Overview:

The oral allergy syndrome, also known as class 2 food allergy or the pollen-food syndrome, is a type of cross-reaction to food that occurs in people with allergies to common pollens. People with oral allergy syndrome (OAS) may experience allergy symptoms when they eat fruits or vegetables with pollens similar to those in the plants whose pollens they are allergic to.

The major symptom of oral allergy syndrome (OAS) is itchiness and tingling of the mouth, lips and throat. Some people with the oral allergy syndrome may also experience angioedema — redness and swelling — of the mouth, lips and face. Many people with oral allergy syndrome have hay fever, or allergic rhinitis, due to pollen allergies.

Birch pollen allergies are associated with apple, carrot, cherry, pear, peach, plum, fennel, walnut, potato, spinach, buckwheat, peanut, honey, celery, and kiwifruit.
Japanese cedar allergies are associated with melon, apple, peach, and kiwifruit.
Mugwort allergies are associated with celery, carrot, spices, melon, watermelon, apple, hazelnut, and chestnut.
Grass pollen allergies are associated with melon, tomato, watermelon, orange, and cherry.
Ragweed allergies are associated with melon, chamomile, honey, banana, and sunflower seeds.Cooked Foods and OAS:

The proteins that cause OAS are heat labile. This means that when they are cooked, they lose their ability to cause the unpleasant reaction. It’s common for someone whose mouth tingles and whose lips swell a bit every time they eat raw apples to be able to eat applesauce with no problems.

While many OAS reactions are mild, OAS can rarely cause anaphylaxis. Therefore, if you’ve experienced OAS symptoms, you should contact your doctor about allergy testing. You will need to avoid any raw fruits and vegetables that can trigger your symptoms, though you should be able to eat them in cooked form.

There are three major aspects to living with oral allergy syndrome: avoiding raw fruits and vegetables that can trigger symptoms, keeping allergic rhinitis symptoms under control, and potentially, allergen immunotherapy for pollen allergies.

Once you’ve identified your potential OAS triggers you’ll need to avoid them in their raw state. Vegetable trays, fruit salads, iced tea sweetened with honey, honey-covered baked goods, and pesto sauces (herbs) are among the types of foods that can trigger OAS symptoms if you’re sensitive to one of the ingredients.

Your allergist may prescribe antihistamines or other medications for allergic rhinitis symptoms year-round or at the height of pollen season. Many people find that their OAS symptoms are worst when the corresponding pollens are in the air, so be especially careful to avoid the offending foods during these times.

Finally, allergen immunotherapy to the pollens related to your food allergens has had a mixed record of success in studies with respect to helping reduce sensitivity to food allergens related to OAS. You may wish to discuss the pros and cons of this therapy with your allergist.

Sources:

Adkinson, N. Franklin, et al., ed. Middleton’s Allergy: Principles and Practice. 6th Ed. Philadelphia: Mosby, Inc., 2003.

Cox, Linda, et al. “Allergen Immunotherapy: A Practice Parameter Second Update.” Journal of Allergy and Clinical Immunology. Sept. 2007 120(3 Suppl): S25-S85.

Kinaciyan, Tamar, et al. “Successful Sublingual Immunotherapy with Birch Pollen Has Limited Effects on Concomitant Food Allergy to Apple and the Immune Response to the Bet v 1 homolog Mal d 1.” Journal of Allergy and Clinical Immunology. Apr. 2007 119(4): 937-43.

Hallux rigidus is the medical name for arthritis that occurs at the base of the big toe. The joint at the base of the big toe is called the first metatarsophalangeal joint, or MTP joint. This is the junction of the long bone of the forefoot, and the small bone of the big toe. Because of the mechanics of our feet, this joint is especially prone to developing arthritis. In fact, hallux rigidus, or big toe arthritis, is the most common site of arthritis in the foot.

Symptoms of Hallux Rigidus

The diagnosis of hallux rigidus is made by testing the mobility of the MTP joint, usually comparing it to the opposite foot to see how much motion is lost at the joint. X-rays are performed to determine how much of the joint cartilage has worn away, and to see if bone spurs have formed in this area. Determining the extent of the arthritis will help guide treatment.

Treatment of Hallux Rigidus

The most common treatments for hallux rigidus include:
Wearing Stiff-Soled Shoes

Stiff-soled shoes limit motion at the base of the big toe. Inserts can be made for shoes that can help support your existing footwear. Alternatively, when buying shoes, look for types with a less-flexible sole that will prevent the arthritic joint from bending.

Adding a Rocker Bottom to Shoes

A rocker-bottom is a curved sole that can be added to your footwear. The rock-bottom, much like the bottom of a rocking-chair, helps the foot smoothly transition from the heel to the toe while walking. This modification also limits the movement of the arthritic toe joint.

Anti-Inflammatory Medications

These medications will help to decrease pain and swelling at areas of inflammation. If the oral medications are not sufficient, and injection of cortisone may also be considered.

Is Surgery Necessary for Hallux Rigidus Treatment?

Surgery is sometimes the best treatment for hallux rigidus, especially if the more conservative measures are not working for you. The two most common surgical procedures are called a cheilectomy or an arthrodesis (fusion). The cheilectomy is a procedure done to remove the bone spurs. The cheilectomy often helps if the bone spurs are limiting the joint motion.

The concern with performing a cheilectomy is that while the bone spurs are removed, the joint is still arthritic, and the spurs can return. While the pain caused by limited motion may be improved, the pain coming from worn out cartilage may remain. A more extensive surgery called a joint fusion may be necessary for these patients. A fusion is an excellent procedure at eliminating much of the pain, but it will cause the toe to be permanently stiff.

Sources:

Mann RA “Disorders of the First Metatarsophalangeal Joint” J. Am. Acad. Ortho. Surg., Jan 1995; 3: 34 – 43.

Question: How is osteoporosis diagnosed?Answer: The diagnosis of osteoporosis is made with a test called a “bone density test.” The test measures the absorption of x-rays in specific areas of the skeleton. Most often, the bone density test measures the hips and the spine.

Can osteoporosis be diagnosed by regular x-rays?

Often patients are told that they have osteoporosis based on an x-ray or after a surgical procedure on their bone. Unfortunately, these statements are misleading, because the only way to accurately make the diagnosis of osteoporosis is with a bone density test.

Your doctor may be able to tell you your bone “felt weak” at the time of surgery or “looks thin” on a regular x-ray, but the diagnosis of osteoporosis has strict criteria that can only be made with a bone density test. If there are concerns that you may have osteoporosis because of the appearance of bone on x-ray or an injury that you sustained, you should ask if you need a bone density test.

Sources:

JM Lane and M Nydick “Osteoporosis: current modes of prevention and treatment” J. Am. Acad. Ortho. Surg., Jan 1999; 7: 19 – 31.

Bromelain is an extract derived from the stem and fruit of the pineapple plant (Ananas comosus, family Bromeliaceae). Bromelain is marketed as a dietary supplement to treat osteoarthritis.

How Bromelain Works

It has been suggested that bromelain, when taken orally, can reduce inflammation and pain associated with the inflammatory process. Bromelain may or may not be effective for the treatment of osteoarthritis. More studies are needed to confirm effectiveness of bromelain for osteoarthritis. Similarly, there is not enough evidence to recommend bromelain for rheumatoid arthritis.

Availability of Bromelain

Despite the lack of evidence to support its use, some individuals do take interest in bromelain. It is available in capsules or tablets. The commonly used dosage is between 500 mg and 2,000 mg / three times a day between meals.

Precautions and Warnings for Bromelain

Bromelain may increase bleeding risk when taken together with drugs that are known to increase bleeding (blood thinners, anti-platelet drugs, and NSAIDs (non-steroidal anti-inflammatory drugs). Bromelain may also affect the absorption of certain antibiotics, increase the effect of blood pressure and blood thinning medications, and increase drowsiness.

Few side effects are linked to bromelain. The most common side effects are stomach upset and diarrhea. Increased heart rate, irritation of mucus membranes, and menstrual problems have been linked to bromelain treatment in a few cases.

Bottom Line

Discuss bromelain with your doctor before using the supplement. Go over all of your medications and supplements, and decide together if the benefit outweighs the risk.

Sources:

Bromelain (Ananas comosus, Ananas sativus). MedlinePlus. Accessed 9/29/2009.

http://www.nlm.nih.gov/medlineplus/druginfo/natural/patient-bromelain.html

Primer on the Rheumatic Diseases. Supplements. Arthritis Foundation. Thirteenth Edition.

I was diagnosed with OA of my knees in 1997 and OA of my spine and hips at a later date. I also have Fibromyalgia and a few other things in addition. I’m not as active as I used to be due to the pain. It hurts to walk, sit, stand, and lie down. If I sleep too long, I wake up in a lot of pain. If I don’t sleep long enough, I’m in a lot of pain. Everything just hurts non-stop. Many times I wish I could get out of this body. I’m 48 but feel like I’m in my 80s. I don’t pity myself, I do feel depressed a lot though. Pain isn’t for wimps.—JewelryDiva

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I’m a lucky mom — besides some relatively minor lactose intolerance, my daughter hasn’t shown any signs of food allergies thus far. We keep a gluten-free kitchen at home, but she does occasionally eat wheat when we’re out. So even though she’s not celiac, she’s learned about cross-contamination. At three, she understands the importance of washing her hands and wiping her face before kissing me after she’s eaten wheat, just in case. “Mommy is a celiac,” she tells people. “Mommy only eats food that is gluten-free!”

For kids with severe allergies, of course, the stakes are far higher and extend far beyond the obvious, especially for allergies to foods whose proteins can be airborne or can persist on surfaces. Many common allergens are hidden ingredients in common foods; you can’t completely avoid milk by avoiding dairy products any more than you can prevent reactions from nuts by staying away from canisters of mixed nuts and nut butter.

On that note, I’d like to share my review of MindFlight’s Beyond a Peanut Flashcards, a resource intended to teach young children how to manage peanut and tree nut allergies (although a few of the cards give general information about allergies, medical information, and how to recognize severe reactions and would be useful for any child learning to live with food allergies). Take a look at the review and share your own tips for helping kids learn to safely live in the world with food allergies in the comments or the food allergy forums!

Beyond a Peanut Flashcards Review Comments are closed for this post. See All PostsShare PrevNextif(zSbL250)gEI(“spacer”).style.height=Math.floor(e[0].height/12)+17.5+’em’;else{var zIClns=[];function walkup(e){if(e.className!=’entry’){if(e.style.styleFloat==’right’||e.style.cssFloat==’right’||e.align==’right’||e.align==’left’||e.className==’alignright’||e.className==’alignleft’)zIClns.push(e);walkup(e.parentNode)}}walkup(e[0]);if(zIClns.length){node=zIClns[zIClns.length-1];var clone=node.cloneNode(true);node.parentNode.removeChild(node);getElementsByClassName(“entry”,gEI(“articlebody”))[0].insertBefore(clone,gEI(“spacer”))}}};CommentsDecember 18, 2007 at 10:10 am(1) Rational Jenn says:

We have the Beyond A Peanut cards and they have been great for talking to my son’s friends about his allergy. We are beginning to use them with our daughter, who is not yet 3, but understands that some things will make her brother sick. It’s hard going to the grocery store with her, because she’s a grabby toddler and it really stresses me out. But now she’s beginning to get the message. I have enjoyed them very much. It would be nice if they put together another packet for milk or egg allergies or perhaps a “mix and match” that a family dealing with multiple allergies could use to customize to their unique situation. Our only allergy is peanut, so the way it is now suits us just fine.

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The first step of a hip replacement surgery is to remove the damaged cartilage and bone. The hip joint has two sides, a ball (the femoral head), and the socket (the acetabulum). When the hip joint becomes arthritic, the normally smooth cartilage surface is worn away.

To remove the worn out ball of the ball-and-socket hip joint, the bone is cut to remove the femoral head. In order to insert a new joint, the damaged bone and cartilage must first be removed. Prev Diagnosis of Hip ArthritisRemoving the Worn Out Hip Joint BallRemoving the Worn Out Hip Joint SocketPlacement of the Acetabular Component Preparing the Femur Placement of the Stem Insertion of the Ball Final Hip Replacement Implant” rel=”next”>Nextfunction zIt2t(C,F){if(C.getElementsByTagName(“a”)[0]){C=C.getElementsByTagName(“a”)[0];var A=document.createElement(“div”);A.className=”tt hide”;A.onmouseover=function(){if(to){window.clearTimeout(to)}};A.onmouseout=function(){sf=this;if(to){window.clearTimeout(to)}to=window.setTimeout(“sf.parentNode.lastChild.className = ‘tt hide’;”,500)};var E=document.createElement(“p”);var B=document.createElement(“a”);B.href=C.href;B.setAttribute(“zT”,C.getAttribute(“zT”));var D=document.createTextNode(C.title);A.appendChild(E);E.appendChild(B);B.appendChild(D);if(C.parentNode.appendChild(A)){C.onmouseover=function(){sf=this;if(to){window.clearTimeout(to)}var I=getElementsByClassName(“tt”,gEI(“pagination”));for(var H=0;H

Question: What is Osteoporosis?Answer: Osteoporosis is a condition that causes weakening of bone, and increased likelihood of sustaining a fracture. Osteoporosis can affect any bone in the body. The diagnosis of osteoporosis is made by measuring bone density. People who are diagnosed with osteoporosis will be treated to modify their condition in an effort to prevent fractures.

Osteoporosis is common, especially in women. About one third of women over the age of 65 have the diagnosis of osteoporosis. The diagnosis of osteoporosis means that your bone density is at least 2.5 standard deviations below the ideal peak bone mass. Osteoporosis is considered severe if you have also sustained a fracture as a result of weak bone.

The two most common reasons people tend to get osteoporosis are low peak bone mass at the time of skeletal maturity, or accelerated bone loss at the time of menopause. An individual reaches her highest bone mass at the time of skeletal maturity, and loses bone steadily thereafter. Therefore, it is of utmost importance that young individuals take steps to ensure they develop as much healthy bone as possible. Once bone loss begins, it is also important to ensure the rate of bone loss is slow. The amount of bone loss can accelerate at the time of menopause. Some people will benefit by taking medications to prevent this bone loss.

Sources:

JM Lane and M Nydick “Osteoporosis: current modes of prevention and treatment” J. Am. Acad. Ortho. Surg., Jan 1999; 7: 19 – 31.

“Osteoporosis: A debilitating disease that can be prevented and treated.” National Osteoporosis Foundation

You are now ready to advance the number of repetitions.

As before, contract your pelvic floor muslces for six seconds. Then relax for six seconds.

Repeat the above exercise 50 times (takes 10 minutes), three times a day.

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Fibromyalgia Basics:

Fibromyalgia is an arthritis-related syndrome characterized by widespread or generalized muscular pain, tenderness, and fatigue. Fibromyalgia literally means pain in the muscles, ligaments, and tendons.

Fibromyalgia is considered a syndrome because it is a set of signs and symptoms occurring together. It is not considered a type of arthritis, but definitely is a form of soft-tissue rheumatism (conditions which cause pain and stiffness around joints, as well as in muscles and bone). There is no inflammation associated with fibromyalgia.

The cause of fibromyalgia remains unknown. Researchers have suggested that fibromyalgia patients experience pain amplification caused by abnormal sensory processing in the central nervous system. Other research has determined that some fibomyalgia patients have:

Increased level of substance P (a chemical which increases nerve sensitivity to pain) in the spinal cord Decreased blood flow to the thalamus region of the brain Imbalance of hormones in hypothalamic-pituitary-adrenal axis (affecting how the patient copes with stress) Low levels of serotonin and tryptophan Abnormal cytokine function

Other than the primary symptom associated with fibromyalgia — widespread muscular pain — there are other symptoms which are linked to the syndrome. The symptoms can come and go and vary in intensity:

Severe fatigue Headaches Irritable bowel syndrome Irritable bladder Cognitive and memory problems TMJ or temporomandibular joint disorder Restless leg syndrome Pelvic pain Noise and temperature sensitivity Anxiety or depression Skin color changes

No single test can diagnose fibromyalgia. Laboratory tests are ordered to rule out other conditions. X-rays do not reveal evidence of fibromyalgia.

In 1990, the American College of Rheumatology established criteria to be used for diagnosing fibromyalgia:

A history of widespread pain in all four quadrants of the body (e.g. above the waist on both sides; below the waist on both sides of the body) for three months or more. Pain at 11 of 18 tender point sites

According to the National Fibromyalgia Association, it has been estimated that it takes five years on average to get an accurate diagnosis of fibromyalgia.

Pain management is a primary area of focus for the treatment of fibromyalgia. Pain can be relieved by using pain medications like acetaminophen or NSAIDs (nonsteroidal anti-inflammatory drugs). Tramadol (Ultram) is another pain reliever prescribed by doctors to treat fibromyalgia pain. Certain anti-depressants or benzodiazepines can also be prescribed to help with sleep and pain. Local injections into tender points may also be helpful.

Lifestyle modifications including regular exercise, good sleep habits, emotional support, and complementary treatments help manage fibromyalgia symptoms.

According to the National Fibromyalgia Association, about 5 to 7 percent of Americans are affected by fibromyalgia. Women are the predominantly affected gender, although men and children also can have fibromyalgia. All races are affected by the condition.

Overlapping symptoms with other rheumatic conditions makes diagnosing fibromyalgia difficult. People who already have a rheumatic disease such as lupus, rheumatoid arthritis, or ankylosing spondylitis are at greater risk for developing fibromyalgia. Activity level, time of day, weather patterns, sleep patterns, and stress can all affect fibromyalgia pain and other symptoms. Being aware of certain patterns may help you manage fibromyalgia. Fatigue or sleep disturbance occurs in 90 percent of fibromyalgia patients. More research is ongoing to study the role of genetics, environmental stress, and physical trauma.

Fibromyalgia Screening Quiz Test Your Knowledge – Fibromyalgia

Fibromyalgia vs. Rheumatoid Arthritis Pain – What Factors Determine Treatment? How is Fibromyalgia Treated? Guaifenesin – Effective Treatment for Fibromyalgia? Fibromyalgia 101 – Free Newsletter E-Course

Sources:

“Fibromyalgia.” Arthritis Foundation. 21 Mar 2007 <http://www.arthritis.org/conditions/DiseaseCenter/Fibromyalgia/fibromyalgia.asp>

“Fibromyalgia.” American College of Rheumatology. 21 Mar 2007 <http://www.rheumatology.org/public/factsheets/fibromya_new.asp?aud=pat>

“About Fibromyalgia.” National Fibromyalgia Association. 21 Mar 2007 <http://www.fmaware.org/fminfo/brochure.htm>