Arthritis Matters

WINTER 2011

FEATURE

Osteoarthritis: Modern research insights into an ancient disease

Dr Matt Iseman

US comedian & TV Star living with rheumatoid arthritis

Oh, to look feminine with rheumatoid arthritis – a personal story FEATURE

Did you know that Children get arthritis?

Challenging Arthritis Challenging Arthritis is now available.

The program can be done completely online or by using the program workbooks or using a combination of the two. Registration for the program is $40.00 for members and $60.00 for non-members.

To register call Arthritis NSW on 02 9857 3300 or visit www.arthritisnsw.org.au/ challenging-arthritis

features

Contents Regulars From the CEO Staff Profile

04 05

Personal Story Research Update

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Out of Joint Alvin’s Recipe

World Arthritis Day te Summer Challenge Upda Around the Branches Education Report

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Upcoming Events

Arthritis Awareness Week Medicines Information

Oh, to look feminine with rheumatoid arthritis – a personal story page Dr Christopher Little

Translational osteoarthritis research - from

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mice to men

20 22 23 24 27 28 30

ins 31 Spotlight on Blue Mounta 32 Branch List

Dr Matt Iseman

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Dr David Hunter

Osteoarthritis:

Modern research insights into an page ancient disease

Out end of September 2011

Do you have any feedback or suggestions for Arthritis Ma tters? If you do e-mail info@arthritisnsw .org.au

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US comedian & TV Star living with rheumatoid arthritis page

Next Issue

Front Cover: Splash for Ar thritis, Sunday 27 March 2011 Photographer: Nick Bowe rs

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Did you know that Children get arthritis? e pag

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Winter 2011

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WINTER 2011

Arthritis NSW & Osteoporosis NSW Locked Bag 2216, North Ryde NSW 1670 1.15/32 Delhi Road, North Ryde NSW 2113 Phone: 02 9857 3300 Fax: 02 9857 3399 Web: www.arthritisnsw.org.au ABN 64 528 634 894 CAN 000587299 CFN 12845 Copyright© 2008 Arthritis NSW Arthritis Matters is mailed out to members and subscribers throughout NSW. Information & Helplines Arthritis: 1800 011 041 Osteoporosis: 1800 242 141 Challenging Arthritis Self-Management Program: 1800 332 131 Advertising To advertise in Arthritis Matters call 02 9857 3300 Contributions Closing Date Spring 2011: 29 July Summer 2011: 11 October Advertising Closing Date Spring 2011: 12 August Patron: Her Excellency Prof Marie Bashir AC, Governor of NSW President: Mr David Riches Hon. Treasurer: Mr Dennis Messner Company Secretary: Mr Evan Manolios Directors Ms Diana Aspinall, Ms Judith Cantor, Prof. Nick Manolios, Dr. Ben Marosszeky, Mr Greg Monaghan, Ms Cosi Pupo, Mr Neil Wildman Chief Executive: Karen Filocamo Manager Health Promotion & Service Development: Di Spragg Marketing and Fundraising Manager: Rob Novotny Business Manager: Therese Carew Finance Assistant & Kidsflix Coordinator: Clarissa Jones Receptionist/ Information Officer: Ingrid Player Membership Officer: Melissa Denham Arthritis Educator: Carol Barnes Self Management Program Development Officer: Eloise Buggy Branches and Community Liaison Officer: Nena Doyle Executive Assistant: Brooke Jay Design: Sensory Creative

Photography: Nick Bowers

Advertising Policy Statement Products and services advertised in Arthritis Matters are not necessarily recommended or endorsed by Arthritis NSW. Some readers may assume that anything advertised in these pages has been cleared, vetted or in some way approved by the charity. This is not so. Arthritis NSW is not equipped to test and approve products and services that are available to the general public. Please exercise careful judgment about whether the item or service is likely to help you personally, and where appropriate, take professional advice from your doctor or specialist before making a purchase.

Whilst all reasonable care has been taken to ensure the accuracy of information inside Arthritis Matters, no warranties or guarantees are given nor any responsibility accepted by the publishers, its agents or anyone else involved in its production for any errors which may occur. Nothing contained inside is intended as medical advice – always consult your doctor regarding treatment or medicines.

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Winter 2011

From the CEO Over the last couple of months Arthritis NSW has made some changes to our service delivery model. The decision to introduce changes was brought about by the need for Arthritis NSW to deliver a service for the community that was both within the current financial capacity of the organisation and provide for sustainability in the longer term.

Uncertainty and change are facts of life in the not-for-profit sector and Arthritis NSW has not been immune to the effects of the global financial crisis. Through refocusing and restructuring our service model we seek to strengthen our focus on prevention, health promotion and quality of life for all people living with arthritis and osteoporosis.

There may be some slight disruption to our services during this period of re-organisation and therefore we appreciate your patience at this time.

This issue focuses on a major priority for us which is research. In NSW, through valuable funds raised by our branches, we offer an annual Branches Scholarship to support a research project. Most recently we supported the Motherhood Choices study

by Dr Tanya Covic focusing on young women with rheumatoid arthritis who are planning to start a family.

Thank you to all our branch representatives who attended the recent NSW regional meetings. It was lovely to see you all again and hear what’s happening in the branches. I am always impressed by the level of commitment to our organisation shown by our branch members. We really appreciate everything you do for us.

On a final note, we have had some staff changes.

The following staff have left the organisation: Tina McKeown, Jacqui Louth, Nadine Garland, Liz McPhee and Dianne Kingswell. We thank them for their contributions to the organisation. We also would like to welcome Brooke Jay to the team.

Karen Filocamo

Meet Eloise Buggy Position at Arthritis NSW? I am the Self-Management Program Development Officer.

I work with a variety of selfmanagement, or lifestyle behaviour change programs that Arthritis NSW has. This includes doing the logistics of room bookings and enrolments to working with our marketing team on how we promote the programs. I am also working on getting the Moving On program up and running now that the UNSW research study is finished.

How long have you been at Arthritis NSW? Just over 2 years.

What is the best part of your job?

I love meeting new people so one of the best parts of my job is when I am able to go along to the groups and meet the participants.

We get such amazing people coming along, from all walks of life, and every one of them has something to add to the programs and something that everyone can learn from. It’s wonderful to see the difference that the programs can make in people’s lives; it makes my job feel so worthwhile.

What do you do when you are not at work?

My boyfriend and I have recently bought an apartment, so a lot of our time on weekends is spent doing DIY renovations. I also spend a fair amount of time at the gym or playing sport. Apart from that I love to read, to learn about history, and particularly to spend time with my family and friends.

What is your favourite food?

Anything. I love Middle Eastern food and food from South East Asia. I always come back to my old favourite, Italian, though.

Are you a dog or cat person?

I am definitely a dog person. I’m one of those annoying people that stops and pats pretty much every dog that I pass in the street.

What is your favourite book?

How do you choose just one?

One of my favourite books would have to be ‘A Tale of Two Cities’

by Charles Dickens. It is such a beautiful piece of prose. The list really is endless though: ‘The Lord of the Rings’, ‘Life of Pi’, ‘The Shadow of the Wind’, ‘The Adventures of Huckleberry Finn’; so many books and so little time.

Calend of Eve ar nts JULY 2011

› Saturday 23: Kidsflix, Entertainment Quarter, Moore Park

› Wednesday 20 & 27: Osteoporosis Self-Management Program, North Ryde (2 weeks)

AUGUST 2011

› Saturday 20: Kidsflix, Ballina Fair Cinema, Ballina

SEPTEMEBER 2011

› Tuesday 7 & 14: Osteoporosis Self-

management Program, North Ryde (2 weeks) › Saturday 17: Kidsflix, Odeon 5 Cinema, Orange › Saturday 17: Kidsflix, Metro Cinema, Bathurst › Saturday 17: Kidsflix, Reading Cinema, Dubbo

OCTOBER 2011

› Wednesday 12: World Arthritis Day › Wednesday 12: Cocktail and Art Show

event, Sydney › Thursday 20: World Osteoporosis Day › Saturday 22: Kidsflix, Event Cinema, Castle Hill For more information or to register for any of these events, contact Arthritis NSW on 02 9857 3300 or visit www.arthritisnsw.org.au/events.

Winter 2011

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Arthritis Matters | Feature

~ Personal Story ~

Marj Townsend Marj Townsend, OAM and Arthritis NSW Life member, was born and bred on the land and, more than 85 years later, she’s still doing what she loves.

Her early efforts in raising money for the Arthritis Foundation resulted in a branch being formed in Bathurst over 20 years ago. Marj is still a member of the Bathurst branch and rarely misses any social function the branch hosts, such as the Christmas in July luncheon and the Christmas

luncheon. She regularly conducts dancing lessons and dancing functions and usually raises funds for the branch as a result. Marj won the Arthritis Foundation Grandmother of the Year Award in 1986, 1987 and 1988 for raising the most money in support of the Foundation.

She holds her fundraising socials on her property, ‘Dreamland’, which is a few kilometres out of Bathurst.

However, her support is not only limited to Arthritis NSW. Marj also gives her time to the Royal Flying Doctor Service, CareFlight, the Heart Foundation, Health Australia and the Bathurst Ambulance Service. Marj’s efforts have not gone unnoticed.

On Wednesday 6 April 2011, the Western Advocate contained a half page article about Marj and her fantastic fundraising efforts and awareness building initiatives and the awarding of her Bathurst’s Citizen of the Month Award.

This award was for Marj’s outstanding fundraising contribution to Arthritis NSW, raising over $50,000 over the past 25 years.

Marj won the Arthritis Foundation Grandmother of the Year Award in 1986, 1987 and 1988 for raising the most money in support of the Foundation.

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Winter 2011

Arthritis NSW would like to thank Marj for all her hard work and congratulate her on her latest recognition.

(Source: Western Advocate, Wednesday 6 April 2011)

2011 survey

the Voice of Arthritis

rity The Ignored Majo2011 The Voice of Art

hritis

the ey to discover A national surv ans ritis on Australi impact of arth

Contents ..2 ...................... s ......................

Headline finding ..........2 ology ......................

Context and method .....3 ...................... ......................

Findings ........... .....4 ...................... ...................... ........... g Fundin

HEADLINE FINDINGS The Voice of Arthritis 2011 was a community-based survey that recruited a representative sample of over 1000 people with arthritis across Australia. The purpose was to find out how arthritis affected people at home and at work and what factors were associated with good or poor outcomes.

Arthritis is Australia’s major cause of disability and, according to the latest estimates, nearly four million Australians live with arthritis. That’s nearly 19% of the population. This does not include the many millions who are indirectly affected through commerce, work, friends and family.

Analysis of the results gathered revealed three distinct groups of people.

About a third of those surveyed are coping quite well with their arthritis, 52% are doing fairly badly and 16% are doing badly.

The two groups which are doing worse represent over two thirds (68%) and are experiencing significantly more pain and disability, with reduction of their work capacity and increased financial strain and social isolation.

A large proportion of people with arthritis (79%) also have another condition such as heart disease, high blood pressure, diabetes or depression, and, in over half the cases, these conditions followed the diagnosis of arthritis.

The way someone is faring with their arthritis is associated with their perceived standard of care, the information made available to them and associated access – not so much with the severity of their arthritis, how long they have had it, their age, their income, private health insurance cover or the impact of other illnesses.

Specifically, what counted was:

› Poorer access to GPs and specialists and allied health

professionals such as physiotherapists. 77% of those in the most affected group found it hard to get an appointment with their GP compared to 24% in the least affected

group. 95% of the most affected found it hard to get an appointment with a specialist compared to 34% in the least affected group.

› Poorer access to adequate information about arthritis. › Poorer care from their clinicians – only 21% in the two

groups more seriously affected by their arthritis were satisfied with their treatment. Even pharmacists were rated as less helpful by the most affected (27% saying they were helpful compared to 83% amongst those people who are coping better).

› Poorer access to rehabilitation. › Poor support from government – only 5% in the two groups more seriously affected by their arthritis felt support was adequate.

› Perceived poor community understanding of the impact of arthritis – only 2% in the two groups more seriously affected by their arthritis felt the community had sufficient knowledge.

› Only one in five of the most affected felt their GP’s

knowledge of treatment options was adequate, compared to 94% in those who were the least affected by their arthritis.

› Only 8% of those in the most affected group felt

they had adequate access to effective pain relieving medications, compared to 85% of those least affected.

› Only 1% of those in the most affected group were

satisfied with rehabilitation services offered by health authorities compared to 40%.

Winter 2011

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the Voice of Arthritis

2011 survey

Thank you to our memb ers who particip ated in this survey .

CONTINUED

The consequences Nearly twice as many in the most affected group were experiencing increasing pain, lack of mobility, poor sleep and being forced to stop work or study compared to the least affected.

› 64% of those most affected felt

that arthritis had put strain on their finances compared to 25% of those least affected.

› 83% of those most affected feared

for their future because of their arthritis compared to 48% of those least affected.

› 51% of those most affected felt

arthritis caused stress in personal relationships with family and friends compared to 20% in those least affected, with similar figures for isolation and affecting people around them.

› None of the most affected group

who had rheumatoid arthritis were in remission.

Source: The Ignored Majority, The Voice of Arthritis 2011 Report. The consequences

Membership Survey – the results: In December 2010, a survey was sent to all members who received Arthritis Matters. From the survey, we received 530 responses (10.6%) and over $3,000 worth of donations. Thank you to our members who participated in this survey.

The information from the member survey has been valuable in providing the following information about our activities:

› The majority of members find

the magazine excellent or good (91.8%) and the majority of readers thought the information was written in such a way as to make it easily understood (97.4%).

› There is a demonstrated

need for greater support and activities for people living in regional and rural areas.

› 70% reported to have arthritis,

22% reported to have both arthritis and osteoporosis, and 4.9% reported osteoporosis only.

› The Moving On and

Osteoarthritis of the Knee (OAK) programs are of greatest interest to members.

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Winter 2011

› Physical activity and pain

management are the topics of greatest interest for coverage in the magazine.

› Osteoarthritis was the condition most widely reported by respondents (61.4%).

› While 64.9% of respondents

indicated they joined Arthritis NSW for access to information and services, only 61% thought they received excellent value for money.

› The majority of respondents

(75%) understood we received little government funding .

Arthritis Matters | Feature

Oh, to look feminine with rheumatoid arthritis…

by Wendy Creamer, Arthritis NSW member.

I love bling. Necklaces, earrings, bracelets and rings – all those sparkly things, but with severe rheumatoid arthritis, and having large deformed knuckles in my hands and fingers, it takes an inordinate amount of time to get them on. My right wrist has a scar from a plastic wrist insert and an inability to bend either wrist, so usually I don’t bother putting on jewellery.

My wedding rings are oversized for when my knuckles swell up.

Sometimes I worry the rings will fall off without my noticing… it’s happened!

Pretty, feminine or cool clothing for our long hot summers, such as shorts, show a long knee replacement scar, so I wear mid-calf skirts. Sleeveless tops reveal a long shoulder replacement scar (before keyhole surgery was available), however, cap sleeves work well.

female, I feel ashamed “of Asmyascarred body and deformed hands, which look far worse than anything a Hollywood monster movie could devise

”

It is impossible to wear toeless, feminine, high heel shoes because of deformed toes and painful metatarsal joints. Comfort, rather than glamour, comes first.

I would love to dress in cooler clothing to compensate for always feeling hot due to underlying inflammation generally and menopausal hot flushes in particular, but I choose not to due to my ‘vanity’ in not exposing my operation scars.

The various operations have been successful and given me pain free movement, for which I am extremely grateful. As a female, I feel ashamed of my scarred body and deformed hands, which look far worse than anything a Hollywood monster movie could devise.

Although you’d think it was bad enough having the pain and sleepless nights of RA without worrying about operation scars and deformities, it doesn’t stop me wishing I could wear pretty rings, cool clothing and high heel shoes!

Each week I shed my clothes at the local pool; I also shed any shame of my scars. At the aqua aerobics classes all my scars are exposed for everyone to see and I don’t think about them at

all, such is my enjoyment and benefit of the water exercises!

RA is a dreadful disease which afflicts more women than men, and one of the by-products of the disease is the emotional letting go of how one would wish to dress, ‘titivate’ oneself and of one’s general appearance. Eventually we opt for pain-free, flat, non-slip shoes - practicality over femininity.

As can be seen from my recent 60th birthday photo, I can find feminine clothing that has the added benefit of covering replacement scars and also have a joyous time with family and friends who love me, scars, deformity and all!

Winter 2011

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Arthritis Matters | Feature

Translational osteoarthritis research – from mice to men Written by: Dr Christopher Little BSc, BVMS, MSc, PhD

Raymond Purves Bone & Joint Research Labs, Institute of Bone & Joint Research, Kolling Institute of Medical Research, University of Sydney at Royal North Shore Hospital.

In Australia nearly one fifth of the population is afflicted with some form of arthritis, osteoarthritis (OA) being by far the most common form.

OA is often considered the inevitable “wear and tear” joint disease of ageing. While it is true that the number of people affected by OA increases dramatically with age, the more we learn about the pathways that underlie joint breakdown, the more apparent it is that OA is an active disease process and may become a preventable and treatable condition. OA is classically defined by the progressive erosion of the almost frictionless tissue that covers the ends of bones – the articular cartilage.

However, OA is not just a disease of cartilage and affects all of the different tissues that make up the joint including breakdown/tears of other structures in the joint, that maintain joint stability (ligaments and meniscus), thickening of the bone under the cartilage, formation of bone spurs at the edges of the joint, and swelling and thickening of the joint capsule and its lining (Figure 1). It is the combination of these changes that leads to the pain and stiffness that typify OA. In clinical patient-based research the lifestyle factors (e.g. diet, obesity, exercise) that increase or decrease the risk and progression of OA can be identified, diagnostic tools to identify disease are developed, and interventions to alter the clinical disease can be studied. In laboratorybased research, our aim is to understand the fundamental (cell & molecular) mechanisms that are underlying and are responsible for the changes in the joint tissues, and how these pathways interact during the initiation and progression of joint damage. Once we understand these processes, we can define better “drugable” targets to halt or perhaps even reverse the tissue changes and associated disability of OA.

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Winter 2011

A very important and powerful way to investigate and define the mechanisms in any disease is the use of genetically modified mice.

Most commonly a particular gene in mice is “knocked out”. This means that the DNA of the mice is manipulated to disrupt or remove the gene that encodes for a protein.

This genetic trait is passed on to all of the offspring and a strain of “knock out” mice can then be bred and maintained. The effect of the particular gene/protein in OA can then be investigated by comparing the disease in knock out versus normal or “wild type” animals.

Obviously, this sort of animal work is not undertaken lightly and is preceded by years of lab bench work and cell culture studies to define potential targets. However, the interactions between all the tissues in the joint, the effect of the body’s immune system, exercise, diet etc. cannot be mimicked in a test tube,

Figure 1.

In osteoarthritis changes occur in all joint tissues. The global joint pathology is depicted in cartoon form (above) and with actual microscopic histology images (below and centre).

and the proof that a particular protein is important in the OA process must ultimately be demonstrated in a living animal. This is one of the crucial steps to identify a potential new treatment – if it works in a knock out mouse the next step is to make a drug that targets the same gene/ protein or process and see if we can halt or reverse OA in other animals.

It’s this pathway of discovery that we call translational research – i.e. we “translate” what we learn in the testtube to animal arthritis and finally to human clinical trials.

Researchers at the Institute of Bone and Joint Research are internationally renowned for their work with animal models of OA. As a result, we have had funding both from the Australian Government (NHMRC) and pharmaceutical industry (Pfizer Inc) to investigate the effect on the onset and progression of OA of a variety of different genetic modifications in mice. This exciting work has

identified some very promising targets, one of which (MMP-13) appears to be a key enzyme in progression of OA. Mice lacking MMP-13 were found to be resistant to cartilage erosion in OA despite untreated joint instability, although, interestingly, they still showed the same bone changes as wild type mice [1]. Specific inhibitors for MMP-13 are in development by a number of companies and time will tell if this proves to be valuable in people and, importantly, how this translates to effects on the clinical signs of OA (pain). A key question is whether stopping cartilage breakdown alone will be enough or do we need to target all the joint tissues [2]? Our ongoing research efforts continue to define disease mechanisms so that we can answer this question and find even better targets to prevent or control joint breakdown in OA, not just in mice but ultimately to translate this to humans.

References 1. Little CB, Barai A, Burkhardt D, Smith SM, Fosang AJ, Werb Z, et al.

Matrix metalloproteinase 13-deficient mice are resistant to osteoarthritic cartilage erosion but not chondrocyte hypertrophy or osteophyte development. Arthritis Rheum 2009;60:3723-33.

2. Little CB, Fosang AJ. Is cartilage matrix breakdown an appropriate therapeutic target in osteoarthritis-insights from studies of aggrecan and collagen proteolysis? Curr Drug Targets 2010;11:561-75.

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n a m e s I t t a M Dr

& n a i d e m o US c g n i v i l r a t S TV d i o t a m u e h with r arthritis

Although he always loved being the center of attention, Matt started down a very different road. After graduating with honors from Princeton University and the Columbia College of Physicians and Surgeons, where he received his MD, he returned home to the University of Colorado for his residency in Internal Medicine. Then, in a move that shocked patients and parents alike, he quit his job as a doctor and moved out to Hollywood to pursue standup comedy and has never looked back.

Dr Matt Iseman was in Australia recently doing an Australian comedy act tour and he was also the MC for “Splash for Arthritis” during Arthritis Week.

Where are you from?

I’m originally from Colorado but now live in Hollywood right in the valley of the beast in the middle of all the action.

What type of Arthritis have you got?

I have rheumatoid arthritis, so for those who don’t know, it’s an autoimmune disease where the body incorrectly thinks that part of itself is foreign matter, like bacteria and attacks it. It tends to localise in the small joints, like the hands and feet.

What happens is the body’s immune system, in trying to heal itself, ends up destroying its joints. Basically it’s like my immune system is a drunk – going

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around picking fights with everybody.

It’s pretty nasty and there is no cure for it, but the great thing is I am on treatment and have responded very well. I’ll have it for the rest of my life and will be on medication for the rest of my life but the medication has done an exceptional job, so basically I’m going around almost normal.

And how old where you when you were diagnosed?

I was 32 when I was diagnosed. For the first onset of symptoms it was a real kind of slow onset and amazingly, being a doctor, I thought I would be in tune to these things. I started having pain in my hand and then it spread to my feet, I was going in to

see a doctor and getting it checked and she was running tests but nothing was coming back positive so she was trying Advil. I tried orthotics and as the pain and inflammation got worse my neck and back got involved. I was trying acupuncture, chiropractors all sorts of different things. Over that year and a half I ended up gaining 55 pounds. I stopped working out. I was sleeping about 12 hours a day and was in pretty bad pain all the time. Finally I was diagnosed and it was really due to an X-ray where they found sort of hallmark changes of rheumatoid arthritis where the bone degenerates in a certain way and so they took a look at it and said I think you have rheumatoid arthritis. They then took a

How did you communicate your condition to your family and friends?

blood test which had been negative only 6 months before and now they were positive.

What parts of the body do you have arthritis?

My hands and feet were the worst hit and then my neck and back had inflammation as well.

What was your first reaction to the diagnosis?

When I was diagnosed I was relieved because it had been a year and a half where my body had just fallen apart and I’d been miserable. I gained 55 pounds; I felt fat; I was tired; I was in pain; I felt sluggish. I was 32 and I felt like I should have been in the prime of my life. I was living in Hollywood on the beach and I was just sleeping in bed feeling lethargic. So when somebody actually gave me an answer as to what was going on, it was a relief just to feel like, ‘okay, now we know what the problem is, now we can attack it better.’ The other thing that was fortunate was I also knew that there were new treatments out there and there was a lot of optimism about these treatments. Nobody wants to be told that they have a chronic disease to which there is no cure. But, again, all things being considered it’s something I can live a long life with and so as long as the treatments around and is something I respond to, its okay. It could be worse.

I just came out and told them because again, it wasn’t like I could hide it based on what had happened. They knew I got fat, was sleeping all the time and became grouchy so it was great to be able to say ‘listen I have an answer now; this is why I was like that.’

I had this chronic disease so it was great to tell them and everybody was supportive. When they hear arthritis, there is this thought that, again, it’s an old person’s disease or something footballers get. Most people haven’t even heard of rheumatoid arthritis.

It was good to have a medical background and be able to explain to them what was going on. Everybody, I think, was a little surprised to hear.

I was an athlete; I played sports my whole life. I wasn’t smoking or doing drugs or anything and you just realize that sometimes disease hits and it can hit anyone. Arthritis affects an unbelievable amount of people throughout the world.

Do you have a message for our readers, people with arthritis?

The thing that I would say is that there is hope. People look at me now and I don’t think they would know I have arthritis. I’m fairly healthy, I’m active, I’m working on four or five shows and I’m doing comedy. I think I know when I was in medicine and when I was first diagnosed, you feel alone, you feel like the only person with it and yet arthritis is one of the most common diseases in the world and there are so many people out there. There are unbelievable treatments that are coming out and that there really

is hope for it. You may have to modify your life in some way but really I feel like I’m leading a normal life I don’t feel like I’m missing out on anything.

So just to say there is hope there really is and there are amazing treatments so keep your chin up and don’t worry.

Did you know 1 in 5 Australians have arthritis?

It’s amazing! You know, especially as it’s such an active populace, there are a lot of guys who are going to grind down knees and hands and osteoarthritis can be very common. I think the key is to keep active, doing things like yoga and kind of lower impact things, especially for guys.

In the States it was all about lifting weights and bulking up and getting tight and with arthritis it’s really been learning to do the opposite. Doing pilates, stretch it out and a little lower impact and I really think that’s been beneficial for the joints. Guys think Yoga’s not the most macho thing.

First of all, it’s a great workout and second of all, women in leotards!

Suck it up guys, get in there!

Visit mattiseman.com for further information about Dr Matt Iseman

Winter 2011

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Arthritis Matters | Feature

Arthritis Awareness Week

2011

Arthritis Awareness Week is one of the biggest events in the arthritis calendar and this year, it proved to be a busy one! During the week of Sunday 27 March and Saturday 2 April, there was a selection of activities which hoped to raise the profile of arthritis in the community and provide information to the public.

Monday 28 March – Challenging Arthritis Launch

Sunday 27 March – Splash for Arthritis “Australia’s largest water class” Our inaugural event – ‘Splash for Arthritis’, Australia’s largest water exercise class, saw the launch of Arthritis Awareness Week. With 110 people hitting the water at the Ian Thorpe Aquatic Centre, Ultimo, it was quite an eventful morning which proved to be both fun and informative, raising the profile of arthritis and Arthritis NSW in the community. Thank you to everyone who participated this year. We are looking forward to growing the event in the coming years.

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The official launch of the newly revised and developed online self-management program ‘Challenging Arthritis’ was held at the Kirribilli Club, Lavender Bay. This was a morning event that saw many health professionals attend and enjoy a light breakfast followed by the launch. The launch provided attendees with information about the revised program and the benefits for participants, as well as an exclusive look at the online program delivery.

To view the program, visit www.arthritisnsw.org.au/ challenging-arthritis.

Tuesday 29 March – Batemans Bay Arthritis Week Seminar

Wednesday 30 March Maitland Arthritis Week Seminar

This was the first seminar for the newly formed Batemans Bay branch. The branch were delighted that 45 people attended the seminar. Quite a number of the attendees joined as members of Arthritis NSW on the day.

Maitland branch had done a lot in the short time to raise awareness of Arthritis Week in general and the seminar in particular. Their success was evident as 70 people attended the seminar at the Maitland Bowling Club on Wednesday 30th March 2011. All three speakers were excellent.

The speakers were excellent and we were very fortunate to have Dr Smith, Orthopaedic Surgeon, from Canberra. Our local speakers were Marcella Levey, Health Development Officer and Anita Doughty, Physiotherapist.

One of the highlights of the seminar was a Tai Chi demonstration. Tai Chi classes have been very successful and the leaders are all volunteers. Tai Chi classes have been an initiative of the Eurobodalla Health Development Unit. The Batemans Bay branch members made contact with the leaders and hopefully there is a possibility that Tai Chi classes may be able to be run through the branch.

Arthritis NSW would like to thank all our speakers and the Tai Chi group who donated their time and expertise to help make the seminar a success. We would also like to thank John Kendrigan from Stryker for his support and chauffeuring skills in enabling Dr Smith to travel to Batemans Bay. As special thanks to the Batemans Bay branch for all their help and assistance to make the seminar a success. Special thanks to Helen and her team on the day.

Physiotherapist, Judy Mitchell started the morning off with a very interesting presentation. It had a strong focus on the importance of exercise especially for those with knee pain. Dr John Van Der Kallen followed with a talk about arthritis in general but focusing on osteoarthritis. He also is a very strong advocate for exercise in the treatment of all forms of arthritis.

The final speaker of the day was psychologist, Diana Golvers who spoke about coping with chronic pain, understanding the role of the brain in pain and the emotional reactions to pain. She was also able to link all this back to exercise being an important tool for coping with pain.

Everyone left the seminar with a new enthusiasm and determination to find an exercise to suit them.

Sunday 3 April Kids family picnic.

The picnic was held at Tunk’s Hill picnic area, Lane Cove National Park.

A BBQ and drinks were provided by the generous volunteers at the Ku-ring-gai Lions Club in return for a gold coin donation. The children enjoyed some arts & craft as they painted some Easter eggs. They then made their way through the park to hunt for some chocolate Easter eggs that the Easter Bunny had left for them. It was a beautiful day as the sun shone and children and parents alike enjoyed the day out and about.

Arthritis NSW would like to thank Luke, Gordon, Graham and everyone at the Ku-ring-gai Lions Club for their support of the picnic over the last few years.

Friday 1 April - Health professional webinar Our first ever online webinar for health professionals was presented by Dr. David Hunter, a rheumatologist at Royal North Shore Hospital. The webinar was viewed by over 45 people from a number of different health professions, including physiotherapy, occupational therapy and osteopathy.

As the online seminar was such a success Arthritis NSW will be looking into offering further webinars for health professionals and also our members in the future.

Luke, Gordon and Graham (l-r) cooked up a sizzling lunch for all.

Winter 2011

15

FEATURE

Osteoarthritis: Modern research insights into an ancient disease Dr. David Hunter, Professor of Medicine, Northern Clinical School, University of Sydney.

Osteoarthritis (OA) is an increasingly common problem in our community. Many individuals with OA are affected by pain, stiffness or some loss of function and are dealing with a disease that is long-lasting. It is also the leading cause of disability among older adults. The evolution of our society has been accompanied by increasing obesity and aging and, with this, increasing prevalence of OA. Best estimates suggest that OA affects approximately 2 million Australians. With the combined effects of obesity and joint ageing, that number will double in the next 10 years.

With these societal trends, new insights are developing into the pervasive disease we know as osteoarthritis.

The purpose of this article is to provide persons with OA with new insights into this disease that have recently come from clinical research and also touch upon research initiatives that may further change the way OA is managed in the future. You may ask what is clinical research; this usually refers to research that is directly related to patient care to help distinguish this from basic science or bench research. I have tried to focus on messages that are important to people with the disease to increase their understanding of what OA is, how it can be prevented and also how it can be treated.

Modern insights no longer see OA as a passive, degenerative (yes that’s right-the use of this term is archaic) disorder but rather as an active disease process with an imbalance between the repair and destruction of joint tissues that is driven primarily by mechanical factors (I will come back to that). Many define OA as a condition that primarily affects hyaline articular cartilage,

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Winter 2011

including William Hunter who in 1743 stated soberly “From Hippocrates to the present age it is universally allowed that ulcerated cartilage is a troublesome thing and that once destroyed, is not repaired” [1]. We now conceptualize OA as a disease of the whole joint organ.

It can affect all of the joint tissues (including bone, ligaments, muscle and synovium), not just cartilage. The common misconception that this is a disease of cartilage undermines the importance of these other tissues.

Cartilage does not contain nerve fibres so cannot be directly responsible for pain.

There are a multitude of reasons a person can develop OA, hence we term this multifactorial. This said, in today’s society the two big risk factors for knee OA are obesity and joint injury. The risk for knee OA in our society attributed to these two risk factors accounts for approximately 80% of the reason for OA development.

Both are eminently preventable yet little is being done to reduce these risk factors [2].

Arthritis Matters | Feature

The impact of both of these risk factors on disease development is largely mediated through effects on the weight bearing mechanics of the joint. For every 1kg of weight carried by the body the contact load across the knee joint experiences 4 times that load. This is critically important when you consider the important impact weight loss can have in reducing the likelihood of a person developing the disease and also helping the person with disease to reduce their symptoms. A reduction of 5% of body weight leads to a 30% improvement in pain and function (Figure 1) [3]. Due to the importance of these findings in a public health setting we have recently started a new trial targeting a larger weight reduction (10% of body weight) to see if we can measure larger improvements in pain and also assess positive changes in joint structure [4].

Similarly, joint injuries, such as a tear of the cruciate ligament (ACL) or meniscus, increases risk of knee OA by altering the contact mechanics of the joint environment i.e. the way weight bearing load is distributed in the joint. ACL ruptures have been found to be linked to osteoarthritic (OA) changes in 50-70% of the patients, 10-15 years following the injury [5]. It is estimated that 25% of incident symptomatic knee OA could be prevented by preventing knee injuries among men (women, 14%). Numerous trials of neuromuscular conditioning programs have demonstrated efficacy in reducing the risk of ACL injury by as much as 60% [6,7].

These programs are simple and have impact; they typically consist of a warm-up, stretching, strengthening, plyometrics and sport specific agility training. These programs have generated widespread support from eminent international organizations including the IOC and FIFA. Despite the impact of joint injury and the known efficacy of these prevention trials, program dissemination and implementation has been limited in Australia.

The prevalence of hip OA is about 9% in those aged over 65 [8] and is also expected to increase as the population ages and the prevalence of obesity rises. Like the knee, recent evidence highlights the importance of local mechanical factors in leading to hip OA and 90% or more of hip OA cases can be attributed to anatomical abnormalities [9]. These anatomic/shape abnormalities are termed femoroacetabular impingement and this insight into the cause of hip OA is one of the most important and provocative new tenets in OA [10].

Sir William Osler, considered to be the ‘Father of Modern Medicine’, once said “Osteoarthritis is an easy disease to take care of - when the patient walks in the front door, I walk out the back door” [11]. No-one denies that the management of OA is a challenge; however, modern clinicians are armed with a plethora

of effective treatment options. Like other chronic diseases, there is no sole treatment or cure, instead there are several strategies to use that can help manage the condition.

Clinicians who manage patients with osteoarthritis recognise that to maximise treatments, it is best to use them as part of a package and incorporate many of the strategies together. For instance, not just taking pain medicines to manage your symptoms, but also considering your weight, your fitness levels and muscle strength and evaluating your daily patterns of activity.

Staying abreast of medical developments through regular appraisal of the medical literature can be an incredibly onerous task for clinicians. This is never more apparent than in a disease area where a multitude of health professionals lay claim to a multitude of interventions and where contention over the most efficacious treatments is a daily occurrence. Clinicians are also charged with discerning what agents are less effective yet still receive generous publicity rigorously eulogizing their benefits.

In this setting, a recent summary of the best evidence by a group responsible for credible osteoarthritis (OA) guidelines across a spectrum of OA treatments, is incredibly informative and possibly a little challenging to the traditional management mantra [12].

No-one denies that the management of OA is a challenge; however, modern clinicians are armed with a plethora of effective treatment options.

Winter 2011

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Arthritis Matters | Feature

In the interests of being provocative I will just focus on the findings that will have potential immediate impact and highlight improvements that can come from more adequate focus on the conservative chronic care of OA. The use of paracetamol is often first line in OA management and has, to date, been recommended as such in most OA guidelines. In a review of high quality trials the effect of paracetamol was indistinguishable from placebo. Because of real safety concerns pertaining to upper gastrointestinal and liver toxicity, the use of paracetamol, especially at doses of 4 gm per day, should be questioned.

Two other therapies that are frequently employed in clinical practice, namely injections into the joint of hyaluronic acid and arthroscopy for knee OA were also drawn into question. For both interventions their effect was indistinguishable from placebo.

In contrast, modest positive effects were seen with conservative management techniques including aerobic exercise, strengthening and weight reduction. Given their efficacy and safety, and that the frequency of their administration in clinical practice is less than optimal, their use in managing this chronic disease should be preferentially employed in favour of the other therapies highlighted above.

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Winter 2011

One of the holy grails of my life as a researcher is to develop agents capable of modifying joint tissues to facilitate repair or reduce risk of further destruction. This is what we call in the field “disease modification” to distinguish it from what we currently do with agents such as analgesics, which is termed “symptom modification”. Unfortunately, many of the trials of disease modifying agents to date have been in joints that have little if any tissue to preserve as the joint destruction of these trial participants has been quite severe.

If we are to develop interventions for osteoarthritis that target the joint before it is irreversibly damaged we need to identify disease earlier and target the tissue that leads to the cascade of events we describe as joint failure. One of the foci of my current research agenda is just this.

We plan to leverage the unparalleled resource of the osteoarthritis initiative (an NIH funded study in the US) in which their cohort will allow pursuit of these research questions. At present therapeutic interventions are primarily limited to analgesia and when this fails, surgical intervention. We need to change this paradigm to intervene when structural changes may be reversible by focusing on early disease. The focus of this research is to identify on MRI the tissues that change first a long while before any radiographic (x-ray) changes occur (Figure 2).

Looking forward, we are reminded by the late Sir Henry Tizard that “The secret of science is to ask the right question, and it is the choice of problem more than anything else that marks the man (“person”) of genius in the scientific world”.

As a researcher clinician, I have been afforded an opportunity to study and treat a much maligned disease that is rapidly evolving. Using this knowledge I am trying to learn from the insights our research is providing to focus even more on important modifiable risk factors such as mechanics and obesity as we develop the therapeutic armamentarium of the 21st century. I am looking forward to the evolution ahead.

As with most chronic diseases the more information the person has about the condition the more in control they feel. There are many sources of good information, but a good place to start is your local GP and Arthritis NSW.

Figure 1. Function scores for different interventions across the 18 month intervention period.

Figure 2. X-ray (2A) shows diffuse marginal osteophytosis (spurring) of the tibia and femur (arrows). MRI (2B) performed on the same day shows bone marrow lesion (arrow) at the top of the tibia just underneath a focal full thickness cartilage defect. There are multiple partial thickness defects of the femoral cartilage (yellow arrowheads). There are more extensive focal full thickness cartilage defect (green arrowhead) at the lateral femoral condyle and almost complete denudation (red arrowheads) subchondral bone at the lateral tibia, as opposed to a normal lateral joint space on the x-ray. The MRI also shows partially destroyed and extruded medial meniscus (thick arrow).

Reference List 1. Buchanan WW: William Hunter (1718-1783). Rheumatology 2003, 42: 1260-1261.

2 Hunter DJ: Lower extremity osteoarthritis management needs a paradigm shift. Br J Sports Med 2011.

3. Messier SP, Loeser RF, Miller GD, Morgan TM, Rejeski WJ, Sevick MA et al.: Exercise and dietary weight loss in overweight and obese older adults with knee osteoarthritis: the Arthritis, Diet, and Activity Promotion Trial.[see comment]. Arthritis & Rheumatism 50(5):1501-10, 2004.

4. Messier SP, Legault C, Mihalko S, Miller GD, Loeser RF, DeVita P et al.: The Intensive Diet and Exercise for Arthritis (IDEA) trial: design and rationale. BMC Musculoskelet Disord 2009, 10: 93.

5. Lohmander LS, Ostenberg A, Englund M, Roos H, Lohmander LS, Ostenberg A et al.: High prevalence of knee osteoarthritis, pain, and functional limitations in female soccer players twelve years after anterior cruciate ligament injury. Arthritis & Rheumatism 2004, 50: 3145-3152.

6. Hewett TE, Ford KR, Myer GD: Anterior cruciate ligament injuries in female athletes: Part 2, a meta-analysis of neuromuscular interventions aimed at injury prevention. Am J Sports Med 2006, 34: 490-498.

7. Yoo JH, Lim BO, Ha M, Lee SW, Oh SJ, Lee YS et al.: A metaanalysis of the effect of neuromuscular training on the prevention of the anterior cruciate ligament injury in female athletes. Knee Surg Sports Traumatol Arthrosc 2010, 18: 824-830.

8. Lawrence RC, Helmick CG, Arnett FC, Deyo RA, Felson DT, Giannini EH et al.: Estimates of the prevalence of arthritis and selected musculoskeletal disorders in the United States. [see comments.]. Arthritis & Rheumatism 1998, 41: 778-799.

9. Tanzer M, Noiseux N: Osseous abnormalities and early osteoarthritis: the role of hip impingement. [Review] [26 refs].

Clinical Orthopaedics & Related Research 2004, 170-177.

10. Ganz R, Parvizi J, Beck M, Leunig M, Notzli H, Siebenrock KA: Femoroacetabular impingement: a cause for osteoarthritis of the hip. [Review] [30 refs]. Clinical Orthopaedics & Related Research 2003, 112-120.

11. Balint G, Rooney PJ, Buchanan WW: A legacy for rheumatology from Sir William Osler. Clinical Rheumatology 1987, 6: 423-435.

12. Zhang W, Nuki G, Moskowitz RW, Abramson S, Altman RD, Arden NK et al.: OARSI recommendations for the management of hip and knee osteoarthritis: part III: Changes in evidence following systematic cumulative update of research published through January 2009. Osteoarthritis Cartilage 2010, 18: 476-499.

Winter 2011

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MEDICINES INFORMATION Government blocks listing of PBAC approved medicines The Federal Government announced on 25 February that it had deferred PBS listing of eight new Pharmaceutical Benefits Advisory Committee (PBAC)approved medicines and vaccines.

The decision followed a recommendation from the Government’s own clinical and health economics expert committee, the PBAC, that the medicines be subsidised on the PBS. The medicines and vaccines recommended for PBS listing by the PBAC and deferred by Cabinet are: Botox (severe sweating), Duodart (enlarged prostate), Invegna sustenna (schizophrenia), Targin (chronic disabling pain), Symbicort (asthma), Fragmin (blood clots), Synarel (IVF treatment) and Prevenar 13 catch-up (pneumococcal vaccine).

Medicines Australia also expressed its concern that the Government had removed the $10 million threshold for medicines requiring Cabinet approval, adding an extra layer of bureaucracy that could further delay patient access to medicines. The Government has cited fiscal circumstances as the drivers of Cabinet’s decision. But new Medicare data shows that expenditure on the PBS is growing more slowly than at any time in the last 15 years.

If you have concerns about these developments and would like to discuss further, please do not hesitate to contact Medicines Australia on 02 6122 8500.

Source: Medicines Matter – an information service for health consumer organisations, Medicines Australia, Vol 8, Iss 1.

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Winter 2011

Medical Benefits Schedule

Consumers want greater involvement Health consumers would like to have a much greater involvement in the operations of the Medical Benefits Schedule, which lists services subsidised under Medicare.

This finding emerged from a series of consumer consultations conducted by Consumer Health Forum of Australia (CHF) as part of a project funded by the Department of Health and Ageing, into the possible development of an MBS Quality Framework that aims to ensure a more effective, safe and cost-effective system for items listed on the Schedule.

As part of the project, CHF facilitated a Second National Workshop in Sydney on 14 February 2011. The aim of the workshop was to further explore the Framework and to look at possible strategies for implementing it appropriately for consumers.

Twenty-two consumer representatives were joined by members of the CHF Secretariat and representatives from the Department of Health and Ageing. Presentations, given by Mr. Richard Bartlett, First Assistant Secretary, Medical Benefits Division; Ms Bethany Leditschke, Reforms Officer, MSAC Secretariat and Ms Cherie Mincherton, Medical Benefits Review Task Group, outlined current MBS Quality Framework and Medical Services Advisory Committee (MSAC) processes.

The principal role of the MSAC is to advise the Minister for Health and Ageing on the strength of the evidence relating to the safety, effectiveness and cost-effectiveness of new medical technologies and procedures.

3 steps to being MEDICINEWISE

During these presentations, the possibility of implementing the Quality Framework process alongside the current MSAC process was raised. In theory this would amalgamate some of the responsibilities of the proposed Quality Framework into MSAC, changing the proposed Quality Framework model.

While attendees recognised that it might be more efficient to have one over-arching framework (rather than two processes operating in parallel), they questioned whether MSAC could handle the volume of work and whether this would increase efficiency or create slower processes.

One of the strongest findings from this workshop and other consultations was the need for consumers to be involved in the ongoing management of the MBS. Consumers have called for greater consumer representation on MBS committees and additional tools and support to enable them to understand and participate in MBS processes more effectively.

Source: CHF website – Consumers Shaping Health, Vol. 5, Iss. 2, April 2011(www.chf.org.au)

Know it’s a medicine: Medicines don’t just come on prescription — they include over-the-counter medicines from the pharmacy, supermarket or other store, as well as herbal remedies, vitamins and other supplements.

Medicines come in many forms including tablets, lotions, drops and inhalers.

Find the active ingredient: Knowing the active ingredient in your medicine will help you to avoid confusion, such as accidentally double dosing if you use different brands with the same active ingredient.

Ask the right questions: By asking questions to get the information you need about medicines from trusted sources such as your doctor or pharmacist, you can get the most benefit from your medicines and make better informed decisions about them.

Source: www.nps.org.au/bemedicinewise

Order now to receive over

$15,000

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is pleased to be selling the new 2011/2012 Entertainment™ Books!

The new 2011 | 2012 Sydney, Sydney North and Sydney Greater West Entertainment™ Books are all available now and contain over $15,000 in valuable 50% off, 25% off and 2-for-1 offers.

Entertainment™ Books feature the best restaurants, attractions, cinemas, sports, hotel accommodation and much more. You can choose what you want to do and when you want to do it with offers valid from now until June 1st, 2012.

For every Book sold Arthritis NSW will receive 20% of the proceeds towards fundraising projects.

To purchase your Book online, please visit www.arthritisnsw.org.au Or contact the Arthritis NSW office on 9857 3300 Winter 2011

21

OUT OF It’s now been 6 months since I first took on the position of Branches and Community Liaison Officer and I am still enjoying the experience. It has definitely been a very busy 6 months and I would sincerely like to thank all the members for their kindness and patience while I learn to juggle all the different facets of this position.

All the regional meetings are now finished and it was pleasing to see so many members come to these important and informative meetings.

The regionals also gave me an opportunity to meet many members and put faces to names and go that one step further than a phone conversation.

Congratulations to all the recipients of the President’s Awards. These awards are given out at regional meetings to the “unsung heroes” of branches who often don’t have a position but help in all sorts of ways and at all times are willing to assist other branch members.

The agenda for the regional meetings was varied, with the first presentation from Karen Filocamo, Chief Executive, speaking about A Strategic Overview of Arthritis.

Following this saw Di Spragg, Education and Member Services Manager, give an Overview of Arthritis NSW Education Team

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By Nena Doyle, Branches and Community Liaison Officer

T N I O J

Activities.

Rob Novotny, Marketing and Fundraising Manager, discussed the importance of marketing and fundraising. The focus group discussion topic - How can we match or exceed expectations, in terms of your Arthritis NSW membership?

- led to varied and interesting answers. All these will be collated and a report will be made available to all branches later in the year.

The annual Senior’s Vacation will be held from October 24th to 29th, 5 nights 6 days and will explore the Cudgegong Valley and surrounding region. We will be staying at the Golden Chain affiliated Ten Dollar Motel in Gulgong with daily tours of Mudgee, Hill End and Wellington.

The motel is centrally located in the heart of the historic township of Gulgong, which was featured on the back of the original $10 note.

This is how the motel gets its name unfortunately it’s not because it costs $10 to stay there. The motel is also an easy walking distance to all attractions and amenities. Some of the activities include the Pioneer Museum, sheep shearing, Prince of Wales Opera House show, Honey Haven, a winery tour and wine tasting.

This vacation is all inclusive so no need to spend another cent unless you would like to buy souvenirs or that special bottle of wine. The total price is $894.00 and is based on, but not limited to, 25 members attending. Should more members wish to attend the price will be adjusted accordingly. A $200.00 deposit is required by 1st August to secure your seat. If you require further information, please do not hesitate to contact me and I will send you out the necessary details.

These last few months has seen me visiting several branches and getting acquainted with the members and I appreciate the time given to discuss your issues and concerns. In due course I will be visiting all branches, but should you wish me to visit your branch sooner, please let me know.

Nena Doyle can be contacted on (02) 9857 3300 or ndoyle@arthritisnsw.org.au

Photography by sixredhats’.

Alvin’s Recipe: NyonyaStyle Fried Quail Ingredients:

Method:

600g quail, each cut into 4 pieces

Marinate the quail with curry powder, salt and coconut milk for at least 4 hours (overnight if possible). In a frying pan, deep fry the seasoned quail until cooked and let cool.

Oil for deep frying 2 tbsp curry powder 1 tsp salt 10 tbsp coconut milk

Heat the oil again till very hot and deep fry for approximately 1 minute or when sizzling subsides. Remove the quail . Allow the oil to heat up again and repeat process twice till quail is very crisp and golden brown.

Did you know more than 3.85 million Australians are affected by arthritis? * Chances are you know someone with arthritis…

Have you spoken to them about becoming a member of Arthritis NSW? If not, let them know now…

The benefits of becoming a member include: • Providing support, advice and information for people with arthritis • Taking part in discounted self-management programs • Receiving the Arthritis Matters magazine every quarter • Access to warm water exercise and Tai Chi classes And many more benefits…

Various membership plans are available. To become a member just call 1800 011 041 or visit arthritisnsw.org.au/membership

* Source: A snapshot of arthritis in Australia 2010, by the Australian Institute of Health and Welfare, Australian Government.

rtists! a g n i r i p s a ll Calling a

World Arthritis Day – 12th October 2011 Do you have a flare for creating art? Are you flowing with creative juices? Enter our second annual art exhibition and get your art displayed and sold in a gallery on World Arthritis Day. We are calling all members of Arthritis NSW who would like to enter our art exhibition and raise some money for Arthritis NSW by selling your piece to the general public.

Your artwork can be of any size or format, painting or sculpture.

You must register your interest with Rob Novotny by no later than 22nd August to receive your entry pack. All paintings and sculptures need to be delivered to Arthritis NSW by 28th September.

This is your chance to have your artwork displayed at a gallery. All entries will be displayed at a gallery in Sydney, for a week prior to World Arthritis Day. We will also have a competition for the best entry as voted by our judges and the public.

On 12th October at 6.30pm we will have a formal cocktail party with our Patron, Her Excellency Professor Marie Bashir. We will be selling or auctioning off the pieces to help raise

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money for Arthritis NSW. Further information, and your exclusive invitation, will be ready for you in the Spring edition of Arthritis Matters.

Please contact Rob Novotny, Marketing and Fundraising Manager, rnovotny@arthritisnsw.org.au or (02) 9857 3300 to register your entry.

Volunteers needed on 12th October 2011 On World Arthritis Day, Arthritis NSW will be holding an “I care about arthritis” spare change giving day, where we will hit the streets and ask people for any spare change they may have to give to Arthritis NSW. However, we need volunteers for both Sydney and regional NSW. If you and/or your branch are interested in volunteering on this day, please contact Rob Novotny on (02) 9857 3300 or rnovotny@arthritisnsw.org.au.

We need as many volunteers as possible so ask your friends, family or colleagues to help out and raise money and awareness for the cause and show the public that you care about arthritis.

Please register by 9th September 2011.

In memory of William Harris 12/11/2004 – 17/4/2011

William at Camp Twinkletoes flying a kite

William at Camp Twinkletoes with Nurse Linda

It’s a loss I cannot fathom, a pain I can’t explain.

It’s looking for a reason, as to why you went away .

It’s waking up each morning, I no longer will make your bed.

It’s not seeing you anymore, sucking your thumb, holding your ted.

It’s explaining to your sister, why you’re not here anymore.

It’s trying to keep my feet on the ground, when I want to hit the floor.

It’s a sorrow far beyond anything else, more than any mother should feel.

It’s waking up each morning, and remembering that its real.

It’s waking up on Christmas morning with one less around our tree.

It’s waking up every morning your face I will never see.

It’s an emptiness of a night, that carries through each day.

It’s remembering the wonderful boy I had, thank you for loving me every day.

I know you came to see me while I cried alone in bed, I felt you touch my hand William, then you gently kissed my head.

It’s my heart that will never recover, our lives never the same.

It’s knowing there is always one missing when we see the children play.

It’s time for you to go now, spread those beautiful wings and fly.

And don’t you stop having fun when you start to see me cry.

Those tears won’t all be sadness, they are happy ones too.

Because I know how truly blessed I was the day God gave me you.

Goodbye my little William, don’t feel you need to stay.

Go find the biggest Monster truck for which to play.

“For My Wilma “ written by Lauren Harris, mother of William.

William was diagnosed with JIA when he was not even 2 years old, after being involved in a serious car accident. He will be sadly missed by his two older brothers Taylor and Jhai, his little sister Makayla and parents David and Lauren.

He will also be missed by everyone at Camp Twinkletoes and the family picnics who had the pleasure of spending time with this amazing little boy.

Winter 2011

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n e r d l i h C t a th w o n k u o y d Di ? s i t i r h t r a t ge

Did you know that 1 in 1,000 children aged 16 and under have Juvenile Idiopathic Arthritis JIA? Unlike the arthritis from the degeneration of joints, JIA is an inflammatory arthritis that is more closely associated with rheumatoid arthritis.

Inflammatory forms of arthritis, such as rheumatoid arthritis and JIA, are also known as connective tissue diseases and can affect eyes and skin as they are all types of connective tissue. Even within the diagnosis of JIA there are seven different subgroups. These relate to the number of joints affected and other symptoms present, such as a rash or fever.

It was believed that most children grow out of JIA; however, current research shows that more than 50% of children will continue to have arthritis into adulthood. Many people are not even aware that children get arthritis, so this means that it can take a long time for a diagnosis to be reached. This leads to a high risk of joint deformity as well as placing a lot of stress on the child and the family due to the uncertainty of what is happening and what to do about it.

One of the most frustrating things about JIA is that people may not be able to see that something is wrong with the child. Pain and stiffness can change from day to day or even within the day. Morning stiffness can make getting to school on time difficult and then, by lunchtime, the child is running around like there is nothing wrong. This may lead to teachers and other people accusing the child of faking it to get out of work or unwanted activities. This is very rarely the case, most children don’t like being different so they tend to mask their pain.

Other times adults and teachers go to the other extreme of wrapping the child in cotton wool, not allowing them to take part in anything physical. This can be just as damaging as not allowing them to rest. The old adage of move it or lose it remains just as true for children as it is for adults with arthritis.

Children with JIA are amazingly resilient. Many have never known any other way and find ways of doing things so they can continue to live a normal life. For example, some children walk with straight knees to reduce pain but they still manage to run around like all of their friends.

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Winter 2011

The prognosis for children diagnosed with JIA now, as opposed to 5 years ago, is much more promising.

However, it is imperative that parents and children work together with their paediatric rheumatologist, paediatrician, physiotherapist, occupational therapists, teachers and Arthritis NSW to ensure the best outcome for their children.

Camp Twinkletoes Camp Twinkletoes was held on 6th May to 8th May at Stanwell Tops.

Activities included Ponding (a walk to the creek to see all the aquatic life) which was a great success at last year’s camp, Kite making and flying and ‘T’ shirt printing.

Kids sudoku

Fill in the blank spaces ensuring that ever row, column and smaller box contain the numbers 1-6 only once

6 1

2

4

5

1 3 5

2

1 6

5 6

3 2

3

4

5

4

5

2

3

4

2

Fill in the blank spaces ensuring that ever row, column and smaller box contain the numbers 1-9 only once.

4

8

7

3

1

3

5 6

4

9 6

5

4

7

2

Arthritis Sum m er Challenge Sn apshot

8

5

2

1

7 3

7

2

4

5

7

9

3

3

9

6 2

4 2

6

9

4

5

7

3 8

9

1 6

Solutions on page 34

9

7 8

2

6

6

9

8 5

2011

• O ver 20 individuals and branches participated this year.

• T he challenge raised over $13k during the month of February.

• A rthritis NSW member, Catherine Hatzigeorgalis, raised an amazing $5,000.

• T here was a range of different activities such as runs, walks, zumba classes, swimming and afternoon teas.

• J oin us next year as we move this event to the first weekend of June 2012. Stay tuned!

Winter 2011

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Around the Branches ALBURY/WODONGA We recently had an Indian Lunch cooking demonstration and sari presentation in May which was successful and fun. The branch was also saddened by the death of our very active member, Alan Clarke who died on the 16th April 2011 and was a great supporter of the organisation.

BLUE MOUNTAINS

birthday which ends in a zero. On these occasions there is a special morning tea, with a birthday cake. We look forward to the Christmas in July at the local RSL. The next speaker is from the council library who will explain the lending of books delivered to the home. A number of quite serious illnesses e.g. heart trouble, joint problems and cancer test have befallen our members. The branch wishes all to have speedy recoveries. Holroyd branch would like to know if there are other branches that are having difficulty in replacing retiring committee members.

LITHGOW

On Saturday 2nd April, we held a street stall in Katoomba for Arthritis Week. We raised $1000 for the children’s camps. Thanks to all members who donated goods and helped on the day.

COOMA During Arthritis Week, Cooma branch members went out to lunch as a group. We decided to each add $5 to our meal to send to Head Office. We enjoyed spending time together for a couple of hours. We were saddened by the death of our member, Mrs. Betty Lamb. Betty had been a good supporter of Arthritis NSW over the years, a lovely person that we are remembering by giving money in her memory for research.

HOLROYD The branch tried placing a largish jar alongside the sign-in book, with the suggestion that members could donate loose change into the jar. After three meetings, this approach to fundraising proved to be quite successful.

In the next two meetings, two members will celebrate a

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Winter 2011

Several members enjoyed a day at the magnificent Mayfield Gardens and local winery near Oberon. Many joined Nena for a farewell lunch and wished her well in her new position. Thank you Nena for all your help and support over the past few years. Our branch has decided to change our meetings to every second month with lunch each other month and this is proving successful. We have enjoyed two days performing Tai Chi in the park then chatting over morning tea supplied by our members.

Tai Chi and warm water exercise classes continue and everyone enjoys the benefits of both. Many thanks to our leader Jo for her friendly guidance. Also a big “Thank You” to all our members for their ongoing help and support and to all who donate beautiful craft for fundraising. You are very much appreciated.

NEWCASTLE At the moment we are donating money at each meeting, which we are going to forward on when we have a sizeable amount. One of our members had a fall earlier this year but had not given a key to anyone to gain access to their home. I thought we could bring this to everyone’s attention, the necessity to have a key in a safe place in case of such emergencies.

PARRAMATTA We held a Cakeless Cake Stall for the Arthritis Summer Challenge and raised $90.30. Member Shanneen Bagala swam 1km at Parramatta Pool and raised over $300 in sponsorship. Our Monthly Trading Table brings in differing small amounts. A speaker from Parramatta Library in March gave us a PowerPoint presentation on facilities of the Library and gave us all a “goodie bag” of information. In April we hosted the City Regional Meeting at Ryde-Eastwood and held a raffle for funds.

Also in April we had 5 prospective members who came in response to our advertisements in local papers. We were very saddened at the passing of former VFO Pat Singh. She was such a friendly and helpful person and will be greatly missed. On 4th July we will have a speaker discussing ‘Look Good, Feel Better – Helping women face cancer with confidence’.

PENRITH The hydrotherapy sessions remain well attended and we are very grateful to those who assist Pearl in running them. Sadly, Eve Ausburn died in April. Eve has been a very enthusiastic, generous worker at the pool since its inception more than 20 years ago. Her husband remains very loyal to the Pool Group and is much appreciated.

Shirley Clow has arranged a wide range of guest speakers for the year – these are advertised in 6 local newspapers, which helps to attract members and visitors to our meetings. The Branch would welcome some ‘new faces’ on the Committee – so that the ‘oldies’ could take a break, after ushering them in. How about volunteering for a year or two??

SOUTHERN HIGHLANDS Our branch continues to raise funds with appliance raffles, trading tables and fruit raffles at each meeting.

A new support group for people with fibromyalgia has commenced this year and is an outstanding success, where

members join in friendly discussions and support others suffering from this painful condition. Our warm water exercise classes are proving very popular. We now have three volunteer retired physiotherapists who generously give their time and expertise to run all our classes. We will be celebrating Christmas in July with a luncheon at the Henrietta Rose Room and we are hoping to have some local talent to entertain us. Di Spragg will come to our August AGM and speak to us about Challenging Arthritis. Everyone is looking forward to the planned Bus Trip to Canberra in September to visit the Art Gallery, Old Parliament House and the War Memorial.

TUGGERAH LAKES This year we have had presentations from Helen Brooks from the Royal Institute for Deaf & Blind Children and Dr James Hasn, Orthopaedic Surgeon. Due to low numbers our warm waters exercises will no longer be held at Wyong Hospital, but members can attend a class held at Mingara pool at 12.30pm on a Monday. We are sorry to report that our valued Secretary Judy cannot continue in her position due to ongoing illness. In addition our President, Helen, is also out of action. Finally, we have recently celebrated our 21st year and are confident that the full support of all members will ensure the future of our club for many more years.

WOONONA- BULLI We have not raised any money so far in 2011. Lynn and Vida have donated $50 vouchers from Crown Central to be raffled between May and August for Healthy Bones Week. Our secretary Marianne Oyston resigned at our March meeting due to health reasons and other commitments. It is usually difficult to persuade people to take such a position so we were delighted when June James immediately volunteered to be our new secretary – many thanks June. Nena Doyle was our guest speaker in March. Four members attended the South Coast Regional Meeting at Mittagong on March 31st.

It was a wonderful opportunity to meet staff from Head Office and catch up on all the latest developments and changes in policy. Any members interested in attending performances at The Miner’s Lamp can contact Lynn or Vida for details and bookings. There will be an information stall and raffle at Stockland Corrimal Court in August, date to be set according to availability.

Winter 2011

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EDUCATION REPORT ARTHRITIS MATTERS

WINTER 2011

Winter is always a difficult time to keep up with your exercise program and the education team members are no exception. In the depths of winter one of the best exercise programs to do is our warm water exercise classes. Rather than give up your exercise in winter you may feel like a warm change so contact the office to find out more about these beneficial warm water exercises.

RA-P (Inflammatory arthritis program) & OAK Program (Osteoarthritis of the Knee) We have completed our first RA-P and OAK programs of the year.

We had a very good response to both programs with 15 participants attending each course. We ran both programs concurrently in February and March. Evaluation from participants was very positive and in fact, the RA-P group is very keen to keep meeting. One of the greatest benefits for participants was the ability to interact with people who have the same condition.

29 people attended the seminar. We would like to thank all the branch members for their hard work before and on the day of the seminar as all your efforts certainly contributed to its success.

We were very fortunate that Dr Pav Sunner (Orthopaedic Surgeon) and Associate Professor Clifton-Bligh (Endocrinologist) travelled from Sydney to present

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Winter 2011

The Sydney Fibromyalgia Support Group held their meeting on the 11th May and members viewed a newly acquired DVD from America called ‘Understanding Fibromyalgia’.

Moving On

Mudgee Seminar The seminar was held in conjunction with the Mudgee branch on the 28th April 2011 at the Mudgee Club.

Fibromyalgia

at the seminar. Our local speakers were Cheryl Dalby (Physiotherapist) and Judy Hickey (Occupational Therapist) .

Arthritis NSW would like to thank all our excellent speakers who donated their time and expertise to help make the seminar a success. We would also like to thank Geoff Taylor and Eli from Stryker for their support and chauffeuring skills in enabling Dr Sunner to travel to Mudgee.

The evaluation report called ‘The ‘Moving On’ Randomised Control Trial Evaluation Report’ has been received from the University of NSW. The report shows that the ‘Moving On’ program is effective in improving self-efficacy and some health behaviours. Overall the program was very well received by participants.

Arthritis NSW will now consider the recommendations made in the evaluation report regarding any changes to the program. We envisage, at the present time, that the ‘Moving On’ program will be able to commence in late 2011.

Spotlight on Blue Mountains and Lithgow

By Nena Doyle

The Greater Blue Mountains Area was unanimously listed as a World Heritage Area by UNESCO on 29 November 2000, becoming the fourth area in New South Wales to be listed.

The area consists of 10, 300 square kilometres of mostly forested landscape on a sandstone plateau 60 to 180 kilometres inland from central Sydney. This includes vast expanses of wilderness and is equivalent in area to almost one third of Belgium, or twice the size of Brunei.

The area is called the Blue Mountains because when the atmospheric temperature rises, the oil of Eucalyptus evaporates and disperses into the air, creating a haze that appears bluish to human eyes.

Less than 2 hours from Sydney, the Blue Mountains, which includes Lithgow and Oberon, is Australia’s most accessible world heritage listed wilderness.

The character and colours of the Blue Mountains region change throughout the year from spring time blooms to falling leaves; fresh cool summers to crisp and cosy winters.

Each season brings with it a calendar of unique events.

‘An Arts Festival with a Metal Edge’, Ironfest celebrates working and playing with metal. Held annually in Lithgow on the closest weekend to Anzac Day, Ironfest brings together

artists, designer/makers, blacksmiths, performers of all kinds, musicians, historical re-enactors and machine enthusiasts and hobbyists from all over Australia and the world.

Historical re-enactments, including medieval re-enactments by Full Tilt (The St George’s Day Championship) and Napoleonic re-enactments by the Australian Napoleonic Association (The Battle of Lithgow) have become a popular feature of Ironfest.

The winter months are a special time in the Blue Mountains. Winter Magic is one of Australia’s largest community festivals and is the day when the Blue Mountains mostvisited town, Katoomba, hands its main street back to the community for the biggest street party in Australia. A month long event held in June celebrates all that is

wonderful in the season, including a street parade that fills Katoomba’s main street with the colourful and extraordinary talents of the local community. Jugglers, gymnasts, musicians, dancers, drummers, troubadours, buskers, storytellers, poets, churches and choirs invite you to share the day with them.

The Blue Mountains, Lithgow and Oberon region is a must see for any visitor. The fresh mountain air and the dramatic landscape of the region create a sense of peace and space, the tranquillity and natural beauty allows you to slow down and relax.

Many villages and towns in the region offer award winning restaurants, cafés, boutique shops, antique emporiums and galleries.

The vibrant arts community include some of Australia’s best painters, sculptors, musicians and writers.

About the Branch Lithgow Branch meets on the 3rd Wednesday of every month from 11am at the Lithgow Library in Main Street.

Contact Lorna 02 6352 1984 Blue Mountains Branch meets on the 3rd Tuesday of every month, at 12 midday, at the Education Centre, Blue Mountains Hospital Katoomba. Contact Adrienne 02 4787 1124 Information was found on the Lithgow and Oberon Tourism websites www.bluemts.com.au and www.visitbluemountains.com.au Winter 2011

31

Branches and support groups Contact local branch for support, information & friendship.

BRANCHES Albury/Wodonga Support Group Social gatherings Warm water ex. only Marie 6021 6204

Cooma 3rd Mon 11.15am Bi/monthly Beg. Feb. Ex Servicemen’s Club Vi 02 6456 3325

Batemans Bay 4th Tues 10.30am Catalina Country Club Helen 02 4471 1246

Corowa 1st Wed 10.30am Comm Hlth Centre Joan 02 6033 3198

Bathurst 2nd Thurs 10.30am Info & N’hood Centre, Russell St Iris 02 6331 5505

Dubbo 2nd Thurs 2.00pm Masonic Hall Darby Close Norma 02 6882 2506 Eastern Suburbs Last Wed 10.15am Bondi Jt RSL Club Function Room Angela 02 9344 7176

Blue Mountains 3rd Tues 12 noon Katoomba Hospital Education Centre Adrienne 02 4787 1124 Chinese Support Bi monthly Granville Lib. 8 Carlton St. Granville Beverly 02 9872 5495 Coffs Harbour 1st Tues 10 am Bi monthly, Beginning Feb. Community Centre 22 Earl Street George 02 6652 7464

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Winter 2011

Forster/Tuncurry 4th Tues 10.30am Mem Services Club Margaret 02 6555 8270 Goulburn Support group Social functions only Necia 02 4821 6285 Grafton 3rd Thurs 10am CWA Rooms Duke St Margaret 02 6643 3801

Hawkesbury 3rd Tues 10.00am Tebbutt Room Windsor Library 300 George Street Julienne 02 4574 1928 Holroyd 4th Wed 10.00am Com Hlth Centre 14 Memorial Ave Merrylands Ron 02 9637 1995 Kids With Arth Alex Internet only kidswitharthritis@ arthritisnsw.org.au Kincumber Last Fri 10.00am Brentwood Village Merle 02 4368 6399 Lithgow 3rd Wed. 11am Lithgow Library Main Street Lorna 02 6352 1984 Lismore 2nd Tues 10.00am Cedar Room Neighborhood Centre Carrington Street Marie 02 6628 6692

Long Jetty 1st Thurs 10.00am Karagi Court Community Hall Yakalla Rd, Bateau Bay Liz 02 4332 5245 Lower Clarence 4th Mon 9.30am Com Hlth Centre Maclean Ron 02 6646 3067 Maitland District 1st Thurs 10.00am East Maitland Bowling Club Bev 02 49332927 Milton/Ulladulla 3rd Wed 10.00am Building 1 Comm Resources Centre St Vincents St Trish 02 4454 0205 Molong 2nd Mon 11am Bowling Club Eucharenna Rd Margaret 02 6366 8045 Mudgee 3rd Thursday Club Mudgee Dorothy 02 6372 0839

Newcastle 4th Wednesday 1pm Mayfield Seniors Centre 102 Hanbury St Mayfield Judy 02 4967 5694 Nowra 1st Thurs 10 am Shoalhaven Lib. Meeting Room Gary 02 4423 3633 Orange 1st Mon. 12 noon HACC Centre Lords/March Sts Pat 02 6362 3820 Parramatta 1st Mon 1.00pm Room C Old Council Admin Building Val 02 9632 6636 Penrith 2nd Wed 9.30am CWA Rooms Cnr Tindale St & Castlereagh St Joy 02 4751 8714 Port Macquarie 2nd Tues 10.00am Senior Citizens Pam 02 6584 6687 Quirindi 4th Tues 2.00pm Ingall Centre Nowlend St Quirindi Val 02 6747 4727 Ryde 4th Thurs 1.00pm Ryde/Eastwood Leagues Club Doris 02 9817 7470 doris_carrall@tpg.com.au

Scone 1st Wed 11.00am Bowling Club Susan 02 6545 9191 Southern Highlands 2nd Fri 10.00am Henrietta Rose Rm Bowral Margaret 02 4885 1430 Taree 1st Friday 10 am Uniting Church Albert St. Taree Margaret 02 6552 4183 Tuggerah Lakes 1st Friday 10.00am Uniting Church Summerside St Toukley Judy 02 4358 8446 Turramurra 1st Friday 10am Dining Rm., Comm.

Complex, Gilroy Lane.

Turramurra Jan 02 9987 4237 Wagga Wagga 1st Thurs 1.00pm Rules Club Lorraine 02 6926 3203 Warilla/ Shellharbour 3rd Thurs 1.30pm Warilla Bowling Club Bruce 02 4296 4420 Wollongong 2nd Tues 10.00am Wesley Auditorium Vicki 0403 352 175 Woonona/Bulli 1st Wed 9.30am Workers Club 313 Princes Hwy, Bulli Marianne 02 4284 8450

Woy Woy 3rd Tues 10.00am Community Centre John Hoare Ct. Valda 02 4341 5881 Young 4th Wed 10.30am Bi monthly Uniting Church Hall, Young. Brenda 02 6382 3247

SUPPORT GROUPS

FIBROMYALGIA SUPPORT GROUPS Arthritis NSW Di 02 9857 3300 or 1 800 011 041 Charlestown Bi monthly Charlestown Multi Purpose Centre Julie 02 4982 9555

Gilgandra 1st Tues 10.00am Cooee Lodge Anne Hall 02 6817 8744

Southern Illawarra Womens Group Last Wed 2pm Warilla Womens Health Centre Barbara 02 4296 3744 Shelagh 02 4272 9251

Parkes Last Tues 10am Bi monthly Parkes Hospital Education Centre Fiona 02 6862 1866

ACT 2nd Tues 12.30pm Pearce Com. Cent.

Collette St Roz Mon/Tues 02 6290 1984

Singleton 1st Friday 1.30pm Activity Centre Maureen 02 6571 1922

FIBROMYALGIA INFORMATION

Young Adults with Arthritis Nena 02 9857 3300 ngarland@arthritisnsw.org.au

Wollongong Winsome Stephenson 02 4284 8890

ARTHRITIS INFORMATION Cowral Joyce 02 6342 5192 Manly Viviene 02 9982 9309

Winter 2011

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Upcoming self-management courses OAK (Osteoarthritis of the knee)

OAK (Osteoarthritis of the knee)

OAK (Osteoarthritis of the knee)

Nepean region Starting 26th July – 30th August (six consecutive Tuesdays)

Central Coast Starting 18th August – 22nd September (six consecutive Thursdays)

Fairfield Starting 6th September – 11th October (six consecutive Tuesdays)

If you would like to register for any of our self-management courses, please call 1800 011 041 or register at www.arthritisnsw.org.au

Arthritis affects 1 in 5 Australians

Everybody in NSW can benefit from your bequest.

Arthritis is the leading cause of disability and chronic pain. It can affect anyone, young, old, male or female. But something can be done.

By leaving us a bequest, you can help us: Fund research into the cause and ultimately help to find a cure Help children with juvenile idiopathic arthritis (JIA) Provide free information and services to people with arthritis Run seminars and community education sessions Conduct Tai Chi and warm water classes.

To find out how you can make a bequest to Arthritis NSW, please contact us on 02 9857 3300 or visit arthritisnsw.org.au Kids sudoku solutions (from p27)

Memorial Gifts We thank the family and friends of the following people who have marked their passing by making a donation to Arthritis NSW: • Valerie Joyce McNaught

• June Bradshaw

• Mr Alan McBeath

• Margaret Greenwood

• Mr Reg Kunkler

• William Harris

• Mrs Janina Sidlauskas

• Mrs Beryl E Ingold AD, M.B.E.

We would also like to acknowledge the generous donations made by members of Arthritis NSW branches in memory of their fellow member and dear friend: • Mrs Anna Margaret Slattery (Orange) We are grateful for this support and join in the commemoration of the lives of these valued members of the community and our branches.

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Need a DVD or Book regarding arthritis?

Arthritis NSW have on offer some wonderful resources such as DVD’s and books to help you manage your condition. Here are some of our more popular ones you can purchase.

DVD’s Exercise Beats Arthritis and More Exercise Beats Arthritis Set (2 discs) Price: $40 inc GST The 2 disc set includes the popular DVDs Exercise beats arthritis and the sequel More Exercise beats Arthritis.

Tai Chi for Arthritis Part 1 Price: $35.00 inc GST 12 lessons with Dr. Paul Lam, plus useful information and demonstrations. Become

BOOKS a student in Dr. Paul Lam’s class in the comfort of your home as he guides you through each Tai Chi movement step-by-step.

Tai Chi for Arthritis Part 2 Price: $30.00 inc GST Tai Chi for Arthritis Part 2 by Dr Paul Lam. Prt 2 is ideal for those who have completed the original program and are looking for a more challenging course.

Arthritis the Essential Guide Price: $35.00 inc GST Arthritis the Essential Guide

by Wayne Rutter, explains the many different forms of the disease and associated muscular-skeletal conditions.

This is a book for those who want to continue to live a full and positive life, despite the limitations of the disease.

Exercise Beats Arthritis Handbook Price: $17.50 inc GST Exercise Beats Arthritis is and easy to follow program of exercises to help you keep active and improve your quality of life.

Visit our website at www.arthritisnsw.org.au to view our full product range or call 1800 011 041 to order your products over the phone.

2011 CHRISTMAS CARDS Now Available!

See the price list and order form provided in this issue of Arthritis Matters or contact Arthritis NSW for more information on: Phone: 02 9857 3300 Toll Free: 1800 011 041 or purchase online at www.arthritisnsw.org.au

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