Wednesday, October 13, 2010

Could Losing Weight Ease Your Arthritis Pain?

Osteoarthritis Health Center

By Gina Shaw

WebMD Feature Reviewed by Brunilda Nazario, MD

For 12 years, Robin Lutchansky spent most of her time in a wheelchair. The pain from her severe osteoarthritis, first diagnosed in her early 30s, made it difficult to walk more than short distances.

Then, a little over three years ago, Lutchansky found her way to a pain management clinic that taught her how to exercise -- first, teaching her how to walk again. Over the next three years, Lutchansky, now 51, gradually lost nearly 100 pounds with calorie reduction and exercise.

“I did it slowly. I started out just lifting 2-pound weights, and I walked in the pool every day,” she says.

Today, Lutchansky is out of the wheelchair and back at work as a public relations representative for a high-tech firm, and says that her daily pain levels have gone from an 8 or a 9 to a 1. “It’s amazing. It’s a new life. I had no idea it was possible.”

What Weight Does to Your Joints

If you are at all overweight, one of the best ways to reduce osteoarthritis pain is by taking off excess pounds. Being overweight increases the load that you put on your joints -- your knees, your hips, your ankle -- with every step you take.

“When we walk, when we go up and down stairs, or get into or out of a chair or car, we can put three to five times our body weight, and sometimes more, on the joints,” says Geoffrey Westrich, attending orthopedic surgeon and Director of Joint Replacement Research at the Hospital for Special Surgery in New York. “So if you’re 50 pounds overweight, you’re putting around 250 pounds of increased stress across your knees and hips.”

Over time, that extra weight makes you much more prone to developing arthritis and can cause arthritis to progress much more rapidly, leading to much more pain once it has developed.

Fortunately, the same principle works in reverse. “For every pound people lose, they lose 3 pounds of stress across their knee and 6 pounds of stress on their hip, on average,” says Westrich.

Small Steps, Big Changes

You don’t have to lose 100 pounds, like Lutchansky, to see a difference in your pain levels. C. Thomas Vangsness, Jr., MD, professor of orthopaedic surgery and chief of sports medicine at the Keck School of Medicine at the University of Southern California, says most of his arthritis patients who lose weight notice that their pain is diminishing after losing about 20 pounds.

Jane Angelich, a 58-year-old California businesswoman, has lost 33 pounds on Weight Watchers.

“What a difference!” she says. “It starts when I get out of bed in the morning. No more limping around and groaning for the first few minutes. Instead of finding excuses to sit on my couch instead of walking around, I now walk the equivalent of a 5k without any issues and can even function the next day!”

Losing weight cannot repair the damage that’s already been done to your joints by arthritis, but in addition to decreasing your pain, it can also help to slow down the further progression of the disease. One study found that knee osteoarthritis in obese men would decrease by 21.5% if they lost enough weight to be categorized as merely overweight; for women, arthritis would decrease by 31%.

“The damage is already done, and arthritis is a progressive process,” says Westrich. “But weight loss can be tremendously helpful in alleviating pain, allowing greater function, and prolonging the period of time before someone needs joint replacement surgery.”

And if you haven’t developed arthritis but you’re worried about it, losing excess weight can significantly lower your risk. If you’re significantly overweight, every 11 pounds you lose cuts your risk of developing arthritis by more than 50%.

Making It Happen

The best way to lose weight, any doctor will tell you, is to eat less, eat healthy foods, and exercise more. But while someone with arthritis can start to change their eating habits in pretty much the same way that someone without the disease can, having arthritis makes exercise a little more complicated.

High-impact exercise, like running, jogging, and aerobics, can put too much stress on the joints, so doctors recommend against these activities. “They can hasten the arthritis process and cause injury,” says Westrich.

Instead, Vangsness recommends that his patients pursue one of three types of exercise that are particularly well suited for people with arthritis:

Swimming
Cycling (especially on a recumbent stationary bike, which is easier on knees and hips than a standard bike)
Elliptical trainers

“These all get your heart rate up without putting any stress on the knee,” he says. “The buoyancy of water helps to alleviate pain during water exercise. And working out using a stationary bike or an elliptical trainer can help strengthen key muscles like the quadriceps. If your quadriceps are strong, that can cushion the ‘heel strike’ moment when you step forward while walking, and decrease pain as well.”

He adds that some of his extremely obese patients have gotten their weight loss started through gastric bypass or gastric banding surgery. “They start peeling off the pounds, and this tremendous loss of weight really knocks down their pain,” he says. “It’s like a whole new knee. And after losing that weight, they can exercise where they couldn’t before, strengthen their muscles, and further reduce pain.”

Gene Predicts Breast Cancer Treatment Success

Breast Cancer Health

Tamoxifen Works Poorly in Women With Active BCAR4 Gene, Study Shows
By Nicky Broyd

WebMD Health NewsReviewed by Keith Barnard, MDOct. 12, 2010 -- Scientists have identified a gene that could help predict whether a breast cancer patient will respond to the drug tamoxifen.

A study published today in the British Journal of Cancer showed a potential link between the activity of a gene called BCAR4 and the likelihood that a breast cancer tumor will not respond to tamoxifen hormone therapy.

The study also found that the level of BCAR4 in a tumour was linked to a poor prognosis regardless of whether the patient received tamoxifen.

A Visual Guide to Breast Cancer

Breast Cancer and Hormone Therapy
Tamoxifen is a hormone treatment given after surgery. It was developed more than 30 years ago and is widely used to treat women with breast cancer.

Tamoxifen comes in tablet form and is given for about five years after surgery to help prevent the disease from returning.

Tamoxifen prevents estrogen from stimulating the growth of breast cancer cells, but some tumors can eventually develop resistance to the treatment, making the drug ineffective.

BCAR4 in Breast Cancer
The research looked into why this might happen by examining whether the BCAR4 gene is involved in tamoxifen resistance. Using samples from 280 breast cancer patients, the researchers found that tamoxifen had a weak, or limited effect, on tumors with a highly active BCAR4 gene.

Study researcher Ton van Agthoven, says in a news release: “We know that breast cancer cells have different ways to escape tamoxifen therapy. Now BCAR4 may be a promising target for development of new treatments.

“Preliminary results show that BCAR4 is only active in the cancer cells and not in normal adult tissues. Therefore, treatments which fight against BCAR4 may have limited side effects for the patient.”

Research into the genes that control how breast cancer responds to treatment will help doctors provide patients with the most effective treatment for their tumor as early as possible, increasing their chance of survival.

It could also lead to the development of new breast cancer drugs to target tumors with a specific genetic makeup.

Further Research
Julie Sharp, senior science information manager at Cancer Research UK, says in a news release, “These early results tell us more about why tamoxifen can stop working for some women. We need further research into the BCAR4 gene to decide if it could lead to better ways to treat patients.

“Understanding the makeup of a tumor can enable drugs to be tailored to individual patients, and this could potentially improve cancer survival in the long term. In the future, doctors may be able to use this type of information to match the best treatment to the patients most likely to benefit and avoid giving treatment that is less likely to be effective.”

Monday, October 11, 2010

Diabetic information

- Diabetes is a chronic condition for which there IS no cure.
- Every year more than one million Americans learn they have diabetes.
- Nearly one in five Americans over the age of 60 have diabetes.
- Diabetes is the fourth leading cause of death in the USA. Most of these deaths are due to heart disease and high blood pressure.
- The risk of stroke and heart disease is 2 to 4 times higher in people with diabetes.
- Up to 65% of people with diabetes have high blood pressure and 70% have some nerve damage.
- Over 20,000 people lose their eyesight every year due to complications from diabetes.
- Every year more people die of diabetes than all the deaths from AIDS, breast cancer, and car accidents.
- One in three American kids will develop diabetes in their lifetime. Many American kids do not exercise enough and overeat.

Elvis Presely, Earnest Hemingway, Arthur Ashe, Sugar Ray Robinson, Mary Tyler Moore, Halle Berry, Thomas Edison, and Elizabeth Taylor were ALL diabetics.

- $592 billion is spent every year taking care of diabetic patients.
- Over 6% of Americans have diabetes, more than 18 million. Unfortunately 1/3 of them have not been diagnosed.
- The average American eats about 150 pounds of sugar every year.
- Simple sugars- candy, cake, jam, white flour- are absorbed and digested quickly and causes a sudden surge of sugar into the blood stream.
- Complex sugars- whole wheat bread, pasta, brown rice, dried beans, and vegetables- are absorbed and digested much more slowly and results in a steady level of blood sugars.