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Archive for September 30th, 2010

Arthritis – Can it Be Prevented?

30 Sep



Overview of Arthritis

Effective help is currently available for people to pro-actively manage arthritis and enjoy life to the fullest. But the actual prevention of arthritis itself is yet another story.

With rheumatoid arthritis (RA), the membranes or tissues lining the joints become inflamed. There is no known way to prevent any form of this disease, including osteoarthritis, adult-onset arthritis and juvenile rheumatoid arthritis. The exact causes of all these conditions are unknown.

It’s very important for people who fear they are at risk of rheumatoid arthritis to realize that at this time there are no medications to take or lifestyle modifications to make that can completely prevent this crippling disease. However, by making changes to your weight and diet and engaging in moderate exercise, you may be able to slow or even halt the disease’s onset and progress.

But you can only really take the measures needed to control arthritis after it is diagnosed. Until it is known for sure if certain bacteria or viruses trigger the disease, contact with people suffering from it will not change your risk of developing it.

Traditionally, medications and physical therapy have been used to manage the disease. A massive amount of nutrient research has also shown the effect diet and supplements have on the body’s healing processes. Lifestyle changes can also make a big difference.

Causes of the Disease

Joint injuries caused by accidents or overuse increase the occurrence of some types of arthritis. You can also inherit certain genes that may increase your risk. More research is needed to find out how to reduce the disease’s onset from these factors.

Some individuals have an inborn tendency to degenerative joint disease because they have changes in the structure of the important protein-building blocks of the articular cartilage which covers the surface of their joints. These seemingly small but significant abnormalities predispose their joints to wear and degeneration. In other cases, joint injuries may contribute to the development of DJD.

No foods have been definitively shown to cause or exacerbate arthritis in most individuals. A variety of diets and “hand-me-down” information exists about certain foods and arthritis, in particular the night shade plants, but none of it has been proven.

There is a rare form of arthritis called Spure which is caused by allergies to wheat products. Avoiding those will eliminate this disease. Associated features include weight loss, diarrhea and osteoporosis. Consult your health care provider if this is a concern.

There are things you can do to reduce your risk for getting certain types of arthritis or to reduce disability if you already have arthritis.

Overweight and obese people have a higher frequency of arthritis. Excess weight increases risk for developing osteoarthritis in the knees, and possibly in the hips and hands. Women are at special risk. In men, excess weight increases the risk for developing gout. It’s important to maintain your recommended weight, especially as you get older.

Arthritis Prevention Programs

The Center for Disease Control has implemented programs in several states to reduce the onset and consequences of arthritis. The National Arthritis Action Plan: A Public Health Strategy delineates the actions necessary to better understand the arthritis burden in the USA and helps to fully apply known and effective interventions.

This document represents the combined efforts of nearly 90 organizations, such as the Arthritis Foundation, government agencies and many other groups and individuals with an interest in arthritis prevention and control.

The NAAP proposes a nationally coordinated effort for reducing the occurrence of arthritis and its accompanying disability by focusing on these three areas:

1. Surveillance, epidemiology and prevention research to strengthen the science base.

2. Communications and education to increase awareness and provide accurate information about arthritis.

3. Programs, policies, and systems promoting increased quality of life for people with arthritis and facilitating arthritis prevention measures.

The CDC continues to accumulate scientific knowledge on the benefits of physical activity. Because healthy eating reduces a person’s risk of becoming overweight, good nutrition plays an important role in preventing knee osteoarthritis. In addition, moderate physical activity is essential for maintaining the health of joints.

Resources/The information outlined in this article is originally from:

HealingWithNutrition, Arthritis Facts, Disease Prevention and Treatment Strategies http://www.healingwithnutrition.com

Center for Disease Control, Framework for Arthritis Prevention and Control http://www.cdc.gov

The University of Washington Orthopedics and Sports Medicine Frequently Asked Questions About arthritis.

 
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Emergency Room Care at Home

30 Sep



Hospital emergency departments (EDs) were initially designed to provide immediate care for patients experiencing acute medical conditions and serious trauma victims. Once patients were stabilized they were either discharged home or transferred to another location for more advanced and specialized care. Now, EDs are experiencing increased use by people who do not have a primary care provider and use the ED for routine medical care. The increased inappropriate usage of the ED places an increased stress on already strained healthcare resources.

EDs have responded to the increased usage for non-emergent services by offering many more resources than the original emergency room. Now the ED has more diagnostic and treatment options than were previously intended. The ED now is a self-sufficient unit within the larger medical center, and has become integrated into the patients’ continuum of care. In-house specialty consultations are usually immediately available as are advanced diagnostic studies. This has perhaps led to a perpetuation of the misuse of the modern day emergency department.

An increasing problem is the misuse of emergency services by patients who do not have a primary care provider and use the ED for routine and non-urgent care. Less than 10% of emergency room visits are actually emergencies. More than half of the patients that present to the ED could be better served by being treated in place (home, skilled nursing facility, occupational health office, or added on to a PCP schedule). One-third of ED visits could be treated in a Primary Care Provider office. It has been well established treatment in Emergency Departments is more expensive than in any of the above mentioned potential care settings.

Despite the high cost of ED services non-emergent use of emergency services continues to grow. Many non-urgent ED visits could have been avoided if patients had a pre-existing relationship with an accessible primary care provider. In addition to the financial cost, crowded waiting areas, long wait times, actual and potential delays in receiving medical care patients are subjected to increased risk for medical errors, exacerbation of pre-existing conditions, and nosocomial infections. ERs will be swamped in the middle of the flu season with a combination of patient types some with actual flu or swine flu while others have minor sprains. Now the person with the sprain has been exposed to the highly contagious flu.

The medical house call has started to make resurgence in many parts of the country to help address many of the primary preventative non-urgent care needs of patients. The average ED visit in NYC can cost upwards of $800 and brings with it the risks of medical errors due to many different health care providers, loss of work and wages due to prolonged wait times, and infectious disease risk due to the gathering of people with airborne illness (Influenza, H1N1, staph and strep infections).

The average cost of a medical house call in NYC ranges from $150- $600 and greatly reduces the risk of nosocomial infections, saves time and reduces lost wages because the patient is able to wait in the comfort of their own home. Often times being able to see the patients normal environment can provide many clues for diagnosing a condition at a fraction of the cost of the ER visit. One hospital in Connecticut has even gone to posting wait times on line for their ERs so patients can log on and see how long it will take to be seen. As much as policymakers say they would like to reign in cost of health care clearly some have decided if you can’t fix the problem you may as well feature the problem.

The modern day medical house call can now offer many of the same services that were once only available in the emergency room. In the modern day medical house call patients can have comprehensive physical exams that include blood work, EKGs, x-rays, and ultrasounds (cardiac echo, carotid Doppler studies etc). These tests are often sufficient to provide the needed data to make a diagnosis and establish a treatment plan. Another benefit of the medical house call is the clinicians that are seeing you are able to give you their undivided attention. Also you will be able to see the same health care provider as opposed to the doctor of the day or medical resident. Another advantage of the medical house call is the increased privacy that you are afforded by the nature of staying in your home. If patient use the medical house call for their primary care needs as well as their sick day needs they may be able to spare themselves the stress and risks of a trip to the emergency room.

Some common conditions that can be treated in the home include common pulmonary infections (pneumonia & bronchitis), gastrointestinal conditions (stomach flu & abdominal pain), dermatological conditions (2nd degree burns, acne, rashes), chronic conditions (diabetes, COPD, hypothyroid, obesity, congestive heart failure, high blood pressure), urological problems (urinary tract infections, prostate inflammation, kidney stones), and dehydration. One preventative care measure that can be done in the home that is not typically done in an ER or even a traditional doctor’s office is health behavior counseling for lifestyle modifications. Typically this is done in doctor’s offices and Emergency rooms by giving you a generic handout. The reason for this is because the traditional care environment is focused doing the least amount of care possible to meet the needs of the masses that are waiting to be seen.

Emergency rooms were initially designed to treat acute medical conditions and to stabilize trauma patients before they are transfer to the appropriate treatment location. Unfortunately, EDs have also become a place to seek treatment for many people who do not have a primary care provider. As a result, the numbers of emergency visits has increased, although the reasons for the visits are often not emergencies. Non-emergent visits are causing a huge backlog of real emergency patients and increasing the amount of money spent on healthcare.

A new medical house calls company in NYC has recently opened which allows patients to communicate with their PCP online via a secure patient portal. Patients can request appointments online. The Nurse Practitioner arrives at the patient’s home, office or hotel usually the same or next day. The NP can diagnose the problem, order tests (most of which can be done at the patients home) and electronically submit a prescription to the local pharmacy that can typically deliver the medication. The company also offers established patients the convenience of web-cam follow-up appointments and email consultations, which allows patients to take their primary care provider with them when they travel. All of this costs a fraction of what the starting price of an ER visit would be. Patients can use their flex spending and health savings accounts or major credit card to pay for this service. As the debate over health care continues more and more innovative and market solutions will answer the call to solve the nations health crisis. The problem will be if policy is made to stifle innovation.

 
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My Joints Are Swollen – Do I Have Arthritis?

30 Sep



In short, ‘maybe’. A good rule of thumb when you are concerned about arthritis is the length of time for which you’ve been experiencing your symptoms. Typically, pain and swelling in the joints that persists for greater than six weeks is a good indicator of arthritis. However, this is not ‘iron clad’ and should be diagnosed by a doctor.

Not all joint pain and swelling is caused by arthritis, and because of the intricacies of the human body, any problem that persists for more than seven days should be evaluated by your physician. This is also true for joint pain.

If you’ve already been diagnosed with arthritis, and you notice new symptoms, consider consulting your doctor about possible causes and to gain advice on treating your pain and stiffness. In the mean time, here are some tips on relieving your swollen joint(s) at home.

Relieve your swollen joints

If you suspect your swelling is due to a recent injury, try icing the joint in fifteen-minute increments over a span of four to six hours. If you don’t have four to six hours to spare, do your best to treat the joint with ice in fifteen-minute increments for at least one hour.

People who have swelling that results from an old injury may find heat therapy to be both soothing and beneficial for mobility. Try a heating pad or microwavable heat pack while you’re watching TV or relaxing in the evening.

Arthritis sufferers will also find heat therapy more beneficial than ice. Moist heat will work well during an arthritic flare up. One of the best ways to utilize moist heat is by placing a wet towel in the dryer and running it until the towel is warm, but damp. Wrap the towel around the affected joint and relax. You can repeat this process as often as you like.

Joint swelling that is a result of infection can be treated with moist heat temporarily until you can see your doctor. If you believe you may have an infection, don’t put off visiting your doctor. The longer you wait, the more severe the infection can become, impacting the health of more than just your joints.

 
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Arthritis in Pets – Identifying Joint Pain Signs in Your Dogs and Cats

30 Sep



Around one fourth of all pet cats and dogs are affected in some way by arthritis. This condition can affect both old and young animals alike. There are several different factors that lead to the development of the arthritis in dogs and arthritis in cats. Injuries, infections, and joint disorders can all lead to this usually painful and even crippling condition. Because arthritis can be a very serious and even chronic disease, it is important to identify and treat it as quickly as possible.

Pets cannot tell or describe their pains and symptoms to you. Therefore, you must be aware of any signs or symptoms indicting that your animal is in agony from pain. There are several different indicators that let pet owners know that their pet may be suffering from some type of arthritic condition. One of the most common signs of joint pain is the change in the activity level of the animal. If a cat or dog begins to move less or slower than normal, then there is a very good possibility that the pet may be suffering from some form of arthritis.

In some cases, pets will not only move slower but they will refuse to move at all under certain conditions. For example, dog joint pain may lead the animal to completely refuse to jump into or out of a truck bed or another high place. Climbing stairs may also be a challenging activity for arthritic animals. Anytime that an animal stops carrying out actions that it once took is a red flag.

With extremely painful arthritis in dogs, the animal may yelp or cry out when touched or moved in certain positions. Dog joint pain can cause some mild mannered animals to even become aggressive when touched or handled. You may also see that the pet has a painful time getting up from a resting position or searches for a softer location to lie down when resting. These changes are typically much easier to identify in younger animals that have higher activity levels in the beginning. In older animals, it is possible that aging is the main culprit of slower activity. However, it could be a combination of age with arthritis that is causing the slower movements and pain in your pet.

Arthritis can also cause pets to lose their appetites and thus, lose weight. Some animals may even have a fever and appear to be sick. Other animals will lick at the aching joint as they lick at a skin wound in attempt to heal or comfort it. You may notice that the area is swollen and hot to the touch from joint inflammation.

Anytime that you notice a change in your pet’s behavior, appetite, or ability to move, then a veterinarian should be notified. The doctor will likely examine the animal, complete blood tests, and gain x-rays of the pet’s bones and joints. In some cases, a simple treatment such as pet medicine may solve the problem. However, the sooner that arthritis is identified, the quicker your pet can find relief from the condition.

 
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