Lupus and Pregnancy, by Amy Lundholm, DO

Posted on February 19, 2019 by Nina Greberman

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 Congratulates Lankenau Medical Center, Voted one of America’s 50 Best Hospitals

Posted on February 15, 2019 by Nina Greberman

https://www.healthgrades.com/quality/americas-best-hospitals-for-2019

The doctors at Main Line Rheumatology are honored to be affiliated with Lankenau Medical Center as one of America’s 50 Best Hospitals™. Just announced, Lankenau received recognition in the top 1% of hospitals in the nation for consistently providing overall clinical excellence across a broad spectrum of conditions and procedures year over year. The premier distinction rewards hospitals that consistently exhibit exceptional, comprehensive quality care, and according to statistics, patients are more likely to have a successful treatment without major complications—and have a lower chance of dying—at America’s Best Hospitals.

Main Line Rheumatology Doctors Awarded 2018 TOP DOCS by Main Line Today Magazine

Posted on December 1, 2018 by Nina Greberman

Main Line Rheumatology is proud to announce Gary Gordon, MD, FACP, FACR, Thomas Harder, MD and Amy Lundholm, DO have been named TOP DOCTORS, Rheumatology, 2018, by Main Line Today Magazine. #rheumatology #topdoctors2018 #topdoctors #mainlinerheumatology #rheumatologist #Lankenau Medical Center #Main Line Health

A Main Line Rheumatology Patient With Rheumatoid Arthritis Runs Her Own Race

Posted on November 16, 2018 by Nina Greberman

Rheumatoid arthritis can be a miserable disease for the millions of people who suffer from it. Patients live with pain, stiffness and disability which can last for many years. As rheumatologists, we always rejoice for those who manage to overcome the inherent difficulties living with a chronic illness. Most of us would probably hang our heads and suffer the outrageous bad fortune, while a few others manage to rise above it.

A hero in rheumatology, and his face graces the cover of a standard text book of rheumatology, is the famous French painter, Pierre Auguste Renoir. Renoir, as most know, had a unique impressionistic painting style beloved around the world. His luscious paintings of his female models might suggest that the painter was some kind of Don Juan with a paintbrush. The reality is that Renoir suffered, and was crippled by rheumatoid arthritis (RA). He had to be physically carried on a chair, transferred from room to room. Paintbrushes were either pushed into his hand and fingers, or taped to the back of his hands. Renoir lived at a time when there was precious little medication to take for his pain and inflammation, other than narcotics, yet he managed to find the determination and will to overcome the enormous difficulties he suffered.

Every rheumatology practice has their own “Renoirs” and the doctors at Main Line Rheumatology are privileged to have a few. One such patient is Susan M. She is a 52-year-old nurse who has rheumatoid arthritis (RA) that required ankle fusion, and elbows that do not bend much, which is a major factor as she enjoys running as a hobby and sport. Her life has been further complicated by breast cancer. In spite of these significant physical roadblocks, Susan M. runs marathons! Not only does she run marathons, but she runs fast enough to have qualified for the Boston Marathon in April, 2019. Given the number of runners to attempt to qualify for this 26-mile race, this was no small accomplishment.

Susan M. comes to Main Line Rheumatology for infusions of the drug, rituximab, under the care of our outstanding nurse practitioner, Cheryl Wieczorek. Under Cheryl’s attentive care, Susan M. continues to do reasonably well controlling the inflammatory part of her RA. The mechanical issues, including her elbow and fused ankle, cannot be helped by any medication, but Susan M. perseveres, nonetheless. Grit and determination come from deep within her determined, athletic and competitive spirit; she is a role model for many, and a marvel to observe and experience. As her health partners and advocates, we are proud of her accomplishments. Good luck in April, Susan M.! In our estimation, you’ve already won the race.

Main Line Rheumatology News

Posted on October 20, 2018 by Nina Greberman

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!

Can Stem Cells Regenerate Damaged Cartilage in Osteoporosis?

Posted on October 19, 2018 by Nina Greberman

If you have arthritis, you know about the term “bone on bone”. We tell patients that you cannot grow new cartilage once it is destroyed, whether from over or repetitive use, the natural aging process, or injury. Stories about stem therapy being used to treat osteoarthritis, an aggressive degenerative form of arthritis, are popular on the internet. But, can stem cells regenerate damaged cartilage with this disease? Maybe one day we can be cautiously optimistic, but for today, I am still skeptical.

Our understanding is that stem cells are the building blocks of all human tissue. Arthritis, or joint degeneration, is due to loss of the cartilage that cushions bones and the stem cell goal is to treat arthritis to regrow cartilage.

Stem cells that come from your own body and are harvested through a medical scientific procedure, are then injected back into your body (stem cell therapy) in a desired location, addressing a specific medical condition, movement or pain problem. A newborn baby’s umbilical cord is rich in natural stem cells, and there has been a movement over the last 5-10 years to freeze and save these stem cells for that baby’s (or natural family member) possible health needs.

The human body is a remarkable repair machine. Skin can regenerate, and a small piece of liver transplanted in a human body, grows miraculously to accommodate the body’s needs. But damaged cartilage causing osteoarthritis, does not naturally regenerate. Making degenerated and damaged bones and joints “almost good as new” is more often than not, only the outcome of surgery.

Dr. Shane Shapiro, at the Mayo Clinic Orthopedic Surgery and Center for Regenerative Medicine, published an article in May, 2018 describing how efforts and studies in stem cell regenerative medicine could treat degenerative conditions such as osteoarthritis, changing the course of orthopedic surgery over the coming years. Although research and studies show promise, stem cell treatment for arthritis is not widely available at this time, as is still being researched.

When discussing stem cell therapy, it’s important to understand that pure stem cells are not currently available to U.S. patients outside of a clinical research study. Stem cell therapies currently used outside clinical studies do not contain pure stem cells; they are a mix of a variety of cells with only a very small percentage, stem cells.

A handful of clinical research trials, monitored by the U.S. Food and Drug Administration (FDA), are ongoing at this time to study stem cell treatment for arthritis. The early findings are encouraging for the future. Many stem cell therapies now marketed to patients are conducted without a required FDA biologics license. Also, some forms of stem cell therapies are mislabeled, and do not contain actual living stem cells. These practices cause concern among rheumatologists as these treatments may mislead, or even harm the public.

Research into stem cells and arthritis shows that there are opportunities for stem cell treatment resulting mostly in pain relief and improvement in function, or quality of life. But only a few limited early studies have demonstrated improvement in new cartilage or bone formation needed to cure arthritis, so I am skeptical. Exactly how that cartilage regrowth occurs, or even how pain relief is achieved, is still unknown.

To conclude, here is my opinion. Stem cell therapy, particularly with fetal stem cells, offers great promise for many diseases, including regenerating the damaged cartilage of osteoarthritis. Free standing stem cell clinics that offer treatment, giving you back a few of your mature stem cells for a high cost. As a cautionary tale, The New York Times reported, October 15, 2018, that Harvard University is retracting data that had implied that stem cells had improved cardiac function, when stem cells were placed in the heart. The odds of success currently are minimal, and insurance does not cover this expensive procedure. The “Religious Right” has prevailed upon the last three administrations to toss umbilical cords into the trash instead of utilizing them to save or improve lives. We hope this will change one day, or maybe other countries can lead the way.

Gary V. Gordon, MD, FACP, FACR Awarded 2018 Rheumatologist of the Year by The Arthritis Foundation

Posted on October 16, 2018 by Nina Greberman

Gary V. Gordon, MD, FACP, FACR, Chief of Rheumatology, Lankenau Medical Center, Wynnewood, PA received the 2018 Rheumatologist of the Year Award from The Arthritis Foundation. He is pictured with Holly Maddams, Executive Director of the Arthritis Foundation, Eastern PA. Dr. Gordon was honored on October 5, 2018 at The Arthritis Foundation’s Bone Bash, held at Mutter Museum of The College of Physicians of Philadelphia.

We Win Awards!

Posted on June 1, 2018 by Gary Gordon

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.