Many pet owners are all too familiar with pain from arthritis.  Pets age quickly and may only live for 15 years.  Reaching maturity in the first year their growth can be astounding especially for a large or giant breed dog.  We see osteoarthritis commonly in certain breeds of dogs.  Hip dysplasia can be very common in dogs like  German Shepards and Saint Bernards.  We will see radiographic evidence of dysplasia early.  Often by 6 months these dogs will have radiographic changes, an abnormal gait and shallow joints.  As they age, some dogs will become progressively worse and need medication for pain.  An occasional dog may be affected and need a total hip replacement with a implant.  Other joints may also be affected and elbow disease is now commonly seen in certain breeds of dogs like the Bernese Mountain Dog.

Signs of joint arthritis can be a dog or cat not getting up and around like normal.  They might resist getting up the stairs or jumping up on furniture. Some will just be stiff when getting up. Watching an animal’s weight and limiting stress in young growing joints might prevent problems later in life.

Veterinarians use a number of medications to help animals who are showing signs of this disease. Nutraceuticles like glucosamine and chondroitin can help.   Non-steroidal anti-inflammatory drugs can prevent pain but must be used with caution to prevent serious side effects.

Lyme Disease in Pets

Lyme disease is now a major problem in Pennsylvania and we are seeing dogs showing signs of infection locally. Some dogs will show a positive on the yearly test without any symptoms. Others will present arthritic with fever, pain and swollen joints. Spread by the tick this disease can be severe especially in humans.  Prevention is key and pet owners and any anyone outdoors should be aware of ticks. Topical medications are very useful for animals. Infected dogs are treated with antibiotics and often recover quickly. Certain breeds do not become infected when exposed.

Rheumatoid Arthritis

Occasionally we see dogs with immune mediated arthritis. An erosive form of immune –mediated polyarthritis can be seen in dogs with Rheumatoid arthritis. Additionally there is an erosive polyarthritis in Greyhounds and a feline chronic progressive polyarthritis seen in cats. This problem is diagnosed with a joint tap. These pets can be treated with corticosteroids and chemotherapy drugs. Caution is advised to void the long term side effects of these drugs.

A nonerosive immune mediated arthritis is also seen in both large and small breed dogs. The idiopathic form is the most common. Certain breeds are over represented with this condition. Usually diagnosed with a joint tap this disease is also treated with steroids and chemotherapy agents.

Animals can be a sentinel for infections like Lyme disease. Breed predisposition can also be used as a research tool to better understand arthritis in animals as this is a complicated and perplexing condition.

Lawrence Gerson, VMD

Guest blogger Lawrence Gerson, VMD,  graduated from the University of Pennsylvania School of Veterinary Medicine in 1975 and founded the Point Breeze Veterinary Clinic in 1976. Dr. Gerson writes a column called “Pet Points” for the Pittsburgh Post-Gazette.

Osteoporosis is a disorder that causes weak bones. It can cause hump in the upper back, loss of height and increased risk of bone fracture. In the United States, osteoporosis affects about 28 million people and results in more than 1.5 million fractures of the back, wrists and hips each year. Pretty daunting stuff!

Alright so why should arthritis suffers be worried about osteoporosis? Well because they are at a heighten risk for it. Having an inflammatory form of arthritis, such as rheumatoid arthritis or lupus, leads to the production of substances that cause bone loss and bone loss increases the risk the osteoporosis. And people that take corticosteroids (powerful anti-inflammatory drugs such as prednisone) to treat their arthritis are also at a greater risk for osteoporosis. These drugs may cause bone loss and are the most common cause of drug-related osteoporosis. Studies show that as dosage amount and frequency increase with corticosteroids so does bone loss.

Your bones reach their highest bone mass density (the strongest they’ll ever be) around ages 25 to 30. Around age 40, bone mass begins to slowly decline and in the first five to 10 years after menopause, women can lose up to one-third of their bone mass. Bone mass breaks down faster than it can be replaced and that is when people develop osteoporosis.

Luckily there are ways to lower your risk, especially if you’re under 35 (because your body is still able to easily build bone mass). Check out this easy list:

How to Prevent Osteoporosis

Before age 35:

• Increase calcium and vitamin D (daily calcium 1,500 mg, vitamin D 800 IU…if you don’t think you’re getting enough in your diet consider asking your doctor about supplements) 
• Make healthy food choices
• Avoid smoking and heavy alcohol use
• Exercise
• Maintain a health body weight

Want to know more? Find out more information from the Arthritis Foundation on Osteoporosis and take this Osteoporosis Risk Assessment.

Has anyone found that their arthritis medications are speeding up bone loss? Has your doctor spoken to you about this possibility? What are you doing to prevent osteoporosis? Any helpful hints? Please share your experiences!

Stay well,

Emily Cope
Communications Director
Arthritis Foundation, Western PA

By sophomore year, three of my friends had injured their ACLs playing high school sports and I come from a small, rural school! Damage to the ACL, or the Anterior Cruciate Ligament, is a common athletic injury. In fact according to one study on the prevalence of ACL injuries in the general population, approximately 1 out of 3,500 people are affected, which means there are about 200,000 new ACL-related injuries per year. So if you or your friends were involved in competitive sports there’s a good chance that you know someone who’s had ACL problems too.

Maybe I was naïve or perhaps I still had too much of that young, invincible attitude, but I must admit before working at the Arthritis Foundation I thought having ACL surgery was “no big deal.” I assumed after recovery and physical therapy, people could go back to whatever sport they played as if nothing ever happened. Of course back then I stuff like osteoarthritis never crossed my mind.

In a recent article, For Young Athletes, Knee Surgery Opens Door To Pain, Frank Deford touches on just this. He points out that while surgeons can perform operations to reconstruct ACLs, which helps young athletes to continue to play sports, some doctors have concerns.

“Doctors know that because the surgery allows young athletes to continue to compete aggressively and put stress on that damaged knee, a significant number will, in as few as 10 years, suffer degenerative osteoarthritis. That is so much more debilitating and painful — and must be endured for the rest of one’s life. Some may even require knee replacement.”

In Deford’s article Dr. Robert Stanton, the president of the American Orthopaedic Society for Sports Medicine, said that despite the risk of life long debilitating osteoarthritis, almost all young athletes choose to proceed with the ACL operation. “They’re young; they’re invulnerable. Above all, they just want to keep playing.”

The potential problem with “playing through the pain” with an ACL injury is that bone structure and cartilage can be torn with this kind of knee injury and cartilage just doesn’t heal, ever. So when the person grows to middle age, osteoarthritis and pain can develop. And once that damage is done…there are no easy fixes.

Now let me make myself clear, I’m not telling you not to get surgery if you injure your ACL. Only you and your doctor can determine what’s right for your specific medical case. I just want young athletes to be aware that ACL injuries (with or without surgery) can lead to osteoarthritis later in life. Be informed, get all the information and think about your future before you make any tough choices. Trust me your middle-aged self will thank you!

It’s your turn to weigh in….Have you ever injured your ACL? Did you get surgery? Do you still play sports? Have you had any pain or symptoms of osteoarthritis? We want to hear from you! Share your experience!

Stay well,

Emily Cope
Communications Director
Arthritis Foundation, Western PA

But there is hope for agricultural workers with arthritis. While there is no cure, medication, lifestyle adjustments and pain management techniques can help greatly.

This video offers easy tips on how farmers and ranchers can protect their joints:

Work simplification can help lessen arthritis pain:

• When possible use labor saving devices or easy-grip tools.
• Alternate difficult jobs with easier ones. Switching between heavy and light tasks spreads your limited energy over a longer period of time.
• When possible sit while you work to take the weight off your joints.

Agriculture is an extremely stressful industry. Farmers worry about everything from market prices to unforeseen weather. Stress reduction is crucial in arthritis pain management.

Here are some suggestions for coping with stress:

• Do away with those things that aren’t really necessary; instead, try doing a few things well.
• Share your problems or concerns with family members or friends.
• Keep in mind that some things are out of your control (the weather).
• Ask for help.
• Join a support group.

For more information on Arthritis and Agriculture please visit:

http://www.arthritis-ag.org/default.aspx

http://www.agrability.org/

Or contact Amber Wolfe, AgrAbility Project Coordinator for the Arthritis Foundation Indiana Office at awolfe@arthritis.org or 1-800-783-2342.

Stay well,

Emily Cope
Communications Director
Arthritis Foundation, WPA Chapter

Gout was once thought to be the disease of kings not only because many royals came down with it but also because it seemed to afflict those who overindulged in food and wine, and only the very rich could afford those luxuries.

Today with an estimated 6.1 million Americans having experienced at least one gout attack, we now know this disease can strike any age or economic status. Gout is actually a form of arthritis that causes sudden, severe episodes of pain, tenderness, redness, warmth and swelling of joints. The large joint of the big toe is the joint most commonly affected, but gout can affect any joint. Gout pain and swelling are caused by increased levels of uric acid in the blood and the formation of uric acid crystals in joints. Uric acid is a substance that normally forms when the body breaks down waste products called purines. Uric acid usually dissolves in the blood and passes through the kidneys into the urine. In people with gout, the uric acid level in the blood becomes elevated, which leads to their joint pain.

Here are some commonly asked Gout Questions & Answers courtesy of http://www.arthritis.org/goutliving.php:

What are the Symptoms of Gout?
During a gout attack, symptoms may include swelling, pain, tenderness, redness and heat in the affected joint or area. In the early stages, there may be no symptoms between attacks. If the disease progresses to an advanced stage, there may be chronic pain between gout attacks.

How Do I Know if I Have Gout?
Only your doctor can accurately diagnose gout. If you are worried that symptoms you’re having could be gout, it is important to make an appointment with your doctor to be examined. Learn more about Gout Diagnosis.

Who is Likely to Get Gout?
Anyone who has high levels of uric acid in their blood may develop gout. But there are certain things that can put you at increased risk:

• Being overweight
• Excessive alcohol intake
• Drinking lots of sweetened beverages, especially soda
• Being dehydrated
• Eating lots of certain purine-rich foods
• Having a family history of gout
• Certain medical conditions like high blood pressure
• Low kidney function
• Use of medications like diuretics (sometimes called “water pills”), cyclosporine and low-dose aspirin

What Should I Know About Gout Attacks?
The most common symptom of a gout attack is waking up in the middle of the night with sharp pain in the big toe or another joint. It’s best to prepare ahead of time for a potential gout attack. Talk to your doctor about medication that can be kept on hand for immediate treatment when an attack flares. While you should be prepared “just in case,” it can be reassuring to know it’s possible to reduce your risk of another gout attack by getting and sticking to a gout management plan that includes strategies for lowering your uric acid level.

What Happens if I Don’t Manage My Gout?
Gout is a chronic condition. As gout progresses, the attacks may become more frequent. Urate crystal deposits, called tophi, may also develop in the soft tissue and joints. This may ultimately lead to deformity and joint destruction. Gout that is not managed well may also put people at high risk of heart disease and stroke.

Gout is a serious condition but with proper management there is no reason you shouldn’t be able to live your life to the fullest. For more information and resources for people with gout and their family and friends please visit http://www.arthritis.org/goutliving.php.

Stay well,

Emily Cope
Communications Director
Arthritis Foundation, WPA Chapter

Bright-colored walls, playrooms, murals, an atrium and library aren’t typically what come to mind when envisioning a hospital. But Children’s Hospital of Pittsburgh of UPMC isn’t your everyday hospital.

Children’s Hospital of Pittsburgh leads the way in advanced technology for pediatric care and is renowned as one of the top pediatric hospitals in the country. Not to mention that Children’s also has one of the largest Pediatric Rheumatology Programs in the United States.

Recently I had a chance to tour Children’s Rheumatology Department and I was blown away.

First off, the building (inside and out) is colorful, bright and welcoming; I loved that it didn’t feel like a hospital. There are so many ways this facility tries to help kids feel more comfortable. One neat concept is that the outpatient medical offices are decorated in animal themes to make visits more fun for their patients. The Rheumatology Department offices have a dog theme and each exam room features a different breed of dog (the Labrador Room, the Dalmatian Room, etc.) The Rheumatology staff has created “puppy passports” for the patients; each time a patient visits a different exam room they get a new stamp in their passport. And they even have Dogs Days where Pet Friends come to visit with patients in the rheumatology clinic (with parents’ consent of course).

What’s even more impressive about Children’s Rheumatology Department is its size and technology. There are less then 200 Pediatric Rheumatologists in the whole country…with about a dozen states that have no Pediatric Rheumatologists at all. Western Pennsylvania is lucky to have one of the largest Pediatric Rheumatology Departments in the country. The staff includes pediatric rheumatologists, rheumatology nurses, and a clinical social worker. This means Children’s is able to see patients quickly. They usually see new patients within 3 business days from their referral. Some hospitals with smaller Rheumatology staffs can take up to 2-3 months before they can see new patients. Many families have commented that being seen quickly by Children’s helped reduce their stress.

Children’s Hospital of Pittsburgh is also on the cutting edge of technology. The hospital is completely paperless, which helps speed up treatment and is environmentally friendly.  The Rheumatology Department has also has a section of its website called “Ask the Pediatric Rheumatologist” where parents or physicians can ask questions regarding arthritis or rheumatic conditions. And Dr. Paul Rosen, Clinical Director of Rheumatology at Children’s,  even communicates with some patients’ families via email to help give quicker responses to their questions or concerns. 

These are just a few of the exciting things going on in Western Pennsylvania when it comes to Juvenile Arthritis care. Please take a moment and share your thoughts and experiences with us. Do you have a child with Juvenile Arthritis? What is most important to you when it comes to your child’s medical care? Have you visited the new Children’s Hospital location? What do you think about it? We want to hear from YOU!

Stay well,

Emily Cope
Communications Director
Arthritis Foundation, WPA Chapter

Caitlin was diagnosed with Juvenile Arthritis when she was 18 months old after she spiked a high fever and began to have swollen kneecaps. Her parents said having a good relationship with her doctors has helped them with the diagnosis.

Our doctor has been a mentor to us, said Becky Koman-Miller, Caitlin’s mom. He told us to treat Caitlin as normal as possible and let her know she can have the same dreams as everyone else. Having good communication with the doctor was so important. Without it we would have sunk.

While Caitlin considers herself lucky because her Juvenile Arthritis hasn’t been as severe as some children’s, she’s still had to deal with the pain and limitations of arthritis.

“I’ve been a dancer for 14 years,” said Caitlin. “Dancing with arthritis has taught me to preserve, to reach my goals by pushing through the pain and never take anything for granted. Last year after a shoulder injury I had to give up dance. I was just tired of getting hurt and being in pain every night. But even though I gave up dance, I’m thankful because I get to be a normal teenager. I spend time with my family, boyfriend and friends as well as have a job.”

In her work with pageants, Caitlin has made Juvenile Arthritis her platform and is an active volunteer with the Arthritis Foundation.

Caitlin picked Juvenile Arthritis as a platform because she wanted to help raise awareness, said Becky. People don’t realize that kids get this disease and even people that know Caitlin has arthritis often don’t know there’s an organization like the Arthritis Foundation that helps families and kids with arthritis. It’s very important to her to get involved.

“I try to do whatever I can with my title and personal experience with arthritis, to reach out and help other kids,” said Caitlin. “If I could give kids one piece of advice it would be to always reach for your goals, the pain may be hard now but just focus on how amazing it’ll feel once you reach it. You won’t even remember the pain then.”

Please join Caitlin and her family at the 2010 Jingle Bell Run on December 11^th at McFadden’s. Be there with bells on as we run/walk for a cure for arthritis!

“Please help us find a cure,” said Becky. “No parent should have to watch their child in pain. We need to find a cure now.”

To register for the Jingle Bell Run or for more information please visit http://jbr.kintera.org.

 Stay well,

Emily Cope
Communications Director
Arthritis Foundation, WPA Chapter

Cooking Tips
• Double your recipes so you can have leftovers. It’s not much harder to double ingredients and leftovers are great for the days when you don’t feel well enough to cook.
• If you’re hosting Thanksgiving dinner, divide up the meal into groups such as veggies, appetizers and desserts, and ask each guest to bring a dish.
• When cooking, keep a stool near by in case you need a place to rest while preparing food.
• Avoid unnecessary work, buy pre-chopped vegetables or meats.
• Use ergonomic kitchen tools that are lightweight, have non-slip handles and easy grips.
• Organize your kitchen so commonly used cookware is easily accessible. Try to keep pots and pans close to where you actually will be using them.

Shopping Tips
• Avoid crowds and long hours on your feet by shopping online for holiday gifts.
• Use gift bags instead of wrapping paper for presents.
• If you do brave the stores, make a list of items you need and have a plan for your trip. Being organized can make shopping trips more manageable.
• Consider bringing a friend along on shopping trips to help carry the bags.

Exercise Tips
Don’t let the hustle and bustle of the holiday season spoil your fitness routine. Here are some tips to keep yourself active:
• Invite Guests – If family or friends are in town, why not invite them to join in your exercise plans.
• Schedule Time – Make an appointment with yourself to workout! You’ll be more likely to keep to your exercise regiment if you treat it as an “appointment”.
• Multitask – If you already have to go shopping or run errands, why not exercise at the same time?  Try to get in some extra steps by using the stairs instead of the elevator, taking additional laps around the mall, and parking far from the front door of the store.
• Work Out At Home – If the weather outside is frightful, just workout at home! Try an exercise video or walk on a treadmill.
• Do Mini-Workouts – During the holidays it can be hard to find time for a full-blown workout. Instead break up your workout into three 10-minute sessions.

We want to hear from you! Do you find that arthritis makes the holidays a challenge? What is your favorite part of the holiday season? Do you have any tips for the holidays? Share your thoughts with us!

 Stay well,

Emily Cope
Communications Director
Arthritis Foundation, WPA Chapter

 As far as I’m concerned, Disney definitely lived up to the hype of being the most magical place on Earth. But what was even more refreshing was how accessible Disney was. Almost every where we went I noticed efforts Disney was making to ensure the parks could be enjoyed by as many people as possible. And since many people with arthritis are affected by accessibility issues (especially on vacation). I thought sharing my observations may help you all plan your next adventure, whether it is to Disney or some where else!

Hotel Accommodations

Like many hotels, Disney Resorts offers a wide range of special room accommodations. Just a few include: wheelchair accessible bathrooms, transfer bench and hand-held shower, bed raised for Hoyer lift, connecting rooms for medical assistance, and others. These accommodations don’t come standard so be sure to ask when making room reservations! Also another good tip is to ask for a room that is close to the elevator and near transportation.

Transportation

Convenient transportation makes vacation much more pleasant and stress free. Since we stayed at a Disney hotel we were able to use the Disney bus transportation system for free, which was awesome. The buses travel to all the Disney parks and hotels and are wheelchair accessible. Personally, anytime there is free (or cheap) public transportation, I like to take advantage of it. I find a lot of tourist places hard to navigate via car. Plus buses tend to drop you off closer to your destination then if you drive yourself and have to park. In Disney the bus stop was very close to our hotel and the buses came pretty frequently. The only downside was there weren’t benches outside the park bus stops so sometimes you were left standing for a bus for up to 20 minutes.

Something else to consider is the amount of walking. Disney’s parks are huge and require a lot of walking to see all the attractions. On my trip, I happened to strike up a conversation with a woman with arthritis who told me said she rented a motorized scooter specifically because of the amount of walking. She knew too much walking would hurt her joints so she rented a scooter to make sure she could keep up with her grandkids and enjoy the parks. Even if you don’t normally use a wheelchair or scooter, you may want to consider renting one to avoid unnecessary pain or arthritis flare ups. Disney rents a limited supply of wheelchairs and motorized scooters at its parks and at select hotels for a low cost; click here for more information.

Guest Assistance Card

While doing some fact checking for this post I stumbled on a great resource. When at Disney stop by the Guest Relations booth and ask for a special pass for people with a disability, called a Guest Assistance Card. (You may be asked to show proof of your disability so ask your doctor for a note explaining any limitations caused by your arthritis such as limited mobility.) You just show this card to the first Disney staff member you see at each line and you and your party will be shown to the entrance that accommodates your disability. From what I’ve read people say it is a cool perk because it basically works like an automatic fast pass for your group. Also while at Guest Relations pick up a “Guidebook for Guests with Disabilities,” it’s free and has a lot of helpful details.

Arthritis or any disability can make vacation planning tricky. I hope these topics and tips help you make your next trip magical!

 Stay well,

Emily Cope
Communications Director
Arthritis Foundation, WPA Chapter

I have been asked to share my story of living with Rheumatoid Arthritis. I have been living with the disease for over 25 years. 

I was diagnosed with Rheumatoid Arthritis several months after my 30th birthday. I have often commented that the arthritis was my 30th birthday present. My symptoms were very vague at first. I knew something was off and my family doctor ran wide variety of tests, which did not explain the symptoms I was describing. Several months later I developed flu-like symptoms, lost weight and hurt all over. My family doctor immediately sent me to a Rheumatologist. My disease was not typical and it affected my large joints rather than my hands and feet. Over the next 25 years I was able to work with few accommodations. Medications continued to improve and I was among the early patients to use a TNF drug which was very effective for me. Because the disease affected my large joint, I had two hip replacements and a knee replacement when I was in my forties. 

Unfortunately the TNF medications can increase the risk for infection. My first hip replacement became worn after 10 years, and I picked up an infection in that joint. I had the joint removed and was on antibiotics for eight weeks. I was able to work from my nursing home room – my secretary commented later that I generated more work for her while I was on sick leave than when I was in the office. I was the only patient typing away on a laptop when the doctor made his rounds! 

 
In 2008 my job was very demanding and my mother was ill. My stress level was off the charts, and I did not take care of my own health. As a result, I was very run down from “burning the candle at both ends” and at the end of March in that year I picked up an infection that was nearly fatal. I had an infection on my spine that caused paralysis in my arms and legs and had to have all three joint replacements removed. After three weeks in intensive care in UPMC Presbyterian, I was transferred to Latrobe Specialty Care for eight weeks of IV antibiotics and then to Health South Harmerville for rehabilitation. At that time it was unclear if I would regain the use of my arms and legs. I was very fortunate that the paralysis was temporary and slowly I regained the use of my arms and hands.  I was discharged from Health South to The Bethlen Home, a nursing home in my home town, for additional therapy. In November of 2008, my first joint, the right hip was replaced again.I slowly regained the strength in my legs and I was able to come home in December 2008.  Two more surgeries followed and by April of 2009 all three joints were back and working well

I am no longer working but have been able to resume most of my activities and am doing very well.  I have learned, the hard way, that I need to take care of my health. 

Although there is no cure for Rheumatoid Arthritis, the treatments have improved dramatically and with research I am confident that the treatments will continue to improve and hopefully a cure is on the horizon.

Sincerely,

 Frankie Graham

2010 Fall Arthritis Walk Adult Honoree

Please join us on October 2nd at Idlewild for the Fall Arthritis Walk. Come support Frankie and 1 in 3 Pennsylvanians that are affected by arthritis! Help us raise awareness and funds for this important cause all while enjoying family fun, wellness information, a kids’ costume contest, bingo, games and prizes! It’s not too late, register today at http://fallwalk.kintera.org!

 Stay well,

Emily Cope
Communications Director
Arthritis Foundation, WPA Chapter