Arthritis

RHEUMATOID ARTHRITIS: DEALING WITH FRIENDS AND FAMILY

From their perspective, your loved ones are also struggling with this new situation. They may be uncertain about how to approach you. Should they offer their help? Should they allow you to do what you can? Should they pretend that nothing’s changed? They will need your guidance. You must set the tone and direction for your future interactions. Your messages to others should be clear and concise. You must communicate with them and not expect them to understand simply because they love you. Mixed messages result in misunderstandings and hurt feelings.

Asking for Help
It’s difficult to ask for help with tasks that you once were able to do on your own, but you’ll need to do this from time to time. If you learn to ask for help in a way that lets you keep your sense of independence and confidence, you’re much more likely to ask for the help you need, and then your feelings of frustration or anger can be avoided. Learn to ask clearly, and without ambiguity, so that the person you’re asking knows exactly how you’d like to be helped. Consider the following unproductive approaches:
“I’ll just do it myself.” (Martyrdom is overvalued.)
“Can’t you see I’m in pain and can’t do this?” (It does no good to try to induce guilt in someone else.) “Wash the dishes or else.” (People who feel as if they are being punished for your arthritis will sooner or later come to resent your requests for assistance.) “I can do it, but I think it’s about time for you to do something around here.” (Denial has the potential to develop into antagonism.)
Now consider the following requests, messages that preserve self-esteem while constructively conveying the need for assistance:
“Here’s what I need help with. I know I can count on you.” (Describe the task and show appreciation; the response will almost certainly be positive.)
“I’m certain I can do this part alone, but I could really use your help with the rest of it.” (Be specific about your needs, including what you don’t need help with.)
“I’ll clean up the living room if you’ll vacuum the rug.” (Negotiation allows equal input from everyone.)
Remember, your attitude has a far greater effect on your personal interactions than your disabilities do.
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RELIEVING TENSION DURING RHEUMATOID ARTHRITIS: DEALING WITH ANXIETY, FEAR, AND STRESS

There are numerous techniques you can use to minimize anxiety, fear, and stress, ranging from the simple to the exotic. It’s worth mentioning here that it is often difficult to separate emotional tension from muscle or physical tension. We know that decreasing tension in one area often relieves tension in the other area, so, as you’ll see, many of these tactics for relieving emotional tension involve physical activities.
Simple tactics include taking short breaks during your workday to relax, away from the noise and bustle of the workplace. While you relax, collect yourself and redirect your energies that are being drained by stress. At home, a long bath combined with relaxing music can ease your mind and body of tension. Making a detour to the whirlpool or sauna on your way home from work is a good way to wind down from an exhausting day. Gentle muscle massage administered by a friend, spouse, or professional masseuse can relax tired, tense muscles and decrease your level of stress.
Often, just relaxing your mind by engaging in an enjoyable task or talking with a friend can reduce emotional and physical tension. Taking slow, deep, and regular breaths (preferably from the diaphragm rather than the chest) is another simple but effective way to decrease muscle tension and stress.
One of the more exotic techniques is a deep muscle relaxation technique called progressive relaxation. Many people incorporate this technique into their daily and nighttime routines. Begin by finding a quiet place and getting into a comfortable position. Close your eyes. Strongly tense up (clench) your toe muscles for about five seconds. Then relax them, feeling the difference between tension and relaxation. Proceed by alternately tensing and relaxing all of the major muscle groups in your body, from toes to head. When done correctly (doing so takes practice) this technique will leave your body loose and relaxed. Dr. Edmund Jacob-son, who first described this technique in 1929, has discovered that it is physically impossible to feel nervous or anxious in any part of our body if our muscles are completely relaxed. This suggests that if we are able to relax the muscles successfully other features of anxiety will be eliminated.
Some individuals incorporate imagery into their relaxation techniques. Closing your eyes and imagining yourself in a pleasant, restful place may help you achieve a peaceful state.
Some people have found biofeedback to be helpful in controlling chronic tension and pain. This technique involves measuring involuntary body functions such as heart rate, blood pressure, skin temperature, and muscle tension with monitoring equipment that is painlessly attached to the skin. Information about the physical (biological) changes taking place in the body is directly fed back to the subject from the equipment. The person being monitored can use this feedback to identify behaviors that bring about pain or tension and can then modify thoughts that induce these changes. The ultimate goal of biofeedback is to achieve mental mastery of the body’s responses.
Eastern concepts of the mind-body connection through meditation, including yoga, are very helpful to some people with RA. The three basic elements of yoga are physical posture, breathing control, and meditation. Yoga exercises include range of motion, stretching, and flexibility routines. When yoga is practiced successfully it can result in the development of intense powers of concentration which can be used to master tension and pain.
Acupressure is an alternative therapy some people use to relieve muscle tension. The technique involves applying gentle but firm finger pressure to points on the body where muscle tension and pain accumulate. Acupressure, like acupuncture, is based on the principle that energy flows through pathways called meridians.
People who are feeling anxious or afraid or whose lives are being adversely affected by stress can use any of these techniques to obtain relief. There are many other effective relaxation programs described in books, on tapes, and on videos. It is important to keep in mind, though, that these techniques are only one component of a comprehensive treatment plan. They should not be used as a replacement for the medical treatment of RA.
Your loved ones need to progress through these emotional changes with you. You will want their help and empathy, for example (but not their pity). You will probably want them to acknowledge your limitations without viewing them as weaknesses. You will need the support of your loved ones, but you won’t want them to hover or be over-solicitous.
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RHEUMATOID ARTHRITIS: COPING WITH STRESS

Stress is a universal aspect of life – a predictable reaction to life’s surprises. Our world is constantly changing and presenting us with new situations and environments, and we draw on our resources to make adjustments to these changes. If the magnitude of the changes overwhelms our ability to adjust, we experience stress.
In our daily routines, we are aware of potential demands and know how to approach them, but when that routine is altered – when change occurs – we may stumble. Stress associated with change is generally a result of our anxiety and fear of the unknown: we don’t know what the future holds, and we may be afraid that we don’t have what it takes to meet this unexpected challenge.
Since RA is a life change that has a great deal of unpredictability associated with it, stress is a normal response to it. In fact, the most stressful part of RA is its unpredictability. People with RA do not know what they need to prepare for. The course of the condition varies among different people and varies over time in the same person. This results in people having to make frequent adjustments, which in itself can be stressful. People often say that if they only knew what to expect they might not feel so anxious, they might adjust easier. If they dwell on potential or unexpected future consequences, such as medication toxicity, medical bills, or pain, people will almost always begin to feel afraid. And, as we have seen, anxiety and fear lead to stress.
Stress changes the pain threshold by opening the pain gate. Stress also causes physical and mental fatigue, which interferes with restful sleep, further increasing pain. And stress affects the body in other ways; it can result in increased heart rate and perspiration and in elevated blood pressure.
But stress is not always harmful. Stress occurs with positive changes as well as negative ones. Consider how you felt when you graduated, bought a house, got married, or went on a long-anticipated vacation. We all know, too, that feeling a little stress can motivate us to get tasks accomplished. Everyone has experienced short-lived deadline pressure and responded to it with increased adrenaline and increased activity. When stress becomes a permanent part of your life, however, it can take its toll on you and your RA.
You can use coping skills to approach negative stress. First, you must identify the source of stress (define the problem). This includes identifying situations that cause you stress at work and at home. Determine which of these can be modified and which cannot. Avoid the frustration of trying to change the unchangeable, and start with a set of goals that can be accomplished.
To solve a stress-related dilemma (problem solving), begin by appraising the situation. What are its demands? Are they reasonable at this particular time? If necessary, modify as many of the demands as possible so that they are reasonable for you at this time. Then call on the following problem-solving tactics:
•    Propose a reasonable long-term goal (reasonable expectations).
•    Plan ahead (include short-term, attainable goals).
•       Provide a supportive environment (communication).
•       Promote your identified strengths (use all resources).
•      Put priorities into perspective (does it need to be done now?).
•      Prepare (get organized).
•      Place time slots in your schedule to allow for inevitable interruptions and rest breaks (expect the unexpected).
•      Pace yourself (one step at a time).
•      Positively reappraise the situation and your abilities (modify negative thoughts and behaviors).
•      Prove to yourself that you can do it.
•       Praise yourself for a job well done.
You can see almost any situation through by calling upon your imagination, and each time you overcome a stressful situation successfully you increase your ability to cope with stress. Each such experience will empower you! Remember, “A great part of courage is having done the thing before”.
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WHAT IS MIXED ARTHRITIS?

There are numerous other types of arthritis which could be classified under the common heading mixed arthritis. Arthritis deformans is a term often used to describe a certain type of arthritis. Actually, though, arthritis deformans is more a description of a condition of severe deformation from osteoarthritis, rheumatoid arthritis, and many other causes than a specific type of disease.

Ankylosing spondylitis is a vicious form of arthritis which mainly strikes down young males under the age of 20. It seldom occurs after age 30. Sacroiliac joints are the most frequent locations of spondylitis.

There are also infectious types of arthritis due to joint infection resulting from tuberculosis, gonorrhea, syphilis, etc.

The types of arthritis which are most topical for the purpose of this book, however, are rheumatoid arthritis and osteoarthritis. Together they are responsible for over 90 per cent of all the cases of arthritis in this country. Rheumatoid arthritis is the most painful and crippling type of them all, and it affects people of all ages, particularly those who are in their most active and productive period of fife.

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MILD TO MODERATELY SEVERE RHEUMATOID ARTHRITIS

In Group #3, fourteen subjects presenting with mild to moderately severe rheumatoid arthritis were supplied with 24 capsules, two capsules to be taken each morning and evening for six days. After three days of treatment eleven reported about 20% to 30% improvement in articulation and inflammation, and about 40% to 50% relief of arthritic pain. In these eleven subjects improvement continued rapidly over the next four days, approaching the 80% to 100% level. The remaining three subjects reported similar improvements by the end of the fourth day, with an overall improvement of 70% to 80% after seven days.

Most of the subjects continued to report minor additional improvement for one week or more even though they were no longer under treatment. However, six in this group began to experience the return of some mild arthritic symptoms after about three to four weeks. (Although not included as part of this study, all of the subjects in this group were treated again and their level of improvement has subsequently stabilized.

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