The Hospital for Special Surgery Rheumatoid Arthritis Handbook

Suzanne Loebl, Michael D. Lockshin, Stephen A. Paget

Description

"This splendid volume is easily understandable, uses real-life situations as examples and is far more up-to-the-minute than other such books. From sexuality to surgery, it offers practical and science-based advice."--Charles M. Plotz, M.D., Editor-in-Chief, Rheuma21st.com

Your complete guide to understanding and living well with rheumatoid arthritis

If you or someone close to you suffers from rheumatoid arthritis (RA), this book is a powerful tool you don't want to be without. Two of the authors are physicians at the Hospital for Special Surgery, one of the nation's oldest and best orthopedic research hospitals. Its purpose is to arm you with the information you need to take charge of your disease management and work with your doctors to develop a treatment program that's right for your lifestyle and life goals.

In plain English, the authors demystify rheumatoid arthritis-its causes, progression, and various effects on the human body-and decode the often perplexing language that doctors use to describe RA and its diagnosis and treatment. They explain the various treatment and pain management options available to you and ways to discuss them with your doctor. The authors also include the true stories of RA patients whose tales offer encouragement and powerful insights for dealing with the difficult psychological and lifestyle issues RA sufferers face. Their expert advice and guidance covers a range of topics of vital concern to people affected by RA, including:
* Old, new, and emerging drug therapies, including gold, corticosteroids, and immunosuppressants
* Analgesics and anti-inflammatories
* Alternative treatment strategies
* Nutrition, diet, and exercise for RA
* Vitamins and supplements, including glucosamine and Evening Primrose oil
* Managing crucial lifestyle issues such as sports, travel, and sex
* Pregnancy and RA
* Alleviating depression and pain
* Surgical options, including joint replacement therapy
Acknowledgments.

Introduction.

1. The Empowered Patient.

2. Your Doctor, Your Partner.

3. What is Rheumatoid Arthritis?

4. How Rheumatoid Arthritis Affects the Body.

5. RA Immunity and Inflammation.

6. Drugs, Drugs, and More Drugs.

7. Aspirin, Other Nonsteroidal Anti-Inflammatory Drugs, Super-Aspirins, and Other Analgesics.

8. Disease-Modifying Antirheumatic Drugs (DMARDS).

9. Corticosteroids.

10. Pregnancy and RA.

11. Nutrition and RA.

12. Exercise, Physical Therapy, and RA.

13. Occupational Therapy and RA of the Hands.

14. Coping with Rheumatoid Arthritis.

15. Jeremiah J. Walsh: A Link Between RA's Past, Present, and Future.

16. Surgery and RA.

17. Surgery of the Knee.

18. Surgery of the Hip.

19. The Upper Extremities and the Feet.

Appendix A: Questions and Answers About RA.

Appendix B: Glossary.

Index.

Sujets

• Santé et bien-être
• Santé du quotidien
• Santé au quotidien
• Santé au quotidien
• Fitness
• Health
• Diseases
• Musculoskeletal

Informations

• Publié par: Turner Publishing Company
• Date de parution: 21 avril 2008
• Nombre de lectures: 0
• EAN13: 9780470308622
• Langue: English

Extrait

The Hospital for Special Surgery Rheumatoid Arthritis Handbook

S TEPHEN A. P AGET , M.D., M ICHAEL D. L OCKSHIN , M.D., AND S UZANNE L OEBL
Dedicated to the memory of Emmanuel Rudd, M.D. St. Petersburg, 1914 - New York, 1995
Who spent his professional life
at the Hospital for Special Surgery ,
a friend of every arthritis patient
fortunate enough to cross his path . . .
and for David always
Copyright 2002 by The Hospital for Special Surgery. All rights reserved
Published by John Wiley Sons, Inc.
No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, recording, scanning, or otherwise, except as permitted under Section 107 or 108 of the 1976 United States Copyright Act, without either the prior written permission of the Publisher, or authorization through payment of the appropriate per-copy fee to the Copyright Clearance Center, 222 Rosewood Drive, Danvers, MA 01923, [phone], fax [phone]. Requests to the Publisher for permission should be addressed to the Permissions Department, John Wiley Sons, Inc., 605 Third Avenue, New York, NY 10158-0012, [phone], fax [phone], email: [e-mail].
This publication is designed to provide accurate and authoritative information in regard to the subject matter covered. It is sold with the understanding that the publisher is not engaged in rendering professional services. If professional advice or other expert assistance is required, the services of a competent professional person should be sought.
This title is also available in print as ISBN 0-471-41045-4. Some content that may appear in the print version of this book may not be available in the electronic edition.
For more information about Wiley products, visit our web site at www.Wiley.com
Contents

Acknowledgments
Introduction
1 The Empowered Patient
2 Your Doctor, Your Partner
3 What Is Rheumatoid Arthritis?
4 How Rheumatoid Arthritis Affects the Body
5 RA Immunity and Inflammation
6 Drugs, Drugs, and More Drugs
7 Aspirin, Other Nonsteroidal Anti-Inflammatory Drugs, Super-Aspirins, and Other Analgesics
8 Disease-Modifying Antirheumatic Drugs (DMARDS)
9 Corticosteroids
10 Pregnancy and RA
11 Nutrition and RA
12 Exercise, Physical Therapy, and RA
13 Occupational Therapy and RA of the Hands
14 Coping with Rheumatoid Arthritis
15 Jeremiah J. Walsh: A Link Between RA s Past, Present, and Future
16 Surgery and RA
17 Surgery of the Knee
18 Surgery of the Hip
19 The Upper Extremities and the Feet
Appendix A: Questions and Answers About RA
Appendix B: Glossary
Index
Acknowledgments


The Hospital for Special Surgery Rheumatoid Arthritis Handbook reflects the skill and knowledge of many experts. Special thanks are due to key staff members as follows, in alphabetical order:
Adina Batterman, CSW, program coordinator for the HSS Rheumatoid Arthritis Education and Support Group (Chapter 14)
Laura Broach, PT (Chapter 19)
Todd Cronin, PT, who is an expert at getting people with arthritis moving (Chapter 12)
Glen Garrison, CPO, Cped, Director (Chapter 19)
Suzanne Graziano, RN, MS, ONC, CAN, clinical nurse specialist, Department of Nursing Administration (Chapters 16, 17, and 18)
Annabel Griffith, OTR (Chapters 13 and 19)
Roberta Horton, ACSW, Program and Research Coordinator, HSS Department of Patient Care (Chapter 14)
Bryan Nestor, M.D., assistant attending orthopaedic surgeon (Chapters 17 and 18)
Thomas P. Sculco, M.D., director of orthopaedic surgery and chief of the Surgical Arthritis Service (Chapter 16)
Medical self-help books draw on works written by others. The authors consulted numerous textbooks, journals, scientific reports, and patient education publications, and attended relevant scientific meetings.
Specific thanks are due to the Arthritis Foundation for their excellent publications and to the American College of Rheumatology and the Association for Rheumatology Health Professionals for their Primer on Rheumatic Diseases and their excellent scientific meetings. Particular thanks are due to Marian A. Minor, Ph.D., PT, for providing information on how patients with rheumatoid arthritis can exercise.
This handbook is richly illustrated. Thanks are due to Lippincott, Williams Wilkins for permission to use the exercises presented in Chapter 12, published in The Manual of Rheumatology and Outpatient Orthopedic Disorders , by Stephen Paget, Paul Pellicci, and John F. Beary. Exercises provided in the chapters dealing with total hip and knee replacement, as well as other illustrations related to surgery and the protection of newly implanted joints, are provided courtesy of Suzanne Graziano, Department of Nursing Administration, Hospital for Special Surgery. The anatomical drawings are from the Columbia-Presbyterian Osteoarthritis Handbook , edited by Ronald P. Grelsamer and Suzanne Loebl, and are courtesy of Hungry Mind Publishers. We also want to thank Amgen, Inc. for the drawing of an inflamed joint; Wright Medical Technology, Arlington, TN, for the photographs of the total knee, total hip, and Swanson finger joint implants; Dr. Alfred R. Swanson for the photographs of the hands before and after surgery; Annabel Griffith for the photograph of the dynamic hand splint; and Glenn Garrison for the foot exercises. Thanks are due to the staff of HSS operating rooms, who provided information when necessary as the authors watched the actual joint replacement surgery, and Suzanne Graziano, who checked the surgery chapters for accuracy.
The authors appreciate the help of their colleagues. Any mistaken interpretation, however, is solely their responsibility.
We want to thank Chip Rossetti, our editor at Wiley, for shepherding this book through its editing and production process.
To be effective, self-help books rely on relating actual experiences. An immense debt of gratitude is owed to the patients who shared their experiences with the authors. Their names have been changed, but their actual words and feelings are used throughout the book.
Introduction


W HO S HOULD R EAD T HIS B OOK
This book is written for people who suffer from rheumatoid arthritis as well as for their families and friends. Rheumatoid arthritis (RA) is a chronic disease for which self-care is crucial. The more you know about the disease, the better you will be able to cope with it. However, in no way can your knowledge substitute for the care provided by your physician and other members of your health team. This handbook s purpose is to amplify and reinforce their instructions and help you participate more fully in your treatment.
W HY T HIS B OOK
For a very long time, rheumatoid arthritis was a mystery. Paradoxically, its symptoms are characteristic of arthritis, a disorder most commonly seen among the elderly-yet, in this case, they occur in the young and vigorous. It is a disorder associated with pain, weight loss, and eventually joint deformity. It is a malady that resembles an infection, yet for years it yielded no identifiable bug. Gradually, the mystery and helplessness lifted. About 150 years ago, it was shown that a new drug, aspirin-whose discovery itself was based on a folk remedy-offered temporary relief. Another drug-gold-was stumbled upon during the 1920s. At long last, on the eve of World War II, scientists realized that rheumatoid arthritis was associated with a malfunction of the immune system. Researchers were finally on the right track. The immune system, however, was a mystery of its own, and even today its function is still being unraveled. Fortunately, enough is known to make your rheumatoid arthritis treatable.
It is absolutely essential to minimize the damage that rheumatoid arthritis can inflict on your body, but keeping the disease in check can be a major undertaking. Helping you to do so is the lifework of the authors of this book.
H OW T HIS B OOK I S O RGANIZED
Chapters 1 through 5 explore the physiological processes that malfunction due to RA and the manner in which these irregularities affect the body. Readers learn about joints, body mechanics, and the immune system, and become familiar with the language used to describe various aspects of the disease, its diagnosis, and treatment.
Chapters 6 through 9 are devoted to drug therapy, one of the principal avenues for better treatment. In addition to general information about medication, the chapters review the different classes of drugs used to treat RA-analgesics, anti-inflammatory agents, immunosuppressants, and corticosteroids-and explore their similarities and differences. Special sections deal with questions you need to ask about newly prescribed drugs: potential side effects, how long to take a specific medication, why it works, and other details.
Chapter 10 explores specific considerations of having a baby when suffering from RA.
Chapters 11, 12, and 13 review nondrug aspects of treatment: nutrition and physical and occupational therapy. Sound nutrition plays a role in the well-being of people suffering from rheumatoid arthritis. Certain drugs, especially corticosteroids, have a major impact on metabolism and body weight and may require a modification of your food intake. Chapter 11 makes specific suggestions on how to handle some of these issues, and also discusses vitamins and popular supplements such as glucosamine and evening primrose oil. Chapter 12 reviews both recreational and therapeutic exercises. Specific exercises designed to keep the body limber and in good shape are suggested. Dysfunctional joints, especially those of the hands, may make activities of daily living (performing routine tasks) difficult. Chapter 13 outlines how to minimize and/or solve these problems, and how to rehabilitate small joints.
In Chapter 14 we meet a group of patients with RA and explore the psychological impact of this chronic disease. Courage and self-reliance are