Is There Hope for Rheumatoid Arthritis?

I am interested in learning about Rheumatoid Arthritis since my young 30 year old daughter has been diagnosed with it. She has tried many natural means of getting the symptoms under control but nothing has helped. The arthritis is getting worse. Is there any hope that it might just go away someday or is it a life-long permanent health problem? She has four children and this is complicating her life. Thanks for your thoughts on this.

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

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