Saturday 23 June 2012

TNF blockers


The biologic response modifiers block an immune system protein called tumor necrosis factor, which acts as an inflammatory agent in some types of arthritis. By targeting this protein, TNF blockers can help reduce pain, morning stiffness and swollen joints. Some people experience side effects during or shortly after these drugs are injected, including chest pain, dizziness and difficulty breathing, as well as redness, itching and swelling at the injection site. Additional side effects of biologic response modifiers may include abdominal pain, headache, respiratory infections such as tuberculosis, and other infections. These medications also may increase your risk of demyelinating disorders, conditions that damage the protective covering (myelin sheath) that surrounds nerves in your brain and spinal cord.
TNF-alpha is one of the most important cytokines , through its entanglement in the cascade of inflammatory reactions. TNF blockers bind to TNF-alpha, rendering it inactive, and interfering with 
inflammatory activity, ultimately decreasing joint damage.

What Is Tumor Necrosis Factor (TNF)?

Tumor Necrosis Factor or TNF, is a cytokine which is involved in the inflammatory process. Cytokines are chemical substances which deliver messages between cells in the body.TNF blocker drugs target the effects of tumor necrosis factor-alpha. 
TNF blocker drugs include.

Enbrel (etanercept)

Enbrel (etanercept) is a biologic response modifier (recombinant human soluble tumor necrosis factor receptor fusion protein). Enbrel is genetically engineered to be like the receptors in the body which bind to tumor necrosis factor (TNF-alpha). Enbrel works by soaking up excess TNF before it can attach to natural receptors.TNF-alpha is a cytokine involved in the inflammatory process. Enbrel is given by self-injection under the skin once or twice a week. Many people learn to give their own injections or receive them from a family member who has received proper instruction. A kit is available from the manufacturer that makes drawing up the medicine and injecting it easier. Enbrel may cause irritation at the injection site, which is diminished by applying a cold pack to the injection site prior to injection. Enbrel's effect can also weaken the immune system.

Are There Special Concerns or Contraindications for Enbrel?

Enbrel is not recommended for pregnant or nursing women. Patients with serious infections should not be treated with Enbrel. People prone to infection or those with uncontrolled diabetes should avoid using Enbrel. Patients with conditions of the central nervous system should also avoid Enbrel.
 

Remicade (infliximab)

Remicade (infliximab) is a biologic response modifier, specifically a monoclonal antibody which binds to and blocks tumor necrosis factor alpha (TNF-alpha). Tumor necrosis factor (TNF) alpha is a cytokine involved in the inflammatory process.As with other biologics, treatments may weaken the body's ability to fight infection.

Are There Special Concerns or Contraindications for Remicade?

Remicade is contraindicated in pregnant or nursing women. Remicade should not be given to people with a history of serious infection or people with uncontrolled diabetes. Remicade should not be given to patients with with moderate to severe congestive heart faiure. Also, a tuberculin skin test must precede treatment with Remicade.

HUMIRA (adalimumab)

HUMIRA ("Human Monoclonal Antibody in Rheumatoid Arthritis"). Like infliximab and etanercept, adalimumab binds to TNFα, preventing it from activating TNF receptors. The drug is an injection that can be self-administered

Points to Remember About Humira:

  •    Tell your doctor if you have an active infection.
  •     Tell your doctor if you have been infected with Hepatitis B or are a carrier. Humira has been associated with re-activation of Hepatitis B.
  •     Tell your doctor if you have numbness, tingling, or have had multiple sclerosis or a central     nervous system disorder.
  •     Tell your doctor if you have been treated for heart failure.
  •     Tell your doctor before receiving any vaccines or surgery.

Saturday 16 June 2012

My rocking rafting experience

Hi friends, its me kushagra reporting about my rocking and adventurous trip. I am sure most of you do not know about places RISHIKESH and HARIDWAR . These are religious spots in India with super awesome natural beauty and quite good for adventure sport also like river rafting and bungee jump. Luckily i got the bookings for river rafting. Now you people might be thinking "river rafting for a person with Ankylosing Spondylitis ". Ya you are right ,even i had that thought in my mind that sitting on the raft for so long and that cold water splash would kill me and my back. But ,if you have read my previous articles than you might have presumed that i am a jackass when it comes to taking precautions for AS and wise ass when it comes to defeating AS. So i simply fooled my mind and went for rafting. At first , that scary water rush was freaking me out then slowly i was enjoying that fear. Now here comes the Grade IV rapid . Before i tell you what happened with me in that rapid you must know that i took an idiotic decision to avoid paddling and sit at front without the paddles. I thought it would be less tiring but unfortunately it was more ass kicking. I was sitting at the front and i was the first one to get hit by massive cold wave on from the right and for a moment i was like,what the hell was it ,my helmet almost went of my head. I any how came into senses ,grabbed my helmet and roared like a wild animal and and and and............ jumped into that icy cold dangerous rapid water. Isn't that insane..Even my friends at the raft thought the same. But whats the fun when you don't do something insane .That icy water for freezing my bones and here comes in picture my AS . My waist and backbone started paining a bit but as you know pain does not stop me ever .My friend told me i have to suffer from pain whole week and i told him "" dude this life time experience is worth more than two days of painkillers"" So i continued in water. More then rafting it was a  swimming experience for me. In spite of my AS probs i was in that water for more then an hour till my hands and legs were almost numb because of that cold water. Enjoyed it to the fullest, i just wanna say that AS fear in my mind was useless. It stopped me from doing rafting from so long time but ones i overtook it then it was just most memorable experience. 
After that amazing experience i headed towards the temple on the mountain top. When i first saw the height of that mountain first thing that came in my mind was that "WTF , why work so hard to make temple on mountain,whats wrong on the ground". It was scorching heat and i knew i would give up before reaching the top because AS have made me little weak and very low stamina. But again in spite of all odds i started my journey to the top in scorching heat and with weak spine. In the middle of my way i almost broke down. I just thought in my mind that i am not weak,i decided something and i cannot back out now, no matter what the pace is but i have to complete it. Its not about showing anyone else but it was about me, nothing to prove anyone. But if i do this then at least i wont fear any hurdles in my life ,doesn't matter if i complete it or not. So i just put on my shades and started to walk that concrete road leading to the top. Guess what, i was last but i reached there. The view from the top was super awesome. It was like the gift of achieving the goal. 
Next thing that i did was a cliff jumping and it was another achievement because i have height phobia. Yap my friends i have height phobia also still i jumped off the cliff in water. I just went at the edge and i already knew that if i thought for a second even ,then my legs would freeze.
So, i completely blocked my mind and jumped into water. It was hardly 3 to 4 second journey to water but i almost felt like my heart was going to pop out of my mouth. As i hit the water i almost broke my ass, it was such a rock solid strike. The feel of weightlessness then being into that water and that gush of icy water striking like a rock is simply like living without limits. For a patient of AS the life without limits is a dream. Like i always wanted to. I wish my dream gets fulfilled...........
I consulted my doctor the next day for bungee jumping .. He said that i cannot do it the jerk would harm my backbone .. Now i don't think i have to tell you what i am planning to do next..


 












Friday 8 June 2012

Best Ways to Ease Ankylosing Spondylitis and Happy living



If you’re living with ankylosing spondylitis, you know the back pain and fatigue that are hallmarks of the condition can be unpredictable. But fortunately, there are many approaches — besides simply relying on medications — that you can take to ease spondylitis pain and stiffness and move more freely. Most of these ideas are free or inexpensive, and even enjoyable to boot. You’ll find that the emotional boost you get from taking these steps can be as great as the physical improvement. Here are 10 ways to get started.


Keep Moving

Your best protection against spondylitis pain and stiffness is to keep moving. Inactivity allow your joints to start fusing, which is what you should avoid with ankylosing spondylitis.The type of movement is not as important as the frequency. You need to be doing some type of exercise twice a day. The best exercise is a low-impact type of exercise like walking." Make simple exercise a daily habit, just like brushing your teeth, and you’ll be well on your way to relieving lower back pain.



Make Mornings More Manageable

Like most people with ankylosing spondylitis, your lower back pain and stiffness is worse in the morning.When joints are stationary for a time, the joint fluid actually thickens a bit, like ketchup.Talk to your doctor or physical therapist to create a morning routine of gentle exercises that can lessen  pain.



Correct Poor Posture

Poor posture increases spondylitis pain and stiffness. Minimize lower back pain with what medical experts call “posture training:” Think tall by keeping your head balanced and your back straight at all times, and practice standing with your back against a wall and lying face down on a firm surface. It should be done for about 30 minutes every day, but you can break this time up into 10 sessions,".


Get Physical (Therapy)

After correcting your posture is to follow a more physical therapy program for ankylosing spondylitis relief. We now know that spondylitis also includes an increased risk for osteoporosis and heart disease. That means you can really benefit from a exercise plan that includes aerobic exercise, range of motion , and strength training,” says experts. Besides lower back pain, bone health, and heart health, a program may contain deep breathing exercises to prevent rib cage stiffness.


Hit the Showers

When the fluids in your joints get thick and stiff, spondylitis pain gets worse. A great way to get those fluids moving is to warm them up with a warm bath or shower, which loosens up your muscles.You may also find that doing your posture training for ankylosing spondylitis after a warm bath or shower, when your body is warmed up, is easier.

Stretch Out in Bed

Fatigue is common with ankylosing spondylitis, so you need to get a good night's sleep."You spend most of your resting time in bed, so it is important to sleep as flat and straight as possible when you have ankylosing spondylitis. You also want your head and neck straight, so you should use a small pillow that does not flex your neck,". If you wake up stiff and sore, try starting your morning movement and stretching exercises while you’re still flat on your back.


Take to Water

Exercises that are good for lower back pain and spondylitis on land are usually even better in a pool."Studies consistently show that water exercises are the best types of exercise for spondylitis pain and stiffness,". Researchers found that the most common exercise for people with spondylitis is walking, but the most effective for relieving pain and the most enjoyable is exercising in a pool.

Quit Smoking

If you smoke, you can save yourself from future spondylitis pain and stiffness by quitting now. "Smoking increases pain, and also decreases the benefits of exercise and the effectiveness of medications used to treat ankylosing spondylitis,". Smoking ups the risk for decreased lung expansion in AS. Smokers with ankylosing spondylitis consistently rate their pain, stiffness, and swelling as being worse than non-smokers.






Wednesday 6 June 2012

BEST TIPS TO MAINTAIN A GOOD POSTURE

Over time, poor posture may be caused by habits from everyday activities such as sitting in office chairs, looking at the computer, driving, standing for long periods of time, or even sleeping. Poor posture can easily become second nature, causing or aggravating episodes of back pain and damaging spinal structures. Fortunately, the main factors affecting posture are completely within one’s ability to control and are not difficult to change.

The following guidelines suggest several ways to improve posture and ergonomics, especially for people who work sitting in an office chair for most of the day.

1.  Get up and move. As muscles tire, slumping, and other poor postures become more likely; this in turn puts extra pressure on the neck and back. One way is to take a break from sitting in an office chair every half hour for two minutes in order to stretch, stand, or walk.

2.  Keep the body in alignment while sitting in an office chair and while standing. While sitting in an office chair, take advantage of the chair’s features. Any single position,  even a good one, will be tiring. Leaning forward with a straight back can alternate with sitting back, using the back support of the office chair to ease the work of back muscles.

3. Using purses, bags, and backpacks that are designed to minimize back strain can also influence good posture. Proper corrective eyewear, positioning computer screens to your natural, resting eye position can also help to avoid leaning or straining the neck with the head tilted forward.

4. Being aware of posture at work, at home, and at play is a vital step towards instilling good posture . This includes making conscious connections between back pain and specific situations where poor posture may be the root cause of the pain.

5. Use exercise to help prevent injury and promote good posture. Regular exercise such as walking, swimming, or bicycling will help the body stay aerobically conditioned, while specific strengthening exercises will help the muscles surrounding the back to stay strong. These benefits of exercise promote good posture, which will, in turn, further help to condition muscles and prevent injury.

6. Wear supportive footwear when standing. Avoid regularly wearing high-heeled shoes, which can affect the body’s center of gravity and change the alignment of the entire body, negatively affecting back support and posture.

7. Remember good posture when in motion. Walking, lifting heavy materials, holding a telephone, and typing are all moving activities that require attention. Back injuries are especially common while twisting and/or lifting and often occur because of awkward movement and control of the upper body weight alone.

8.  Avoid overprotecting posture. Remember that it is important to maintain an overall relaxed posture to avoid restricting movements by clenching muscles and adopting an unnatural, stiff posture. For individuals who already have some back pain, it is a natural tendency to try to limit movements to avoid the potential pain associated with movement.

BEST BACK CARE TIPS

It is very important that you take care of your back from the moment you wake up and even after you sleep.Every small effort counts when the health of your back comes into picture.You just have to be conscious of your activities that you do through out the day.

Here are some helpful tips for the activities that are very common in your daily life.I follow these tips to live a happy life with AS
  
1. Exercise regularly. Do not be lazy at this.You must take out time daily for exercise and best time for it is morning hours.You must wake up early according to your schedule and do basic exercises that will help you lead a normal day.

2.Walking and swimming are all excellent ways to strengthen your back muscles.These are low-impact exercises that slowly ends up the stiffness and warms up the body. Swimming greatly strengthens your back muscles.

3. Always bend your knees and your hips, not your back.

4. Never twist and bend your back simultaneously.

5. Always lift and carry objects close to your body. It reduces stress on backbone.

6. Maintain a good posture. Avoid slumping in your chair whenever you sit. It is very important because most of the time we spend sitting on chair.

7. Use a chair with a backrest. Sit with your feet flat on the floor or on a footrest. Change your sitting position regularly.Do a little leg and hand stretching after few hours.

8. Quit smoking. I read somewhere that smoking reduces the blood supply to the discs between the vertebraes.This may lead to degeneration of discs.As i experienced smoking reduces chest expansion.

9.  Lose your excess weight.
  
10. Choose a suitable mattress according to your height, weight, age and sleeping position.Try to use little hard mattress for sleeping.Do not sleep facing your stomach.

11. Do not overload your backpack while you travel.

Sunday 3 June 2012

LEARN TO BE HAPPY WITH ANKYLOSING SPONDYLITIS

 "Life with AS is like a hurdle race. After some steps there is another hurdle to cross.Only difference is that you don't win it at the end, with every passing hurdle its a win and enjoy that every short win."

In my  post " My experience with Ankylosing Spondylitis "  i told you about my bad journey of getting diagnosed with ankylosing spondylitis and whatever i lost. Although i have almost similar physical conditions but i am happy now. In my poem "I will win" that i posted i wanted to show a life of AS patient. All the things that i saw changing in my life,all the bad experiences. But that is not how life should be so i ended up with a win.

It took me a long time to accept that i have AS. I am sure everyone out there faces the same problem and always have a question in mind "WHY ME". Even after lot of tears and pain we don't find answer to this question. Its because we don't accept the reality. For almost 4 years i kept searching internet for symptoms and kept consulting doctors about the cure of disease. Every time when i visited doctor i always asked this question that HOW LONG DO I HAVE TO LIVE LIKE THIS? .I always knew the answer but still mind was never at peace. I stopped believing in myself and I was so depressed that i even consulted a psychiatrist. But he turned out to be a jerk. I couldn't stop laughing at myself that i went to a psychiatrist. I was depressed and tired of living but still my smile never goes of my face. Its a rare quality mostly found in mad people.But it helped me a lot. Life with AS is very hard ,it takes away all your colors. That is because we never want to live a life that we should. AS doesn't allow us to lift heavy weights in gym but still we do it and end up with more pain and frustration. It doesn't give us liberty to have a flexible mornings but still we avoid exercises which slowly degrades our mobility. Life is precious ,live happy with what you have. Don't ignore what your body says just because you are lazy or weak enough to accept that you do not have a healthy body like normal people around you. You know the results ,after sometime you will end up with fused spine and you will think "Why didn't i listen to my body. Now i have to pay a big price for being lazy ".At that moment no matter how dedicated you are ,your flexibility will not be back without a surgery.

Next time when you ask yourself the question that WHY ME. I would suggest you to ask another question.
Why not parkinsons?
Why not cancer?
Why i didnt end up with permanent disability??
Have you got answers to these questions. Hope you have realized that even though you are a patient of painful disease called AS ,you are still lucky to have a lot more then many unfortunate people. Its depends on you whether you see the cup half empty or half full.

I am a patient myself so i understand the mental state of AS patient. That constant urge to relieve physical pain and urge to find someone to share your grieve. Even i looked for people to listen to my cries. But it didn't took me long to understand that no one would understand it and this world is not good enough to share your weakness. Just for that support i became what i was not, a person living on mercy of others support. But now i am not the kind of person who lives with the crowd. For me terms like love,expectations,satisfaction are complete different ideas based on reality, not on normal human perception. More then the world around me i try to explore myself. How my mind control me and how these subtle expectation with every thing that we do effect us. You can go to any doctor or search for shoulders to cry upon but someday you have to look for your support.

 I often read that a person with AS needs someone to love him/her. This advise is for the weak  who cannot dare to challenge AS. I don't need anyone to support me and i am happy. I enjoy life to the fullest ,i party with my friends ,travel a lot with the same pain that you have. Like you even i am in relationship but its not a dependency. For me love is not dependency neither the way to change myself according my partners need. When i am in pain i look for my support. The simple way to do that is look for what you have. For me its my family, my brother, my best friend and my never ending smile. Before you feel that life is hell just keep in my that even after crying for hours you have to life the same life with AS,suffer the same pain. So why not learn to be happy. Physical pain have many cures but for mental pain you have to be your doctor. Neither you have to change yourself nor you have to cry for changes in your life. You just have to know yourself and your body.

Learn to take life easy. Do not take daily exercises as a compulsion. Think of a body builder, gym is a worship place for him. You do not need any weight lifting neither you have to prove anyone that you are normal person who can lift any amount of weight. You already know that you are not normal so listen to your body and accordingly follow daily exercises. You can do low-impact exercise like swimming. Swimming is a great fun ,you will enjoy it.

Enjoy whatever you want in life. Your mind decides your limit of what you can do. If you enjoy it even in the pain then its in your limits,doesn't matter how extreme it is. I play sports even in pain because the enjoyment of playing with friends is much more then every painful step on ground. That is the power of happiness and the attitude of living life with smile.I don't ever care about my diet ,i am crazy for good food no matter it has any amount of starch or fat. Daily exercises makeup for this extra weight. I know how much my  body can handle and how much i can control my mind. I wont advise you to go to extremes but you should know your limits. I wake up in pain but i don't stop. I put on my shoes go for little jogging to warm up. Then i continue with moderate stretching exercise and some yoga. At last pushups. Every pushup makes me feel like AS kicker. It is enough to live a healthy and flexible day and how much effort does it take to be conscious of how you are sitting. Whenever you sit just be conscious of how you are sitting. Just keep your back straight and soon it will come into habit. If you have severe pain then instead of alopathic painkillers you can have ayurvedic painkillers. They are equally effective and harmless for your body.

After reading this article i am sure some of you would say its not that easy to be happy with the help of these few words. This question would come in the mind of only those who refuse to accept that they are not normal. So, learn to be happy with Ankylosing spondylitis .

If you have anything to share that can help me or every other person with AS then you are welcomed to share it here.

Friday 1 June 2012

I WILL WIN (a poem on my life with AS)


                                                                                                 
 Its bright shiny morning today,
but the darkness in me never goes.
Its a new beginning today,
but my mind is never empty. 
The world changes every second,
but my watch is constant.
I see someone running without legs,
but my legs seldom moves.
I have climbed the mountains,
but now even cliff seems to be taller.
I have won the races,
but now even walking seems harder.
I have jumped off the hurdles,
but now i look for ladders.
I always liked the blue sky,
but now i have walls around me.
I have lost that flame in me,
but i can still feel that spark
and i will never let it die..................

by:- kushagra jain 

If you liked this poem then you are welcomed to express your feelings through comments..