One kind of arthritis targets young men’s backs
EAR DR. DONOHUE: I am a 49year-old man with a diagnosis of seronegative spondyloarthropathy. I take sulfasalazine, prednisone and ibuprofen. In the morning, my hands are swollen. My eyes are inflamed, and my left eye stays red. What causes this, and is there a cure? I am considering taking Humira or Enbrel. What are their side effects? — M.C.
ANSWER: “Spondylo” refers to the spine, the backbones. “Arthropathy” is another word for arthritis. “Seronegative” indicates that blood tests do not show that the arthritis is rheumatoid arthritis. The most common kind of this variety of arthritis has an equally daunting name, ankylosing spondylitis (ANK-ul-LOW-sing SPAWN-duh-LITE-us), which means about the same thing. I believe that’s what you have. It’s arthritis of the spine, and it affects relatively young men. Other joints, like the knees and ankles, often are involved. The sacroiliac joint, the joint that connects the lowermost spine to the pelvic bones, is practically always affected. The two SI joints are on the right and left sides of the body, slightly below the top of the buttocks. Finger swelling is a common sign, as is eye inflammation.
Genes play a big role in this illness. And the genetic influence is seen in one lab test called HLAB27. Almost all with this illness have a positive HLA-B27 test.
Naturally, back pain and stiffness are prominent symptoms. The stiffness can creep all the way up to and include the neck.
The goals of treatment are keeping the spine as limber as possible, controlling the inflammation and minimizing pain. The medicines you’re taking are stan-
Ddard for this illness. How about your eyes? You should be on eyedrops. If you are not, see an eye doctor. “Cure” is too strong a word. Control, however is possible. The two drugs you mentioned, Humira and Enbrel, neutralize one of the inflammatory chemicals that stir up all the trouble. One of them should be considered if present medicines are making no headway. Both work well. Both have major side effects, as do all effective medicines. Infections, a small chance of tumors, nerve damage, a decrease in blood cells and liver problems are some of those side effects.
The arthritis booklet covers this topic in greater detail. Readers can obtain a copy by writing: Dr. Donohue—No. 301, Box 536475, Orlando, FL 328536475. Enclose a cheque or money order (no cash) for $6 Cdn with the recipient’s printed name and address. Please allow four weeks for delivery.
DEAR DR. DONOHUE: I have had a filter in for 17 years. I also take blood thinners.
I know I should not have grapefruit. Can you tell me if I can have half a teaspoon of cinnamon a day? — A.P.
ANSWER: Grapefruit and grapefruit juice increase the blood levels of some drugs. On the list are three cholesterol-lowering drugs, Lipitor (atorvastatin), Zocor (simvastatin) and Mevacor ( lovastatin); the heart drugs nifedipine (Procardia) and amiodarone (Cordarone); and the tran- quilizers Valium and BuSpar. I haven’t mentioned all the drugs, but I hope that information from the pharmacy indicates if grapefruit affects any of your prescribed medicine.
I don’t see that cinnamon is a danger to your blood thinner or to your filter. You mean a filter that’s put in the body’s main vein to prevent clots from travelling to the lungs, right? Cinnamon won’t hurt such a filter.
DEAR DR. DONOHUE: Last October, my husband woke up at 12:45 a.m., dizzy, sweaty and about to pass out. I called an ambulance. He was admitted to the hospital for overnight observation. All the tests that were done were fine. He had a threehour stress test. It was fine. The doctors don’t know what happened. He was told to do everything as usual. I am so afraid this will happen again. I would like your input. — E.B.
ANSWER: An experience like the one you had puts everyone on edge. Not finding a cause makes anxiety even greater. However, with a battery of normal tests and with a normal stress test, you can be assured that nothing serious has gone wrong and that a second episode is unlikely. Having had such an investigation, your husband is less likely to have an unexpected medical disaster than you or I am. OTTAWA (CP) — Health Canada is advising consumers that rare but potentially deadly skin reactions have been reported with the use of Accutane for the treatment of severe acne.
In an advisory, the federal department said there have been “very rare” reports of severe skin reactions linked to Accutane that can result in hospitalization, disability or even death.
Accutane (isotretinoin), made by Hoffmann-La Roche Ltd., is prescribed for serious acne that cannot be cleared up by other treatments, including antibiotics. The skin condition, which mainly affects adolescents, causes pimples, cysts and nodules that most often appear on the face, chest and back.