Living with gout - Arthritis Victoria

Transcription

Update
Autumn 2010
Volume 23: Issue 1
The official publication of
Arthritis Victoria and
Osteoporosis Victoria
ISSN 1446-6570
PRINTPOST 330747/00059
Living with gout
Welcome to the first issue of Update for 2010.
Focus on gout
Anyone who has experienced the pain and discomfort of gout will identify
with Barry, an Arthritis Victoria member who has suffered the discomfort of
this painful condition for many years. Barry’s story, which is featured in this
issue of Update, is typical of a growing number of people in the developed
world who are being diagnosed with this common form of acute arthritis.
As Melbourne rheumatologist Dr Alex Stockman explains, there are a
number of lifestyle changes that people diagnosed with gout should make
to help prevent future attacks, along with medically-prescribed treatments
to manage the condition. Dr Stockman also presents case reports taken
from his medical records to illustrate two typical sets of symptoms, medical
histories, diagnosis and treatment.
In this issue...
On the lighter side, we take a whistle-stop tour through the history of
gout, and introduce you to some famous people who have lived with the
condition.
Feature
About gout
3
News from Arthritis Victoria
Gout resources in our library
6
In this issue, we also bring you news of many Arthritis Victoria activities
scheduled for this year. There is our Annual General Meeting in April, our
parent information workshop on juvenile arthritis in May, and our consumer
forum at the end of May, which has been planned to coincide with the 51st
annual scientific meeting of the Australian Rheumatology Association in
association with the Rheumatology Health Professionals Association.
In good company
6
Getting to grips with gout
7
Gout throughout history
7
Activities for semester 1
From the desk of the CEO
2
And if you are contemplating how best to improve your level of physical
activity, or if you would like to explore the leader training and professional
development opportunities offered by Arthritis Victoria, you will be
interested in our calendar for semester 1, which appears on pages 10 – 11.
News in brief
9
Happy reading – and as always, we welcome your feedback.
Sue Montague
Update editor
03 8531 8024
sue.montague@arthritisvic.org.au
Other stories
What’s on in 2010
10
What’s new in our library
12
Managing your chronic
medical condition
13
Raffle draws: how do they work?
14
Writers block
14
Newsletters make a difference
15
A lasting legacy
16
An inspiring story: Another Alice
17
Local focus
18
Memorial gifts
18
Advocacy at Arthritis Victoria
19
Active living, informed living, living well...for musculoskeletal health
Autumn 2010
From the desk of the CEO
This year begins with the
enthusiasm generated by the
improved financial position
achieved in 2009. The generosity
of our donors and supporters of
the raffle program was significantly
supplemented by the efficiencies
achieved in how we conduct
those programs. The resultant
improvements in the funds
generated by our fundraising effort
have enabled the organisation to
plan for growth in 2010.
Annual General Meeting
This is the time of year when we
report the outcome of the annual
Board recruitment process and
prepare for the Annual General
Meeting (AGM) which will be held
here at 263-265 Kooyong Road,
Elsternwick on 28 April at 3.00 pm.
Our President of one year, His
Honour Philip Misso, is looking
forward to meeting many of you at
the AGM. As members of Arthritis
Victoria, you are all encouraged to
attend.
Two nominations were received
for the advertised vacancies.
Continuing Board members, Mr
Noel Smith and Mr Bill David, were
Consumer engagement
During 2010, we intend to work
more closely with our consumers.
The Board has recently appointed
three new members of the
Consumer Advisory Committee.
On 1 March we welcomed Dr
Samantha Thomas, Ms Janine
Fisher and Ms Lee White to the
first meeting for this year. At that
meeting the Committee discussed
Arthritis Victoria’s new advocacy
framework. It also heard our plans
for involving consumers in areas
such as research and training
and development for articulating
consumer issues to government
and other relevant organisations.
I hope that all of our volunteers
will join us on 11 May at Hawthorn
Receptions in Glenferrie Road,
Hawthorn. Invitations will be mailed
out in due course.
About gout
This edition of Update is dedicated
to gout, a condition that is
increasing in prevalence across the
developed world. I am sure that the
information will be meaningful to
so many of you and to members of
your families.
Please share your copy of Update
with friends and families. Selected
articles will be placed on our
website for you to pass on to
others.
Natalie Savin
Chief Executive Officer
03 8531 8000
In May, we will be honouring our
volunteers at the annual Volunteer
Celebration. Amongst the awards
Directors
263 Kooyong Road Elsternwick 3185
PO Box 130 Caulfield South 3162
Phone: 03 8531 8000
Toll free: 1800 011 041
Fax:
03 9530 0228
Email:
afv@arthritisvic.org.au
Website: www.arthritisvic.org.au
President:
Vice President:
Hon Treasurer:
ABN 26 811 336 442
to be presented on that day, we will
be celebrating 30 years of service
by four more volunteers following
the presentation of our first 30 Year
Awards last year.
Celebrating our volunteers
Arthritis Victoria
The Arthritis Foundation Victoria Inc.
2
elected unopposed. Dr Michael
Summers will retire after four years
on the Board. We thank him for
his diligent attention to all matters
concerning consumer engagement
and research. We are grateful that
he has offered to continue his
relationship with Arthritis Victoria in
an advisory capacity.
Opportunity shops
Judge Philip Misso
John Zika
Russell Green
Elaine Bee
Bill David
Jim Dixon
Prof Keith Hill
Ross Illingworth
Dr Ian Relf
Heather Rose
Noel Smith
Dr Michael Summers
1428 High Street Malvern
Phone 03 9509 6263
10 Everage Street Moonee Ponds
Phone 03 9370 4447
CEO:
Natalie Savin
Update editor: Sue Montague
© Copyright Arthritis Victoria 2010
Advertising policy statement
All agencies or organisations must seek
written permission from Arthritis Victoria before
reproducing any material. The views and opinions
expressed in Update are not necessarily those
endorsed by Arthritis Victoria.
Arthritis Victoria does not necessarily recommend
the products and services advertised in Update.
Please do not assume that anything advertised
in these pages has been cleared, vetted or in any
way approved by Arthritis Victoria.
It is important to exercise your own judgement
about whether the advertised service or product
is likely to help you personally and, where
appropriate, take professional advice from your
doctor or health professional before purchasing.
About gout
Dr Alex Stockman, a rheumatologist
practising mainly in Melbourne’s
western suburbs, sees many
patients with gout. Here, he outlines
some facts and treatments for
gout, and provides useful advice
for people at risk of developing
this painful and often debilitating
condition.
Gout is a common form of acute
arthritis characterised by recurrent
attacks of pain, swelling, and redness
affecting one or several joints at a time.
It is one of only two forms of arthritis
where the cause and cure are known,
the other being septic (infectious)
arthritis.
Gout has been known in medical
practice for thousands of years.
The first recorded description of the
condition comes from the Egyptians in
2640 BC. Around 400 BC, the Greek
physician Hippocrates described it as
‘arthritis of the rich’ because at that
time only affluent people could afford
alcohol and food rich in purines, both
of which are associated with gout.
Today, with greater access to a richer
diet, gout affects people from all walks
of life.
The facts
• The prevalence of gout in the
developed world is growing in line
with an increase in obesity.
• There is a higher prevalence of gout
in some racial groups, for example,
Maori men in New Zealand.
• Around 70,000 people in Australia
have this form of arthritis.
• Gout is more common in men, and
often several men of the one family
can be afflicted by the condition. In
the UK, the unadjusted prevalence
of gout in 1999 was 1.4 per cent
with the highest rate of 7.3 per cent
being observed in men aged 75-84.
How is gout caused?
Gout occurs when uric acid, a waste
product, builds up in the bloodstream
and deposits urate crystals in
the joint. This is caused by either
overproduction of uric acid or underexcretion by the kidneys, which is far
more common.
Uric acid is not very soluble in blood
and forms crystals when it reaches
concentrations of more than
360mmol/L.
Animals other than humans and higher
primates possess an enzyme (uricase)
which converts uric acid to a more
soluble substance (allantoin), which
can easily be excreted.
Who gets gout?
Men of any age, but especially older
men, are more likely to experience
attacks of gout; although it can also
affect post menopausal females. These
groups often have other conditions
such as kidney impairment or high
blood pressure, both of which can be
contributing factors.
Because men tend to be bigger in size
to women, they metabolize larger
amounts of purines, which form uric
acid. They also tend to drink more
alcohol which predisposes them to gout.
In females, oestrogen increases
the excretion of urate through the
kidneys. This makes gout very rare in
premenopausal women.
Gout can also occur in children –
although very rarely. In these cases, it
is likely to be due to enzyme deficiency
and is associated with other clinical
features.
Risk factors
• Elevated urate level in blood.
• Heavy alcohol intake.
• A diet containing too many purines
such as meat, sweetbreads and
other offal, shellfish, beans, lentils
and fructose (found in most soft
drinks).
• Obesity.
• Certain drugs, especially diuretics
(‘water tablets’).
What are the symptoms?
• One joint is usually affected,
most commonly the big toe or a
foot. Ninety (90) per cent of gout
sufferers have had an attack in their
big toe. This is called ‘podagra’.
Other joints that may be affected
are the knees, ankles, wrists,
fingers and elbows.
• People with gout experience
sudden pain and swelling, often
accompanied by redness. The
pain is usually so severe that they
cannot walk without crutches and
are unable to go to work.
• Without treatment the attack
usually resolves after one or two
weeks. But with medications such
as non steroidal anti-inflammatory
drugs (NSAIDs), cortisone (steroid)
tablets/injections or colchicines,
the attack can be controlled within
several days.
• An attack of gout can happen for no
reason, often in the middle of the
night. But it can also happen after
trauma, for example after stubbing
the big toe, after a bout of drinking,
or after surgery.
• Initially, the attacks may be years
apart, so it is important to tell your
doctor about any previous attacks
that you may have experienced.
With time, the attacks are likely to
become more frequent, perhaps
once a month. They may even
merge into each other.
How will the doctor
diagnose gout?
To make a diagnosis of gout, your
doctor will look for an elevated urate
level in your blood, together with a
history of recurrent attacks of joint pain
and swelling.
• If you have not been diagnosed
with gout before, your doctor
may aspirate the affected joint
(remove a sample of fluid and
cells through a needle) to make a
definite diagnosis. If you have gout,
uric acid crystals can be seen in
large numbers in joint fluid when
examined under a microscope.
Update Autumn 2010
3
About gout
continued...
This test is also important to
exclude other conditions such as
infection.
• If you are experiencing an attack
of gout, your doctor will look for
swelling, redness and marked
tenderness of the painful joint. This
can extend to surrounding tissues
in the foot or the back of the hand.
• Colchicine, which is derived from
the autumn crocus and is a specific
drug for gout
• Corticosteroids (commonly known
as steroids or cortisone).
Some of these medications have
side effects, so need to be used with
caution. They should also be avoided if
you are using warfarin. Your doctor will
be able to advise you.
Newer, more effective drugs are
currently being tested for people who
cannot tolerate these medications.
Preventing future attacks
of gout and chronic
management
• The doctor will also look for ‘tophi’,
which are painless lumps of whitish/
yellow-looking material full of uric
acid. These are often seen on
fingers, toes, elbows, knees and ear
lobes. Tophi can sometimes appear
rapidly and deform joints (usually
fingers) if chronic and left untreated.
• Because a gout attack can last
for a short time only, you could be
symptom-free by the time you see
the doctor. However, a diagnosis
can be made from your history,
and you will need to discuss with
your doctor how best to manage
your condition. Importantly, gout
or elevated levels of uric acid can
also be associated with other
medical conditions that may need
treatment, such as high cholesterol
or diabetes.
It is always important to seek a
medical diagnosis if you experience
any pain or discomfort in your joints.
Treating acute gout
If you are having an attack of gout,
your doctor may prescribe one or more
of the following drugs to reduce the
immediate discomfort.
• NSAIDs (ibuprofen, naproxen and
similar)
• COX2 inhibitors, such as celexoxib
(Celebrex)
4
The aim of chronic or ongoing
treatment of gout is quite different to
management of an acute attack.
The goal of chronic management is
to reduce the level of uric acid in the
blood so that it does not form crystals
in the tissues and joints. Apart from the
main reason of abolishing future gouty
attacks, reduction of urate also slows
the progression of renal disease which
may be caused by deposits of urate in
the kidney.
Reduction of urate may even reduce
the risk of heart disease, and research
into the effect of elevated uric acid on
the heart is currently being carried out.
To manage your condition, your doctor
may prescribe:
• Allopurinol (Progout, Zyloprim,
Allohexal, Allosig) to reduce the
formation of uric acid. Allopurinol
is the most common urate lowering
agent currently used.
• Drugs to increase the excretion
of uric acid in your urine, such as
probenecid, certain blood pressure
medication such as losartan
(Cozaar – not on BPS) or fenofribate
(Lipodil), a drug used for lowering
fats. These last two medications are
primarily recommended if you have
high blood pressure or high lipid
(cholesterol) level.
advise you how to minimise these, for
example by drinking plenty of fluid and
taking additional medication to prevent
acute attacks.
Drugs that metabolise (break down)
uric acid to allantoin are not yet
available for general use, but they can
be very effective. Allantoin is a more
soluble substance that can be easily
excreted.
Don’t be tempted to stop treatment
because you think that your attacks
of gout won’t recur. Missing even one
tablet can result in a recurrence – so
make sure you have a supply of your
medications at all times.
While lifestyle changes are often not
enough in themselves to reduce your
level of uric acid, they can be very
effective in helping to control gout and
metabolic syndrome.
• Reduce your weight and maintain
it at a healthy level. Having a low
body mass index can help protect
you against gout.
• Cut down on alcohol consumption,
particularly beer.
• Reduce your intake of fructose,
found in many soft drinks.
• Avoid purine-rich foods (see
above under ‘Risk factors’). Dairy
products and moderate amounts of
coffee can help reduce your risk of
developing gout.
Above all, you should always work
closely with your doctor to prevent
further attacks of gout and manage
your condition.
The above medications take time
to work, and you may experience a
few side effects. But your doctor will
About gout
continued...
Case study 1
Case study 2
NV, a 69 year old male was first seen in August 2005,
with a 20 year history of recurrent pain and swelling
affecting his big toes, ankles and knees. He had been
having 4-6 attacks per year, lasting 4-5 days. He
was responding to indomethacin and more recently,
colchicine.
JD, an 84 year old female, presented in September
2008 with a 12 month history of increasing stiffness
and deformity of the fingers, but hardly any pain.
She has had past attacks of gout involving the big
toes, but not for many years. She is on frusemide
(Lasix) for heart failure, and also takes medication for
hypertension (high blood pressure).
Reason for referral
NV has been experiencing pain and swelling in the
proximal interphalangeal joints (the upper two joints
of the first and second fingers) in his hands for the
last 4-6 weeks. His hands have not been affected
before.
Social history
NV admits to drinking 6-8 stubbies per day.
Examination
On examination, multiple tophi were seen on NV’s
ears, and a large effusion (build up of joint fluid) in
the left ankle. There were signs of osteoarthritis in
his middle finger, with soft tissue swelling and similar
findings in his left thumb. NV’s uric acid level was
raised at 0.49.
Diagnosis
The above presentation is typical of gout. Men are
at greater risk of elevated uric acid, along with those
who drink alcohol heavily.
Management
In view of his long history of severe, tophaceous gout,
NV was commenced on allopurinol to lower his urate
and thus prevent further attacks and dissolve tophi.
As prophylaxis (prevention), colchicine was added.
Progress
NV experienced 2 attacks of gout during the next
4 years. He was last seen in November 2009. He
continues taking allopurinol, with no side effects. Uric
acid is 0.33mmol/L, which is a satisfactory level. He
has fewer tophaceous deposits.
Summary
Because of his many attacks of gout and formation
of tophi, NV requires chronic management of gout
with a urate lowering agent (allopurinol). This has
been successful and he has had only 2 attacks of
gout in 4 years whilst on this drug. Furthermore, the
tophaceous deposits have been reduced in size and
will eventually disappear, provided he remains on
this drug indefinitely. The treatment has undoubtedly
averted progression of gout, including formation of
deformities caused by gouty deposits.
Examination
On examination, osteoarthritis in the fingers was
seen, together with a number of tophaceous deposits
including the left 3rd toe. X-rays of JD’s hands show
erosions (a loss of substance in the surface of bone),
often seen in gout and osteoarthritis. Uric acid is
elevated at 0.52. JD has mildly impaired kidney
function.
Diagnosis
Although she has had no recent history of acute
attack, JD has a history of them in the past. With
progression of gout, tophaceous deposits have
developed – resulting in damage to the joints.
Risk factors
Post menopausal, on Lasix (water tablet), reduced
kidney function.
Management
JD was commenced on allopurinol to lower urate
level, preventing further joint damage and dissolving
tophi. As prophylaxis, colchicine was added.
Progress
JD was last seen in October 2009. She is able to
tolerate 100mg of allopurinol and her urate level has
dropped to 0.37, which is just above target level. She
recently had an attack of gout in the middle toe of
the left foot, so allopurinol will be slowly increased to
reach the target level of urate.
Summary
JD does not have classic attacks of gout, but this
is not uncommon at her age. Diuretics and reduced
renal function are common risk factors for gout in the
elderly, who often are on multiple drugs for various
related conditions. JD will require allopurinol as
long-term treatment to prevent further tophaceous
deposits and more deformity of the joints.
Update Autumn 2010
5
Gout resources in our library
Books
Useful websites
Emmerson, Bryan 2003, Getting rid
of gout: A guide to management and
prevention, Oxford University Press,
Melbourne.
The Gout & Uric Acid Education Society
www.gouteducation.org
Arthritis Victoria
www.arthritisvic.org.au
Porter, Roy Rousseau, GS 1998, Gout:
The patrician malady,
Yale University Press, New Haven.
Arthritis Foundation USA
www.arthritis.org
Schneiter, Jodi 2001, Gout haters cookbook: Recipes
lower in purines and lower in fat, Reachment
Publications, Palm Coast, FL.
Arthritis Canada
www.arthritis.ca
Arthritis Research Campaign – UK
www.arc.org.uk
Information sheets
1. Gout
2. Gout and diet
NIAMS – National Institute of Arthritis & Musculoskeletal
& Skin Diseases – USA
www.niams.nih.gov
Cochrane reviews
1. Colchicine for gout
2. Systemic corticosteroids for acute gout
For a free copy of the plain language summaries of these
Cochrane reviews, phone the Telephone Information Service
on 03 8531 8000 or 1800 011 041 (toll free for country callers).
Lisa Bywaters
Arthritis Victoria Librarian
03 8531 8031
lisa.bywaters@arthritisvic.org.au
In good company
Many famous people throughout the ages have had gout. Here are a few of them.
Charlemagne (742–814)
King of the Franks
Kublai Khan of China (1215-1294)
Mongol Emperor
Leonardo da Vinci (1452-1519)
Renaissance scientist, inventor, and
artist
Henry VIII (1491-1547)
King of England from 1509 until his
death
Charles V (1500-1558)
Holy Roman Emperor
Galileo Galilei (1564-1642)
Italian physicist, mathematician,
astronomer, and philosopher
Oliver Cromwell (1599-1658)
Lord Protector of England, Scotland,
and Ireland from 1653 –1658
John Milton (1608-1674)
English poet and author
Sir Isaac Newton (1643-1727)
English physicist, mathematician,
astronomer, natural philosopher,
alchemist, and theologian
Benjamin Franklin (1706-1790)
One of the founding fathers of the
United States of America
William Pitt the Elder (1708-1778)
British Whig statesman and Prime
Minister of Great Britain
Charles Darwin (1809-1882)
English naturalist
Karl Marx (1818-1883)
German philosopher, social scientist,
historian and revolutionary
Joseph Conrad (1857-1924)
British novelist
Theodore Roosevelt (1858 -1919)
President of the United States
Jared Leto (1971- )
American actor and musician
Harry Kewell (1978- )
Australian professional soccer player
Johann Wolfgang von Goethe
(1749-1832)
German writer and polymath
6
Getting to grips with gout
Barry Williams – or ‘Baz’ to his
friends – is newly retired. He has
been coping with gout since his
30s. Now in his mid-60s, Barry has
recently retired from working as a
warehousing despatch clerk in the
printing trade.
Around 30 years ago, when I was living
in Townsville, my right toe became
inflamed and very painful. The pain was
so bad that I couldn’t even bear the
weight of a sheet on my foot. The GP
examined my toe and ordered some
blood tests, which showed that I had
gout. I can’t recall what he prescribed,
but it did the trick.
Apart from a few minor attacks, I didn’t
experience any major symptoms for a
number of years. But around the time
of my 50th birthday I began to have
more frequent and severe attacks in
various joints, including my thumb,
knee, elbow, toes and fingers. Then, in
late 2008 I had the worst attack of all! It
lasted over four weeks and affected my
right knee really badly.
On a scale of 10, I’d rate the pain at 8
or 9. It certainly put the brake on things
for a while. My doctor advised me to
drink plenty of water and prescribed a
medication that would stop the crystals
building up.
So how does Barry manage his
attacks of gout? And how does he
try to minimise their occurrence? His
strategies are simple.
It’s never pleasant when I have an
attack, so I always curse a bit at the
start. First, I drink plenty of water to
flush my system out. Then I take some
anti inflammatory tablets. After that, it’s
a case of ‘grin and bear it’.
I’ve read a few books about gout, and
because my wife is into this ‘health
caper’, we eat a healthy diet. I used
to have high cholesterol, but with my
GP’s help that is under control now.
I have also cut down on my alcohol
consumption, although I still enjoy a
glass of red wine in the colder months.
Our daily diet is a good one. We eat
plenty of vegetables and fruit, and
avoid take-aways like the plague. I still
love my red meat, but now we have
fish for dinner a couple of times a week
instead. I keep off certain shellfish like
oysters and lobster, acid foods like
grapefruit and raw tomatoes, and offal.
It’s quite hilly where we live, and we
have always walked a lot, so I keep
pretty trim. There is always something
to do around the house, which helps
keep me in pretty good physical
condition. Having just retired, I’m
keen to get the house up to spec, and
then the wife and I are off on a bit of
interstate travel.
As the youngest of four brothers,
Barry is the only one with gout. But
he has discovered that some of his
mates have gout as well.
I can always talk to my family, which is
important to me. A couple of my friends
have gout too, and my best mate had
an attack just before Christmas, so
we speak freely about it. We share our
experiences and remedies. We even
joke about it.
I know that gout can affect different
people in different ways, but for me it’s
important to keep it in perspective.
Eat a healthy diet – that’s the main
thing. Keep an eye on your stress
levels. Watch your weight. And keep
active…
Did you know that gout has
a rich and colourful history?
Our librarian, Lisa Bywaters,
has unearthed these gems.
• Gout comes from the Latin gutta,
meaning ‘drop’.
• The prevailing belief amongst
physicians until the 18th century
was that the physical manifestations
of disease could be attributed to an
imbalance in the four main humours
of the body – blood, phlegm,
melancholy (black bile) and choler
(yellow bile). It was thought that
gout was caused by drops of these
humours into the affected areas.
• Hippocrates, the Greek physician
born in 460 BC who became known
as the founder of medicine, is
believed to be the first person to
accurately describe gout in 400 BC.
He believed that gout resulted from
an abnormal accumulation of one of
the humours in the joints. He called
it ‘the unwalkable disease’.
• Evidence of gout has been found in
skeletons of mummies from Upper
Egypt.
• “Be temperate in wine, in eating,
girls, and sloth; or the Gout will
seize you and plague you both”
said Benjamin Franklin, one of the
Founding Fathers of America
(1706-1790).
Informed living
Contact us for information sheets on
• Gout
• Gout and diet
Phone 03 8531 8000 or
1800 011 041 (toll free for
country callers) or visit
www.arthritisvic.org.au
continued next page
Update Autumn 2010
7
continued...
• Gout was personified as one of
the Greek deities, Podagra, born
of Dionysus (Bacchus), the god
of wine, and Aphrodite (Venus),
the goddess of love. The idea that
gout resulted from service to these
gods and was a consequence of
overindulgence in sex, food and
wine was recorded by ancient
Roman authors and persisted into
the Christian era.
• Sydney Smith, English writer and
clergyman (1771-1845), said that
when his big toe became swollen
and painful, it felt “like walking on
my eyeballs”.
• “…the rich ate and drank freely,
accepting gout and apoplexy
as things that ran mysteriously
in respectable families…” wrote
George Eliot, pen name of English
novelist Mary Ann Evans (18191880).
• “People wish their enemies dead,
but I do not; I say give them the
gout, give them the stone!” said
Mary Worley Montagu – English
aristocrat and writer (1689-1762).
• Gout was referred to as
‘morbus dominorum et dominus
morborum’, ‘lord of disease and
disease of lords’, because of its
association with rich foods, alcohol
consumption and intemperance
afforded only by the wealthy.
• Gout was sometimes seen as a
desirable malady because of the
number of influential and powerful
people who had gout. A comment
in the London Times in 1900
highlights this: “The common cold
is well named – but the gout seems
instantly to raise the patient’s social
status”, and another in Punch
magazine in 1964, “In keeping
with the spirit of more democratic
times, gout is becoming less upperclass and is now open to all... It
is ridiculous that a man should be
barred from enjoying gout because
he went to the wrong school.”
• In the 16th to 18th centuries some
people considered gout to be a
remedy and not a disease. This was
because they believed that gout was
incompatible with other diseases.
The English writer Horace Walpole
(1717-1797) wrote: “It prevents
other illness and prolongs life. Could
I cure the gout, should I not have
a fever, a palsy, or an apoplexy?”
It was therefore sought by some
who did not have it, in the hopes of
curing them of their melancholia or
consumption.
Treatments
• An emphasis on diet and healthy
living has been a common approach
for dealing with gout through
the ages. English surgeon John
Abernathy (1764-1831) was asked
by an indolent and luxurious citizen,
“Pray, Mr. Abernethy, what is a cure
for gout?” He replied cogently: “Live
upon sixpence a day – and earn it.”
• Taking the waters and spa
treatments, particularly in English
spa town Bath, was a common
therapy for gout in the 18th century.
Taken both internally and externally,
and combined with a change of diet,
Bath waters often led to aggravation
of the condition followed by a period
of remission.
Definitely NOT to be attempted!
Here are some unorthodox and ill-advised treatments from the annals of history that illustrate just how far we
have come in our treatment of gout in modern times.
• Place a [particular type of] moss on the affected area,
and light it with a perfumed match. After this, bind a
clove of garlic over the area.
• Boil a large quantity of horse dung in a pail of water and
immerse the affected foot in it, with the water as hot as
the patient can bear. Continue for one hour, keeping the
water hot. Then send the patient to bed, and keep warm
so that they perspire throughout the night. The patient
will be well by morning.
• Whip the affected area with a rod of nettles until it
blisters. Next day, bathe the area in oil composed of
nettles.
• With the advent of the technological age, a myriad
of steam jets, atmospheric chambers and electrical
contraptions appeared – all designed to relieve the pain
of gout.
• Drink Venice treacle in a glass of mountain wine and
then go to bed. Relief will come in 2 hours, and you
will be better in 16 hours.
• Bloodletting was another therapy used to treat gout
for many years. Its use was rooted in the theory that
disease was caused by an imbalance in the four main
humours of the body. Physicians believed that to regain
balance, and therefore health, it was necessary to rid
the body of the excess humours.
• At least 13 saints and other holy people have been
credited with curing gout.
References
1.
2.
3.
4.
5.
6.
8
Bhattacharjee, Shom 2009 ‘A brief history of gout’, International Journal of Rheumatic Diseases, 12, pp. 61–63
Nicholson, Geoff 2008, ‘My literary malady’, The New York Times, 3 August, viewed 19 January 2010 http://www.nytimes.com/2008/08/03/books/review/Nicholson-t.html
Nuki, George & Simkin, Peter 2006, ‘A concise history of gout and hyperuricemia and their treatment’, Arthritis Research & Therapy, 8 (Suppl 1), viewed 18 January 2010
< http://arthritis-research.com/content/8/S1/S1>
Proter, Roy & Rousseau GS 1998, Gout: The patrician malady, Yale University Press, New Haven.
Rodnan, Gerald P & Benedek, Thomas G 1963, ‘Ancient therapeutic arts in gout’, Arthritis and Rheumatism, 6(4), pp 317-340.
Scholtens, Martina 2008, ‘The glorification of gout in 16th to 18th century literature’ Canadian Medical Association Journal, 179 (8), viewed 19 January 2010
< http://www.cmaj.ca/cgi/content/full/179/8/804>
News in brief
Annual General Meeting
2010
Arthritis Victoria’s Annual General
Meeting (AGM) will be held at 3pm
on Wednesday 28 April 2010 at our
offices at 263-265 Kooyong Road,
Elsternwick.
All members of Arthritis Victoria are
welcome to attend.
For information about the program for
the AGM and details of the speakers,
please check our website,
www.arthritisvic.org.au.
Christmas raffle results
Congratulations to the winners of
our Christmas raffle, drawn on
18 December 2009.
1st prize
Ticket 393130. Choice of car or
travel voucher valued at $31,000.
The winner selected a Holden Cruze
CDX automatic, plus RetraVision gift
vouchers worth $1,400.
2nd prize
Ticket no 164341. Get Away holiday
package valued at $4,000.
3rd prize
Ticket no 406542. RetraVision gift
cards valued at $2,000.
Early bird prizes
Early bird prizes, drawn on
18 September 2009, were won by:
Parent information workshop
Do you have a child diagnosed with juvenile idiopathic
arthritis (JIA)? Would you like to find out more about this
condition and have the opportunity to meet other parents
facing similar challenges?
During May, Arthritis Victoria is holding the first of a series
of workshops for parents of children with JIA.
The workshop will feature a number of informative and
participative sessions.
• Parents as advocates
• Parents as carers
• Paediatric rheumatology: your questions and answers
Mr Bill Van Den Broek
Coles Myer gift cards worth $1,000
Mrs Tracie PILKINGTON
Mrs Maureen MILLER
2010 raffles
The first raffle for this year is the Your
Choice raffle, to be drawn on Friday 23
April 2010. First prize is a car or travel
voucher valued at $31,000, with minor
prizes totalling $9,000.
The Early Bird draw for this raffle takes
place on 1 April.
Orders
Tickets cost only $2 each.
To buy your book(s) of tickets, call
03 9222 2928 or email your request to
raffles@arthritisvic.org.au
Muscles, bones and joints:
consumer forum
Want to learn more about your musculoskeletal
health?
Hear and interact with key experts in the fields of
inflammatory arthritis, fibromyalgia, osteoarthritis and
osteoporosis while they discuss current treatment
options, research and future trends at Arthritis
Victoria’s consumer forum.
When:
Saturday 22 May 2010
Registration:
12.30pm
Forum commences: 1pm – 4.15pm
These sessions will be led by staff from Arthritis Victoria
and Carers Victoria, and by medical experts in the field of
paediatric rheumatology.
Where:
Melbourne Convention and
Exhibition Centre
When:
Saturday 8 May 2010
Cost:
Duration:
Full-day workshop. Times to be
confirmed
$10 for Arthritis Victoria members
and concessions.
Where:
$18 for non members. Carers
accompanying participants are
welcome to register free of
charge.
Arthritis Victoria, Elsternwick
Further information: For information, and to register your
interest in attending this workshop,
please contact the Youth & Family
Services team on 03 8531 8028.
Or email nicole.riley@arthritisvic.org.au
Bookings:
Please contact Reception on
03 8531 8000.
Or email
reception@arthritisvic.org.au
Update Autumn 2010
9
What’s on in 2010
Leader training and
professional development:
semester 1
Warm water and chair-based
exercise leader training
Learn how to run safe and effective
warm water and/or chair-based
exercise classes for people with
chronic musculoskeletal conditions.
Enrol in either one or both components
of the course. Accredited by Kinect
Australia.
7 April - 9 April, 9.00 am - 4.00 pm,
Sunshine
11 June - follow up session
20 April –22 April, 9.00 am - 4.00 pm,
Shepparton
Tai Chi for Arthritis (TCA) Part 2
Tai Chi for Arthritis leader update
Learn the final nine movements of
TCA for people with musculoskeletal
conditions. Accredited by Kinect
Australia.
Update your knowledge of
contemporary practice in Tai Chi.
Accredited by Kinect Australia.
28 March, 9.00 am - 4.30 pm,
Elsternwick
Exercise and chronic
musculoskeletal conditions seminar
Improve your knowledge of the
prevention and management of chronic
musculoskeletal conditions such as
osteoarthritis and osteoporosis, with a
focus on safe and effective exercise.
Accredited by Kinect Australia.
6 May, 9.30 am - 4.00 pm, Elsternwick
24 June - follow up session
17 June, 9.30 am - 4.00 pm,
Shepparton
Better health self management
leader training
Strength training for chronic illness –
prescribers seminar
Learn how to co-lead a communitybased self management program for
people with chronic conditions such
as arthritis, heart disease, diabetes,
asthma, bronchitis.
Enhance your knowledge and skills
to deliver safe and effective strength
training programs for people with
arthritis, osteoporosis, diabetes and
heart disease. Accredited by Australian
Physiotherapy Association and
Exercise & Sports Science Australia.
18 May - 20 May, 9.00 am - 5.00 pm,
Elsternwick
Strength training for chronic illness –
supervisors course
Learn how to run safe and effective
strength training programs in
the community for people with
chronic conditions such as arthritis,
osteoporosis, diabetes and heart
disease. Accredited by Kinect
Australia.
15 April, 9.30 am - 4.30 pm, Bendigo
23 June – follow up session
Tai Chi for Arthritis (TCA) leader
training
Learn how to safely and effectively
conduct TCA classes for people with
musculoskeletal conditions. Accredited
by Kinect Australia.
5 June - 6 June, 9.00am – 5.00 pm,
Elsternwick
leader update
Update your knowledge of
contemporary practice in better health
self management.
19 April, 9.30 am - 1.00 pm,
Elsternwick
Information and bookings
Phone 03 8531 8000 or 1800 011 041
(toll free for country callers)
Email reception@arthritisvic.org.au
Web www.arthritisvic.org.au
(Courses & Events)
Community activities:
semester 1
WAVES warm water exercise
5 May, 9.00 am - 4.00pm, Elsternwick
Give your body a general workout
with these gentle warm water
exercise classes. Classes are held in
hydrotherapy pools across Melbourne.
Health professionals clinical update
Contact us for dates and venues.
Update and gain current evidencebased knowledge of medical
and conservative prevention
and management strategies for
musculoskeletal conditions.
course
10 May, afternoon, Clayton
Develop skills and strategies to
manage your chronic health condition.
A support person is welcome to
attend with you.
Warm water and chair-based leader
update
25 March - 29 April, 1.00-3.30pm,
Elsternwick
Update your knowledge and skills for
running safe and effective warm water
and/or chair-based exercise classes
for people with musculoskeletal
conditions. Accredited by Kinect
Australia.
26 May - 30 June, 1.00-3.30pm,
Footscray
24 June, 10.00 am - 3.30 pm, Bendigo
Learn how to manage your rheumatoid
or psoriatic arthritis. A support person
is welcome to attend with you.
25 June, 10.00 am - 3.30 pm,
Shepparton
28 June, 1.00 pm - 6.00 pm,
Elsternwick
10
27 March, 9.00 am - 5.00 pm,
Elsternwick
Inflammatory/rheumatoid arthritis
education & self management
program
29 April - 3 June, 6.00 - 8.30pm,
Heidelberg (Austin Hospital)
What’s on in 2010
Community activities continued...
Osteoarthritis of the knee education
& self management program
Learn how to manage osteoarthritis of
the knee. A support person is welcome
to attend with you.
14 April - 19 May, 1.00 - 3.30pm,
Cranbourne
Early arthritis seminar
For people diagnosed with
inflammatory arthritis (such as
rheumatoid arthritis, psoriatic arthritis
or ankylosing spondylitis) in the last two
years, and their partners and carers.
15 April, 6.00 - 8.30pm,
Heidelberg (Austin Hospital)
Nordic walking
Learn how to use specially designed
poles to engage the upper body
whilst walking. Suitable for people
who have, or who wish to prevent a
musculoskeletal condition.
16 April - 21 May, 10.00-11.00am,
Caulfield
Managing your relationships with a
chronic condition
Join us at this interactive workshop for
people with a musculoskeletal condition
and their partners, siblings, parents or
children. We focus on managing the
impact of chronic conditions on your
closest relationships.
24 June, 6.00-8.30pm, Elsternwick
My Tai Chi
Try this gentle form of mind-body
exercise to promote general health
and wellbeing. Suitable for people with
chronic musculoskeletal conditions. All
classes are held in Elsternwick.
Introductory course (6 weeks)
Early lupus seminar
23 February - 30 March, 10.00-11.00am
For people diagnosed with systemic
lupus erythematosus in the last two
years, and their partners and carers.
6 April – 11 May, 10.00-11.00am
8 June, 6.00 - 8.30pm, Clayton
(Monash Medical Centre)
Continuing course (10 weeks)
25 May - 29 June, 10.00-11.00am
25 February – 29 April, 10.00-11.00am
Regional seminar – Numurkah
Learn how to manage your
musculoskeletal condition at this public
afternoon seminar hosted by Numurkah
Arthritis Self Help Group.
16 June, time TBA, Numurkah
(Information Centre)
For further information
Phone 03 8531 8000 or 1800 011 041
(toll free for country callers)
Email reception@arthritisvic.org.au
Web www.arthritisvic.org.au
(Courses & Events)
27 May - 29 July, 10.00-11.00am
Arthritis Victoria Members receive a FREE GIFT with purchase
Your one stop shop for Arthritic Aids and Appliances
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Thighs and Back. Provides warmth and support during those cold winter months.
“These products have truly made a difference to
people with arthritis because they enable them to
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Stated Armin U. Esq American Arthritis Foundation
Chairman, October 5, 1993.
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PHONE: (03) 9591 6234
FAX: (03) 9591 6292
Update Autumn 2010 11
What’s new in our library
Sasse, Margaret 2009,
Smart start: How exercise can
transform your child’s life,
Exisle Publishing Limited,
Auckland.
Full of practical advice on
exercise designed to encourage
optimal physical and intellectual
development in your child from an
early age.
Bonner, Dede 2009,
The 10 best questions for living
with fibromyalgia: The script
you need to take control of your
health, Fireside, New York.
Svensson, Malin 2009,
Nordic walking,
Human Kinetics, Champaign.
A guide to the basics of Nordic
walking, including information
on safety, etiquette, and tips for
selecting the correct gear.
Learn how to become your own
best advocate by asking the
questions you need to ask.
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Managing your chronic medical condition
Did you know that you may be able
to access a number of different allied
health services to help manage your
chronic musculoskeletal condition
through the Chronic Disease
Management scheme?
The Chronic Disease Management
scheme covers a number of Medicare
items on the Medicare Benefits
Schedule (MBS). The scheme enables
General Practitioners (GPs) to plan
and coordinate the health care of
their patients with chronic medical
conditions. This includes people with
chronic musculoskeletal conditions such
as arthritis. The MBS items allow GPs
to develop a comprehensive Chronic
Disease Management Plan.
There are two types of Chronic Disease
Management Plans available through
the scheme:
• GP Management Plans (GPMPs) and
• Team Care Arrangements (TCAs).
GP Management Plans
of a number of different allied health
providers to help with management of
your condition, including:
• Aboriginal health workers
on, or likely to impact on, your general
health. Access includes up to $4,250
in Medicare benefits for dental services
over two consecutive calendar years.
• Chiropractors
More information
• Dieticians
• Exercise physiologists
• Mental health workers
• Occupational therapists
• Osteopaths
• Physiotherapists
• Psychologists
• Podiatrists.
With both a GPMP and a TCA, you will
be able to claim a maximum of five (5)
allied health services per calendar year
through the MBS.
Dental services
If you have both a GPMP and a TCA,
you will also be eligible to access dental
services if your oral health is impacting
Chronic Disease Management
Medicare items
For information about management
plans and allied health items, visit
www.health.gov.au and search for
‘chronic disease management medicare
items’.
Dental items
For information about dental items, visit
www.health.gov.au and search for
‘dental care services’.
Susannah Wallman
Policy Officer
03 8531 8056
advocacy@arthritisvic.org.au
If you have a chronic medical condition,
your GP may suggest a GPMP. To do
this, your GP will:
• assess how your chronic condition is
affecting you
• help you to develop some
management goals
• identify actions that you can take to
help manage your condition
• identify appropriate treatment and
ongoing services that may assist you
• review all of these factors at least
once every six months.
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If you also have complex care needs
and require treatment from two or
more other health care providers, your
GP may suggest a TCA as well. This
involves the GP collaborating with the
other health care providers to ensure
you have a coordinated approach to
management of your condition, with
review at least every six months.
Allied health providers
If you have both a GPMP and a TCA you
will be eligible to access the services
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Raffle draws: how they work
Remember the good old days when
raffle draws used to be conducted
using a barrel? Nowadays, it’s all
done electronically, using a compact,
one-touch piece of new technology.
Preparing for the draw
To be able to conduct raffles, Arthritis
Victoria must hold a minor gaming
permit, which is granted by the
Victorian Commission for Gambling
Regulation (VCGR). This permit
number appears on each raffle ticket.
Representatives from the VCGR may
choose to attend the draw, and notify
us immediately before the draw date.
We must report to the VCGR after
each draw. All draws take place at
Arthritis Victoria’s Elsternwick office.
On the day of the raffle draw a
representative from Apple Marketing
Group Pty Ltd, the organisation that
coordinates our raffles, arrives with
the information and equipment that
will determine who will be the lucky
prize winners. This includes the raffle
database for that particular draw,
which contains the numbers of every
ticket allocated from 1 to 450,000,
and the numbers of every ticket sold,
and the Raffle Master electronic
machine used to randomly select the
winning raffle tickets.
One touch to win
From then on, it’s a simple process.
The person doing the draw presses
a button, and a ticket number is
illuminated on the panel. Each prize
is awarded to the first sold ticket
selected at random by the computer.
Melissa Northcott, a Telephone Information Service volunteer
at Arthritis Victoria, with the new electronic draw machine
Writer’s block
Over the years we have received many queries from
people asking whether they have to complete each
individual butt in their book of raffle tickets.
To make life easier for you, Arthritis Victoria has
introduced a tick box on the first raffle butt. When you
want to inform us that the whole book of tickets is yours,
all you need to do is fill in your details just once on the
first butt and tick the box.
The first raffle winner to take advantage of this innovation
was Mrs W Mace, who held 3rd prize winning ticket
number 026372 in our Spring 2009 raffle draw.
14
2
Please complete your details
Name
Address
$
Telephone (H)
Telephone (W)
Postcode
ALL TICKETS IN THIS NAME
Learn more about arthritis/osteoporosis
by phoning 1800 011 041
or visiting www.arthritisvic.org.au
The person whose name appears above
must be over the age of 18 years.
AFV0110
Mrs Mace had ticked the box on the first ticket butt
(number 026371), which saved her the trouble of writing
her details on each butt in the book of tickets.
263-265 Kooyong Road
Elsternwick Victoria 3185
Phone (03) 8531 8039
ABN 26 811 336 442
“This is a great
idea,” said Mrs
Mace. “It saved
me a lot of time
and effort.”
One of the first
items to be
purchased by
Mrs Mace with
her RetraVision
gift cards worth
$1,000 was a
digital radio.
Newsletters make a difference
We have received the following letter from Carole Marshall, who coordinates the South East
Melbourne Osteoporosis Support Group.
“Thank you for the excellent articles on osteoporosis
in the Summer 2009 issue of Update, and especially
for mentioning the two osteoporosis support groups in
Melbourne. As Co-ordinator of the South East Melbourne
Osteoporosis Support Group, I want to emphasise the
importance of all support groups to people with any
serious medical condition and to highlight that group
meetings, important though they are, are only part of
the deal. Both of the osteoporosis support groups in
Melbourne publish regular newsletters that provide up
to date information on the condition. Our South East
Melbourne group also has an email network,
bonesgroup@hotmail.com.
Many people cannot get to support group meetings,
especially those living in rural areas. Yet in many cases,
they can benefit from membership of a support group like
New Styles
Black only
ours that has a newsletter, because it can help them feel
confident that they are ‘not alone’. The communication
lines open up and greater strides are taken in self
management of their health condition.
For people living with osteoporosis, moves are afoot to
organise a new support group in Shepparton, where much
interest has been shown. I would encourage anyone with
osteoporosis or osteopenia, and those who care for
someone with the condition, to contact Arthritis Victoria
and obtain details of the Arthritis Victoria-affiliated
osteoporosis support groups.
Best wishes for your continued excellent support of
people with all musculoskeletal conditions.”
Carole Marshall
South East Melbourne Osteoporosis Support Group
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A lasting legacy
Our supporters choose to help Arthritis
Victoria in different ways. Some give
financial donations to our appeals or
buy items from our op shops. Others
volunteer their time and skills. Many
buy our raffle tickets. Some choose
to contribute to our work by making a
bequest.
You may find it surprising to learn that
10 per cent of Arthritis Victoria’s annual
income comes from bequests – money
or assets that people leave to Arthritis
Victoria in their Wills. That’s nearly
three times as much as we receive in
government funding.
Why are bequests so
important?
Each gift given to Arthritis Victoria,
no matter what the size, is gratefully
received. However, the gifts that
we receive as bequests play a very
specific role in helping transform the
lives of people coping with chronic
musculoskeletal conditions such as
arthritis, osteoporosis, ankylosing
spondylitis, fibromyalgia and lupus.
Natalie Savin, Arthritis Victoria’s CEO
explains: “As a direct result of our
supporters’ generosity and foresight
to include us in their Wills, Arthritis
Victoria has had the confidence to
make exciting and important steps
towards helping those in need of our
support. For example, with the help of
recent bequests, we have been able
to establish our own internal Research
Management Unit to support and
extend our research capabilities.”
“The bequests we receive help us to
respond to the needs of the Victorian
community, and to ease the burden of
painful, life-altering musculoskeletal
conditions affecting people of all
ages. With the help of our supporters’
bequests, we can continue to do this
today, tomorrow and into the future.”
Why make a bequest?
In many cases, people choose to
make a bequest for the same reason
that they choose to support us during
their lifetime – because they or a
close family member live with chronic
musculoskeletal conditions themselves.
16
They include us in their Will because
they have first-hand experience of
the challenges, pain and impact that
musculoskeletal conditions have on
their own lives or on the lives of their
family and friends.
Some want us to continue helping other
people to get the support they need to
lead healthier, less painful lives through
our community programs of safe and
appropriate physical activity. Some
want to support our work with children
and families touched by juvenile
arthritis. Others want to contribute
towards improving awareness and
understanding of musculoskeletal
disease, or to research that will lead
to better treatments and prevention of
these life-altering conditions.
What these supporters have in common
is that they have taken positive action to
support future generations.
Maggie’s story
What you can do
Maggie, who lives in Beechworth, is the
most recent of our supporters to tell
us that she has included a bequest to
Arthritis Victoria in her Will. Having lived
with arthritis for many years, she has
received continuing help and support
from our self-help groups. When she
phoned us just before Christmas last
year, she asked how she could support
Arthritis Victoria in a more meaningful
way.
Please consider leaving a bequest
to Arthritis Victoria. Your decision
to include us in your Will can make
a real and positive difference to the
lives of people affected by arthritis,
osteoporosis, fibromyalgia, lupus and
other musculoskeletal conditions, now
and in generations to come.
After discussing Maggie’s wishes for
the future, we sent her some additional
information explaining how she could
leave a bequest to Arthritis Victoria.
Maggie decided to visit her solicitor to
update her Will.
“The help and support that I’ve had over
the years has made a huge difference to
my life. Arthritis Victoria has helped me,
so I wanted to find a way of supporting
this charity’s great work”, she explained.
“I don’t want people to suffer like I have.
By remembering Arthritis Victoria in
my Will now, I know that my gift will be
put to good use after I’ve gone, to help
other people like me in the future.”
Keeping in touch
We have recently produced a new
booklet called Your legacy for a healthier
future which explains how to include
Arthritis Victoria in your Will. It includes
practical information, and real-life
stories from some of our supporters
and those whom your bequest could be
helping in the future.
Please contact us to request your copy
of Your legacy for a healthier future.
Or let us know if you have already
made a decision to include a bequest
to Arthritis Victoria in your Will. We
would like the opportunity to thank you
personally for your thoughtfulness and
generosity.
Ross Anderson
Donor Liaison Coordinator
03 8531 8014
ross.anderson@arthritisvic.org.au
An inspiring story: Another Alice
This is the true story of a young girl who, at the age of
18 and with a promising tennis career ahead of her, was
diagnosed with rheumatoid arthritis.
The author, Alice Peterson, describes her life with the
debilitating condition, rheumatoid arthritis, following
diagnosis in her early teens. It is a roller coaster ride. She
takes us through the grieving process associated with
her loss of independence, her feelings of isolation, the
experience of falling in love, and the importance of family
support.
At the time of her diagnosis Alice is at the peak of a
promising tennis career. But as her joint pain grows worse
she is eventually forced to give up her dream of turning pro.
She turns her focus to completing her university degree,
regaining her personal independence, and using her own
life experiences to help others.
Alice also writes about the endless medical appointments,
surgery, hospital stays, and feelings of hopelessness when
most treatment options have failed.
Her courage to make a life-changing decision to participate
in a drug trial provides her with more hope of gaining control
over her life than ever before.
Another Alice is a thought-provoking look into a worst case
scenario of rheumatoid arthritis. Alice’s strength, and her
optimism that she will not to be defeated by her daily pain,
will make you laugh and cry.
It is difficult for someone who does not live with a chronic
musculoskeletal condition to contemplate what rheumatoid
arthritis can do to your physical appearance and more
importantly, what it can do to your state of mind. Alice’s
brutally truthful encounter of suicidal thoughts brings home
the hidden, and for some, shameful side of living with
rheumatoid arthritis. Having spent the last 18 years living
with this condition myself and having experienced many
of the same situations Alice describes, for me this book
reinforces the saying “you are not alone”.
Another Alice is an inspiring read for any person coming
to terms with living with rheumatoid arthritis. It may also
be helpful for family members or anyone seeking to gain a
greater understanding of this condition.
Peterson, Alice 2009, Another Alice: an inspiring true story
of a young woman’s battle to overcome rheumatoid arthritis,
Icon Books, Cambridge.
Another Alice was reviewed by Nicole Riley, Youth & Family
Services Administrative Assistant, Arthritis Victoria. It is
available on loan from the Arthritis Victoria Library.
Want more information?
The information provided in Update
is just a taste of what we have available
at Arthritis Victoria.
Our Telephone Information Service is open Monday to Friday
from 10am to 4pm, and is staffed by trained volunteers. Call
03 8531 8000 or 1800 011 041 (toll free for country callers).
Our website, www.arthritisvic.org.au is updated regularly
and features all of our information sheets, which you can read on
screen or easily print off.
Local focus
Latrobe and Wellington
regions
The Latrobe and Wellington regions are
located in Gippsland. The Latrobe region
includes the major townships of Moe,
Morwell and Traralgon. Further east is
Wellington, with the major townships of
Sale and Yarram. The region is known for
its beautiful natural landscape and historic
townships.
Wellington: training for health
professionals & fitness
instructors
Arthritis Victoria works with the Wellington
Primary Care Partnership (PCP) to deliver
training for health care workers and fitness
instructors in the region. Recently, health
educators from Arthritis Victoria delivered
a new training course, Strength Training
for Chronic Illness Supervisors, in Sale.
This course aims to increase participants’
knowledge of running safe and effective
strength training programs in the community
for people with chronic conditions such as
arthritis, osteoporosis, diabetes and heart
disease.
For information on strength training
programs in the Wellington region, contact
Rachael Dooley, Health Promotion Coordinator, Wellington PCP, 03 5143 8868.
Community health services
Moe, Morwell & Traralgon
Latrobe Community Health Service provides
a range of physical activity classes and
access to allied health services. Classes
include Nordic walking, strength training, Tai
Chi for falls prevention, hydrotherapy, Aqua
Movers, relaxation, and an arthritis-specific
class that focuses on improving joint
mobility and strength. Allied health services
include physiotherapy, occupational
therapy, dietetics and podiatry. Some
services require a GP referral.
Contact 1800 242 696 or visit
www.lchs.com.au/
Sale
Central Gippsland Health Service provides
a range of allied health services and
physical activities, including exercise
groups for pre- and post- total hip and
knee replacements, falls and balance, and
arthritis. Some services require a GP referral.
18
An assessment by a physiotherapist may be
required before inclusion in a group program.
www.gha.net.au/cghs/
Yarram
Yarram and District Health Service provides
exercise groups and access to allied health
services, based at Yarram Hospital. Allied
health services include physiotherapy,
dietetics, podiatry and occupational
therapy. Various exercise groups include a
balance and mobility program, Tai Chi for
Arthritis, and Prime Movers (for pre- and
post- total hip and knee replacements. In
most cases a GP referral is not required.
www.gha.net.au/ydhs/
Memorial
gifts
The family and friends of the
following people have marked
their passing by making
donations in their name to
support the work of
Arthritis Victoria.
Mrs Bronie Knight
Mrs Violet Joyce Fredrickson
Self help groups
Mrs Joyce Dawson
Arthritis Victoria supports four self-help
groups in the Latrobe and Wellington
regions.
Mrs Elsie Thiele
Moe/Narracan Arthritis Self Help Group
meets on the third Monday of every second
month. It also runs warm water exercise
classes for group members. Annual
membership fee is $10.00. There is no
charge to attend meetings. Some members
speak languages other than English,
including Dutch, Greek, Italian, Polish and
German.
Mrs Anthea McIntyre
Ms Elizabeth Cull
Mr Christopher Pitts
Contact Beverley on 03 5126 2416
Latrobe Valley Arthritis Self-Help Group
meets bi-monthly (Fridays) in Morwell.
Annual membership fee is $9.90. Each
meeting costs $8.00 and includes lunch.
The group runs warm water exercise
classes for members.
Sale Arthritis Support Group meets on
the first Monday of each month. Annual
membership fee is $5.00, but there is no
charge to attend meetings. The group
conducts warm water and chair-based
exercise classes for members.
Contact Joy on 03 5144 3194 or
Margaret on 0408 514 833
Yarram Self Help Group meets on the
second Thursday of each month. The group
conducts self-management courses, but
does not run exercise classes. There are no
membership fees.
Mrs Jennifer May Nero
Mrs Barbara Barnes
We gratefully acknowledge
this support and join in the
commemoration of the lives of
these valued members of the
community.
For more information on
memorial gifts, contact
Ross Anderson on
03 8531 8014 or
ross.anderson@arthritisvic.org.au
Contact Ann Kay on 03 5182 0233
Advocacy at Arthritis Victoria
l
An important part of Arthritis Victoria’s job is to ensure
that people with musculoskeletal conditions have a strong
voice within the health system and community at large.
This involves understanding what the key concerns are for
people living with these conditions, and creating a strong,
collective effort towards addressing the issues. The formal
term for this activity is ‘advocacy’.
of the recent advocacy issues we have been working on
is the Government’s removal of joint injections from the
Medicare Benefits Schedule (MBS). We have been calling
on people to write to the Government and their local MPs
in opposition to this removal. For more information visit
our website at www.arthritisvic.org.au. Follow the link for
‘About us/News’.
What is advocacy?
Arthritis Victoria is also developing our Advocacy Strategy
and Action Plan, which will identify and prioritise the key
advocacy issues that we will take on over the next year.
We are now seeking feedback via an online survey on
what your key advocacy concerns are. If you haven’t yet
had an opportunity to provide feedback, please email
advocacy@arthritisvic.org.au to find out how you can
contribute.
The word ‘advocate’ comes from a Latin word meaning ‘to
be called to stand beside’. The World Health Organization
defines advocacy for health as:
“A combination of individual and social actions designed
to gain political commitment, policy support, social
acceptance and systems support for a particular health
goal or programme”.
At Arthritis Victoria this relates to addressing the individual
‘health goals’ that come from understanding what you, our
consumers, feel are the issues impacting on your lives.
Over the last few months we have been developing our
Advocacy Framework – a toolkit of advocacy information,
tools and templates to assist our advocacy efforts. One
Watch this space for news on future Arthritis Victoria
advocacy campaigns. The more people who get involved,
the more powerful our collective voice will be!
Susannah Wallman
Policy Officer
03 8531 8056
advocacy@arthritisvic.org.au
Have you discovered
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Elsternwick: 03 9528 5774 Moonee Ponds: 03 9326 0266
Mont Albert: 03 9899 7899 Geelong: 03 5224 2216
www.extradepthfootwear.com.au
Attention Arthritis Sufferers
■ The original Rose-Hip Vital imported from
Denmark is a powerful antioxidant and may help:
✓ Temporarily relieve the pain of
Arthritis, Osteoarthritis and Rheumatism
✓ Increase joint mobility
✓ Relieve inflammation and joint swelling
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in the hands
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Use only as directed. If symptoms persist consult your healthcare professional.
Available from health stores and pharmacies.
www.rosehipvital.com.au
1800 851 888

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