Treating sore joints

Various methods help both rheumatoid arthritis and osteoarthritis

Monday, August 02, 2004

For years, Mel Oliver suffered knee pain caused by osteoarthritis.

On July 12, that began to change when the 69-year-old Bowling Green man had a partial right knee replacement, called unicompartmental knee arthroplasty, at Jewish Hospital Medical Center East in Louisville.

Before the surgery I could probably walk 75 or 100 feet and (have) to get off of it, Oliver said.

On Wednesday, Oliver said he can now walk 100 or 150 feet with no trouble at all, and expects to be back to normal soon.

But he knows feeling great will take some work.

Hes learned that from The Medical Center Home Care physical therapist assistant Derek Lehman, who taught Oliver exercises after surgery, and Brian Eppolito, a physical therapist at Bluegrass Outpatient Center, where Oliver began therapy Wednesday.

I know as long as I do this, the quicker Ill be back to normal, without all the pain killers and Vioxxes and stuff to keep (down) inflammation and stuff, Oliver said as he peddled a stationary bicycle under Eppolitos supervision.

Eppolito said exercise is important when it comes to treating both osteoarthritis and rheumatoid arthritis.

Dr. Asad Fraser, a rheumatologist who treats arthritic patients at Graves-Gilbert Clinic, said its possible to have both osteoarthritis and rheumatoid arthritis at the same time.

Osteoarthritis affects 16 million adults in the United States, Fraser said. It comes with the normal aging process wear and tear on the joints and is confined to the joints.

When you get up you can feel it, in a knee, for example, Fraser said.

Rheumatoid arthritis affects 2.4 million Americans.

Your body reacts to your immune system and causes this disease, Fraser said.

Rheumatoid arthritis causes joints to be red, hot and swollen, with a lot of stiffness, but can also affect other parts of the body, including the eyes, lungs and blood vessels, Fraser said.

Not exercising because of either type of arthritis pain can cause joints to become more stiff and painful, according to Eppolito. This can then lead to less mobility and a decreased quality of life.

Its a chain reaction, he said.

Eppolito and Fraser said aquatic exercises are great for arthritis.

In the water, youre using a lot of joints and muscle, but not putting much pressure on them, Fraser said.

At Bluegrass Outpatient, patients can swim in place in a small pool that has a current.

But there are other treatments for both kinds of arthritis.

Osteoarthritis is treated with analgesics and inflammatories you can give them a cortisone shot in the joint, Fraser said.

Also, ultrasound and electrical stimulation can be used to treat osteoarthritic patients to alleviate pain so they can exercise more, Eppolito said.

Losing weight can help relieve both osteoarthritis and rheumatoid arthritis.

For each pound you put extra on the body, you put three to five extra pounds of pressure on the weight-bearing joints, Fraser said. So if you lose 10 pounds, you reduce 50 pounds on the joints, and the joints last longer.

For rheumatoid arthritis, disease-modifying antirheumatic drugs can be used to get the disease in remission, Fraser said.

Such drugs include Enbrel and Remicade.

Fraser said its important to seek treatment for arthritis as soon as you think you may have it.

Rheumatoid leads to deformities, he said, adding that studies show the disease needs to be treated aggressively within the first two years of onset.

But its never too late to treat a disease, Fraser said.

He said hes seen a lot of patients improve with treatment.

So has Eppolito, who teaches patients that they must exercise to ease pain, even when he cannot work with them.

Because coming here two to three times a week for approximately one hour and not doing your exercises at home will not benefit you, he said.

Miranda Pederson/Daily News

Physical therapist Brian Eppolito evaluates Mel Oliver at Bluegrass Outpatient Center in Bowling Green during Olivers first visit following knee surgery in Louisville.

FEATURES

Desire to help others longtime feeling for retired nurse

By ALYSSA HARVEY

The Daily News

aharvey@bgdailynews.com/783-3257

Marilyn Clark Decker has enjoyed taking care of people from the time she was a little girl.

I always knew I wanted to be a nurse, she said. When I was a little girl, I had a cigar box with bandages, Band-Aids and methoilate. When anyone would get hurt or was sick, Id say, Let me take care of you. Taking care of other people fascinated me.

For 25 years, Decker who lives in the Grassland-Windyville Community in Edmonson County with her husband, Danny has answered her calling as a public health nurse. Her most recent job was as the Edmonson County Health Department center coordinator, from which she retired Friday.

I have a lot of mixed feelings about retiring, she said, a week before she retired. Im sad to leave people Ive worked with for so long. I really enjoyed working with the kids.

As coordinator, her duties included keeping the staff abreast of policy changes, handling staffing needs, working with program coordinators at the district and state level and working with schools for the health department to provide various screening and immunizations.

At the clinic, she did physicals, immunizations, screenings and treatment for sexually transmitted diseases and worked with the Family Planning Clinic. She also helped bring some of the clinics services to the community.

There were a lot of things going on in the community that would take us outside the clinic. We have a good team working here, she said. Wed do flu shots at businesses and schools and there would be health fairs. There are different activities at different times of the year.

Deckers career as a nurse has provided her with a lot of variety. She got an associates degree in nursing from Western Kentucky University and started out as a licensed practical nurse in 1976 at Greenview Regional Hospital. She began working in public health in 1979 at the Warren County Health Department, where her duties included managing the pediatric clinic and pediatric cardiology clinic, working in the prenatal clinic and giving immunizations and tests for sexually transmitted diseases.

She transferred to the Edmonson County Health Department and became head nurse in 1983. She received a bachelors degree in nursing from Western and became a registered nurse in 1987. She has been center coordinator for the past 10 years.

In retirement, Decker plans to spend time with friends and family, which includes her son, Brian, of the Huff community, and her mother, Daphene Phelps of Roundhill.

Each day I enjoy coming here and I think, Ill have those other days (of retirement) later. Now I want the time and opportunity to enjoy and pursue other interests, she said. Im looking forward to parts of it, but its kind of scary not to know what the future is going to hold.

But she will always hold the memories of people she helped at the health department like the young rape victim who reached out to Decker for a hug, or the preschool boy who felt he needed to pay Decker for her services at the health department, so he reached into his pockets to give her his nickels and pennies. It was cases like those that touched her heart, she said.

It makes everything worthwhile, she said. If I had to do it all again Id still be a public health nurse.

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