Mental Health and Chronic Diseases

Depression and anxiety are often experienced at a higher rate in people with chronic diseases than the general population and those with rheumatoid arthritis (RA) are no exception.

At the recent American College of Rheumatology Conference, a study was presented that looked at the impact that depression and anxiety have on people living with RA.  In those people whose depression and anxiety was not treated, they had less response to treatment, which resulted in higher levels of disease activity compared to people who did not have depression. This encourages those suffering from these conditions to seek treatment to receive the fullest benefit from their RA medications.


Our pharmacist, Carolyn Whiskin, recently returned from The American College of Rheumatology Conference, the largest international meeting held for rheumatology. Over 15,000 health professionals from around the world specializing in research and the care of people with arthritis were in attendance. Today’s blog post is one several to come with information Carolyn learned at the Conference.

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New Pain Pathways in Osteoarthritis

New pain pathways are being identified in osteoarthritis. This is the most common type of arthritis in North America.  Keeping active and weight loss are important in slowing the progression of osteoarthritis.  For some people, joint damage can be significant and yet they may not be able to have joint replacement surgery.  Many new treatments are being researched to address pain being generated by the joints specifically.  One area of research is aimed at reducing NGF (nerve growth factor).  This type of treatment may also be of great help in reducing bone cancer pain, diabetic neuropathy, low back pain and interstitial cystitis.  Stay tuned as this research moves forward.


 

Our pharmacist, Carolyn Whiskin, recently returned from The American College of Rheumatology Conference, the largest international meeting held for rheumatology. Over 15,000 health professionals from around the world specializing in research and the care of people with arthritis were in attendance. Today’s blog post is one several with information Carolyn learned at the Conference.

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Vaccination in Auto-Immune Diseases

We’ve spoken before about how important vaccination is for those with auto-immune diseases and as flu season is upon is, it is a great time to think about infection prevention. The annual flu shot is highly recommended to all patients on biologic therapy. It is not a live vaccine and therefore is safe to be given while on treatment.

The importance of vaccination for people with auto-immune diseases was highlighted at the American College of Rheumatology Conference that I recently attended. The risk of getting the flu, pneumonia and shingles is much greater in people who have conditions with elevated inflammation that are auto-immune in nature.  It appears that only one third of people who would greatly benefit from vaccines are receiving them, which is a much lower number than we would like to see.

Our clinic has developed guidelines for vaccination as well as tips for reducing infection risk.  It is available here or in hard copy at our offices. Please don’t hesitate to ask us for a copy.


Our pharmacist, Carolyn Whiskin, recently returned from The American College of Rheumatology Conference, the largest international meeting held for rheumatology. Over 15,000 health professionals from around the world specializing in research and the care of people with arthritis were in attendance. Today’s blog post is one several to come with information Carolyn learned at the Conference.

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Gut Health

I attended a GI Conference in Toronto in early November, “Meeting of the Minds.” This year the focus was on our environment related to our gut flora. It seems that there are villains, sticky bacteria, and heroes, known as butyrate producers. Sticky bacteria which produce toxins are much more difficult for the body to shed from the gut and may result in chronic inflammation. Good gut bacteria release butyrate which stops the immune system from attacking the gut endothelium reducing chronic inflammation such as in Crohns and Colitis.

They recommend staying away from high animal fat foods, emulsifiers, artificial sweeteners, and gluten/wheat, and consuming more fibres and certain starches. In the studies that were presented, dietary emulsifiers impacted mouse gut microbiota promoting Colitis. Consumption of dietary fibre from fruit caused a 40 percent reduction in the risk of Crohn’s Disease. It is important to remember that all fruits and vegetables should be peeled and all seeds removed. The adverse effect of a high fat diet on Colitis is dependent on the type of fat consumed. Olive oil is protective and increases clearance of invasive microbes. Diets that are high in anhydrous milk fat and corn oil result in translocated gram negative proteobacteria microbes and systemic inflammation. A diet with a higher component of olive oil, butter or coconut oil and fish while limiting vegetable oils, promotes a microbiome that supports balanced immunity and is thus beneficial to IBD patients.

Many of these recommendations are the result of new and ongoing clinical trials and may not be accepted as standard of care yet.


Evelyn Gilkinson is the Nurse Lead for Charlton Health Inc. Before devoting herself solely to Infusing Biologics, Gilkinson worked at Toronto General Hospital, Flinders Medical Centre (Adelaide, Australia), and the London Health Science Centre in Thoracic Step Down, neonate, pediatric and adult Intensive Care, Recovery Room, and Emergency Medicine. Evelyn has done research for The Canadian Cervical Spine Study and with the AIM Health Group. She established the first out-of Hospital Infusion Centres in London and Waterloo. For the last twelve years, Evelyn was the Nurse Supervisor for South Western Ontario for many infusion sites until joining the Charlton team in the summer of 2016.

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Diabetes and Rheumatoid Arthritis

People with Rheumatoid Arthritis have a higher incidence of Diabetes than the general population. A study was recently conducted to see if any of the medications commonly used by patients who have Rheumatoid Arthritis, were helpful in lowering blood glucose (sugar) levels.

The study found that two common medications had a significant benefit in reducing the risk of diabetes: hydroxychloroquine (Plaquenil) a disease modifying medication taken as a tablet, and the biologic medication abatacept (Orencia). However, it has been found that the steroid medication prednisone can increase the risk of diabetes and raise blood glucose levels.

Many people with Diabetes also take cholesterol lowering medications, referred to as “statins”.  These medications can also raise blood glucose levels, however their benefit reducing heart disease is still felt to outweigh this risk.

For more information on Diabetes and Rheumatoid Arthritis, speak to your healthcare provider.


Our pharmacist, Carolyn Whiskin, recently returned from The American College of Rheumatology Conference, the largest international meeting held for rheumatology. Over 15,000 health professionals from around the world specializing in research and the care of people with arthritis were in attendance. Today’s blog post is one several to come with information Carolyn learned at the Conference.

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Rheumatology & Weight

We often hear of the many great impacts maintaining a health weight can have on our health. Losing weight has always been known as a benefit for our joints, especially people with osteoarthritis. At the recent American College of Rheumatology Conference, a study was presented looking at the impact of weight loss on rheumatoid arthritis, an autoimmune disease.

It was found that for people who have a BMI (body mass index) over 25, that a weight loss of 5 kg resulted in a 42% improvement in their level of overall disease activity compared to an improvement of only 19% in those who did not lose weight. Both groups were on similar treatments. Even a 1kg loss of body weight showed improvement in lowering disease activity as excess fat is known to produce several inflammatory chemicals in the body.


Our pharmacist, Carolyn Whiskin, recently returned from The American College of Rheumatology Conference, the largest international meeting held for rheumatology. Over 15,000 health professionals from around the world specializing in research and the care of people with arthritis were in attendance. Today’s blog post is one several to come with information Carolyn learned at the Conference.

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Pharmacy Corner – Excess Inflammation

We’re happy to share information from our Pharmacy Specialists that we know our patients will benefit from in this series called “Pharmacy Corner.” Here’s the first edition from Carolyn Whiskin, RPh, BScPhm.


 

Excess inflammation is an aspect of many autoimmune conditions.  There are many non-prescription products that can be very successful in reducing inflammation without causing stomach irritation or elevated blood pressure, which are known adverse effects from traditional anti-inflammatories.

Omega-3 Fish oil has been well researched to reduce inflammation while providing nourishment to the skin, brain and blood vessels.  Omega-3 fish oil contains two active ingredients; EPA and DHA.  A high EPA content is needed to reduce inflammation. The total amount of EPA and DHA taken daily should be 2000-3000mg.  Doses above 3000mg can increase blood thinning. We are happy to provide information on the many natural options for decreasing inflammation.

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It’s that time of year again… flu season!

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As flu season is upon is, it is a great time to think about infection prevention. The annual flu shot is highly recommended to all patients on biologic therapy. It is not a live vaccine and therefore is safe to be given while on treatment. The ideal time for maximum vaccine effectiveness is to receive your flu shot between your biologic doses, or for those who receive an infusion every eight weeks, two weeks prior to your next dose. If you have not already received your pneumonia vaccine, this is also highly suggested and can be given while on biologic treatment. Prevnar 13 is given first, followed by Pneumovax eight weeks or more later. This will offer several years of protection against pneumonia. The shingles vaccine (Zostavax) is now available through public health at your family physician’s office for Ontario residents age 65-70. Those turning 71 anytime in 2016 can have their vaccine at no charge until the end of December 2016. As this is a live vaccine, be sure to check on the best timing to have this administered in regards to biologic/immunosuppressive treatment.

Regular hand washing is the best defence against infection. Be sure to wash regularly, especially after being in public places and always before eating. We encourage all patients to wash their hands when entering our infusion clinics and before giving a self-injection at home.

We have prepared an information sheet on infection prevention which is available at all our clinics. Please ask your local staff for a copy.

Please don’t hesitate to ask our pharmacists for more information on vaccination or maintaining your health while using biologic therapy.

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Rare Disease Day on February 29th, 2016

29 February 2016 marks the ninth international Rare Disease Day coordinated by EURORDIS. On and around this day hundreds of patient organizations from countries and regions all over the world will hold awareness-raising activities.

Charlton Health is privileged to provide treatments to those living with rare diseases. Our staff are joining hands in celabration of the wonderful people we treat. Last month we featured Pompe’s disease in our news letter to raise awareness. Join us in making the voice of rare diseases heard.

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Exercise Control Over Arthritis

Are you missing out on one of the most effective treatments for joint pain and arthritis?

Physical activity plays a key role in managing arthritis symptoms.

Take the first step to a stronger, healthier you.
Order your free Physical Activity and Arthritis booklet today from www.arthritis.ca or 1-800-321-1433

TCRA Hamilton April 2016

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