Other Chronic Diseases

Osteoporosis 
What is osteoporosis? 
Osteoporosis is a medical condition characterized by weakened bones, making them more brittle and prone to fracture. It occurs when the body loses too much bone mass and/or fails to make enough new bone tissue, resulting in a decrease in bone density. Osteoporosis often develops slowly over many years and is more common in older adults, especially women after menopause. Other risk factors for osteoporosis include a family history of the condition, low levels of calcium and vitamin D, smoking, excessive alcohol consumption, and certain medical conditions such as rheumatoid arthritis or celiac disease. Osteoporosis can lead to fractures, which can be debilitating and cause significant pain and loss of mobility. Treatment typically involves a combination of medication, dietary changes, and exercise to prevent further bone loss and reduce the risk of fractures.

Diagnosis, treatment and management of osteoporosis:
Diagnosis:
The diagnosis of osteoporosis is typically made using a bone mineral density (BMD) test, which measures the amount of calcium and other minerals in a specific area of bone, usually the hip or spine. The results of the BMD test are reported as a T-score, which compares the patient's bone density to that of a healthy young adult of the same gender. A T-score of -2.5 or lower is considered osteoporosis.

Treatment:
There are several medications that can help prevent further bone loss and reduce the risk of fractures in people with osteoporosis, including:
•    Bisphosphonates, which slow down the bone breakdown process
•    Hormone therapy, which can help maintain bone density in postmenopausal women
•    Denosumab, which reduces bone breakdown and increases bone density
•    Teriparatide, which stimulates the growth of new bone tissue
Surgery may also be an option in some cases, such as for fractures that do not heal properly or for spinal deformities caused by severe osteoporosis.
It's important to work with a healthcare provider to determine the most appropriate management and treatment plan based on individual needs and risk factors.

Management:
Managing osteoporosis involves several lifestyle changes and interventions, including:
•    A balanced diet rich in calcium and vitamin D
•    Regular weight-bearing and muscle-strengthening exercises
•    Avoiding smoking and excessive alcohol consumption
•    Fall prevention measures, such as removing tripping hazards and using assistive devices
•    Regular bone density testing and monitoring


Osteoarthritis 
What is osteoarthritis? 
Osteoarthritis is a common joint disorder that occurs when the protective cartilage that cushions the ends of bones in joints gradually wears down over time. As the cartilage deteriorates, the bones can rub against each other, causing pain, swelling, and stiffness in the affected joint. Osteoarthritis can occur in any joint, but it most commonly affects the hands, hips, knees, and spine. Age, genetics, and certain lifestyle factors such as obesity or joint injuries can increase the risk of developing osteoarthritis. There is no cure for osteoarthritis, but treatments such as medication, physical therapy, and surgery can help manage the symptoms and improve quality of life.

Diagnosis, treatment and management of osteoarthritis:
To diagnose osteoarthritis, your doctor will likely perform a physical exam, review your medical history, and order imaging tests such as X-rays, MRI or CT scans to assess the affected joint(s) for signs of damage or cartilage loss.

Treatment:
While there is no cure for osteoarthritis, there are several treatment options available to help manage symptoms, including:
•    Medications: Over-the-counter pain relievers such as acetaminophen, nonsteroidal anti-inflammatory drugs (NSAIDs), and topical pain relief creams may help to alleviate joint pain and inflammation.
•    Physical therapy: A physical therapist can help develop an exercise program to improve joint flexibility and strength, as well as reduce pain and stiffness.
•    Weight loss: Losing excess weight can help reduce the stress on weight-bearing joints, such as the knees and hips.
•    Assistive devices: Assistive devices, such as braces, crutches, and canes, can help relieve pressure on affected joints and improve mobility.
•    Surgery: In severe cases, joint replacement surgery may be necessary to replace the damaged joint with an artificial one.
 

Management:
In addition to treatment options, there are several self-care measures you can take to manage osteoarthritis symptoms, including: 
•    Exercise regularly to maintain joint flexibility and strength.
•    Avoid activities that put excessive stress on affected joints.
•    Use hot or cold compresses to alleviate pain and swelling.
•    Eat a healthy diet rich in anti-inflammatory foods, such as fruits, vegetables, and whole grains.
•    Get enough rest and manage stress to help reduce inflammation and promote healing.

It's important to work with your doctor to develop a comprehensive treatment plan that addresses your individual needs and helps you manage your osteoarthritis symptoms effectively.

Living with osteoarthritis and osteoporosis 
Living with osteoarthritis or osteoporosis can be difficult, but with the right treatment, management plan and lifestyle choices, you can live a long and healthy life. Support is also important when living with a chronic condition- not only from healthcare professionals, but from family, friends and support groups. If you have osteoarthritis, osteoporosis or another rheumatic condition- and you would like to be part of the arthritis community, you can join the Arthritis and Rheumatism Association Malta (ARAM). They provide support, education and increase awareness of osteoarthritis and rheumatic conditions in Malta.
Self-management is also an important part of living with a chronic condition, learning skills such as pacing, communicating effectively with healthcare professionals and managing stress can all help with living with a chronic disease. That’s why we offer a free self-management programme for persons living with a chronic condition- to teach these (and many more!) skills and help you self- manage your condition effectively. 
To join our free programme ‘Hu Kontroll’ please fill out the application form here


Epilepsy 
What is epilepsy? 
Epilepsy is a neurological disorder that causes recurrent, unprovoked seizures, which are brief disruptions in the normal electrical activity of the brain. These seizures can vary in severity and frequency, and may involve a loss of consciousness, convulsions, muscle spasms, or other unusual sensations or behaviours.

Early signs and symptoms of epilepsy may include:
•    Uncontrollable jerking movements of the arms and legs
•    Staring spells or brief loss of awareness
•    Temporary confusion or inability to speak
•    Sudden falls for no apparent reason
•    Strange sensations such as tingling, numbness, or a feeling of déjà vu
It is important to seek medical attention if you or someone you know experiences these symptoms, as they may be signs of epilepsy or another neurological condition.

Diagnosis:
To diagnose epilepsy, your doctor will typically perform a physical and neurological examination, as well as take a detailed medical history. They may also order tests such as an electroencephalogram (EEG) or magnetic resonance imaging (MRI) to evaluate the electrical activity and structure of the brain.

Treatment:
The goal of epilepsy treatment is to reduce the frequency and severity of seizures, as well as minimize side effects of treatment. Treatment options for epilepsy may include:

Medications: 
•    Anticonvulsant medications are typically the first-line treatment for epilepsy, and work to prevent seizures from occurring.
•    Surgery: In some cases, surgery may be recommended to remove the part of the brain that is causing seizures.
•    Vagus nerve stimulation (VNS): This involves implanting a small device under the skin of the chest that sends electrical signals to the vagus nerve, which can help reduce the frequency and severity of seizures.
•    Dietary therapy: A ketogenic diet, which is high in fat and low in carbohydrates, may be recommended for some people with epilepsy, as it has been shown to reduce seizures in some cases.

Management:
In addition to treatment, there are several lifestyle modifications that can help manage epilepsy symptoms and reduce the risk of seizures, including:
•    Getting enough sleep and managing stress
•    Avoiding triggers, such as alcohol, flashing lights, or lack of sleep
•    Wearing a medical alert bracelet or necklace to alert others in case of a seizure
•    Keeping a seizure diary to track symptoms and triggers
It's important to work with a healthcare professional to develop an individualized treatment plan that meets your specific needs and helps you manage your epilepsy effectively. 

Living with epilepsy 
Living with epilepsy may require adjustments to daily life. For example, it may be necessary to avoid certain activities or situations that can trigger seizures. It is important to discuss these restrictions with a healthcare professional and to find alternative ways to participate in activities.
Support from family and friends can be important for individuals with epilepsy. It may be helpful to educate loved ones about the condition and how to provide assistance during a seizure. It is also important to communicate with teachers, employers, and other individuals who may need to know about the condition to ensure that appropriate accommodations are made.
One of the biggest challenges of living with epilepsy is the stigma surrounding the condition. Epilepsy is often misunderstood, and many people have misconceptions about the condition. This can lead to discrimination, bullying, and isolation for individuals with epilepsy.
It is important to educate others about epilepsy and to advocate for greater awareness and understanding. This may involve participating in support groups or advocacy organizations, sharing personal experiences, and educating others about the condition and how to provide support. 
In Malta, there is Caritas Malta Epilepsy Association offering support, education and awareness for epilepsy.
Self-management is also an important part of living with a chronic condition, learning skills such as pacing, communicating effectively with healthcare professionals and managing stress can all help with living with a chronic disease. That’s why we offer a free self-management programme for persons living with a chronic condition- to teach these (and many more!) skills and help you self- manage your condition effectively. 
To join our free programme ‘Hu Kontroll’ please fill out the application form here