Arthritis
By: Tammi L. Shlotzhauer, M.D. and James L. McGuire, M.D.
Course Outline
A trusted guide and an invaluable resource, Living with Rheumatoid Arthritis offers practical advice for the millions of people coping with this painful disease. Now thoroughly revised and expanded in a second edition, this book brings readers up to date with the latest methods of diagnosis and treatment.
Providing detailed information on medication, nutrition, and resources (online and off), this volume is a complete and comprehensive guide to the management of a difficult disease.
About the Authors
Tammi L. Shlotzhauer, M.D., is a clinical instructor of medicine at the University of Rochester Medical Center and a practicing rheumatologist at Rheumatology Associates of Rochester.
James L. McGuire, M.D., was a chairman of the department of medicine at Mount Auburn Hospital in Cambridge, Massachusetts.
Course Contents
| 1.1 | The Joints | |
| 1.1.1 | Rigid joints | |
| 1.1.2 | Slightly mobile joints | |
| 1.1.3 | Freely movable joints | |
| 1.1.4 | What are the parts of a synovial joint? | |
| 1.2 | The joints in RA | |
| 1.2.1 | What is inflammation? | |
| 1.2.2 | How is the inflammation of RA different from normal | |
| 1.2.3 | Inflammation? | |
| 1.2.4 | The stages of RA: How does inflammation affect the joints? | |
| 1.3 | Summary | |
| 2.1 | The course of RA | |
| 2.1.1 | How does RA usually start? | |
| 2.1.2 | What course of arthritis can I expect? | |
| 2.1.3 | Can a remission be brought on with medications? | |
| 2.2 | The Prognosis of RA | |
| 2.2.1 | Can arthritis be cured? | |
| 2.2.2 | Will other joints become involved with time? | |
| 2.2.3 | Will I become disabled? | |
| 2.2.4 | Does RA shorten a person’s life? | |
| 1.3 | Summary | |
| 3.1 | Clinical History | |
| 3.2 | Physical Examination | |
| 3.3 | Differential Diagnosis | |
| 3.3.1 | What makes RA so difficult to diagnose? | |
| 3.4 | Diagnostic Tests | |
| 3.4.1 | What tests are used to diagnose or monitor activity of RA? | |
| 3.4.2 | What tests are used to rule out other types of arthritis? | |
| 3.5 | What tests are used to screen for complications of RA or medication side effects? | |
| 3.6 | Summary | |
| 4.1 | Blood and Blood Vessels | |
| 4.1.1 | How does RA affect the blood? | |
| 4.2 | What about blood vessels? | |
| 4.3 | Eyes and Mouth | |
| 4.4 | Skin | |
| 4.5 | Nerves | |
| 4.6 | Chest and Lungs | |
| 4.7 | Vocal Cords | |
| 4.8 | The Heart | |
| 4.9 | The Bones | |
| 4.10 | Summary | |
| 5.1 | Define and Assess the Problem | |
| 5.2 | Set Realistic Goals and Expectations | |
| 5.3 | Develop Methods for Problem Solving and Negotiating | |
| 5.3.1 | Eliminating the problem | |
| 5.3.2 | Circumventing the problem | |
| 5.3.3 | Working with the obstacle | |
| 5.3.4 | Modifying the goal | |
| 5.4 | Utilize All Available Resources | |
| 5.5 | Modify Negative Thoughts and Behaviors | |
| 5.6 | Be Willing to Reassess | |
| 5.7 | For More Information | |
| 6.1 | Pain | |
| 6.1.1 | What is pain? | |
| 6.1.2 | Pain and your emotions | |
| 6.1.3 | What is the pain message in RA? | |
| 6.1.4 | Decreasing pain | |
| 6.2 | Fatigue | |
| 6.2.1 | Why am I so tired? | |
| 6.2.2 | Controlling fatigue | |
| 6.3 | For More Information | |
| 7.1 | Anger | |
| 7.2 | Managing anger | |
| 7.3 | Depression | |
| 7.3.1 | Managing depression | |
| 7.4 | Anxiety, Fear, and Stress | |
| 7.4.1 | Relieving tension: Dealing with anxiety, fear, and stress | |
| 7.5 | Dealing with friends and Family | |
| 7.5.1 | Asking for help | |
| 7.5.2 | The special case of children | |
| 7.5.3 | Love and intimacy | |
| 7.5.4 | Friends and relatives | |
| 7.6 | For More Information | |
| 8.1 | Joint Protection Guidelines | |
| 8.2 | Protecting Specific Joints | |
| 8.2.1 | Hands and wrists | |
| 8.2.2 | Elbows and shoulders | |
| 8.2.3 | Hips and knees | |
| 8.2.4 | Ankles and feet | |
| 8.3 | For More Information | |
| 9.1 | Trends in therapeutic Advice | |
| 9.2 | Types of Exercise | |
| 9.2.1 | Range of motion | |
| 9.2.2 | Strengthening | |
| 9.2.3 | Endurance | |
| 9.3 | Starting and Exercise Program | |
| 9.3.1 | Warm-up | |
| 9.3.2 | Workout | |
| 9.3.3 | Cools-down | |
| 9.4 | Exercises That Are Right for You | |
| 9.4.1 | For people with very inflamed joints | |
| 9.4.2 | For people with moderately inflamed joints | |
| 9.4.3 | For people with controlled joints | |
| 9.5 | For More Information | |
| 10.1 | Range-of-Motion and Strengthening Exercises | |
| 10.1.1 | Neck range-of-motion exercises | |
| 10.1.2 | Neck muscle-strengthening exercises | |
| 10.1.3 | Shoulder range-of-motion exercises | |
| 10.1.4 | Elbow range-of-motion exercises | |
| 10.1.5 | Shoulder and elbow muscle-strengthening exercises | |
| 10.1.6 | Wrist and finger range-of-motion exercises | |
| 10.1.7 | Hip range-of-motion exercises | |
| 10.1.8 | Knee range-of-motion exercises | |
| 10.1.9 | Hip and knee muscle-strengthening exercises | |
| 10.2 | Endurance, or Aerobic, Exercises | |
| 10.2.1 | What is your target heart rate? | |
| 10.2.2 | Taking your pulse | |
| 10.2.3 | Beginning your aerobic exercise program | |
| 10.3 | For More Information | |
| 11.1 | The Past: The Conservative Approach | |
| 11.2 | The Present: More Aggressive Approaches to Therapy | |
| 11.3 | The Future | |
| 11.4 | Current Treatments: NSAIDs, DMARDs, BRMs, and Corticosteroids | |
| 11.5 | For More Information | |
| 12.1 | Aspirin | |
| 12.1.1 | Side effects of aspirin therapy | |
| 12.1.2 | Cautionary notes | |
| 12.2 | Traditional NSAIDs | |
| 12.2.1 | Side effects of traditional NSAIDs | |
| 12.2.2 | Cautionary notes | |
| 12.3 | New NSAIDs: COX-2 Inhibitors | |
| 12.3.1 | Side effects of COX-2 inhibitors | |
| 12.3.2 | Cautionary notes | |
| 12.4 | Stomach Medications Frequently Used with NSAIDs | |
| 13.1 | Nonimmunosuppressant DMARDs | |
| 13.2 | Immunosuppressants | |
| 13.3 | For More Information | |
| 14.1 | Understanding Cytokines and Inflammation | ||
| 14.1.1 | Using the body’s secrets to tame inflammation: Creating the Biologics | ||
| 14.2 | Biologic Response Modifiers against TNF | ||
| 14.3 | Biologic Response Modifiers against IL-1 | ||
| 14.4 | A Biologic Medical Device for Protein A Immunoadsorption | ||
| 14.4.1 | Side effects of prosorba column therapy | ||
| 14.5 | For More Information | ||
| 15.1 | Oral Corticosteroids | ||
| 15.1.1 | Side effects of oral corticosteroids | ||
| 15.1.2 | Cautionary notes | ||
| 15.2 | Corticosteroid Injections | ||
| 15.2.1 | What to do after a joint injection | ||
| 16.1 | Dietary and Life-Style Treatments | |
| 16.2 | Medicinal Treatments | |
| 16.3 | For More Information | |
| 17.1 | Aromatherapy | ||
| 17.2 | Ayurveda | ||
| 17.3 | Bodywork | ||
| 17.4 | Breathing Techniques, Breath Therapy or Breathwork | ||
| 17.5 | Chinese Medicine | ||
| 17.5.1 | Acupuncture | ||
| 17.5.2 | Tai Chi | ||
| 17.5.3 | Qi-gong | ||
| 17.5.4 | Chinese herbs | ||
| 17.6 | Music and Sound Therapy | ||
| 17.7 | Other Mind-Body Therapies | ||
| 17.8 | Naturopathy | ||
| 17.9 | Spa Therapy and Hydrotherapy | ||
| 17.10 | Homeopathy | ||
| 17.11 | Guidelines for Evaluating Unproven Treatments | ||
| 17.12 | For More Information | ||
| 18.1 | Nutrition and RA | ||
| 18.2 | A Well-Balanced, Nutritious Diet | ||
| 18.2.1 | The food guide pyramid | ||
| 18.3 | Dietary Guidelines for Americans | ||
| 18.4 | Special Diets | ||
| 18.4.1 | Elimination Diets | ||
| 18.4.2 | Fasting | ||
| 18.4.3 | Vegetarian diets | ||
| 18.4.4 | Gluten-free diet | ||
| 18.4.5 | Fad diets | ||
| 18.5 | A Word on Food Supplements | ||
| 18.5.1 | Guidelines for evaluating food supplements | ||
| 18.6 | Vitamins and Minerals | ||
| 18.6.1 | Vitamins | ||
| 18.6.2 | Minerals | ||
| 18.7 | Herbs and Plant-Based Medicine | ||
| 18.8 | Other Supplements | ||
| 18.9 | For More Information | ||
| 19.1 | Surgeons Specializing in the Treatment of RA | ||
| 19.2 | Types of Surgery | ||
| 19.2.1 | Arthroscopic surgery | ||
| 19.2.2 | Synovectomy | ||
| 19.2.3 | Tendon reconstruction and transfers | ||
| 19.2.4 | Joint fusion | ||
| 19.2.5 | Osteotomy and bone resection | ||
| 19.2.6 | Joint replacement | ||
| 19.3 | Preparing for and Recovering from Surgery | ||
| 19.3.1 | Before surgery | ||
| 19.3.2 | During your recovery | ||
| 19.4 | For More Information | ||
| 20.1 | Disability Benefits | ||
| 20.1.1 | Commercial and employment disability programs | ||
| 20.1.2 | State disability policies | ||
| 20.1.3 | Social Security disability benefits | ||
| 20.1.4 | Vocational rehabilitation benefits | ||
| 20.2 | Health Insurance | ||
| 20.2.1 | Private health insurance | ||
| 20.2.2 | Government health insurance | ||
| 20.3 | Veterans Administration (VA) Benefits | ||
| 20.4 | Income Taxes | ||
| 20.5 | For More Information | ||
| 21.1 | Surfing the Net: Empowerment or Deception? | ||
| 21.2 | Clinical Research | ||
| 21.2.1 | What is clinical research? | ||
| 21.2.2 | How do clinical studies operate? | ||
| 21.2.3 | Should I participate in a clinical trial? | ||
| 21.3 | Travel Tips | ||
| 21.3.1 | Medical tips for travelers | ||
| 21.3.2 | Driving tips | ||
| 21.3.3 | When traveling by air | ||
| 21.4 | Pregnancy and Childbirth | ||
| 21.4.1 | Can I become pregnant? | ||
| 21.4.2 | How will my pregnancy affect my RA? | ||
| 21.4.3 | How will my RA affect my unborn child? | ||
| 21.4.4 | Can I breastfeed my infant? | ||
| 21.4.5 | Will my child have RA? | ||
| 21.4.6 | Will I be able to care for my baby? | ||
| 21.5 | Immunization for the Person with RA | ||
| 21.5.1 | Should I get a yearly flu shot? | ||
| 21.5.2 | Are there other vaccinations that I may want to get? | ||
| 21.6 | RA in Children and Adolescents | ||
| 21.7 | For More Information | ||
Closing Thoughts
Glossary
Bibliography
Index