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Autumn 2013

ArthritisToday www.arthritiswa.org.au

Understanding Scleroderma PAIN, Mental Health & Depression

Trekking the Great Wall

Building Healthy Bones


with

The original Rose-Hip Vital™ with GOPO® imported from Denmark is a powerful anti-oxidant and may help:


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Contents

4. 5. 6. 8. 10.

From the Desk of the Executive 41st Annual General Meeting Latest News Feature Story: Understanding Scleroderma Events: Great Wall of China 40th Anniversay Golf Day

18. 21. 22. 23.

Arthritis & Osteoporosis Youth Support Services Volunteers Health and Lifestyle: Exercise Pain & Mental Health/Depression Margaret’s Recipe

30. 31.

Country Rheumatology Support Groups

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FEATURED THIS ISSUE

8.

Understanding Scleroderma

18.

Camp Freedom

24.

Pain & Mental Health/ Depression


From the desk of the

Executive Director

Welcome to another year and welcome to our first issue for 2013 and thank you for supporting us. I hope you find the articles informative, and helpful in easing the impact caused by bone and joint disease. Passing forty years, as we did last year, caused me to reflect with some pride, on all that we have achieved. It felt we had traveled miles but with the effects of arthritis still wreaking havoc, clearly there is still a long way to go. Two years ago the Board elected to step up the pace and establish a Chair in Rheumatology & Musculoskeletal Medicine, the intent being to focus on musculoskeletal medicine, to train GP’s and undertake research. We began an appeal seeking funds to help establish the Chair and more especially provide seed funding

Arthritis & Osteoporosis WA Arthritis Today is published by Arthritis & Osteoporosis WA. Address: 17 Lemnos Street, Shenton Park, WA 6008 Postal Address: P0 Box 34, Wembley, WA 6913 Tel: (08) 9388 2199 Fax: (08) 9388 4488 Toll Free: 1800 011 041 (Country Callers only) Website: www.arthritiswa.org.au Email: general@arthritiswa.org.au President: Dr J Edelman MBBS FRACP Executive Director: Mr R Forlano CPA BCOM AICD Magazine Editor & Advertising: Amy Radunz amyr@arthritiswa.org.au Front Cover Photography: Abigail Harman Photography www.abigailharman.com

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for the new Professor once appointed, to kick start significant research. Two years on, the position of Professor has been advertised and we hope to appoint someone in the next months. The appeal for funds has been well supported, we hold pledges and funds now near $2 million but until our new Professor actually commences work, we remain cautious. Elsewhere in this issue, you will read about Scleroderma and the connection between Pain, Depression and Fatigue not to overlook our advertisers whose support helps make possible the preparation and publishing of this magazine.

Copyright: Articles appearing in this publication may be reproduced subject to written agreement from Arthritis WA. Arthritis WA retains editorial control over its content.

Board

President: Dr J. Edelman MBBS FRACP Vice President: Dr I.D. Froyland PhD(Crim), MA(Psych), Dip Ed Hon Treasurer: Ms Silvia Caratti B Com FCA MBA Members: Prof. R. Prince BSc MB ChB Birm.; MD Melb, FRACP, MRCP(UK); Dr B. Langlands MBBS FRACP; Dr Margaret Mazur MD FRACP; Mr Brad Gordon SA (Fin.), Fdn DFP, MAICD; Ms Debbie Borshoff BA (UWA), Dip Ed

Production Arthritis Today is published by Arthritis & Osteoporosis WA. This magazine is designed by kembercreative. This magazine is printed by a “Level 2 Green Stamp” environmental accredited printer, using petroleum free vegetable based inks and 33% green electricity generated from solar panels. The paper is sourced from FCC accredited sustainable and well managed forests and is 100% recyclable.”

Enjoy the read and thank you for being part of our community.

Ric Forlano Executive Director

Mission Statement The objective of Arthritis & Osteoporosis WA is to reduce the incidence and disabling effects of arthritis, osteoporosis and related conditions in the people of Western Australia through programs in Care, Education and Research.

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


Arthritis Today | AUTUMN 2013

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Latest News

A Call to Prioritise Musculoskeletal Disorders Following findings from the Global Burden of Disease Study 2010 Influential global alliance calls on governments to prioritise musculoskeletal health. The recently published findings identified that in Australasia, Musculoskeletal disorders, such as lower back pain and osteoarthritis are second, only to cancer, as the leading burden of death and disability. While the Australian government recognises musculoskeletal disorders as a national health priority, to date, the conditions have not received an equitable level of priority. Professor Lyn March, of the University of Sydney, and her team have been working for the past four years to identify all the studies of arthritis and musculoskeletal conditions from around the world. Professor March highlighted that the new study provides strong evidence that musculoskeletal conditions should be given the same policy and resource priority as cancer, mental health and cardiovascular disease. The study directly compares diseases and the impact of dying from a condition with the impact of living with the condition. Professor March explained that the level of disability is a combination of the length of time people live with a condition as well as the level of severity of their condition

and the impact it has on daily life through pain, psychological impact and loss of function. “When the disability component alone is looked at, which reflects the pain and suffering of people living with the conditions and the enormous associated economic impact in productivity losses and need for health services – the Musculoskeletal category is the leader,” Professor March stated. Ainslie Cahill from Arthritis Australia echoed the importance of our state and federal government’s urgent action on improving prevention and management. “We want to see equitable access to effective treatments and professional support for all Australians struggling with arthritis no matter where they live.” Australia’s health system must do more to address the growing burden of musculoskeletal conditions. The Australian BJD national action network, an alliance of organisations and professional bodies caring for people with musculoskeletal conditions including the Australian Rheumatology Association, Arthritis Australia and the Australian Physiotherapy Association, has launched a call to action for our state and national governments to address the prevention and control of this growing burden of musculoskeletal conditions. Their vision is ‘to keep people moving’


Building Healthy Bones Do You Have

Low Back

Pain? A team of researchers at Curtin University is investigating persistent low back pain.

80

%

of Australians have low back pain Why some people have on going pain in still unclear. Research suggests multiple factors may be involved and finding effective treatments for low back pain can be difficult. This research aims to increase our understanding of the complex mix of factors that are associated with persistent low back pain. Better understanding of the factors contributing to persistent low back pain will assist in the development of innovative treatment for this common and troubling problem. If you have had back pain for at least three months, and would be interested in being a participant in our research, or would like more information please contact Martin Rabey, Specialist Musculoskeletal Physiotherapist, at the School of Physiotherapy, Curtin University by telephoning 0487007116 or e-mailing: martin. rabey@postgrad.curtin.edu.au. Thank you.

The Medical Journal of Australia’s open access has recently published an article presenting recommendations on building healthy bones for different stages of life. Over 100 leading experts, from a range of disciplines, had the opportunity to analyse and critique evidence specific to bone health and prevention strategies. This study addressed the growing 1.2 million Australians who have osteoporosis and the 6.3 million who have osteopenia (low bone density)*. In addition to the 80,000 Australians who suffer minimal trauma fractures each year** Prof Ebeling, Medical Director of Osteoporosis Australia and lead author on the paper, highlighted that the key to improve our nation’s bone health is a combination of adequate calcium, vitamin D and exercise provided at all life stages. “Childhood plays an important role in determining our future bone health. It is estimated that osteoporosis can be delayed by 13 years if a 10% increase in peak bone mass (bone bank) can be achieved in childhood and adolescence. It is also estimated that a 50% reduction in the risk of fracture later in life can be achieved if this gain is maintained,” said Professor Ebeling. Both Ebeling and Associate Prof Deborah Kerr, School of Public Health, Curtin University and coauthor, indicated that although people generally understand calcium, vitamin D and exercise are important for their bones, they are often not taking action to ensure daily requirements are met.

Teenagers were the group most at risk of not meeting daily calcium requirements, likely due to the decline in milk intake and its replacement with carbonated beverages, high in caffeine and phosphorus. The paper indicates how periods of non-active lifestyle should be avoided from childhood right through to older age due to its detrimental effect on bone. Specific types of exercise such as weight bearing and muscle strengthening exercise are known to have a positive effect on bones, and are therefore encouraged. Professor Michael Kimlin, Faculty of Health, Queensland University of Technology and co-author, said “The role of vitamin D is critical in maintaining healthy bones from childhood and throughout life, yet how much Vitamin D you get from sun will depend on where you live in Australia, the season and your skin type.” However we must of course balance our vitamin D needs and sun exposure in order to avoid skin damage. Professor Peter Ebeling said, “The clear message is we have an opportunity to make a difference to bone health for all Australians. We have the tools, but we now have to use them all. Our call is to both the public and general practitioners to focus more attention on bone health.” * Henry MJ, Pasco JA, Nicholson GC, Kotowicz MA. Prevalence of osteoporosis in Australian men and women: Geelong Osteoporosis Study. MJA September 19, 2011; 195 (6): 321-322. ** Australian Institute of Health and Welfare. Australia’s health 2010. Australia’s health series no 12. Canberra. AIHW, 2010. (Cat. No. AUS 122)

Arthritis Today | AUTUMN 2013

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Feature Story 8

Understanding Scleroderma Systemic sclerosis (also known as Scleroderma) is a connective tissue disease that involves changes in the skin, blood vessels, muscles, and internal organs. It is a type of autoimmune disorder, a condition that occurs when the immune system mistakenly attacks and destroys healthy body tissue.

more widespread and the pattern of skin involvement allows for the classification of the disease. Sometimes the limited form of the disease is referred to as either limited cutaneous Scleroderma, or CREST syndrome.

It is a rare disease affecting between 4 – 485 people per million, depending on country and racial origin. It affects women more than men.

The cause of systemic sclerosis is unknown, but research is continuing. What we do know is that patients with SSc have dysfunction of the blood vessels, abnormalities of the immune system and fibrosis of the skin and internal organs in varying degrees. The risk factors for the development of SSc are complex including genetic and environmental factors. It is unlikely that either a single gene or environmental exposure is responsible for the development of SSc.

The term scleroderma comes from the Greek root, “sclerosis” meaning hardening or thickening of the skin “derma”. When scleroderma is associated with other internal organ involvement it is termed systemic sclerosis (SSc). The pattern of skin involvement can be limited or

At present there is not a cure for SSc but over recent years effective treatments have become available. These treatments manage the condition and reduce complications of the disease. Studies have shown that appropriate early treatment not only improves quality of life

but also reduces mortality in the more severe forms of the disease. Like many chronic diseases the disease spectrum in Systemic Sclerosis is very wide with varied presentations. Every person’s disease is individual and unique therefore it is important that the appropriate targeted therapy is used according to the organ involved. In general in the early stages of the diseases most people will experience fatigue and weight loss and skin involvement. The earliest changes are usually noted in the fingers, hands and face. In the limited form of the disease (lcSSc) these areas may develop features of the CREST syndrome. This syndrome includes calcium deposits under the skin (Calcinosis), blanching of the fingers (Raynauds), difficulty swallowing (esophageal dysmotility), and small spider like rashes (telangectasia). In the diffuse form of the disease (diffuse SSc) the skin involvement is progressive. This progression may indicate to your doctor other organ involvement.


Features of the disease Skin In the early phase the skin is often puffy and itchy, but later on becomes tight and tethered. Grip becomes quite limited and weak. Care to avoid sustaining trauma to the fingers, and the use of moisturising cream, are both essential measures to follow at all times. As yet no treatment is universally effective in preventing skin progression.

Blood Vessels Most patients develop Raynauds phenomenon – where the fingers change colour in response to cold. The sequence of colour changes is often white, to blue then to red (as they warm up). This process can be painful and is caused by spasms of the blood vessels. It is a common condition often occurring in people with no underlying disease. However in Systemic Sclerosis Raynauds phenomenon is usually more severe due to underlying fibrosis

of the wall of the small blood vessels undergoing spasm and this can result in ulcers of the finger tips. Finger exercises and avoiding cold exposure helps as well as medications which dilate the blood vessels. But these are not the only blood vessels which may be involved in SSc. Blood vessels supplying other organs are also affected, including the arteries which supply the lungs, kidney and the stomach. When these organs are affected the complications may be serious; therefore it is important to initiate treatment early. To allow for early detection of these complications it is recommended all patients with scleroderma are screened for these complications.

Gastrointestinal Most patients with SSc will have involvement of the gastrointestinal tract at some level. Involvement of the esophagus is very common and patients frequently experience

heartburn, difficulty swallowing or even coughing after ingestion of food. Treatment to prevent acid reflux or aid in motility can help prevent sequel such as stricture of the esophagus. Involvement of the lower bowel can result in bloating, nausea, pseudo-obstruction and sometimes malabsorption of nutrients. Specific treatment is required for these complications.

Kidneys Kidney failure is rare, but may present quite suddenly, usually in those patients with diffuse skin disease. As mentioned above this is due to involvement of the artery supplying the kidney and requires prompt treatment. This usually presents with an increase in blood pressure, headaches and occasionally seizures.

Arthritis Today | SUMMER 2012

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Feature Story

Lungs

Musculoskeletal

The lungs are frequently involved in SSc and this involvement presents in two way, pulmonary artery hypertension (PAH), or inflammation of the lungs (interstitial lung disease). This can result in shortness of breath or a persistent cough. Therapies are available to treat these complications. Although in many cases these therapies are effective, they all have potential side effects and need careful monitoring.

Patients may experience joint pain, but rarely develop inflammation in joints resulting in deforming arthritis. Fibrosis around joints may result in contractures, especially around fingers. Pain in the muscles (myalgias) and occasionally muscle inflammation (myositis) may require treatment.

Heart Rarely SSc can directly affect the heart lining (pericarditis), muscle (myocardidtis) or cause conduction system abnormalities (arrthymias). Cardiac symptoms may also result from lung involvement.

Systemic Sclerosis is a rare and complex disease. It is important to recognise which organs are involved in order to initiate appropriate treatment. Early recognition allows earlier treatment which improves outcomes. In general, many of the serious complications, if they are going to occur will do so in the first five years of disease, but this is not the case for PAH which may occur later in the disease.

This highlights the importance of ongoing monitoring even when symptoms improve. Much work is needed to better understand and treat SSc, but a lot of progress has been made. In Australia, advancements have been made through the ASIG (Australia Scleroderma Interest Group) establishing a screening program and developing a national data base of patients with Systemic Sclerosis. This large data base has taught us much about the patterns of SSc in Australia, the effectiveness of treatments. This database has allowed us to collaborate with SSc special interest groups in other countries. More information can be obtained about ASIG by contacting Scleroderma Australia or Arthritis & Osteoporosis WA.

Scleroderma Seminar Arthritis & Osteoporosis WA are presenting a Scleroderma seminar as part of the Arthritis Awareness Week 2013. A number of specialist speakers will cover the management of Scleroderma, information on respiratory and digestive tract involvement and lab test results. We are also pleased to have the President of Scleroderma Australia join us. This seminar will be of interest to people with scleroderma, crest syndrome and pulmonary hypertension. Further details will be available at a later date.

Saturday 23 March 2013

10:30am - 3pm, (10.15am registration) Wyllie Arthritis Centre, 17 Lemnos St, Shenton Park. Cost: $10 | Bookings essential. | Light refreshments provided. Call 9388 2199 or visit www.arthritiswa.org.au/events 10


Twelve trekkers from across Australia embarked on a weeklong adventure through Beijing and along the Great Wall in September last year, all helping to raise awareness and funds for their state’s Arthritis foundation.

Day 1 We arrived late afternoon in Beijing, and were greeted by our local guides, Jessie and Hero. It was a quiet evening, after being awake for almost 32 hours we were all exhausted. We shared our first beautiful banquet dinner and went to bed.

Day 2 The first stop for the day was the Temple of Heaven where we saw the people of China come together to play hacky sack, sing songs, dance, and practice the art of tai chi in the gardens. Every which way we turned there was graceful movement and energetic activity happening. We ended our visit with a tai chi session led by our guide Jessie. For the remainder of the day we became educated on Chinese history as we explored Tiananmen Square and the Forbidden City.

Day 3 We woke up early, ready to leave Beijing and set off on a long drive to the Great Wall via the East Qing Tombs. Our driver, Mr Good, faced some frustrating detours and challenging terrain. He masterfully drove us through deep ruts, mud puddles,

Amy Radunz, Bec Beazley and Mak Maketo raised $12,000 for Arthritis & Osteoporosis WA. Their nine months of physical training and fundraising paid off when they embarked on their memorable adventure. Here is their story.

across bumpy patches of dirt, and dodged vehicles, animals and people. Following a day of continuous detours, we were behind schedule, when we should have already been at the Wall. To make up time, Mr Good stepped on the gas. The drive turned into a race against the clock as the gates closed at 5pm. It was 4pm as we sped up a narrow mountain road. The rush was well worth it as we took our first steps on the Wall. Your first impression once you have reached the top and can see the Wall snaking along the mountains is unforgettable. The enthusiasm was palpable and our smiles stretched to our ears as we absorbed the view. Everyone kept muttering ‘wow’ over and over again.

Day 4 Our day began with more offroad excitement as Mr Good (now nicknamed ‘Mr Excellent’) navigated our bus through even more unimaginable terrain. The large bus rocked sideways, upwards and downwards. It groaned and creaked as we crossed rivers and drove through construction sites. Mr Good manoeuvred the bus around a hairpin bend on a steep gradient. It was impossible for him to get the bus

Events

The Great Wall of China

around in one go so the front of the bus came face-to-face with the jagged cliff as he carefully inched the bus backwards enough so that we could make the turn. We all held our breath and let out a sigh of relief when we made it to the top of the road unscathed. Mr Good had a beaming smile as compliments flowed from the back of the bus. Our trek started at a small village. As we made our way up to the Wall, the path narrowed and the views were breathtaking. This part of the Wall had not been rebuilt. It was such a great contrast from the day before, enabling us to really grasp the age of the Wall. Climbing up into the mountains we came to a part of the Wall where the land beneath us simply seemed to disappear. A local woman explained that this part was the barrier between China and Mongolia and pointed to what was once considered the realm

Arthritis Today | AUTUMN 2013

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Events of the Mongols who persistently tried to invade from the north. Our path began to narrow so much in some parts of trail that it wasn’t much wider than our shoes – testing any form of vertigo anyone may have. As the day wore on, the Wall became more and more visible in every direction. Bec was telling everyone to stop and just take it all in. She was right. There was so much to take in. After having lunch at the top of a tower, we diverted from the Wall as this section was occupied by the military. As we veered away, we descended into a valley of corn fields and passed through thick scrub. We met a 72 year old farmer who carried on his back an 80–100kg bag of corn. A couple of the men in our team tried to lift the bag onto their back to see how heavy it was, however they were unsuccessful. The farmer was grinning ear to ear from all the compliments he received from us on his strength and fitness. At the end of the day Julie B, CEO of Arthritis SA, said ‘that is the hardest thing I’ve ever done and I made it!’ Bec made a comment that it is for this reason we were there. Moments like these are rare and should be cherished. We can push our bodies further than we think and when we do, we should stop and bask in our accomplishments.

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Day 5 Thanks to the rain the night before, we stepped outside and we were ecstatic to see blue sky for the first time. We started our trek with an incline until we reached the top of the Wall. From there we followed the Wall as it snaked its way across the mountains. We went up and down and up again. We came across steps that were so high that we thought they must’ve been built for giants. The biggest challenge of the day was a set of stairs that were very daunting to look at. Each step was so high many of us used our hands to crawl our way up (for fear of losing balance and falling backwards). The highlight of the day for everyone was the blue sky. It is hard to grasp the expanse of the Wall and just how far it extended. Even the best of cameras cannot capture the Wall in all its glory. However, having blue sky as the backdrop enabled us to see further than we had previously seen. The view kept ‘wowing’ us.

Day 6 We started the day with a cable car ride up the mountain. Then we tackled the infamous Stairway to Heaven! 800 continuous steps! This is one of the best-restored sections of the Great Wall. From the top, we took a narrow path to the left and found ourselves on an unrestored part of the Wall jostling with plants, shrubs and trees. It was

overgrown and challenging but such an adventure. Soon we emerged from the shrubs and climbed a distinct part of the Wall until we found ourselves perched high on a tower overlooking glorious mountains. One of the best views of the trip, and where we ate our subway lunch. Rain clouds were fast encroaching upon us and the temperature dropped. We began making our way down to the village where we would be staying, following a trail through thick forest. Dirt turned to mud and shiny rocks turned lethal. Every step was hazardous and slippery as we made our way down the mountain, to our homestay with Mr Chow and his family. At dinner Angela, from Arthritis Tasmania, shared with us an inspirational excerpt from a poem “Always I will take another step. If that is of no avail I will take another, and yet another. In truth, one step at a time is not too difficult… I know that small attempts, repeated, will complete any undertaking… I will persist until I succeed.” Og Mandino

Day 7 We woke to a picturesque scene, our accommodation surrounded by the Great Wall snaking along the mountain tops. We commenced our last trek and followed Mr Chow through dense forest back up to the Wall. We emerged from the undergrowth and found


ourselves face-to-face with a seriously steep section– 38 steps that were in a serious state of disrepair. They were with not enough room to land a full shoe on them. We had to use our hands to hold on tightly as we inched upwards and skywards. It was certainly not for the fainthearted as we discovered later on when a group we’d encountered a number of times along the Wall gave up and took a short cut back to the village. We all felt a huge sense of achievement as we stood atop the peak and looked back down on where we’d climbed. We let out a shortlived sigh of relief as we saw that we had to go down the other side and up another similar ascent.

We bravely continued our test of endurance as we got to know the Wall intimately. It was certainly more of a rock climb than trek but it was a fantastic way to end a great trip. The ‘Serpentine’ section of the Wall was framed by the brilliant blue sky and we couldn’t have asked for more. Our trek ended when we came to the ‘Steps to Heaven’; a set of sky-high steps not scalable by humans. Stepping off the Wall, we re-entered the forest and made our way down the mountain, sad to be finishing our trek so soon. Our bus took us back to Beijing.

Day 8 On our final day in China Jessie and Hero took us to a traditional hútòng area where we cycled through the local area dodging cars, bikes, people and dogs. Hútòngs are narrow alleyways that are lined with traditional courtyard housing. That evening we headed out for a celebratory dinner – Beijing style. We went to a restaurant known for its Peking duck, the perfect banquet meal to end a perfect trip. Even more exciting was the fact that Jessie, Hero and Mr Good joined us to celebrate our achievements and reflect on an incredible adventure.

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Events

March 1972

40

th

Anniversary On the 12th October 2012, co-founders, dedicated supporters, volunteers, employers and friends came together at the Wyllie Arthritis Centre to celebrate 40 years since the inauguration of Arthritis & Osteoporosis WA. The foundation was honoured to celebrate the evening with the foundation’s patron and Governor Malcolm McCusker. Governor McCusker unveiled the 40th anniversary plaque, which you will now see sitting within Wyllie Arthritis Centre rose garden. Following the formal activities of the evening, guests enjoyed canapés and a small Art Exhibition. A total of $10,000 was raised from all artworks sold on the evening. The evening gave an opportunity to reflect on all the accomplishments over the past 40 years. We would like to share some of those major milestones:

Exploratory Meeting of five Medical Professionals and six Citizens was held, the agenda addressed the concern about the problems of arthritis and rheumatism in the community in Western Australia

October 1972 The West Australian Arthritis & Rheumatism Foundation was publicly inaugurated in Government House Ballroom by the Foundation‘s Patron and Governor, Sir Douglas Kendrew

1983 The first camp for Children with Juvenile Chronic Arthritis was held at York Dr Evan Owen stood down as President of WAARF and was succeeded by Dr Paul Zilko. Dr Owen was made a Life Governor of the Foundation

1973

1986

The Foundation moved from the ANZ Bank Building in Murray St to the R & I Bank at 853 Hay Street where it remained until 1983

The first country Branches of the Foundation were established in Bunbury, Merredin and Albany

Dr Phyllis Goatcher gave a significant donation to the Foundation to establish a fund to be used to finance visiting Clinical Rheumatologists to Perth. A condition of the gift was that a portion of the income earned from the Fund each year is to be added to the capital to maintain the real value of the Fund, thus ensuring that this valuable contribution will continue in perpetuity

1974

1989

The Ladies Auxiliary was established

Dr Jack Edelman became President, a position he holds to this day

Dr Paul Zilko was appointed the first WAARF Fellow in Rheumatology at the Perth Medical Centre

1975 Dr Phyllis Goatcher, President of the Foundation, became Citizen of the Year Our first grant was made to fund work in immunological research

1977 World Rheumatism Year Meeting in Perth opened by Dr Christian Barnard, a Rheumatoid Arthritis sufferer, was attended by 4,500 people, the largest attendance at any medical congress in Australian History.

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Dr Phyllis Goatcher stepped down as Foundation President and was succeeded by Dr Evan Owen. She became a Life Governor in 1978 and was made an Officer of the Order of Australia

1991 Change of Name to ARTHRITIS FOUNDATION of WA Incorporated

1992 The Capital Appeal for the Arthritis Centre was launched by the Governor, Sir Francis Burt, Patron, and Vice Patrons Sir Charles Court, Sir James McCusker and Dr Phyllis Goatcher.

Governor Malcolm McCusker


1994 Official Opening of the new Resource Centre by the Governor of Western Australia, Major General Michael Jeffrey AO, MC

1995

First Primary School Awareness Pack developed – DEM BONES & JOINTS Lotteries Commission Grant of $98,000 to fund a new telephone system, audio visual equipment, new computers and the establishment of the website

Following receipt of a major gift from the Wyllie Family, the Resource Centre was officially named the “Wyllie Arthritis Centre”

2002

Launching of the Bone Bank, an osteoporosis project

2005

1996 Osteoporosis WA was established as a division of the Arthritis Foundation of WA 30 Rheumatology Clinics in WA was commenced state-wide with 15 Specialists and 9 Community Nurses

1997 Permanent private practising Rheumatology Service commenced at the Wyllie Arthritis Centre

1998 Development of New Health Model Multidisciplinary Assessment Team (MATS)

Osteoarthritis of the Knee (OAK) Program commenced

Health Services Manager Jean McQuade and Nurse Sophie Coleman presented our MATS program at the EULAR (European League against Arthritis) annual congress in Vienna Lotterywest Grant was received for $106,000 to solar heat the hydrotherapy pool and to provide computers and associated equipment

2011 Signing of the Memorandum of Understanding took place between the University of Western Australia, Arthritis & Osteoporosis WA and the North Metropolitan Area Health Service to establish the professorial position (Chair in Rheumatology) within the School of Medicine, UWA. Main focus is to be on research and education in Musculoskeletal Disorders

2012 Telethon Grant to fund a Bone and Joint Online School initiative to be launched 2013

Photography by Abigail Harman

Ben Horgan appointed Chairman of the Bone & Joint Decade, National Action Network, in Australia Commonwealth Government Grant funded the Foundation the sum of $224,000 for “the design and development of an evaluation based multidisciplinary program for adolescents, young adults and consumers with Rheumatoid Arthritis”

Debbie and John Borshoff Arthritis Today | AUTUMN 2013

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Events

Golf Classic On the 23rd of November, sixty golfers were in full swing at this year’s Abbot Solutions Golf Classic event. The event was held at the prestigious Royal Fremantle Golf Club, where participants gathered for lunch and registration before the game started. There were sixteen teams in total, comprising of corporate teams, eg: Abbot Solutions, Good Dharma and Marketing mix, as well as various independent teams. The weather was perfect for the day; with beautiful blue skies, a slight breeze and cold beers awaiting the golfers return. Tee off commenced at 12.30pm, and marked the start of an exciting game for both players and spectators. A massage tent was set up for the players to enjoy during the game, as well as cold beverages available throughout the course.

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After eighteen challenging but rewarding holes, the players returned to the clubhouse for some well-deserved drinks and snacks by sunset before dinner, prize giving and the wine wall raffle began. While enjoying some drinks, players also had the chance to take part in a hole in one competition. At dinner, the participants enjoyed decadent food and wine while viewing pictures taken during the day as well as enjoying the company of fellow players. Players were able to partake in a wine wall raffle, an auction as well as go in the running to win a two and half hour yacht cruise. As the players waited in anticipation, Good Dharma was announced as the winning team! Carol Wittenbaker, director of Good Dharma, played her first full 18 holes on the day, and to her surprise scored a Birdie in the competition along with winning one of the Nearest to Pins awards.

As the evening came to a draw, it was clear this year’s Abbot Solutions Golf Classic was a spectacular success. Many thanks to Tony McDowell and Abbot Solutions, for sponsoring this event for the fourth year in a row. A huge thank you to the sponsors of the day; Mal Atwell Leisure Group, Good Dharma, Wood Brothers Mazda, Pit Crew Consulting Management, and Marketing Mix. Also, the generosity of the following supporters is greatly appreciated; Metropress, JLT, Sebel Mandurah, Alliance Insurance, Swings & Roundabouts, Howard Park Winery, Arimia, De Bortoli Wines, Ferngrove Wines, Djurra Salon & Spa, Marriwood park, Barwick Wines, Madfish Wines and Chalice Bridge Estate.


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Arthritis and Osteoporosis

Youth

Camp Freedom 2012 by Kerry Mace

Wow what a camp, we had the best time ever.

Our camp began with 31 campers and 9 leaders meeting at the Arthritis Foundation for the bus journey to Forrest Edge Lodge in Waroona, along the way new friendships were started and old friendships renewed. Many campers don’t see each other from one camp to another as they come from far and wide, from Bunbury to Darwin. Arrival at camp had us meeting Brooke, our activities coordinator for the week, we didn’t know what to expect from the camp as we had never been there before, what a week we had. Abseiling, Flying Fox, Rafting, Kayaking, Target shooting, Screen printing and who can forget the Incentive course with the mud fight at the end. Personal goals were met and smashed. Our outing this year was a trip on the Hotham Valley Railway Steam train, we had a relaxing trip through the forest around Manjimup, with a little drama thrown in at the end. It started to rain, the track became slippery and we couldn’t go forward, eventually we arrived back in Manjimup for a picnic lunch before heading back to camp.

Our education sessions were again presented by Debbie our Rheumatology Nurse from PMH and Ben from Perth North Medicare Local presenting the Me Managing Me programme, a self management course designed for kids. Camp would not happen without the support of Lotterywest, who supply our funding, so a very big thankyou from everyone and our wonderful volunteer leaders, who give up their time to spend the week with our campers. Thank you to Gloria, Anne P, Ann S, Tim, Erik and Pavla, without you guys we wouldn’t have a camp, look forward to seeing you all again. Planning for camp 2013 has already commenced, put these dates in your diary Monday 30th September to Friday 4th October, the campsite will be confirmed soon, keep a watch on our website for the location.

I enjoyed being able to do fun activities. It was great to make new friends and even share with people along the way. 18


If you would like information on the 2013 Camp Freedom, held during October School holidays email jiacamp@arthritiswa.org.au

I like Camp Freedom, you can share everything without people laughing and teasing.

At my first camp I learnt that there are many other people like me.

Arthritis Today | AUTUMN 2013

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Arthritis and Osteoporosis

Youth

New Bones and Joints School The objective of Arthritis and Osteoporosis WA is to reduce the incidence and disabling effects of arthritis, osteoporosis and other related conditions in the people of WA. It is a well-known saying, “prevention is better than a cure”, so therefore it makes sense to target our young people with the knowledge required to develop lifelong healthy habits and prevent the onset of particular diseases. There are several key areas of focus in the prevention of some chronic diseases and there is a module dedicated to each of these areas;

prevention is better than a cure

Food

Growth

Injury Prevention and Management

Joints

Skeleton

Teeth

Juvenile Idiopathic Arthritis

Telethon is funding the development and implementation of a website to complement the current Arthritis and Osteoporosis WA website. It will focus on assisting families and students to

learn more about appropriate nutrition and exercise to avoid long term damage to their bodies. Teachers are also targeted with the provision of teaching materials. In the ‘Teachers’ section, there will be a dedicated portal whereby teachers can access lesson plans meeting Australian Curriculum standards and myriad of links to resources from the Foundation Year to Year 10. We will be providing professional development sessions for teachers and visiting schools to promote the use of this exciting learning package! The ‘Students’ section will contain detailed information and links with interactive websites to pique their interest! There will also be some revision sheets to support their class work. In the ‘Families’ section, you will find fun and interesting practical information and activities suitable for the whole family to enjoy, whilst learning to maintain optimal health and well-being. We are currently in the throes of creating the website so watch this space for its exciting launch around May!

JIA Parents Support Group Arthritis & Osteoporosis WA has long recognised the need for a support group for parents of children with juvenile arthritis and bone disease. After discussions with some of the parents, particularly those whose children are too young to attend the JIA camp, an initial meeting was organised in October. As a result of the meeting it was decided that the group would meet monthly to share information and resources and invite

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guest speakers to talk on various topics at future meetings.

Next meeting: Tuesday 26th March 2013, 7.30 – 9pm @ Wyllie Arthritis Centre, Shenton Park. RSVP on 9388 2199 or email general@arthritiswa.org.au or book online www.arthritiswa.org.au/events


Our volunteer Telephone Advisors provide an invaluable service for Arthritis and Osteoporosis WA. If you have queries about specific conditions, support services, courses, or genuine concerns about your conditions, the advisors can point you in the right direction. The advisors will provide you with up-to-date information and details of the services we provide and send out fact sheets and pamphlets to inform you about conditions such as Arthritis, Osteoporosis and related conditions.

Hours are either a morning or afternoon, Monday to Friday between 10am and 4pm. We aim to respond to your query as soon as possible because your questions and queries are important to us. However if we are busy with another phone call or our volunteer is not available at that particular time, please leave a short detailed message and we will get back to you within 24 hours. It is a free service to assist you in making informed and educated decisions about your condition.

Support Services

Telephone Advisory Line

Wyllie Arthritis Centre’s Second Hand Book Shop Many thanks for all those people who have supported our second book shop since it started either by donating books for selling or buying books. A big thank you to Patricia our volunteer “book lady”

for organsing the books every week. You might be interested to know that last year we raised over $1,500! If you have any second hand books in good condition and relatively new which you do not want, please

bring them in or if you are in need of a good read and are in the area, come along and check out what is on offer.

Social Lines Do you have arthritis which sometimes limits your social interaction? Perhaps you would like to make a new friend, a volunteer from Arthritis & Osteoporosis WA who will telephone you on a regular basis at a time mutually agreed upon.

He who asks a question is a fool for five minutes; he who does not ask a question remains a fool forever. - Chinese proverb

If you want to talk about a hobby, a recent activity, your family or even have a grumble, they are there for you. If you are interested in being part of the Social Lines Program or know of someone who might, please call us on 9388 2199 or email general@ arthritiswa.org.au

Arthritis Today | AUTUMN 2013

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Volunteers

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One of the most vital ingredients that contribute to the success of Arthritis & Osteoporosis WA are our volunteers. Volunteers are the backbone of our organisation because of their commitment, energy and enthusiasm, and we are very fortunate to have such a great bunch of people volunteering for us.

Volunteer Positions Available At the moment we are looking for volunteers for two positions –a Gardener and a Social Lines Volunteer.

a hobby, a recent activity, their family etc. Calls are made from the volunteer’s home.

Gardening Volunteer would be assisting our handyman with general gardening duties – mainly weeding, pruning and general tidying on either one morning or afternoon a week. Social Lines Volunteers are linked up to a person in the community who has arthritis and finds it difficult to get out and about to meet people. The volunteer chats to them every week or fortnight on the phone about anything they want to talk about –could be

All volunteers receive training both formal and informal, ongoing support, volunteer reimbursement, and are covered by insurance. If you are interested in either of the positions and would like to be part of our team, please call Margaret on 9388 2199 for further details.

“Don’t ever question the value of volunteers. Noah’s Ark was built by volunteers; the Titanic was built by professionals” – Unknown

.

Volunteers’ Christmas Lunch The Volunteers Christmas Lunch was held at the beginning of December to thank all our wonderful volunteers and to wish them a very happy Christmas. Irene Froyland, AOWA’s vice president thanked all the attendees for their hard work and support throughout the year. Everyone sat down to enjoy a traditional Christmas

buffet lunch from The Lame Duck Café. During courses, entertainment was provided by Men in Harmony – fifteen gentlemen singing a wide range of popular songs in barbershop style. This was greatly enjoyed by both staff and volunteers, with many singing along.


By Melanie Browne Tai chi is a martial art which originated in ancient China and is today practised by millions throughout the world for health and relaxation. There are many styles of tai chi, with each style having its own defining characteristics. The 5 main styles include Chen, Yang, Wu, Hao and Sun. If you have arthritis or osteoporosis it is a good idea to choose a style of tai chi and a class which is suitable for you. At Arthritis & Osteoporosis WA we support Dr Lam’s Tai Chi for Health programs. Dr Lam, a physician and tai chi expert, worked with a team of tai chi and medical specialists to create the Tai Chi for Arthritis program, a program which studies have shown is safe and effective for people with arthritis. It is based on the Sun style of tai chi which includes a large qigong (energy cultivation) component which is beneficial for relaxation and healing. Tai Chi for Arthritis strengthens muscles and improves balance thereby helping to prevent falls. It increases flexibility,

strengthens muscles... improves balance... increases flexibility... promotes relaxation... promotes general wellbeing... improves cardiovascular fitness...

improves cardiovascular fitness and promotes relaxation and general wellbeing. In the second half of 2013 we will be introducing a specific tai chi program for people with osteoporosis. Dr Lam’s Tai Chi for Osteoporosis program is based on the Sun and Yang styles of tai chi and has been designed to help strengthen bones, improve balance, prevent falls and improve overall quality of life.

Health & Lifestyle

Exercise Tai Chi for Arthritis & Tai Chi for Osteoporosis

Arthritis & Osteoporosis WA’s aim is to make Tai Chi for Health classes widely accessible throughout Perth and Western Australia. To help achieve this aim Arthritis & Osteoporosis WA will be hosting Tai Chi for Arthritis and Tai Chi for Osteoporosis instructor training workshops for people with a tai chi or health background who are interested in becoming Tai Chi for Health practitioners.

This program (Tai Chi for Arthritis) accommodated my joint pain and stiffness. It raised my self-esteem and helped me to relax and focus so that for the hour, I left my busy life behind. It became a form of meditation as well as exercise.’’ Arthritis Today | AUTUMN 2013

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Health & Lifestyle

Pain, Depression & Fatigue: What Is The Connection? By Dr John Quintner Both psychological and physical People experiencing stressors (such as infection, tissue chronic pain often wake damage, low blood sugar and up feeling exhausted. blood loss) can unleash a stress They are also more likely response. to experience low mood. Stress and the HPA axis Conventional teaching has The hypothalamo-pituitary-adrenal long held that pain causes (HPA) axis can be activated by both these complaints. stressors. This axis prepares us to fight, flee or freeze when we But when you think are confronted by threats to our about it, pain is a lived existence. experience, as are Certain hormones, such as depression and fatigue. corticotrophin releasing hormone So could they all be (CRH) and arginine vasopressin (AVP), and substances such as different manifestations those involved in inflammation, of persistently activated are involved in HPA axis stress response systems activation. and disruption of The HPA axis response to stress biological rhythms? is highly variable, according

About stress Stress can be defined as “any actual or perceived threat to a person’s state of well-being and homeostasis” (a process whereby the body maintains a state of equilibrium). Activation of stress response systems improves the chances of our survival when we are threatened. This is achieved by the integration between complex systems located in the brain and signals from various parts of the body.

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pain

to age, sex, prenatal and natal programming, genetic background, and even ethnicity. Stressors cause a rapid increase in c-fos (an early gene product produced by nerve cells) followed by activation of other genes, such as those that trigger increased production of stress hormones. As a result, cortisol is produced in excessive amounts by the adrenal glands to help us cope with the stressor. After a stressful event (physical and/or psychological), enhanced

is a lived experience...

activity of the HPA axis may be observed as long as 24 hours after the last stress exposure.

Circadian rhythm Many aspects of our behaviour and physiology show circadian rhythm, including sleep, physical activity, alertness, hormone levels, body temperature, immune function, and digestive activity. Light cues the body to produce cortisol, serotonin, melatonin and other hormones and neurotransmitters which are responsible for controlling the normal circadian rhythm of these various physiological processes. Animals under chronic stress have a markedly altered regulation of the circadian rhythms. Their circadian rhythm can be flattened or lost. When we are under stress, the circadian rhythm (a daily cycle of biological activity) of our HPA axis is most affected. The normal rhythm of secretion of these substances appears to be disturbed in patients with Fibromyalgia Syndrome (FMS) and it is not surprising that many of the symptoms (e.g. difficulty in sleeping, fatigue, malaise, muscle aching, gastrointestinal disturbance and problems with thinking) are similar to


those observed in individuals whose circadian pacemaker can be abnormally disrupted by lack of sleep or extreme jet lag.

Chronotypes All humans are entrained (i.e. synchronised) to environmental time; that is, we are awake in one interval of the 24 hour day and asleep in the other. The evolutionary value of entrainment allows for optimal performance at the right time of day, because being able to anticipate future tasks gives rise to the most appropriate physiological and psychological preparation. However, our state of entrainment varies dramatically between individuals. These are the so-called “chronotypes”. Early chronotypes or “larks”, who rise early and go to bed early, fit better into society’s norms than late chronotypes or “owls”. Entrainment can have its disadvantages, since our modern society often imposes deviations from the regular work-rest scheme, as in shift work. Failure to adapt to environmental and sociological-societal pressures leads to misalignment of our internal biological clock. This ‘dys-entrainment’ comes with enhanced risk of errors and accidents, loss of productivity, and health risks (increased propensity for cancer, depression, sleep disturbances,

gastrointestinal and cardiovascular disorders, decreased immune responses and life span).

Fibromyalgia syndrome and chronotype A very detailed online survey of 1548 individuals with FMS suggested those with a late chronotype (“owls”) rate their symptoms as more severe than those with the early chronotype (“larks”). But the study did not answer the “chicken and egg” question – whether the “owls” are more susceptible to developing the symptoms or whether the symptoms do in fact challenge sleep quality.

HPA axis function in Fibromyalgia syndrome The pattern of basal circadian rhythm of HPA axis hormones has been found to differ between patients with FMS and those with chronic fatigue syndrome (CFS) compared to their matched control groups. The former group tended to have raised evening cortisol levels whereas those with CFS tended to have depressed early morning cortisol levels. Thus in both groups there was evidence of dysfunction of the HPA axis but the differences between them were rather subtle.

Investigators have postulated a loss of HPA axis resiliency in patients with FMS consistent with the hypothesis of “wear and tear” related to lifelong exposure to stress.

Leptin and fibromyalgia? Leptin is a hormone released by fat cells that is important in regulating both our appetite and metabolism. It inhibits HPA activity during stressful situations by reducing CRH release. Low leptin levels have been found in patients with anorexia nervosa and in highly trained athletes. Leptin resistance appears to be an important factor in obesity. Eating too much fructose can result in leptin resistance. The “Leptin diet” has been promoted for patients with FMS. However, levels of leptin in patients with FMS do not appear to differ from those in control subjects. Furthermore, after 3 months of treatment, leptin levels did not change significantly. Whether there is any benefit to those with FMS who follow such a diet remains to be determined.

Conclusion

maintaining our circadian rhythms must be given a high priority item for our good health and well-being.

Unraveling the connections between fatigue, mood and pain is proving to be an intriguing but very complex task that requires an overall understanding of how we have evolved to cope with life stressors. It is not possible to properly answer the question posed at the beginning of this article. However, maintaining our circadian rhythms must be given a high priority item for our good health and well-being.

Arthritis Today | AUTUMN 2013

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Health & Lifestyle

LEMONY CAKE Recipe The basis is similar to a sponge cake but all ingredients are mixed together at once and as an alternative filling to butter icing or jam, I use homemade lemon curd. Both the cake and filling are quick and easy – the sort of cooking I like!

Cake Ingredients

I don’t often make cakes but if called upon to do so, this is the one I always make which never fails to keep my friends happy!

1 tablespoon lemon juice 175 g (6 oz) sifted self-raising flour 1 level teaspoon baking powder 175 g (6 oz) butter at room temperature 175 g (6 oz) caster sugar 3 large eggs

Lemon Curd Filling Ingredients 250g (1 cup) white sugar 3 eggs Finely grated rind and juice of 3 lemons 125g unsalted butter, melted METHOD

1. In a microwave-safe bowl, whisk

METHOD

together the sugar and eggs until smooth. Stir in lemon juice, lemon rind and butter.

a large bowl and mix together using an electric whisk until smooth and creamy.

minute intervals, stirring after each minute until the mixture is thick enough to coat the back of a metal spoon.

non-stick 22cm tin.

Remove from the microwave, and pour into small sterile jars.

1. Preheat the oven to 180 degrees C 2. Measure all the ingredients into 2. Cook in the microwave for one 3. Pour the mixture into a greased 4.

Place in the oven for 25-35 minutes (until the cake feels springy to touch).

5. Turn out of the tin and cool on a

wire rack.

3.

4. Cut the cake in half when cool and spread with the lemon curd. Dust the top of the cake with icing sugar.

5. The lemon curd can be stored in the fridge unopened for 3 weeks.

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This 6 week program is specifically for people with diagnosed rheumatoid, psoriatic or seronegative inflammatory arthritis. It offers a holistic approach providing disease specific

education and self-management techniques and is run by health professionals.

When: 1:00pm – 3:30pm Where: Thornlie Public Library Cost: $30 per person or $35 For you plus Partner/Carer. Book: call 9388 2199 or online at arthritiswa.org.au/events

Sat 9 Mar Pain Explained – Talk Two A discussion series for the benefit of people in pain. Presented by Melanie Galbraith, Senior Physiotherapist, and John Quintner, Rheumatologist and Pain Physician. In this discussion Melanie will demonstrate that everyone CAN exercise when they are shown how to do it. Practical teaching will be the order of the day. Wear comfortable clothing and footwear.

John worked as a rheumatologist during the epidemic of pain in Australia known as “RSI” (Repetitive Strain Injury). He gained first-hand experience of the stigma then attached to sufferers of the condition and to the doctors who tried to help them. John will explore the process of stigmatization of chronic pain sufferers by looking through the window of the “RSI” phenomenon.

Morning tea provided. When: 10:00am – 12:00pm Where: Wyllie Arthritis Centre, Shenton Park Cost: $10 per person Book: call 9388 2199 or online at arthritiswa.org.au/events

Upcoming Events

Thu 7 Mar Inflammatory Arthritis Education & Self-Management Program

Fri 15 Mar Multicultural Health Festival 2013 Come visit the AOWA stall at the Multicultural Health Fest. Celebrating the Culture, Health and Diversity of Western Australia, the Multicultural Services Centre of WA Inc. will host a vibrant Multicultural HealthFest 2013. The HealthFest is one of the initiatives of the Swap It, Don’t

Stop It campaign, aimed to raise awareness about lifestyle related chronic diseases and promote healthy lifestyle behaviours among Western Australians from diverse cultural backgrounds. When: 9:00am – 4:00pm Where: The RISE, 28 Eighth Avenue, Maylands

17 Mar – 23 Mar

Sat 23 Mar Scleroderma Seminar A number of specialist speakers will cover the management of Scleroderma, information on respiratory and digestive tract involvement and lab test results. We are also pleased to have the President of Scleroderma Australia join us. This seminar will be of interest to people with scleroderma, crest syndrome and pulmonary

Arthritis Awareness Week

hypertension. When: 10:30am - 3pm, (10.15am registration) Where: Wyllie Arthritis Centre, Shenton Park Cost: $10 per person, includes light lunch and tea and coffee. Bookings essential, call 9388 2199 or online at arthritiswa.org.au/ events

Arthritis Today | AUTUMN 2013

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Upcoming Events

Tues 26 Mar JIA Parent Get-Together Arthritis & Osteoporosis WA has started up a social group for parents of children with juvenile arthritis and bone disease. If you would like to meet other parents in a similar situation to chat and share information then come to the meeting this March.

When: 7.30pm – 9:00pm Where: Wyllie Arthritis Centre, Shenton Park Cost: FREE RSVP: call 9388 2199 or email general@arthritiswa.org.au

Thurs 28 Mar Perth Wide Blue Illusion Fundraiser We would like to invite all ladies to come along and view the Autumn collection by Blue Illusion at this free event, to be held at each of the Blue Illusions Stores in the Perth region. Each lady attending will receive sparkling wine and nibbles while enjoying the fashion show. 20% of all sales on the day will be donated to Arthritis & Osteoporosis WA. Ladies who purchase items will also receive a goodie bag and Blue Illusion

discount voucher. The event will be hosted at each the following stores – Claremont Quarter, Garden City Shopping Centre, Cottesloe, Karrinyup Shopping Centre, Subiaco and Westfield Whitford City. When: 12pm until 3pm at each store. To RSVP your attendance call 9388 2199 or visit www. arthritiswa.org.au/events

Tue 2 Apr Ankylosing Spondylitis Education & Self-Management Research Program This 7 week research program is specifically for people with diagnosed Ankylosing Spondylitis (AS). It offers a holistic approach providing disease specific education and self-management techniques and is run by health professionals.

When: 6:00pm - 8:30pm Where: Wyllie Arthritis Centre Cost: FREE Bookings Essential: call 9388 2199 or online www.arthritiswa.org.au/ events

Thu 4 Apr Nordic Pole Walking Instruction 5 week Nordic Pole Walking lessons. Nordic Walking is a fun and easy form of fitness using light weight poles that allows a total body workout without the feeling of greater exertion. Great exercise for anyone, including people with arthritis or osteoporosis.

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Participants should be able to walk at least 500m unaided. When: 9.30am – 10:30am Where: Kings Park Cost: $60 per person Register: call 9388 4404 or online at www.arthritiswa.org.au/events

Sun 5 May Fremantle International Portrait Prize Competition Opening Enter your photographic portraits into this year’s portrait prize to win $5000 and other great prizes. The online entries portal will open from Noon, Western Australian Standard Time (GMT +8 hours) until 8 July 2013. All proceeds from the Competition go to Arthritis & Osteoporosis WA. For more information visit www. fremantleportraitprize.org.au

Sun 26 May HBF run for a Reason There are many reasons people choose to run, jog or walk in this event. This year Arthritis & Osteoporosis WA staff will be taking part in the event – because WE CAN. Don’t let bone and joint conditions take over your life. Take control – because YOU CAN. If you can walk, jog or run, come join us in the challenge, while raising awareness and vital funds for Arthritis & Osteoporosis WA. For more information call Amy on 9388 2199 or Register online www. hbfrun.com.au


Writing a Will Suggested wording when leaving a bequest to arthritis and osteoporosis in your will Bequests are a powerful and effective way to support Arthritis & Osteoporosis WA with little or no impact on your lifestyle today. A bequest is simple to arrange, allows you to retain your assets throughout your lifetime, whilst also ensuring your loved ones and friends are taken care of when you are no longer here. Since 1973 Arthritis and Osteoporosis WA has been serving the community, funding research and helping those affected by Arthritis and Osteoporosis. Bequests are a vital source of our income and allow us to not only continue our services but to continue to fund research in the hope that one day something can be done to help those affected by this debilitating disease.

Suggested wording and types of bequests:

Specific bequest (particular thing/property)

Residuary bequest (part of leftover estate)

I give, devise and bequeath to Arthritis Foundation of WA Incorporated free from all duties, the following item/s and direct that the receipt of the Executive Director for the time being will be a sufficient discharge to my trustees:....... (description of items)...

I give, devise and bequeath to Arthritis Foundation of WA Incorporated free from all duties, (nominate percentage or fractional share) of my residuary estate (OR) the remainder of my residuary estate and direct that the receipt of the Executive Director for the time being will be a sufficient discharge to my trustees.

Pecuniary bequest (particular sum of money) I give devise and bequeath to Arthritis Foundation of WA Incorporated free from all duties, the sum of $______ and direct that the receipt of the Executive Director for the time being will be a sufficient discharge to my trustees.

All bequests to Arthritis & Osteoporosis are treated in a confidential matter. For further information or for a confidential chat please call Ric Forlano on 9388-4411 (direct line).

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✂ Simply make a donation to help offset our printing costs, and we’ll deliver your own copy, three times per year. We pride ourselves in delivering services for the many thousands who daily, struggle with the trauma and limitations imposed on them by musculoskeletal diseases. Services include access to our specialist bookshop, courses on arthritis and osteoporosis and use of our exercise and hydrotherapy facilities. Education is just one aspect of our work as is our ongoing funding of vital research. If you can assist us by making a donation, we will be most grateful. Whether it’s to find a cure or to simply make living with arthritis or osteoporosis a little easier, we know we will do better if we had your support too. All donors receive receive a years subscription to “Arthritis Today”, our magazine filled with up-to-date information about arthritis and osteoporosis, as well as news on our regular presentations and events. Thank you sincerely, Ric Forlano Executive Director

To help offset some of the costs Arthritis & Osteoporosis WA incurs and to receive a years subscription to Arthritis Today, here is my contribution of: $20

$30

Cash

$40

Cheque

Mastercard

Exp. Date:

Rural Rheumatology Clinics Established since 1974, the Rural Clinic Program aims to provide early diagnosis and specialist treatment to patients of Regional WA. A doctor’s referral is needed when making an appointment. Please call Arthritis WA for further information regarding each clinic area.

Toll free 1800 011 041

MAR- JUNE 2013 ALBANY

NARROGIN

March, April, May, June. Clinic held every mth.

May Clinic held every 3 mths.

BRIDGETOWN

NORTHAM

March Clinic held every 4 mths

March, May Clinic held bi-monthly

GERALDTON

PORT HEDLAND

March, May, June Clinic held every mth.

April Clinic held every 6 mths.

KALGOORLIE

BUNBURY & DUNSBOROUGH

$50 or $

OR, please charge my gift to my credit card: Visa

Country Rheumatology

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Want Arthritis Today delivered to your door?

Amex

/

March, April, May, June. Clinic held every mth.

Name on card:

KARRATHA

Signature

April Clinic held every 6 mths.

Mr/Mrs/Ms/Miss:

MANJIMUP

Address:

Phone: Email: PLEASE SEND TO: PO Box 34, Wembley, WA 6913

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March Clinic held every 4 mths

Private Clinics - contact Specialist Rooms in Perth for clinic dates.


Groups held at the Wyllie Arthritis Centre 17 Lemnos Street, Shenton Park Inflammatory Arthritis (IA) Support Group

Evening Inflammatory Arthritis Social Group- for those of working age

Meets 1st Tuesday of the month 10:30am – 12noon. Wyllie Arthritis Centre. Dates: 5 Mar, 2 Apr, 7 May, 4 Jun. (meets @10am if talk organised).

Meets 3rd and 4th Wednesday of the month from 7pm - 9pm. 3rd Wed (North) Mille Café, Inglewood. Dates: 20 Mar, 17 Apr, 15 May, 19 Jun. 4th Wed (South) Fremantle area, call for details. Dates: 27 Mar, 24 Apr, 22 May, 26 Jun.

Joint Replacement Group

For more information about attending a support group, please call Arthritis & Osteoporosis WA on (08) 9388 2199 or email clarac@ arthritiswa.org.au Talks are sometimes held during support group meetings. For details of talk topics and dates, please see page 27 and 28.

Meets quarterly on a Friday, 11am–12:30pm. Dates: 24 May, 23 Aug, 22 Nov 2013 JIA Parents Group A newly formed group for parents of children who have arthritis. Meets monthly from 7pm - 8:30pm. Next meeting: Tues 26 Mar, Apr - Jun dates TBA, call for details.

Suburban & Regional Groups / Branches Ankylosing Spondylitis Exercise Group

Mandurah Scleroderma Support Group Meets quarterly on the 3rd Tuesday, 10am-12 noon, Eastlake Church, 99 Lakes Rd, Mandurah. Dates: 21 May, 20 Aug, 19 Nov 2013

Support Groups

Arthritis & Osteoporosis WA has a number of support groups which are led by a trained volunteer leader. If you would like the opportunity to talk freely about your experiences and feelings in a safe, nonjudgemental environment; share helpful hints and practical tips; receive and give encouragement and support – why not come along to one of our groups?

Albany Branch Meets 4th Wednesday of the month, 1pm–1:45pm, Resource Centre, Lotteries House, 211 North Road, Albany. Dates: 27 Mar, 24 Apr, 22 May, 26 Jun Bassendean Arthritis Group

Meets every Monday evening for hydrotherapy and gym exercise program at RPH, Shenton Park.

Meets every Tuesday for gentle exercise, 1:30pm - 2:30pm. Bassendean Community Centre (Main Hall), 48 Old Perth Road

THURSDAY 28TH MARCH, 12PM-3PM FREE ENTRY

Join us at any of the above stores to see the new collection and enjoy drinks and nibbles!

20% OF PROCEEDS WILL BE GIVEN TO SUPPORT ARTHRITIS & OSTEOPOROSIS WA

RSVP ONLINE AT www.arthritiswa.org.au/events or CALL (08) 9388 2199

Arthritis Today | AUTUMN 2013

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In 2012, photographers just like you, from 22 countries, entered 696 images in the inaugural Fremantle Portrait Prize award

CAMERA ! ACTION ! ... KAA-CHHING ! your family snapshot or artistic pose could be worth its weight in gold Be part of the ...

FREMANTLE iNTERNATIONAL PORTRAIT PRIZE 2013

ENTRIES OPEN 5 MAy 2013 www.fremantleportraitprize.org.au

All proceeds to Arthritis & Osteoporosis WA AOWA A4 Feb 2013b.indd 1

Photograph by Bill Gekas

$5,000

05/02/2013 04:29:56 PM


Arthritis Today Autumn 2013