Use ice to prevent pain.

“1 recommend cold treatments for those times when a joint’s been stressed from overuse or overwork.” says King. She uses a gel pack on her clients but notes that ice in a plastic bag or a bag of frozen peas will do just as well. Apply for 15 to 20 minutes, then remove for 10 to 15 minutes. “That can be repeated for hours at a time,” she says, “if needed.”

Use heat to reduce pain.
When joints become hot, swollen, and tender, heat is the best solution, says King. “Cold would make them very painful.”

Don’t baby your joints.

“1 like people to follow an aerobic exercise program for arthritis,” says Dr. Mollen. “1 recommend walking, bicycling, or swimming because they don’t traumatize the joints. But do whatever type of exercise you can tolerate that will elevate the pulse rate to at least 120 beats per minute and give you a beneficial effect on the heart and lungs.”
Research by Susan Perlman, M.D., of Northwestern University Medical School, has shown that vigorous exercise can even be safe for patients with rheumatoid arthritis and often results in both physiological and psychological improvements. To see if symptoms such as fatigue and depression were the result of poor physical conditioning, she decided to put 54 patients through a low-impact aerobics program.
The result? The vigorous exercise did not result in joint inflammation, but it did improve the walk time, physical activity, and health status of the participants, while reducing their joint pain and swelling, as well as their general pain.

Get off addictive drugs.

Sleeping pills, tranquilizers, and narcotic painkillers can become part of life for a person with arthritisunfortunately. “It’s not that these drugs don’t work.” says Nelson Hendler, M.D., assistant professor at the Department of Neurosurgery at Johns Hopkins University School of Medicine. “They do - but for most people they are needed in ever-increasing amounts andend up creating many more problems than they solve.” Though it may require professional help, Dr. Hendler believes such drugs should be slowly replaced with biofeedback or other forms.

Cut back on vegetable oil

There’s no question that vegetable oils are generally beneficial to most people, says George Blackburn, MD., chief of the Nutrition/Metabolism Laboratory with the Cancer Research Institute at New England Deaconess Hospital in Boston. But, he cautions, studies show that people with arthritis may be a special case and may need to minimize their intake of vegetable oils while increasing their intake of oils rich in omega-S’s,
That doesn’t mean doing without vegetables, he says, but it does mean cutting back on oil-containing products like salad dressings, fried foods. and margarines. These foods contain high levels of omega-6 fatty acids. which have been shown to cause inflammation in those with rheumatoid arthritis. 1Wo oils that are low in omega-6’s are canola oil, made from rapeseed, and olive oil. Dr. Blackburn says these two oils can be used in moderation, noting that it’s best to keep the overall level of fat in your diet at less than 30 percent of total calories.

Carry on with carrot juice.

A vegetable-juice fast significantly reduces pain for many patients with rheumatoid arthritis at Dr. Mollen’s clinic. “I started prescribing this type of fast several years ago and have found it very beneficial,” says Dr. Mollen. Carrot juice, celery juice, cabbage juice, or tomato juice can be used.
Dr. Mollen suggests fasting on nothing but the vegetable juice for one day during the first week to get started. Follow that by alternate fasting for two days during the next week (i.e., Monday and Wednesday) and three days during the third week (Monday; Wednesday; and Friday). Don’t attempt any type of fasting without a doctor’s supervision, however.

The Case for Copper

Sometimes longevity confers respect along with age. Artifacts that were rarely noticed in their day take on new meaning and value as they persist throughout time. Such is the case with the copper bracelet, which for decades has been worn for arthritis relief and remains popular today. Studies have shown that some people with arthritis seem to have difficulty metabolizing copper from the food they eat, leading to increased pain. That observation led Helmar Dollwet, Ph.D., of the University of Akron to theorize that arthritis sufferers may need to get their copper from another source. “The dissolved copper from [a copper] bracelet bypasses the oral route by entering the body through the skin,” he wrote in his book, The Copper Bracelet and Arthritis. Dr. Dol/wet thought this might be the only way arthritics ever receive the copper their bodies need-copper that studies have shown can indeed relieve pain. Physicians remain somewhat skeptical about bracelets but don’t entirely dismiss them, either. “I see people wearing copper bracelets, and they’re wearing them because it helps them,” says Elson Haas, M.D. “I think copper may have a role. It’s possible that a copper deficiency does increase joint inflammation, and it doesn’t seem that supplementing copper in the diet has the same effect as wearing it.” Does that make Dr. Haas a believer? “I don’t necessarily supply copper bracelets to people, but I don’t discourage them from wearing one either.” The beginning exercise techniques are easy for anyone to follow: They consist of waving, walking, and bending motions performed in chest-deep water. The more advanced movements look like aquatic dance steps designed to take advantage of water’s natural resistance and gentle buoyancy.

Get your spouse involved.

Though it’s only natural for a husband or wife to do whatever’s possible to help a mate who’s hurting, such help can often do more harm than good. “When a wife tries to do everything herself and is constantly asking her husband how he feels, she is reinforcing his pain,” says Judith Turner; Ph.D., a psychologist with the Pain Center at the University of Washington. Her advice: Don’t be attentive and supportive only when your spouse is in pain, but also when he or she is feeling good and being active. “That’s the time to say, ‘Gee, I’m really happy to see you doing things,’” Dr. Turner says. “Praise is really important and something people tend to forget to do.”

Float pain away.

Studies have shown that floating in specially designed flotation tanks, also known as isolation or sensory deprivation tanks, can relieve arthritic pain. “You usually spend about an hour in the tank,” says Roderick Borrie, Ph.D., a Brooklyn, New York, psychologist. “The pain relief is produced by stress reduction. The body is relaxing, the muscles are relaxing, and this seems to stimulate a release of endorphins, the body’s natural painkillers.” Water in the tanks is heated to precisely 93.5°F, the same temperature as the skin, and the surrounding air is warm and tranquil, leading to deep relaxation. Dr. Borrie says there are about 200 tank centers located throughout the nation. For more information, contact the Flotation Tank Association, Box 30648, Los Angeles, CA 90030.

Mix oil and water.

“I have rheumatoid arthritis in my hands,” says Donna King, a massage instructor at the Atlanta School of Massage. “I’ve taken courses in hands-on arthritis treatment, and I’ve also figured out what works on me-so I know this treatment works.”
Her recommendation: Heat and eucalyptus ointment, in the form of a thick, oil-based product called Eucalypta-Mint, work for both osteoarthritis and rheumatoid arthritis. It’s available from Therapeutic Supply and Services Company; 3931 Peachtree Road NE, Atlanta, GA 30319. “I use that in conjunction with moist heat when I’m feeling stiff or having pain,” she says. Simply rub it on and wrap the joint in plastic wrap. “The moist heat can be applied with warm towels, or you can soak your hands or feet in warm water.”

Work wonders with watercise.

Ask a dozen doctors about the merits of any arthritis treatment and you’ll get a dozen different opinions. But ask them about exercising in water and a strange thing happens - they all agree. “Water exercises are excellent,” says Dr. Mollen, echoing the sentiments of many. “Your pain will be significantly reduced in the water, and you become much more flexible in water than you are in air. I can’t say enough about water exercises!”

Arthritis may be the oldest known ailment on earth. Mummies uncovered in Egypt had it, prehistoric man had it, dinosaurs had it. Close to 40 million Americans have it, and a million more will have it a year from now: If you’re reading this, perhaps you have it, or you know someone who does. Though new books touting new treatments with potent drugs and surgery seem to pop up every day; we’re not going to tell you about any new “miracle” cures here. What we are going to tell you is how to bring about pain relief without getting a prescription filled or making a trip to the doctor. There’s a lot you can do on your own, at home, without a lot of expensive equipment or pain or risk. So let’s get started. (Unless otherwise noted, the following tips are helpful for all types of arthritis.lose weight, gain relief. “There’s no one magic food or diet that’s going to do away with arthritic pain,” says Art Mollen, D.O., director ofthe Southwest Health Institute in Phoenix, Arizona. “But if you’re overweight and you lose weight, it will reduce a significant amount of the stress and pain you feel in your spinal column, knees, hips, ankles, and feet.

Reason: The more overweight you are, the more stress and pressure vou place onyour joints. This increases the stress on the cartilage, which .Interferes with the bone, thus increasing the incidence of inflammation, swelling, and pain.

Solution : Work with your doctor or nutritionist to find a diet that marks for you, and stick with it.Stretch gently for strength and mobility. When it comes to arthritis, says Mary P. Schatz, M.D., a private practitioner in Nashville, Tennessee., “moving hurts, but not moving destroys. Incorrect moving harms, but intelligent moving heals.”
Dr. Schatz keeps that philosophy in mind when prescribing yoga for her arthritic patients. “Yoga teaches movement with proper joint alignment,” she says, “which helps bring deformed joints back to normal position as appropriate muscles are lengthened and strengthened.” Consider a private session with an experienced teacher or buying a book to learn the correct poses. But remember, “Smart yoga exercise is the key to restoring health to arthritic joints,” says Dr. Schatz. Work within the limits imposed by the disease, but don’t letyourselfbe immobilized by it.
Find relief through less stress. “If you are hurting and you tense up, you hurt more,” says Beth Ziebell, Ph.D., a psychologist specializing in stress and pain management in Tucson, Arizona. “People who have things in their lives under control will be better pain managers than people who don’t.”
Recent research confirms the importance of psychological attitude on arthritis pain relief, something Dr. Ziebell has been preaching for years. Some of her specific attitude tips include: Don’t race-pace. “People with arthritis need to learn how to pace themselves and not try to do everything they can possibly do on the days when they’re feeling good,” she says. “All that does is make you tired and sore the next day. 1Iy to do a little each day; whether you are having a flare-up or not.”
Learn to relax. “Take a lesson from natural childbirth classes,” Dr.Ziebell advises. “Childbirth is very painful, but women learn how to deal with that pain by learning how to relax.” Books and audiotapes teaching relaxation techniques are available at many bookstores, she notes. Dr. Ziebell also believes idle joints can become painful joints. “If you focus on pain, it hurts more, but if you get busy doing other things that are important to you, you’re not going to feel it,” she says.
Try P. M. prevention for A.M. stiffness. “Almost 90 percent of the patients I see suffer from some type of morning stiffness,” says Ilya Rubinov; M.D., a physician at the Arthritis Medical Center in Fort Lauderdale, Florida. He advises them to apply a muscle ointment at night before going to bed. “It relaxes you and gives you a psychological boost as well,” Dr. Rubinov says. The reason? “People with arthritis tend to feel much better all day if they aren’t stiff when they wake up in the morning.”

Clear the air.

For those of you who smoke, kicking the habit is the most important thing you can do. On a scale of one to ten, it rates a ten, stresses George Beller, M.D., professor of medicine and head of the Division of Cardiology at the University of Virginia School of Medicine.Smoke increases blood levels of carbon monoxide, which displaces oxygen. And since angina is an artery -clogged heart crying out for oxygen, smoking is clearly the worst thing you can do. On the other hand, Dr. Bellernotes, those who quit usually show an immediate decrease in episodes of angina. What’s more, Cigarette smoke makes your blood platelets stick together, further blocking your partially blocked arteries. Last, but far from least, smoking diminishes the effects of any medication you may be taking. Here’s another fact that may help encourage you to quit. Studies have found that angina patients who quit smoking have half the death rate of those who continue.

Take an aspirin a day.

For those with unstable angina (the kind that can hit you without exertion, such as when you’re resting or even sleeping), aspirin can be a lifesaver, some doctors believe. “It appears that aspirin prevents the initial activation ofthe blood clotting mechanism,” says Dr. Beller. If your blood clots too easily; of course, it can’t get through the narrowed artery and can trigger a heart attack. In a study conducted at a Canadian hospital, researchers found angina patients reduced their chances of heart attack by 51 percent by taking four buffered or coated aspirin tablets daily. As a result of this and similar studies, many physicians recommend one aspirin daily for minimum effectiveness. All heart patients, however. should get their doctors’ approval before starting on aspirin. Even though it is an over-the-counter drug, aspirin can have side effects. In addition, it could interact with other medication you may be on.

Put your body on tilt at night.

If you experience angina attacks at night, tilting the head of your bed up 3 or 4 inches can reduce the number of attacks, says cardiologist R. Gregory Sachs, M.D., assistant professor of medicine at Columbia University College of Physicians and Surgeons. Sleeping in this position makes more blood pool in your legs, so not so much returns to the heart’s narrowed arteries. And it may help reduce a need for nitroglycerine.

Put your foot down.

If you do get angina attacks at night, Dr. Sachs suggests an alternative to reaching for a nitroglycerine tablet. Simply sit on the edge of the bed with your feet on the floor. “It is equivalent to the effect of nitroglycerine,” he says. If you don’t feel your symptoms begin to subside quickly; then reach for your medication.

This means less salt, less fat, less calories. “Just one overly fatty, overly salty meal can cause an angina attack because it raises your blood pressure suddenly;” Dr. Beller says. To control the level of fat in your diet, most doctors and the American Heart Association suggest a diet containing less than 30 percent of calories from fat. This means cutting back as much as possible on foods containing saturated fat-the kind (such as butter) that hardens at room temperature-and cholesterol. Here are a few good ways to get started.

• Eat no more than 6 ounces of meat, seafood, or poultry daily:
• Eat only meat that is lean and trimmed of all fat, and trim it before cooking. Ground beef should be labeled as having no more than 15 percent fat.
• If possible, remove the skin from poultry before cooking. If not, remove it before eating.
• Learn to use meat, fish, and chicken sparingly in meals. For example, serve it stir-fried in heart-healthy monounsaturated oil (like olive oil) or polyunsaturated oil (like vegetable oil), with lots of vegetables.
• Limit your daily intake of all oils to 5 to 8 teaspoons. And use only monounsaturated or polyunsaturated oils.
• Eliminate cholesterol-rich organ meats, such as liver, kidney; or heart.
• Eat only nonfat or 1 percent fat milk products. And be careful when checking out the cheese counter. Some low-fat cheeses are high in salt.
• Increase your daily intake of fresh fruits and vegetables and eat more grains, particularly oat bran, which has been shown to help bring down cholesterol levels.

 Learn to relax.

“Whether it’s relaxation exercises or meditation, learn how to control your emotions instead of having them control you,” advises Dr. Beller. “I have patients who never get angina except when they have a fight with their spouse, yet they can exercise with no problem.”Work on resolving your conflicts and you can do as much to improve your angina as if you just took more drugs,” he says.

Can you live a life totally devoid of butter, cream, cheesecake, and eggs? Can you steer clear of fatty foods, like ribs, and salty foods, like fries, and devote your diet to vegetables, fruits, and whole grains?
Sure you can, says Monroe Rosenthal, M.D., medical director of the Pritikin Longevity Center, Santa Monica, California, because thousands of people have done it and continue to do it, and they have shown a remarkable improvement in their heart health as a result. “We recommend a diet in which 10 percent of calories come from fat,” states Dr. Rosenthal. That means no more than 3Y2 ounces per day offish, poultry, or lean meat. And since the average American diet comprises 50 percent of calories from fat, that’s a pretty drastic cutback! “Sure, it’s tough,” Dr. Rosenthal says. “Some people do go on the diet and fall off. But it’s a great alternative to heart bypass surgery or to being apprehensive all the time that you’re going to get chest pain whatever you do. The diet requires commitment, a positive attitude, and some effort.”
But the payoff, he says, can be big. “Blood pressure drops, cholesterol drops, episodes of chest pain decline, and clinical symptoms improve,” he says. “Frequently we can completely eliminate certain medications.”
One study of 893 Pritikin patients, for example, showed that their cholesterol levels dropped an average of 25 percent after just four weeks on the diet. And 62 percent of the angina patients left, drug-free, while many others were able to reduce their need for medication after finishing the complete program of diet, exercise, and education. How realistic is a goal of 10 percent of calories from fat? Sidney C. Smith, Jr.MD says it is attainable by only 10 percent of the population. The recommendations from mainstream medicine and the American Heart Association (AHA) to cut back to 30 percent of calories from fat are more realistic. “These guidelines are effective and attainable by a fairly large percentage of the population,” he says. But, he adds, he’d like to eventually see the guidelines get even lower. “In my own diet I’m a lot stricter than the AHA guidelines. I’ve made those changes in my own life.” And that, in Dr. Rosenthal’s opinion, is the bottom line. “It’s not really a diet-it’s a way of life.”

Lots of angina patients like to sell themselves on the notion that exercise is out of the question because it exerts the heart, and since exertion brings on angina, exercise should be avoided. This just isn’t so, says Dr. Beller.

Julian Whitaker, M.D., founder ofthe WhitakerWellness Institute in Newport Beach, California, has firsthand knowledge of how important exercise can be for angina patients. He likes to tell the story of a group of patients awaiting heart transplants who were put on an exercise program to strengthen them for surgery. “Over a period of several months, half improved their heart function so much they no longer needed the surgery,” he says.

“It’s almost routine that when patients start an exercise program, they will experience angina at the beginning of a session,” Dr. Whitaker says. “Angina is not a reason not to exercise.”
But people with angina need to stay attuned to their bodies, Dr.

Beller notes. “If they feel an attack of angina building up, they should know that if they slow down it will dissipate without their having to stop completely. ”

Why, you may wonder, is exercise so crucial? For one thing, exercise is a proven stress releaser, says Dr. Beller. And it will also help you lose weight. Both stress and overweight are counterproductive to heart health. “It will also lower your heart rate and reduce your blood pressure, which, in tum, will help reduce your need for medication.”

Exercise produces these changes, Dr. Whitaker notes, because exercisetrained muscles can pull more oxygen out of arterial blood. “That decreases the amount of work the heart has to do to pump the same amount of oxygen to the muscles,” he says.
Both Dr. Beller and Dr. Whitaker agree that exercise alone is no panacea. It takes exercise and diet combined to be effective.

Before you start exercising, consult your doctor and get a stress test. “That way you know what your limit is, and you can gain confidence,” Dr. Beller says. “You have to have a dialogue with your doctor on what you both consider to be tolerable pain and what isn’t.” Always be sure to warm up gradually; Dr. Whitaker adds, especially if you’re going out into cold temperatures.

You’ve been diagnosed as having angina-attacks of chest pain that result from a decrease in the supply of blood to your heart. You know what induces an attack and how to avoid it. You also know what to do when you feel one coming on. But do you know when your symptoms are saying something else, when something serious could be wrong? If not, here are a few signs that say “see your doctor-ASAP”

• You’ve been exercising to a certain level without getting angina, but now you’re beginning to get angina at that level.
• You experience angina at a lower level of exercise than before.
• You’ve had stable angina (attacks that come on only with exertion), but now you’ve developed unstable angina (attacks that occur during rest). These may all be signs that the arterial blockage that affects blood flow to your heart is getting worse, says Sidney C. Smith, Jr., M.D. Another warning sign is angina pain that lasts for more than 15 to 20 minutes. ‘This could be a sign of heart attack or what we call coronary insufficiency, which is the most extreme form of unstable angina,” says George Beller, M.D. “Coronary insufficiency causes prolonged pain but without the irreversible damage characteristic of a heart attack. But you can’t tell the difference, so consider it a medical emergency.”
“It’s a source of major concern to me to see patients take expensive drugs and not make a commitment to modify their lifestyles,” he says. “They’re only going to get angina again. At times we look for quick answers to tough problems. That doesn’t work with angina and heart disease. “I spend a lot of time educating patients about their symptoms, what to do when they have them, the importance of clean living,” he says. “But we don’t feel we’ve done a complete job unless the patient is involved.” With a good attitude and the desire to live a healthier life, the other necessary changes will come a whole lot easier.

Ollie slumps on the couch after gorging himself on Eula Mae’s latest offering of his favorite meal: roast ham, baked potato with sour cream, hot, buttered com on the cob, and apple pie a la mode. He lights up a cigarette. But he can’t relax because he and Eula Mae are beginning their nightly postdinner argument - this time over who’s going to shovel the snow; It’s not long before an aggravated, red-faced Ollie rolls off the couch and waddles out into the frigid January night, vanquished once again. Minutes later; Ollie is gasping and clenching his chest in pain as a heavy; squeezing pressure radiates from his heart. “Oh, Lord!” he cries. “Eula Mae! Eula Mae! This is The Big One! I’m a goner fer sure! I want to live!”
But it’s not The Big One, and Ollie is not headed for that Big Greasy Spoon in the Sky. Five minutes later the pain has subsided and Ollie recalls what Dr. Hartebeest had told him just last week. His pain is not a heart attack, and it’s not heartburn. It’s angina. And it’s a sign that the arteries in Ollie’s heart are clogging up with fat. The blood can’t get through to nourish his heart. That high-fat, high-salt feast, that argument with Eula Mae, going out into the cold, shoveling snow; Anyone of those things can bring on angina. “Here are some pills to take when you get the pain, ” Dr. Hartebeest had said. “But I’m warning you, Ollie. If you don’t change your ways, you’re asking for trouble.” What are poor Ollie and others like him to do? Here’s what the experts advise.

Get a new outlook on life.

Sidney C. Smith, Jr., M.D., director of cardiology at Sharp Memorial Hospital in San Diego, California, is tough and outspoken about the need for angina patients to see the light and make some lifelong lifestyle changes