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Mast cells, Histamine, allergic reactions

Helpless Without Epinephrine Kit

 By Dr. Gifford Jones  Thursday, October 7, 2010

“Why are you using, Celebrex a oral nonsteroidal anti-inflammatory drug (NSAID), to treat arthritis of your knee when a safer medication Pennsaid is available? There’s also a report from Boston that will also help to ease your pain.” It’s advice I recently gave to my tennis partner.

Several years ago in my book, “The Healthy Barmaid” I told the story of a patient whose arthritic fingers were improved by playing the piano. For years I’ve been convinced that many people would not require hip and knee replacements if they used their legs more.

But a report from Boston claims that once arthritis sets in, walking isn’t the entire answer. Dr. Ronenn Roubenoff, a rheumatologist at Tuft’s University, says it also depends on the type of exercise.

He claims that few people realize the enormous pressures to which the joints are subjected. Amazingly for every pound we weigh, a single step creates three pounds of pressure across the knees and hips.

This can be a problem therefore when the doctor says, “You’ve got to walk more”. Rather than helping the pain the knee hurts more and patients stop walking. This creates a vicious cycle. Inactivity leads to further weight gain and more pressure on the knees causes more pain. It’s a lose, lose situation.

Dr. Roubenoff says specific exercise is needed to strengthen muscles which act like the shock absorbers of a car. We know that we feel every bump if the car’s shock absorbers fail. And this is what happens to joints if muscles are weak.

Fortunately Dr. Roubenoff’s program needs no expensive equipment nor the worry of Draconian exercise. Leg muscles are strengthened by simply sitting in a chair and repeatedly getting up and down.

Another exercise involves placing increasing weights on the extended leg while sitting in a chair and moving the knee up and down. Dr. Roubenoff’s patients were asked to do this twice a week.

By the end of 16 weeks his patients had increased muscle strength 71 per cent. Now many could walk up and down stairs, sleep better and pain was decreased by 43 per cent.

But to achieve this end Dr. Roubenoff insisted it’s mandatory to push muscles beyond their current limits. This is what eventually makes the muscles more powerful. And if patients have the motivation to do so, they do not have to blindly accept the diagnosis of chronic arthritic pain.

A recent Harvard study, however, reported that rheumatoid specialists only recommended exercise in 50 per cent of cases of rheumatoid arthritis. And a study in Canada showed that family doctors prescribed exercise to only one-third of patients with arthritis of the knee.

Today many patients are taking Celebrex, Vioxx and the other oral NSAIDs to treat arthritis of the knee. But these drugs can cause serious complications such as gastro-intestinal bleeding. It’s estimated that 1,900 patients die in Canada every year due to these drugs.

This is a high price to pay for pain relief and I have no desire to lose a tennis partner. That’s why I told my tennis friend not to take this chance and to use muscle-strengthening exercise and the new locally applied Pennsaid.

Pennsaid, is a non-steroidal anti-inflammatory solution initially applied to the surface of the knee four times a day. Since it’s locally applied NSAID this markedly decreases the likelihood of serious side-effects. Equally important, studies show that it is as effective in controlling symptoms of osteoarthritis as the oral NSAIDs

The most common side-effect of Pennsaid is a skin rash. But this problem pales in comparison to losing your life or possibly developing kidney and liver problems with the oral NSAIDs.

Doctors and patients have been waiting a long time for a safer product to treat osteoarthritis. Pennsaid, a prescription drug fills that need and is a godsend for arthritic patients.

My tennis friend has found Pennsaid equally effective as Celebrex. That’s good news as I don’t want to lose a tennis partner. Besides it makes no sense to take an oral NSAID with it’s potential serious side-effects when a safer medication is now available.

Ask your doctor about this new medication.

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Dr. Gifford Jones  Bio
Dr. Gifford Jones Most recent columns

W. Gifford-Jones M.D is the pen name of Dr. Ken Walker graduate of The Harvard Medical School. He’s been a ship’s surgeon, hotel physician and family doctor and later trained in surgery at McGill in Montreal, University of Rochester N.Y. and Harvard. His medical column is published by 60 Canadian newspapers and several in the U.S. He is the author of seven books. Dr. Walker has a medical practice in Toronto. His Web site is: http://www.mydoctor.ca/gifford-jones

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