Q&A: PsA; Sandwiches; Cancer Treatment
Q. What is psoriatic arthritis, and what makes it different from other types of arthritis?
A. Psoriatic arthritis (PsA) is an inflammatory arthritis; its symptoms mimic other forms of arthritis, so it is often difficult to diagnose. Symptoms include joint pain and stiffness, swollen fingers and toes, changes in nails, such as discoloration and pitting, scaly red skin patches or rash, and overall fatigue. It is often confused with rheumatoid arthritis because it can affect the same joints on opposite sides of the body, or osteoarthritis. Spondylitis affects the spinal column, causing stiffness in the neck, lower back, spinal vertebrae or sacroiliac. Another severe, and fairly uncommon, form of PsA is arthritis mutilans, which affects the small joints in the fingers and toes. There is no cure for PsA, bur it can be treated, and the earlier, the better. Early treatment can help reduce the risk of comorbidities, such as cardiovascular disease and osteoporosis. Medications such as disease-modifying antirheumatic drugs can help slow the progression of the disease. In addition, some new classes of drugs have been approved for PsA treatment, including ustekinumab (Stelara), apremilast (Otezla), both of which target inflammation, and an anti-TNF blocker, certolizumab (Cimzia).
Q. My husband takes a sandwich to lunch every day, and has done so for years. Is there any harm in this? This is a sandwich made at home, not a supersized hero or submarine type of sandwich.
A. Sandwiches, which are possibly the most convenient, and satisfying form of food-on-the-go, can be powerhouses of sodium! Researchers from the U.S. Department of Agriculture have found that sandwiches account for about one-fifth of average sodium intake, a key cause of hypertension. Researchers found that almost half of Americans eat a sandwich on any given day, and they average 600 more milligrams of sodium a day, one-quarter of the recommended 2,300 daily milligrams, and almost half of the 1,500 recommended milligrams for those needing a more restricted sodium intake. Sandwich eaters also consume an average 300 more calories daily. When making sandwiches, consider adding more vegetables, whole grain bread, and fewer processed, cured meats, or forgo the sandwich altogether and make soup or salad in a plastic recyclable container your go-to food-to-go.
Q. My good friend is undergoing cancer treatment. Are there any alternative/complementary therapies she can do to help her get through this difficult period?
A. There are several kinds of complementary therapies your friend can choose that may help relieve her cancer stress and enhance her quality of life as much as possible. They also can help mitigate side effects of some treatments. They include acupuncture, meditation, yoga, herb and botanical supplements, and aromatherapy. Acupuncture is an ancient Chinese treatment in which needles are inserted into specific “meridian” points on the body to release the body’s natural energy flow. It seems to have a strong placebo effect, but exactly how is unclear. Its benefits appear to mitigate pain, relieve chemo-induced vomiting, and boost the immune system. Meditation is a state of concentration on a single image, sound, or idea. It may help to decrease the circulation of stress hormones that boost inflammation, as well as relieve anxiety. Yoga involves stretching and deep breathing, and can even be done on a chair if getting onto a mat on the floor is difficult. It is a known stress- and anxiety-reliever. Many people with cancer use herbs and botanicals, such as echinacea, St. John’s wort, green tea, curcumin, and ginger. Ginger may help relieve chemo-related nausea (when used along with usual anti-nausea medication), while curcumin has been shown to have anti-cancer activity in colorectal cancer. It’s important to speak with your doctor before taking any supplements; some may interact with your treatment. Aromatherapy, which uses essential oils from flowers, fruit, seeds, leaves, and bark of certain plants, can be inhaled or applied topically. It can help in promoting sleep, and some vapors reduce nausea and vomiting.
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