Re: ankylosing spondylitis and ...

From: Douglas Krell (sfth@roadrunner.com)
Sun Apr 28 08:34:26 1996


Ealgail@aol.com wrote:

> we can help that
> along by actually saying, "It's the MOST serious threat to health you
> have...greater than osteopororsis, greater than ulcers, greater than the
> ankylosing spondylitis.." and "if you only do one thing for your
> health....quitting smoking is the thing to do". In my experience, they need
> counseling and it takes 15 to 20 minutes of office time, so charge for

Thanks for your enthusiastic stop smoking tips. I'm quite certain that all of us have patients who will appreciate these tips when "they're ready".

Peter V Weston wrote:

I would start her on appropriate Estrogen therapy and give her Fosamax. I would contact Merck and ask them whether they have any info on AK and Fosamax. If you want to be academic you can order Bone Mineral Density studies but I would put money on her having significant demineraliztion. I would consider the test an unnecessary expense.

That's also my feeling about bone densitometry in general although I've felt that if a patient carried the diagnosis and is on therapy that BD studies could help us follow the progression or regression of disease. I will contact Merck about Fosamax and Ankylosing Spondylitis. Usually the reps have nothing to say about E2 and Fosamax together.

Dr. Freeland wrote:

I would want strong affirmation by the patient that the prednisone is making a significant difference in order to keep her on it. NSAIDS do virtually nothing for AS.

Yes. I agree that we should challenge her MD's dosage of prednisone.

Thanks,

--
Douglas Krell MD
sfth@roadrunner.com




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