Arthritis Insight Newsletter * Vol. 5 Issue 175 December 10, 2003

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Welcome to the 175th 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.

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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.

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Notes From Tina
(Tina@arthritisinsight.com)
Tina Underwood aka KrissyJo

It's beginning to look a lot like Christmas! The tree is up, presents are wrapped and there is snow on the ground! Knowing I always flare during the holidays, I got everything done early this year. My husband built a couple of wood items that I need to paint, but otherwise I am finished! Now I can relax and fight off that flare.

A very cool website was brought to my attention, http://angelsforhope.org. Angels of Hope provide crochet angels free of charge to those who are severely injured and/or chronically ill, as well as their caregivers, or just someone that needs hope - as a tangible reminder that you are not alone, that others care, and that we remember you in our thoughts and prayers. If you would like to request an angel for someone or maybe help crochet, stop by the website.

That's all for me! Have a great week!

- Tina

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Ron's Ramblin's
(Ron@arthritisinsight.com)
Ron Griffin aka IndyRon

Just call me thumbs. I have been trying to wrap stuff for the holidays and have rediscovered that I am undoubtedly the worlds worst at it. No matter how hard I try, it ends up looking as if the wrapping paper had been wadded up and run through the washer and dryer before going on the package. It really isn’t that bad, but I just can’t seem to make the packages look like the ones wrapped at the stores. I guess that the "home wrapped" look will add a bit of a homey touch to the season, and a few smiles of understanding as the gifts are unwrapped.

Oh well, I don’t really think anyone will mind.

I wish for everyone a pain free and wonderful week ahead.

-Ron

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Your Weekly Giggle
Santa's Stress
(I grabbed this from A.S.A., *many thanks* to Gwen for posting it - she always makes me smile)

Not long ago and far away, Santa was getting ready for his annual trip...but there were problems everywhere. Four of his elves got sick and the trainee elves did not produce the toys as fast as the regular ones so Santa was beginning to feel the pressure of being behind schedule.

Then Mrs. Claus told Santa that her mom was coming to visit. This stressed Santa even more. When he went to harness the reindeer, he found that three of them were about to give birth and two had jumped the fence and were out; heaven knows where to... More stress!

Then when he began to load the sleigh, one of the boards cracked and the toy bag fell to the ground and scattered the toys. Totally frustrated, Santa went into the house for a cup of coffee and a shot of whiskey.

When he went to the cupboard, he found the elves had hit the liquor and there was nothing to drink. In his frustration, he dropped the coffee pot and it broke into hundreds of little pieces all over the kitchen floor.

He went to get the broom and found that mice had eaten the straw it was made from.

Just then the doorbell rang and Santa cussed on his way to the door. He opened the door and there was a cute little angel with a great big Christmas tree.

The angel asked: "Where would you like to put this tree, fat man?"

And that my friend is how the little angel came to be on top of the Christmas tree.

Check out all the jokes at:
/fun/jokes
Send yours in today!

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Tina's Tips
Tina@arthritisinsight.com

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.

Last week I asked for homemade gift ideas and here they are:

I made full length night gowns for the girls (their request as I made some two years ago) Christmas dresses for the daycare girls and a shirt, tie and pants for the daycare boy. I'm embroidering breadcloths to put in baskets for some and sewing tv remote caddies for others. I love sewing it saves money although I'm slower this year , I leave the machine set up so I can do just one seam at a time if thats all I can do that day. ~Michelle, Ontario, Canada

This year I am making bird treats for my brothers-in-law -- all avid birdwatchers. Pinecones packed with peanut butter or suet then rolled and packed with seed. Tie rustic brown twine to hang. The birds love them!
That is my crafty-gifty thing this year! Merry Christmas!!! and be well
~Patricia B., Indianapolis

I think most of alt.support.arthritis is making no sew fleece blankets. You can find the directions here:
http://www.hancockfabrics.com/jump.jsp?itemID=191&itemType=CONTENT

I made coffee gift baskets that included instant coffee mixes and homemade liqueurs. Here are some recipes:

http://beverage.allrecipes.com/directory/1349.asp
http://www.recipegoldmine.com/foodgift/foodgift.html

I bought a bunch of pretty pot holders for 50 cents each and cut a small hole into each one. I poured rice into the hole and then stitched it closed. A fast and pretty rice pack! I added crushed cinamon sticks for a pleasing scent.

Debbie sent great directions for note cards, but I lost it! Could you please resend, Debbie? Thanks!

Patricia B, you are the random winner of the bottle opener! (www.bottle-popper.com). Send me your address and I will get it in the mail.

Check out more tips at /living/tips.html and send in yours today to Tina@arthritisinsight.com Keep those tips coming!

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What’s New

Advice For Better Living
Hubby help needed!
/living/advice/

Member Stories
Three new stories and an update.
/community/stories

Arthritis & Employment
Another member tells us What do you do?
/living/employment/do.html

Birthday Board
Updated once again! Who gets to party this week?
/community/birthday

Question of the Week
Flare, schmare, what do you call a flare?
/community/question

Disease Index
Our Lupus section has been updated with lots of new Links.
/medical/disease/sle/links.html

News
Another week's worth of news for your arthritis and general health.
/news

Newsletter
Yes, it's Friday. Time to find a cuppa something good and check out this week's issue.
/community/newsletter

Message Boards
Don't forget to stop by and wish everyone happy holidays. :)
/community/boards

Check out all the latest updates at
/updates.html

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Arthritis Insight Chat
/community/chat

Time to get the party started! Got some extra time? Can't sleep? Drop into the chatroom to talk to other members that know exactly what you're going through.

Watch for the chat schedule to be updated soon!

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Cooking with Char
Char LeFleur
cookingwithchar@arthritisinsight.com

Hello friends! The holidays are fast approaching and most of us have way more to do to get ready for them, than we are happy with. So anything that is a time saver is welcome. Todays recipes are a Potato Soup you make in the crockpot, a crescent roll that is faster than most, for those holiday dinners and a solution to make your Christmas tree, flame retardant.

Here's hoping they all help to save you some time. Now let's get started!!

This recipe is from our very own Kimmy. Thanks for thinking of me, and sharing the recipe!

Crockpot Potato Soup

6 cups cubed potatoes (I leave the skins on, but if you're up to peeling, feel free)
5 cups water
2 cups chopped onions
1/2 cup chopped celery
1/2 cup thinly sliced carrots (I use the little already cleaned ones)
4 teaspoons chicken bouillon granules (or 4 cubes)
1/4 cup butter or margarine
2 teaspoons salt
1/4 teaspoon pepper
1 can (12 oz.) evaporated milk

(Optional)
3 tablespoons fresh parsley, chopped
2 cups shredded cheddar cheese
diced ham
crumbled bacon

In a large crock pot, combine first nine ingredients. Cover and cook 7-8 hours on high or till vegetables are tender. Add milk (and parsley, cheese, ham, or bacon) Cover and cook another 30-60 till heated thru.

This is one of those recipes you can dress up as much as you like. If I need a cheap meal - we skip the options. If it's a good night - we add the cheese & some meat and maybe top it with a dollop of sour cream. Add a loaf of fresh italian bread, a salad, crackers, whatever you've got. This is a great dinner for a cold winter night. Feeds all six of us even with a couple of the guys going back for seconds (or thirds).

Hurry-Up Crescent Rolls

1 (1/4-ounce) envelope active dry yeast
3/4 cup warm water (105? to 115?)
3 to 3 1/2 cups biscuit mix
2 tablespoons sugar

Combine yeast and warm water in a 1-cup liquid measuring cup; let stand 5 minutes.Combine biscuit mix and sugar in a large bowl; gradually stir in yeast mixture.

Turn dough out onto a floured surface, and knead until smooth and elastic (about 10 minutes).

Roll dough into a 12-inch circle; cut circle into 12 wedges. Roll up wedges, beginning at wide end; place, point side down, on a lightly greased baking sheet.

Cover and let rise in a warm place (85?), free from drafts, 1 hour or until doubled in bulk.

Bake at 425? for 10 to 12 minutes or until golden.

NOTE: Rolls may be frozen up to 2 months. Bake at 425? for 5 minutes; cool. Warp in aluminum foil, and freeze in an airtight container. Thaw at room temperature on a lightly greased baking sheet; bake at 425? for 7 to 8 minutes or until golden.

And last, but certainly not least from Firechief--

Christmas Tree Solution

Combine these ingredients in a bucket::

1 gallon warm water
1 pint clear Karo Syrup
4 ounces liquid chlorine bleach
1/2 teaspoon borax
2 ounces cider vinegar
2 ounces liquid Woolite

The recipe is designed to increase fluid intake for a freshly
cut tree and help keep it from drying out too quickly and
becoming a fire hazard.

Make a fresh cut three inches from the base of the tree's
trunk, and place the tree in the bucket. Fill the remainder
of the bucket with warm water.

For best results, leave the tree in the bucket at least five
days before bringing it inside. Use an remaining mixture
in the tree stand.

If you have questions, comments, or suggestions, that you would like to share, please send them to cookingwithchar@arthritisinsight.com.

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From the NIH/NIAID:
Understanding Autoimmune Diseases
For the complete article see:
http://www.niaid.nih.gov/publications/autoimmune/


What Are Autoimmune Diseases?

The word "auto" is the Greek word for self. The immune system is a complicated network of cells and cell components (called molecules) that normally work to defend the body and eliminate infections caused by bacteria, viruses, and other invading microbes. If a person has an autoimmune disease, the immune system mistakenly attacks self, targeting the cells, tissues, and organs of a person's own body. A collection of immune system cells and molecules at a target site is broadly referred to as inflammation.

There are many different autoimmune diseases, and they can each affect the body in different ways. For example, the autoimmune reaction is directed against the brain in multiple sclerosis and the gut in Crohn's disease. In other autoimmune diseases such as systemic lupus erythematosus (lupus), affected tissues and organs may vary among individuals with the same disease. One person with lupus may have affected skin and joints whereas another may have affected skin, kidney, and lungs. Ultimately, damage to certain tissues by the immune system may be permanent, as with destruction of insulin-producing cells of the pancreas in Type 1 diabetes mellitus.

Who Is Affected by Autoimmune Diseases?

Many of the autoimmune diseases are rare. As a group, however, autoimmune diseases afflict millions of Americans. Most autoimmune diseases strike women more often than men; in particular, they affect women of working age and during their childbearing years.

Some autoimmune diseases occur more frequently in certain minority populations. For example, lupus is more common in African-American and Hispanic women than in Caucasian women of European ancestry. Rheumatoid arthritis and scleroderma affect a higher percentage of residents in some Native American communities than in the general U.S. population. Thus, the social, economic, and health impact from autoimmune diseases is far-reaching and extends not only to family but also to employers, co-workers, and friends.

What Are the Causes of Autoimmune Diseases?

Are they contagious? No autoimmune disease has ever been shown to be contagious or "catching." Autoimmune diseases do not spread to other people like infections. They are not related to AIDS, nor are they a type of cancer.

Are they inherited? The genes people inherit contribute to their susceptibility for developing an autoimmune disease. Certain diseases such as psoriasis can occur among several members of the same family. This suggests that a specific gene or set of genes predisposes a family member to psoriasis. In addition, individual family members with autoimmune diseases may inherit and share a set of abnormal genes, although they may develop different autoimmune diseases. For example, one first cousin may have lupus, another may have dermatomyositis, and one of their mothers may have rheumatoid arthritis.

The development of an autoimmune disease may be influenced by the genes a person inherits together with the way the person's immune system responds to certain triggers or environmental influences.

What other factors may influence the development of autoimmune diseases? Some autoimmune diseases are known to begin or worsen with certain triggers such as viral infections. Sunlight not only acts as a trigger for lupus but can worsen the course of the disease. It is important to be aware of the factors that can be avoided to help prevent or minimize the amount of damage from the autoimmune disease. Other less understood influences affecting the immune system and the course of autoimmune diseases include aging, chronic stress, hormones, and pregnancy.

How Does the Immune System Work?

The immune system defends the body from attack by invaders recognized as foreign. It is an extraordinarily complex system that relies on an elaborate and dynamic communications network that exists among the many different kinds of immune system cells that patrol the body. At the heart of the system is the ability to recognize and respond to substances called antigens whether they are infectious agents or part of the body (self antigens).

T and B Cells

Most immune system cells are white blood cells, of which there are many types. Lymphocytes are one type of white blood cell, and two major classes of lymphocytes are T cells and B cells. T cells are critical immune system cells that help to destroy infected cells and coordinate the overall immune response. The T cell has a molecule on its surface called the T-cell receptor. This receptor interacts with molecules called MHC (major histocompatibility complex). MHC molecules are on the surfaces of most other cells of the body and help T cells recognize antigen fragments. B cells are best known for making antibodies. An antibody binds to an antigen and marks the antigen for destruction by other immune system cells. Other types of white blood cells include macrophages and neutrophils.

Macrophages and Neutrophils

Macrophages and neutrophils circulate in the blood and survey the body for foreign substances. When they find foreign antigens, such as bacteria, they engulf and destroy them. Macrophages and neutrophils destroy foreign antigens by making toxic molecules such as reactive oxygen intermediate molecules. If production of these toxic molecules continues unchecked, not only are the foreign antigens destroyed, but tissues surrounding the macrophages and neutrophils are also destroyed. For example, in individuals with the autoimmune disease called Wegener's granulomatosis, overactive macrophages and neutrophils that invade blood vessels produce many toxic molecules and contribute to damage of the blood vessels. In rheumatoid arthritis, reactive oxygen intermediate molecules and other toxic molecules are made by overproductive macrophages and neutrophils invading the joints. The toxic molecules contribute to inflammation, which is observed as warmth and swelling, and participate in damage to the joint.

MHC and Co-Stimulatory Molecules

MHC molecules are found on all cell surfaces and are an active part of the body's defense team. For example, when a virus infects a cell, a MHC molecule binds to a piece of a virus (antigen) and displays the antigen on the cell's surface. Cells that have the capability of displaying antigen with MHC are called antigen-presenting cells. Each MHC molecule that displays an antigen is recognized by a matching or compatible T-cell receptor. Thus, an antigen-presenting cell is able to communicate with a T cell about what may be occurring inside the cell. However, for the T cell to respond to a foreign antigen on the MHC, another molecule on the antigen-presenting cell must send a second signal to the T cell. A corresponding molecule on the surface of the T cells recognizes the second signal. These two secondary molecules of the antigen-presenting cell and the T cell are called co-stimulatory molecules. There are several different sets of co-stimulatory molecules that can participate in the interaction of antigen-presenting cell with a T cell.

Once the MHC and the T-cell receptor interact, and the co-stimulatory molecules interact, there are several possible paths that the T cell may take. These include T cell activation, tolerance, or T cell death. The subsequent steps depend in part on which co-stimulatory molecules interact and how well they interact. Because these interactions are so critical to the response of the immune system, researchers are intensively studying them to find new therapies that could control or stop the immune system attack on self tissues and organs.

Cytokines and Chemokines

One way T cells can respond after the interaction of the MHC and the T-cell receptor, and the interaction of the co-stimulatory molecules, is to secrete cytokines and chemokines. Cytokines are proteins that may cause surrounding immune system cells to become activated, grow, or die. They also may influence non-immune system tissues. For example, some cytokines may contribute to the thickening of the skin that occurs in people with scleroderma.

Chemokines are small cytokine molecules that attract cells of the immune system. Overproduction of chemokines contributes to the invasion and inflammation of the target organ, which occurs in autoimmune diseases. For example, overproduction of chemokines in the joints of people with rheumatoid arthritis may result in invasion of the joint space by destructive immune system cells such as macrophages, neutrophils, and T cells.

Antibodies

B cells are another critical type of immune system cell. They participate in the removal of foreign antigens from the body by using a surface molecule to bind the antigen or by making specific antibodies that can search out and destroy specific foreign antigens. However, the B cell can only make antibodies when it receives the appropriate command signal from a T cell. Once the T cell signals the B cell with a type of cytokine that acts as a messenger molecule, the B cell is able to produce a unique antibody that targets a particular antigen.

Autoantibodies

In some autoimmune diseases, B cells mistakenly make antibodies against tissues of the body (self antigens) instead of foreign antigens. Occasionally, these autoantibodies either interfere with the normal function of the tissues or initiate destruction of the tissues. People with myasthenia gravis experience muscle weakness because autoantibodies attack a part of the nerve that stimulates muscle movement. In the skin disease pemphigus vulgaris, autoantibodies are misdirected against cells in the skin. The accumulation of antibodies in the skin activates other molecules and cells to break down, resulting in skin blisters.

Immune Complexes and the Complement System

When many antibodies are bound to antigens in the bloodstream, they form a large lattice network called an immune complex. Immune complexes are harmful when they accumulate and initiate inflammation within small blood vessels that nourish tissues. Immune complexes, immune cells, and inflammatory molecules can block blood flow and ultimately destroy organs such as the kidney. This can occur in people with systemic lupus erythematosus.

A group of specialized molecules that form the complement system helps to remove immune complexes. The different types of molecules of the complement system, which are found in the bloodstream and on the surfaces of cells, make immune complexes more soluble. Complement molecules prevent formation and reduce the size of immune complexes so they do not accumulate in the wrong places (organs and tissues of the body). Rarely, some people inherit defective genes for a complement molecule from their parents. Because these individuals cannot make a normal amount or type of complement molecule, their immune systems are unable to prevent immune complexes from being deposited in different tissues and organs. These people develop a disease that is not autoimmune but resembles lupus erythematosus.

Genetic Factors

Genetic factors can affect an individual's immune system and its responses to foreign antigens in several ways. Genes determine the variety of MHC molecules that individuals carry on their cells. Genes also influence the potential array of T-cell receptors present on T cells. In fact, some MHC genes are associated with autoimmune diseases. However, genes are not the only factors involved in determining a person's susceptibility to an autoimmune disease. For example, some individuals who carry disease-associated MHC molecules on their cells will not develop an autoimmune disease.

How Are Autoimmune Diseases Diagnosed?

The diagnosis of an autoimmune disease is based on an individual's symptoms, findings from a physical examination, and results from laboratory tests. Autoimmune diseases can be difficult to diagnose, particularly early in the course of the disease. Symptoms of many autoimmune diseases (such as fatigue) are nonspecific. Laboratory test results may help but are often inadequate to confirm a diagnosis.

If an individual has skeletal symptoms such as joint pain and a positive but nonspecific lab test, she or he may be diagnosed with the confusing name of early or "undifferentiated" connective tissue disease. In this case, a physician may want the patient to return frequently for follow up. The early phase of disease may be a very frustrating time for both the patient and physician. On the other hand, symptoms may be short-lived, and inconclusive laboratory tests may amount to nothing of a serious nature.

In some cases, a specific diagnosis can be made. A diagnosis shortly after onset of a patient's symptoms will allow for early aggressive medical therapy; and for some diseases, patients will respond completely to treatments if the reason for their symptoms is discovered early in the course of their disease.

Although autoimmune diseases are chronic, the course they take is unpredictable. A doctor cannot foresee what will happen to the patient based on how the disease starts. Patients should be monitored closely by their doctors so environmental factors or triggers that may worsen the disease can be discussed and avoided and new medical therapy can be started as soon as possible. Frequent visits to a doctor are important in order for the physician to manage complex treatment regimens and watch for medication side effects.

How Are Autoimmune Diseases Treated?

Autoimmune diseases are often chronic, requiring lifelong care and monitoring, even when the person may look or feel well. Currently, few autoimmune diseases can be cured or made to "disappear" with treatment. However, many people with these diseases can live normal lives when they receive appropriate medical care.

Physicians most often help patients manage the consequences of inflammation caused by the autoimmune disease. For example, in people with Type 1 diabetes, physicians prescribe insulin to control blood sugar levels so that elevated blood sugar will not damage the kidneys, eyes, blood vessels, and nerves. However, the goal of scientific research is to prevent inflammation from causing destruction of the insulin-producing cells of the pancreas, which are necessary to control blood sugars.

On the other hand, in some diseases such as lupus or rheumatoid arthritis, medication can occasionally slow or stop the immune system's destruction of the kidneys or joints. Medications or therapies that slow or suppress the immune system response in an attempt to stop the inflammation involved in the autoimmune attack are called immunosuppressive medications. These drugs include corticosteroids (prednisone), methotrexate, cyclophosphamide, azathioprine, and cyclosporin. Unfortunately, these medications also suppress the ability of the immune system to fight infection and have other potentially serious side effects.

In some people, a limited number of immuno-suppressive medications may result in disease remission. Remission is the medical term used for "disappearance" of a disease for a significant amount of time. Even if their disease goes into remission, patients are rarely able to discontinue medications. The possibility that the disease may restart when medication is discontinued must be balanced with the long-term side effects from the immunosuppressive medication.

A current goal in caring for patients with autoimmune diseases is to find treatments that produce remissions with fewer side effects. Much research is focused on developing therapies that target various steps in the immune response. New approaches such as therapeutic antibodies against specific T cell molecules may produce fewer long-term side effects than the chemotherapies that now are routinely used.

Ultimately, medical science is striving to design therapies that prevent autoimmune diseases. To this end, a significant amount of time and resources are spent studying the immune system and pathways of inflammation.

What Are Some Examples of Autoimmune Diseases?

Rheumatoid Arthritis

In people with rheumatoid arthritis, the immune system predominantly targets the lining (synovium) that covers various joints. Inflammation of the synovium is usually symmetrical (occurring equally on both sides of the body) and causes pain, swelling, and stiffness of the joints. These features distinguish rheumatoid arthritis from osteoarthritis, which is a more common and degenerative "wear-and-tear" arthritis.

Currently available therapy focuses on reducing inflammation of the joints with anti-inflammatory or immunosuppresssive medications. Sometimes, the immune system may also target the lung, blood vessels, or eye; occasionally patients may also develop symptoms of other autoimmune diseases such as Sjogren's the inflammation, itching, and scaling. For more severe cases, oral medications are used. Psoriasis is common and may affect more than 2 out of 100 Americans. Psoriasis often runs in families.

Multiple Sclerosis

Multiple sclerosis is a disease in which the immune system targets nerve tissues of the central nervous system. Most commonly, damage to the central nervous system occurs intermittently, allowing a person to lead a fairly normal life. At the other extreme, the symptoms may become constant, resulting in a progressive disease with possible blindness, paralysis, and premature death. Some medications such as beta interferon are helpful to people with the intermittent form of multiple sclerosis.

In young adults, multiple sclerosis is the most common disabling disease of the nervous system. Multiple sclerosis afflicts 1 in 700 people in this country. Researchers continue to search for triggers of the disease.

Immune-Mediated or Type 1 Diabetes Mellitus

Type 1 diabetes mellitus results from autoimmune destruction of the insulin-producing cells of the pancreas. Insulin is required by the body to keep the blood sugar (glucose) level under control. High levels of glucose are responsible for the symptoms and the complications of the disease. However, most of the insulin-producing cells are destroyed before the patient develops symptoms of diabetes. Symptoms include fatigue, frequent urination, increased thirst, and possible sudden confusion.

Type 1 diabetes mellitus is usually diagnosed before the age of 30 and may be diagnosed as early as the first month of life. Together with Type 2 diabetes (not considered an autoimmune disease), diabetes mellitus is the leading cause of kidney damage, loss of eyesight, and leg amputation. Close control of sugar levels decreases the rate at which these events occur. There is a genetic predisposition to Type 1 diabetes, which occurs in 1 out of 800 people in the United States. Among individuals who have a close relative with Type 1 diabetes, those at high risk for developing disease can be identified. Efforts are now under way to evaluate prevention strategies for these family members at risk.

Inflammatory Bowel Diseases

This medical term is used for both Crohn's disease and ulcerative colitis, two diseases in which the immune system attacks the gut (intestine). Patients may have diarrhea, nausea, vomiting, abdominal cramps, and pain that can be difficult to control. Illness in afflicted individuals can result from intestinal inflammation and from side effects of the drugs used for the disease. For example, daily use of high-dose corticosteroid (prednisone) therapy, which is needed to control severe symptoms of Crohn's disease, can predispose patients to infections, bone thinning (osteoporosis), and fractures. For patients with ulcerative colitis, surgical removal of the lower intestine (colon) will eliminate the disease and their increased risk for colon cancer. More than 1 in 500 Americans has some type of inflammatory bowel disease.

Systemic Lupus Erythematosus

Patients with systemic lupus erythematosus most commonly experience profound fatigue, rashes, and joint pains. In severe cases, the immune system may attack and damage several organs such as the kidney, brain, or lung. For many individuals, symptoms and damage from the disease can be controlled with available anti-inflammatory medications. However, if a patient is not closely monitored, the side effects from the medications can be quite serious. Lupus occurs in 1 out of 2,000 Americans and in as many as 1 in 250 young, African-American women.

Psoriasis

Psoriasis is an immune system disorder that affects the skin, and occasionally the eyes, nails, and joints. Psoriasis may affect very small areas of skin or cover the entire body with a buildup of red scales called plaques. The plaques are of different sizes, shapes, and severity and may be painful as well as unattractive. Bacterial infections and pressure or trauma to the skin can aggravate psoriasis. Most treatments focus on topical skin care to relieve the inflammation, itching, and scaling. For more severe cases, oral medications are used. Psoriasis is common and may affect more than 2 out of 100 Americans. Psoriasis often runs in families.

Scleroderma

This autoimmune disease results in thickening of the skin and blood vessels. Almost every patient with scleroderma has Raynaud's, which is a spasm of the blood vessels of the fingers and toes. Symptoms of Raynaud's include increased sensitivity of the fingers and toes to the cold, changes in skin color, pain, and occasionally ulcers of the fingertips or toes. In people with scleroderma, thickening of skin and blood vessels can result in loss of movement and shortness of breath or, more rarely, in kidney, heart, or lung failure. The estimated number of people with any type of scleroderma varies from study to study but may range from 1 to 4 affected individuals for every 10,000 Americans (or as many as 1 out of 2500 individuals).

Autoimmune Thyroid Diseases

Hashimoto's thyroiditis and Grave's disease result from immune system destruction or stimulation of thyroid tissue. Symptoms of low (hypo-) or overactive (hyper-) thyroid function are nonspecific and can develop slowly or suddenly; these include fatigue, nervousness, cold or heat intolerance, weakness, changes in hair texture or amount, and weight gain or loss. The diagnosis of thyroid disease is readily made with appropriate laboratory tests. The symptoms of hypothyroidism are controlled with replacement thyroid hormone pills; however, complications from over- or under-replacement of the hormone can occur. Treatment of hyperthyroidism requires long-term anti-thyroid drug therapy or destruction of the thyroid gland with radioactive iodine or surgery. Both of these treatment approaches carry certain risks and long-term side effects. Autoimmune thyroid diseases afflict as many as 4 out of 100 women and are frequently found in families where there are other autoimmune diseases.

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You Say...
Alone Time
Harry Nine Toes

Harry here, psoriatic arthritis brings me to these fine venues. It is so important to be able to share common experiences. Arthritis in any form saddles the sufferer with a lot of alone time. Most of alone time is not by our choice but seems to go with the disease.

Now as to how to spend this overabundance of alone time. To me it seem that it breaks down into two categories, useful and harmful. Most of us has had plenty of experience with the latter so I find it unnecessary to decorate the tree with any of the harmful time user, rather I think I shall suggest some useful time takers.

The first think to do is recognize those periods during the day, week or month that are just over flowing with alone time.
For me it is Monday, I am alone all day while my wife works and my step daughter is in class. It comes down to me and the pets.

The advantage for me is that I know ahead of time when alone time is going to be a problem for me. Thus I can plan some activities to fill in that period.

Now that we have identified the period inwhich we will have possibly too much alone time we need to fill it with something.

At this point a list of possible activities useful in filling in the alone time period could be inserted. Yea I could do that but then the list would be my list and so of little real use to you.

Instead I offer broadly defined activities for your consideration.

Think of something that would take some uninterrupted time, something that would take a lot of organization. Something that you have wanted to do but just could not dedicate the time. How about an activity that requires telephone time. Nothing eats up time better than hanging on the phone. How about something that you can stop and restart later, like family genealogy. Sitting in front of the boob tube but with a twist. Watch a show, one you have been meaning to but just never did. That movie that everyone else has seen but you. Never just turn the tube on and surf. Check out the TV or CABLE guide, read the blurbs, check out a critic. Watch with a purpose, what did so and so really say in whatever. Perhaps you are not too hot on foreign films, take a fresh breath and sit through one, just to say you did.

You get the idea spend your alone like cash and try and get some benefit out of it. You are not going to be successful in managing alone time all the time but you can try and apply some sore to management strategy. At least you are the one in charge and you are not just being lead around.

Well, there you have it. A few of the techniques I have found useful. We are all in this together, the fact that you have read this article so far is proof of that. If we hang together we can make this curse, known as arthritis, a little bit more manageable. Perhaps if we all chip in with our own ways of dealing with it, someday we are going to beat this disease.

EDITOR'S NOTE: This is something new in the newsletter - a feature article written by one of our members. Got something to say? Type it up, send it off and we'll see if we just can't get your article in the newsletter too.

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Notes and Insights:

Birthday Board!
Happy Birthday to Phyllis, Kalala, and Miranda!!!
Check out all the birthdays at
/community/birthday
and make sure to send them an arthritis-friendly e-card:
/cgi-bin/postcards/postcard.pl

Join the Arthritis Dieters!
This is a group of people with arthritis who want to lose weight with others who know of the challenges of living with is arthritis. All those medications that make living with arthritis tolerable, but pile on the pounds. This group has been set up to give us a protected group where we can talk to others who know what it is like.
http://groups.yahoo.com/group/arthritis-dieters/

Wanna help?
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.

Ken Akers Cheer Fund
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.
/community/kenscheerfund

Thank You!
A great 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 are donating baskets for our Arthritis Warriors.

Special Offers for Arthritis Insight Members
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 (http://sorenomore.com) gel will send a free sample of the pain relieving gel to any Arthritis Insight Community Member who emails them at dma@glogerm.com.

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Weekly News Summary
Karen Sears
kaekae@arthritisinsight.com

ADDING ATTITUDE TO ARTHRITIS; JUMPINGLY FIT
Pain gets most of the attention when it comes to arthritis of the knee. But a new study that tracked a group of older patients for three years found that factors like self-confidence and social support also appeared to predict who was able to avoid being disabled by the arthritis.

MEDICARE LAW ADDS BIOTECH ARTHRITIS DRUGS
The sweeping Medicare legislation that President Bush signed yesterday will open a new front in the battle among biotechnology companies for the lucrative rheumatoid arthritis market.

PROTECTING THE KNEES OF SENIORS
Social support, aerobic activity and self-efficacy are among the factors that help prevent disability in elderly people with osteoarthritis (OA) of the knee. That's the claim of a study in the December issue of Arthritis & Rheumatism.

THOUSANDS BRAVE WEATHER TO SUPPORT ARTHRITIS RESEARCH
More than 3700runners and walkers jingled their way through Saturday's tricky weather to benefit the Arthritis Foundation. The 20th annual Jingle Bell Run raised about $130,000 dollars for arthritis research.

ARTHRITIS - IT'S NOT JUST ONE DISEASE
Although people often talk about arthritis as if it’s one disease, it’s not. Arthritis refers to diseases of the joints. It occurs in more than 100 forms. The December issue of Mayo Clinic Health Letter highlights some signs and symptoms. Some forms occur gradually over time, others appear suddenly. Some lead to chronic symptoms. With others, symptoms come and go. Some types cause pain that may occur in many joints. With others, pain may occur in just one joint.

ARTHRITIS SUFFERS SHOULD TAKE THE PLUNGE FOR EFFECTIVE RELIEF
By moving their workouts into a pool, people with severe arthritis not only can improve muscle strength and reduce pain but also exercise more vigorously than ...

ARTHRITIS GROUP CITES YEAR'S TOP GAINS
Tougher artificial knee and hip joints, prevention of heart disease complications in rheumatoid arthritis patients, and a new blood test for the disease were cited last week by the Arthritis Foundation among the top research advances in 2003.

NEW PROCEDURE FOR SEVERE GREAT TOE ARTHRITIS SEEN AS MAJOR ...
Severe great toe arthritis, known in medical communities as "hallux rigidus", is a major cause of foot pain. When conservative treatments fail to provide long-term relief, surgical treatment is usually needed. The traditional surgical procedures involve complete removal of the joint followed by either fusing the ends of the toe bones together or using a plastic-like implant. While these procedures each have there proper indications, a new procedure, developed by Dr. Thomas S. Roukis, a podiatric foot and ankle surgeon, and colleagues, uses the body's own tissues to create a durable, pain-free cushion which surrounds the joint and allows immediate weightbearing after surgery. Once fully healed, no specialized shoe gear or inserts are usually needed.

More health news can be found on our site:
/news/

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The A.I. Help Desk
Linda Peck

Q: What is a "Buffer?"

A: A buffer is basically an area of memory a hardware device or software program uses when it needs a constant, uninterrupted flow of information. For example, if you ever listened to any kind of streaming audio, the program you use probably "buffers" the signal a little before the music starts to play. Here's how it works. Your audio program "collects" a few seconds of audio then starts playing them. If there is a split second interruption, you don't notice it since the audio you're listing to is already a couple seconds old. Since you're not listening to the audio at the same instant it comes in, it gives the program a few seconds to compensate for any slight interruptions (and there are lots of those). Doesn't always work if the connection isn't good, but it does help.

Q. How can I email pictures that transfer quickly and open quickly?

A. The size of the picture is the key! What's the "right" size for a picture? Well, that depends on the photo. Most monitors display at 72 dpi (dots per inch). So, if you want the picture to be 5 inches wide (probably about the biggest you would want for an e-mail message), the picture would be 360 pixels wide (5 inches x 72 dpi = 360 pixels).

Pixel is short for "Picture Element" and is the smallest unit of visual information used to build an image. If you have ever zoomed in on an image, Pixels are those little squares that you see. The more pixels in an image, the better the resolution. So, how do you make the picture the right size? Use your imaging software! Most scanners and digital cameras come with some sort of imaging software that will allow you to resize an image.

Open the picture in your imaging software and resize the image to your desired resolution. You can usually do this via an Image or Edit menu. Your menu style and commands may vary depending on your software. Usually, you'll get a screen that lets you input the image size in pixels. If there's a checkbox that allows you to constrain proportions, make sure that's checked (this insures that when you change the height or width the picture remains proportional).

That should do it. Since you've changed the picture size, you may want to save it under a different name. Use the Save As command under the File menu of your imaging software. This comes in handy when you want to place a picture on your desktop or if you send it by email. Now your friends won't wait forever to download a 10 meg picture file that is WAY too big when it could have been 10K and just the right size.

If you don't have imaging software, my recommendation is IrfanView - and you can download a free imaging editor at the following link - http://www.irfanview.com/ I've been using this image editor for years and have found it to be one of the best. I highly recommend it for ease of use.

Tip of the Week - Don't Lose the Program Serial Number Again

Maybe you're reformatting your hard drive or you just bought a new computer and need to reinstall a program from the CD, but can't find the little card with the serial number on it. I hate that! Before you reformat or erase the drive on your old system, go to Help/About... in each program and the serial number should be there. If it isn't, you can get it from the registry (only advanced users should try this). For more about this see the tip "What's My Code" - http://www.worldstart.com/tips/system-maintenance/prodkey.htm
Now that we have the numbers, what to do about it? You could type up a list, but since you still have the CD, just get a sharp permanent marker and write the number on the disk. Now it doesn't matter what happens to the little card, book, or whatever the number was on. As long as you have the disk, you have the number.

Source: Computer Tips & Techniques
http://www.worldstart.com
Copyright 2001, Worldstart - Reprinted with permission.


This Week's Clicks

A great "Do it Yourself" site
For all the dog lovers, "Cool Dog site of the Day"
Fun and free Christmas stuff
Christmas cookie recipes
Decorate a tree!
Free Christmas screensavers
Christmas downloads
8 Holiday organizing tips
Holiday snow globe

Until next week,

"If a man is called to be a street sweeper, he should sweep streets even as Michelangelo painted, or Beethoven played music, or Shakespeare wrote poetry. He should sweep streets so well that all the hosts of heaven and earth will pause to say, here lived a great street sweeper who did his job well."


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Contribute

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.

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A Closing Thought
Another Christmas Carol - make sure you memorize all the words - we'll be singing it later ;)

Hark! The Herald Angels Sing
Hark! the herald angels sing
Glory to the new-born King!
Peace on earth and mercy mild,
God and sinners reconciled!
Joyful, all ye nations, rise,
Join the triumph of the skies;
With the angelic host proclaim
Christ is born in Bethlehem!
Hark! the herald angels sing
Glory to the new-born King!

Christ, by highest heaven adored;
Christ, the everlasting Lord;
Late in time behold him come,
Offspring of the Virgin's womb.
Veiled in flesh the Godhead see;
Hail the incarnate Deity,
Pleased as man with man to dwell;
Jesus, our Emmanuel!

Mild he lays his glory by,
Born that man no more may die,
Born to raise the sons of earth,
Born to give them second birth.
Risen with healing in his wings,
Light and life to all he brings,
Hail, the Sun of Righteousness!
Hail, the heaven-born Prince of Peace!
Hail the Heaven-born Prince of Peace
Hail the Son of Righteousness
Light and life to all He brings
Risen with healing in His wings
Mild He lay His glory by
Born that man no more may die

Come Desire of Nations come,
Fix in us thy humble home.
Rise, the woman's conquering Seed,
Bruise in us the serpent's head.
Adam's likeness now efface
Stamp thine image in its place

And for our members that celebrate Hanakkah:

Oh Hanukkah

Oh Hanukkah, Oh Hanukkah,
Come light the menorah.
Let’s have a party,
We’ll all dance the hora.
Gather round the table,
We’ll give you a treat.
S’vivon to play with,
Latkes to eat

Happy Hanakkah!

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Arthritis Insight Newsletter Copyright 2003