“What are you up to this weekend?” “Flying to Guam.” “What? Why?” “I promised an entire island I’d be their doctor.” In fall 2021, Jonathon Thorp, MD, phoned a friend. A passionate internist, he was bound and determined to bring a rheumatologist to Guam. Unlike most primary care providers (PCPs), he was willing to prescribe…
Over the past decade, a number of pilot studies have provided proof of concept for the use of vagus nerve stimulation (VNS) to treat rheumatic conditions. The studies represent an expansion of this treatment approach into rheumatology, building on years of scientific inquiry into the mechanisms of VNS on disease states that led to preclinical…
Granulomatosis with polyangiitis (GPA) is a type of anti-neutrophil cytoplasmic antibody (ANCA) associated small vessel vasculitis that typically affects the kidneys, lungs and sinuses.1 Due to an overlap in signs and symptoms, GPA may initially be difficult to distinguish from IgG4-related disease, another condition that can affect multiple tissues and has variable presentations. Further complicating…
Spam, spam, advertisement, spam … wait wait, what’s this? A small envelope, addressed from Maine. I wonder what this is about? Usually, when I get an envelope this size, it’s a letter from someone trying to sell me something or complain about something I have no control over. So imagine my surprise when I found…
In a small study, an anti-inflammatory diet helped reduce pain and swelling in a subset of people with rheumatoid arthritis (RA). Diet changes are complementary to standard treatment. Diet-related research can be challenging, but many patients with RA are motivated to try healthy changes.
A minority of patients experience lingering symptoms after infection with SARS-CoV-2, similar to some other previously known post-infection syndromes. Although we are just beginning to understand the different presentations, pathophysiology, risk factors, prognosis and treatment of long COVID, rheumatologists can play a leadership role in managing patients with the illness and contributing to this important research…
Research has demonstrated that exercise-based physical therapy is as effective at maintaining knee function as surgery in patients with degenerative meniscal tears at risk of developing knee osteoarthritis.
I have been reading Yuval Harari’s thought-provoking and engaging book, Sapiens: A Brief History of Humankind, about our species’ struggles and the path that led to our emergence as the predominant species. I was captivated by the drawing of the hand of one of our ancestors and mused about what that forebear was thinking as…
A plain X-ray film appeared on the computer screen—a humerus, a radius and an ulna were all visible. My pupils zoomed around the screen, and on initial inspection, everything looked fine. However, this X-ray was unlike any film I had ever reviewed. You see, it was for my then 4-year-old puppy, Lexi. My sweet little…
Rheumatologists are often called upon to see patients with unexplained symptoms and mysterious illnesses and to manage disease, sometimes with a dearth of evidence. Patients in rheumatology practices also tend to explore treatment modalities outside of the established medical model, sometimes referred to as fringe medicine. Complementary and alternative medicine practices that comprise fringe medicine…