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January 30, 2011
Food is necessary to enable the human body to function properly. In many cultures, food is scarce. I recently saw Frank McCourt, the author of Angela’s Ashes (a book I loved), on a television show talking about his childhood and hearing that people in America were actually dieting to lose weight. He commented that he didn’t understand the concept as he spent almost his entire childhood in Ireland hungry and at times starving. Our bodies have not made us overweight. Our behavior has made us overweight.
One night I was flipping channels and came across the movie Cast Away. In it, Tom Hanks plays a plumpish Federal Express employee who survives a plane crash and ends up on an uninhabited tropical island. Because he has to hunt his own food and physically perform all the labor required to survive, he loses weight. In order to realistically depict the passage of time, production was halted for six months to enable Tom Hanks to shed weight to bring his physical appearance in line with his character’s new environment and behavior. Clearly, his body had not made him overweight; his behavior had. The movie depicted this reality. You can do the same with your reality. It’s your behavior. You control it.
*53/280/5*
January 11, 2011
As a systemic illness, rheumatoid arthritis (RA) can affect more than one part of the body. That is why people with RA often have symptoms that are seemingly unrelated to joint stiffness or swelling. They may be experiencing generalized fatigue, for example, or they may notice a decrease in appetite or run a low-grade fever.
Symptoms or changes occurring outside the joints are called extra-articular features of RA. Some extra-articular features, such as those mentioned above, are very common and cause only minor discomfort or inconvenience; others, such as swollen lymph nodes (an indication that inflammation is affecting other parts of the body), are less common; and still others are extremely rare and frequently serious. It is worth emphasizing that less than 5 percent of people with RA develop the most serious consequences of RA.
How Does RA Affect the Blood?
The blood disorder, which affects between one half and two thirds of all individuals with RA, is the condition that results when the number of red blood cells decreases notably. Anemia may develop as one of the consequences of long-standing inflammation, and its severity often reflects the activity of the arthritis. Called the anemia of chronic disease, this type of anemia usually improves when the arthritis is brought under control. In some situations, the drug erythropoietin can be administered intravenously to increase red blood cell production temporarily. This medication can be used in a pre-surgical situation when an individual wants to donate his own blood for a scheduled surgery.
Another kind of anemia, called iron deficiency anemia, may develop as a side effect of taking anti-inflammatory drugs, which can irritate the stomach lining and cause minor (or, rarely, major) loss of blood. Anyone who develops iron deficiency anemia needs to be evaluated to determine whether he or she is losing blood from the stomach. This may mean examining the stool for blood or investigating the stomach using other techniques (an endoscopy or upper gastrointestinal series). It may be necessary to discontinue non-steroidal anti-inflammatory drug (NSAID) therapy and to begin a course of stomach-healing medication.
Anemia may also develop as a component of an unusual complication of RA known as Felty’s syndrome. This syndrome occurs in fewer than one of one hundred people who have long-standing RA. In addition to anemia and arthritis, people with Felty’s syndrome develop an enlarged spleen and a decreased white blood cell count. A low white blood cell count means a reduction in the body’s ability to fight infection and therefore means that infection is more likely to occur. Another complication of this syndrome is a decrease in the number of platelets in the blood, the blood cells involved in clotting. A low platelet count can be dangerous because it carries the risk of excessive bleeding. Skin ulcerations and dark patches of skin are two other effects of Felty’s syndrome.
Treatment for Felty’s syndrome generally involves use of disease-modifying anti-rheumatic drugs (DMARDs). Occasionally, however, when medication proves ineffective and the person with Felty’s syndrome experiences recurrent infections, the person’s spleen must be removed surgically.
As noted above, individuals with RA do, rarely, develop a low platelet count (thrombocytopenia) as a result of Felty’s syndrome. On the other hand, people with RA often have a high platelet count {thrombocytosis), a condition that is generally harmless and resolves with treatment of the arthritis.
*25/209/5*
January 3, 2011
One way to get through your tunnel is to remember nobody’s life is perfect, even though commercials and TV shows like to claim it’s possible. My friend, Lynda, was looking really sharp, and I told her so. She remarked that she had bought a new bra, and the name of it was “NOBODY’S PERFECT!” That reminded me of how many of us have to live in situations where nothing and nobody is perfect—not even halfway perfect at times.
It’s easy to expect too much from people, or from products that are advertised as “The perfect answer.” I was in a car wash recently, and while I was paying my bill, I saw a counter display selling little bottles called “New Car Smell.” On the label was a picture of a spanking new car wrapped with a big bow on it, and without bothering to take a sample sniff, I just bought a bottle, figuring I could stand a new car smell in my ’77 Volvo.
When I got home, I sprayed it around inside the car and almost got sick from the aroma that seemed to be a combination of old oil, tar, and bananas. If a new car ever did smell like THAT, the owner would surely think something was wrong.
I also remember some years back when stores carried un-popped popcorn that came in colors. The kernels were bright red, green, purple, and orange. I bought some, thinking that when it popped, we would have some truly colorful popcorn. We stood around and watched it popping, only to learn that it came out snow white as usual. The colors we anticipated never did show up.
Advertisements have a way of building our expectations, but we learn reality the hard way. No spray will make an old car smell new, and colored popcorn always comes out white. Yet, something inside of us keeps us willing to believe those ads. Maybe we’re always hoping for that miracle, and that’s why we always try something new to see if it does what somebody says it will, to see if we can find the perfect solution.
*19\316\2*