Monday, January 28, 2008
Is There Hope for Rheumatoid Arthritis?
An autoimmune disease is when cells of the immune system, for some reason, begin to attack their own body. No one really knows the cause of this, though there are many theories. Most probably the causes are multiple, including genetic tendencies, bacterial or viral, parasites, allergies, toxins, emotional trauma, etc.
Rheumatoid arthritis (RA) is an autoimmune disease that causes chronic inflammation of the joints, the tissue around the joints, and can effect other organs in the body, including the blood cells, and is therefore considered a systemic disease. Typically, RA is a progressive illness that has the potential to cause joint destruction and functional disability. Chronic inflammation of the joint and joint tissues can lead to the destruction of the cartilage, bone and ligaments, causing deformity of the joints.
RA is comparatively common, affecting more than two million people in the United States. Women are afflicted with it three times more than men, though all races are affected equally. The disease can begin at any age, but most cases are diagnosed between the ages of 40 and 60. A family history of autoimmune diseases suggest a possible genetic component.
As with many autoimmune diseases, RA can have cycles of being active or going into remission. Other cases are consistently progressive, with no remissions. When the disease is active, the most common symptom, of course, is joint pain and stiffness, especially in the mornings or when moving after being still. Joints frequently become red, warm, swollen, painful, and tender to the touch. Other symptoms can include fatigue, lack of appetite, low grade fever, muscle aches, and stiffness.
Though there are always exceptions, normally in osteoarthritis a joint on one side may be affected, while usually in RA both sides are affected at the same time. The small joints of the hands, and often the feet, are commonly affected, usually before the involvement of the larger joints.
The diagnosis of RA can be made by any primary care physician, but often they refer to a specialist called a rheumatologist. The diagnosis will be made from the pattern of symptoms, the distribution of the inflamed joints, and the blood and x-ray findings. Abnormal blood antibodies can be found in patients with rheumatoid arthritis. A blood antibody called "rheumatoid factor" can be found in 80% of patients. Citrulline antibody (also referred to as anti-citrulline antibody, anti-cyclic citrullinated peptide antibody, and anti-CCP) is present in most patients with rheumatoid arthritis, and can be used for diagnosis when the RA factor is not present. Another antibody called the Anti-nuclear Antibody (ANA) is also often present in many patients with autoimmune diseases.
Traditional western medicine believes there is no known cure for rheumatoid arthritis. To date, the goal of treatment in rheumatoid arthritis is to reduce joint inflammation and pain, maximize joint function, and prevent joint destruction and deformity. This is generally done through a step-wise progression in various types of medicines, ranging from non-steroidal anti-inflammatory drugs to steroid anti-inflammatory drugs to anti-cancer drugs to immune-modulating drugs. These can be effective in slowing the progression of the disease, though they do not stop the progression or cure the disease. They can all have serious side effects. This is why so many people are seeking alternative treatment for RA.
There is hope for improvement with other forms of medicine. One treatment was studied and the protocol set forth by Thomas Brown, M.D. He was studying RA in gorillas, which is very similar to RA in humans, and discovered that if he gave the blood from a gorilla with RA to a gorilla without RA, the second gorilla would develop RA. He theorized that RA must have an infectious source. Through many studies, he discovered high levels of antibodies to various bacteria of the mycoplasma family. Mycoplasma are an unusual type of bacteria without a cell wall. Therefore immune system doesn't recognize them in the same way that they can regular bacteria. Dr. Brown theorized that the mycobacteria are able to "hide" in the body and the immune system sets of a generalized reaction attempting to destroy it.
Dr. Brown set a protocol of low-dose long-term antibiotic therapy with very good success. New studies have been done which are showing positive results. I have been using Dr. Brown's protocol for about ten years with good success, including a reduction and even elimination of pain, in a majority of my patients with RA. It can also help scleroderma and some other autoimmune diseases. For more information you can get a book called "The Arthritis Breakthrough" by Henry Scammell, which includes Dr. Brown's original book called "The Road Back" plus the results of more current studies. This book is available at our office (http://www.freedommedcenter.com/). Also visit http://www.roadback.org/, which gives more information and also sells the book.
Besides low-dose antibiotics, our office uses a form of acupuncture called the Jaffe-Mellor Technique, combined with another form called Sensitivity Reduction Therapy to deal with allergies and sensitivities. We also use nutritional supplements to improve immune function and reduce inflammation, and encourage emotional therapy to work through limiting belief systems that may be holding onto or allowing illness. We believe that a severe disease process such as RA must be dealt with on a wholistic level to reach the improvement most patients are looking for.
Until we meet again,
Dr. Judi
Saturday, January 12, 2008
The Causes of Illness

I took a short vacation to Spain! It was a whirlwind--24 hours of travel with only 4 full days there, but we filled the days completely and saw a lot. We spent New Year's Eve at the Puerto del Sol, Madrid's equivalent to New York's Time Square, jam packed among tens of thousands of people! Normally I would feel claustrophobic in any other situation where I was crushed by people from every side, but as the panic started rising I decided to change my attitude and see this as exciting, fun, and a new experience. We did have a lot of fun, toasting to the New Year and then eating one grape and making a resolution with each gong of the bell at midnight, as is the Spanish custom. By the twelfth gong, my mouth was very full and I had cheated, repeating the same resolution with each gong. However, I thought it was a good resolution: In every moment of this year I resolve to be enthusiastic about it, to enjoy it, or at least to accept it. And this is what this blog is about.
The medical researchers are constantly looking for the cause of disease. There is the germ theory, genetics, nutritional status, inflammation, weight, what we put into our body such as smoking, drugs, fat, sugar, chemicals and pollution, etc. All of these definitely have an effect on our bodies and on our health. However, we all know someone that did everything "wrong" and still lived to a very old age. There is one aspect of causality of disease states that most doctors and many researchers never address, and that is attitude and emotional state. Avrom King, in his book Choosing to Choose, states that "we are learning that an individual's attitudes--indeed, certain specific attitudes--seem to be the primary determinants of longevity."
He states that the scientific literature now provides more than 300 studies which predictably link attitude to physiological outcome. One study took a group of 3,000 adults who had no evidence of disease. They found that the best predictor of whether a person would have a life-threatening illness during the next ten years were based on the person's response to three core issues:
- how a person feels about his/her work
- how a person feels about his/her relationships
- how a person feels about his/her health
These attitudes were more predictive than any other combination of laboratory tests and physician examination.
Larry Dossey tells about a study involving more than 2,800 men and women age 65 and over. They found that our own opinion about the state of our health is a better predictor than such objective factors as physical symptoms, findings from exams and laboratory tests or behaviors such as cigarette smoking. These findings are consistent with results from five other large studies involving more than 23,000 people, age 19 to 94. In other words, if we believe we're sick, or fear getting sick, we get sick, and if we believe we're not, we don't.
Nearly 2/3 of people who suffer a heart attack before age 50 don't have any risk factors, except for the majority have a type A personality, experiencing over-work, anger and frustration.
In my own experience, I have found that serious illness often comes after traumatic events, such as a woman experiencing multiple sclerosis after her young husband died, and another after her husband left her for another man, another elderly woman who had a stroke soon after her husband died. Sometimes the trauma is more chronic emotional strain and anxiety, such as the high incidence of women with autoimmune diseases who have an autistic child, and the high incidence of chronic fatigue and fibromyalgia among people who are somewhat perfectionistic and place their own value on what they are able to accomplish, and can never do it all.
If society would look at the statistics, rather than pouring billions of dollars into research for new treatments for diseases, wouldn't the health care dollar be better spent teaching people how to let go of fear and be happy with what they have and with where they are in their journey through life?
Just something to think about.
Answers to Questions
Is it better to exercise when you are sick or not?
In my opinion, during an acute cold or flu, the more rest a person can recieve the better. I believe that exercise can be stressful to the body in certain situations, and this is one of them.
However, in a chronic disease, exercise can be beneficial, if it is not overdone and the disease process is taken into consideration. Otherwise muscle mass is lost, making the person even weaker.
What about stomach virus/food poisoning? How can you tell the difference? I had a bad case on Christmas just after reading your blog, and I know you recommended the BRAT diet once (bananas, rice, applesauce, and toast) for people who've recovered enough to eat solid foods. Any other pointers? I was bad enough I ended up in the emergency room (a first for me), and they rehydrated me with an IV and ordered a number of blood tests. I'm curious about what tests they would have ordered and specifically why passing lots of blood would make them so concerned (I know it concerned me, but I don't have a medical reason other than just knowing it's not normal).
It is hard to tell the difference between the causes of vomitting and diarrhea, which can be from a communicable virus, a bacteria (usually from bad food and often called "food poisoning"), or a parasite. Food can also harbor viruses, such as hepatitis A. These are usually on the food from the person preparing or handling the food, not because the food has gone rancid and bacteria are growing. All three causes can cause intestinal bleeding if they are bad enough, but bacteria is the biggest culprit, and I'm sure they were checking you for the deadly type of E. coli, which can cause hemorrhaging, along with salmonella, shigella, and campylobacter, which are common causes of food poisoning and can make you quite sick. The blood tests were also probably testing for electrolyte imbalances, white blood cell count, and signs of anemia.
However, most food poisoning is a 24 hour illness. So it may be difficult to tell from an intestinal virus, which only lasts one to two days. In either case, there is generally no treatment unless there is a threat of dehydration, which seemed to be your problem. With the symptoms you had, it is good you sought medical help.
Treatment for simple vomiting and diarrhea: stop eating and sip on diluted juice, 1/3 juice to 2/3 water. Take just a little sip every 15 minutes. Or suck on a popcycle. Sometimes a tablespoon of heavy peach syrup every 15 minutes will calm the stomach (there are syrups for vomiting sold over the counter). Vomiting 2-3 times a day won't cause dehydration, but if you are vomiting every time you eat or drink, and especially if you have diarrhea with the vomiting, watch for the signs of dehydration, written below.
When you can begin to hold the fluid down, increase the amount you are drinking, and eat small amounts of simple foods, such as a saltine cracker, bananas, dry toast, over-cooked rice (rice water is good for diarrhea), applesauce, chicken noodle soup, maybe yogurt. When the diarrhea slows down you can advance the diet.
I usually don't recommend a person take anything for the diarrhea for the first day, because vomitting and diarrhea are how the body rids itself of the virus or bacteria, and often after 24 hours it resolves itself. If it continues after that, I believe that Pepto-bismol is a good, gentle medicine to help it stop. The others often will plug you up. Two tablets or two tablespoons of the liquid each time you have a diarrhea stool up to 4 times in a day will often do the trick in a day or two. Pepto-bismol may turn the stools black, so be aware of that. If you have have been using Pepto-bismol for 2-3 days without any change, you will probably want to have a stool culture.
A common homeopathic remedy for food poisoning is Arsenicum Album, which will also help viruses with the same symptoms. A good remedy for diarrhea in children is often Podophyllum. But Iwould recommend getting a family homeopathic book to be able to better look at which remedy would be best for which symptoms.
Signs of dehydration: very little or no urination, crying with no tears, dry mouth with little saliva, poor skin turgor (pinch the skin between the fingers and if it stays up there is poor skin turgor), in infants a sunken soft spot, poor mentation. Seek immediate help if these signs arise.
Until we meet again,
Dr. Judi
Monday, December 24, 2007
Short Answers to Complicated Questions
For those of you expressing difficulty figuring out how to send a comment: At the end of the blog it says "__ of comments posted." Click on this and it will give you a space where you can make comments.
"My question involves my wife. She is 59 and is taking female hormones. She took them to prevent the swetting. If she quits will she start swetting again? Her Doctor has left the decision to her. she can continue or she can quit. What will be her experience if she quits? Is it good for her to continue to take the hormones at her age? Thank you for your assistance."
The most common use for female hormones is for hot flashes, which can range in the peri- and post-menopausal woman from none or minimal to very severe and extremely uncomfortable. The common misconception, however, is that if a woman takes the hormones for a few years until "the change" has passed, that she can then stop taking the hormones without any further hot flashes.
No one knows what truly causes hot flashes, though there are many theories. But hot flashes are usually more severe in women with a lot of stress, depression and/or anxiety in their lives. They can be affected by diet. If there is no hormone replacement, the majority of women stop having hot flashes or have them only rarely after about 2-5 years as the body adjusts to the change in hormone levels. However, if a woman is replacing the hormones that are naturally decreasing in her body, she will still go through the menopausal symptoms if she stops taking them in the future. I usually recommend that a woman who desires to stop hormone replacement therapy wean off gradually, decreasing the dose slowly over 6 months to a year to allow the body time to adjust to the changing levels.
Is hormone replacement good for your wife? It would depend on what kind she is using and how she is metabolizing them. That will have to be in another discussion. Also at another time I will talk about other things that can be used to reduce menopausal symptoms besides hormones, and the difference between Premarin and Provera vs. bio-identical hormones.
"This is the season of colds. What is the best thing to do for a cold? Do the homeopathic remedies available over the counter (Zicam, zinc tablets, Cold eaze, etc.) work? Or is it just rest, liquids, time, and a little chicken soup?"
The first thing to do for a cold is prevention. Though there are other reasons, the most common reason that people get colds is that they allow themselves to get run down by not allowing themselves enough down time, relaxation time and/or sleep. I like to imagine my body telling me, "If you don't take time to slow down a little I'll make you slow down!" And then if I don't listen and keep going full speed in spite of the cold, my body may say, "You made it through this time but it will come back again soon!" Or it may say, "Since you're not slowing down with this warning, I'll give you bronchitis or sinusitis or even pneumonia so that you'll HAVE to rest!"
Another common cause is eating a lot of sugar. Sugar reduces the activity of the phagocytes (the little pac-men inside our blood stream that eat foreign invaders like bacteria and viruses). The amount of sugar in one can of soda can reduce phagocyte activity for 4 hours! So if we are eating sugar all day, our immune system isn't functioning fully.
Once you get a cold, what do you do? The most effective treatment, the one that none of us have time for or want to do, is take a day off to rest. Rest and sleep, along with self-pampering, are the best healers. Beyond that, yes, studies show that Vitamin C, Zinc, echinacea, Vitamin A, and chicken soup all reduce sick time for the common cold. I usually recommend 500 to 1000 mg. of Vit. C every 1-2 hours while sick. If the cold starts with or is accompanied by a sore throat, sucking chewable vitamin C and zinc lozenges help. I usually recommend 50 to 75 mg. of zinc, and up to 100,000 IU of Vit. A (not beta carotene). If you are pregnant, don't use over 5,000 IU of Vit. A. These higher doses can be used for 3-4 days without any toxicity.
There are various somewhat expensive over-the-counter cold remedies with these combinations, and they often help reduce symptoms faster, especially if taken immediately.
Homeopathic occillococcinum has also been shown in studies to stop a cold or flu more rapidly than placebo if taken at the first sign of symptoms.
In the future I would like to write a column on the individual homeopathic remedies for colds and flu, and the indications to take them.
For those of you who commented on the design, you are right. I was in a hurry just to get the site up and didn't spend much time on it. However, my dear daughter Monica, the design expert, will be working on it. If anyone would like to see samples of her webpage designs go to http://www.monicastrang.com/. I'm quite proud of her work!
Please send this site to your family and friends!
Until we meet again,
Dr. Judi
Saturday, December 22, 2007
Yep, I'm new to blogging
I've been told by those savvy to the cyber world that I need a blog. I've thought about it a lot; over a couple of years I've thought about it. I'm not a great expert in the world of computers. I write e-mails and compose my thoughts and books. So, I'm told, this is no different. It's like writing a daily e-mail, I'm told. So I said yes, I would like to blog, but still never got around to it.
But I got an e-mail today promising that if I posted their ad on my blog, they'd give me a free course on blogging. Now I'm big on getting courses, reading them, being impressed by them, and using about 5% of what I learned. However, 5% many times adds up, so I thought, why not? And it gave me an incentive to start blogging. So thank you, Mark Joyner, for causing me to do what no one else has been able to: start this thing.
A little about me. I went to medical school late in life: when I was 35, with six children ranging from 3 to 13 in age. They were little troopers, and sacrificed much for my education. I've been a physician for 17 years. Many of my patients call me a resort doctor: the doctor of last resort. They've often pursued every avenue in their journeys towards health, and they come to me saying they'll try one more thing before they give up. I can't say that we assist everyone, but I would say the great majority are able to live at a better standard than before they came to our clinic. I've found that many chronic diseases are caused or contributed to by the stressors and traumas of life, and so besides dealing with the physical body issues, we also deal with the emotional body issues.
I'd like to talk on this blog about problems that I find are not well taken care of in the medical community. I've added a little survey on the page so I can find out what the biggest interest is out there. I welcome comments; many people have their own experiences that can be of great benefit to others. The more we open our minds to all of the possibilities, the greater the chances of finding solutions to our problems. I also welcome questions. That's why the blog is called "Ask Dr. Judi". I want to talk about what your concerns are.
I'll be writing at least once a week, and hopefully more often. Please send this link on to your friends so we can work together towards healing the world!
Now for the promised ad:
I'm evaluating a multi-media course on blogging from the folks at Simpleology. For a while, they're letting you snag it for free if you post about it on your blog.
It covers:
- The best blogging techniques.
- How to get traffic to your blog.
- How to turn your blog into money.
I'll let you know what I think once I've had a chance to check it out. Meanwhile, go grab yours while it's still free.
Until we meet again,
Dr. Judi