I have arthritis in my neck and lower back.  It exacerbates congenital Muscular Dystrophy, so I wrote "must attend" in my program book for Stephen J. McCarthy, of Queens, NY, doing two sessions on arthritis during the three-day World Congress on Disabilities & Expo (WCD) at the Pennsylvania Convention Center in Philadelphia.  He will return to the WCD November 2-4, 2007.

McCartney said his Arthritis Intensive Self-Care Workshop was designed to provide strategies individuals and health professionals can use to reduce arthritis pain, possibly slow disease progression, and overcome obstacles arthritis pain may cause.  "You can’t choose whether you’ll get arthritis, but you can take steps to minimize its impact on your life.  Causes of pain; physical problems caused by disease, weak or tense muscles, stress, depression, fatigue - exercise is one effective way to break this cycle at various points," he observed.

At his first session, McCarthy offered, among other topics, an overview of arthritis and fibromyalgia self-management, pain and cognitive symptom management; distraction techniques, and action planning.  He went over dealing with problems; exercise for fun/fitness; identifying exercise barriers, and difficult emotions.  In the second session, he delved into healthy eating; preventing and slowing osteoporosis; energy conservation; relaxation through guided imagery; medication usage, and dealing with depression.

In November, New York Film and Video Festival officials announced award winners in its latest competition.  McCarthy won for best health documentary, Arthritis: Up Close and Personal.

WCD is one of the largest events for people with disabilities and all who are affected: family members, friends, healthcare professionals, caregivers, and educators."  William Schwaninger, president/CEO of WCD Expo Inc., added, "Adaptive race cars, stair-climbing wheelchairs, robotic wheelchair/conversion vans, revolutionary new urine disposal systems - and hundreds attended our conference program.  The sports and recreation activity center again was a favorite destination, and the Career Fair gave job-seekers and employers a chance to explore relationships.  Some of the world’s leading physicians and healthcare experts provided state-of-the-art solutions, while individuals who have conquered countless obstacles inspire others to defy difficulty and thrive," he said.  "Another winner was an exhibit showcasing the works of professional artists with disabilities, including arthritis" said Schwaninger.

WCD will return to the Pennsylvania Convention Center, November 2-4, 2007.

The National Institutes of Health (NIH) estimates arthritis is one of the most common U.S. diseases, with millions of adults and half of those 65 and older troubled by it.  Older people most often have osteoarthritis (OA), rheumatoid arthritis, or gout.  OA is the most common type of arthritis in older people and starts when cartilage begins to become ragged and wears away.  Cartilage is the tissue that pads bones in a joint.

"The Arthritis Foundation explains arthritis covers 100-plus medical conditions that affect nearly 46 million U.S. adults and 300,000 children.  The most common form - osteoarthritis (OA) - is most prevalent in people over 60.  Arthritis can begin in infancy, while some forms affect those in their young adult years; still others emerge in the peak career and child-rearing years.  The common thread is they all affect the musculoskeletal system and the joints specifically.  Joint woes include pain, inflammation, stiffness, and damage to joint cartilage, and surrounding structures.  That damage can bring joint weakness, instability, and visible deformities that, depending on location, can interfere with basic daily tasks: walking, climbing stairs, using a computer keyboard, cutting food, or brushing teeth.

Many forms are classified as systemic - they can affect the whole body and cause damage to virtually any organ or system: heart, lungs, kidneys, blood vessels, and skin.  Together, arthritis and related conditions cost the U.S. economy more than $124 billion per year in medical care and indirect expenses such as lost wages and productivity - and cost millions of people their health, physical abilities and, in many cases, independence.

McCarthy explained rheumatoid arthritis is an immune system disease - "my mother is among the sufferers."  In a healthy person, the immune system keeps out or destroys "invaders" such as bacteria or viruses.  For people with auto-immune diseases like RA, the immune system mistakes the body's cells as an invader and attacks.  The object of the attack is the lining of the joints.  RA is progressive, he said, and can continue to damage joints more over time and the damage done could become very severe.

Reportedly, Manhattan-based Pfizer Inc. may not convince the U.S. Food and Drug Administration (FDA) that its painkiller Celebrex should get approval to treat children with juvenile rheumatoid arthritis (JRA), a devastating form.  Pfizer wants FDA approval for Celebrex to treat JRA, which affects as many as 60,000 U.S. children and causes painful joint swelling and can affect growth and development.  FDA approved Celebrex for use in adults with osteoarthritis and rheumatoid arthritis in 1998.

Meanwhile, the American College of Rheumatology stated more than 40% of U.S. arthritis sufferers report using alternative medicine, including dietary supplements.  Such usage has increased since FDA issued health warnings about anti-inflammatory drugs such as Celebrex.  Effectiveness of many supplement ingredients hasn’t been studied adequately, and to complicate the matter, over-the-counter supplements aren’t regulated the same way as drugs.  A study examined the effect of turmeric, a botanical supplement long thought to have anti-inflammatory properties, on arthritis.  Led Janet L. Funk and Barbara N. Timmermann, University of Arizona/Tucson researchers had shown turmeric can prevent joint inflammation in rats.

As for pain management, McCarthy urged WCD attendees to "identify the warning signs: swelling in one or more joints; early morning stiffness; recurring pain/tenderness in one or more joints; inability to move a joint normally; redness, warmth in a joint; unexplained weight loss, fever, weakness, combined with joint pain, and symptoms that last more than two weeks."  Your problem-solving steps "should include a list of ideas on what to do; an assessment of probable results; utilize all resources, and accept the problem may not be resolved now." 

McCarthy envisions an action plan with "something reasonable you want to do; specific behavior, such as exercise for fun/fitness, and a high confidence that you will complete the entire action plan." 

Food, medication, and rest all play major roles.  McCarthy advises eating a variety of foods on a regular schedule, with a balanced breakfast; eating the same amount at each meal, and drinking 6-8 glasses of water - visit www.bottledwater.org and click hydration calculator.  "You should inform your doctor of all medications and dosage; and determine the need for each one, using each as prescribed and reporting the effects.  Also, go to bed at the same time every night and get up at the same time every day - even weekends.  Avoid caffeine, including chocolate, for four hours before bedtime and avoid alcohol near bed time.  Most of all, if you have a sleep disorder, like sleep apnea, treatment can make a real impact on your pain." 

As for and difficult emotion such as depression, McCarthy suggested the audience "write down self-defeating thoughts and try to change them to be rational and helpful.  Practice them and be patient with yourself." 

Understanding the tie between pain and mood will help with difficult emotions, McCarthy said.  He added, "Keep active when you have pain; this will take your mind off pain and help you feel better.  Don’t be a martyr; tell friends and family you’re in pain.  A request for help isn’t being dependent; it’s a direct, honest, and often necessary communication allowing them to help you.  Remember, pain is related closely to stress and depression.  Reducing them will ease pain." 

To "stay rejuvenated from arthritis pain," McCarthy has a Top 10 list that isn’t as funny as David Letterman’s Top 10 rankings, but certainly is more helpful.  McCarthy suggests:

1. Rehydrate - learn how fluids are absorbed.
2. Healthy eating.
3. Environmental control - make your home user-friendly.
4. Exercise to improve flexibility, strength.
5. Rest/sleep well.
6. Form a support team.
7. Communicate any changes.
8. Don’t ignore pain; listen to your body.
9. Be patient.
10. Revisit your action plan and problem-solving techniques often.

In his wheelchair in Jacksonville, FL, Herb Drill is a charter member of the Society of American Business Editors and Writers.  His e-mail address is herbdrill@ableme.com.