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DrRussMD
DrRussMD, Board Certified MD
Category: Medical
Satisfied Customers: 63865
Experience:  Board certified Internal medicine and Integrative medicine. Many years of experience all areas.
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I have suffered from Psoriatic/Rheumatoid Arthritis 12

Customer Question

I have suffered from Psoriatic/Rheumatoid Arthritis for over 12 years. I am now 59 female and very overweight. I was taking Methotrexate, celebrex, sulphasaladine, hydroxichloroquin, paracetamol as well as Sertraline for depression, Mirabegron for urinary problems, a drug for high blood pressure & Omneprazol. About 2 years ago I developed a cough and was immediately taken off methotrexate. A CT scan showed a mild Bronchiectasis. The cough has eased and the methotrexate replaced by a 2 weekly injection of HUMIRA. I have also been diagnosed with chronic sleep apnoea, I have had a very expensive mouth guard made which I hope will help me have better sleep patterns. Over the last 6 months I have been getting chronic lower back pain, which seems to be getting worse and is now debilitating almost from the moment I get up. The only way to ease it is to sit in a hard back chair and press my back against it. I realise that I need to exercise more and that this is probably one of the roots of all my problems. But my Psoriasis, which I get on my scalp, is getting worse and I cant cope without my antidepressants. I also get a bit more pain in my joints without the methotrexate. It is a vicious circle, I've had to give up yoga as my wrists cant take it any more and I've lost my job because of my sleepiness. I wonder if there is a holistic doctor, who would view ALL my symptoms and perhaps treat them as one, or if I'm going down the right path with all this medication. I use Voltarol gel on my back and joints. It is my back that is most worrying at present. Please could you advise
Submitted: 6 months ago.
Category: Medical
Expert:  DrRussMD replied 6 months ago.

Hello.

I am Doctor Thomas, a double board certified doctor in internal medicine and integrative medicine [American College of Medical Examiners], with advanced training in several other fields. I am a clinician of over 20 years experience. I will give you an initial answer or ask you a question, but be sure to use reply to expert to communicate with me as needed.

I am sorry to hear this once again. You are not alone.

The medicines cause their own problems, particularly when your are on so many.

They don't address underlying disease mediators, but some doctors are trained to do that.

The correct anti inflammatory diet is a must, but I will bet that no one has taught you this.

The medicines need to be streamlined.

You need an MRI of the lower back to see if this is from early disc problems, which can be remedied with specific physical therapy. A consultation from an MD of physical medicine and rehabilitation will help.

As to the metabolic aspects and disease mediators, the Institute of Functional Medicine has now trained a couple of groups of UK docs.

These docs will look at: neurotransmitter function, cellular energy function, hormonal function, bowel function, structure and toxicity and biotransformational ability, and address these, often with supplements, and help you stop the inflammation, as well as taper your meds and lose weight.

Call them here for a referral and see the practitioner list.

functionalmedicine.org

OK, so you might have more questions or want to give me more information: Please use reply to expert if you have further questions. Also, please click a positive rating [hopefully excellent—that’s how we are paid, per rating]. If you forgot something, just use reply and come back. I am here http://www.justanswer.com/medical/expert-dr-thomas/

DrRussMD, Board Certified MD
Category: Medical
Satisfied Customers: 63865
Experience: Board certified Internal medicine and Integrative medicine. Many years of experience all areas.
DrRussMD and 3 other Medical Specialists are ready to help you
Expert:  DrRussMD replied 6 months ago.

Tell me your diet

meal to meal, typical day

Customer: replied 6 months ago.
Breakfast - 2 croissants or 2 slices of bread with butter and maybe ham, marmite, marmalade or peanut butter. Or bowl quick porridge or all in one cereal, Juice and 2 mugs tea with semi skimmed milk and sweetener. very occasionally soft boiled eggs with toast or bacon and tomato sandwich, on French loaf or sour-dough bread.
Snacks - Orange or apple or pineapple or strawberries or sweet biscuits or packet of crisps
Lunch - bowl of soup with bred or piece of quiche with salad (try not to eat sandwiches as make me feel bloated) scrambled egg or one of my breakfast choices if not already had it.
I have to be careful with eggs - they can go right thru me and cause stomach cramps.
Dinner: Baked potatoes with cheese and coleslaw or tinned tuna and mayonaisse or chilli OR chilli with basmati rice or spaghetti bolognese ( need to be careful with pasta) or thai curry with rice and vegetables. Or grilled, chop/steak with potatoes and veg. or roast chicken/lamb/pork with potatoes and veg. I do eat a lot of veg including courgettes, aubergine, mushrooms, broccoli, Kale, spinach, cabbage, corn, carrots, marrow, lettuce, tomatoes, garlic, onions. I eat a little cheese but not much. I do cook with cream but also natural yoghurt and low fat Fromage Frais. I also love fish - grilled cod or sea bass scallops or prawns with Courgetti ( I have a spiralliser). I need to be careful with farmed salmon and battery chickens ( maybe the hormones they are fed?) I cant eat sandwiches or pizza. I love cauliflour, but with cheese sauce, although i love it and sometimes yearn for it, it does affect me negatively!
Expert:  DrRussMD replied 6 months ago.

OK

You must find the type of doctor I mentioned.

In terms of starting on your own

The diet, in order of preference in quantity, should look like this
leafy greens
green veggies
other veggies
whole fruit, beans and peas
Whole grains no yeasted breads, dry cereals or anything refined
Seeds and nuts, but cut out seeds if you have any diverticulosis.
A little tofu or tempeh daily
A little high quality soy or coconut milk yogurt

The soluble fiber in this strategy will stabilized colon function in about 6 to 8 weeks, then about 2 or three helpings of animal foods a week, preferably fish, can be added back.
See the book Eat to Live by Dr. Joel Fuhrman, for instructions on this type of diet.

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