managing osteoarthritis treatment options rheumatoid...
TRANSCRIPT
Could your joint pain be
osteoarthritis?arthritisquiz.ca
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ARTHRITIS AWARENESS MONTH
BONES & JOINTS
How Four-Time Major Champion Phil Mickelson won his battle against Psoratic Arthritis
MOVING THROUGH THE PAIN
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AN iNdepeNdeNt SUppLeMeNt FROM MediApLANet tO tHe NAtiONAL pOSt
September 2011
XXXXXXXXXXX
THE COMPLETE
MOVING THROUGH XXXXXXX
XXXX
THE COMPLETE
EDITION3 FACTS INSIDE
THE ARTHRITIS AWARENESS
Coping with chronic painthe challenges of managing osteoarthritis
Avoiding the knifebe aware of your treatment options
Fighting backtips on living with rheumatoid arthritis
AN iNdepeNdeNt SUppLeMeNt by MediApLANet tO tHe NAtiONAL pOSt2 · SepteMbeR 2011
CHALLENGES
Did you know that arthritis is the leading cause of disability? However, though it a� ects nearly 4.5 million Canadians, many mistakenly believe it’s a routine part of aging. This perception must be challenged—bone and joint pain doesn’t need to be a way of life.
“Maintaining a healthy body weight through physical activity and a balanced diet is one of the best ways to avoid OA, as well as other chronic conditions like diabetes, heart disease and high blood pressure.”
Coping with chronic painHow Canadians are learning to manage this increas-ingly common condition.
We reCoMMeNd
pAGe 3
Alleviating the burden p. 5day-to-day life with arthritis.
Combating joint pain p. 7How physical exercise can bring relief.
For many suffering from arth-ritis, surgery can provide re-lief from pain and has helped thousands of Canadians re-turn to a life of mobility and in-dependence.
The news that an operation will give you relief from arthritis symptoms and disability can be very comforting. However, it can also cause concern, anxiety and fear. Becoming prepared mentally and physically for your sur-gery is an important step toward a successful result.
Finding supportWhen facing major surgery, the information about your treatment and what you need to do can be over-whelming. As daunting as that can be, learning and preparation are key to achieving the best possible outcome from surgery. That’s because beyond the expertise of your orthopaedic sur-geon, you (the patient) have the most
important role to play in regained mobility.
Patients and their families face doubt and questions about upcom-ing surgical treatments. Where can they turn for guidance? Who can they
depend on to o� er a real world view of what to expect? In many cases, speaking with someone who has been through the same experience can provide needed support.
Peer to peerThe Canadian Orthopaedic Founda-tion’s free Ortho Connect peer sup-port program matches people needing bone and joint surgery with trained volunteers who have had the same surgery. All types of orthopaedic sur-gery are covered, from hip and knee replacements to spine reconstruction to ACL repair and beyond. Client-vol-unteer matches are made by phone, based on surgery type, languages spoken, geography, and more to o� er new patients a real-world view of what to expect and how to prepare for surgical treatment and recovery.
A grant from the Ontario Trillium Foundation made in 2010 is helping to fund the expansion of the Ortho Connect program in Ontario, includ-
ing the launch of its new website www.orthoconnect.org. This patient focused website is the newest way for Canadians to fi nd information, tools and a community of peer patients to help them cope and increase their confi dence.
Join the discussionTaking part in decisions about your orthopaedic surgery, asking ques-tions, and learning about what is expected to happen are ways to dispel your concerns. People who take part in decisions about their health care are more likely to have better outcomes. A live voice or online peer who under-stands just what you’re going through provides immeasurable comfort—and a personal view of what to expect and how to get ready for your return to mobility.
Be an active participant in your orthopaedic journey
DR. JAMES P. WADDELL
doN’t MiSS!
■ Follow your orthopaedic sur-geon’s orders—he or she is looking out for you.
■ Maintain or attain a healthy weight.
■ Arrange any supportive care, if needed, in preparation for dis-charge from hospital.
■ Organize a “recovery room” for your return after surgery.
■ Remove area rugs and electrical cables that could cause a fall.
■ Prepare/buy frozen microwave-able and other easy-to-prepare dinners.
■ Arrange a ride to and from the hospital.
■ Order special equipment recom-mended by the surgeon.
■ Identify a local pharmacy and grocery with delivery service.
■ Find out if you will need physio-therapy after your surgery, and fi nd a clinic close to home.
■ Learn from someone who’s been there. Sign up for the Ortho Con-nect peer support program to be matched with a trained volunteer who has already undergone simi-lar surgical treatment, available at www.orthoconnect.org.
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bONeS & JOiNtS3Rd editiON, SepteMbeR 2011
responsible for this issue:Publisher: Brittney [email protected]: Penelope [email protected]: dr. Gillian Hawker, Sara Henderson, damien lynch, Steven McNair, indrani Nadarajah, dr. James P. Waddell, Participaction
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Distributed within:National Post, September 2011this section was created by Mediaplanet and did not involve the National Post or its editorial departments.
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Arthritis: Knowing is half the battleA
s President and CEO of The Arthritis Society, I’m struck by how so many people in Canada are a� ected by arth-ritis—chances are
you, a member of your family, a friend or a neighbour lives with it—and the extent to which this impact goes is largely unnoticed. Considering that arthritis a� ects nearly 4.5 million Canadians, it needs more prominence.
The Society is trying to change the public’s perception of arthritis to give people greater insight into the sever-ity of this disease. Many mistakenly think that arthritis is a natural part of aging. In reality, 60 percent of Can-adians with arthritis are under 65, a staggering number indeed. Juvenile arthritis is a leading chronic disease among children, a� ecting one in 1,000 Canadian boys and girls under the age of 16.
A sore subjectOthers believe arthritis is just aches and pains. In fact, people with arth-ritis often fi nd that their ability to per-form daily tasks is limited due to the e� ects of the disease. Even buttoning a shirt or opening a door can be di� -cult as a result of intense pain and loss
of fl exibility.Arthritis is a leading cause of dis-
ability. It disrupts millions of lives, consumes health-care resources and drains our economy. It can cause dis-fi gurement, reduced life expectancy and even death.
The quest for reliefWhile we’re still looking for a cure, there is much hope for people with arthritis. When you’re diagnosed early and start the right treatment plan, you can take control of your disease and reduce the damage to your joints. Most people with arthritis can lead active and productive lives with the help of the right medication, healthy eating, exercise, rest and joint-protec-tion techniques.
That’s why for this September’s Arthritis Awareness Month, The Arthritis Society is reaching out to those who may not even know this disease is a� ecting them. As much as we know about the toll arthritis takes on our communities, so much of it goes unreported and is not treated by healthcare providers.
Living with the painJoint pain is a daily reality for mil-lions of Canadians, but unfortunately many never follow up with their doc-
tor. Some think it’s inevitable, others hope it will go away. Ignoring the problem, though, may make it worse. Learning more about what lies behind your joint pain is a major quality of life issue. Establishing an early diagnosis of osteoarthritis (OA), the most com-mon type of arthritis, is critical to the outcome of the disease, since it only gets progressively worse and ther-apies work best when started as early as possible.
Aside from funding innovative research in search of a cure and pro-viding quality programs and servi-ces to those in need, the best way we can fi ght the debilitating e� ects of arthritis is to encourage people with it to become an active self-manager of their symptoms. That starts with fi nding out whether your joint pain results from a disease that seems harmless at fi rst, but can have devas-tating long-term consequences if left untreated.
half the battle
Steven McNair president and CeO , the Arthritis Society
■ Establish a correct diagnosis, as therapies work best when started as early as possible.
■ Consult your healthcare pro-vider about an appropriate physical activity regimen. Exercise protects joints by strengthening the muscles around them.
■ If you’re overweight, consider a balanced diet. Losing 10 pounds reduces the pressure on each knee by 40 pounds.
■ Avoid activities, such as kneeling, squatting, and repeated heavy lifting.
■ Pace yourself by alternating heavy or repeated tasks with lighter tasks.
MY BeSt tiPS
! Read more on the web:
to see if your joint pain is osteo-arthritis, visit www.arthritisquiz.ca. With increased awareness about arthritis, Canadians can empower themselves to prevent permanent joint damage.
How Can I Manage Osteoarthritis?
Dr. James P. WaddellChair, Canadian orthopaedic Foundation
How to prepare for Orthopaedic Surgery
AN iNdepeNdeNt SUppLeMeNt by MediApLANet tO tHe NAtiONAL pOStAN iNdepeNdeNt SUppLeMeNt by MediApLANet tO tHe NAtiONAL pOSt SepteMbeR 2011 · 3
CHALLENGES INSIGHT
Canadians are living longer. But more of us are overweight or obese, and liv-ing with at least one chronic condi-tion—like diabetes,
heart disease, depression or cancer. Less talked about is the growing num-ber of Canadians living with osteo-arthritis (OA), a painful and debilitat-ing disease that can lead to activity limitations, fatigue, poor sleep and depressed mood—a downward spin that leads to worsening of pain.
A increasingly common conditionOA is the most common form of arth-ritis, impacting approximately one in 10 Canadians. By age 65, most Can-adians have OA in at least one joint, typically the hands, feet, hips, knees or low back. And the numbers are increasing.
While there is no cure, there are a var-iety of e� ective approaches to prevent and manage its impact.
Maintaining a healthy body weight through physical activity and a bal-anced diet is one of the best ways to avoid OA, as well as other chronic con-ditions like diabetes, heart disease and high blood pressure.
Finding the right treatment for youIf you’re already suffering from OA-related pain, several treatment options are available. Combining non-drug approaches—such as exer-cise, maintaining a healthy diet and acupuncture—with medications like
acetaminophen, glucosamine and anti-inflammatory drugs can help improve physical function and reduce pain. When pain becomes increas-ingly excessive and debilitating, joint replacement surgery should be con-sidered, and is highly e� ective.
Although such treatment options are available, statistics show that many patients are under-treated. This is often due to the perception of OA, by both patients and their physicians, as a nor-mal part of the aging process, the result of wear and tear, for which nothing can be done. But the fact is OA is a complex disease caused by a combination of bio-mechanical and infl ammatory factors that lead to joint destruction.
Chronic complicationsWhat’s more, complications arise as OA patients are often living with other chronic conditions linked with obesity and aging—such as high blood pressure or diabetes. Though more research is needed to understand the links between these chronic condi-tions, we do know that the impact is quite signifi cant. For example, a patient with OA may have di� culty bending at the hip, which can a� ect
the ability of a diabetic to do foot checks, exercise, prepare meals or get to physician visits.
When it comes to OA, there is a critical need for increased awareness of the dis-ease as a common, chronic condition that substantially impacts the quality of life of Canadians. Patients and phys-icians need to know that viable treat-ment options exist, even within the context of other chronic diseases. And more research is needed to enhance our understanding of how chronic condi-tions impact each other and how we should manage patients with mul-tiple diseases so they can live longer and healthier lives.
For more information about OA and the Multidisciplinary Osteo-arthritis Program at Women’s Col-lege Hospital, please visit www.womenscollegehospital.ca/osteo-arthritis.
Dr. Gillian Hawker is physician-in-chief at Women’s College Hospi-tal in Toronto and senior scientist at Women’s College Research Institute.
LIVING WITH OSTEOARTHRITIS
“OA is the most common form of arthritis, impacting approximately one in 10 Canadians.”Dr. Gillian HawkerChief of Medicine, Women’s College Hospital; Senior Scientist, Women’s College research institute.
DR. GILLIAN HAWKER
IT’S IMPORTANT TO MOVE AND STRENGTHENYOUR BODY
IT’S IMPORTANT
FACT
1
DAILY MAINTENANCEMaintaining a healthy body weight with physical exer-cise and a balanced diet is an effective part of osteo-arhtritis management.
Chances are you know some-one with osteoarthritis. They may not even know they have it. Arthritis is the term used for over 100 diseases and condi-tions that involve infl amma-tion of the joints. Osteoarthritis is the most common type of arthritis and the one most often seen in seniors. It occurs when cartilage, the material in a joint that cushions the ends of bones, breaks down. It’s estimated that 85% of Canadians will be affected by osteoarthritis by age 70. This condition is a major cause of falls in the elderly, and it can lead to loss of mobility and joint pain. Osteoarthritis most often affects weight-bearing joints like the feet, knees, hips or spine, but it can also affect the hands, fi ngers or shoulders. There is no cure for osteoarthritis and treatments usually work to lessen pain and discomfort. Surprisingly, people can have damaged joints from the disease and experience no symptoms at all. When symptoms are felt, they include pain in or around a joint, stiffness or trouble mov-ing the joint or swelling in the area. Osteoarthritis can be caused by repeated overuse of or previous injury to a joint. It can also result from the strain of carrying excess weight. A recent study found evidence that extra weight was a factor in over 80% of knee replacement surgeries. Weakened muscles resulting from inactivity may also put more stress on joints and contribute to the develop-ment of osteoarthritis. Once osteoarthritis has developed, and if a person has symptoms that are interfering with daily activities, there are several ways it can be treated. Taking off weight and strength-ening muscles can help, and
over-the-counter drugs, like acetaminophen or ibuprofen, or stronger prescription drugs can lessen the pain and infl am-mation. However, regular use of these may cause problems like side effects or interactions with other drugs. If drugs don’t work, steroid injections into the joint can provide short-term relief. Another option, specifically for osteoarthritis of the knee, is called viscosupplementa-
tion. It involves injecting a thick fl uid into the joint. In normal joints, cartilage acts as a shock absorber and synovial fl uid “oils” the joints. In people with osteoarthritis, the carti-lage has broken down and their joint fl uid has become thinner. Viscosupplementation can help lubricate damaged joints. “Viscosupplementation can be very helpful,” says Dr. Wayne Marshall, Assistant professor of surgery at the University of
Toronto. “If it works, it tends to work for relatively long per-iods of time, typically at least 6 months, often times a number of years.” Studies show that up to 70% of patients with knee osteoarthritis could see a bene-fi t from this procedure. A much riskier and more inva-sive option is joint replacement surgery. In cases where pain and damage is extreme, this surgery can cure the problem, but, like any operation, it comes with
risks of serious complications.Osteoarthritis is a condition that affects different people in different ways. One in 10 Can-adians have it, and many more of us will experience it as we age. There are various treat-ments to consider and patients need a treatment plan tailored to their experience of the disease. The good news is there are lots of options.
LAURA MANN
AdvertoriAl
Osteoarthritis and you
AN iNdepeNdeNt SUppLeMeNt by MediApLANet tO tHe NAtiONAL pOSt4 · SepteMbeR 2011
Veteran champion golfer Phil Mickelson was poised to take on the 2010 U.S. Open when he experienced wrist and hand pain so severe that almost took him out of the game. Rather than lay down his clubs, he educated himself on his options—and continued on to be a winner.
Overcoming the bogeyDays before the 2010 U.S. Open, golfing pro Phil Mickel-son developed pain near his right ankle that made walking difficult. His left index finger and right wrist also felt as if they were sprained.
“At fi rst, I thought these aches could be caused by years of practising and play-ing golf and that they would eventually pass. Then, after two days of preparing for the U.S. Open, I awoke and the pain in my joints was so intense I could hardly get out of bed,” he recalls.
He made himself go on and fi nished fourth in the high profi le tournament. But the pain persisted and he soon real-ized that this was no mere muscle ache he was dealing with.
Rather than stick his head in the sand, Mickelson got informed. He acted quickly to educate himself about his symptoms, which led him to a rheuma-tologist who was able to provide him with some answers. One week after the U.S. Open, he was diagnosed with psori-atic arthritis.
What is psoriatic arthritis?Psoriatic arthritis is a chronic disease that has no cure. It is characterized by infl ammation of the skin (psoria-sis) and joints (arthritis). Psoriasis is recognised by patchy, raised, red areas of skin infl ammation with scaling. One in 10 patients who have psoriasis also develops infl ammation of their joints.
Psoriatic arthritis generally occurs in the fourth and fi fth decades of life, with males and females a� ected equally. One interesting fact is that psoriasis and arthritis often appear separately. In fact,
the skin disease precedes the arthritis in nearly 80 percent of patients. (Mickel-son is reported to have had a scaly scalp before the arthritis set in.)
While the causes are still not known, individuals are thought to be genetic-ally predisposed to it. The disease can lie dormant for years before being trig-gered. Stress is thought to be a powerful trigger.
Early diagnosis is crucialMickelson is now managing his disease by injecting himself with a powerful drug. He says he is largely pain free, and is back on the golf circuit. He was a strict vegetarian for fi ve months, something that attracted a lot of media commen-tary given his well-known penchant for burgers.
“That went OK, but ultimately it was doomed to fail,” Mickel-son admits. “I continue to eat a lot more vegetables than I have in the past and I’m trying to have a bet-ter balance now than instead of all protein. “
As with any chronic disease, the goal is to diagnose psoriatic arthritis in its earliest stages, to enable more e� ective treatment, and to minimize the damage to the joints that uncontrolled infl am-mation can cause.
Mickelson launched “On Course with Phil” earlier this year, an educa-tion web-based program dedicated to providing information on the symp-toms and treatment for people who may be living with certain chronic inflammatory joint and skin dis-eases. His website is sponsored by the National Psoriasis Foundation and the Arthritis Foundation, along with pharmaceutical manufacturers Amgen and Pfi zer.
“This is meant to give people who have similar symptoms the tools and resources that will help them get questions of their own answered,” he says.
Being thankfulDespite his disease, Mickelson still con-siders himself fortunate.
Despite earlier news reports stat-ing his hope that he would only be on medication for a year, Mickelson now says, “that’s something that will never go away but… I was fortunate because I got on it right away. So the key for me now was getting on it right away before there was permanent damage to any joints or whatnot.”
The best part of all is that he can still do what he loves.
“Every day I’m thankful that I can play golf and spend quality time with my wife and my three children,” Mickelson says on his website.
leAder to leAder
INSPIRATION
TOP OF HIS GAMEPhil Mickelson of the United States reacts to holing an eagle putt on the 7th green during the final round of The 140th Open Championship at Royal St George’s on July 17, 2011 in Sandwich, England.PHOTO: STUART FRANKLIN/GETTY IMAGES
DAMIEN LYNCH
STAY IN YOUR GAMEFirst Clinically Proven
Collagen Supplement
to Relieve Joint Pain
and Ease Mobility
Dr. Michael Clarfield’s Joint Health Tips1
2
3
4
5
6
7
8
Maintain a healthy weight. Excess weight puts additional stress on joints and ligaments that in turn increases pain and inflammation, especially around the knees.
Get regular exercise. Although you might be experiencing decreased mobility, your joints need to move. Moderate low-impact aerobic exercise along with light strength training has been proven to help eliminate joint pain and stiffness.
Get plenty of rest. Recharge your body with seven to nine hours of sleep each night.
Make some occupational changes. Take frequent breaks and walk around to keep joints limber. Make sure your desk provides ample leg room so you can stretch.
Apply heat to problem joints to increase blood flow and decrease stiffness and pain.This can also be applied or used during activity. Ice problem joints for 15 to 20 minutes after activity to reduce inflammation brought on by exercise.
Physical therapy. Work with a physiotherapist, chiropractor or massage therapist to increase your mobility and ensure the proper alignment of your musculoskeletal system.
Stay hydrated. Drink plenty of water to keep tissues hydrated and to reduce inflammation.
Make some dietary changes. Eat an abundance of colourful fruits and vegetables, vegetable protein and whole grains. Restrict the amount of red meat, dairy, sugar and processed food in your diet, all of which can cause inflammation.
A complete joint care regimen also includes the following supplements:• UC-II Undenatured Collagen: Promotes cartilage repair, increasing joint mobility.• Glucosamine: Helps relieve joint pain associated with osteoarthritis.• Omega-3 Complete: Fish oil may help reduce joint inflammation. • Vitamin D: Low Vitamin D levels can have a negative impact on bone health and increase the progression of osteoarthritis.
For more information on joint care please visit jamiesonvitamins.com
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as a reminder, discuss the supplements and medications you take with your health care providers. osteo bi-Flex™ is not suitable for everyone, read label directions and warnings prior to use. individual results may vary. 1 Reference: sengupta, K. et al. 2008. a double blind, randomized, placebo controlled study of the efficacy and safety of 5-loXiN™ for treatment of osteoarthritis of the knee. Arthritis Research & Therapy; 2008, 10:r85.2 based on results of a GfK Healthcare 2011 survey among physicians who recommend a brand of Glucosamine and Chondroitin or Glucosamine supplements; and the results of a Pharmacy times survey among pharmacists who recommend a “bone/joint strengthener” dietary supplement, 2011.
To learn more about Osteo Bi-Flex™ and the advanced ingredient 5-LOXIN,™ please visit www.osteobiflex.ca
The Advanced Glucosamine and Chondroitin Formula. Helps to relieve osteoarthritis joint pain
Helps maintain healthy cartilage
onany
To the Dealer: Nature’s bounty will reim-burse you the face value of this coupon plus our specified handling fee provided it is redeemed by your consumer at the time of purchase on the item specified. other applications constitute fraud. Failure to send in, on request, evidence that sufficient stock was purchased in the previous 90 days to cover coupons presented will void coupons. Coupons submitted become our property. reproduction of this coupon is expressly prohibited. For redemption mail to: Nature’s bounty, Po box 1600, Pickering, ontario, l1V 7C1.
To the Consumer: Provincial law may require the retailer to charge the applicable tax on the full value of the purchase(s) before the reduction in coupon value. Gst, Pst and Hst are included in face value where applicable. Unauthorized reproduction of this coupon is unlawful. limit one coupon per purchase. Not valid with any other coupon offer. offer valid only in Canada.
CoUPoN eXPires: 30/06/2012
Available in Canada at drug, grocery and mass discount retailers.
5-loXiN™ is a registered trademark of Pl thomas & Co., inc. © 2011 Nature’s bounty, inc. 11-ob-1089ra
The #1 Doctor Recommended Joint Care Brand in the U.S.2
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ProFile
Phil Mickelson ■ Born: June 16, 1970, San
diego ■ Position:
Professional golfer, as of 1992
■ Current tour: PGA ■ Pro wins:
Winner of the 2004, 2006 and 2010 Masters tournaments.
■ Nickname: “lefty” for his left-handed swing. He is otherwise right-handed.
CATCHING IT EARLY CAN
MAKE ALL THE DIFFERENCE
CATCHING IT EARLY CAN
FACT
2
AN iNdepeNdeNt SUppLeMeNt by MediApLANet tO tHe NAtiONAL pOStAN iNdepeNdeNt SUppLeMeNt by MediApLANet tO tHe NAtiONAL pOSt SepteMbeR 2011 · 5
STAY IN YOUR GAMEFirst Clinically Proven
Collagen Supplement
to Relieve Joint Pain
and Ease Mobility
Dr. Michael Clarfield’s Joint Health Tips1
2
3
4
5
6
7
8
Maintain a healthy weight. Excess weight puts additional stress on joints and ligaments that in turn increases pain and inflammation, especially around the knees.
Get regular exercise. Although you might be experiencing decreased mobility, your joints need to move. Moderate low-impact aerobic exercise along with light strength training has been proven to help eliminate joint pain and stiffness.
Get plenty of rest. Recharge your body with seven to nine hours of sleep each night.
Make some occupational changes. Take frequent breaks and walk around to keep joints limber. Make sure your desk provides ample leg room so you can stretch.
Apply heat to problem joints to increase blood flow and decrease stiffness and pain.This can also be applied or used during activity. Ice problem joints for 15 to 20 minutes after activity to reduce inflammation brought on by exercise.
Physical therapy. Work with a physiotherapist, chiropractor or massage therapist to increase your mobility and ensure the proper alignment of your musculoskeletal system.
Stay hydrated. Drink plenty of water to keep tissues hydrated and to reduce inflammation.
Make some dietary changes. Eat an abundance of colourful fruits and vegetables, vegetable protein and whole grains. Restrict the amount of red meat, dairy, sugar and processed food in your diet, all of which can cause inflammation.
A complete joint care regimen also includes the following supplements:• UC-II Undenatured Collagen: Promotes cartilage repair, increasing joint mobility.• Glucosamine: Helps relieve joint pain associated with osteoarthritis.• Omega-3 Complete: Fish oil may help reduce joint inflammation. • Vitamin D: Low Vitamin D levels can have a negative impact on bone health and increase the progression of osteoarthritis.
For more information on joint care please visit jamiesonvitamins.com
Better performance is closer than you think.
clevelandclinic.ca
1.866.432.0851 181 Bay Street, 30th floor, Toronto
Let our Sports Health program help you move better, faster and without pain.
Physician consultations and imaging are covered by OHIP.
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clevelandclinic.caWe’re close, convenient and completely focused on your health.
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Fonts:FuturaHelveticaSerpentineZapf Dingbats
Colors: CMYK
Printed at 100%ENGLISH - COUPON ON RIGHT
SAVE $5.00
as a reminder, discuss the supplements and medications you take with your health care providers. osteo bi-Flex™ is not suitable for everyone, read label directions and warnings prior to use. individual results may vary. 1 Reference: sengupta, K. et al. 2008. a double blind, randomized, placebo controlled study of the efficacy and safety of 5-loXiN™ for treatment of osteoarthritis of the knee. Arthritis Research & Therapy; 2008, 10:r85.2 based on results of a GfK Healthcare 2011 survey among physicians who recommend a brand of Glucosamine and Chondroitin or Glucosamine supplements; and the results of a Pharmacy times survey among pharmacists who recommend a “bone/joint strengthener” dietary supplement, 2011.
To learn more about Osteo Bi-Flex™ and the advanced ingredient 5-LOXIN,™ please visit www.osteobiflex.ca
The Advanced Glucosamine and Chondroitin Formula. Helps to relieve osteoarthritis joint pain
Helps maintain healthy cartilage
onany
To the Dealer: Nature’s bounty will reim-burse you the face value of this coupon plus our specified handling fee provided it is redeemed by your consumer at the time of purchase on the item specified. other applications constitute fraud. Failure to send in, on request, evidence that sufficient stock was purchased in the previous 90 days to cover coupons presented will void coupons. Coupons submitted become our property. reproduction of this coupon is expressly prohibited. For redemption mail to: Nature’s bounty, Po box 1600, Pickering, ontario, l1V 7C1.
To the Consumer: Provincial law may require the retailer to charge the applicable tax on the full value of the purchase(s) before the reduction in coupon value. Gst, Pst and Hst are included in face value where applicable. Unauthorized reproduction of this coupon is unlawful. limit one coupon per purchase. Not valid with any other coupon offer. offer valid only in Canada.
CoUPoN eXPires: 30/06/2012
Available in Canada at drug, grocery and mass discount retailers.
5-loXiN™ is a registered trademark of Pl thomas & Co., inc. © 2011 Nature’s bounty, inc. 11-ob-1089ra
The #1 Doctor Recommended Joint Care Brand in the U.S.2
11-ob-1089-aD-laY.indd 1 8/30/11 2:13 Pm
INSIGHT
According to Sta-tistics Canada, 51 percent of women and 34 percent of men over the age of 65 are burdened by arthritis.
Osteoarthritis (OA) is the most prevalent form of arthritis and a major concern of patients seeking naturopathic care. OA is a degen-erative joint disease characterized by a disruption in cartilage that is associated with pain, inflam-mation and stiffness. Years of wear and tear on the body have a pronounced effect on freely move-able joints such as the hips, knees, wrists and shoulders. Conven-tional support includes NSAIDs, cortisone injections and in some cases surgery, all of which are asso-ciated with negative side effects.
The good news is that there are many other safe and effective pre-ventative and treatment options. The newest addition to this thera-peutic arsenal is undenatured type II collagen (UC II). This joint nutri-ent not only promotes cartilage-building activities, it also blocks the breakdown of joint cartilage by immune cells. Research pub-lished in the International Journal of Medical Sciences in 2009 con-firmed that 40 mg of UC II daily is twice as effective as 1500 mg of glucosamine and 1200 mg of chon-droitin. This is exciting news con-sidering that many patients find relief from taking glucosamine and chondroitin formulas. Some patients find it most beneficial to take type II collagen in addition to glucosamine and chondroitin. This joint nutrient can only be found
exclusively in Jamieson’s Collagen Glucosamine Complex.
Other popular options to pro-mote joint health include: omega-3, MSM, hyaluronic acid, natural egg shell membrane and turmeric, as well as techniques such as acupuncture and prolotherapy. A nutritive, anti-inflammatory diet and a balanced, active lifestyle should also be of top priority when it comes to preventing and manag-ing joint ailments.
Whether you have been diagnosed with osteoarthritis, are an aging adult, or simply someone who leads an active life, UC II could be the solu-tion to your joint care concerns.
SARA HENDERSON
Jamieson Laboratories
Sara HendersonJamieson laboratories
“the good news is that there are many other safe and effective preventative and treatment options.”
ALLEVIATING THE BURDEN OF ARTHRITIS
NO SLOWING DOWNInvestigate alternative options, such as supple-ments, to help maintain your lifestyle.
AN iNdepeNdeNt SUppLeMeNt by MediApLANet tO tHe NAtiONAL pOSt
It was the pain that heralded the arrival of a new chapter in Mark Toe-ws’ life. Seven years ago, it lodged in his sternum, refusing to budge. His doctor initially diagnosed a viral infection.
A week later, the pain descended to his hips, making movement almost impossible. He did not realize it then, but life was unravelling with dizzying speed for Toews, husband, father-of-two and sports enthusiast.
The pain seemed to have a mind of its own, choosing specific joints to nestle in. That was a warning for his doctor, who referred Toews, then 30, to a rheumatologist. But even diagnosing the disease was a pain—the blood test which should have shown that he had rheuma-toid arthritis returned a negative result.
“It was torture,” he says simply, as his rheumatologist tried to figure out what was ailing this once-active man.
When he was finally diagnosed with rheumatoid arthritis, he was stunned. Toews has no family history of the disease, which can affect anyone at any age, but most often appears between the ages of 25 and 50.
A zombie-like existence
Diagnosing the disease was the first part. Then came the struggle to isolate the appropri-ate medication for him. Each and every day, Mark suffered from extreme fatigue and relentless pain. Work (he worked as an IT manager) became a struggle. His days were marked by the all-con-suming need to sleep whenever he could—be it at lunchtime or after work. “Thankfully, I had an understand-ing boss, or I don’t know how I would have coped,” he says.
Toews was reduced by his disease to living life “like a zombie. I was moving, but only just.”
Life was lived through a fog of pain. “I felt like I couldn’t see or feel anything clearly. Every-thing was cloudy, some distance away.” He felt isolated, despite having family around him, because he did not know anybody else who had the disease.
Fortunately, as an active church goer, he was part of a com-munity of faith which helped keep him strong and focused, even when there didn’t seem to be a way out. “I had people praying for me, and helping out with the initial medication costs.”
It was this support
network that helped him through that ter-rible time. “I don’t know how people can even try to live with rheumatoid arthritis if they have no support. Your life would literally shrink to the size of your room as getting around would just be too painful,” he says.
Life is a lot better now after the proper medication
After a year of trying out various medica-tions, Toews’ rheuma-tologist finally hit on the one drug that turned out to work well for him. It is a biologic drug (one of a class of drugs that work on the body’s immune system) that he injects himself.
It was soon after his symptoms were under control that life started to turn around for Toews. The depression and anxiety has now lifted. The emptiness, that once threatened to suck him in, has receded.
But Toews takes no chances with his now fragile body. He is care-ful with what he eats. He does not follow any specific diet, but eats healthily and keeps processed and sugar-rich foods to an abso-lute minimum.
Proper medication, religious faith and healthy eating, have all helped him, but the
undeniable reality is that he has an auto-immune disease—that seemingly appeared out of nowhere and now refuses to say goodbye. “I have learned to accept that my life has changed for-ever, and it will never go back to the way it was. I can’t spend too much time mourning what used to be,” he com-ments.
T.S. Eliot wrote that, for many, “there is only the fight to regain what has been lost.” It is a fight that is fought repeatedly, many times in vain, but the trying is what makes us human. It describes a rheuma-toid arthritis patient’s struggle to reclaim any bit of physical and emotional territory lost to the disease and to not surrender any more ground if they can help it.
The disease has left distinctive call-ing cards on Toews’ body—his right shoul-der is “frozen” and his knees (a vulnerable area for most patients) have borne the brunt of the disease. While not totally ravaged, they are painful on any given day. He expects they will be replaced some day.
His family (he now has three children) has learned to accept that there must be some physical boundaries.
“My children know
that daddy’s knees are off limits. I wake up in the morning and it’s a mystery to me, what my knees will be like, but I’ve gotten used to it.”
He has not run for seven years, but still plays baseball, though not as well as he used to. For the past two years he has resumed cycling, after train-ing himself on a semi-recumbent bicycle. He also swims and skates.
Don’t settle for less
Toews would not disagree with the observation that he drew the short straw when he developed rheumatoid arthritis. It is part of his identity now, but he is using his hard-won know-ledge to reach out to other patients, even rheumatologists, to emphasize the import-ance of persevering until they find the right medication that works.
His advice for other sufferers is simple—be informed, don’t give up. It is not a death sentence.
“Keep educating yourself. You have to be your own advo-cate. If you think your doctor is not listen-ing to you, find some-one who will. This is a partnership effort,” he stresses.
“You must believe that life is worth fighting for.”
Life is worth fighting for
Being diagnosed with rheumatoid arthritis was a cruel blow for Mark Toews, but he has not allowed it to diminish his life.
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AN iNdepeNdeNt SUppLeMeNt by MediApLANet tO tHe NAtiONAL pOStAN iNdepeNdeNt SUppLeMeNt by MediApLANet tO tHe NAtiONAL pOSt SepteMbeR 2011 · 7
AN IN-DEPTH LOOKA thorough examination of each individual joint is one way to diagnose rheuma-toid arthritis.
Fighting back against rheumatoid arthritis
It may not have the public pro-file of cancer, but 20,000 new patients are diagnosed with rheumatoid arthritis every year, according to Dr. Claire Bombardier, professor of medicine and rheumatology division director at the Univer-sity of Toronto.
Already, one in 120 Canadians has the condition. “It is more common than you think,” she says.
What is rheumatoid arthritis?Rheumatoid arthritis is the most crippling form of arthritis. An auto-immune disease a� ecting three times as many women, it infl ames the small lining surrounding the joints. The body responds by causing synovial cells (present in the joint lining) to proliferate. This contributes to the swelling and infl ammation.
It was thought that viruses, bacteria or fungi caused the condition, but it is now believed patients are genetically predisposed to the disease.
Early detection, while crucial, is not always achieved, says Bombardier. While there is a blood test to show if rheumatoid arthritis is developing, it should be administered early—and the result may still be negative.
A thorough physical examination, especially of the individual joints is also required. But family doctors may not have the specialised training for this, she says.
Proper managementA huge hurdle is the lack of specialists. There are only 270 rheumatologists
in this country, and this is impacting patient care.
In Toronto, for example, only one quarter of patients are referred to a rheumatologist within three months. At six months, only half have seen a specialist, says Bombardier.
Prolonged inflammation wreaks havoc on the joints and interferes with a person’s ability to perform normal daily activities. Left untreated long enough, such patients can su� er severe physical limitations.
“This is so unnecessary,” Bom-bardier insists. “Patient outlook is good because of the various treat-ment options available.” These span anti-inflammatory drugs, and the more aggressive disease-modifying
anti-rheumatic drugs (DMARD). The rheumatologist’s arsenal also includes powerful drugs called ‘bio-logics’, but these are very expensive, she says.
A mindset change Patients with rheumatoid arthritis need to have their relevant health indicators monitored routinely.
Therefore, rheumatologists have coined a new campaign motto—Treat to Target or T2T. Patients will have their joints swelling monitored every three months, with treatment tailored accordingly. “T2T is part of the new treatment recommendations from the Canadian Rheumatology Association that are being released in September,” says Bombardier.
A screening triage is also being mooted, initially for Ontario. A physio-therapist or a specialist nurse will screen patients who will be moved to the top of the referral list, if any deteri-oration is detected. A similar program also exists in Alberta.
“patient outlook is good because of the various treatment options available.”Dr. Claire Bombardierprofessor of Medicine and Rheumatology, University of toronto
INDRANI NADARAJAH
■ Question: How can Canadians cope with an increasingly common and crippling form of arthritis?
■ Answer: Proper maintenence and monitoring of health indicators is the fi rst line of defence.
At ParticipACTION we en-courage all Canadians to get their bodies moving. But who wants to exercise when their joints are causing them pain?
“Unfortunately, many sufferers of arthritis often skip taking part in physical activity because of the pain, and the worry that exercise may aggravate symptoms,” says Kelly Murumets, president and CEO of ParticipACTION. “Yet encour-aging evidence points to the very opposite; regular physical activ-ity actually helps reduce pain, and improves functional ability and muscular strength.”
In fact, the stronger you make your muscles and bones, the more able they are to support joints that have become weakened by arthritis. And exercise will actually improve cartilage, since it needs joint move-ment in order to absorb nutrients and absorb waste.
Your personal fitness planNot only can an appropriately-tailored physical activity program help reduce pain and fatigue, but by getting more active, you’ll also improve your overall fi tness level and reduce your risk of other chronic diseases, like diabetes, heart disease and high blood pres-sure.
Another vital benefi t of increas-ing physical activity while su� ering from joint pain is the lift it gives to your emotional health—which is often compromised when you are confronted with chronic pain. Physical activity can help elevate your mood and increase a sense of wellbeing, which in turn can help keep you motivated to get moving.
Get moving–but how much?So what activities are right for someone who is currently su� ering from joint pain? The fi rst step is to consult your doctor on what activ-ities are right for your unique situa-tion. He or she will be able to discuss the types and amount of move-ments that you can participate in. In general, physical activities that include balance, endurance, range-of-motion, and strength training are benefi cial for the management of osteoarthritis.
Balance exercises can be as sim-ple as walking on uneven ground, like the unpaved paths you might fi nd in the forested part of a park. Tai chi and yoga are also both fan-tastic balance-improving activities.
Endurance activities are ones that keep you moving continuously and include walking, swimming and dancing as well as activities that you can do around the house, like garden work and even running the vacuum around.
Taking actionAs for strength building—it doesn’t necessarily mean hitting the gym and lifting weights. Lifting and carrying groceries, climbing stairs and doing heavy yard work all qual-ify as strengthening exercises.
Physical activity is an important weapon in the arsenal to combat chronic joint pain. At ParticipAC-TION we always encourage Can-adians to start small, fi nd a friend to get active with, and give “mov-ing more” a try. You’ll be happy you did—we guarantee it.
doN’t MiSS!doN’t MiSS!
NEWS
Avoiding the knife: What are your treatment options?
INDRANI NADARAJAH
Joint replacement surgery, though very effective, does not suit all patients, says Cleveland Clinic Canada’s Dir-ector of Sports Health, Dr. Tim Rindlisbacher.These include patients whose health profi le is so poor that surgery poses an unacceptable risk and patients who are terrifi ed of surgery, even though they would be ideal candidates, as well as patients who are too young to have the operation.
“Joint replacements typically last up to 20 years, so a patient in their mid-50s would be looking at possibly having another surgery (revision) when they are in the 70s. Studies have shown that revision knee replace-ments are usually not as successful as the fi rst joint replacement,” he explains.
Temporary measures“Too many physicians under-treat osteoarthritis. They prescribe anti-infl ammatory drugs too early, then send them off to the orthopaedic surgeon when these medications no longer help, while missing out on valid interventions,” Rindlisbacher says.
There are certain things that patients with osteoarthritis can do to delay the need for surgery, he adds.
■ Weight loss: Losing weight can help the knees and hips tremendous-ly. Even a modest reduction of be-tween fi ve percent to 10 percent of body weight can dramatically reduce joint pain.
■ Physiotherapy: This incorporates strengthening and stretching exer-cises. Physiotherapists can also use
their hands to put pressure on muscle tissue and mobilize joints to decrease pain caused by muscle tension and joint dysfunction. These mobilization techniques are more complex than a basic massage.
■ Neoprene sleeves: These wrap around the knee, providing compres-sion, support and warmth. They also help stimulate the muscles to work more e� ectively.
■ Unloader knee brace: This brace partially “unloads” weight from the a� ected part of the joint and is usual-ly prescribed for patients with osteo-arthritis a� ecting the inner portion of the knee. It is a custom-made brace made of fi breglass, foam, and steel struts, and forces the knee to bend away from the painful side. These
braces are probably the least popular option for patients with arthritis, says Rindlisbacher. “I estimate that about 20 percent of patients would be can-didates, but less than half can tolerate wearing them.”
■ Hyaluronic acid. It is common for patients with osteoarthritic knees to be injected with cortisone, but doc-tors have recently been injecting pa-tients with hyaluronic acid, a key component of the synovial fl uid which lubricates the joints. “About 80 percent of patients who receive this injection are happy with the results, as the e� ects last from between six months to one year.”
COURTESY OF PARTICIPACTION
Combat your joint pain with exercise
SEEKING OUT A SPECIALIST IS
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