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Tuesday, Jun 27, 2017

Work with your doctor to improve arthritis treatment

BY MICHAEL ROIZEN, MD., AND MEHMET OZ, MD
King Features Syndicate
Published:
When the French Impressionist Pierre-Auguste Renoir developed rheumatoid arthritis in the 1890s, there was nothing but mineral baths, aspirin and red wine to ease his pain and prevent his hands from becoming deformed. About a hundred years later, in the 1980s, when heart surgeon Christian Barnard (he did the first-ever heart transplant) was forced to retire because of RA's crippling effects, treatment options were still limited. (Disease modifying anti-rheumatic drugs, or DMRDs, such as methotrexate, were just coming into widespread and effective use.) Now, in the past decade, 10 approved biologic medications have become game changers. They promise great benefits (with some risks, such as increased infections and some cancers) when other treatments don't work. This has made doctors and patients more optimistic about slowing joint damage, preserving mobility - and even achieving remission.
So why do more than half of RA patients stop taking their medication or grudgingly switch therapies within two years? Almost 40 percent report that their meds aren't working the way they want them to, and 20 percent say it's because they are worried about side effects.
But having to try a new combination of medications is not failure; with RA that's the process you have to go through to discover what works best for you. So let your doctor know your concerns and expectations and explain how your meds affect you. Chances are very good you will be rewarded with a new treatment plan that provides big improvements in your quality of life. Don't stop treatment; find out what works for you!
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There are few things more embarrassing - or, truth be told, more common - than piddling in your pants. Internet pictures of celebrities prove that sometimes, a gal just has to go with the flow. But despite the fact that it's a reported problem for 7 percent of women ages 20 to 39, 17 percent of women ages 40 to 59, 23 percent who are 60 to 69 and 32 percent of those over age 80 (and probably afflicts many more), no one likes to talk about it, even to a doctor.
That's unfortunate. Keeping quiet can hurt your social and love lives and keep you from exercising. But at least 80 percent of the time, opening up about it lets you resolve or at least improve the situation. (By the way, guys: 3 percent to 11 percent of young and middle-age men and 15 percent of men 80 or older have to deal with it, so listen up.)
Whether you have stress incontinence and leak when you strain, cough or laugh, or urge incontinence and often feel a sudden need to urinate, there are remedies. Talk to your doctor about medications, devices and procedures. And in the meantime, here's what you can do to ease your discomfort.
Kegel away! Contract your pelvic (and in women, vaginal) muscles used to stop the flow of urine; don't move your butt or belly. Hold for three seconds; release for three; repeat 10 to15 times, three or more times a day, every day.
Ask your doc about biofeedback. It's effective in gaining control over muscles in your bladder and your urethra.
Drink plenty of water; dehydration makes things worse. Really!
Mehmet Oz, M.D., is host of "The Dr. Oz Show," and Mike Roizen, M.D., is chief wellness officer and chair of the Wellness Institute at the Cleveland Clinic. To live your healthiest, visit sharecare.com.
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