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A Key Treatment for Unriddling Rheumatoid Disease by Anthony di Fabio Part 4 (Final Chapter) Summary During the past three issues we’ve explained the findings of several doctors regarding the source (not cause) of arthritis joint pain. To the extent that the joint, itself, is treated, only secondary conditions are treated. The actual cause of joint pain, inflammation, swelling, and destruction starts and continues with some sort of damage to nerve ganglia that control electrical conduction to the involved joint. The nerve ganglia are like tiny computers that receive and distribute impulses to the joint, the spinal column and to the brain. They are usually located very near the surface of the skin and do not have protective insulation, as do the deeper lying nerve fibers. The first set, near the skin, are called the “C” fibers, whereas the second set, buried deeper, usually larger, and with protective insulation are called “A” fibers. When the nerve ganglia along the line of the C fibers is disturbed, signals travel in two directions: (1) directly to the spinal column and back to the affected joint, and (2) directly to the brain cells and back to the affected joint. The second set, directly to the brain cells, returns to the affected joint signaling the production of pain, swelling, and inflammation at that joint. It’s the first set, directly to the spinal chord and back, that creates the conditions for damage to the joint. Called a “reflex arc” the signal tells the nerves and muscles at the affected joint to tighten up, thus causing a clamping together of the tendons, ligaments and muscles of the joint. Unfortunately all of our joints require a pumping action -- a squeezing together and release -- in order for protective cartilage to receive nourishment. Why? Because there is virtually no blood supply in the form of blood vessels to the cartilage. The cartilage requires a constant squeezing and releasing, like a sponge being squeezed and released, to soak up blood, gather in nutrients, and to discharge wastes. Whenever the affected joint receives more squeezing than it does releasing, cartilage no longer obtains the proper volume of blood containing the required quantity of nutrients, and also the cartilage can no longer rid itself of waste materials. Serious consequences result from this nutrient/waste disposal imbalance: cartilage erodes, joints are damaged, and crippling can ensue. This damaging condition applies regardless of whether you suffer from Rheumatoid Disease or Osteoarthritis! The causes are surely different in either disease, but the source of the joint damage is identical! Finding the nerve ganglia that controls signals to the affected joint is easy -- virtually elementary! Anyone can do so. Temporarily -- sometimes permanently -- halting the process is equally simple. Any doctor can do so. The following paragraphs will explain how to find the source

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(not cause) of the joint-damaging signals, and what your doctor can do to at least temporarily eliminate the hazard during which time you can pursue and eliminate the actual causes of this condition. How to Spot the Nerve Ganglia Affecting an Arthritic Joint Frequently joint-controlling nerve ganglia are protected by bony protrubances. One such protected ganglia is found at the outer base of the bony protrubance at the far right or left of your wrist. Palm downward, follow your little finger from fingertip inward to the wrist. Immediately in front of this bony protrubance -- little finger side -will be a major joint-controlling nerve ganglia. At your crazy bone, partially protected by additional bony protrubances, is another major joint-controlling nerve ganglia. If you press on either of these ganglia, and it is especially sore or tender, then you’ve a problem that is affecting the joint(s) being controlled by either of these major nerve ganglia. In Dr. Pybus’ Intraneural Injections for Rheumatoid Arthritis and Osteoarthritis & Control of Pain in Arthritis of the Knee (http:// www.arthritistrust.org, “Books & Pamphlets” tab) is the following explanation. “In between these two nerve points, along the arm, and following a nerve pathways between, there are smaller nerve ganglia, any one of which may also be tender to the light pressure touch which doctors call palpation.The treatment of all arthritic joints is exactly the same. The joint is first assessed clinically as to shape, colour, swelling, temperature, degree of pain and function. It will also be observed that the joint is still and the muscles in spasm, and on attempting movement creaking or crepitus is elicited. The joint is next palpated with a definite intent in view by means of a prodder (the eraser end of a pencil or even the thumb of the operator is usually adequate for the purpose) along the course of known nerves, and certain positions of intense tenderness will be noted.” Drs. Prosch, Pybus and others describe various simple techniques of injection around these tender spots, one doctor preferring to mark the points first, then anesthetizing the skin at those points, and finally injecting a substance which helps the body to stabilize the nerve conduction. Others have found that simply injecting the anesthetic without first deadening the skin is sufficient. Whichever method is preferred by the practitioner, they all agree on where the points are located: usually in a one-to-one correspondence with known acupuncture points -- but not always so. Great joint pain relief is immediately noted and this relief may last from 3 weeks to 20 years, according to Pybus’ records. Of course, during the period of relief, without further patient suffering, the patient/doctor can then freely pursue the actual causes of the nerve ganglia disturbance, be it nutritional, infectious, sports/ work injuries, or whatever. A series of Pybus’ drawings follow, best illustrating the simplicity of locating key injection points. The final chart “Injection Points for Intraneural Injections,” displays the correlation between acupuncture points and key injection points for arthritics developed by Gus J. Prosch, Jr., M.D. and Dr. Paul K. Pybus. KEY TREATMENT continued on next page

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Julian Whitaker, M.D.

Disease Mongering by Julian Whitaker, M.D. Health & Healing (July 2006, Vol. 16, No. 7) [Published by Healthy Directors, LLC, 7811 Montrose Road, Potomac, MD 20854-3394; (800) 539-8219] Jock, a 57-year-old lawyer, is in great shape. He exercises regularly, maintains his ideal weight, and has never had any chest pain, shortness of breath, or other signs of cardiovascular disease. For the past few years, he has undergone regular executive physicals (comprehensive checkups that include complete lab work, an exercise stress test, and other screening tests), and he always receives a clean bill of health. At his most recent exam, however, there was a glitch. Although he did fine on his stress test, displaying excellent physical conditioning with no significant abnormalities, there was a slight alteration in his EKG, as compared to previous tests. His doctor was “concerned” and recommended an angiogram. Jock consented, as most patients do when white-coated experts scare them by insinuating they may have a serious, even life-threatening health problem. He went to a hospital, a catheter was snaked up an artery in his leg into his heart, and X-rays were taken of his coronary arteries. Based on these images, the doctor informed Jock that his coronary arteries were “too large.” This sounded serious, so Jock’s wife, beside herself with worry, insisted that he come to Whitaker Wellness to get to the bottom of it. Conjuring Up Disease When Jock told me this story, I had to laugh. We’ve seen a lot of nonsense pass through our doors, but this malarkey about coronary arteries being “too large” was definitely a first. We evaluated him, found him to be in good health, and replaced the drugs his doctor had put him on with a targeted nutritional supplement program. But it’s not funny. Nothing in Jock’s exam suggested that he had cardiovascular disease of any kind. Yet his doctor — who, in my opinion, is far more dangerous than the disease he was looking for — pushed him into having a completely unwarranted procedure. Unfortunately, scenarios like this are repeated tens of thousands of times a day across the country, and they are not limited to screening of the heart. Creating a Nation of Sick People Cancer screening tests such as mammography, which is recommended annually for all women over 40, and PSA testing, 6

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recommended for men over 50, have dramatically inflated cancer diagnoses and funneled untold numbers of people into biopsies, surgeries, chemotherapy, and radiation therapy. Yet, the death rate from cancer has hardly budged for the past 50 years. Cholesterol screenings, which authorities suggest you start by age 20 — or younger if a family history of disease is present — reveal that 40 million Americans have the “disease” of hypercholesterolemia (high cholesterol), and should be on cholesterol-lowering statin drugs. Incredibly, there is no evidence that these drugs reduce risk of death from heart disease, except in a small subgroup of men with existing disease. Bone density screenings, advised for all postmenopausal women, tag more than half of them with osteopenia (bone density below a certain level), a “disease” that has only existed for a dozen years. This has led to an enormous increase in prescriptions for osteoporosis drugs, even though women with osteopenia have no significant risk of fracture. Mental health screenings — which, if things go according to plan, will be mandatory for everyone, including preschoolers — detect unprecedented numbers of “disorders” such as attention deficit hyperactivity, depressive, generalized anxiety, bipolar, and post-traumatic stress. They also slap on new “disease” labels like social anxiety disorder and female sexual arousal disorder. Of course, for each of these “illnesses,” there is an expensive drug that provides an easy cure. “Selling Sickness” Folks, what we have here is not disease, but disease mongering, defined in an excellent article in the online journal PLoS Medicine as “the selling of sickness that widens the boundaries of illness and grows the markets for those who sell and deliver treatments.” Disease mongering is the installation of fear in large numbers of people by making them think they are sick. It is the driving force behind the recommendations formulated by doctors’ groups, medical societies, and government panels (and often funded by the pharmaceutical industry) that trickle down to your physicians, who convince you that all these tests are necessary and could even save your life. It is the lifeblood of the drug companies and their multimillion-dollar media campaigns, urging you to ask your doctor for “the healing purple pill” if you have a stomachache; Strattera if you feel “distracted, disorganized, restless, unable to finish things;” or Lipitor if you have high cholesterol. It is an all-out, no-holds-barred effort to turn risk factors into full-fledged diseases that need to be treated with drugs. And it’s only going to get worse as the art of disease mongering picks up speed. Screening Is More Dangerous Than Disease I can state with confidence that looking for and treating disease is more harmful to your health than the disease itself. According to the scrupulously documented Death by Modern Medicine by Carolyn Dean, MD, every year in this country 476,000 people die of cancer, 450,000 of heart disease, 162,000 of strokes, and 125,000 of chronic respiratory diseases. However, nearly 784,000 people die not from any disease, but from adverse effects of drugs, medical procedures, and hospitalizations. And screening tests are the first step on the slippery slope of medical intervention. You go in healthy, feeling DISEASE MONGERING continued on next page


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great, and you come out with a disease and a dangerous drug to treat it. Even if you are not physically harmed by screening tests, they often take a toll. False positives — tests that appear abnormal and lead to additional workup and procedures that turn out to be normal — are unbelievably common and extremely stressful. Imagine being told that you may have a serious heart problem (as Jock was) or cancer (as are three out of 10 women who have mammograms yearly for a decade). Of course, you’re relieved when you’re told that everything’s clear, and you may even be grateful to your doctor for the news. But don’t forget that it was a screening test that caused this needless trauma in the first place. Another pitfall of screening tests is that they channel patients into unnecessary treatments. Not every blockage in a coronary artery requires angioplasty or bypass surgery; the vast majority of these procedures are completely unwarranted. Not everyone with high cholesterol, below-normal bone mineral density, or situational depression requires a drug; in fact, very few do. Prevention, Not Screening I’m not saying that all screening tests are worthless, nor am I telling you to never have any of these tests. That is something only you can decide. But I do urge you to see these tools of disease mongering for what they are: a funnel for far more expensive and dangerous procedures and treatments that are good for the business of medicine, but debilitating to you. See a doctor when you’re sick. The rest of the time, take control of your well-being by eating a healthy diet, exercising regularly, taking nutritional vitamins and minerals, maintaining your optimal weight, and managing your stress. This will result in far greater improvements in your health than all the screening tests in the world. Recommendations: • Avoid free or low-cost health screenings sponsored by hospitals or medical centers. They are simply marketing ploys to get new patients. • Beware of pharmaceutical company-sponsored “disease awareness” campaigns that urge you to talk to your doctor about “underdiagnosed” conditions. Forget about improving public health — they’re just looking for new customers. • Doctors order unnecessary tests, first, because they buy into the hype, and second, because they worry about missing something and being sued, a reasonable concern in our litigious society. If your doctor urges you to have a screening test, ask questions. Why should you have it? What are your options? How will it affect treatment? Consent only if the test is medically necessary. • For virtually every health problem, there are natural therapies that are equally effective and much, much safer than the drugs and surgeries that make up the arsenal of conventional medicine. If you’ve been told to take a drug or undergo a procedure based on the results of a screening test, get a second opinion from an independent-minded doctor. To locate such a physician, visit http://www.acam.org. If you’d like to schedule an appointment at the Whitaker Wellness Institute. call (800-4881500).

Although we’ve always concentrated on finding solutions to health problems, as opposed to use of band-aids, symptom suppressors, or suggestions for items for physical assistance, such as wheel chairs and door-openers, we realize that there is a definite need for these items for some folks. From time to time we’re also asked about the Social Security disability rules for those suffering from arthritis. We’re not in that business, but here’s an interesting article by an attorney who can answer such questions.

Documenting Limitations for Arthritic Impairments by Thomas E. Nance, Attorney at Law (Tennessee) http://www.tendisability.com May 2006 Millions of people are affected by various forms of arthritis, and the incidence is highest in the over-50 age group. In spite of promising [really?:Ed] new drug treatments, it is still a majordisabling condition. The disease eats away at cartilage, tissue and bone. It causes unremitting pain, and can sometimes be seen in the twisted fingers and painful joints of its victims. The Social Security Administration (SSA) regulations view some forms of arthritis as orthopedic impairments, and some as autoimmune disorders. Osteoarthritis is evaluated as an orthopedic impairment by lab tests and effect on soft tissue, bones and joints. Other forms of arthritis such as the connective tissue, psoriatic and rheumatic forms of the illness, lupus, sclerosis and scleroderma, are evaluated under the autoimmune regulations. Any case requires more than simple findings of reduction in mobility and reports of pain. The physical findings must be supported by appropriate lab tests or a biopsy. The autoimmune regulations are currently in a revision process that will take several more years. An examination by a rheumatologist is optimal, but may not always be available. Unfortunately, it is rare that SSA will send a claimant out for a consultative examination with a board-certified expert. X-rays are routinely done, but x-rays do not show soft tissue and cartilage damage and may not show bone deterioration. Recent regulatory changes recognize the superior forms of evidence that can be provided by MRI’s and CAT scans. SSA says, however, that these are “quite expensive and we will not routinely purchase them.” Applicants fortunate enough to have treating physicians order these tests are in a better position to win claims. Showing functional limitation is an integral part of proving a case. Along with detailed medical records, it is helpful to have clear statements from doctors and witnesses about limitations in use of hands, use of arms or legs, and ability to sit, stand and walk. It is particularly important to note fine motor skill impairment, such as inability to hold a pen or coffee cup. If repetitive motion exacerbates pain, this should be noted. There is a big difference in being able to lift something once and being able to lift multiple times during a day. If a person must lie down and rest for extended periods, it is important to have this noted in the medical records and letters of observation. The combined effect of arthritis and obesity should be considered where appropriate. Social Security disability law asks whether a person is able to do full-time work on a predictable, consistent and productive basis. Ability to work on a hit-or-miss basis is not enough. Our office will work with you to be certain all the evidence is prepared and presented in the best possible way to win your client’s case. Winter 2007

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A Few Wise Sayings What would men be without women? Scarce, sir . . . mighty scarce -- Mark Twain By all means, marry. If you get a good wife, you’ll become happy; if you get a bad one, you’ll become a philosopher -- Socrates Youth would be an ideal state if it came a little later in life. -- Herbert Henry Asquith

Bequests Plan Us Into Your Future A good way to make your contribution live for years onward is to plan us into your will. A bequest such as those provided by others provides that a specific amount of money, property, or a percentage of your estate be given to The Arthritis Trust of America. A general guideline for making such a provision is this: "I give, devise, and bequeath to The Arthritis Trust of America the sum of $ ----" (or describe the real or personal property). All contributions to The Arthritis Trust of America® are tax-deductible to the full extent allowed by law. While easy to write, best that you work this provision out with your attorney or CPA -- and again, many thanks!

Maybe it’s true that life begins at fifty . . .but everything else starts to wear out, fall out, or spread out. --Phillis Diller

Published quarterly by the Board of Directors Board Members United States of America Perry A. Chapdelaine, Sr., M.A., U.S. Executive Director/Secretary Harold Hunter, M.S., U.S. Treasurer/Chairman Lucelyn Verano-Chapdelaine, President, U.S. Paul Jaconello, M.D., Chief Medical Advisor, Canada Curt Maxwell, D.C., N.D., M.D., Mexico The Arthritis Trust of America and The Rheumatoid Disease Foundation are projects of The Roger Wyburn-Mason & Jack M. Blount Foundation for the Eradication of Rheumatoid Disease 501(c)(3) Tax Exemption approved by The United States Internal Revenue Service Chartered in Tennessee Editor-in-Chief: Perry A. Chapdelaine, Sr. Internet: http://www.arthritistrust.org E-mail: admin@arthritistrust.org

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