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Arthritis Insight Newsletter * Vol. 3 Issue 66 July 18, 2001
--------------------------------- --------------------------------- --------------------------------- Hi! Did you miss us? I think all of us enjoyed a great couple of weeks off. A lot has happened in the past two weeks, so I'll give you the condensed version.
First, my daughter came home. Finally! Three weeks is a long time for a mommy to be without her little girl, but obviously it's not such a long time for her little girl to be without her mommy! She called from London the night before she was due to come home and asked if she could stay another week! Sheeesh! But she did come home, safe and sound. She is now in love with the UK and plans on living there someday. She also has boyfriends around the globe. Thank goodness for email! I don't want to even imagine what the phone bills could be!
I got a lot of work done in my garden. I just do a little each day and maybe, eventually, it'll all get done. I had fun taking garden pictures and you can see some of them at http://www.fadedjeans.com/tina/garden.html
Now, the bad news. While we were off playing our mail server crashed. We lost everything, member stories, questions for the experts and/or webrarian, member directory entries or updates, warrior nominations, questions or responses for the "Question of the Week/Month", personal e-mails, tips, jokes, etc... If you sent us anything prior to July 3 and you do not see it posted or did not receive a response, please resend it.
Then, shortly after the mail server crashed, my computer did the same. I lost everything. A word to the wise: backup, backup, backup! My computer is at the repair shop and I am on a borrowed laptop. I lost my personal email (AOL) in the crash, so please don't think I am ignoring you. Chances are if I haven't responded to something, it got lost.
All in all, I am glad to be back to work! Have a great week!
--------------------------------- Well, we are back at it again. Hope this new edition of the newsletter finds all in reasonable health and good spirits. I did take a few days to go visit with my dad while we were off. Being there gave me reason to reflect back on things and how fortunate I have really been. As I was at dads, I was in the basement and ran across dads tackle boxes (yes that is plural, some things just run in the family). As I was looking through the tackle, I started reminiscing about the times Dad and I went fishing together. Even when I was a small lad, dad would take me over to the local pay lake and we would go cat fishing. He was patient with the lad who threw his bait across five peoples lines and got them all tangled up. He was patient as he watched me struggle with just where to catch that catfish so it wouldn't fin me and he was patient when I just couldn't sit still any longer.
Then, there were the summer family vacations to the ocean. There, he taught me how to surf fish. I made mistakes but still he hung in there with me. We had some good times fishing.
As I went through the lures, I thought about the time I 'borrowed' one of his lures and snuck in where I wasn't supposed to be and caught a really nice bass. He never did believe that I caught it out of the creek, but he never got mad at me either.
It is really amazing that so many memories can be held in such a small area.
Til next week, ~Indy Politically Correct Ways To Say Someone Is Stupid
A few clowns short of a circus. Check out all the jokes at: --------------------------------- Arthritis can affect your ability to do even the simplest of tasks. I've heard some people say, "Accept your limitations." I'm not sure accepting them is the way to go. I prefer to challenge those limitations, work around them, finding alternate ways of achieving the same goal. Every week I'll share some tips I've found to work around those annoying limitations and I hope all of you will send in your tips too. We may not be the next Martha Stewart, but sometimes the simplest things can help so much.
A garden tip from Fay: And a great household tip from Joan: Check out more tips at /living/tips.html and send in yours today to Tina@arthritisinsight.com
--------------------------------- Question of the Week: Disease Index Chat Schedule Member Stories Arizona Sunrise Greeting Cards Advice for Better Living Expert Advice
Is there any work going on the use of anti malarial drugs to deal with the fatigue of FMS? I know it is useful for fatigue in lupus. I am on prozac and pain meds as I cannot take nsaid's.? What do you want to see on Arthritis Insight or in the Newsletter? Let us know and we'll do our best to accommodate!
--------------------------------- Anyone interested in hosting? We could use a couple new chat hosts! If you are interested, let us know what days you are available.
For the complete schedule see: /community/chat/schedule.html
--------------------------------- Hello Everyone! Seems like we have been away for a long time. Glad to be back.
Here in Iowa, the weather is hot and muggy. Typical Iowa July. Yuck! The last thing I want to do is heat the house up with cooking. So here are some things I do to combat that.
1. Cook ahead. I make large bowls of cut up fruit, potato salad, pasta salad, and/or marinated vegetables. These will last in the refrigerator for several days, without any problems.
2. Grill anything you can possibly grill. Keep that heat outside!
3. If you can't grill it, microwave it! This produces less heat in the house also.
4. If you must cook, try to get it done in the early hours of the morning before things start to heat up again.
5. For baked goods, check out farmers markets. Lots of times you can find homemade goodies as well as fresh fruits and vegetables.
6. When all else fails-----EAT OUT!
And speaking of grilling, here are a couple of recipes.
Basil Shrimp
Ingredients Directions Makes 4 servings.
Beer Butt Chicken (I didn't name it. LOL) Ingredients Directions
1 Preheat an outdoor grill for low heat, and lightly oil grate. Makes 4 servings.
If you have questions or comments regarding this column, or if you have a recipe or recipes you would like to share, send them to Char@arthritisinsight.com If I use your recipe in my column, you are eligible to receive a copy of the "Cooking With Char" mini cookbook.
For those of you waiting for your copy of the cookbook, I have been having printer problems. I promise you will get you copy eventually. It's the most common gastrointestinal disorder seen by doctors. Abdominal pain, cramps, gas, bloating, diarrhea and constipation are among the symptoms. For years, many thought it was a psychological condition, rather than a physical one. But the discomfort and inconvenience that result from the gut-wrenching pain of irritable bowel syndrome (IBS) are very real. "It feels like you're giving birth over and over again," says Hope Marcus of Miami, Fla.
Indeed, people with IBS can't stay out of the bathroom or their stomachs feel like they're tied in knots. Their bowel movements are either frequent and runny or sporadic and unusually hard. Mike Hoffman of West Palm Beach, Fla., says his intestines feel like they're constantly twisting and untwisting, "as though they're being wrung out like a dishrag." Jeffrey Roberts of Hallandale, Fla., says the sudden recurring knife-like pain "doubles you over," while others claim it brings you to your knees. Some liken the pain to a charley horse, but in the gut--pain that is horrendous and then intensifies.
"And don't picture a diarrhea attack happening in the privacy of your own clean bathroom," says Cynthia Huschle of Tolland, Conn. "Picture it in the bathroom at work, the store, the movie theater, the park, the baseball stadium, or the port-o-potty at the fair."
****Cynthia M. Huschle, 36, was a teacher forced to give up classroom teaching. The severity of her condition prevents her from instructing a group of children all day. She bought a van that would not only afford her privacy in her "time of need," but also more space. Huschle doesn't mind admitting she keeps an emergency bag in her vehicle that contains essentials such as antidiarrheal tablets and clean underwear, in anticipation of sudden attacks. "The van and the emergency bag give me the ability to get out into the world."
IBS is a disorder of the intestine that shows no sign of disease that can be seen or measured. But doctors know that the intestine isn't functioning normally. Second only to the common cold in causing days missed from work, IBS may affect up to 20 percent of Americans--some 54 million people. IBS in women is not inherently different than in men, according to doctors at the American College of Gastroenterology (ACG), but the number of women with IBS is three times greater than the number of men. Researchers say that men are less likely to report the problem, and consequently, few studies on men with IBS have been done. Onset of IBS usually is in late adolescence or early adult life. It rarely appears for the first time after age 50.
"It's important that we allay those fears that IBS leads to more serious diseases," says William R. Stern, M.D., a Rockville, Md., gastroenterologist, "so that people can deal with the illness itself." Stern says that those he diagnoses with IBS seem more concerned about potential long-term implications of the illness than focusing on treating the symptoms they actually have. Although IBS is associated with severe pain and discomfort, he says, the illness does not lead to cancer or life-threatening conditions or surgery.
Limits of Lotronex But as exciting as Lotronex was, its market life was short-lived. Just 10 months after hundreds of thousands of IBS sufferers began taking the drug, it was pulled off pharmacy shelves after several people died and many more suffered serious side effects associated with its use.
The FDA closely monitored Lotronex prior to, and after, its approval. Specifically, the agency was concerned about earlier reports of mild-to-moderate intestinal damage resulting from reduced blood flow to the intestine (ischemic colitis) and obstructed or ruptured bowels from complications of severe constipation. An FDA advisory committee--a panel of scientific and medical advisers outside the agency--recommended that both doctors and patients must be informed of the potentially serious adverse effects associated with Lotronex. The FDA updated the health-care professional labeling for the drug, and required the manufacturer, Glaxo Wellcome, now GlaxoSmithKline, to advise users of the risks in writing.
However, the FDA began receiving reports of deaths and more serious complications of ischemic colitis that required blood transfusions or surgery. The agency then met with the manufacturer to develop risk-management options that would ensure the drug's safe use. One option was to allow Lotronex to remain on the market under restricted conditions.
"This risk-benefit evaluation was difficult," says Janet Woodcock, M.D., director of the FDA's Center for Drug Evaluation and Research, "because we were aware that many users of Lotronex did not experience these adverse effects." But in November 2000, the manufacturer voluntarily withdrew Lotronex from the market.
The removal of Lotronex, however, has resulted in an odd turnabout. Despite the risks, some patients with IBS and their doctors want it back.
"The fact is," Marcus says, "there's a drug out there that's helping people. There's no excuse for allowing pain and suffering to continue when there's a remedy." Marcus blames both the manufacturer for withdrawing Lotronex and the FDA for not making it easier for the manufacturer to continue marketing it. She was one of thousands of Lotronex users who contacted Woodcock personally to protest the drug's withdrawal.
"Most of the letters have focused on the severity of some cases of irritable bowel syndrome," Woodcock says, "and the need for continued access to an effective treatment."
Mark Birns, M.D., a gastroenterologist in Rockville, Md., thinks Lotronex "came out at too high a dose." He believes the drug simply needs to be relabeled, or its dosage altered. In a practice with two other physicians, Birns says neither he nor his partners have seen a single case of ischemic colitis in the hundreds of patients they treat.
Still, consumer advocate groups, like Public Citizen in Washington, D.C., argue that a drug with the potential to threaten life does not belong in the marketplace, especially since IBS is not life threatening. The group insists there is no way to predict who is at risk for complications.
For now, the FDA is working with the manufacturer to address the safety issues surrounding Lotronex. Woodcock adds that the agency plans not only to develop better tools to protect those who may be harmed by new medications, but also to ensure that medicines are available for those who need them.
Understanding IBS According to the National Institutes of Health, people with IBS seem to have colons that are more sensitive and reactive than usual, so they respond to stimuli that would not bother most people. Eating, stress, gas, depression, and other ordinary events can cause the colon to overreact. Certain medications and foods, such as milk products in lactose-intolerant people, dietary fats, corn, and wheat, are known to trigger spasms in some people. Sometimes these spasms delay the passage of stool, leading to constipation.
IBS often is mistaken for colitis and is commonly referred to as spastic colon--terms which are "inadequate, inaccurate or both," says Marvin M. Shuster, M.D., a gastroenterologist at Johns Hopkins Bayview Medical Center in Baltimore. Colitis, for example, means that the colon is inflamed, and IBS does not cause inflammation.
"Irritable bowel syndrome is the most suitable and accurate term used by doctors," Shuster says, because it emphasizes that the condition is a "motor disorder manifesting irritability" that "involves many areas of the gut."
****Jeffrey Roberts, 40, has IBS flare-ups once or twice a month. Despite the pain and diarrhea he's had for 25 years, he's always been able to get around without much restriction. Still, he keeps a "bag-of-tricks-to-go" in anticipation of an emergency. Shortly after he formed an IBS self-help group, he was amazed to learn that people's lives could be affected so dramatically by IBS. "I just kept thinking, could my IBS ever get that bad?"
Marcelo A. Barreiro, M.D., a medical officer in FDA's division of gastrointestinal and coagulation drug products, explains that most people assume that the brain alone controls all activity in the body. In fact, he says, the gut has its own independent nervous system that regulates the processes of digesting food and eliminating solid waste. "There's a network of nerve cells within the wall of the gut--the gut nervous system--that does not depend on the brain for its minute-to-minute function," Barreiro says, but rather, "responds to its inputs under various conditions."
Under stress, for example, the brain sends conflicting messages to the gut that may exaggerate the irritability of the gut nervous system. Barreiro says that with IBS, the connections between the brain that is the central nervous system, and the gastrointestinal, or gut, system, also known as the enteric nervous system, "appear to be out of sync." (See "IBS and the Gastrointestinal (Enteric) Nervous System.")
Douglas A. Drossman, M.D., of the University of North Carolina in Chapel Hill, emphasizes that "stress does not cause IBS," although it may aggravate the symptoms. Therefore, minimizing stress is for many, but not necessarily all people, an important part of coping with IBS.
Another Point of View On the other hand, Spiro recognizes that some people, like Marcus, complain of abdominal pains that are far more than a simple annoyance. Marcus is often awakened by excruciating cramps about every hour in the middle of the night, and seldom, if ever, can commit to activities outside her home. Spiro believes that research behind new drugs is certainly worth reviewing in the hope that future developments will successfully calm, for whatever the reasons, an overactive intestine.
****Hope Marcus, 53, has had IBS for 12 years. The severity of her condition forced her to close down a business and work from home. Until she began taking Lotronex, she couldn't leave the house. Unexpected hemorrhoid surgery in October 2000, quelled Marcus' IBS symptoms, deceiving her into thinking she was cured. When the pain and diarrhea returned four months later, "I didn't worry because I had a month's supply of Lotronex." Now that the drug is no longer available, Marcus worries constantly about the day she will use her last pill.
Drossman says that in about 65 percent of the population with IBS, the condition isn't severe enough to prompt them to see a doctor. They may have pain in the gut from time to time that bothers them, "but it's possible they may not even recognize it as a clinical condition."
In a significant number of women with IBS who have severe constipation or other bowel disorders, doctors also uncovered a history of sexual or physical abuse. Some say that such experiences may make people unusually sensitive and vulnerable to their bodily sensations.
In a recent issue of the American Journal of Gastroenterology, a relatively small study piqued the interest of many as another possibility to understanding and treating IBS. Scientists at Cedars-Sinai Medical Center in Los Angeles looked at the possibility that there may be excess bacteria in the small intestine, causing symptoms similar to IBS. Further research is being carried out to determine the mechanism by which bacterial overgrowth occurs.
Whatever the cause, doctors agree on one thing: IBS symptoms can be controlled when people work with their doctors to find the best combination of treatments.
Treating IBS In general, doctors say a normal diet is best. People with abdominal distension and increased gas should avoid beans, cabbage, and other foods that are difficult to digest. Sorbitol, an artificial sweetener used in dietetic foods and in some drugs and chewing gums, should not be eaten in large amounts. Fructose (a common sugar found in fruits, berries, and some plants) should be eaten only in small amounts. A low-fat diet helps some people.
Hoffman spent years eliminating foods from his diet in a desperate effort to relieve the excruciating abdominal pain that gripped him after meals. "I went from cutting certain things out of my diet to cutting the right things out," Hoffman says. Although he's been in remission for five years, he says the awful truth is, "If I eat a bowl of spaghetti, I'll be in pain by tomorrow night."
****Mike Hoffman's symptoms of alternating constipation and diarrhea began when he was 8 years old. Through the years, he has tried over-the-counter remedies and some doctor-prescribed medicines, popping as many as 20 pills a day. "By the time I was 40, I was a gastrointestinal cripple." After a bout with IBS, Hoffman says his internal organs would ache for days, as though he'd been beaten with a baseball bat. For the last five years, as long as he eliminates certain foods from his diet, he remains symptom free.
But a substantial number of Americans with IBS have more severe symptoms that often do not respond to dietary or lifestyle changes alone. Drugs that slow the function of the gastrointestinal tract and are considered to be antispasmodics, such as Bentyl (dicyclomine hydrochloride), are frequently prescribed. Antidiarrheal drugs, such as Lomotil (diphenoxylate) and Imodium (loperamide), may help people with diarrhea. Antidepressant drugs, mild tranquilizers, psychotherapy, hypnosis, and behavior modification techniques also may bring relief to some people with IBS. Newer brain imaging techniques could help doctors understand the relationship between altered emotional states with pain enhancement and other gastrointestinal symptoms.
But doctors say the real key to achieving relief is for people to understand that IBS is a complex disorder with physical and stress-related dimensions. A strong partnership between the informed patient and a knowledgeable doctor can help improve outcomes.
"Confidence in the diagnosis and educating and reassuring the patient are vital therapeutic tools," says Edy Soffer, M.D., from Ohio's Cleveland Clinic. People who have not responded to lifestyle changes and careful use of over-the-counter medicines, such as fiber supplements, laxatives and antidiarrheal drugs, should consider being evaluated by a gastroenterologist.
The Future "IBS patients have lived with a juggling act of symptoms," says Nancy J. Norton, president of IFFGD. "But research is targeting very specific things now, and the most important thing to come out of all this is that people are finally recognizing the burden of illness that's associated with IBS."
****Nancy Norton, 51, started having cramps and diarrhea as a teenager. In her 30s, the symptoms plagued her two weeks out of every month. She only learned she had IBS 15 years ago. Norton founded the International Foundation for Functional Gastrointestinal Disorders (IFFGD), a nonprofit organization that provides practical information and the results of clinical studies to people with IBS. IFFGD brings together leaders in gastroenterology to conferences that attract worldwide professionals. "We're making progress, but we need to continue the research. We can't stop," she says.
Once the factors that cause the symptoms and the mechanisms of their production are fully understood, different treatment options will enable people to deal more effectively with the disorder.
--------------------------------------------------------------------------------
What Makes Irritable Bowel Syndrome (IBS) Different?
Understanding IBS is important because it is often confused with other similar digestive disorders, such as inflammatory bowel diseases. Below are the most common digestive disorders, with some characteristic differences that help distinguish one from another.
Functional Intestinal Disorders:
IBS Dyspepsia Inflammatory Bowel Diseases:
Crohn's disease Ulcerative Colitis --------------------------------------------------------------------------------
Where to Get More Information:
National Digestive Diseases Information Clearinghouse The Cleveland Clinic Foundation International Foundation for Functional Gastrointestinal Disorders The American Gastroenterological Association American College of Gastroenterology Irritable Bowel Syndrome Self-Help Group --------------------------------- Happy Birthday! Wanna help? Donate! Arthritis Insight will always be free for anyone to use, we will never charge any fees. We try very hard to keep our operating costs as low as possible, but running a website as large as Arthritis Insight can be expensive. To date we've relied on our few sponsors for support and have paid for many of the expenses out of our own pockets. No one on our staff currently receives a paycheck for their hard work and dedication. Although you are not obligated in any way, if you are financially able to help support Arthritis Insight, it would be greatly appreciated. In exchange for your donation you'll receive some thank you gifts, a tax deduction and the satisfaction of knowing you are partly responsible for the entire Arthritis Insight Community. Ken Akers Cheer Fund Arthritis Insight Wish List Thank You! And another big thank you to NeedaBasket.com (http://needabasket.com). NeedaBasket is now Arthritis Insight's official gift basket company. They are giving us a great discount and donating baskets for our Arthritis Warriors.
Stop by and tell them thanks for the support!
Special Offers for Arthritis Insight Members --------------------------------- Hi everyone,
As the AI staff vacation concludes, so does our first week with the newest member of our family. On July 6th, we could no longer bear the empty, quiet rooms and adopted a 1 year old German Shepherd from a no-kill shelter in our town. So my AI vacation has been a very happy one, and we believe our new girl was destined to join our family. We couldn't have done better if we had special-ordered her!
Now on to some helpful info!
Computers 101:
Q: My computer display is off center on my screen. It looks like it needs to be moved over to the left some more. I've looked all over my display settings and can't seem to find an adjustment. Is there any way to get things centered? Q: What's the Documents Menu for? Tip of the Week: Source: Computer Tips & Techniques, http://worldstart.com P.C. Smiles: This Week's Links:
http://www.eangler.com - Everything you always wanted to know about fishing.
http://householdnotebook.com/index.shtml - Create an "Organized Home Household Notebook" for free.
http://stormlover.com - Excellent info on all types of storms.
Until next week, linda@arthritisinsight.com --------------------------------- NO LINK FOUND BETWEEN PAINKILLERS, KIDNEY DISEASE ORAL COLLAGEN MAY BE AN EFFECTIVE TREATMENT FOR RHEUMATOID ARTHRITIS SERUM NITRIC OXIDE ELEVATED IN PATIENTS WITH RHEUMATOID ARTHRITIS AUTOIMMUNE DISEASES AMONG TEACHERS DOCTORS' GROUP ADVOCATES STEM CELL RESEARCH KERATOCONJUNCTIVITIS SICCA: COMMON IN JUVENILE RHEUMATOID ARTHRITIS UNDERSTANDING PAIN STUDY CONFIRMS LINK BETWEEN LEFT-HANDED AND IDB HEALTHY HABITS MAY ADD YEARS TO LIFE SPAN: STUDY FDA WILL NOT YET WITHDRAW UNAPPROVED THYROID DRUG CHRONIC CONSTIPATION LINKED TO ANXIETY, DEPRESSION
Reuters Health, Jul 12
http://dailynews.yahoo.com/h/nm/20010712/hl/depression_1.html
RHEUMATOID ARTHRITIS MAY UP RISK OF GUM INFECTION KNEE ALIGNMENT LINKED TO PROGRESSION OF KNEE OSTEOARTHRITIS HERBAL MEDICINES POSE RISK DURING SURGERY: REPORT BLUE CROSS LINKS PHYSICIAN BONUSES TO QUALITY ENZYME PLAYS CRITICAL ROLE IN INFLAMMATORY ARTHRITIS TACI IMMUNOADHESIN TARGETS B CELLS AND T CELLS, HALTS ARTHRITIS IN MICE FIBROMYALGIA, IRRITABLE BOWEL SYMPTOMS OVERLAP SHORT BOUTS OF EXERCISE BOOST MOOD, ENERGY LEVEL BORRELIA BURGDORFERI INDUCES MATRIX METALLOPROTEINASES IN CARTILAGE TWO CLINICAL DECISION RULES EFFECTIVELY TARGET WOMEN AT RISK OF LOW BMD GENETIC IMBALANCES MAY PLAY ROLE IN LUPUS PROGRESSION ARTHRITIS DRUG MAY HELP MIGRAINE SUFFERERS PETS IN WORKPLACE PLEASE WORKERS, MAY REDUCE STRESS WANT TO BE AN ORGAN DONOR? TELLING FAMILY IS KEY LYME DISEASE VACCINE APPEARS SAFE AND EFFECTIVE FOR CHILDREN FDA APPROVES DISPOSABLE NEEDLE-FREE SHOT CD40L BLOCKADE EFFECTIVELY SUPPRESSES MYASTHENIA GRAVIS IN ANIMAL MODEL ACUPUNCTURE BETTER THAN MASSAGE FOR NECK PAIN LIGHT JOGGING MAY STRENGTHEN BONES MODERATE LEVELS OF PHYSICAL ACTIVITY PROTECT AGAINST HIP FRACTURE PARENTS OF JUVENILE ARTHRITIS PATIENTS MAY NEED EDUCATION ABOUT COPING WITH
PAIN INSURANCE COMPANIES GET STRICTER ON CLINICAL TRIALS POSITRON EMISSION TOMOGRAPHY HELPS MONITOR ARTHRITIS PATIENTS CLINICAL BENEFIT OF ETANERCEPT FOR RHEUMATOID ARTHRITIS CAN BE SUSTAINED FOR
YEARS --------------------------------- Have you written something you think our subscribers would like to read? Send it to Tina@arthritisinsight.com and maybe we'll use it in our newsletter.
--------------------------------- One day a teacher asked her students to list the names of the other students in the room on two sheets of paper, leaving a space between each name.
Then she told them to think of the nicest thing they could say about each of their classmates and write it down. It took the remainder of the class period to finish their assignment, and as the students left the room, each one handed in the papers.
That Saturday, the teacher wrote down the name of each student on a separate sheet of paper, and listed what everyone else had said about that individual. On Monday she gave each student his or her list.
Before long, the entire class was smiling. "Really?" she heard whispered. "I never knew that meant anything to anyone!" "I didn't know others liked me so much."
No one ever mentioned those papers in class again.
She never knew if they discussed them after class or with their parents, but it didn't matter. The exercise had accomplished its purpose. The students were happy with themselves and one another.
That group of students moved on. Several years later, one of the students was killed in Vietnam and his teacher attended the funeral of that special student. She had never seen a serviceman in a military coffin before. He looked so handsome, so mature.
The church was packed with his friends. One by one those who loved him took a last walk by the coffin.
The teacher was the last one to bless the coffin. As she stood there, one of the soldiers who acted as pallbearer came up to her. "Were you Mark's math teacher?" he asked. She nodded, yes. Then he said "Mark talked about you a lot."
After the funeral, most of Mark's former classmates went together to a luncheon. Mark's mother and father were there, obviously waiting to speak with his teacher. "We want to show you something," his father said, taking a wallet out of his pocket. "They found this on Mark when he was killed. We thought you might recognize it."
Opening the billfold, he carefully removed two worn pieces of notebook paper that had obviously been taped, folded and refolded many times. The teacher knew without looking that the papers were the ones on which she had listed all the good things each of Mark's classmates had said about him.
"Thank you so much for doing that," Mark's mother said. "As you can see, Mark treasured it." Mark's classmates started to gather around us.
Charlie smiled rather sheepishly and said, "I still have my list It's in the top drawer of my desk at home."
Chuck's wife said, "Chuck asked me to put his in our wedding album. "
I have mine too," Marilyn said. "It's in my diary."
Then Vicki, another classmate, reached into her pocketbook, took out her wallet and showed her worn and frazzled list to the group. I carry this with me at all times, " Vicki said without batting an eyelash. " I think we all saved our lists."
That's when the teacher finally sat down and cried. She cried for Mark and for all his friends who would never see him again.
The density of people in society is so thick that we forget that life will end one day. And we don't know when that one day will be. So please, tell the people you love and care for, that they are special and important.
Tell them, before it is too late....
Author Unknown If you wish to unsubscribe to this newsletter, just let us know.
Arthritis Insight Newsletter Copyright 2001 Staff
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Vol 3 Issue 66
Welcome to the 66th issue of the Arthritis Insight Newsletter. All back issues will be posted at /community/newsletter/
Feel free to pass this newsletter around to others who may be interested.
The information in this newsletter should not take the place of advice and guidance from your own health-care providers. Material in this newsletter is provided for educational and informational purposes only. Be sure to check with your doctor before making any changes in your treatment plan. Information presented here is the opinion of the authors and has not necessarily been approved or endorsed by the medical advisors.
Notes From Tina
(tina@arthritisinsight.com)
Tina Underwood aka KrissyJo
Ron's Ramblin's
(ron@arthritisinsight.com)
Ron Griffin aka IndyRon
(((((((((((((HUGS)))))))))))))))))))
---------------------------------
Your Weekly Giggle
A few fries short of a happy meal.
The wheel's spinning, but the hamster's dead.
Slipped into the gene pool when the lifeguard wasn't watching.
All foam, no beer.
The butter has slipped off his pancake.
The cheese slid off his cracker.
Body by Fisher, brains by Mattel.
Warning: Objects in mirror are dumber than they appear.
Couldn't pour water out of a boot with instructions on the heel.
He fell out of the stupid tree and hit every branch on the way down.
As smart as bait.
Doesn't have all his dogs on one leash.
Her sewing machine's out of thread.
One fruit loop shy of a full bowl.
Her antenna doesn't pick up all the channels.
His belt doesn't go through all the loops.
Proof that evolution CAN go in reverse.
Receiver is off the hook.
Not wired to code.
Skylight leaks a little.
Her slinky's kinked.
Too much yardage between the goal posts.
Got a full 6-pack, but lacks the plastic thingy to hold them together.
A photographic memory, but the lens cover is on.
During evolution his ancestors were in the control group.
Gates are down, the lights are flashing, but the train isn't coming.
Is so dense, light bends around her.
If brains were taxed, he'd get a rebate.
Standing close to her, you can hear the ocean.
Some drink from the fountain of knowledge, but he just gargled.
She stayed on the Tilt-A-Whirl a bit too long.
Submitted by: Susan
/fun/jokes
Send yours in today!
Tina's Tips
I just found a new hose nozzle (at Lowes) that switches on and off with a trigger-type button. Sure beats having to continuously squeeze my old one. It's so much easier on my hands!
I bought non slip mats out of Woolworth's I have them on my work bench in the kitchen so pots and pans don't glide away from me also great on the dining room table for the diner plates great for sore hands and wrists no more chasing the plates when they move.
What's New?
What is your favorite part of Arthritis Insight and why? What would you like to see added to AI? What don't you like about the website?
/community/question
Information on Dupuytren's disease and deQuervain's Tendinitis has been added.
/medical/disease
Two great feature chats on the schedule for August!
/community/chat/schedule.html
Karen shares her RA story, and Gary, KJ, Irene and Panda update their journals.
/community/stories
Johnie shares a video clip of a gorgeous Arizona sunrise.
/jhh.mov
Some new cards to send to your friends.
/cgi-bin/postcards/postcard.pl
A question for the ladies:
I'm having big problems at the moment, the last two periods i am having big flare ups. My knees are so painful especially my left, the weakest. Do you have many female members experiencing this problem. Spoke to my consultant and was told it is common to have these flare ups when you have periods. But the problem is that i am unable to walk let alone work. Sunday was embarrassing, it started at work and i had to be carried out by my husband. Hence now I'm off work for at least a week. ANY SUGGESTIONS?. Keep up the good work!
/living/advice
/medical/advice
Arthritis Insight Chat /community/chat
Cooking with Char
Char LeFleur
Char@arthritisinsight.com
2 1/2 tablespoons olive oil
1/4 cup butter, melted
1 1/2 lemons, juiced
3 tablespoons coarse grained prepared mustard
4 ounces minced fresh basil
3 cloves garlic, minced
salt to taste
1 pinch white pepper
3 pounds fresh shrimp, peeled and deveined
1 In a shallow, nonporous dish or bowl, mix together olive oil and melted butter. Then stir in lemon juice, mustard, basil and garlic, and season with salt and white pepper. Add shrimp, and toss to coat. Cover, and refrigerate for 1 hour.
2 Preheat grill to high heat.
3 Remove shrimp from marinade, and thread on skewers.
4 Lightly oil grate, and arrange skewers on grill. Cook for 4 minutes, turning once, until done.
A whole chicken is seasoned and slowly cooked on the grill. This is a bit unorthodox, but the end result is moist, flavorful and amazing. All you'll need is some chicken, butter, beer and seasonings.
1 cup butter
2 tablespoons garlic salt
2 tablespoons paprika
salt and pepper to taste
1 (12 fluid ounce) can beer
1 (4 pound) whole chicken
2 In a small skillet, melt 1/2 cup butter. Mix in 1 tablespoon garlic salt, 1 tablespoon paprika, salt and pepper.
3 Discard 1/2 the beer, leaving the remainder in the can. Add remaining butter, garlic salt, paprika and desired amount of salt and pepper to beer can. Place can on a disposable baking sheet. Set chicken on can, inserting can into the cavity of the chicken. Baste chicken with the melted, seasoned butter.
4 Place baking sheet with beer and chicken on the prepared grill. Cook over low heat for about 3 hours, or until chicken is no longer pink and juices run clear.
---------------------------------
>From the FDA:
Irritable Bowel Syndrome: A Poorly Understood Disorder
By Carol Lewis
Until last year, treatment for IBS relied in most cases on a diet high in fiber, use of antispasmodics and other medications, and recommended lifestyle changes. But many of those options generally treat only a single symptom of IBS. In February 2000, the Food and Drug Administration approved Lotronex (alosetron hydrochloride), the first of a new generation of agents developed specifically to treat the multiple symptoms of IBS in women whose main complaint was diarrhea. Two large clinical trials indicated that the drug was effective in relieving pain and discomfort, reducing the urgency to defecate, and decreasing stool frequency.
IBS is one of three major "functional intestinal disorders"--a general term for conditions that show no physical evidence of disease in the intestines upon examination, and the cause of which does not show up in a blood test or an X-ray.
Not all doctors agree that IBS should be labeled a syndrome--a group of symptoms that collectively indicate or characterize a disease. Some physicians traditionally have considered the symptoms to be mostly psychological because they could not find something physically wrong to explain the trouble. Others, like Howard Spiro, M.D., a retired Yale University School of Medicine professor, worry that the catch-all term "IBS" has become a marketing tool that will send thousands of basically healthy people running to their doctors demanding prescriptions. Spiro, who continues his practice as a consulting gastroenterologist, believes that irritable bowel for many people is an emotional response to the troubles and incidents of everyday life, which he says have always led to digestive problems, and probably always will. "Recognizing an irritable bowel is one thing," he adds. "Deeming it the equivalent of a disease is another."
Nearly all people with IBS can be helped, but no single treatment works for everyone. The first step is a personal evaluation of history, stress level and diet. People who can identify particular foods or types of stress that bring on the problem should avoid them. For most, especially those who tend to be constipated, regular physical activity helps keep the gastrointestinal tract functioning normally.
The FDA and the drug industry currently are developing guidance for clinical trials involving people with IBS that would address many of the safety and effectiveness issues associated with the use of drugs for IBS. Meanwhile, support groups, research organizations, and patient education and advocacy groups, such as the Wisconsin-based International Foundation for Functional Gastrointestinal Disorders (IFFGD), are escalating efforts to educate doctors and patients about the disease.
-affects large intestine (colon or bowel)
-causes abdominal pain, bloating, diarrhea, constipation
-does not cause inflammation
-does not lead to other complications
-affects upper abdomen or chest
-causes feeling of fullness, gas, and burning pain
-can be caused by stomach ulcers, stomach inflammation or stomach cancer
-can be early warning of a serious disease
-affects any area of gastrointestinal tract
-causes inflammation sporadically throughout intestine
-causes diarrhea, crampy abdominal pain, loss of appetite, loss of weight, or skin sores
-can lead to other complications, such as intestinal obstruction
-affects all or part of only the large intestine
-causes inflammation and ulcers of the large intestine
-causes bloody diarrhea, abdominal cramping, fever
-does not affect the small intestine
NIH
2 Information Way
Bethesda, MD 20892
1-800-891-5389
www.niddk.nih.gov/health/digest/nddic.htm
Department of Gastroenterology
9500 Euclid Avenue
Cleveland, OH 44195
1-800-223-2273 (x48950)
www.clevelandclinic.org
P.O. Box 17864
Milwaukee, WI 53217
1-888-964-2001
www.iffgd.org
7910 Woodmont Avenue, 7th Floor
Bethesda, MD 20814
www.gastro.org
4900 B South 31st Street
Arlington, VA 22206
(703) 820-7400
www.acg.gi.org
P.O. Box 94074
Toronto, Ontario
Canada M4N 3R1
(416) 932-3311
www.ibsgroup.org
Notes and Insights:
Happy Birthday lpjmom aka Laura and Christine Campbell aka Christi!! Check out all the birthdays at
/community/birthday and make sure to send them an arthritis-friendly e-card: /cgi-bin/postcards/postcard.pl
Having surgery? Starting a new drug or treatment? Filing for disability? Keep an Arthritis Insight journal so all of our members can share and learn from your experience. If you want to keep a journal just let us know. Write an article! We always need articles on all subjects relating to arthritis.
C'mon folks, we can't do this without you.
/about/donate.html
Donations to the Ken Akers Cheer Fund will be used to send flowers and gifts to those community members who are hospitalized, flaring or just in need of some good cheer.
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We realize that many of you are unable to contribute financially to Arthritis Insight. But we need more than money. Please check out our wish list and see if you can help.
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A great big thank you to our "Diamond Level" Corporate Benefactor, allaboutarthritis.com. Please stop by their site and say hello! http://allaboutarthritis.com
Whenever possible we will try get to our sponsors to agree to discounts and the like for our members. Here are our current special offers:
Sore No More gel (http://www.sorenomore.com) will send a free sample of the pain relieving gel to any Arthritis Insight Community Member who emails them at dma@glogerm.com
The AI Help Desk
Linda Peck
A: You bet. The setting you're looking for is actually on your monitor. Most newer monitors allow you to adjust the horizontal and vertical spacing / placement via buttons located on the front of the monitor (older monitors may have a twisty dial thing on the back for adjustment).
Usually, you need to play with the buttons a little to figure out what does what. Normally, there are some sort of icons either on screen or on the buttons that give you an idea of where to start.
A: Quick - name a Windows feature that's really useful but almost no one uses. Yup, you guess it, the Documents Menu.
Your documents menu is found under your Start Button, Documents. It gives you a list of your most recent documents. Note that these documents can come in the form of word processor documents, web pages you've worked on, images, etc.
So, if you have a document you've recently been working on, find it on the Documents menu and click it. The program associated with it will open up and you can get back to work. You don't have to run the application, hit the Open button, sort through all your folders, and finally open the document.
Oh, if you want to get at it even faster, hit the Windows key on your keyboard and then the letter "D". Next, click the first letter of the file you're looking for and hit Enter. Faster than a speeding mouse huh?
Have you ever wished you could empty the Documents menu? (To see what's in there now, click Start, and highlight Documents). Here's How:
1. Click the Start button, Settings, Taskbar & Start Menu.
2. Click the second tab ("Start Menu Programs" for win 95/98 --
"Advanced" if you use ME) and press the "Clear" button.
It shows a recycle bin next to the clear button but don't worry. The contents of the menu are all that's removed. Your documents are still safe and sound on your hard drive.
Copyright 2001, Worldstart - Reprinted with permission.
http://209.15.122.1/terri1/toons5/email.gif
"Friends are God's way of taking care of us."
Help Desk Archives: /living/help/index.html
Weekly News Summary
Karen Sears
kaekae@arthritisinsight.com
Contrary to some existing evidence, chronic use of common painkillers like
aspirin does not appear to harm kidney function in healthy people, according
to new study findings.
Reuters Health, Jul 17
http://dailynews.yahoo.com/h/nm/20010717/hl/kidneydisease_1.html
Oral bovine tracheal type II collagen (CGII) might represent an effective,
well-tolerated treatment for rheumatoid arthritis (RA).
Doctor's Guide, Jul 17 (free registration required)
http://www.docguide.com/news/content.nsf/news/
8525697700573E1885256A810067733D?OpenDocument&id=
961CDD58B2967A7C852569E40007966F&c=Rheumatoid%20Arthritis&count=10
Patients with rheumatoid arthritis have elevated serum nitric oxide (NO)
levels that are correlated with disease activity parameters. Previous
studies have suggested that NO is involved in the pathogenesis of
inflammatory reactions in autoimmune diseases like rheumatoid arthritis
Doctor's Guide, Jul 16 (free registration required)
http://www.docguide.com/news/content.nsf/news/
8525697700573E1885256A8100680672?OpenDocument&id=
961CDD58B2967A7C852569E40007966F&c=Rheumatoid%20Arthritis&count=10
Here is one more problem for the nation's school teachers. New research
shows they have a significantly higher risk of dying from an autoimmune
disease such as multiple sclerosis, rheumatic fever or lupus. According to a
report in this month's Journal of Rheumatology, the overall mortality rate
from these diseases for teachers is 2.3 percent, compared to 1.7 percent for
people with other professional occupations.
Ivanhoe Newswire, Jul 16
http://www.ivanhoe.com/docs/newsflash/autoimmunediseasesamoungteachers.html
The American Academy of Pediatrics (AAP) said on Friday it supports federal
funding for stem cell research using human embryos but opposes creation of
embryos specifically to harvest the cells.
Reuters Health, Jul 13
http://dailynews.yahoo.com/h/nm/20010713/hl/stem_1.html
As keratoconjunctivitis sicca is common in juvenile rheumatoid arthritis,
patients should be screened for the complication.
Doctor's Guide, Jul 13 (free registration required)
http://www.docguide.com/news/content.nsf/news/
8525697700573E1885256A8100681559?OpenDocument&id=
961CDD58B2967A7C852569E40007966F&c=Rheumatoid%20Arthritis&count=10
Researchers from the University of Michigan provide new insights into the
body's natural pain-fighting system in a report published in the journal
Science.
Ivanhoe Newswire, Jul 13
http://www.ivanhoe.com/docs/newsflash/understandingpain.html
British researchers report that left-handed people are twice as likely to
suffer from irritable bowel disease (IBD) as right-handed people.
Reuters Health, Jul 12
http://dailynews.yahoo.com/h/mn/20010712/hl/lefties_1.html
Showing that clean living may the key to longevity, researchers have found
that Seventh-Day Adventists have significantly longer-than-average life
expectancies. They ascribe this longevity to church members' high rates of
vegetarianism and regular exercise and virtually non-existent rates of
smoking.
Reuters Health, Jul 12
http://dailynews.yahoo.com/h/nm/20010712/hl/habit_1.html
In a move partially meant to allay the fears of the millions of Americans
taking Synthroid, the US Food and Drug Administration (FDA) clarified on
Thursday that the agency has given makers of the thyroid drug until August
14 to file for approval.
Reuters Health, Jul 12
http://dailynews.yahoo.com/h/nm/20010712/hl/fda_1.html
Psychological well-being is known to be intertwined with gastrointestinal
health, and new research suggests that women with chronic constipation are
more likely to be anxious or depressed than women who don't have bowel
problems.
People who suffer from rheumatoid arthritis may be prone to developing
chronic gum disease that can lead to tooth and bone loss, according to
Australian researchers.
Reuters Health, Jul 12
http://dailynews.yahoo.com/h/nm/20010712/hl/gums_1.html
In patients with primary knee osteoarthritis (OA), even a small misalignment
of the knee increases the risk of disease progression, according to a report
in The Journal of the American Medical Association for July 11.
Medscape, Jul 11 (free registration required)
http://rheumatology.medscape.com/reuters/prof/2001/07/07.12/20010711clin012.html
Taking herbal medications and having surgery may be a risky combination that
can lead to excessive bleeding, heart instability or a reduction in blood
sugar levels.
Reuters Health, Jul 10
http://dailynews.yahoo.com/h/nm/20010710/hl/herbal_1.html
In a groundbreaking move, Blue Cross of California has announced that it is
dropping its system of rewarding physicians in its HMO networks solely for
controlling costs and utilization. Instead, the health insurer said it would
base bonus payments largely on patient satisfaction and the quality of care
provided.
Reuters Health, Jul 10
http://dailynews.yahoo.com/h/nm/20010710/hl/bonuses_1.html
California researcher have found that c-Jun N-terminal kinase (JNK), a
member of the mitogen-activated protein kinase family, plays a critical role
in metalloproteinase expression and joint destruction in inflammatory
arthritis.
Medscape, Jul 10 (free registration required)
http://rheumatology.medscape.com/reuters/prof/2001/07/07.11/20010710scie001.html
The interaction of the tumor necrosis factor receptor TACI (transmembrane
activator and CAML interactor) with its ligands is important for B-cell
function and for T-cell-mediated immune responses, report investigators with
Genentech Inc. Blocking TACI may therefore represent a therapeutic approach
to autoimmune diseases that involve both B and T cells.
Medscape, Jul 9 (free registration required)
http://rheumatology.medscape.com/reuters/prof/2001/07/07.10/20010709scie001.html
Patients with irritable bowel syndrome may have symptoms that overlap with
those of fibromyalgia and other functional disorders.
Doctor's Guide, Jul 9 (free registration required)
http://www.docguide.com/news/content.nsf/news/
8525697700573E1885256A7D0067A127?OpenDocument&id=
961CDD58B2967A7C852569E40007966F&c=Fibromyalgia&count=10
The benefits of exercise on the shape of the body and the heart are well
known, but a new study reports that as little as 10 minutes of moderate
exercise daily can improve mood and reduce fatigue.
Reuters Health, Jul 6
http://dailynews.yahoo.com/h/nm/20010706/hl/bouts_1.html
Erosive arthritis changes in Lyme disease are likely due to induction of
matrix metalloproteinases (MMP) induced by sustained infection with Borrelia
burgdorferi, researchers report.
Medscape, Jul 6 (free registration required)
http://rheumatology.medscape.com/reuters/prof/2001/07/07.09/20010706scie004.html
The use of two clinical decision rules, Simple Calculated Osteoporosis Risk
Estimation (SCORE) and Osteoporosis Risk Assessment Instrument (ORAI),
appear to be better than the use of the current national practice guidelines
in identifying women who should be tested for low bone mineral density
(BMD), according to a report in the July 4th issue of The Journal of the
American Medical Association.
Medscape, Jul 5 (free registration required)
http://rheumatology.medscape.com/reuters/prof/2001/07/07.06/20010705pub1001.html
An imbalance between interleukin-6 and adrenomedullin may play a key role in
the progression of systemic lupus erythematosus.
Doctor's Guide, Jul 5 (free registration required)
http://www.docguide.com/news/content.nsf/news/
8525697700573E1885256A71006D0F9B?OpenDocument&id=
961CDD58B2967A7C852569E40007966F&c=Lupus&count=10
A common arthritis drug may be useful in preventing the recurrence of
migraine headaches, according to research presented last week at the 10th
International Headache Congress.
Reuters Health, Jul 4
http://dailynews.yahoo.com/h/nm/20010704/hl/arthritis_1.html
Many employees are in favor of having pets in their workplace and believe
they help reduce stress and improve their health, a recent study suggests.
Reuters Health, Jul 4
http://dailynews.yahoo.com/h.nm/20010704/hl/pets_1.html
While many people say they would like to donate their organs after they die,
in reality only about half the number of families asked to donate a loved
one's organs do so.
Reuters Health, Jul 3
http://dailynews/yahoo.com/h/nm/20010703/hl/organ_donor_1.html
The recombinant lipoprotein outer surface protein A (OspA) Lyme disease
vaccine (LYMErix) appears to be safe and effective in children 4 to 18 years
of age, according to a report in the July issue of Pediatrics.
Medscape, Jul 3 (free registration required)
http://rheumatology.medscape.com/reuters/prof/2001/07/07.04/20010703clin005.html
Equidyne Corp. said on Monday that its disposable system using ``jet
injection'' instead of a needle to deliver medications has been approved by
the US Food and Drug Administration (FDA).
Reuters Health, Jul 2
http://dailynews/yahoo.com/h/nm/20010702/hl/needle_shot_1.html
Antibodies that target the CD40 ligand (CD40L) effectively suppress an
experimental form of myasthenia gravis in rats, even during the chronic
stage of disease, according to a report published in the June 1st issue of
the Journal of Immunology.
Medscape, Jul 2 (free registration required)
http://rheumatology.medscape.com/reuters/prof/2001/07/07.03/20010702scie001.html
What could be better than a massage to treat chronic neck pain? Acupuncture,
according to a team of German and Swiss researchers. They report that
although the Western massage may be the customary short-term treatment,
acupuncture may be more effective.
Reuters Health, Jun 29
http://dailynews.yahoo.com/h/nm/20010629/hl/acupuncture_1.html
A weekly jog around the park may not put an individual into the same league
as Michael Johnson or other Olympic runners, but it may help keep bones
healthy, new study findings suggest.
Reuters Health, Jun 28
http://dailynews.yahoo.com/h/nm/20010628/hl/jogging_2.html
Moderate levels of leisure-time physical activity protect against later hip
fracture, according to a report in the July issue of the American Journal of
Epidemiology. Further, the risk for hip fracture is increased with a decline
in physical activity over time.
Medscape, Jun 28 (free registration required)
http://rheumatology.medscape.com/reuters/prof/2001/06/06.29/20010628epid002.html
New evidence that children with juvenile idiopathic arthritis (JIA) use many
of the same pain-coping strategies as their parents could have important
implications for pain management in this population.
Medscape, Jun 27 (free registration required)
http://rheumatology.medscape.com/reuters/prof/2001/06/06.28/20010627clin002.html
In preparation for what the insurance industry believes will be a marked
increase in the number of lawsuits filed by subjects in drug and device
trials over the next few years, underwriters are tightening up their
requirements for companies seeking coverage of clinical trials, Chubb
Insurance Life Sciences Casualty Manager Jill Wadlund said during an
interview with Reuters Health.
Reuters Health, Jun 27
http://dailynews.yahoo.com/h/nm/20010627/hl/trials_1.html
Researchers have found a way to track and quantitatively assess changes in
the joints of patients who have arthritis.
Doctor's Guide, Jun 27 (free registration required)
http://www.docguide.com/news/content.nsf/news/
B219CEB835E3D33485256A7800475EED?OpenDocument&id=
961CDD58B2967A7C852569E40007966F&c=Arthritis%20Other&count=10
Extending previous findings about the short-term efficacy of etanercept, US
researchers have found that the drug is safe and efficacious for long-term
treatment of rheumatoid arthritis.
Medscape, Jun 26 (free registration required)
http://rheumatology.medscape.com/reuters/prof/2001/06/06.27/20010626clin001.html
Contribute
A Closing Thought
---------------------------------
If you wish to advertise in the Arthritis Insight Newsletter, contact us at advertising@arthritisinsight.com
Page last updated on July 18,
2001
The information provided by
Arthritis Insight.com should not take the place of advice
and guidance from your own health-care providers. Material in this site is provided
for educational and informational purposes only. Be sure to check with your doctor before
making any changes in your treatment plan.
Information presented on ArthritisInsight.com is the opinion of the authors and
has not necessarily been approved or endorsed by the medical advisors. The
information contained on this web site may not be published, broadcast or
otherwise distributed without prior written authorization.
