“-ITIS” – The 4 Letter Word of Medicine

As I sail to the other side of the world, surrounded by fellow travelers from literally 34 countries, our similarities appear far more striking between us than the differences. The beating heart, coupled with the human spirit longing for adventure, is the most obvious similarities between us all. Further, our deference to both “Mother Nature” controlling the weather, the tides, and our daily rituals; as well as “Father Time” controlling our aging process has become quite obvious amidst the beauty of our passage around Cape Horn and through the Straits of Magellan. The courage of those explorers from the earliest of days astounds me, sailing into the complete unknown being beyond most of our capacities. How anyone could have survived not only the sailing to these destinations, but the settlement of these desolate locales, is beyond comprehension. I salute them for their sacrifice, and will remember these sights forever!

Most interesting has been my discussions with my fellow travelers in regards to their medical issues, mainly centered around past surgical procedures, some successful, some not;  as well as the acute daily health concerns faced on a 2 week cruise. From the sore throat, to the aching joints and feet, (head to toe), the similarities CONTINUE between us all! When we are 100%, the body is rolling along in a fluid and appropriate manner, all “ship shape”, as they say!! When we are not 100%, no matter WHERE we are not right, the bottom line is the same: something, somewhere, somehow has become inflamed!!!

Thus “-ITIS”, the Latin root for inflammation, is the ultimate enemy, both acute and chronic!! For example, tonsils and the back of the throat feel normal until one develops “tonsillitis” or “pharyngitis”. Your joints (arth being the root) don’t hurt until you develop “arthritis”. Similarly your stomach feels well until you develop “gastritis”, and your bladder works well until you develop “cystitis”.  Just find the Greek or Latin root for the body part, add that nasty 4 letter word,”- ITIS”, and it’s easy to define. Both acute and chronic (think tendonitis for the simple ankle sprain, rheumatoid arthritis for the chronic); the process is all about the inflammation!!! The treatment, on the other hand, can be much more challenging than the definition, certainly for the chronic conditions.

The hallmarks of acute inflammation are easy to recognize. Redness, warmth, swelling, and of course pain being the BIG 4! Think acute gouty arthritis, if you’ve ever seen a gouty toe or the back of your throat when you’ve had strep. Treatment always starts with rest, coupled with ice and elevation, compression with an ace wrap or splint of the body part if possible to reduce the swelling. Medications are used with various levels of success. ANTIBIOTICS, of course, are the solution if the cause is a bacterial infection; ineffective for viral infections although still often utilized. The strongest of the anti-inflammatory medications, the steroids (prednisone, cortisone), work great in general, but can’t be used every day without significant side effects. They still are used daily in certain severe inflammatory conditions (severe arthritic conditions, connective tissue diseases, etc.), when the benefit outweighs the risks. The NSAID’s (non-steroidal anti-inflammatory drugs), aspirin being the oldest (ibuprofen, naproxen, many others) are widely used with a great safety profile, but longer term, daily use should always be discussed with your primary care practitioner, as they too can have side effects over the long term. Interestingly, Tylenol (acetaminophen), while excellent for pain relief is not an anti-inflammatory drug, nor are the narcotics of course.

Chronic pain is tougher, a huge problem for many, especially as “Father Time” wins his battle as he always does, and a topic for another blog:  this one is long enough already! Remember, -ITIS  is the enemy, common sense with activities the best way to avoid it, but it’s just a part of our common human condition we all MUST face from time to time, no matter how healthy we are!! Remember R.I.C.E. as the treatment…rest, ice, compression/elevation for swelling, antibiotics for the appropriate infectious causes, and see your doctor if it persists or recurs!! Be well all!!