sidney Kimmel, who grew up relatively poor in Philadelphia, rose through the ranks to become CEO of the apparel company, Jones New York, and is a real life Horatio Alger. He has been generous in providing funds for cancer research at many institutions including Sloan Kettering and Johns Hopkins.


Viktor Frankl, an eminent Viennese psychiatrist, was a Nazi concentration camp survivor. In his famous book, Man's Search For Meaning, describing his experience, he wrote "Everything can be taken from a man but one thing: the last of human freedoms- to choose one's attitude in any given set of circumstances, to choose one's own way..."


Medicine, the proudest profession, has been crushed by onerous governmental regulations, emasculated by insurance companies, and pillaged by lawyers. As physicians, we still have the ability to choose our attitude. I am determined to survive and thrive. My experience with philanthropy has given me a new understanding of what is really meaningful. I "get" why people like Sidney Kimmel do what they do. It is a privilege and honor to give.

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