Question
QUESTION: Hello Dr. Durin.

I have just been diangosed with osteo or infamatory arthritis, pending further tests to determin which. I am loaded with it in both hands, ankles and feet. I also have notable signs of atrophy. I am 10 months out of chemo for breast cancer. I am 47 years old. My pains became very bad since the end of chemo and for a time it was thought that taxol was the cause of nerve pain, but as it rapidly got worse to the point I can not walk far or have full use of my hands a bone scan was done and the arthritis was discovered. My Dr is surprised at the rapid decline as he says that it generaly developes over time. As yet no treatment is being given until the results of the further tests. I am really hoping for the inflammatory type as that just sounds more easily treatable and less permanent. According to my research online, following chemo, as the cells regroup and try to return to normal, the body becomes confused as to what is normal and begins to fight itseld...thus the developement of inflammatory arthritis. Is this true?
I am really tired of being down. Just before the cancer I was being treated for multiple lumbar disk herniations and bi-lateral rotator cuff tears. Now this. I would like to know what questions to ask my dr and be better informed as to healthy treatment options. Any direction you can point me to would be VERY appreciated.
Much thanks for your time...Lisa

ANSWER: Hi Lori,

Well this revelation sure clears things up. The blood work I wanted finally was performed, this should have been performed along time ago. No secret to what is causing rapid destruction of your joints either, the medication. Have your doctor try changing it to a generic equivalent since new drugs tend to be notorious for complications that are too late to treat or reverse, add to that, they are rarely improved.

Inflammatory arthritis in most cases is difficult to treat where osteoarthritis is reversible or at least can be stopped with glucosamine sulfate. If the blood work I recommended was drawn, there would be little doubt on cause being either inflammatory of Osteo. A simple CRP would show this.
You have to ask yourself if the cancer is controlled and/or in remission so you can weigh if the cure is worse than the side effects at this point. How far out are you from the original diagnosis of cancer? It was earlier assumed that these simple blood tests were performed and systemic causes were ruled out for arthritis, apparently not.
I would get another opinion and possible modification on your meds since this is likely the cause, especially at your age.
Bilateral rotator cuff tears often require surgery if bad enough, lets hope yours is minimal.
Thank you for keeping me updated and I will continue to monitor progress, and with your permission, continue to supervise your treatment.
Thanks for keeping me in the loop, I will continue to watch for anything that doesn't add up.

Also, Google the meds you are on and pay particular attention to side effects, you may be alarmed.

The Medrol Dose pack is obviously contraindicated now since you revealed Hx of cancer, so NSAIDS are OK.

Good Luck on your recovery!

Dr. Timothy Durnin
drs.chiroweb.com

---------- FOLLOW-UP ----------

QUESTION: Dr Durnin,
Thank you for your quick response.
My Test results today showed that there is no inflammation, therefore I have straight up osterarthritis. I do not see my Dr again until next month. Thus far I have a huge bottle of darvocet that I am loath to take. I can't believe I am now left hanging until then.
In the meantime, I am doing stretching with my hands and fingers in an attemp to lessen the atrophy. Will this help?
I have recently stopped taking lyrica...which may or may not account for the swelling in my hands and feet. I am currently taking arimidex and multi=vitamins. At night I take ambien cr. During the day I take norco as needed...this for my back. The darvocet is for nightime use as needed.
Re the rotator cuff tears...I had surgery in one shoulder. Both still bother me from time to time. More frequently my back still pains me as does the accompaning sciatica. All of this however is very tolerable compared to the arthritic pain in my hands feet and ankles. More advice???
Lisa and again...thanks for your time.

Answer
Ok Lisa,

Good news so far,

OA is stoppable and reversible with glucosamine sulfate and MSM, did you look it up?

I doubt atrophy is a concern in the hands, exercising them may aggravate the hands by creating inflammation.

Best bet would be to get them(hands and shoulder) some therapeutic ultrasound treatment underwater in combination with GS (glucosamine). Also getting ultrasound to your shoulder will help increase blood supply therefore speeding up healing. I suspect the meds are causing most of your problems, not the Norco or Ambien but the one you stopped. Check the PDR on Lyrica to make sure it is OK.

Find a physician with F/D tables! I can't stress that enough since you have a history of herniated discs, then you can throw out the Norco which will eventually cause addiction and liver damage.

Let me know of any updates, thank you for your kind comments.:)

Dr. Timothy Durnin