?Rheumatoid arthritis Essay
Rheumatoid arthritis ,(RA), is a type of arthritis with no known cause or cure. It is the inflammation of the membrane lining the joints and tendons. The definition of Rheumatoid arthritis, as given by the Yahoo Health Centre, a chronic inflammatory disease that primarily affects the joints and surrounding tissues, but can also affect other organ systems. Arthritis is so common that most older adults consider it inevitable. The results of rheumatoid arthritis are pain, swelling, stiffness and bone dislocation.
It is also been called the “great Crippler”, (Hollander, pg. 409). There is no ure for arthritis and most people that suffer from it will have their good days and their bad days. Rheumatoid arthritis is not linked with age, but most elderly people do eventually get affected by this disease. There are many risk factors for arthritis, such as: obesity, gender, smoking and stress on joints. Women are two times more likely to receive arthritis as men. There is no cure for arthritis, but there are many treatments available.
First, to relieve the suffering of rheumatoid arthritis patients, there are many options. There are drug- free methods, such as heat or cold packs, proper ositioning and the use of splints. ( Hollander, pg. 410). There are also treatments in the therapeutic field, including, acupuncture or transcutaneous electrical nerve stimulation (TENS). (Hollander, pg. 410). Also, patients can receive narcotics and relaxants, if their case is severe enough. The most common drug to treat joint inflammation is the trusted, easily accessible, aspirin.
Rest is necessary, but too much of it can lead to weakness, muscle atrophy and restricted motion of joints. Patients are encouraged to change their body position frequently, preferably every two hours. Also, initiating aggressive therapy with disease- modifying anti- rheumatic drugs (DMARDs), when the diagnosis is actually confirmed. (Hollander, pg. 410). Deformities can be prevented by physical therapy and exercises and aided by steroids if necessary. (Hollander, pg. 417). There is criteria that have to be met in order to be diagnosed as having Rheumatoid arthritis.
Some of the factors, listed by Paul Bilka 1968, are: morning stiffness (for more than 1 hour), loss of appetite, fatigue, weakness, skin redness or inflammation, paleness, swollen glands, pain on motion or tenderness in at least one oint, swelling (soft tissue or fluid) of at least one joint and swelling of at least one other joint. The main areas of the body affected by Rheumatoid arthritis are the hands, feet, wrists, fingers and ankles. RA affects both sides of the body, it is considered to be symmetrical.
Also, there are little nodules, hard, painless, round or oval bumps that appear under the skin. They are normally only present in the most severe cases but they can happen to anyone that has been inflicted with the disease. RA varies from person to person. In some people, the disease will be mild, with periods of activity, called flares. In other people the disease will be active the whole time and seem to get worse over time. (Rheumatoid Arthritis, April 2, 2003). Many scientists believe that RA is triggered by an infection, i. e, that it is contagious. There is no proof to support these claims.
Another cause of Rheumatoid arthritis is that the white blood cells of the immune system move from the bloodstream into the joint tissues, hence the production of antibodies and other molecules that create the sick feeling in most RA patients. (Rheumatoid Arthritis, April 2, 2003). Some RA patients find that certain foods will either aggravate or help their rthritis, but doctors have done numerous studies and they have not found any evidence to support this case. It is healthy to maintain a well balanced diet, and to ensure that Rheumatoid Arthritis patients are receiving enough protein and calcium. Gardner & Matsen, pg. 6).
Many people who suffer from RA will also suffer from depression or emotional stress. They are arthritis support groups available to help patients cope with their disease. The most important thing that arthritis patients can do is to be very knowledgeable about their disease and to have friends and family they can talk to about their problems. Some patients of Rheumatoid arthritis may suffer from certain types of lung disease or they may develop Pericarditis ( inflammation of the pericardium).
Also there is a Felty’s Syndrome which includes, weight loss, anorexia, fatigue and fever in association with the pathological aspects of RA. (Morgan, April 2, 2003). Many of the risk factors involved in arthritis are preventable. Some of the factors are: obesity, smoking, too much stress on the joints (such as strenuous activities), occupational stress, heredity and gender. Although people cannot change their gender, they can control most of the other factors. Although there is no cure for Rheumatoid arthritis, there are many treatments available.
According to Don Morgan, 1995, there are seven areas in which the patient and the doctor should practice in order to achieve a healthy and “normal” lifestyle. The seven areas are: Patient and Family Education, Prevention of disability and preservation of function, Surgical intervention, Pharmacological therapy, Maintenance of lifestyle, Symptomatic treatment, Social and emotional support. The first area of patient and family education consists of educating the family and the patient of the full extent of the disease.
They should expect to have “good” days and “bad” days and to remember that there is no cure for the disease, but that by following the treatment plan, RA is easy to control. (Morgan, April 2, 2003). The second area of treatment is that of prevention and preservation. This area consists of an exercise routine that strengthens the joints. The family and patient should be taught how to carry out the exercises. The exercise routine should be done twice daily and there may be slight discomfort. Patients are also encouraged to switch body positions often. (Morgan, April 2, 2003).
Thirdly, there is the area of surgery. There are some types of surgery that can be done to destructed joints. Of course, there are also risks involved with surgery, such as, Deep Vein Thrombosis (DVT). Some of the surgeries include: Tenosynovectomy and Synovectomy as well as joint arthroplasty. (Morgan, April 2, 2003). The fourth area of treatment is that of medication and drugs. The physician will prescribe a drug to “optimize the therapeutic benefit to the patient”, (Morgan, April 2, 2003). There are many different types of medications which each have their own purpose.
These medications include: analgesics to control the pain, nonsteroidal to ontrol the inflammation and disease modifying antirheumatic drugs. The doctor will weigh out the risks and the benefits to properly choose a drug for the patient. (Morgan, April 2, 2003). The fifth area of treatment falls under the category of maintaining a healthy lifestyle. This area deals with the Rheumatoid arthritis affecting the patients activities of daily living (ADL’s) and the instrumental activities of daily living (IADL”S). The doctor will evaluate every aspect of the patients life to teach the patient new skills to cope with their disease.
Also the patient must take into consideration the financial spect of having RA, since the cost of managing a chronic illness can create both emotional and physical stress on the person suffering. (Morgan, April 2, 2003). The sixth area of treatment is that of symptomatic treatment. This area concentrates on other types of treatment such as therapy. These therapeutic techniques consist of hot/cold packs, whirlpool baths, paraffin wax and swimming pool therapy. The practitioner must discuss the options with the patient and they will come to a decision together. (Morgan, April 2,2003).
The last area of treatment falls under the category of emotional and social support. Most patients will suffer from mild depression due to the fact that RA is a chronic disease and the chance for total remission is not possible. This area mainly consists of the support the patient will receive from family, friends and significant others. (Morgan, April 2,2003). I myself have been personally affected by Rheumatoid arthritis. My grand- mother was diagnosed with RA in 2001. She is a young lady, only a mere 52 years old when she got diagnosed. She has such a severe case that all of her joints are swollen.
She is deteriorating right before our eyes, and her doctor said that she will be crippled within the next 3 years. She can no longer wear sneakers because her feet are too swelled. Also she has to rest a lot more often then she used to. My grand- mother is a very hard working woman and because of this disease she had to quit her job. I”m sure that she would have received arthritis eventually, but my grand- mother did have a lot of the risk factors; she was overweight, smoked very frequently, did very heavy house work and she did not maintain a well balanced diet.
All of these factors contributed to her getting Rheumatoid arthritis. She is currently on medication, Vioxx and an anti-inflammatory. She also has pool therapy two times a eek at the hospital. My grand-mother was very upset when she found out she had arthritis because she is independent and she does not want to put her family threw her pain and suffering. My grand-mother knows that we are always here for her and my mother decided to take my nanny in to live with us when she does have to be in a wheelchair for the rest of her life.
To me that is a very scary thought, a 57 year old woman being confined to a wheelchair. There are many people who suffer from arthritis and hopefully medical teams and scientists will eventually find a cure. In conclusion, arthritis comes in many different forms and sizes. Some people may get it bad and others maybe not so bad. Although there is no exact cure for this disease, there are many things that sufferers can do to diminish the toll that arthritis is taking on their body and their life.
There are numerous steps and areas available for treatment. These areas include; family and patient education, prevention of disability and preservation of function, surgical intervention, pharmacological therapy, maintenance of lifestyle, symptomatic treatment, social and emotional support. Also the patient needs a lot of rest and an exercise routine suitable to their lifestyle. Too uch rest is a bad thing because Dr. Frank Krusen said, ” The day the arthritic goes to bed is the day he becomes a cripple. ” (Hollander, pg. 410).
The counter argument to that statement is this one, “Clearly the answer rests with appropriate therapy with an anti-inflammatory drug both tolerable and helpful for each patient and adequate rest balanced with exercise as tolerated to prevent muscle atrophy and restricted joint function. ” (Hollander, pg. 410). The best method to cope with Rheumatoid arthritis is to choose the right one for each individual patient. All in all, arthritis is a chronic disease that not only affects he inflammation of the joints, but can also affect the surrounding organs.
In the worst case scenario, some RA patients even suffer from lung disease. There are drugs that can be taken to lessen the pain of arthritis, but they do have some side affects as well. One of the most common medications is aspirin. Also, there is the option of surgery, but again there is always the possibility of something going wrong or even a post- surgery mix-ups. For my grand-mother’s sake and everyone else who is inflicted by this disease, hopefully there will be a cure found for Rheumatoid and all other types of arthritis.