SCRIPT NUMBER 125 RHEUMATOID ARTHRITIS - 2 (TWO SPEAKERS)

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1 SCRIPT NUMBER 125 RHEUMATOID ARTHRITIS - 2 (TWO SPEAKERS) PROGRAM NAME: HEALTH NUGGETS PROGRAM TITLE: RHEUMATOID ARTHRITIS - 2 PROGRAM NUMBER: 125 SUBJECT: SYMPTOMS, CAUSES, TREATMENT, SELF-CARE OF RHEUMATOID ARTHRITIS KEY WORDS: IMMUNE SYSTEM, STEROIDS, ANTI-INFLAMMATORY, TOTAL JOINT REPLACEMENT DATE OF SCRIPT: AUGUST 16, 2013 AUTHOR: RICHARD YUKL, MD, FACS Raja is a 12-year-old girl who developed swelling in her right knee and her right ankle. She did not remember injuring her leg, and the swollen joints were only mildly tender. Eventually, her mother noticed that she had begun walking with a limp, and students at school began making fun of the way she walked. The swelling had lasted for nearly a year when Raja s mother measured her legs and found one leg to be longer than the other. Alarmed, she took her to a doctor, who diagnosed Raja with rheumatoid arthritis. In our last visit, we spoke about osteoarthritis, or degenerative joint disease, the most common form of arthritis. It is a condition in

2 which the slippery lining tissues of a joint have become worn, causing pain. Today, we want to talk about another important form of arthritis, rheumatoid arthritis. What is the difference between osteoarthritis and rheumatoid arthritis? Whereas osteoarthritis tends to involve the joints that are under the greatest physical stress, joints such as the knees and hips, rheumatoid arthritis most often involves small joints, such as those in your hands and feet. Rheumatoid arthritis involves ongoing inflammation. We were created with a defense system called our immune system. It was designed to attack and destroy foreign proteins that enter our bodies, proteins such as those found in invading viruses and bacteria. In rheumatoid arthritis, the immune system mistakes its own joint surfaces and the capsules that hold the joint s lubricating fluid as an invading protein. It attacks those tissues, damaging them and replacing them with scar. The person actually becomes allergic their own joints. The resulting inflammation eventually destroys the joints. Rheumatoid arthritis is 2-3 times more common in women than in men. And, unlike osteoarthritis, rheumatoid arthritis can be found in very young children. If I develop rheumatoid arthritis, what are its symptoms? Symptoms vary depending on how active the disease is at

3 any particular time. There may be times when your joints are red, swollen, and tender to the touch, and then periods of relative calm when the swelling and pain fades or even disappears. The joints become red, swollen and tender when the disease is in an active phase. At those times, inflammation of the lining tissues of the joint causes pain, and the joint will produce excess fluid. When the disease is active, there may also be joint stiffness on awakening that lasts for hours. Pain in the hands may cause difficulty doing even simple tasks such as turning doorknobs and opening jars. Inflammation in the small joints of the feet can lead to awkward walking, as it did with Raja. Other symptoms that can occur when the inflammation is active include a low-grade fever and a loss of energy and appetite. What causes rheumatoid arthritis? No one knows exactly, but invasion of the body by certain viruses and bacteria may sometimes trigger the disease. Other risk factors include a family history of the disease and smoking. Smoking tobacco increases your risk of developing the disease, while quitting reduces your risk. How is rheumatoid arthritis treated? Initial treatment usually involves your taking medicines to reduce inflammation, helping to relieve the pain and to prevent or slow destruction of the joint. Medicines that reduce mild inflammation can be bought

4 without a prescription. Such anti-inflammatory medicines have now kept Raja s symptoms under control for more than two years. If the disease is in an active phase, strong medicines called steroids can reduce the inflammation and pain. Steroids can cause serious side effects, so a doctor must either prescribe them for you or inject them directly into your joints. Your doctor or a physical therapist will teach you how to protect your joints, and how to lower stress on painful joints by using assisting devices such as a cane, or gripping and grabbing tools. And, if medicines and therapy fail to control my symptoms? Your doctor may recommend surgery to replace the damaged joints. A total joint replacement will remove the destroyed joint and replace it with a metal and plastic device that can be expected to relieve pain for up to 20 years. The joint can also be surgically joined together. The stabilized joint will no longer have movement, but it will function without pain. What things can I do for myself if I develop symptoms in my joints that are suspicious for rheumatoid arthritis? Gentle exercise will help strengthen the muscles that surround the joints. Try walking, swimming or gentle water aerobics, but avoid exercising at times when your joints are severely tender and inflamed, and if your joint pain becomes worse when you exercise, stop. Applying heat can relax tense, painful muscles and help ease your pain. Effective ways to apply heat

5 include taking a hot shower or bath lasting at least 15 minutes, applying a hot pack, or applying an electric heating pad set at a low setting. Finally, resting when you are tired, and reducing your stress is helpful. Keep your family aware of how you are feeling. They may not feel comfortable asking you about your pain, but they may be able to help you when you need it. Make peace with your enemies, and renew your relationship with God. Recent medical literature suggests that religious intervention such as intercessory prayer improves the outcomes of several diseases including rheumatoid arthritis. In summary, do whatever it takes to live a life of peace and harmony. That will reduce your anxiety and allow you to feel more relaxed, thereby removing unnecessary strain from your joints. Health Nuggets is written by Dr. Richard Yukl, a medical doctor working in the United States. The medical views expressed in this program are his and may differ for your particular health needs. If you need medical advice, please consult a medical professional in your area.

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