RHEUMATICS
1.
What is rheumatism?
Rheumatism is a collection of symptoms affecting limbs,
especially bones, joints, muscles and spine, along with
pain and dysfunction. These could be accompanied by
swelling or other signs of inflammation and dysfunction.
2.
Is rheumatism only a disease of the elderly?
No, rheumatism could affect all ages, from newborn to
the elderly, only with different cause and frequency. It
mostly affects the 40-50 year-old and above, caused by
calcification and bone loss. Sometimes it is caused by
inflammation and increased uric acid level.
3. What are the symptoms?
Pain, swelling, dysfunction of the limbs or other more
severe impairment of movements may occur with
rheumatism.
4.
What is the treatment?
It depends on the cause. For example, inflammation is
treated with anti-inflammatory drugs and pain-killer. If
inflammation is due to autoimmune process,
immuno-suppressants are given. If there is
calcification, medicine to prevent calcification is
given, along with weight-bearing reduction and posture
correction, and also weight-loss. Treatments to reduce
calcification also include joint and muscle training,
physiotherapy and administration of joint lubricant. If
there is bone-loss, medication preventing further
bone-loss should be given together with calcium
supplement. Medication to increase bone-mass could also
be administered.
5.
Is there a new therapy or treatment method for
rheumatic disease?
It depends on the disease, especially for inflammatory
arthritis like Rheumatoid Arthritis (RA), Ankylosing
Spondylitis, Juvenile Rheumatoid Arthritis (JRA) there
is a new therapy which provides good result but
relatively expensive. It is given by injection twice
weekly and given for several months until the disease is
controlled. The drug is Anti DNF-a (Enbrel) and some
other medications.
6.
What is the condition of rheumatic patients
in Indonesia?
In adults the process is as follows: mechanical muscle
pain, calcification and inflammation (due to autoimmune
process or accumulation of uric acid, and sometimes due
to bacterial infection), to bone-loss and resulting to
bone fracture, especially in the elderly. While in
children, it is usually caused by hereditary
abnormalities or joint inflammation.
7.
How could it be prevented early?
Prevention should be tailored to its cause. For example
mechanical pain should be prevented by correct posture
and correct working methods or body weight-bearing. If
it is autoimmune, prevention would be difficult except
for early treatment to prevent disease progression.
Calcification, which is common after middle age, could
be prevented by reducing excessive joint loading and
weight reduction. Bone loss should be prevented early by
ensuring adequate calcium intake and if necessary bone
mass measurement so that the right treatment could be
provided. Prevention could be done by taking calcium (in
milk), physical exercise and if necessary taking hormone
replacement or drugs to improve bone strength like
biphosphonate.
OSTEOPOROSIS
1.
What is osteoporosis?
Osteoporosis is a disease affecting the bones which
is characterised by a decrease in bone mass and density
that increases the risk of broken bones, particularly in
the spine, wrist, hip, pelvis and upper arm. The disease
occurs in women after the menopause.
Unfortunately most people don't know they have
osteoporosis until they break a bone. As such, a new WHO
study has stated that early detection of low bone
density could significantly reduce the impact of
osteoporosis.
Osteoporosis can be diagnosed relatively easily by:
• medical history
• basic investigations, including x-rays
• bone mass density
– QCT (quantitative computed tomography)
– QUS (quantitative ultrasound scanning)
• DXA (DEXA) dual energy x-ray absorptiometry
• biochemical markers of bone turnover (serum + urine)
– bone formation
– bone breakdown
2.
Is Osteoporosis a new disease?
No, osteoporosis is as old as human civilization.
Hippocrates described thinning and tendency to fracture
of the bones in the aged. Only the last 50 years,
medical science has begun to shed some lights on the
nature of the disease.
3.
Why is everybody so concerned about Osteoporosis
nowadays?
The electronic media in particular the daily TV
advertisements in promoting the sales of milk and milk
products daily induce awareness of osteoporosis in the
community. This is a good thing, but on the other hand
it creates misinformation what milk and milk products
can do against osteoporosis.
4.
Can food supplements prevent or be used for treatment
of Osteoporosis?
No, milk, milk products, and calcium in tablets,
liquid, and powder are food components that everybody
must take daily to grow and remain healthy until old
age. These are not medicines to cure or prevent
osteoporosis. To treat and prevent osteoporosis we
require adequate nutrition and this includes milk and
milk products.
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