Have you ever heard of this, this…”Ankylosing Spondylitis?” Did I spell that correctly?
Anyway, no, I never heard of it either. Having seen and read this article written by Linda Andrews [whom I have never heard], I came to this sharing conclusion: You must read this….
Medically Reviewed on March 13, 2017 by Brenda B. Spriggs, MD, FACP
While many patients endure these painful symptoms for up to 10 years before receiving a proper diagnosis, those who work with their doctors to find proper treatment experience a much greater quality of life.
Experts agree that ankylosing spondylitis and other related diseases can run in families, so if you have relatives with a history of immune problems, you may be more likely to develop ankylosing spondylitis.
If you’re experiencing lasting pain for more than three months that feels worse in the morning and better with movement, you should talk to your doctor about ankylosing spondylitis as the potential cause of your symptoms.
Your doctor will perform a physical exam and ask you about your symptoms and whether you have a history of injuries in the affected joints. Your doctor may order imaging tests, such as an X-ray or MRI, to get a better look at what’s causing your pain. You can also expect a simple blood test to check for signs of inflammation, as well as to rule out other potential illnesses.
Your family doctor may initially diagnose you with inflammatory back pain, and refer you to a rheumatologist, a doctor who specializes in medicine related to joints and autoimmune diseases. As ankylosing spondylitis is not associated with mechanical issues that occur with injury-related back pain, it cannot be simply remedied with surgery and requires other therapies.
While scientists continue to look for a cure for ankylosing spondylitis, there are many effective therapies that can relieve pain, improve dexterity, and delay advanced complications, such as joint damage.
Doctors often rely on drugs to reduce the painful and destructive joint inflammation with ankylosing spondylitis. These include nonsteroidal anti-inflammatory drugs, known as NSAIDs, and TNF, or tumor necrosis factor, blockers. TNF blockers are part of class of medications called biologics that suppress aspects of the body’s inflammatory response and may slow the progression of ankylosing spondylitis.
Many patients also benefit from regular exercises with a physical therapist. Patients often find that stretching and rage-of-motion exercises, such as yoga or pilates, can help relieve pain, increase flexibility in joints, and improve physical strength.
Ankylosing spondylitis may be a lifelong condition, but it doesn’t have to be a life-limiting one.
Working closely with your doctor about latest treatments and making smart lifestyle choices can help keep painful symptoms at bay so you can live your life as you see fit.
To learn more about Ankylosing Spondylitis, take a look at the information we have here at Healthline or make an appointment with your doctor.
Ankylosing spondylitis (AS) is a form of arthritis that’s associated with chronic inflammation of the joints in the spine. The result is pain and stiffness in the back and hips — symptoms that tend to get worse as time passes. AS can also lead to complications such as a stooped posture, eye or bowel inflammation, and reduced lung or heart function.
If you have AS, there’s a lot you can do to fight back. Proper treatment helps ease pain and stiffness, and it might also prevent or delay complications. Treatment is generally most effective when started early, before the disease causes permanent joint damage.
Here’s an overview of the treatment options for AS. By working closely with your healthcare team, you can find the best combination of treatments for you.
Medication
Several types of medication are helpful for AS, but some may work better for you than others. You’ll probably wind up taking one or more of the following:
Nonsteroidal anti-inflammatory drugs
Nonsteroidal anti-inflammatory drugs (NSAIDs) are the most widely used type of medication for treating AS. They include:
NSAIDs can help relieve inflammation, pain, and stiffness. Long-acting ones taken at night may improve sleep as well.
High doses and long-acting drugs increase the chance for side effects, such as upset stomach, heartburn, or, less often, bleeding stomach ulcers or kidney disease. However, high doses may be needed to ease symptoms of the disease.
Corticosteroids
When NSAIDs alone don’t provide enough relief, doctors may prescribe a corticosteroid, a potent inflammation fighter.
Sometimes, a corticosteroid such as cortisone is injected into an inflamed joint for fast but temporary relief. Other times, an oral corticosteroid such as prednisone (Rayos) or prednisolone (Omnipred) is prescribed for a short time. This can help calm down a flare or get a new exercise program off to a strong start.
Corticosteroids usually aren’t taken for long due to the risk of numerous side effects.
Tumor necrosis factor inhibitors
Tumor necrosis factor (TNF) inhibitors are genetically engineered drugs that block a particular cell protein that triggers inflammation. Examples include:
- adalimumab (Humira)
- etanercept (Enbrel)
- golimumab (Simponi)
- infliximab (Remicade)
These drugs — taken by injection or through an IV line — can help reduce joint pain, stiffness, and swelling. They may be effective even when NSAIDs aren’t. But like other drugs, they can have side effects. The most serious one is an increased risk for infections, especially tuberculosis.
Disease-modifying antirheumatic drugs
Disease-modifying antirheumatic drugs (DMARDs) aren’t considered primary treatment options for AS, but they may be used in severe cases. They target the process that sets the disease in motion.
Sulfasalazine (Azulfidine) is the most commonly prescribed DMARD for AS. It may help control not only joint disease, but also the bowel inflammation that sometimes goes along with it. One rare but serious side effect is bone marrow suppression.
Exercise
Exercise plays a key role in managing AS. Done carefully and consistently, it can help lessen your pain and keep you moving. Your doctor might suggest working with a physical therapist to develop an exercise plan that’s suited to your needs. Two types of exercise are particularly important:
Strengthening exercises
Stronger muscles provide better support for painful joints. To perform strengthening exercises, you could use weights or weight machines. A physical therapist might also show you how to tighten and release your muscles without moving your joints so you can keep building strength even during disease flares.
Range-of-motion exercises
Stretching helps maintain joint flexibility and preserve good posture. A physical therapist can show you how to safely stretch your back even when it’s painful and stiff. In the long run, this can help ward off disability.
Posture training
Practicing good posture is another crucial element of treatment. In some people with AS, long-term inflammation causes bones of their spine to fuse together. Posture training may influence the pattern of fusion so that your spine doesn’t become locked into a hunched-over position. This affects not only how you look, but also how well you’re able to get around.
One component of good posture is awareness. You can learn how to check your posture in a full-length mirror. Done regularly, this helps you detect any changes early and increases the potential for correction. You can also start paying closer attention to how you sit, stand, and walk. This helps you break the habit of slouching and focus on holding yourself up straight.
In addition, you can do posture exercises. One of the simplest and best involves lying face-down on the floor or a firm bed for up to several minutes at a time.
Heat and cold therapy
Applying heat or cold to the affected area may make you more comfortable. Heat helps ease pain and soreness in stiff joints and tight muscles. A warm bath or shower is often a soothing choice. Or you might try a heating pad, hot pack, or heated washcloth.
Cold helps reduce swelling around inflamed joints. A cold pack can also numb a sore area when you’re in the midst of a flare.
Surgery
Surgery is not a primary treatment for AS. However, sometimes inflammation affects joints outside the spine. If you have joint damage to your hip or knee that’s severe enough to make it hard to get around, your doctor might recommend joint replacement surgery.
Rarely, an operation called an osteotomy may be performed to straighten the spine after it has fused into a stooped position. This surgery involves cutting and realigning bones of your spine. Because it’s considered high risk, osteotomy isn’t a common option.
Article Resources
Read more: https://www.healthline.com/health/ankylosing-spondylitis/treatment#ixzz51M4J3vR1
End of Story! I hoped you enjoyed reading and learning through this article. I certainly have!
Just sayin’…#buckroth
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A. K. Buckroth shared their post.
Look for this poster in the Sylvan Oaks Library, Community Room, 6700 Auburn Boulevard, Citrus Heights, CA, on Saturday, December 16, 2017
Update: You can now listen to our Diabetespeaks podcast episode of this event by clicking here: https://www.podbean.com/media/share/pb-ny8f7-7e17c9
Last month, this concerning issue was presented at T1D Exchange’s Annual Meeting. Four individuals currently or soon facing this dilemma spoke on a patient panel, bringing to light a new complication of type 1 diabetes rarely discussed in a public forum.
“This is a new problem, based on our recent success in treating T1D,” said Dr. Nick Argento, an endocrinologist and person with diabetes (PWD). “The Joslin 50-year survivors used to be sort of an elite group. That’s not true anymore. Now, it’s expected, not the exception.”
Joining Argento on stage was Paul Madden, Bunny Kasper, and Sandy Brooks, each with a different diabetes experience, but all in their later stages of life.
Bunny Kasper, who is in her mid-seventies and has lived with diabetes most of her adult life, volunteers as a support group leader for families with children who have T1D. She shared that this group of parents recently commented that she should find diabetes management easier because she’s been doing it for so long. But what they didn’t understand was how much more tired she is at this age, and that it’s actually harder, not easier, after all these years.
“There’s just very little understanding about the elder generation and what we deal with,” said Kasper.
In addition to physical wear and tear, the panelists shared how much fear plays a role in their daily lives with T1D, and how vulnerable they all feel about their future.
“I’m afraid of being alone, and not being supported with my care,” said Paul Madden, 66, diagnosed 55 years ago.
Argento shares the same fear, and has already seen this issue in his own T1D patients.
“Their network has broken down. They’ve had a spouse who was their advocate and assistant, but then has a stroke or develops dementia or dies and suddenly, they’re not present anymore.”
Not only is a caregiver or partner helpful at home for everyday diabetes tasks, but also as an advocate in hospitals or other institutions. Argento and others on the panel shared stories of healthcare providers ignoring their T1D needs during surgery or other hospitalizations, and highlighted the importance of the greater medical community to become more educated about diabetes in order to care for all people with T1D.
“What if I can’t advocate for myself?” said Argento. “I’m deathly afraid of that, and I’ve seen some horrible outcomes, unfortunately, for my patients in the same situation. It creates tremendous anxiety.”
Sandy Brooks, a registered nurse and surgical type 1, says nursing homes are even less prepared and educated about insulin dependency.
“There are great people there who work hard, but T1D adds an aspect that you don’t learn about in nursing or medical school.”
The cost of diabetes management and access to technology, therapies and care, are also a big worry for these panelists, especially as many of them are or will soon be eligible for Medicare. Argento has advocated fiercely for CMS coverage of continuous glucose monitoring (CGM) systems, including representing the Endocrine Society before the FDA to approve non-adjunctive use of Dexcom, which was a necessary step towards CMS’ decision to cover CGM. He was also in a pivotal meeting with CMS on the Dexcom approval, which came through earlier this year.
“There was a huge population of type 1 patients who were depending on CGM, and couldn’t live without it. They’d hit Medicare age and they’d lose it,” said Argento, who encourages all people with diabetes to persist, and insist, on the care and therapies they need. “They should have gotten a medal for making it to Medicare age, not a denial from CMS.”
Kasper pointed out that the way she planned financially for her retirement over the previous decades now won’t cover her diabetes costs under the current landscape, and that older people like her cannot make up this shortfall by earning more income.
“If you don’t have the money you need, you’re not going to get the supplies or the care,” said Kasper.
Madden had one piece of advice for seniors facing these unchartered waters with T1D. He spoke of the importance of having a good relationship with one’s providers and finding one that will listen to your concerns, whether they’re related to aging, diabetes, or both.
“It’s amazing how important that relationship is,” said Madden, whose current endocrinologist looks at him as an individual, listens to his questions, and helps him refine his questions before answering, because, he says, sometimes he doesn’t know how to ask them. “That’s powerful when that happens. That’s access at the fullest level.”
We thank our patient panel for sharing their perspective, and opening the community’s eyes to this very important topic. As always, Glu and T1D Exchange need feedback from our patient community in order to research critical issues in type 1 diabetes like this one, so please comment and share your thoughts on aging with type 1 diabetes and other topics you feel are important.
—Amy Bevan/GluMom
Protecting your heart is very important, wouldn’t you agree? That’s what “heart sense” is all about inclusive of diet and exercise. Even babies born with heart defects are immediately cared for if and when needed. Young children, older children, adolescents, young adults, middle-agers, older folks have all heard or read somewhere in their lifetimes about taking care of their hearts.
So, let me briefly tell you my heart sense story….
As a T1D diagnosed in 1959, it wasn’t until about the year 2000 that I thought I should see a cardiologist. Oh, my heart was fine as far as I could tell. At least I felt fine. My diabetes was under control. But, being “proactive” about my life this long as a diabetic, I thought that seeing a cardiologist would be beneficial, especially for my future.
The medical insurance process is tedious and long. Nothing new. I had to make an appointment with a General Practitioner. Of course that individual wanted to know “why.” Explaining my “proactive beliefs” after having successfully lived with diabetes for over 40 years at that time, that doctor agreed. A referral was faxed to a cardiologist of whom I never met. No problem. He or she was “in my medical insurance program.” Meeting him or her was not a problem. I was interested in his or her viewpoint concerning my heart’s longevity equaling my life’s longevity.
Happily showing up to the designated appointment, not one but two nurses met me inside the office door. I thought that a little strange. A gut feeling. One left while the other led me into an examination room directing me to remove all my clothes – all of them – and to put on a hospital “johnny,” leaving it open in the front. Then she left. Cold and naked, I anxiously waited for this unknown, unmet, male heart expert to enter.
He did. His stature was tall and thin with white hair. I watched him as he immediately skittered over to the exam room’s conveniently placed computer against a far wall. He never looked at me. The nurse that told me to become naked suddenly brushed in the room, stating to me that “you’re not covered. Your insurance will not cover this.” BAM!
As soon as the cardio guy heard this, he left, too quickly, still not looking at me. And the nurse speedily left, right on his coattails! WTF, man?! I was alone. Almost horrified, and extremely puzzled, I dressed with the deafening silence of that room. Making my way to the corridor, I peaked through the doorway right then left. No one was there. The place was completely abandoned, the whole floor was quiet as I imagina a mausoleum could be. I could not – and still do not – believe to this day that that deflating experience happened. Never never never having heard from these characters, these participants in my important health care, nothing happened.
Moving on to 2017, now having lived 60 years with diabetes, a new insurance plan got me what I needed. I almost gave up…on myself! Not good. All in all, this latest expereince was 100% better and I am well. I am going to live to be 100! Whew.
Just sayin’…. A. K. Buckroth (#buckroth)
Pertaining to T2Ds: https://www.foryoursweetheart.com/?&utm_source=bing&utm_medium=cpc&utm_term=diabetes_and_heart_disease&utm_campaign=Unbranded_Sweetheart_[exact]&gclid=COmOy87UhNcCFZDbDQodlNUPNA&gclsrc=ds
“For someone with T1D,the number of years with T1D increases risk for CVD. T1D associated neuropathy can impact resting heart rate and peak heart rate and add complexity to diagnosis of cardiovascular disease.”
Have you ever heard of such a thing…”Urban Diabetes?” I have not. Until today. With that being written here’s a link for you to visualize this subject…. http://www.citieschangingdiabetes.com/
Norvo Nordisk, one of many a pharmaceutical companies in the world, began 90 years ago! [“It began with the two small Danish companies Nordisk Insulin Laboratorium and Novo Terapeutisk Laboratorium founded in 1923 and 1925, respectively. The two companies started the production of the revolutionary new drug insulin that had just been discovered by two Canadian scientists.”]
“Nearly two-thirds of all people with diabetes live in cities. It’s an emergency in slow motion. But urban diabetes is not inevitable. If we work together, we can create cities which help us live more healthy lives.”
Check it out at: #UrbanDiabetes in 75 seconds. I’m a T1D, also a life-long ‘urbanite!’ How about you?
Just sayin’…A. K. Buckroth
The second half of 2017 continues to move forward with appearances of author A. K. Buckroth.
August 24, 2017– HAS BEEN POSTPONED to Thursday, August 31, 2017…. Diabetes Talk: T1D vs. T2D,1:30pm – 2:30pm3:30pm – 4:30pm ± in the Brookdale Senior Living Center, 7414 Stock Ranch Road in Citrus Heights, CA. Book give-away along with hand-outs regarding the international sign and color for diabetes, meal planning discussion/information, carbohydrates in alcohol beverages, the JDRF (Juvenile Diabetes Research Foundation) and more. Audience shares encouraged.- Saturday, October 14, 2017 – Walnut Grove Library, 14177 Market St. P.O. Box 40, Walnut Grove, CA, 95690; 1:00pm – 5:00pm. “Authors Showcase” = Numerous authors will be available to share their books.
- Saturday, November 4, 2017 – Fair Oaks Library, 11601 Fair Oaks Blvd., Fair Oaks, CA, 95628, (916) 264-2770; 12:30pm – 5:00pm. “Authors Showcase” = Numerous authors will be available to share their books.
- Saturday, December 9, 2017 – North Highlands-Antelope Library, 235 Antelope Road, Antelope, CA, 95843, (916) 264-2920; 2:00pm – 5:00pm. “Authors Showcase” = Numerous authors will be available to share their books.
- Saturday, December 16, 2017 – Sylvan Oaks Library, 6700 Auburn Blvd., Citrus Heights, CA, 95621, (916) 264-2700; 2:00pm – 5:00pm. “Authors Showcase” = Numerous authors will be available to share their books.
- Book presentations with readings, autographing and sales will be available at all events. See you soon!