November 18, 2003 [Volume 4, Issue 24]

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In this issue of To Your Health:

• Another Reason to Communicate With Your Doctor
• Rupture Risks Rise With Antibiotics?
• Fatty Foods May Put More Than Women's Waistlines at Risk
• Figuring Out Fibromyalgia

Another Reason to Communicate With Your Doctor

What's your relationship with your health care provider? Do you talk about your health problems openly and honestly, or do you keep most of your opinions and feelings inside - perhaps out of fear that your doctor "won't listen" or "won't understand"?

Communication is the key to optimizing treatment, say Swiss researchers after conducting a controlled clinical trial on rheumatoid arthritis (RA) sufferers. Findings suggest that feedback sessions should be held on a monthly basis between patients and their doctors, due to the changing patterns of RA and the uniqueness of its effect on each patient. The trial, which included 228 patients and 48 rheumatologists, used a rheumatoid arthritis disease activity index (RADAI) questionnaire. Patients who saw the largest advantage of feedback were those with "high disease activity," with a reduction of more than three points in their RADAI scores.

While the stats indicate success through patient-to-doctor updates, they echo a common complaint among health care administrators: "Tell us what's wrong - on an ongoing basis."

The doctor-patient relationship is one of the keys to making sure you stay healthy, and if you have an illness or disease that requires constant assessment, it's an even more important tool to get you back on the road to health. If you don't feel comfortable talking to your doctor - or if you don't think your doctor is comfortable or interested in talking/listening to you - try to open the communication lines, or find another doctor. Your health is that important.

Reference: Fransen J, Stucki G, Twisk J, et al. Effectiveness of a measurement feedback system on outcome in rheumatoid arthritis: a controlled clinical trial. Annals of the Rheumatic Diseases July 2003: Volume 62, pp.624 - 629.

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Rupture Risks Rise With Antibiotics?

A warning to elderly patients currently taking "quinolones": You may be at a higher risk of suffering an Achilles tendon rupture, and the risk may grow exponentially with age.

What are quinolones, you ask? They're a group of commonly used antibiotics you probably know best by some of their brand names: Cipro, Floxin and Noroxin. A recent study conducted by researchers from the Netherlands compared antibiotic use among 1,367 patients with Achilles tendon rupture and 50,000 people without rupture. Patients in their 60s and 70s who used quinolones had a six times greater risk sustaining a rupture than nonusers, and patients in their 80s and 90s were 20 times more likely to suffer a rupture.

Of the top three antibiotics associated with Achilles tendon rupture, Floxin led, followed by Noroxin and Cipro. Patients using oral steroid drugs were even more likely to sustain a rupture than those using quinolones.

Admittedly, only 4 percent of Achilles tendon ruptures are related to quinolones, but the researchers are quick to admonish doctors of their risks and suggest prescribing alternative antibiotics. Older patients are also recommended to consult their doctors, especially those suffering from potentially serious orthopedic injuries (usually requiring surgery).

More importantly, this is yet another example of the well-documented potential side-effects of various prescription and over-the-counter medications. Always talk to your doctor about the risks and benefits before starting any medication, and don't be afraid to inquire about the possible nonpharmaceutical options for managing your condition. For more information on the dangers of drugs, visit www.chiroweb.com/find/archives/general/drugs/index.html.

Reference: Van der Linden P, Sturkenboom MCJM, Herings RMC, et al. Increased risk of Achilles tendon rupture with quinolone antibacterial use, especially in elderly patients taking oral corticosteroids. Archives of Internal Medicine 2003: Volume163, pp.1801-1807.

Fatty Foods May Put More Than Women's Waistlines at Risk

Several studies have shown that women who consume fatty foods may increase their risk of developing breast cancer, although most of these studies involved postmenopausal women. Now (perhaps for the first time), a study appears to correlate diet with breast cancer risk in younger women who have not yet reached menopause - and perhaps more significantly, it suggests that eating specific types of fatty foods may increase your risk of developing this frightening disease.

The results of an eight-year study of more than 90,000 premenopausal women were reported recently in the Journal of the National Cancer Institute (JNCI). Participants in the Nurses' Health Study II were administered two health questionnaires over a five-year period that asked about how often they ate fatty foods; 714 developed breast cancer over eight years. The study's lead author, Dr. Eunyoung Cho, of Boston's Harvard Medical School, noted the majority of the subjects were premenopausal at the time of diagnosis.

Even more intriguing was the observation that the quality, rather than the quantity of foods consumed seemed to account for the increased risk. Consumption of animal fats (e.g., red meat and/or high-fat dairy products) appeared to increase the risk for developing breast cancer, whereas consumption of vegetable fats did not.

Although animal fats are thought to have an effect on hormones that can promote breast cancer, there is speculation that a chemical unique to animal fats is responsible for the increase, according to the researchers. Ask your chiropractor about the essentials of a sensible diet and exercise program that will keep you healthy, whatever your age. To learn more about women's health, go to www.chiroweb.com/find/archives/women.

Reference: Cho E, Spiegelman D, Hunter DJ, Chen WY, et al. Premenopausal fat intake and risk of breast cancer. Journal of the National Cancer Institute July 2003: Volume 95, Number 14, pp.1079-1085.

Figuring Out Fibromyalgia

Fibromyalgia is one of the most baffling illnesses on the planet. Characterized by chronic fatigue and widespread soft-tissue and muscle pain and tenderness, fibromyalgia has only been recognized as a medical disorder since the 1980s. While the cause of fibromyalgia remains unclear, scientists at Georgetown University may have found a link between the disease and another condition: sinusitis, an inflammation of the membranes that line the nose and sinus cavities.

In a study published in the Archives on Internal Medicine, researchers surveyed 297 patients age 40 or younger. While undergoing a general medical exam, they were asked questions about fatigue, body pain and symptoms typical of a sinus infection. Approximately 22 percent of the patients complained of unexplained chronic fatigue; 11 percent complained of unexplained chronic pain; and 9 percent reported both. These patients were 10 times more likely than other patients to have symptoms associated with sinusitis.

Sinus symptoms were more common among patients with unexplained fatigue than fatigue caused by mental or physical illness, suggesting a link between sinus problems and unexplained fatigue. In addition, most of the patients who met the criteria for chronic fatigue syndrome reported having sinus problems.

The results of this study suggest that while treating the sinuses won't cure fibromyalgia, there's a chance it may relieve some of the pain and fatigue associated with the condition. Your doctor of chiropractic can advise you of the treatments available for sinusitis, and also suggest ways to relieve muscle pain, improve sleep quality and increase energy.

Reference: Chester AC. Symptoms of rhinosinusitis in patients with unexplained chronic fatigue or bodily pain. Archives of Internal Medicine, Aug. 11, 2003: Volume. 163, Number 15, pp.1832-1836.

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