The link between periodontal disease and arthritis

 They are now connecting the dots.  It was known there was a connection, but which came first?

"For many years, there had been suggestions that the oral bacteria causing periodontal disease might contribute to rheumatoid arthritis. For instance, past studies have found that periodontal disease occurs even more often in people with rheumatoid arthritis. People with both conditions also tend to have more severe arthritic symptoms that can be more stubbornly resistant to treatment.

What’s been missing is the precise underlying mechanisms to confirm the connection. To help connect the dots, a research team, which included Dana Orange, Rockefeller University, New York, NY, and William Robinson, Stanford University, Stanford, CA, decided to look closer."

Connecting the Dots: Oral Infection to Rheumatoid Arthritis – NIH Director's Blog

I had gum surgery for periodontal disease about 45 years ago.  I think I also had surgery for a frenectomy at the same time (removal of labial frenulum between front teeth).  Very painful.  Don't let them tell you it's no big deal. Anyway, until recently I've had no pain in my fingers.  Some in left hand now--don't know if it's arthritis or just old age.

Makes me want to leave the computer an floss.  

Arthritis and diversity social policy

 

Two friends have described to me their terrible problems with rare forms of arthritis, so today I decided to look at NIH and see what sort of research was going on at the federal level of support.  That took me to The National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS).  The first statement I encountered was not about this challenging debilitating constellation of diseases, but about diversity!  Yes, that diversity--they've even changed the name of the Precision Medicine Initiative to All of Us. Read the message of the "guest director."

Since its inception, the Precision Medicine Initiative® (PMI) Cohort Program — recently renamed the All of Us^SM Research Program — has been deeply committed to diversity. This commitment was inherent in the President’s vision when he announced the program in January 2015, with the goal that this massive new effort scale the benefits of precision medicine across health statuses and across populations.

 Our goal is for people of all ages, races and ethnicities, sexual orientations, and socioeconomic statuses to join us in this unprecedented effort. To achieve this, we aim to build trust through intensive community outreach and engagement, maintaining the highest standards for security and privacy, and providing a meaningful value proposition to the people who generously share their information with us including through a firm commitment to returning research information. We share with NIAMS the commitment to multicultural outreach and the goal of bringing populations historically underrepresented in biomedical research into the fold — and ensuring that precision medicine discoveries yield meaningful advances to all communities across the United States

Good luck, sir, on sorting out the "diversity" goals of this administration with transgendered folks who don't have the cell, muscular or bone structure of the sex they are pretending to be. Be careful or your researchers will be called transphobic.

The guest director, Eric Dishman's message also alerts us to the real reason for the Electronic Health Records foisted on us and medical community through ARRA funding in 2009 at great cost, from which it hopes to use our data.  Good luck if you need mine or my husband's, because it takes months to move them a mile or so down the road from Riverside hospital to our doctor's office.  A carrier pigeon would move faster.

Eric Dishman and Ted Talk

http://www.healthcareitnews.com/news/eric-dishman-exits-intel-head-national-institutes-health-precision-medicine-research

Steroid Shots No Long-Term Help in Knee OA

“In the study, which was funded by the National Institutes of Health, there were no significant differences between patients who received injections of triamcinolone hexacetonide every 12 weeks and those given placebo in change in pain on the Western Ontario and McMaster University Arthritis Index (WOMAC), with differences of -2.2 in the steroid group and -2.8 in the placebo group (P=0.3), reported Timothy E. McAlindon, MD, of Tufts University in Boston.”

Read here.

"I think we can conclude that intra-articular corticosteroids used at the dose of 40 mg for 2 years has no major effect on structure in the joint -- either deleterious or beneficial -- and that over the long-term we don't see an overall effect on patient-reported outcomes or physical function," he said [Timothy McAlindon].

Psoriatic Arthritis—light after darkness by guest blogger Sarah Terry

Sarah has PsA (Psoriatic Arthritis) and a year or so ago I visited her in a nursing home after a terrible flare up. Today on Facebook Sarah wrote about her long and successful climb back to encourage those new to the disease, but I believe her message is also an encouragement for those facing other health challenges.

“Today I had an appointment with my rheumy, who I have come to like very much. When we first met last January 2014, I was in a wheelchair, it was 23 degrees below zero outside and I was in so much pain, I could barely move. I was so weak that I couldn't even kick off sheets from my legs. Everything hurt and I do mean everything, because I'd been off my Remicade since August due to a tooth infection that went nuts in my body and gave me what I call my super flare and led to 2 weeks in the hospital and 3 months in a nursing home, because I literally could not stand, toilet, walk, wash- -nothing.

Fast forward to today. My rheumy said he thought that I was glowing (I thought ... glowing?? I'm certainly not pregnant, lol). He said that with as many things as I had going on and all the meds, I looked absolutely joyful - to which I replied, I try and when I'm down, I very much remember the distance I've come. That I can now walk, go to the store, drive a car, take a shower, take out my trash, pick up my cat, change her litter box - most all of what I did before, except working. But even that is all right because I had 32 years at Ohio State University.  Although I had planned to work another 10 years, this is what happened and I am now in a better place than I had been for the past 15 yrs.

So what is my message?  Well, it is that there is light after darkness. That often you will have to dig deeper in yourself than you ever thought possible. That things happen for a reason, although you might not know that reason. That there are always options, even though you thought you might not ever have considered those unknown to you. That you are here for a reason and you will learn the lessons and you will be of help to others. That your pain is real and so is your joy and in time, you can learn to experience more joy than pain or even both at the same time - but you won't be held down by the pain, unless you choose to be.

The good news is that medicine has made advances and those of us with this disease have so much more available to us than previous generations. With the internet we can become educated and better advocates for ourselves. Now we have choices.”

My 100% remission from Rheumatoid arthritis, by guest blogger Gerhard Maroscher, Circleville, OH

In the summer of 2006 I suddenly came down with rheumatoid arthritis (RA).  The only warning I had that something was amiss prior to 2006 is that several years before, for a nine month period I had muscle pains and was diagnosed with fibromyalgia. I started anti-inflammatory drugs in 2006 and did my best to stay active from 2006 to 2012, but always had some pain.  At times the pain was debilitating. 

In July of 2012 I contacted a woman whose RA had gone into remission through a special diet.  She told me she had gone 100% dairy free and 100% gluten free, and within a short period of time she was pain free.  I believed her story, and I had nothing to lose and decided to follow her diet.

July 25 of 2012, which was one of my cycles with severe pain, I began a new diet.  I eliminated all dairy and gluten from my diet.  Regarding dairy, I even avoided anything where dairy was even a minor or even minuscule ingredient.  I stayed on my meds because I did not expect the diet change to have any impact.  Amazingly I was totally pain free in two weeks.  I then began to taper off my medicines over the next three months.  I continued to improve until about December.
 
I began to educate myself and read two books she had recommended.  From my reading I think the most likely reason I am in remission is the elimination of all dairy products, but I‘m not willing to risk adding back in the gluten. 

In December 2012 my joints were in better shape than one can expect at 69, but I felt there was room for improvement and I modified my diet again.  Of course I stayed dairy free and gluten free.  I then went on The China Study diet which is a whole plant food diet.  No processed foods and no animal protein.  The change was not dramatic, but my joints improved nevertheless.  I am now 71 and have zero joint issues and zero joint pain.  I have now been blessed for almost three years with 100% remission from RA.

My current diet is 95% in keeping with the China Study diet.  The whole plant food diet is modified a bit by me occasionally eating fish or meat, but never very much.  By the way the China Study diet does not see a problem with gluten in the diet. What it does recommend is whole plant foods and of course zero dairy.

The take way from all this?  Diet is more important than we realize.  One is never too old to make a good decision. 

For anyone considering a diet change test, based on my experience and my reading, if there is going to be a positive result, it will be seen within four weeks.  Such a diet change as mine will not help everyone, and certainly will not help many as dramatically as it helped me, but even it there is a little bit of improvement, that is a good thing. 
My qualifications for discussing the above?  I have absolutely no nutrition training and no medical training.  But I have the real life experience of a miracle healing.  
 
I recommend reading “The China Study” by T. Colin Campbell.    There are a number of opportunities at this website for more research. http://www.thechinastudy.com/the-china-study/about/

Dr. Pamela Popper wrote a book suggesting whole food plant based diet with very little fish and meat. http://wellnessforum.com/
 
Dr. McDougal also wrote several books.  McDougal recommends eating no animal products.  http://www.drmcdougall.com/health/education/health-science/featured-articles/articles/diet-only-hope-for-arthritis/

After reading the above I also recommend reading “The Inflammation Free Diet Plan” by Monica Reinagel and she also has a blog and is on Facebook. http://inflammationfactor.com/monica-reinagel-ms-ln-cns/

Arthur and me

There’s a joke going around since before my grandmother’s day about going out with Arthur--i.e. arthritis. The last time I chatted with my nice doctor, who increasingly has moved into management and can’t take on new patients (sorry), I told him about the aches I have in my legs and hip joints especially first thing in the morning, or after vigorous exercise. It goes away, but if I‘ve done much walking on Tuesday, especially on hard surfaces like concrete sidewalks or mall walking, Wednesday morning I‘m a bit unsteady. When I stand up to leave during intermission (here at Lakeside), I’m almost out of the auditorium before my gait is normal. So even a few minutes of sitting creates an ache similar to 30 minutes of brisk walking. He didn’t seem too concerned, but said it was arthritis and recommended glucosamine chondroitin (3 weeks before you notice any change, he said) or some pain medications.

So I’ve been doing a bit of research on the internet (PubMed, Medscape, Google Scholar), looking at 1) physical problems that aggravate the joints, 2) affects of mild exercise, 3) interventions like acupuncture or supplements for osteoarthritis, 4) and the possibility of orthotics. The pain I experience is actually very familiar--I remember it as young as age 12 when repetitive motion like ballroom dancing or horse back riding would create that same ache after only a few minutes. So I’m guessing something is out of alignment and it gets worse as I age. I’ve learned that any type of aerobic dance exercise, although great fun and a good cardio workout, will really set in motion a pain sequence. Some years ago my doctor recommended trying acupuncture for hip pain, and I did--only 2 or 3 sessions. Whatever it did, either reducing inflammation or interrupting pain messages to the brain, a few sessions worked for many months. So I’m definitely taking another look at that research.

Because of our aging population, this is a rich vein for researchers. If you don’t have arthritis now, just wait a few years. The mine field in working through medical research is “the gap.” If you go to any web page of the NIH or health foundation, you see there are vast amounts of grant money if you want to research the gap in care, treatment, or diagnosis between races, income groups, genders, education, etc. Now all I have to do is find the researcher looking for ME--white, healthy, well-educated, normal BMI, married, suburban and retired.

Right now I’m looking through the research of Brian C. Focht, an assistant professor in the College of Public Health at Ohio State. Here’s why. Assistant professors are hungry for grants and publications, because that’s how you get ahead in academe--they need to be cutting edge and find their niche**; the College of Public Health used to be the School of Public Health, so it is eager to establish itself (recently got a mega grant from NIH to do all that “gap” research--our tax dollar at work); and OSU is right next door, so it’s easy to check things out if a new study is gearing up and they are looking for me.

Millions are being invested in "lifestyle" research. It's not just the women's magazines--the government is eager to get you coming and going and control everything that goes in your mouth, nose or other orifices. That's why I liked the results of this one.

“Exercise + dietary weight loss results in improved mobility-related self efficacy; changes in these task-specific control beliefs and self-reported pain serve as independent partial mediators of the beneficial effect of exercise + dietary weight loss on stair-climb performance.” “Exercise, self-efficacy, and mobility performance in overweight and obese older adults with knee osteoarthritis,” Brian C. Focht and others, Arthritis Care and Research, 53:5; 659-665.

It seems this group did better than the “healthy lifestyle” control group. I love it when my own “eat less, move more” plan comes out on top, and doesn’t cost a thing.

Another article I read, also about knees, not hips, described mild exercise as slow walking. So I’ve slowed down, and right away I can tell the impact on the hip joints has lessened. Seems simple, but so much in exercise stresses cardio, that sometimes we forget those other muscles and joints have needs too.

Johns Hopkins Health Alerts--Arthritis

**Barack Obama, who spent 12 years teaching at the University of Chicago Law School and didn't publish a single paper, is the exception (according to the NYT, July 30). Some folks get a different set of rules.