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Reducing the Risks of Arthritis treatment

Would you choose to fly with an unlicensed pilot in an airplane held together with baling wire when you could fly with a well-trained professional pilot in a 747 airliner? Most of us value our lives enough that we would want to fly with the most experienced, well-trained/well-equipped airline company available.

Yet when it comes to matters of health, how many of us “fly with an unlicensed pilot,” trusting our most valuable asset - our health – to testimonials from others who claim to have found miracle cures for various ailments. People with chronic pain are ideal subjects for peddlers, swindlers, and persons who make unsubstantiated claims for products. The sale of untested, unproven, and fraudulent remedies has become a multibillion-dollar business. Because modem medicine has not found a cure or most forms of these ailments, and because their victims hope that something may be discovered to help their pain, they easily fall prey to the unscrupulous who exploit that hope.

Arthritis and rheumatism are cyclic. That is, they get better and then worse spontaneously, without any treatment. Because of these cycles arthritic conditions, along with the proven fact that placebos (sugar pills) improve the aches and pains of 30 percent of arthritis patients, the sufferers from these chronic diseases prove ideal targets for quackery. One can easily get testimonials for almost any treatment. Therefore, for a treatment to be considered effective, it must significantly exceed a 30 percent success rate.

No Better Than Sugar Pills

Many popular arthritis treatments have been shown to be no more effective than a sugar pill. These include acupuncture, copper bracelets, vitamin C (one gram daily), vaccines, hormones, and topical creams. Treatments that may have some effect on arthritis in certain individuals but are frequently more toxic than helpful include Vuron, Leifcort, Gerovital, and snake venoms. Others such as uranium or “radon” mines, Chuifong Teukuwan (a Chinese herbal' medicine), and cocaine are actually harmful.

Studies are being conducted on such substances as DMSO, bee venom, and specific diets. A few patients at Loma Linda University maintain that certain foods, bee stings, and various other things seem to help their arthritis. So far, however, these appear to be individual responses not applicable to most arthritis sufferers.

The greatest problem with• unproven remedies is the loss of time, leading to increased damage to joints and other tissues that legitimate treatment might have helped slow down or stop. Joints do not regenerate or heal well; once destroyed, they stay that way. Therefore, •correct early treatment becomes essential.

Physicians are not blameless concerning treatment of these diseases. Many have not learned much about, or tend not to pay much attention to, arthritis and rheumatism, usually because of frustration arising from limited success in curing them. However, a physician who is knowledgeable and experienced in the treatment of rheumatic diseases can make a positive difference for most patients.

Anecdotes That Illustrate

More than 100 diseases have arthritis as a feature. This article focuses primarily on rheumatoid arthritis, the most common crippling form, but much of the information applies to other forms, as well.

Although anecdotes do not prove a point, one or two may help illustrate the importance of early diagnosis and treatment. Prior to coming to Loma Linda University, several patients had spent months or years going to arthritis clinics along the Mexican border. Although Mexico has many good physicians and clinics, some unregulated clinics along the border prey on unsuspecting people by promising impossible cures for cancer and arthritis. Frequently the clinics do not reveal the nature of the treatment, or they give the patient something other than what he thinks he is getting.

One such patient came to the Loma Linda clinic with the medicines she had been given, stating that they worked for a few weeks, and then stopped working. She had been told she was receiving intravenous DMSO and some arthritis pills. An investigation of the medications found that what was supposed to be DMSO was really a potent steroid, and the arthritis pills were actually a tranquilizer and a strong but somewhat dangerous anti-inflammatory drug that should be taken with caution.

Another patient came to Loma Linda's clinic after receiving high doses of steroids for two years. He had felt very good for about a year and a half, but now suffered the consequences of long-term high-dose steroid usage, including frequent infections, diabetes, marked weight gain, and thin, brittle bones. The destructive effects of his arthritis had not been stopped, only covered up, because the steroids made the patient feel good temporarily.

Nothing Risk-free

Do proven arthritis medications involve risks? Yes. A totally risk-free medication does not exist. This includes the so-called natural medicines. Your physician has the responsibility to recognize the risks and benefits of treatments and to use medications whose benefit outweighs the risk.

The non steroidal anti-inflammatory drugs (NSAIDS), such as aspirin, Advil or Motrin, and lndocin, are useful for decreasing the inflammation and pain of arthritis. However, they appear to have no ability to slow down or stop the destruction of cartilage or bone in the joints. The most frequent side effects of these medicines include a skin rash, upset stomach (occasionally ulcers), and easy bleeding. Most patients tolerate these medications reasonably well if they take them with meals and in appropriate dosages. Sometimes the physician has to change from one medication to another until he finds the one that gives the least side effects.

Most rheumatologists agree that the majority of rheumatoid arthritis patients should be on a long-acting disease-modifying drug. These drugs are potentially more toxic and require close follow-up by a physician familiar with their use. This monitoring provides for a rapid resolution of any potentially harmful side effects. This group of medication includes “gold shots,” hydroxychloroquine, penicillamine, and methotrexate. Before one of these is prescribed, its toxic effects must be carefully weighed against the damage expected from the arthritis if the medication is not used.

Medications Versus Quackery

How do side effects from these medications compare with those from unproven remedies or quackery? With proven treatments, repeated testing has developed an awareness of the likelihood of side effects. They can be detected in their initial stage and immediately reversed.

This is not the case with unproven remedies and quackery, of which it may be said “Let the buyer beware!” They provide no system of checks and balances. Examples include radiation from uranium mines and “radon cures,” which can increase one's risk of cancer. Exotic foreign plant extracts often contain unregulated toxic substances that may be weak in one batch and strong in another. People have died as a result of being treated with an especially potent version.

The proper use of rest, physical therapy, non steroidal anti-inflammatory drugs, and long acting anti rheumatic drugs and the judicious use of low doses of corticosteroids in appropriate situations provide part of an acceptable treatment program for rheumatoid arthritis. Other forms of arthritis and rheumatism require their own specialized treatment program.

Probably the most important advancement in the past 25 to 30 years has been the development of good surgical replacements for people with severely damaged joints. The proper timing of joint replacement is critical to achieving the best result. The decision on when to have a joint replacement should be made jointly by the patient, a doctor knowledgeable about arthritis, and an orthopedic doctor competent in the latest joint replacement technology. The results often prove very gratifying to the arthritis sufferer.

A knowledgeable, experienced mechanic is essential to the diagnosis and repair of automotive problems. Research and testing are essential to develop the safest airplanes possible. Just so, research, testing, knowledge, and experience are crucial to the discovery of safe, effective treatment programs for arthritis. Why fly with an unlicensed pilot who doesn't file a flight plan? Why gamble with your health?

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