THE DOCTOR TREATING BETTY FORD'S ARTHRITIS PRESCRIBES PLENTY OF COMMON SENSE
(From People Magazine, Volume 4, Number 5, August 4, 1975)
One in four Americans (three times as many women as men) suffers from the effects of arthritis—a disease which takes many painful and often crippling forms and can even cause death. One of the leading experts on the disease is Dr. William Felts, a specialist in internal medicine and rheumatology at Washington's George Washington University Hospital who counts among his patients Mrs. Betty Ford (the arthritis in her neck has been severe enough to interrupt her schedule). Newscaster Eric Sevareid and Jane Weinberger, whose husband, Caspar Weinberger, cited her worsening arthritis as a reason for his recent resignation as U.S. Secretary of Health, Education and Welfare, are also victims of the disease. Dr. Felts, who at 52 does not suffer from arthritis, recently discussed the disease and how to cope with its
painful effects with Barnard Collier for PEOPLE.
How much of a national problem is arthritis?
About 50 million Americans suffer to some degree from the disease. It is often mistakenly thought of as an ailment of the elderly, but it strikes children and young adults as well. While some forms are severe enough to cause death, most are mild enough to torture without killing.
What exactly is arthritis?
It's 86 different conditions. There's rheumatoid arthritis, which inflames the joints, connective tissue, lungs, skin and can even affect the eyes. Ankylosing spondylitis begins mostly in teenage boys and young men and affects the spine. Lupus is a form that can be fatal. It is found most often in women, and is so named (lupus is Latin for wolf) because of the skin rash that appears on the face and gives the person a wolflike appearance around the eyes. And there is osteoarthritis, sometimes called "wear and tear" arthritis, since it is generally related to old age. I'm not sure what causes it, but it's very common. Even dinosaurs are known to have had it. Gout, too, is another form of arthritis.
Isn't gout supposed to be a disease of the ambitious?
Maybe it is. It's terrifically painful. Sometimes even morphine doesn't help it. Excesses in the diet, including too many rich foods, may precipitate it in people who have gouty tendencies. There is evidence that gout is inherited and, of all the arthritic diseases, it comes closest to being controlled. There are now drugs that may relieve gout symptoms for life.
Is it true gout settles in the big toes?
Yes. It starts there about 60 percent of the time. It's an explosive disease. You may go to bed feeling perfectly fine and wake up in tremendous pain, so that even the weight of a sheet on the toe is excruciating.
Why is arthritis more common among women than men?
We don't know. In my practice women patients outnumber men about two-to-one. True, I see more women with milder forms of the disease than I do men. Men usually wait until they hurt more. Perhaps women are simply bigger complainers.
Do you think women have a lower pain threshold than men?
We recognize a variable pain threshold. There's no way to tell by measuring how much pain someone is suffering. Sometimes it's a matter of not giving into the pain when it comes to living with arthritis.
What do you mean by "not giving into pain"?
I teach people how to live with arthritis as part of the treatment. I stop more drugs than I prescribe. You have to learn what to treat and what to put up with, despite the pain.
How does a person know when he or she has arthritis?
Generalities are difficult to make with arthritis because it has so many forms. For example, with rheumatoid arthritis the joints become inflamed, with damage to the connective tissue. Scar-type tissue forms. There is swelling. There may or may not be redness and tenderness-cardinal signs of inflammation. In this kind the wrists and knees are the most common sites, but any joint can be involved.
What is the common reaction when a person first finds signs of arthritis?
Usually fear. Sometimes depression. They worry about being bedridden or crippled.
How long do those fears usually last?
Until they come to grips with the reality of the disease. Before that point people often have a tendency to reject emotionally the fact that there is no cure. When they get the unhappy truth—that out of ignorance we can't really do much about it—they sometimes jump to the first guy who hands them a copper bracelet or tells them to sit in an old uranium mine. In Mexico they even try extracts from the prostate glands of goats.
How do people hear about such remedies?
Mostly from testimonials. Except for the out-and-out quacks, most are well-meaning. Sometimes people have natural remissions. Maybe people relate the remission to something they've tried, like smoking fig leaves in a cemetery at midnight.
Don't any of the panaceas work?
One was an apparently innocuous potion concocted by someone in Canada. People went in droves to get it. Some was sneaked back into the U.S. and tested. It was loaded with cortisone, which is nothing new. The potion was made by someone trying to misuse the drug. With cortisone there is a severe risk of high blood pressure, loss of minerals in the body and peptic ulcers.
Are certain personalities prone to arthritis?
Some people say that passive, dependent personalities are more prone to arthritis. But passiveness may be more an effect than a cause. With arthritis, in some cases more than others, there is a constant struggle to achieve emotional balance in spite of pain. For example, a woman in pain may fight and fight and fight, and then quit. She may think: "Why struggle?"
Are there also determined strugglers?
Some try denial. They try to convince themselves that the problem doesn't exist. So they may overuse inflamed joints to somehow prove they are still very fit.
Do you recommend exercise?
Yes. One should be able to keep a range of motion. But when the joint is hurt and hot and swollen, rest it.
Does weather affect arthritis?
There aren't many controlled studies to substantiate that idea. But in one test there was a significant worsening of symptoms with the fall of pressure and the rise in humidity, which is what happens right before a storm.
Then does warm, dry weather help arthritis?
In living daily with arthritis, most patients do best where they are happiest. Contentment is more important than climate.
What drugs do you prescribe?
A whole range of drugs, depending on the patient. But there have been no major therapeutic breakthroughs. Perhaps the most successful new work so far has been in the replacement by orthopedic surgeons of the large joints like hips and knees. There's a woman in Virginia called the $1 Million Woman who had been bedridden until surgeons replaced both her hips, her knees, her right elbow, her right wrist, the small joints of her right hand, and joints in her left wrist, hand and elbow. She was walking the last I heard and she may have a few years in which she can take care of herself. As for drugs, aspirin is the first I prescribe. After that it's strong drugs like cortisone to control inflammation.
Is there much overdependence on strong drugs?
Judge George L. Hart, chief judge of the federal district court in Washington, D.C., came to me very sick with rheumatoid arthritis, and I took him off almost all drugs. He was in the hospital three months suffering from withdrawal symptoms. Hart was an excellent patient. He didn't ask for as much as an aspirin. He took therapy and slowly got better. A year after he went into the hospital he was back on the bench. Three years ago he took up making glass model sailing boats as a hobby. Now his courtroom is decorated with the fleet of sailboats he's made himself.
What is the most important prescription for arthritis?
A large dose of common sense.
