My Blog
By Rheumatoid Arthritis
October 29, 2018
Category: Rheumatologist

Find out the best ways to manage your joint pain and inflammation for the long term.

Have you been diagnosed with rheumatoid arthritis? This chronic autoimmune condition attacks the rheumatoid arthritislining of the joints, causing stiffness in your joints, joint swelling and pain that can lead to complications such as deformity and bone loss and functional impairments. This is the reason it is so important that those with Rheumatoid Arthritis have a Rheumatologist like our own Board Certified Rheumatologist, Dr. Mark Fisher in Haddon Heights, NJ, who can provide the effective treatment plan you need to manage symptoms and to prevent complications and most importantly to try and keep you active and enjoying the activities you love.

Even though there is currently no cure for Rheumatoid Arthritis, our Haddon Heights, NJ, Rheumatoid Arthritis Doctor can create a treatment plan and help you determine the right medication (or medications) to help you manage your symptoms and improve your quality of life. Our goal is to make living with RA easier for you. Make no mistake about the fact that No Cure DOES NOT MEAN there is no effective life-changing treatments!!  There are good effective treatments available to you!!

Here are the most common treatments that our doctor may prescribe:

ALL Medications have potential risks and the benefits vs risks of medications must always be taken into account for your condition and other medical problems if present.

Nonsteroidal Anti-Inflammatory Drugs (NSAIDs)

This includes those over-the-counter medications like ibuprofen or naproxen, which can help alleviate mild inflammation and discomfort. Of course, our rheumatologist may also prescribe stronger NSAIDs if these OTC medications aren’t enough.

Corticosteroids

One of the most commonly used steroids for treating RA is prednisone. This is a very strong medication that can handle more severe forms of inflammation while also slowing down joint damage. Of course, this medication should only be used for a short period of time and not long term. This is always to be considered only for temporary care where possible.

Disease-Modifying Antirheumatic Drugs

These medications do several  things: they slow the progression of RA ; they help to  protect the joints and tissues around the joints from serious and long-term damage and deformity; they reduce ongoing pain and symptoms of the arthritis by reducing the inflammation caused by this disease; and most importantly, they help to keep patients maintaining their quality of life.

Biological Monoclonal Antibodies and Small Molecule Medications:

These medications act on specific areas of the immune system that are responsible for triggering an inflammatory response in the body and damage from this chronic inflammatory disease. By suppressing these areas of the immune system, the medications can reduce inflammation, joint damage and deformities from occurring, and also other systemic effects of RA. New such medications are becoming available all of the time. These medications, in particular, have been life-changing for so many patients with RA.

These are very costly and the expense can be prohibitive. Fortunately, most insurances do help with these costs.

Also, the pharmaceutical companies do offer financial assistance for most patients requiring it, making it more affordable to many patients.

Other Treatment Options for Rheumatoid Arthritis:

Medications aren’t the only modality needed to treat rheumatoid arthritis. Your Rheumatologist may also recommend exercise or physical therapy to help keep joints feeling their best and keeping mobility optimal. Regular physical therapy can help keep joints supple and flexible. A physical therapist can also provide a list of advice and tips for how to execute certain everyday tasks to make it easier on you and your body.

In severe cases, it might be necessary to have surgery to repair joint damage and keep a patient active. Surgery may also be the only way to restore functionality within certain damaged joints or to correct deformities as a result of RA. Fortunately, the need for surgery has been significantly reduced in patients being treated early with a Rheumatologist with the newer medications currently available.

If you are suffering from rheumatoid arthritis, or if you are experiencing symptoms that you believe to be RA and you are living in or around Haddon Heights, NJ, or Southern NJ in Burlington, Camden, Gloucester, Atlantic, and Cumberland Counties, please give our office a call today to learn more about the different ways in which we can help you treat your long-term condition early and effectively. Call our Board Certified Rheumatologist 

Mark Fisher MD FACR at 856-547-8004 today.

Most major health insurances and Medicare are accepted.

By Mark Fisher MD
June 25, 2018
Category: Rheumatologist
Tags: Osteoporosis  

What your doctor in Haddon Heights wants you to know.

As you get older, you may be thinking more about your health. Your body changes as you get older, along with your health. You may Osteoporosisdevelop medical conditions often associated with age. One of these conditions is osteoporosis, caused by a greater rate of bone loss than bone formation in the body leading to a decrease in bone mass or density. 

Dr. Mark Fisher in Haddon Heights wants to share the facts about osteoporosis. He proudly serves the residents of Haddon Heights, and all of South Jersey, Hammonton, and Camden County, NJ, and he can help you too. He is a Board certified Rheumatologist by the American Board of Internal Medicine.

Osteoporosis can be very subtle and appear with no signs or symptoms that you are losing bone mass until you have osteoporosis. There are a few signs and symptoms you may recognize, including:

  • A stooped posture and inability to stand up straight
  • A loss of 2 or more inches in height over the years
  • Back and spine pain caused by collapsed vertebra due to fractures and these can be painless in 30% of patients.
  • A DEXA or bone density scan is the best study to detect this condition

Your bones will also fracture more easily. Typical fracture sites include the spine especially the mid-back area, hips, shoulders, ankles, and wrists. Symptoms only occur when there is an active fracture and is otherwise a silent disease making recognition more challenging. Awareness is the key.

There is increased risk of developing osteoporosis in women, older age groups, white more than non-white races, Asian descent, small body frame less than 127 pounds, early menopause, or have a family history of osteoporosis or fractures. Increased alcohol and caffeine intake and unstable gait or balance are other risks factors for osteoporosis and fractures.

Menopause often initiates the onset of osteoporosis because lowered levels of hormones in women begin to accelerate bone loss. Excessive thyroid and parathyroid hormone states can also cause loss of bone at elevated levels. Other medical conditions can also increase bone loss and increase fracture risk in patients, especially those requiring steroids for various conditions.

There are many steps you can take to try to prevent or minimize bone loss and the effects of osteoporosis by changing your diet and doing resistive exercise. Your diet should include adequate amounts of:

  • Protein from various sources including lean meats, soy, nuts, and legumes
  • Calcium with at least 600 to 1200 mg. from various sources including low-fat dairy, green vegetables, soy, or canned salmon or sardines
  • Vitamin D3 with at least 1000 IU from various sources including sunlight and oral supplements

You should also take steps to get adequate exercise to keep your bones strong. Great exercises to prevent osteoporosis include strength training, weight-bearing and balancing exercises.

For more detailed information about osteoporosis please visit the Osteoporosis page on Dr. Fisher’s website and blogs at http://www.markfishermd.com/osteoporosis.html

If you notice some of the signs and symptoms of osteoporosis, it’s time to visit an expert. Call Dr. Mark Fisher in Haddon Heights, NJ, serving the residents of Haddon Heights, Hammonton, and Camden County, and all of South Jersey. Awareness and early recognition are the best ways to intervene and treat early and have a successful management of this disease.

Call today! 856-547-8004

By Mark Fisher MD
June 07, 2018
Category: Rheumatologist
Tags: Psoriasis  

PsoriasisManaging your psoriasis can be difficult, particularly during painful flare-ups. It is a chronic condition that cannot be cured, but several highly effective treatments are available for minimizing and soothing the symptoms of a psoriasis flare-up. Moderate to severe cases of psoriasis can benefit  from treatment with biologics, which suppress overactive immune systems. Psoriasis is caused, in part, by an overactive immune system. Dr. Mark Fisher is your Rheumatologist for treatment of psoriasis in the South Jersey area.

Types of Psoriasis

Psoriasis is associated with red patches, white scales, and flaky areas on the skin. The condition is the result of an accelerated growth cycle of skin cells. New skin cells mature so quickly that the body is unable to shed them before new skin cells are produced. As skin cells begin to build up, red patches, white scales, and flakiness develop. When psoriasis flares up, it tends to affect the skin on the elbows, knees, legs and back most often, but can appear anywhere on the body. There are five types of psoriasis:

  • Plaque Psoriasis
  • Inverse Psoriasis
  • Pustular Psoriasis
  • Guttate Psoriasis
  • Erythrodermic Psoriasis

Biologic Treatments for Psoriasis

There are a number of treatments for psoriasis, including topical ointments, light therapy, and oral medications. These methods are good for treating mild to moderate cases of psoriasis and may have very limited success. However, a stronger treatment method is needed for moderate to severe cases of psoriasis. Your Rheumatologist for treatment of psoriasis in Haddon Heights can recommend the best option for treating your psoriasis.

Biologic drugs, also referred to as biologics, are one of the most effective treatments for more serious cases of psoriasis. 

Biologics are administered by injection, either intravenously or

subcutaneously, and work by modifying the immune system, which is often overactive in patients struggling with psoriasis. These monoclonal antibodies are directed against specific inflammatory proteins causing inflammation and are the most effective treatments for psoriasis management. 
In addition, this severe inflammatory skin disease can be associated with severe arthritis as well, and all of these symptoms can be very well controlled with such medications.

The main risk for these medications is infection and the use of preventive care with vaccines can be very useful in reducing such risks.

It can be very uncomfortable and socially inhibiting when your psoriasis flares up. Your Rheumatologist can prescribe the best course of treatment for managing your psoriasis. Biologics offer extended relief for individuals with moderate to severe cases of psoriasis. The benefits and results of treatment can be very dramatic medically, personally, and socially.

For treatment of psoriasis in South Jersey, schedule an appointment with Dr. Fisher by calling the office at (856) 547-8004.

 

Announcement from the American College of Rheumatology(ACR):

Dear ACR/ARHP members,

Early this morning we watched as Congress passed a sweeping spending agreement and sent the package to the White House for the President's signature. Along with a two-year agreement on spending, the package accomplished four of the College's top policy priorities: 
• Fixed the CMS rule that would have applied payment adjustments to Part B drug reimbursements and penalized physicians for providing high-cost drugs;
• Permanently repealed the arbitrary Medicare therapy caps, which could have affected millions of patients' access to vital rehabilitation services;

• Repealed the Independent Payment Advisory Board (IPAB), which would have had the power to impose cuts on providers without the review and deliberation of the regular legislative process; and
• Eliminated the Medicare Part D "donut hole," supporting our patients' ability to adhere to treatment plans. 
These are incredible victories for the Rheumatology, arthritis, and general medical communities that come after months of sustained advocacy efforts of the ACR and the participation of countless ACR/ARHP members. In particular, the rheumatology community led the charge to stop Medicare payment adjustments on Part B drugs. To those of you who contacted congressional offices, submitted letters to the editor to your local paper, and gave money to RheumPAC - your efforts paid off today. Because of your investment of time, talent, and money to magnify the College's voice on Capitol Hill, Congress heard us loud and clear. Thank you!

Even as we celebrate these victories, there is still much work to do to ensure that the 54 million Americans living with RA and other rheumatologic conditions can continue to access innovative, medically necessary, and life-sustaining care. Stay tuned as we continue to advance policies that provide relief from administrative hassles, boost rheumatology research and training, minimize our workforce shortage, and reduce drug costs so that patients can access innovative, critical treatments.

To address the challenges that lie ahead, it will take all of us pulling together to protect our patients and our profession. Thank you to all members of the ACR and ARHP who regularly take action on behalf of our patients. Thank you also to those members who are contributors to RheumPAC. Investing in RheumPAC is critical to help the ACR build the relationships with Congress that lead to these victories.

The ACR will continue to work for you, so you can be there for your patients.

Thank you,

David Daikh, MD, PhD
ACR President


© 2018 American College of Rheumatology | 2200 Lake Blvd NE | Atlanta, GA 30319 | US

 

This will be a huge help in preserving the needed access to care for patients with rheumatic diseases, especially those requiring some very costly drugs and other prescriptions to maintain a high quality of life and well controlled arthritic conditions and joint protection. 

Good to see much needed help and cooperation from the Congress, Senate , and President.
Mark Fisher MD

 
 

Coming soon.

 

Reuters reports that the incidence of hip fractures in older women in the U.S. is rising after more than a decade of decline, according to a large new study of Medicare recipients.

Researchers analyzed Medicare claims data from 2002 to 2015, from more than 2 million women age 65 or older. They found that hip fracture rates declined each year from 2002 to 2012, the researchers found. But starting in 2013, hip fracture rates leveled off and were higher than expected.

Increases in fracture rates were prominent in women ages 65 to 69, which had risen by 2.5 percent, and in women ages 70 to 74, which had risen by 3.8 percent, from 2014 through 2015.

The net results is more than 11,000 additional estimated hip fractures over the time periods 2013 to 2015.

The U.S. Preventive Services Task Force (USPSTF) recommends that women age 65 or older get screened for osteoporosis with a type of X-ray called a DEXA scan to measure bone loss. Postmenopausal women under age 65, with risk factors for osteoporosis, should also be screened. Risk factors include a family history of osteoporosis, diseases such as rheumatoid arthritis, the use of certain medications, and smoking and drinking alcohol.

Osteoporosis screening by DEXA or bone density exams is critical since there is a 25% mortality risk over 1 year and 25% risk of functional limitation after hip fractures. This is a TREATABLE DISEASE and prevention is key!!





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Camden County, NJ Rheumatologist
Mark Fisher, MD
713 Station Ave
Haddon Heights, NJ 08035
(856) 547-8004