Gary V. Gordon, MD, FACP, FACR

"Remember that building new healthy habits can take some time and it's OK to treat yourself to avoid feeling deprived. Stay focused on your goal, and if you sli...p along the way, just start again." Wise words! #rheumatology #mainlinerheumatology #rheumatologist #healthcare https://health.clevelandclinic.org/11-simple-health-habit/

If one of your parents has had a broken bone, especially a broken hip, you may need to be screened earlier for osteoporosis. #mainlinerheumatology #rheumatologist #osteoporosis https://www.cdc.gov/genomics/disease/osteoporosis.htm

The following Jane Brody article on osteoporosis is a great summary which elegantly states that the greatest risk for a fracture from osteoporosis is having alr...eady had a previous fracture. #osteoporosis #mainlinerheumatology #rheumatologist https://www.nytimes.com//after-a-broken-bone-the-risk-of-a

As rheumatologists, we know that many of our patients will be going to the polls November 3 to exercise their constitutional right to vote. Some have already v...oted by mail and others have deposited their ballots at Voter Services offices or dropboxes. You may be worried that your vote may not be counted unless you go to the polls, but our understanding is that voting by mail is common in many States and is secure. You can vote at the polls even if you have received a mail-in ballot, but you must bring that ballot with you to your polling place, to be voided so you can vote a regular ballot at the polls. If you requested a mail-in ballot but have not received it (or have lost it), you will be allowed to vote a provisional ballot at your polling place. It will be counted once it’s determined that you didn’t already vote by mail. You can double-check your polling location at votespa.com/polling place or iwillvote.com/votinginfo/pa In addition, the rheumatologists at Paoli, Bryn Mawr, and Lankenau Hospitals want you to be prepared in case there are long lines. Don’t forget to wear your mask and bring a small bottle of hand sanitizer. Dress for the weather and bring a small umbrella. Take food and drink. Don’t forget to take your medications. If you have trouble walking or standing, take a cane or walker with a small seat. We applaud all of you for taking your civic duty seriously. Amy Lundholm, D.O., Hyon Ju Park, M.D., Thomas Harder, M.D, and Gary V Gordon, M.D.

Here's an article showing the similarities between Covid19 and some of the auto-immune diseases that we treat. #mainlinerheumatology #health #rheumatology #rheumatologist #arthritis #osteoporosis https://www.nytimes.com//covid-antibodies-autoimmunity.htm

Fish oil, SAM-e and curcumin are among the supplements with the best evidence to support them. The research on glucosamine and chondroitin, some of the most pop...ular supplements for osteoarthritis, is mixed. Glucosamine sulfate might work but almost no evidence to support glucosamine hydrochloride (HCl). #rheumatology #mainlinerheumatology #Arthritis #health #rheumatologist https://www.arthritis.org//sup/choosing-supplements-wisely

Don’t let osteoporosis affect you! If you are at risk, talk to your doctor. #Osteoporosis #rheumatology #rheumatologist

The majority of fragility fracture patients are neither assessed, nor treated by their health-care system hence there is failure to ‘Capture the Fracture’ and reduce risk of subsequent fractures. #osteoporosis #worldosteoporsisday #rheumatology #rheumatologist

Patients have told us that topical Voltaren which is now available over the counter (no prescription) is cheaper at Bed Bath and Beyond compared to local pharma...cies. Remember to use one of their 20% discount cards you get in the mail or can download from their website. Also, Costco and Sam's Club have low priced Advil or Aleve if you are willing to buy in bulk. One of the best prescription savings we have seen is with GoodRx.com for those of you who do not have a prescription plan. They ask for your zip code and after you enter the name of the drug, you are provided with participating drug stores in the area and what the medication will cost. Savings can be significant.

Remember to take your medications as prescribed during Yom Kippur, a few bites of crackers and sips of water are permitted for health. We wish an easy fast to all who celebrate.

A Rheumatology View of Covid For the last 6 months, it has been difficult for all of us to think of anything else other than Covid as our world has been turned ...upside down to borrow a phrase from Hamilton. As rheumatologists, we have our own particular view of Covid. Other than the unfortunate politicizing of social distancing, most of the world understands that this is vital if we are to survive this pandemic. Wearing masks, frequent hand washing, staying an appropriate distance from others and quarantining when necessary is vitally important. Avoiding prolonged exposure to others in non-ventilated rooms is obviously worthwhile. We have learned much in the last 6 months and the turnaround in former hot areas like New York City teaches us that we can do it but unfortunately at huge economic sacrifice for many. As we often say, Listen to Fauci. In our office, we are using HEPA filtering which significantly reduces the amount of virus particles in the air. Questioning patients as to travel and having temperatures taken makes it a considerably safer place then many (i.e. supermarkets). We also continue to offer TeleMed visits which provides sufficient information in many cases but obviously does not work when infusions of medications, joint aspiration and injections are necessary. We now know that neither the diseases we typically treat nor the medications we use are risk factors for Covid. Identified risks are obesity, lung disease, vaping, smoking, and diabetes. We have learned that many of the deaths cause by Covid have less to do with overwhelming infection and more to do with our bodies ‘accelerated inflammatory response to the infection. This is commonly referred to as cytokine storm where the immune system essentially goes haywire trying to eliminate Covid but unfortunately ends of damaging the endothelial cells which line the insides of blood vessels. Damaged blood vessels are more prone to promote clots throughout the body as well as limiting the ability of the lung to oxygenate blood. Numerous drugs are being studied to better control cytokine storm. Thus far there are no definite winners. The public gets their hopes up when drugs like hydroxychloroquine (Plaquenil) get endorsed by non-medical politicians but there are some other medications that are intriguing. As rheumatologists, we have used virtually all of them for the inflammatory diseases that we treat. Corticosteroids are being carefully examined as they are inexpensive and suppress inflammation. Of course the timing is critical. Using drugs that suppress inflammation can allow infection to go unchecked. Thus, drugs that may work on Covid infection such as remdesavir would be more useful in the beginning of a Covid infection and less useful later whereas the cytokine storm inhibitors need to be given at a later time. Currently the 2 drug classes being most intensively studied are interleukin-1 and interleukin-6 inhibitors. Examples of these drugs include Kineret, Ilaris, Actemra and Kevzara. They are approved for use in rheumatoid arthritis. As of this writing, all these medications are considered off label and not covered by insurance for Covid. Double-blind studies suggest that they may work but are certainly not conclusive. Numerous studies are underway in the United States and around the world and we anxiously await the results. Work on vaccines is moving along rapidly. Historically we have never been able to develop a vaccine as fast as current work is proceeding in this area. Efficacy and safety still need to be established and hopefully this will not be another politicized issue. This is reminiscent of the speed with which ships and fighter airplanes were built in a few days during World War II. (I think of this often when I see the bridges being repaired in Ardmore which take at least 2 years each). We will get past this. The economic and social impact is already devastating. People are out of work or unable to go to work if they have children unable to go to school. Nothing will be the same, but Main Line Rheumatology and Osteoporosis along with the dedicated health care providers in the Philadelphia area plan to provide the best health care we can offer. #medicine #rheumatology #COVID19 #Rheumatologist #doctor #telemedicine

We appreciate our patient's taking the time to write a note thanking our doctors and nurse practitioner! Amy Lundholm, D.O. Cheryl Wieczorek, CRPN, MSN

Five-Minute Coronavirus Stress Resets, how to get unstuck from your anxiety.

As cases of coronavirus continue to rise across the country, experts are pointing to an array of evidence suggesting that masks also protect the people wearing them, lessening the severity of symptoms, or in some instances, staving off infection entirely. Please wear a mask!