Sunday, December 29, 2013

Service Dogs

 Service Dogs

Most people thing of guide dogs for the blind when they hear "service dog". However, many people benefit from having a service dog.
Those with autoimmune diseases may need a service dog to retrieve dropped items, provide emotional support, provide mobility for those in wheelchairs, and many other tasks.
If you think a service dog is right for you, there are some things you should know. First of all, you must be healthy enough to care for the dog. He will need regular vet visits, food, fresh water, etc. If you're unable to provide these things, then someone in the home will need to care for the animal.
You will need to determine if you can train your own dog or if you would rather obtain an animal from a group like Canine Companions for Independence. CCI doesn't charge for their dogs. They are provided by donations. You can read about their organization on their website.
If you decide to train your own dog, you should first enroll in a basic obedience class. If there is a PetSmart in your community, they offer basic obedience and most will help you with advanced obedience. Our local PetSmart trainer will assist with training on some basic assisting behaviors.
For those communities where there isn't a PetSmart, try a local community college or ask at a local pet store if they know of anyone who provides basic obedience training.
Dana L. Marshall has some great advice and books on website. If you're thinking of self-training your dog, I strongly suggest reading the information on her website.
Assistance Dogs International provides standards for service dogs. They have a copy of the test they require members of ADI to administer before placing a service dog in a home. If you train your dog to their standards and your dog can pass this test, your dog is NOT considered certified by ADI.
Federal Law provides access for those with service animals. You are not required to have a certification. There are many companies that try to sell certifications without ever seeing the dog, but they are just asking for your money and are not necessary. A copy of the law may be found here.
Once your dog is trained, you may take him anywhere the public is generally allowed. Staff may only ask you two questions: 1. Is the dog a service animal required because of a disability, and 2. what work or task has the dog been trained to perform.

The staff may not ask you what your disability is, or ask you to show a certification of training. They also may not ask you to have the dog demonstrate his ability to perform the task.

You may download the PDF from the ADA site or Amazon sells cards that outline the law that you may give or show to anyone who questions you about the service animal.

In conclusion, if you feel you would benefit from a service dog, review the sites above, then decide whether you want to apply for a trained dog, or put in the work to train an animal to fit your needs.

If you have a service dog, I would love to hear more about you and your animal.

Thursday, November 7, 2013



Methotrexate is used for a variety of disorders. While it is used to treat some types of cancer, in lower doses, it is used to treat autoimmune diseases. 

For autoimmune diseases, methotrexate may be taken orally or as an intramuscular injection. The normal dose for rheumatoid arthritis is 7.5mg per week. It may be given in one dose or in divided doses.

Some patients have side effects to oral methotrexate that can be decreased by switching to the injectable form.

Before you start methotrexate, your physician will do routine lab tests to check blood counts and to ensure your liver is healthy enough for the medication. Tell your physician if you are an alcoholic, have liver or kidney disease, stomach ulcers, or an infection.

It's very important that you provide your physician with a list of all the medications, even over the counter medicines, that you are taking. Your doctor also needs to know about any other types of treatments you may be taking - like radiation therapy.

Methotrexate can cause birth defects in a baby when taken by the mother or father. Don't use it if you (or your wife) are pregnant or planning to become pregnant. Notify your physician as soon as you suspect that you might be pregnant if you are on therapy.

Side effects can include serious, life threatening side effects.

Call 9-1-1 if you experience the following:

  • Swelling of the mouth, throat, tongue or other signs of severe allergic reaction

If you experience any of the following, call your physician right away:
  • Very dark urine or blood in your urine
  • Vomiting coffee ground or bloody emesis
  • Bloody, black, or tarry stools
  • Diarrhea
  • Changes in vision
  • Confusion
  • Seizures
  • Coughing
  • Swelling of legs or feet
  • Red dots on the skin
  • Shortness of breath
  • Any unexpected bleeding or bruising
  • Sores in mouth and lips - can lead to dehydration if it interferes with drinking
  • Back pain
  • Signs of infection - fever, cough, chills
  • Dizziness
  • Drowsiness
  • Headache
  • Painful or difficult urination
  • Unusual tiredness or weakness
  • Yellow discoloration of the skin or eyes
Common side effects:
  • Loss of appetite
  • Nausea and vomiting
  • Acne
  • Boils
  • Skin Rash or Itching
  • Hair loss
It is important to avoid alcohol while taking methotrexate due to the increased risk of liver damage. Also, be sure to keep your follow-up appointments with your physician, including those for lab work only.

Routine labs are needed to monitor liver function and to ensure your blood counts are adequate to continue the medicine.

For more information on rheumatology, visit the International Foundation for Autoimmune Arthritis.

Wednesday, August 14, 2013

Psoriatic Arthritis

Psoriatic arthritis falls into the category of inflammatory arthritis, yet this disease is not as well known as some of the other autoimmune diseases.

It's usually occurs in people with psoriasis, but about ten percent of the time, the arthritis shows up first, then the psoriasis. PsA is usually sero-negative and it affects joints of the fingers, including the DIP joints, and the spine and sacroiliac joints.

PsA usually follows psoriasis - 60% to 70% of the time, but 15% to 20% of the time the PsA and the psoriasis appear within one year of each other. In only about 15% to 20% of cases does the arthritis present first.

When the arthritis presents first, it can create problems in diagnosis. Often patients are diagnosed with inflammatory polyarthritis or sero-negative RA.

There are no lab tests to diagnose PsA, but sometimes patient have a low positive RA titer or ANA. Often the CRP and Sed Rate are also elevated. If the patient has severe psoriasis, the uric acid levels may also be elevated.

On x-ray the damage caused by PsA looks different than the damage caused by RA, but the disease can still cause severe damage, so early treatment is important.

Treatment can resemble the treatment of RA. Methotrexate, Arava, and TNF inhibitors are used to treat the disease and prevent progression.

Early and aggressive treatment is important to prevent many of the deformities associated with PsA. If you believe you could have PsA, it is important to discuss this with your physician.

Wednesday, May 1, 2013

It's time to REGISTER for FREE to attend World Autoimmune Arthritis Day's 2013 Virtual Convention!


You can also tweet about it: Register now 4FREE! WorldAutoimmuneArthritisDay #WAAD13 5.20.13-LIVE chats/Experts/36Nonprofits!

Some background detail for you:  World Autoimmune Arthritis Day is an annual 47-hour event where nonprofits, advocates, and experts from around the world unite in order to provide educational and awareness information to patients, their supporters, and the general public.  This years event aims to triple in size from 2012, adding Nonprofit Booths, Vendors, a Raffle and a special feature: A Day in the Life with Autoimmune Arthritis (an Apple/Android app and Exhibit Booth).

WAAD13 begins at midnight of the first World Time Zone and ends at 11:59 of the last World Time Zone, or 6am ET/USA May 19th and ends at 5am ET/USA May 21st, 2013. It is an interactive, LIVE, Virtual Convention that you can attend for FREE...just find an internet connection and join the rest of the world for 47 hours of education and fun!