Rheumatoid
Arthritis Managed With Creative Changes
Experts
say there are dozens of quick, simple ways to help the 2.1 million US
adults with rheumatoid arthritis (RA) rise above daily pain.
A morning T'ai Chi
session, a quick afternoon nap to restore energy, and an oversized
"easy-grip" pen are three ideas of many suggested by the Arthritis
Foundation.
"A lot of times,
the mental stress associated with rheumatoid arthritis is equal to the
joint pain people feel," explains Dr. Shannon Whetstone Mescher, a physiologist
and spokeswoman with the Arthritis Foundation.
"The emotional,
mental part has to do with the fatigue, the lack of energy, the inability
to do things that they want to do," she says. "There's the feeling that
they're slowly losing their lifestyle."
Seeking
Lifestyle Enhancements
One of the biggest
frustrations for arthritis sufferers stems from difficulties in completing
simple tasks - actions such as opening jars, grabbing items off a high
shelf, or even working a computer mouse.
Experts note
that RA is a disease that affects the entire body, and is one of the
most common forms of arthritis.
It is characterized
by inflammation of the membrane lining the joint or other internal organs,
causing pain, stiffness, warmth, redness, and swelling.
The disease is usually
chronic, but can also be marked by flare-ups, according to the Arthritis
Foundation.
Luckily, the buying
power of an aging population has led to a revolution in arthritis-friendly
product design.
In fact, the Arthritis
Foundation's "Ease of Use" initiative, in
partnership with private industry, has helped launch dozens of innovative
products. Some of these include Pilot brand Dr. Grip pens and pencils,
the quick-open Folgers AromaSeal coffee container, and the Virtually
Hands Free computer mouse from Designer Appliances.
But, people
with arthritis can do more to ease daily pain.
Because of a phenomenon
known as "gelling" - where synovial fluid gels during sleep, producing
joint stiffness - morning is often the toughest part of the day for
those with rheumatoid arthritis.
Alleviating that
pain "is often as simple as taking a warm bath or shower just after
getting up," says Dr. John Klippel, president of the Arthritis
Foundation.
Exercise programs
that emphasize joint flexibility are another great way of relieving
joint stiffness and pain.
"We talk about 'joint-safe'
forms of exercise," Dr. Klippel says. "Things like T'ai Chi and yoga
not only increase muscle strength and flexibility, but there's not a
lot of stress across joints."
But he emphasizes
that for individuals with arthritis, exercise should be balanced with
rest.
"The typical person
with rheumatoid arthritis has very little energy, so one of the coping
skills that they begin to learn is building rest time into their daily
activities," Dr. Klippel says.
"Energy tends to
ebb in mid-afternoon, so workers with arthritis may want to consider
a short restorative nap at that time, if at all possible," he says.
There are other
ways of dealing with the chronic pain, however. According to Dr. Mescher,
studies have shown that meditation eases arthritic symptoms, as does
guided imagery.
"Guided imagery
is, for example, imagining yourself on a beach," she says. "It's a talk-through
of some sort of relaxing activity that helps you take your mind away
from the pain and stress that come with the disease."
Support
Groups and Supportive Friends Help
"One caveat
I'll add to that, however, is that sometimes we've found there are unhealthy
kinds of support mechanisms out there, such as groups where everyone
simply complains about their disease," Dr. Mescher says.
With those types
of feedback sessions, most participants "just leave feeling worse,"
she says.
Instead, Dr. Mescher
prefers groups where arthritis patients offer each other creative solutions
to the tough challenges they face every day. "That really seems to help,"
she says.
The very best group
activities combine social support with exercise. Joining a local aquatics
club, for example, gives someone with RA "several positive benefits,"
Dr. Mescher says. "It takes a lot of effort sometimes to get up in the
morning and get out, but the class gives it a social component as well."
Above all, people
with rheumatoid arthritis should not isolate themselves. The support
of family and friends can make the difference, Dr. Mescher says, although
there is often a learning curve.
"Be a good listener,"
she says. "Obviously, a loved one with rheumatoid arthritis has a lot
on their mind, a lot they want to share and talk about. Do some research
on your own to understand what they're going through."
In her work with
caregivers interested in learning more about rheumatoid arthritis, Dr.
Mescher often has them spend time with their thumbs taped firmly to
their index fingers.
"Then they try and
pick up different things around the house - obviously, it makes a big
impact on what you're able to do, and gives you a taste of what life
is like for someone with RA," she says.
Of course, medication
therapy remains key in alleviating joint pain.
The pharmaceutical
options now available include NSAIDs (nonsteroidal anti-inflammatory
drugs) that include aspirin and ibuprofen; steroid medications like
prednisone; and a newer category of drugs called disease-modifying antirheumatic
drugs (DMARDs), which include methotrexate.
"Drug therapy is
still the best way we know of to reduce pain and minimize the disability
that comes with this disease," Dr. Klippel says.
Always
consult your physician for more information.
Online
Resources
Arthritis
Foundation
Centers
for Disease Control and Prevention (CDC)
National
Institute of Arthritis and Musculoskeletal and Skin Diseases
National
Institute of Mental Health
National
Institutes of Health (NIH)
National
Library of Medicine
US
Department of Heath and Human Services
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October 2004
Rheumatoid
Arthritis Managed With Creative Changes
Seeking
Lifestyle Enhancements
Support
Groups and Supportive Friends Help
Mood
Disorders a National Focus in October
Online
Resources
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Resources:
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a St. John's Mercy Physician
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John's Mercy Center for New Health Options
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John's Mercy Classes and Programs
Mood
Disorders a National Focus in October
According
to the National Institute of Mental Health (NIMH), in any given
one-year period, 9.5 percent of the population, or about 18.8 million US
adults, suffer from a depressive illness.
For those seeking
help, National Depression Screening Day is Oct. 14,
and many local centers are prepared to meet with visitors wishing to
be screened.
Depressive illnesses
often interfere with normal functioning and cause pain and suffering
not only to those who have a disorder, but also to those who care about
them.
Most people
with a depressive illness do not seek treatment, although the great
majority - even those whose depression is extremely severe - can be
helped.
Thanks to years
of fruitful research, there are now medications and psychosocial therapies
such as cognitive/behavioral, "talk," or interpersonal that ease the
pain of depression, states the NIMH.
A depressive
disorder is an illness that involves the body, mood, and thoughts. It
affects the way a person eats and sleeps, the way one feels about oneself,
and the way one thinks about things.
A depressive
disorder is not the same as a passing blue mood. It is not a sign of
personal weakness or a condition that can be willed or wished away.
People with
a depressive illness cannot merely "pull themselves together" and get
better. Without treatment, symptoms can last for weeks, months, or years.
Types
of Depression
Depressive disorders come in different forms, just as is the case with
other illnesses such as heart disease, the NIMH states.
Major depression
is manifested by a combination of symptoms that interfere with the ability
to work, study, sleep, eat, and enjoy once pleasurable activities. Such
a disabling episode of depression may occur only once but more commonly
occurs several times in a lifetime.
A less severe
type of depression, dysthymia, involves long-term, chronic symptoms
that do not disable, but keep one from functioning well or from feeling
good. Many people with dysthymia also experience major depressive episodes
at some time in their lives.
Another type
of depression is bipolar disorder, also called manic-depressive illness.
Not nearly as prevalent as other forms of depressive disorders, bipolar
disorder is characterized by cycling mood changes: severe highs (mania)
and lows (depression).
Sometimes the
mood switches are dramatic and rapid, but most often they are gradual.
When in the depressed cycle, an individual can have any or all of the
symptoms of a depressive disorder.
Symptoms
of Depression
Not everyone who is depressed or manic experiences every symptom,
according to the NIMH. Some people experience a few
symptoms, some many.
Depression
-
Persistent
sad, anxious, or "empty" mood
-
Feelings
of hopelessness, pessimism
-
Feelings
of guilt, worthlessness, helplessness
-
Loss of
interest or pleasure in hobbies and activities that were once enjoyed,
including sex
-
Decreased
energy, fatigue, being "slowed down"
-
Difficulty
concentrating, remembering, making decisions
-
Insomnia,
early-morning awakening, or oversleeping
-
Appetite
and/or weight loss or overeating and weight gain
-
Thoughts
of death or suicide; suicide attempts
-
Restlessness,
irritability
-
Persistent
physical symptoms that do not respond to treatment, such as headaches,
digestive disorders, and chronic pain
Mania
-
Abnormal
or excessive elation
-
Unusual
irritability
-
Decreased
need for sleep
-
Grandiose
notions
-
Increased
talking
-
Racing
thoughts
-
Increased
sexual desire
-
Markedly
increased energy
-
Poor judgment
-
Inappropriate
social behavior
Always consult
your physician for more information.
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