Arthritis Does Not Have To Cripple You
Dr Ely Lazar and Dr Adele Thomas
One of the images of older people is someone with a walking stick, hunched over and shuffling along. This image is used in parking lots to designate seniors parking!
Arthritis can be caused by wear and tear of joints over the years or by a disorder that is very destructive of joints, particularly in the hands and feet, called rheumatoid arthritis. Both forms of arthritis can develop at any stage of life although the damage to the bigger joints like knees and hips tends to appear later in life.
Arthritis does not have to ruin your life. Many people when they develop pain in a joint stop all exercising. It is important to do the opposite keep exercising. Get help from a physiotherapist to find the best exercise program for you.
With long waiting times to see an orthopedic surgeon in a public hospital, then a further wait to get surgery, it is easy to end up housebound, overweight and totally unfit. This is not a good way to prepare for surgery. Now many hospitals provide pre-surgery water-based exercise programs to rebuild muscles that greatly improves the outcome.
Arthritis does not have to cripple you. Find a way to get around your particular limitations and get yourself as fit as you can and live life to the full. Get help from your doctor and allied health professionals to achieve this. Medicare provides access to many additional services to do this.
Enjoy life to the full.
Will Osteoarthritis Cripple Me
Osteoarthritis is a very dangerous condition because it eventually leads to the destruction of the joint involved but the good fact about it is that it has a very slow progression and usually its progression fasten after the age of 65 years. It has been divided based on clinical classification into 4 stages in the order of which symptoms begin to appear. Initially, in stages 1 and 2, it starts with slight pain in the affected joint which subsides upon movement and occurs only for a limited period. There is limited evidence of damage in the affected joint upon a radiological investigation but it could be more easily demarcated in advanced investigations like magnetic resonance imaging, computed tomography, etc.
As the osteoarthritis progression increases and the disease reaches stage 3, there is increased involvement of joint cartilage and the damage also increases resulting in difficulty in joint movement as well as the development of bony spurs at the ends of bones which can be well appreciated even in X rays. As the disease progresses further until stage 4, there is an occurrence of joint fusion leading to a very limited range of movement or even no movement.
The Number Of Swollen Painful Joints You Have Is An Indicator Of Disease Severity
The more joints that are painful and swollen, the more severe the disease may be, says Dr. Cush. Joint pain and swelling are characteristic signs and symptoms of rheumatoid arthritis. Rheumatologists consider this a very important way to measure disease severity.
Your doctor should examine joints in your hands, feet, shoulders, hips, elbows, and other spots to see how many are causing problems. Symmetrical symptoms, such as having the same swollen joints on both sides of the body, are also hallmark symptoms of rheumatoid arthritis, Cush says.
Dr. Domingues adds that the traditional morning stiffness and joint swelling that are characteristic symptoms of RA should be discussed with a rheumatologist as soon as possible. Those are signs of active rheumatoid arthritis, and when it presents like that, it gives doctors an opportunity to be aggressive in early treatment or to switch to another class of drugs if symptoms are worsening.
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Dont Say: Are You Sure You Arent Depressed You Sleep A Lot
Lea Dooleys husband Ted has always been supportive, but as a clinical psychologist, he worried about the number of naps she was taking, and it caused some issues between them. Chronic fatigue is a real issue for patients with rheumatoid arthritis, but research also backs up Teds concerns. One 2014 study found that nearly three-quarters of RA patients had some degree of depression their symptoms correlated with the severity of their RA disease.
But mental health is a sensitive subject. Its important to express concern about how a loved one is doing emotionally, but make sure you choose your words and tone carefully. You want to sound like youre coming from a place of love and concern, not judgment.
How Does Osteoarthritis Evolve
It is likely that in the early stages, damage to the cartilage might be completely reversible, thanks to the healing capacities of the lesions, especially in the very young.
Once these lesions become significantly established and especially after a certain age, it will be difficult for the body to repair these lesions, osteoarthritis will then evolve to a worsening stage which means that there will be an increasingly greater loss of cartilage.
This loss of cartilage evolves in 3 clinical forms:
- a slow and progressive deterioration over several decades
- or, conversely, a very rapid deterioration leading to loss of cartilage in 12 to 24 months (this is known as rapidly destructive osteoarthritis
- or an intermediate form in which the evolution is punctuated by periods in which the osteoarthritis evolves very quickly and other periods, on the contrary, when the osteoarthritis does not evolve or evolves very little.
Osteoarthritis does not evolve uniformly, it is unpredictable. It can remain silent for a long time and not manifest itself even though the joint looks very damaged on the X-ray. But it can also worsen rapidly over several weeks or months at a stage when the X-rays are almost normal. It is this imbalance between pain and radiographic osteoarthritis which makes it difficult to understand and evaluate.
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Dont Say: Tough It Out
Kops has heard push through it more times than wants to, and its not just because hes a guy. Redulla has also been lectured with mind over matter by well-meaning but ill-informed people. The power of positive thinking is lovely but lets not overstate its ability to help people with RA feel less pain. Rheumatoid arthritis is a lifelong disease that is currently incurable. Friends and family, the best way to be an ally to someone with rheumatoid arthritis is to practice kindness, understanding, and patience. And, please, take a moment to think before you speak!
What Exactly Is Rheumatoid Arthritis
Rheumatoid arthritis is an autoimmune disease. In a healthy person, an immune system is designed to help protect the person from getting sick. However, those with an autoimmune disease have a faulty immune system.
Instead of protecting their bodies, their immune systems attack the healthy cells in their bodies by mistake. This attack causes swelling and pain, also called inflammation.
Rheumatoid arthritis mainly attacks the joints of the body such as the hands, wrists, knees, and feet. In more severe cases, it can also affect other parts of the body such as the heart, lungs, and kidneys.
Rheumatoid arthritis is considered a progressive disease, meaning that for most people it tends to get worse over time. This means that some people may not initially qualify for SSDI benefits, but they may be able to qualify once the disease progresses.
While there is no known cure for RA, there are many possible treatments to help slow the progression and severity. These treatments could include diet modifications, medications, and physical therapy.
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What Can People With Ra Do To Make It Easier To Do Their Job
The Arthritis Foundation offers the following suggestions for making it easier to stay in the workplace:
- Maintain a positive attitude.
- Create an efficient work environment so you limit the amount of lifting, reaching, carrying, and walking you do.
- Try not to sit in one position or do repetitive activity for long periods of time.
- Set priorities and pace yourself. Do the most important tasks while you feel strongest and most energetic.
- Maintain a schedule. Go to bed at a regular time and get enough rest to carry you through the next day.
Tom Juneman of Houston has another important suggestion: Let your employer know what your limitations are, and ask if you can take breaks throughout the day.
Juneman was diagnosed with RA as a college student 35 years ago and now takes the biologic drug Remicade. “I still have fatigue,” he says. “I tend to stay close to my coffee and sodas, but I try not to overdo it. I really have to learn to get proper sleep and rest, which I didn’t do in my earlier life.”
Taking Control Of Osteoarthritis
It is important to understand that two joints that show the same cartilage loss on x-ray may behave very differently in terms of discomfort and limited function. The weak, stiff joint will be more painful and disabling than a joint with preserved strength and motion. And of course, additional factors such as body weight, other joint involvement and general health are also very important in determining the level of disability and quality of life. Patients who embark on a conservative course of treatment for arthritis are taking control of their condition and seeking the best possible outcome.
Certainly the place to begin is cultivating good general health, including cardiovascular conditioning. Dr. Jones also places a strong emphasis on maintaining a healthy body weight. “This is particularly important in individuals with arthritis of the hip, knee and low back, in whom excess pounds place a tremendous strain on the joint.”
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Make Time For Deep Relaxation
This is similar to self-care, but the goal was to really focus on getting the mind relaxed so that the nervous system could be in the rest-and-digest mode rather than the fight-or-flight mode.
I used deep breathing or meditation to get into a relaxed state. When in this state, I would feel no pain so I tried to do this many times during the day, increasing the length of time where I experienced no pain. I especially liked to listen to guided healing meditations and imagining the healing that was happening in my body.
Dont Say: Go Gluten Free Or Stop Eating Sugar
This May, at the age of 15, Charlie Kaufmann was diagnosed with polyarticular juvenile idiopathic arthritis and hospitalized for six weeks. The unsolicited advice he received was immediate, in particular, about what not to eat. Im a teenager, Charlie says. So when people tell me to cut out gluten or red meat, I think, I just want to eat pizza and burgers with my friends!
Many people in the arthritis community cut out gluten because they think it can help relieve their symptoms, but the relationship between RA and gluten is controversial. There seems to be a connection between people who have celiac disease an autoimmune disorder in which your body cannot digest gluten and other autoimmune diseases, but there isnt good scientific proof that people with RA or other kinds of arthritis who dont have celiac will necessarily benefit from avoiding gluten.
There is some evidence that too much sugar is bad for RA. For example, a 2014 study published in the American Journal of Clinical Nutrition found that women who drank one or more sugar-sweetened beverage a day had a 63 percent greater risk of developing RA than women who never or rarely consumed the stuff. A diet filled with excess sugar is also bad for weight management and is linked to an increased risk of heart disease and diabetes, which RA patients are more vulnerable to.
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Spend Time With People Who Support You
I felt best when I was with people who cared about me, so I did more of that. I also tried to connect with other people who had rheumatoid arthritis.
When I couldnt find a local rheumatoid arthritis support group, I started one. Being connected to a community of people who understood what I was going through really helped. It removed those feelings of isolation and self-pity that can sabotage healing.
Does A Diagnosis Of Rheumatoid Arthritis Mean I Am Going To Eventually Be Crippled Or Disabled
Not anymore.
RA is considered a chronic disease. Decades ago, many patients with poorly controlled or untreated RA developed bony joint deformities and progressive and irreversible damage in multiple joints, such as the hands, wrists, feet, spine, shoulder, hips, and knees.1 These sorts of changes often contributed to reduced functional status and the ability to physically perform activities of daily living without limitations. By the end of their lives, some patients with RA were confined to a wheelchair and had significantly deformed hands and wrists.2
Fortunately, over the last several decades, significantly more effective medications and treatment strategies have become available, and outcomes for patients with RA have substantially improved.3
Given the impact of RA on functional, radiologic, and structural outcomes, early and intensive treatment with disease modifying anti-rheumatic drugs is now considered best practice.4 RA treatment guidelines recommend using a treat-to-target strategy, in which patient response to DMARD therapy is closely monitored every 1-3 months and therapies are adjusted in response to disease activity. The goal of this approach is to rapidly reach a state of sustained remission or low disease activity.5,6
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Do I Qualify For Social Security Benefits
To be eligible for Social Security benefits, your medical records will need to show that your symptoms are severe enough to prevent you from working at a level which would support you. Additionally, your illness needs to be disabling for at least 12 months.
As previously mentioned, RA is a progressive illness that is unlikely to get better over time. Unfortunately, that means that your mobility may continue to decline.
What Symptoms Do I Need To Qualify
There are a range of symptoms that can be expected when you have rheumatoid arthritis, and they all might affect your ability to work. Here are some signs that your RA might help you qualify for disability benefits:
- Persistent swelling or pain might make it difficult to perform many tasks with your arms and hands. For example, typing or carrying an object may become painful and challenging.
- Pain, stiffness, or difficulty moving could affect the joints of your lower body, making it difficult to walk. You may need to use a cane, walker, or wheelchair to get around. If your job requires any time on your feet, you may experience difficulty moving.
- Rheumatoid nodules, or small lumps, may form under your skin over bony areas. These nodules may not be painful, but they can make it harder to move. If you cannot perform fine and dexterous movements, such as typing on a computer, you may qualify for SSDI benefits.
- If your organs become affected by RA, you could begin to experience fever, weight loss, fatigue, and a general feeling of illness, making it difficult to function as you normally have. This is especially true if you have a labor-intensive job.
If your doctor puts you on medications for RA, you may experience some side effects that may affect your quality of life.
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Symptoms Of Ra Progression
The attack from your immune system can affect more than your synovial tissue. RA can also damage the ligaments and tendons that hold your joints together. You may also experience inflammation in your lungs.
Some people develop firm lumps under the skin of their:
- fingers
- heels
- elbows
These lumps are called rheumatoid nodules. Theyre usually found on pressure points throughout the body.
Many people with RA experience flare-ups, or episodes when symptoms worsen. Lifestyle modification and medication can sometimes help reduce these flare-ups.
Some people who have RA also develop depression. You should talk to your doctor if you think youve developed depression. Antidepressant medications, exercise, and support groups may help you manage the symptoms.
Dont Say: You Cant Do That Youll Hurt Yourself
After Charlies hospital stay, his parents didnt allow him to help out around the house anymore, doing chores like mowing the lawn his coaches didnt want him to play hockey. That upset him. I dont like when people say I cant do the things I used to be able to do or put limits on me, says Charlie. They think everything hurts. Like many people with RA, he has good days and bad days, where something new hurts and he cant walk well or open doors. Nevertheless, he persists. Im playing hockey. I fix things around the house. I still want to help and I can depending on the day.
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Rheumatoid Arthritis And Pregnancy
Heres what you should know if you are pregnant, planning to become pregnant and breastfeed.
Planning to have a baby is a major milestone in a womans life. Some questions are universal will I have severe morning sickness? Should I have natural childbirth or get an epidural? Will I use cloth diapers or disposables? But if you have rheumatoid arthritis you probably have some unique ones will my disease or medication affect my babys development? Will my symptoms worsen during pregnancy? Will arthritis affect my delivery? Will I be physically able to care for my new baby?
In most cases, the answer to these questions can be quite reassuring, says Mehret Birru Talabi, MD, PhD, assistant professor of medicine in the University of Pittsburghs Division of Rheumatology and Clinical Immunology.
Heres what you should know about common concerns when youre thinking about having a baby, during pregnancy and after the delivery.
Rheumatoid Arthritis and Pregnancy
Planning for Pregnancy
Pregnancy: The Whole Nine Months
After Delivery
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