Transcript: Show #19 | Feb 13, 2001

A slate appears with the caption "The advice given in the preceding programmes is of a general nature only viewers should consult their own medical professional for medical advice specific to their circumstances."

The title of the show appears: "Your Health." Clips of the episode are displayed behind the title sequence.

Maureen says THIS WEEK, A
SPECIAL LOOK AT ARTHRITIS.
A PATIENT'S DETERMINATION.

A clip shows a woman in her thirties exercising.

She says THIS IS IMPORTANT TO KNOW
ABOUT ME.
I'M COMPETITIVE BY NATURE,
YOUNG, RELATIVELY FIT AND I
HAVE OSTEOARTHRITIS.

Maureen says A DOCTOR'S HOPE.

A doctor says THIS IS THE MOST EXCITING
TIME IN THE HISTORY FOR THE
TREATMENT OF ARTHRITIS.
THERE HAS NEVER BEEN A TIME
IN THE HISTORY OF TREATMENT
WHERE WE HAVE MORE HOPE FOR
OUR PATIENTS, NEVER.

Maureen says AND JOE SCHWARCZ
ON A NATURAL TREATMENT.

Joe says INDEED, IN EUROPE 13
STUDIES HAVE SHOWN THAT
PEOPLE WHO TAKE DIETARY
SUPPLEMENTS OF GLUCOSAMINE
DO BETTER IN TERMS OF
OSTEOARTHRITIS.

(music plays)
The opening sequence begins.

Clips of different people flash against a grey background. A 30-year-old woman with shoulder length black hair looks through a microscope, a 30-year-old with very short black hair holds up her 1-year-old son, a pharmacist counts and organizes red-and-yellow pills, a surgeon cuts into the abdomen of a patient and, finally, a man wearing a ted tank-top lifts weights. An animated microscope, pill bottle, syringe, and small dumbbell fly around the screen.

The title appears: "Your Health."

Maureen stands in a wood-paneled studio with T.V. screens embedded in the walls. She is in her forties, with short wavy red hair. She wears a white turtleneck and a bright blue blazer.

Maureen says HELLO, I'M
MAUREEN TAYLOR, RHEUMATOID...
RHEUMATOID AR DELIGHT SIS A
PAINFUL DEBILITATING
DISEASE.
PATIENTS HAVE INFLAMED AND
SWOLLEN JOINTS THAT CAN
LEAVE THEM CRIPPLED AND
IMMOBILE IT IS AN AUTOIMMUNE
DISEASE THAT DOESN'T CARE
HOW OLD OR YOUNG ARE YOU.
THERE IS NO CURE BUT DOCTORS
ARE EXCITED ABOUT NEW DRUGS
COMING ON TO THE MARKET.
WHILE THEY RACE TOWARD
BETTER TREATMENTS, ONE YOUNG
WOMAN IS ATTEMPTING A RACE
OF HER OWN.

Jackie is in her thirties, with long straight black hair. She wears athletic gear.

She says I'M HOT, SWEATY, RED
FACED, EXTREMELY THIRSTY AND
IN DIRE NEED OF A BATHROOM.
IT IS RAINY, COLD AND I'M
TRAINING FOR MY FIRST
MARATHON, MY NAME IS JACKIE
SONG.
THIS IS IMPORTANT TO KNOW
ABOUT ME.
I'M COMPETITIVE BY NATURE,
YOUNG, RELATIVELY FIT, AND I
HAVE RHEUMATOID ARTHRITIS.

A caption reads "Doctor Ed Keystone. Rheumatologist."

Ed is in his forties, clean-shaven and with short straight brown hair. He wears a beige shirt, printed tie and a white coat.

Ed says ARTHRITIS IS INFLAMMATION
IN THE JOINT, A JOINT IS
WHERE TWO BONES COME
TOGETHER AND ARE JOINED.
AND INFLAMMATION MEANS THERE
IS HEAT, REDNESS, SWELLING,
PAIN AND DYSFUNCTION.
RHEUMATOID ARTHRITIS IS ONE
FORM OF 115 KINDS OF
ARTHRITIS SO IT IS ONLY ONE
OF THOSE KINDS.
IT IS AN AUTOIMMUNE DISEASE
IN WHICH THE BODY'S IMMUNE
SYSTEM OR DEFENCE SYSTEM
ATTACKS THE PATIENT'S OWN
TISSUE.
300,000 CANADIANS SUFFER
FROM RHEUMATOID ARTHRITIS,
TWO-THIRDS AS I SAID ARE
WOMEN, AND WITHIN ABOUT TEN
YEARS YOU CAN GUARANTEE THAT
50 percent OF THOSE PEOPLE WILL NO
LONGER BE WORKING, AND WILL
BE SIGNIFICANTLY DISABLED.

The caption changes to "Jackie Song."

Jackie says I GUESS IT STARTED WHEN I
WAS ABOUT 16.
MY ANKLE, MY RIGHT ANKLE WAS
REALLY SORE.
I COULDN'T GET OUT OF BED.
LIKE IT HAD... IT JUST ALL
OF A SUDDEN WENT FROM THE
ONE ANKLE TO EVERYTHING.
AND I FOUND THAT I HAD TO
CRAWL TO MY PARENT'S ROOM
BECAUSE I COULDN'T GO TO
WORK AND EVERYTHING HURT AND
I WAS CRYING.
AND SO I CALLED IN TO WORK
AND I COULDN'T COME IN.
AND THAN BY 10:00 I WAS FINE,
I WAS WALKING AROUND AND IT
DOES A LOT TO YOUR PSYCHE
BECAUSE YOU THINK AM I JUST
MANAGING IT.
WHY AM I FINE NOW BUT NOT
BEFORE.

Ed says WHEN THEY WAKE IN THE
MORNING THEY FIND THEIR
JOINTS STIFF AND AS THE DAY
WEARS ON THEY FEEL BETTER.
AND IT IS A SYMMETRICAL
ARTHRITIS INVOLVING BOTH
SIDES OF THE BODY AND
INVOLVES PREDOMINANTLY THE
SMALL JOINTS OF THE HANDS
AND FEET BUT ALL JOINTS OF
THE BODY CAN BE INVOLVED.

Jackie says WHY WOULD SOMEONE WITH
ARTHRITIS WANT TO RUN A
MARATHON, AN EVENT THAT EVEN
COMPLETELY HEALTHY PEOPLE
ARE TAKEN TO THE LIMITS.
WELL, FIRST, A MARATHON NO
LONGER SEEMS LIKE AN EVENT.
IT SEEMS EVERYONE HAS EITHER
DONE ONE OR IS TRAINING TO
HAVE DONE WITH.
EVEN OPERA HAS DONE ONE.
IT WASN'T UNTIL HE USED THE
TERM DISEASE THAT IT REALLY
HIT HOME.
LIKE I ALMOST STARTED CRYING
IN HIS OFFICE.
I THOUGHT OH MY GOD, LIKE
THAT IS WHAT IT IS, IT IS A
DISEASE.
AND SOMETHING ABOUT THAT
WORD REALLY STRUCK HOME.

Ed says THE REASON WHY RHEUMATOID
ARTHRITIS IN ITS EARLY
STAGES IS DIFFICULT TO
DIAGNOSE IS BECAUSE IT IS
ACTUALLY SPREADS OVER TIME
FROM ONE JOINT TO ANOTHER TO
ANOTHER.
SO INSTEAD OF
BEING THIS SYMMETRICAL OR ON
BOTH SIDES AND MANY JOINTS
OF THE HANDS AND FEET, THAT
IS THE FINAL POSITION THAT
THE PATIENT FEELS.

Jackie says IT IS FRUSTRATING FOR ME
IN PARTICULAR BECAUSE PEOPLE
DON'T SEE THE DISEASE WHEN
THEY LOOK AT ME.
LIKE THEY DON'T SEE ANY
SIGNS OF IT.
SO THEY JUST ASSUME THAT ARE
YOU OKAY.
AND THEY JUST MAKE THE
ASSUMPTION THAT YOU CAN DO
THINGS THAT EVERYBODY ELSE
CAN DO WHEN IT IS NOT TRUE.
ONE THING THAT IS REALLY,
I FIND A BIT OF A CHALLENGE
FOR ME, PARTICULARLY IN THE
EVENING HOURS WHEN I'M GOING
TO BED, BRUSHING MY TEETH, I
CAN'T... BECAUSE I DON'T
HAVE THE GRIP TO HOLD THE
TOOTHBRUSH IN A NORMAL WAY,
USUALLY WHAT I DO IS I
EITHER PRESS MY LITTLE
FINGER UNDER MY TOOTHBRUSH
TO GET A TIGHTER GRIP ON IT
OR I HAVE TO BRUSH MY TEETH
WITH TWO HANDS.
AND I THINK JUST GOING DOWN
THE STAIRS, LATE AT NIGHT
USUALLY, IT CAN BE REALLY
DIFFICULT.
I HAVE TO HOLD ON TO BOTH
SIDES OF THE STAIRS.
IT IS KIND OF LIKE A LITTLE
KID WHEN THEIR LEGS ARE TOO
SHORT THEY GO DOWN ONE STEP
AT A TIME.
OR EVEN IN THE MIDDLE OF THE
NIGHT LIKE USING... I USE MY
TEETH TO PULL UP THE SHEETS
AND THE BED SPREAD BECAUSE I
DON'T HAVE THE STRENGTH IN
MY HANDS TO DO IT.
WE ALL DEAL WITH IT
DIFFERENT WAYS, I USE
HUMOUR.
I TRY TO PUSH MY LIMITS.
THAT IS WHY MY ARTHRITIS AND
I ARE OUT HERE AT MILE 3.

Ed says THE EARLIER YOU TREAT THE
MORE LIKELY YOU ARE TO
RESPOND TO THERAPY IT IS
MORE DIFFICULT TO DIAGNOSE
EARLY ON BUT IF YOU HAVE
JOINT SWELLING AND EVEN IF
IT DOESN'T MANIFEST
COMPLETELY SO THAT ALL THE
JOINTS ARE INVOLVED, BUT YOU
HAVE A SENSE THAT THIS IS
RHEUMATOID ARTHRITIS THAN
OFTEN YOU WILL TREAT BECAUSE
THERE ARE REAL PROBLEMS OR
COMPLICATED IF YOU DO NOT
TREAT EARLY.
WE ARE MORE AGGRESSIVE IN
OUR THERAPY.
WE USE COMBINATION THERAPY
EARLY ON BECAUSE WHAT WE ARE
TRYING TO DO IS PREVENT
IRREVERSIBLE DAMAGE.
CURRENTLY FOR RHEUMATOID
ARTHRITIS IN TERMS OF
THERAPY THERE IS NO CURE.
BUT THERE ARE MEDICATIONS
THAT CONTROL THE ILLNESS,
REDUCE THE SWELLING, REDUCE
THE PAIN AND STIFFNESS,
PROVIDE THE PATIENT A BETTER
QUALITY OF LIFE AND NOW EVEN
MORE THAN EVER, STOP THE
PROGRESS OF DAMAGE AND
DISRUPTIONS TO THE JOINT.

Jackie says COMPARED TO PEOPLE MY OWN
AGE WITH ARTHRITIS I'M DOING
QUITE WELL.
I'M RUNNING.
THAT ALONE IS REASON FOR
JOY.
BUT I'M ONLY DOING WELL
BECAUSE OF THE EIGHT TO 14
PILLS I SWALLOW DAILY.
I KNOW THAT.
SOME OF THESE PILLS HELP
EASE THE PAIN.
SOME ARE DESIGNED TO SLOW
THE PROGRESSION OF THE
DISEASE AND SOME ARE TO
PREVENT THE DEBILITATING
SIDE EFFECTS OF THE ONES
THAT EASE PAIN.
DOES IT EVER END.
I'M NOT SO SURE.
AND TO THINK AT ONE TIME...
IN SPITE OF ALL OF MY
PROBLEMS, AND MY ISSUES WITH
MY JOINTS, I AM RUNNING THE
MARATHON BECAUSE IT IS A
PERSONAL CHALLENGE THAT I'VE
ALWAYS WANTED TO ACCOMPLISH.
AND I HAVE NEVER BEEN ONE
REALLY TO LET MY DISEASE
STOP ME FROM DOING THINGS.

Ed says THE CONCEPT OF IMPROVING
EARLY DIAGNOSIS IS VERY
IMPORTANT.
AND THERE IS A PATIENT
PARTNER PROGRAMME WHICH IS A
PROGRAMME IN WHICH PATIENTS
LEARN TO TEACH PHYSICIANS
ABOUT RHEUMATOID ARTHRITIS
AND HOW TO DIAGNOSE
RHEUMATOID AT LEAST AT THE
BEDSIDE.
I MUST ADMIT THAT EDUCATION
IS PROBABLY THE MOST
IMPORTANT ISSUE THESE DAYS
TO TEACH THE PRIMARY OR THE
FAMILY PHYSICIAN TO LOOK FOR
JOINT SWELLING AND TO LOOK
FOR THE SIGNS AND SYMPTOMS
OF RHEUMATOID.
THAT IS WHERE WE WILL
DIAGNOSE IT EARLIER IF WE
CAN DO TWO THINGS.
HELP THE PHYSICIAN DIAGNOSE
IT QUICKER BY UNDERSTANDING
HOW TO FIND IT AND ALSO MAKE
THE FAMILY DOCTOR AWARE THAT
THIS IS A SERIOUS,
POTENTIALLY DISRUPTIVE AND
DAMAGING DISEASE SO THAT
THEY SHOULD REFER TO THE
HUMAN... RHEUMATOLOGIST OR
SPECIALIST ONCE THAT
DIAGNOSIS IS MADE.
WHEN WE LOOK AT THE PATIENT
WHAT WE ARE TRYING TO DO IS
ASK HOW MUCH INFLAMMATION IS
THERE, HOW MUCH DAMAGE IS
THERE, AND HOW MUCH FUNCTION
IS THERE.
SO WE LOOK AT THE JOINTS FOR
INFLAMMATION, REDNESS AND
SWELLING, THE JOINTS FOR
THEIR RANGE OF MOTION WHICH
IS THE FUNCTION AND THAN WE
LOOK AT THE JOINTS FOR
DAMAGE, THAT IS ONE BONE
GRINDING AGAINST ANOTHER, IS
THERE DEFORMITY, AND THOSE
ARE THE KINDS OF WAYS THAT
WE ASSESS A PATIENT.

He says to a patient CAN YOU MAKE A FIST FOR
ME.
GREAT, OPEN YOUR FINGERS UP
FOR ME.
BEND YOUR WRIST DOWN.
BEND YOUR WRIST BACK, GREAT.

Jackie says MY ADVICE TO PEOPLE WHO
ARE JUST BEING DIAGNOSED OR
EVEN WHO HAVE HAD IT FOR A
LONG TIME IS TO JUST NOT LET
IT RULE YOUR LIFE.
KNOW THAT THERE ARE THINGS
YOU CAN ACCOMPLISH IF YOU
WANT TO.

Ed says THIS IS THE MOST EXCITING
TIME EVER IN THE HISTORY OF
THE TREATMENT OF RHEUMATOID
ARTHRITIS.
THERE HAS NEVER BEEN A TIME
IN OUR HISTORY OF TREATMENT
WHERE WE HAVE MORE HOPE FOR
OUR PATIENTS, NEVER.
BECAUSE WE HAVE MANY MORE
MEDICATIONS, WE HAVE BETTER
MEDICATIONS.
WE KNOW HOW TO DIAGNOSE IT
EARLIER AND THEREFORE WE ARE
DOING MORE FOR OUR PATIENTS
TO PREVENT OR PREVENTING
DAMAGE AND DESTRUCTION AND
PREVENTING DISABILITY THAN
WE HAVE EVER DONE BEFORE.

A clip shows Jackie running the marathon with the caption "Courtesy of Global Television."

Jackie says WE EACH DEALT A HAND THAT
A IS ACCOMPANIED... SOME
MORE DIFFICULT THAN OTHERS.
THIS IS MINE.
FOR SOME REASON I FEEL THE
NEED TO PROVE TO MYSELF AND
PERHAPS OTHERS THAT I HAVE
NOT BEEN CHEATED BY MY
DISEASE.
I'M STILL ABLE TO DO THE
EVERY DAY THINGS AND
ACCOMPLISH MY PERSONAL GOALS,
ONE OF WHICH IS COMPLETING
THIS MARATHON.
MY IDEAL GOAL, FOR THE
MARATHON IS TO FINISH THE
FULL IN LESS THAN FIVE
HOURS.

Back in the studio, Maureen says LAST MONTH
JACKIE SONG COMPLETED A 26
MILE MARATHON IN FOUR HOURS
55 MINUTES AND 21 SECONDS.
STAY TUNED, IN A MOMENT
WE'LL HEAR MORE ABOUT THE
LATEST TREATMENTS FOR
RHEUMATOID ARTHRITIS IN AN
INTERVIEW WITH DOCTOR ED
KEYSTONE.

The health quiz appears on screen.

Maureen says BUT FIRST THIS WEEK'S
HEALTH QUIZ.
IF YOU RECEIVE A SUBCURATIVE
DOSE OF MEDICINE, IS IT TOO
MUCH, TOO LITTLE, OR THE
WRONG DRUG.
THE ANSWER LATER ON "YOUR
YOUR HEALTH."

Now Maureen sits in the studio with a guest.

Maureen says WE HEARD DOCTOR KEYSTONE
SAY HE HAS NEVER BEEN MORE
EXCITED ABOUT DRUG
TREATMENTS FOR RHEUMATOID
ARTHRITIS.
WE WILL ASK HIM TO TELL US
MORE ABOUT THESE AMAZING
THERAPIES FOR RA AND WHY
HEALTH CANADA IS TAKING SO
LONG TO MAKE THEM AVAILABLE
HERE.
WELCOME DOCTOR KEYSTONE.

The caption changes to "Doctor Ed Keystone. Reumatologist."

Ed wears a black suit, white shirt and tartan red tie.

Ed says THANK YOU.

Maureen says WHAT ARE THESE
DRUGS THAT HAVE YOU SO
EXCITED.

Ed says WELL, LET ME JUST TELL
YOU WHAT IT IS ALL ABOUT.
THE KEY ISSUE HERE IS THAT
THESE MEDICATIONS ARE BETTER
THAN WE HAVE SEEN BEFORE.
THEY WORK FASTER AND THEY
HAVE A PHENOMENAL EFFECT AT
SLOWING OR INHIBITING OR
STOPPING JOINT DAMAGE IN A
HIGH PROPORTION OF PEOPLE
WITH RHEUMATOID ARTHRITIS.
AND THAT IS PHENOMENAL.

Maureen says BECAUSE THEY ARE
WHAT THEY CALL DISEASE
MODIFYING DRUGS THEY DON'T
JUST TREATMENT SYMPTOMS.

Ed says THEY SLOW THE PROGRESSION
OF THE DISEASE, STOP THE
PROGRESSION IN A PROPORTION
OF PATIENTS.
LET ME JUST REMIND YOU THAT
IN THE LAST 40 YEARS WE'VE
HAD SIX SO-CALLED DISEASE
MODIFYING DRUGS AND THEY DO
WORK, SIX IN 40 YEARS.
THIS YEAR THERE WILL BE
THREE NEW ONES ON THE
MARKET.
NEXT YEAR THERE WILL BE
ANOTHER ONE.
IN TWO YEARS THERE WILL BE
ANOTHER TWO.
SO IN FOUR YEARS WE ARE
GOING TO HAVE FIVE OR SIX
NEW ONES.
IT TOOK US 40 YEARS TO GET
SIX.

Maureen says SO THINGS ARE
MOVING RAPIDLY.

Ed says SPEED.

Maureen says CAN YOU HELP US
UNDERSTAND HOW THEY WORK.

Ed says SURE.
I THINK THE POINT IS THAT IN
THE LAST NUMBER OF YEARS
BIOTECHNOLOGY, GENETIC
ENGINEERING, PLUS A BETTER
UNDERSTANDING OF THE DISEASE
PROCESS ITSELF HAS ALLOWED
US NOW TO SELECTIVELY TARGET
USING THESE NEW THERAPIES TO
PROCESSES IN THE JOINT.
WE DON'T CAR BET... CARPET
DOM BOMB THE WHOLE IMMUNE
SYSTEM EVEN THOUGH IT IS A
PROBLEM, WE SELECTIVELY
TARGET ELEMENTS OF THE
IMMUNE SYSTEM, CERTAIN CELLS,
CERTAIN HORMONES IT THAT ARE
THE KEY OR THE PIVOTAL
PROBLEMS IN THE JOINT.
AND THAT MAKES A DIFFERENCE.
THEY ARE GOING TO BE
GENERALLY SAFER.
GENERALLY MORE EFFECTIVE
BECAUSE WE ARE ACTUALLY
HONING IN ON THE VERY
PROCESSES THAT DRIVE THE
INFLAMMATION.
BEFORE, WE HAD TO CARPET
BOMB EVERYTHING IN SIGHT TO
GET WHAT WE WANT.
NOW WE USE THE SMART BOMB,
THE GUIDED MISSILE TO GET IN
THERE AND FIND WHAT THE KEY
TARGETS ARE IN THE JOINT.

Maureen says COULD THESE
DRUGS HELP PEOPLE WHO SUFFER
FROM OSTEOARTHRITIS AS WELL
AS RHEUMATOID ARTHRITIS.

Ed says EVENTUALLY THEY WILL.
AS SOON AS WE UNDERSTAND
WHAT THE KEY PROCESSES ARE
IN THE JOINTS OF PATIENTS
WITH OSTEOARTHRITIS WE WILL
USE THE SAME TECHNOLOGIES TO
ALTER THOSE ELEMENTS IN
THOSE JOINTS.

Maureen says BUT NOT THESE
SPECIFIC DRUGS.

Ed says SOME OF THEM MAY DO.
THERE IS ONE PARTICULAR ONE
THAT IS JUST BEING DEVELOPED
FOR RHEUMATOID AND IT LOOKS
LIKE THE SAME HORMONES, THE
SAME CELLS MAY BE INVOLVED
IN OSTEOARTHRITIS.
I THINK IT MAYBE ALSO A
MATTER OF DEGREE, RHEUMATOID
IS A VERY DESTRUCTIVE
PROCESS.
IT IS LIKE THE JOINTS ARE
DESTROYED AND THEY ARE
GNARLED WHEREAS
OSTEOARTHRITIS IS SLOWLY
PROGRESSIVE PROCESS WHERE
THE CARTILAGE IS WARN DOWN
AS OPPOSED TO EATEN AWAY BY
THE CELLS AND TISSUE IN
RHEUMATOID ARTHRITIS.
AND IT IS A MATTER OF
DEGREE.
SIMILAR HORMONES ARE
RELEASED IN OSTEO, MANY MORE
HORMONES, MUCH MORE
INFLAMMATION IS OCCURRING IN
RHEUMATOID ARTHRITIS.

Maureen says SO WHY AREN'T
THESE DRUGS AVAILABLE HERE
IN CANADA YET.

Ed says WELL, THAT IS A VERY GOOD
QUESTION, I'M GLAD YOU ASKED
ME THAT.
I THINK THE ANSWER IS THAT
HEALTH CANADA LIKE ANY
ORGANIZATION APPROPRIATELY
IS REVIEWING EACH OF THESE
AGENTS BEFORE THEY COME ON
THE MARKET FOR EFFECTIVENESS,
AND PARTICULARLY FOR SAFETY.
SO IT IS APPROPRIATE THAT
THEY SHOULD REVIEW IT.
THE PROBLEM AS I SEE IT, MY
OPINION ONLY, IS THERE
PROBABLY IS NOT ENOUGH
RESOURCES IN HEALTH CANADA
BECAUSE OF ALL OF THESE NEW
AND WONDERFUL MEDICATIONS,
NOT ONLY IN ARTHRITIS BUT
MANY DIFFERENT AREAS BECAUSE
OF THE SPEED OF THESE NEW
MEDICATIONS BEING FORMULATED
IT, HEALTH CANADA SO FAR
DOES NOT APPEAR TO HAVE THE
RESOURCES TO REVIEW THEM AS
QUICKLY AS THEY SHOULD.

Maureen says THEY HAVE PROVED
THOUGH WHERE ELSE.

Ed says UNITED STATES FOR TWO
YEARS.
SEVERAL OF THEM, ONE IS OUT
FOR TWO YEARS, ONE OUT FOR A
YEAR AND A HALF.
IN FACT THE THREE NEW ONES
HAVE BEEN OUT FOR AT LEAST A
YEAR AND A HALF TO TWO
YEARS.
I MUST SAY WE ARE PROBABLY,
A GUESSTIMATE, THE LAST
CIVILIZED NATION TO HAVE
SOME OF THESE NEW THERAPIES.
AND WHAT IT MEANS IS, IT
MEANS THERE ARE PATIENTS OUT
THERE LIKE 300,000 PATIENTS
WITH RHEUMATOID, MANY OF
WHOM SHOULD HAVE HAD THE
AGENT A YEAR OR TWO YEARS
AGO AND NOW HAVE MORE
PERMANENT DAMAGE AND
DESTRUCTION AN EVERY MONTH
AND EVERY DAY THAT GOES BY
YOU HAVE IRREVERSIBLE DAMAGE
THAT CANNOT BE REPAIRED.

Maureen says WHAT IS THE
STANDARD OF TREATMENT FOR
RHEUMATOID ARTHRITIS NOW.

Ed says RHEUMATOID ARTHRITIS IN
TERMS OF MEDICATIONS IS WE
USE WHAT ARE CALLED
NON STEROIDAL
ANTI-INFLAMMATORY DRUGS AND
THEY RELIEVE THE SYMPTOMS.
THEY MAKE YOU FEEL BETTER,
GIVE YOU A BETTER QUALITY OF
LIFE BUT DON'T PREVENT
PROGRESSION.
THAN THE DISEASE MODIFYING
DRUGS AND THESE SLOW THE
PROGRESS, PREVENT THE DAMAGE
AND DESTRUCTION IN ADDITION
TO RELIEVING THE SYMPTOMS.
SO THEY ACTUALLY PREVENT THE
DAMAGE AND THEREFORE PREVENT
THE NEED FOR JOINT
REPLACEMENTS, ETCETERA.
AND THERE ARE FOR MILD
DISEASE WE USE MEDICATIONS
SUCH AS PLAQUENIL, ACTUALLY
AN ANTI-MALARIAL BUT IT
WORKS.
WE USE GOLD.
WE GIVE PEOPLE GOLD INTRAMUSCULARLY
IN THE MUSCLE IT
IS ACTUALLY GOLD AND WE HAVE
BEEN DOING THIS FOR 50
YEARS.
AND WE USE THE STANDARD OF
CARE FOR WE WILL CALL IT
MODERATE TO SEVERE DISEASE
WE USE A MEDICATION CALLED
METHOTREXATE.
AND THAT IS A CHEMOTHERAPY
THAT THEY USE FOR CANCER BUT
WE USE IT AT ABOUT 1 HUNDREDTH OF
THE DOSE.
A LITTLE BIT OF METHOTREXATE
GOES A LONG WAY.
IT IS RELATIVELY SAFE IT IS
THE STANDARD OF CARE FOR
RHEUMATOID AT THIS TIME.

Maureen says BUT THESE NEW
DRUGS, REMICADE, ENBREL,
ARAVA, THEY ARE GOING TO BE
USED IN CONJUNCTION WITH
METHOTREXATE, RIGHT.

Ed says RIGHT NOW THEY WILL BE.
THAT IS THE STANDARD OF CARE
IS METHOTREXATE FIRST, IF
YOU FAIL METHOTREXATE WE
GENERALLY ADD THESE TO
METHOTREXATE.

Maureen says WHY NOT GO TRAIT
TO REMICADE IF IT IS SO
WONDERFUL.

Ed says WELL, FOR REMICADE IN
PARTICULAR, YOU NEED A
LITTLE BIT OF METHOTREXATE
ON BOARD AND THERE ARE SOME
TECHNICAL REASONS WHY THAT
IS IMPORTANT.
SO YOU HAVE TO USE IT WITH
METHOTREXATE.
ENBREL AND ARAVA DO NOT HAVE
TO BE USED WITH METHOTREXATE.
ONE OF THE PROBLEMS IS, IS
THE COST.
THAT IS THEY ARE VERY
EXPENSIVE AND FOR EXAMPLE,
ENBREL AND REMICADE, ARAVA
IS MUCH CHEAPER.
BUT BECAUSE OF THE COST OF
ENBREL AND REMICADE WE TEND
TO USE THEM A LITTLE BIT
LATER.
WE USE SOMETHING THAT WORKS
WELL, WHICH IT DOES, BUT AS
SOON AS IT FAILS OR NOT
WORKING AS WELL WE
IMMEDIATELY ADD THEM.
IF THE COSTS COME DOWN, AND
IF THERE IS ENOUGH PRODUCTS
ON THE MARKET, THAT IS THAT
THE COMPANIES MAKE ENOUGH
AND ONE OF THE PRODUCTS, FOR
EXAMPLE, ENBREL THE PROBLEM
RIGHT NOW IS A SUPPLY ISSUE,
BUT IF THERE WEREN'T A
PROBLEM WITH ACCESS AND
WEREN'T A PROBLEM WITH COSTS,
THESE AGENTS SHOULD PROBABLY
BE THE STANDARD OF CARE EVEN
BEFORE METHOTREXATE.

Maureen says WHAT DO YOU
EXPECT THE TWO EXPENSIVE
ONES WILL COST ONCE THEY ARE
AVAILABLE IN CANADA.

Ed says OH, I WOULD SAY IN
CANADIAN DOLLARS 12 TO
15,000 A YEAR.

Maureen says A YEAR.

Ed says A YEAR.
BUT REMIND YOU, IF YOU GIVE
SOMEONE A MUCH BETTER
QUALITY OF LIFE, THEY ARE
WORKING.
IF YOU GIVE THEM LESS JOINT
DAMAGE AND DESTRUCTION,
THEREFORE JOINT REPLACEMENTS
WILL BE LESS.
HOSPITALIZATION WILL BE LESS,
DOCTORS VISITS WILL BE LESS.
AND IN FACT, YOU ARE
CHANGING THE QUALITY OF LIFE
OF A PATIENT WITH A 15,000 A
YEAR DRUG FOR THEIR
LIFETIME.
THE AVERAGE PERSON HAS
RHEUMATOID FOR 30 TO 40
YEARS.
SO YOU ARE CHANGING THEIR
LIFESTYLE DRAMATICALLY.

Maureen says SO IT IS CONCEIVABLE THAT
THERE WILL BE PEOPLE WHO
WON'T BE COVERED PERHAPS WHO
WILL SAY TO YOU I CAN'T
AFFORD THAT.

Ed says THAT'S CORRECT.
WE ARE SEEING IT ALREADY.
WE ARE SEEING IT ALREADY.
THERE WILL BE PATIENTS OUT
THERE WHO WILL NOT BE ABLE
TO HAVE IT RIGHT NOW.
NOW THE GOOD NEWS IS THAT
NEW AGENTS LIKE THESE ARE
COMING ON THE MARKET IN THE
FUTURE WHICH WILL LIKELY BE
CHEAPER AND ONCE THERE IS
THIS, YOU KNOW, MARKETING
ISSUE, THAT IS MULTIPLE
PRODUCTS ON THE MARKET, THAN
ASSUMING... COMPETITION, THE
COST WILL COME DOWN AND SOME
OF THESE ARE MADE EVEN
CHEAPER THAN THE BUNS RIGHT
NOW.
BECAUSE THE ONES PLAYED NOW
ARE MADE IN WHAT IS CALLED
MAMMALIAN CELLS.
IT TURNS OUT THEY ARE CELLS
THAT MAKE THIS.
IF YOU CAN MAKE THIS IN
ANOTHER KIND OF MATERIAL
THAT IS MUCH CHEAPER, THAN
EVENTUALLY THEY WILL COME ON
THE MARKET AT A LOWER RATE.

Maureen says ANY SIDE
EFFECTS.
WHAT IS THIS LINK BETWEEN
ENBREL AND MS.

Ed says THAT IS A VERY GOOD
QUESTION.
LET ME SUGGEST THAT RIGHT
NOW WE ARE LEARNING ABOUT
THE SIDE EFFECTS OF THESE
OVER TIME.
DURING THE TRIALS WE
DIDN'T... THE CLINICAL
TRIALS WE DIDN'T SEE SIDE
EFFECTS.
ONCE YOU HAVE TREATED 80 OR
100,000 PATIENTS
WILL YOU START TO SEE SOME
OF THESE ISSUES.
WE ALREADY KNEW EVEN BEFORE
THESE WERE ON THE MARKET
THAT IF YOU TREAT SOMEBODY
WITH THESE AGENTS WHO HAVE
MS THAT THE MS GETS WORSE.
SO WE ALREADY KNEW THIS.
SO IT WASN'T A SURPRISE TO
US THAT A FEW PATIENTS MAY
DEVELOP MS.
IN GENERAL RIGHT NOW WHAT WE
CAN SAY IS IF YOU HAVE MS
AND RHEUMATOID ARTHRITIS YOU
SHOULD NOT BE TAKING THIS
MEDICATION.
NOW THAT IS TEN PATIENTS SO
FAR OUT OF 80,000 PATIENTS
TREATED.
SO WE KNOW IT IS A VERY LOW
RISK AND ALL WE SAY IS IF
THERE IS ANY SUGGESTION OF
SOMETHING LIKE MS YOU
SHOULDN'T BE USING THE
AGENT.

Maureen says YOU GUYS ARE
DOING CLINICAL TRIALS ALL
THE TIME.

Ed says YES.

Maureen says WITH PATIENTS.
WHAT EXCITES YOU ABOUT THE
FUTURE FOR PEOPLE WITH
RHEUMATOID ARTHRITIS.

Ed says I MUST SAY, WHAT EXCITES
ME IS THE BETTER CONTROL,
THAT IS THE PATIENTS WILL
EVEN BE BETTER THAN THEY ARE
TODAY, LESS DAMAGE, LESS
DEFORMITY, LESS DESTRUCTION,
THEREFORE QUALITY OF LIFE
AND ABILITY TO DO THINGS
THEY'VE NOT DONE BEFORE.
THEY WILL BE WORKING.
THEY WILL BE LOOKING AFTER
THEIR CHILDREN, GETTING UP
AND ABLE TO BRUSH THEIR
TEETH.
AND FOR SOME PEOPLE, THAT'S
WHAT THEY NEED TO BE ABLE TO
DO.

Maureen says I GET EXCITED
EVERY TIME I HEAR YOU TALK
ABOUT THINGS LIKE THIS.
THANK YOU VERY MUCH.

Ed says YOU ARE WELCOME.
PLEASURE TO BE HERE.

Maureen says COMING UP.

Joe says OSTEOARTHRITIS IS BAD
BUSINESS.
WE WILL ALL EXPERIENCE IT TO
SOME DEGREE ASSUMING THAT WE
LIVE LONG ENOUGH.

Maureen says JOE SCHWARCZ
LOOKS AT THE EFFECTIVENESS
OF GLUCOSAMIN.

The opening slate appears again.

Now Maureen stands next to a screen with the caption "Health digest. Labour pain."

Maureen says HERE ARE SOME HEALTH STORIES
MAKING NEWS.
A NEW DRUG SAID TO SPEED UP
CHILDBIRTH AND MAKE IT LESS
PAINFUL FOR MOTHERS, THE
DRUG DOESN'T EVEN HAVE A
NAME YET BUT IT WORKS BY
MIMICKING A NATURAL PROCESS
IN THE BODY THAT SOFTENS THE
CERVIX.
IT REDUCES LABOUR TO TWO TO
THREE HOURS RATHER THAN THE
18 OR 20 HOURS MANY FIRST
TIME MOTHERS EXPERIENCE.
THE SCOTTISH DRUG HAS BEEN
TESTED ON ANIMALS AND HUMAN
TRIALS WILL BEGIN THIS YEAR.

The caption on the screen changes to "C-section."

Maureen says IF THAT DRUG EVER HITS THE
MARKET IT MIGHT HELP REDUCE
CANADA'S RATE OF CAESAREAN
SECTIONS.
THE C SECTION RATE IS ON THE
RISE IN CANADIAN HOSPITALS.
ACCORDING TO THE MOST RECENT
DATA, 18 MY 7 percent OF HOSPITAL
BIRTHS WERE BY C SECTION IN
1997, 98 UP FROM 17.7 percent FIVE
YEARS EARLIER.
THE AVERAGE RATE IN EUROPE,
14 percent.

The caption on the screen changes to "Obesity."

Maureen says A REPORT BY THE CANADIAN
TRANSPORT AGENCY RECOMMENDS
AIRLINES GIVE OBESE
PASSENGERS A SECOND SEAT AT
NO EXTRA CHARGE TO
ACCOMMODATE THEIR SPECIAL
NEEDS IT.
THE REPORT SAYS THAT OBESITY
SHOULD BE CONSIDERED A
DISABILITY.
CURRENTLY OVERWEIGHT
PASSENGERS WHO DON'T FIT
COMFORTABLY IN TO STANDARD
SEATS MUST PAY FOR AN
ADJACENT SEAT THEMSELVES OR
UPGRADE TO EXECUTIVE CLASS.
AIR CANADA ALLOWS THEM TO
BUY A SECOND SEAT AT HALF
PRICE.
BUT A GROUP REPRESENTING
CANADIAN AIR CARRIERS SAYS PROVIDING EXTRA SEATS TO
OBESE PASSENGERS WOULD BE
PROHIBITIVELY EXPENSIVE.

The health quiz appears on screen again.

Maureen syas HOW ARE YOU FEELING AFTER
THIS WEEK'S QUIZ.
IF YOU RECEIVED A
SUBCURATIVE DOSE OF MEDICINE
YOU MIGHT NOT BE GETTING ANY
BETTER BECAUSE YOUR DOCTOR
DIDN'T PRESCRIBE A LARGE
ENOUGH DOSE.
NATIONALURE PATH KNEW IT, SO
DID PATIENTS WHO TRIED IT
AND A NEW STUDY IN EUROPE
CONFIRMS IT, GLUCOSAMINE
SULFATE SLOWS THE
PROGRESSION OF CARTILAGE
LOSS IN PEOPLE WITH
OSTEOARTHRITIS, REDUCES
THEIR PAIN AND KEEPS THEM
MORE MOBILE.
THE GOOD NEWS DIDN'T
SURPRISE JOE SCHWARCZ.

The scene changes to Joe Schwarcz standing in a lab.

A caption reads "Doctor Joe Schwarcz, Ph.D. Professor of Chemistry."

Joe is in his mid-forties, clean-shaven and with short wavy gray hair. He wears a black suit, a black shirt and a black tie.

Joe says OSTEOARTHRITIS IS BAD
BUSINESS, AND WE'LL ALL
EXPERIENCE IT TO SOME DEGREE,
GIVEN THAT WE LIVE LONG
ENOUGH.
OUR BONES ARE PROTECTED BY A
TISSUE CALLED THE CARTILAGE.
SORT OF LIKE A CURB ON THAT
PREVENTS BONE FROM RUBBING
ON BONE.
BUT UNFORTUNATELY, AS WE AGE
THROUGH WEAR AND TEAR THIS
CARTILAGE WEARS AWAY AND
THAT CAN BE A PAINFUL
EXPERIENCE.
TREATMENT USUALLY REVOLVES
AROUND USING NONSTEROIDAL
ANTI-INFLAMMATORY DRUGS.
THOSE TAKE AWAY THE PAIN BUT
THEY CAN LEAD TO GASTRIC
COMPLICATIONS.
BUT NOW THERE MAY BE ANOTHER
APPROACH, A CRUSTACEAN
APPROACH,

He takes out a plastic lobster off his pocket.

He says IT TURNS OUT THE
SHELLS OF CRUSTACEANS CAN BE
PROCESSED INTO SOMETHING
CALLS GLUCOSAMINE, THE RAW
MATERIAL THAT THE BODY CAN
USED TO MAKE PROTEOGLYCANS,
BUILDING BLOCKS OF CARTILAGE
AND MANUFACTURE HYALURONIC
ACID WHICH DISSOLVES THE
SYNOVIAL FLUID WHICH CELLS
ARE BASED AND PROVIDES A
CUSHIONING EFFECT.
INDEED, IN EUROPE, 13
STUDIES HAVE SHOWN THAT
PEOPLE WHO TAKE DIETARY SUPPLEMENTS
OF GLUCOSAMINE DO
BETTER IN TERMS OF
OSTEOARTHRITIS.
AND IN FACT, RECENTLY A
STUDY RIGHT HERE AT THE
UNIVERSITY OF TORONTO BY
DOCTOR JOSEPH HOUPT SHOWED THAT
49 percent OF PEOPLE WHO TOOK
GLUCOSAMINE IMPROVED IN
TERMS OF THEIR SYMPTOMS OF
OSTEOARTHRITIS, ALTHOUGH 40 percent
OF THOSE TAKING A PLACEBO
ALSO IMPROVED.
SO WE'RE NOT LOOKING AT A
DRAMATIC RESULT BUT WE ALSO
HAVE TO UNDERSTAND THAT THE
SIDE EFFECTS ARE BASICALLY
NONEXISTENCE WITH
GLUCOSAMINE.
THE ONLY LINGERING CONCERN
IS FOR DIABETICS AND FOR
PEOPLE WHO ARE OVERWEIGHT,
BECAUSE GLUCOSAMINE MAY
SOMEHOW IMPAIR INSULIN
FUNCTION.
THERE IS JUST ONE MORE
OUTSTANDING ISSUE, AND THAT
IS IF YOU DECIDE TO TAKE
GLUCOSAMINE, HOW DO YOU KNOW
THAT WHAT YOU THINK YOU ARE
TAKING REALLY IS WHAT ARE
YOU TAKING, THAT THE LABEL
MATCH THE PRODUCT INSIDE.
UNFORTUNATELY, THERE ARE NO
GUARANTEES HERE.
MANUFACTURERS DO NOT HAVE TO
PROVE TO ANY GOVERNMENT
AGENCY THAT THEY REALLY PUT
INTO THE PILL WHAT THEY SAY
THAT THEY PUT IN.
A SURVEYS IN STORES HAVE
SHOWN THAT THE LABEL IN FACT
DOES NOT ALWAYS MATCH THE
PRODUCT.
BUT YOU KNOW WHAT, MAYBE I'M
JUST BEING TOO CRABBY ABOUT
THAT.

Maureen says THAT IS A
LOBSTER, JOE.
ANYWAY, A TRANSCRIPT ABOUT
ALL OF JOE'S HERBAL ADVICE
IS ON OUR WEB SITE W,
W.TVO.ORG/YOURHEALTH.
AND NEXT WEEK, A SPECIAL
EDITION OF YOUR HEALTH.

A teenage boy says THIS IS A SPEECH
PROJECTOR.
THIS GOES WITH IT.
IT WAS DEVASTATING.

A woman in her thirties says I FEARED HE WOULDN'T
SPEAK, NOBODY WOULD
UNDERSTAND HIM.
HE WOULD HAVE TO STAY HOME
AND I DON'T KNOW, I JUST
FELT HE WOULD LIVE A SHELTERED LIFE.

A sign language interpreting a young man says WE DON'T SUPPORT
IMPLANTING YOUNG CHILDREN
BECAUSE WE FEEL IT IS VERY
MUCH A MEDICAL VIEW OF
DEAFNESS WHICH IS OFTEN THE
VIEW OF SOCIETY.
LOOKING AT DEAF PEOPLE AS A
DYSFUNCTIONAL GROUP OF
INDIVIDUALS.
AND WE DON'T SEE OURSELVES
AS DYSFUNCTIONAL.

Maureen says THE IMPORTANCE OF BEING
HEARD.
A LOOK AT THE ONGOING DEBATE
OVER COCHLEAR IMPLANTS.
THAT IS NEXT
WEEK ON "YOUR HEALTH."
I'M MAUREEN TAYLOR.
JOIN US THEN.

A slate appears with the caption "Email: yourhealth@tvo.org. Fax: 416-484-4519. Mail: Box 200, Station Q. Toronto, Ontario. M4T 2T1."

Another slate reads "Special thanks: Saint Michael’s Hospital and Mount Sinai Hospital."

Music plays as the end credits roll.

Executive producer: Patricia Ellingson.

Producer: Cathy Perry.

Director: Michael Smith.

CEP Local 72m.

A production of TVOntario.

Copyright 2001. The Ontario Educational Communications Authority.

Watch: Show #19