Rheumatoid arthritis — a chronic autoimmune condition that causes pain and stiffness in the joints affects between 0.3% and 1% of the world’s population, according to the World Health Organization (WHO). Now, a new review appearing in the journal Frontiers in Nutrition shows that following a plant based diet can be a useful intervention when it comes to coping with this condition, as it triggers some helpful biological changes, stating, “Symptoms may improve or even disappear.”
Many rheumatologic diseases are difficult to sort out in the beginning. New York Times medical writer, Jane Brody, describes polymyalgia, an inflammatory disease affecting muscles and connective tissue in the shoulder/pelvic region, and the overlapping and more serious temporal or giant cell arteritis, involving blood vessels to the scalp and the eyes with potential risk of blindness. Talk to your primary care physician and consider seeing a rheumatologist if you have these symptoms.
To accommodate our patients, Main Line Rheumatology has increased its hours to better serve you!
LANKENAU MEDICAL CENTER
Monday 9am – 5:30pm
Tuesday and Wednesday 8am- 4pm
Thursday 9am – 4pm
Friday 8am- 4pm
MAIN LINE HEALTH CENTER, Broomall
Tuesday, Wednesday and Friday 9am – 4pm
Systemic Lupus Erythematosus (SLE) or Lupus can be associated with gestational hypertension (maternal high blood pressure), preterm birth, intrauterine growth restriction and fetal death. Lupus patients may have abnormal placentation (attachment), which is a major contributor of many pregnancy complications due to reduction in maternal blood flow to the fetus. Despite potential risks, women with SLE can have healthy pregnancies. Women with SLE should have low disease activity for the 6 months prior to conception for the best chance of a successful, healthy pregnancy. The PROMISSE Study was a large multicenter prospective study of pregnant and postpartum SLE patients. The study showed that 26 % of patients had a flare (worsening) during pregnancy, and 24.4% had a flare in the postpartum period. Most of the flares were mild and infrequently required therapy. Only 6.3% of the patients had severe flares during pregnancy and 1.7% had severe postpartum flares.
Data suggests that the drug, Plaquenil, used during pregnancy was associated with fewer preterm births and less intrauterine growth restriction. Findings also suggest that discontinuation of Plaquenil is associated with higher lupus disease activity during pregnancy.
For SLE patients not looking to conceive, IUDs are considered safe and effective. Other acceptable contraceptive options, when used appropriately, include condoms, progestin (only oral contraceptives) or depo-provera injections. Estrogen-containing contraceptives are contraindicated in the setting of active lupus, as they may flare the disease.
Main Line Rheumatology’s Amy L. Lundholm, DO, is board certified in both rheumatology and internal medicine. Dr. Lundholm holds current membership in the Pennsylvania Osteopathic Medical Association and the American College of Rheumatology. She was chosen as a rheumatology Top Doctor 2018 Main Line Today magazine. To read more about Dr. Lundholm, go to Our Staff.
Main Line Rheumatology is more mobile! Our improved mobile website now makes it easier for you to be well informed, every day! Read all about our doctors, get office information, learn more about diseases we treat, read about us in the News, and catch up on daily social media posts ~ all in one place. Come visit!
Most patients who are curious and comfortable using the internet, often go to Google to check out information that their doctor gave them during an office visit. Is Dr. Google always dependable or useful? Sometimes.
While online, patients visit websites, enter chat rooms or interact online with friends and family in the differential diagnosis of possibilities that might prove helpful in finding additional information, helping to facilitate a full and accurate diagnosis and treatment plan. On the other hand, not all websites, chat rooms or friends and family’s opinions are created equal. I have found the most dependable information on medical school-related websites such as Harvard, Johns Hopkins, Mayo Clinic, U Penn and Stanford University. In comparison and in my medical opinion, I often disagree with information presented on WebMD and Drugs.com, among other websites.
It is helpful in maintaining a good and trusted relationship with your doctor to ask whether information you have discovered makes sense in your medical condition, or case. Confronting your doctor and saying he or she is “wrong” and that you have discovered “correct” data from WebMD, for example, not only weakens your doctor-patient trust bond, but can burn bridges and end up being of little help. Today, patients want to be informed consumers. I applaud being curious and responsible in the quest for answers; this is our new normal. But some medical information available to patients online, even on trusted websites as above, can be easily misunderstood or read out of context, such as listed medication side effects, or even dangerous drug combinations. Every patient is an individual. Every medical condition is unique to each individual patient. Let your doctor who is your trusted medical partner and knows your personal medical history, listen to everything you have to share and about your concerns and address your diagnosis and treatment.
When watching TV drug commercials, if you are a patient with a certain condition or disease, you know the frightened reaction you may have when hearing about serious drug side effects, especially the biologics which doctors use to treat rheumatoid and psoriatic arthritis. Are they real side effects that could actually affect you? Yes and no. The drug manufacturer is concerned about liability and being sued for not stating a list of potential side effects, and after seeing the commercial, we ask ourselves, “Why would anyone in their right mind take on such risk?” For example, most of these commercials talk about cancer and lymphoma. To the best of my knowledge, there are no recent studies showing an increase in the frequency of solid tumors. Lymphomas occur more commonly in rheumatoid arthritis, regardless of whether patients are on a biologic (drug) agent, and it is still unclear whether the biologic drugs like Humira or Enbrel, increase the risk of lymphomas. Not treating an active disease like rheumatoid or psoriatic arthritis, can have its own obvious consequences.
So what is the conclusion? An ounce of prevention is worth a pound of cure. Be an informed consumer, discuss with your doctor and together, agree on the right treatment for you.
Main Line Rheumatology’s Gary V. Gordon, MD, FACP, FACR and Thomas Harder, MD have been named 2018 “Top Doctors” by Philadelphia Magazine and Main Line Today Magazine. Also Amy Lundholm, DO was named a 2018 “Top Doctor” by Main Line Today Magazine.
Dr Gordon was awarded “Top Doctor” by Philadelphia Magazine for years 2018, 2016, 2015 and 2014, and by Main Line Today Magazine for years 2018, 2017, 2016, 2015, 2014 and 2013.
Dr. Harder was awarded “Top Doctor” by Main Line Today Magazine for years 2018, 2017, 2016 and 2015.