“America’s Mom”, Barbara Billingsley, takes her “Leave”.

Barbara Billingsley, beloved as her iconic “America’s Mom” role of June Cleaver has died at the age  of 94  of rheumatoid polymyalgia. The 1950’s TV star of  Leave it to Beaver was the model of American Motherhood, always wearing a dress, high heels and pearls, even while housecleaning. Leave it to Beaver is the longest continuously running TV show, still being seen in syndication around the world since 1957. Billingsley is also well known for the cameo appearance she made in the 1980’s comedy Airplane!: Informing a frazzled flight attendant “Oh, stewardess, I speak ‘jive,'” she proceeded to “translate” the urban ghetto talk of an ailing black male passenger.

Her Leave it to Beaver “children” Jerry Matthers (“Beaver”) and Tony Dow (“Wally”) told CNN:

“Barbara was a patient adviser and teacher. She helped me along this challenging journey through life by showing me the importance of manners and respect for others.”   -Jerry Mathers

“She was as happy as a lark being recognized as America’s mom,” – Tony Dow

What is Polymyalgia Rheumatica?

Polymyalgia rheumatica, also called PMR,  is a condition in which the muscles in the neck, shoulders, hips and thighs become inflamed. “Inflamed” means redness or heat, swelling, and pain. This causes stiffness and aching in these areas. The pain and stiffness usually occur in the morning or after a period of inactivity. It typically lasts longer than 30 minutes. For most people, the condition develops gradually. But for some people it can develop quickly—even as quickly as overnight. In addition to stiffness, symptoms may include  fever, weakness, and weight loss.

Polymyalgia rheumatica sometimes occurs along with giant cell arteritis (GCA) (see below), an inflammatory condition that causes swelling of the arteries in your head. Symptoms include headaches and blurred vision.

The cause of polymyalgia rheumatica is not known. It is linked to immune system problems, genetic factors, and an event, such as an infection, that can triggers symptoms. The fact that polymyalgia rheumatica is rare in people under the age of 50 and becomes more common as age increases, suggests that it may be linked to the aging process. It is also more common in women and in Caucasians.

Polymyalgia rheumatica usually resolves within 1 to several years. The symptoms of polymyalgia rheumatica are quickly controlled by treatment with corticosteroids, but symptoms return if treatment is stopped too early. Corticosteroid treatment does not appear to influence the length of the disease.

What is Giant Cell Arteritis?

Giant cell arteritis causes inflamed arteries of the scalp, neck, and arms.  The arteries most affected are those in the temples on either side of the head. These arteries narrow, so not enough blood can pass through. Early symptoms of giant cell arteritis may resemble flu symptoms such as fatigue, loss of appetite, and fever. Symptoms specifically related to the inflamed arteries of the head include headaches, pain and tenderness over the temples, double vision or visual loss, dizziness or problems with coordination, and balance. Pain may also affect the jaw and tongue, especially when eating, and opening the mouth wide may become difficult.

Like PMR, GCA is treated with corticosteroids. However, for the best outcome,  GCA should be treated as early as possible to prevent permanent complications including blindness and stroke.

How Are Polymyalgia Rheumatica and Giant Cell Arteritis Related?

It is unclear how or why polymyalgia rheumatica and giant cell arteritis frequently occur together.  PMR occurs in about 50 % of patients who have GCA, while approximately 15% of patients with PMR develop GCA. There may be a common genetic component between the two disorders. Some people with polymyalgia rheumatica also develop giant cell arteritis either simultaneously, or after the musculoskeletal symptoms have disappeared. Other people with giant cell arteritis also have polymyalgia rheumatica at some time while the arteries are inflamed.

How Are These Conditions Diagnosed?

There is no single test to tell if you have polymyalgia rheumatica. The doctor usually bases the diagnosis on:

  • Medical history
  • Symptoms
  • Physical exam
  • Blood tests- including an erythrocyte sedimentation rate (ESR), C-reactive protein and Rheumatoid Factor (RF) tests

To find out if you have giant cell arteritis, the doctor will see if the artery in your temple is inflamed. He or she will check the artery for a reduced pulse. If the doctor suspects giant cell arteritis, he or she will order a biopsy. A small part of the artery is taken out and looked at under a microscope.

For more information about Polymyalgia Rheumatica and Giant Cell Arteritis, click here to go to the Resounding Health Casebook on the topic.

Mark Boguski, M.D., Ph.D. is on the faculty of Harvard Medical School and is a member of the Society for Participatory Medicine, "a movement in which networked patients shift from being mere passengers to responsible drivers of their health" and in which professional health care providers encourage "empowered patients" and value them as full partners in managing their health and wellness.

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