Medications
and the immune suppressant cyclosporine (Sandimmun, Neoral). The newest DMARD, leflunomide (Arava), eases inflammation by stopping white blood cells from reproducing. DMARDs are sometimes given in combination.
You may also benefit from a new class of arthritis drugs called biologic response modifiers, which when used early, forestall progressive joint erosion. These include inflixmab (Remicade), which is infused by IV every four to six weeks in a doctor's surgery, and etanercept (Enbrel), which you can learn to self-inject twice a week at home. Both block the inflammatory cytokine tumour necrosis factor (TNF) and are sometimes called TNF blockers. In tests, patients felt better after taking these drugs, some with complete relief of certain symptoms. Using these drugs with methotrexate or other DMARDs may be even more effective. For very sever flare-ups and recurrences, powerful immuosuppressants, such as azathioprine (Imuran), chlorambucil (Leukeran) or cyclophosphamide (Cycloblastin, Endoxan), may be given. These medications suppress the overaall immune system but can be toxic.
With all of these drugs, you may feel better after several weeks although treatment is usually continued long term. Your dose may be reduced over time or you may be given new drug combinations.
PROMISING DEVELOPMENTS
Despite the seriousness of this condition, you can take certain actions on your own to feel better.
Low-impact exercise may have benefits. Try walking, cycling or learn the slow, graceful movements of tai chi.
Spa therapy, with natural hot spring water, has long been used to relieve rheumatic complaints. Research confirms that warm-water exercise programs can be beneficial; the optimal water temperature is 28 degrees to 31 degrees C. Gentle massage performed by a professional can also relax muscles and maintain flexibility.
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RHEUMATOID ARTHRITIS DRUGS: KNOW THE RISKS
Drug effective against rheumatoid arthritis can have serious side effects.
Herbs have proved useful in treating rhueumatoid arthritis. Evening primrose oil (1000 mg three times a day) has anti-inflammatory properties that may soothe sore joints. Boswellia (150 mg three times a day) has long been used in India to reduce the inflammation. Cayyenne creams with capsaicin, the ingredient that makes chilli peppers hot, can be applied to affect joints three or four times a day. A food elimination diet (see on allergies) to identify the foods that trigger your symptoms is advocated by nutriontially oriented physicians to curb painful symptoms.
A novel blood-filtration procedure called prosorba (protein-A immunoadsorption) therapy may offer benefits for those who have not responded to medications. Blood is drawn from one arm, filtered through a special cylinder that pulls out inflammatory substances, then returned through your other arm. Sessions are once a week for 12 weeks. You should start feeling better soon after completing your last treatment and the benefits may continue for a year and a half. Only if your deterioration is severe will surgical procedures, such as hip, knee or finger joint replacement, be necessary (see Arhtritis).
and the immune suppressant cyclosporine (Sandimmun, Neoral). The newest DMARD, leflunomide (Arava), eases inflammation by stopping white blood cells from reproducing. DMARDs are sometimes given in combination.
You may also benefit from a new class of arthritis drugs called biologic response modifiers, which when used early, forestall progressive joint erosion. These include inflixmab (Remicade), which is infused by IV every four to six weeks in a doctor's surgery, and etanercept (Enbrel), which you can learn to self-inject twice a week at home. Both block the inflammatory cytokine tumour necrosis factor (TNF) and are sometimes called TNF blockers. In tests, patients felt better after taking these drugs, some with complete relief of certain symptoms. Using these drugs with methotrexate or other DMARDs may be even more effective. For very sever flare-ups and recurrences, powerful immuosuppressants, such as azathioprine (Imuran), chlorambucil (Leukeran) or cyclophosphamide (Cycloblastin, Endoxan), may be given. These medications suppress the overaall immune system but can be toxic.
With all of these drugs, you may feel better after several weeks although treatment is usually continued long term. Your dose may be reduced over time or you may be given new drug combinations.
PROMISING DEVELOPMENTS
- Medications for rheumatoid arthritis don't just make you feel better, they may also save your life. Researchers at the Univeristy of Kansas Medical Centre report that those taking the arthritis fighter methotrexate were 60% less likley to die prematurely, particularly from a heart attack, than those not taking the drug. The scientists suspect that the benefits, it proven, may be due to the medicine's inflammation-blocking effects. Inflammation is increasingly suspected as a culprit in heart disease and strokes.
>ACUPUNCTURE MAY OFFER RA BENEFITS. A small British study showed less discomfort in rheumatoid arthritis sufferers after a treatment. Some patients were able to reduce their pain medication from an average of 17 tablets a week to just 6.
Lifestyle changes
Despite the seriousness of this condition, you can take certain actions on your own to feel better.
Low-impact exercise may have benefits. Try walking, cycling or learn the slow, graceful movements of tai chi.
Spa therapy, with natural hot spring water, has long been used to relieve rheumatic complaints. Research confirms that warm-water exercise programs can be beneficial; the optimal water temperature is 28 degrees to 31 degrees C. Gentle massage performed by a professional can also relax muscles and maintain flexibility.
-----------------------------------------------------------------------------------------------------------------------------
RHEUMATOID ARTHRITIS DRUGS: KNOW THE RISKS
Drug effective against rheumatoid arthritis can have serious side effects.
NSAIDs such as aspirin and naproxen, for example, can cause stomach ulcers, internal bleeding and liver and kidney problems; they're estimated to contribute to thousands of deaths each year. The never COX-2 inhibitors, such as Vioxx and Celebrex, appear to be more stomach-friendly, but early findings raise the unsettling possibility that they could increase your heart attack risk.
Methotrexate, like other DMARDs has side-effect risks, including liver problems, bone marrow suppression, lung problems and kidney toxicity.
Some people taking the TNF blockers Enbrel and Remicade develop serious and even deadly infections. Using the lowest possible dose may minimise problems. If you take a combination of drugs the risks may be reduced since lower dosages can be used. However, drug cocktails also present new, unforeseen dangers.
The side effects of the corticosteroid prednisone are legendary. They include cataracts and glaucoma, gastric bleeding, thinning of the skin, swollen facial tissues and weight gain, increased diabetes risk, even destruction of the hip.
Bottom line: Work closely with your medical team and take an active role in your treatment. Know about your drugs and monitor your symptoms closely. Make lifestyle adjustements to help you adpat and listen to what your body is telling you.
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Methotrexate, like other DMARDs has side-effect risks, including liver problems, bone marrow suppression, lung problems and kidney toxicity.
Some people taking the TNF blockers Enbrel and Remicade develop serious and even deadly infections. Using the lowest possible dose may minimise problems. If you take a combination of drugs the risks may be reduced since lower dosages can be used. However, drug cocktails also present new, unforeseen dangers.
The side effects of the corticosteroid prednisone are legendary. They include cataracts and glaucoma, gastric bleeding, thinning of the skin, swollen facial tissues and weight gain, increased diabetes risk, even destruction of the hip.
Bottom line: Work closely with your medical team and take an active role in your treatment. Know about your drugs and monitor your symptoms closely. Make lifestyle adjustements to help you adpat and listen to what your body is telling you.
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JUVENILE RA
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About 1 in 1000 children have the disabling inflammatory disease called juvenile theumatoid arthrtis, or JRA (in adults it's known as Still's disease). JRA often appears in toddlers and young teenages although it's possible at any age. It may begin with a fever and shaking chills, followed by pink rash on the thighs or chest, swollen glands and painful and swollen joints.
Aspirin, in high doses, is usually the fist line of attack. Your doctor may then prescribe a DMARD, such as methotrexate, gold injections or sulfasalzine (Salazopryin, Pyralin), which help about two-thirds of children. A newer biologic response modifier, such an Enbrel, may be tried. steroids such as prednisone are not normally used for children because they can stunt growth; steroid injections directly into the joints, however, may allay occasional flare-ups. Many cases of JRA disappear by adulthood.
>When will I feel better?
About 1 in 1000 children have the disabling inflammatory disease called juvenile theumatoid arthrtis, or JRA (in adults it's known as Still's disease). JRA often appears in toddlers and young teenages although it's possible at any age. It may begin with a fever and shaking chills, followed by pink rash on the thighs or chest, swollen glands and painful and swollen joints.
Aspirin, in high doses, is usually the fist line of attack. Your doctor may then prescribe a DMARD, such as methotrexate, gold injections or sulfasalzine (Salazopryin, Pyralin), which help about two-thirds of children. A newer biologic response modifier, such an Enbrel, may be tried. steroids such as prednisone are not normally used for children because they can stunt growth; steroid injections directly into the joints, however, may allay occasional flare-ups. Many cases of JRA disappear by adulthood.
>When will I feel better?
You first flare-up of rheumatoid arthritis can be a frigthening experience because it seems as if your joints have become swollen and painful in just a few days. What you will quickly discover is treat aspirin and other NSAID pain relievers give relief in a matter of hours. However, do not delay seeking medical advice and initiating a treatment plan with your doctor. Medications are now available that actually change the course of the illness, rather than just treating the symptoms. It may take a month or so before you notice less pain, inflammation and morning stiffness, but the relief may be long term.
Melted paraffin baths can be very effective in easing hadn stiffness and pain, especially prevalent early in the morning. Paraffin bath kits, available commercially, make the procedure easier.
Plenty of rest is necessary, particularly during flare-ups, so you can preserve your energy and optimise your ability to cope.
A diet rich in fruit and vegetables that contain the antioxidant vitamins C AND E can protect the joints from damage (although no foods can cure rheumatoid arthritis.) The mineral zinc, found in meats, eggs, diary, seafood and nuts, also has antioxidants properties.
Melted paraffin baths can be very effective in easing hadn stiffness and pain, especially prevalent early in the morning. Paraffin bath kits, available commercially, make the procedure easier.
Plenty of rest is necessary, particularly during flare-ups, so you can preserve your energy and optimise your ability to cope.
A diet rich in fruit and vegetables that contain the antioxidant vitamins C AND E can protect the joints from damage (although no foods can cure rheumatoid arthritis.) The mineral zinc, found in meats, eggs, diary, seafood and nuts, also has antioxidants properties.
Natural methods
Herbs have proved useful in treating rhueumatoid arthritis. Evening primrose oil (1000 mg three times a day) has anti-inflammatory properties that may soothe sore joints. Boswellia (150 mg three times a day) has long been used in India to reduce the inflammation. Cayyenne creams with capsaicin, the ingredient that makes chilli peppers hot, can be applied to affect joints three or four times a day. A food elimination diet (see on allergies) to identify the foods that trigger your symptoms is advocated by nutriontially oriented physicians to curb painful symptoms.
Procedures
A novel blood-filtration procedure called prosorba (protein-A immunoadsorption) therapy may offer benefits for those who have not responded to medications. Blood is drawn from one arm, filtered through a special cylinder that pulls out inflammatory substances, then returned through your other arm. Sessions are once a week for 12 weeks. You should start feeling better soon after completing your last treatment and the benefits may continue for a year and a half. Only if your deterioration is severe will surgical procedures, such as hip, knee or finger joint replacement, be necessary (see Arhtritis).
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