Showing posts with label Rheuma. Show all posts
Showing posts with label Rheuma. Show all posts

May 7, 2023

Living with inflammatory arthritis

 

Dear Bloggers,

I probably have told you in earlier stories about my stiffness in joints and on a rainy and cold day it is harder to get out of bed and go on the move. No, I am not a complainer somehow there is a feeling that people around don’t know a lot about the condition and that there is a lot of pain involved. (One of the reasons that I only write once a month instead of every week.) I have used quite some pain relievers during the last fifteen years. As I stopped last year with the medication on advice of the rheumatologist. The inflammations took a flight. From sour joints until inflammatory bursitis in my hip and being treated with a nerve Intercostal Block on my rib.

Inflammatory arthritis is a condition many people endure for a lifetime. Thanks to advances in treatment, however, innovative medications can delay and even halt the progression of the disease, and non-drug approaches have can help relieve symptoms so you can live a full and productive life.




What is inflammatory arthritis?

Inflammatory arthritis describes a group of diseases caused by an overactive immune system. The most common symptoms are joint pain and stiffness. Affected joints may feel warm, swollen, and tender. But inflammatory arthritis can also affect other tissues in the body, including the lungs, heart, eyes, skin, and other organs. Left untreated, it can cause irreversible damage. Early treatment is the best way to relieve symptoms and limit the effects of inflammatory arthritis on the body.

While it’s not known what causes inflammatory arthritis in every patient, what is known is that the immune system does not know when to put on the brakes. Normally when we are exposed to bacteria, viruses, or fungi, the immune system produces white blood cells called lymphocytes as well as immune proteins to mount an attack against these invaders. Lymphocytes and immune proteins cause inflammation, which under typical circumstances is limited and resolves once the foreign substance is defeated.

But in someone with inflammatory arthritis, the immune response does not know when to stop. It turns on your body, attacking your own tissues instead of the foreign substance and causes continued inflammation. For this reason, inflammatory arthritis is known as an "autoimmune disease" − auto meaning "self" and “immune” because the immune system loses its ability to distinguish self from foreign.




How are inflammatory arthritis and osteoarthritis different?

Although they share some common symptoms, inflammatory arthritis and osteoarthritis are quite different diseases. Osteoarthritis is a common condition causing wear-and-tear of the cartilage of the joints due to age and/or prior injury. Here are some other differences:

Inflammatory Arthritis - A "systemic" disease which may affect the joints as well as other organs, such as the lungs, heart, eyes, tendons, and skin. Patients may show elevations in proteins such as rheumatoid factor, C-reactive protein (CRP), and erythrocyte sedimentation rate (ESR) on blood tests. Autoimmune disease related to body-wide inflammation.

Osteoarthritis - Symptoms are limited to the joints. Blood tests for biomarkers are negative. Mechanical wear-and-tear on joints due to age or injury.

 


What are the different types of inflammatory arthritis?

If you are experiencing symptoms that suggest inflammatory arthritis, your doctor will perform a number of tests, including a physical exam, blood tests, and imaging exams (such as X-rays, joint ultrasound, and/or MRI or CT scans). Sometimes the physician takes a sample of fluid from an affected joint for analysis − a procedure called joint aspiration. 

Based on the results of these exams, your physician will determine if you have inflammatory arthritis and if so, which type:

Rheumatoid Arthritis (RA) is the most common form of inflammatory arthritis. It tends to involve more than one of the small joints of the hands and feet. In particular, the lining of the joint or tendons (the synovium) is inflamed, causing warmth, pain, and stiffness. In 30% to 60% of people with RA, blood tests confirm the presence of proteins called rheumatoid factor (RF) or anti-cyclic citrullinated peptide (anti-CCP) antibodies. It is very important to control inflammation in the synovium to stop joint destruction and to treat RA to minimize damage to the heart, lungs, and eyes.

Psoriatic Arthritis is a type of arthritis called a "spondyloarthropathy" that is a combination of psoriasis (red, scaly patches on the skin, especially the knees, elbows, and scalp) as well as pain and swelling in the large and small joints and sometimes the spine. It can cause complete swelling of a finger or toe − a condition called "dactylitis."

 


 

Juvenile Idiopathic Arthritis (JIA) affects young people under age 16, causing inflammation in the joints and sometimes in the spine and ligaments (tissues that connect bone to bone) that lasts for more than six weeks. Swelling or mobility problems, including a limp if the legs are affected, may be the only signs of JIA. Some types of JIA cause eye inflammation that can occur without symptoms, so prompt diagnosis, treatment, and monitoring of JIA are vital to prevent permanent damage. Children and teens with JIA are best treated by a pediatric rheumatologist.

Ankylosing Spondylitis (AS) affects primarily the spin and hip joints, breastbone, and large joints in the body. Over time, AS can result in noticeably reduced motion in the spine. Up to half of people with AS have a gene called HLA-B27, the presence of which can help confirm the diagnosis of this condition when it is found in combination with AS symptoms.

Gout & Pseudogout (calcium pyrophosphate dehydrate deposition disease or CPDD) are forms of arthritis caused by elevated levels of certain crystals in the body. Gout results from excess uric acid, causing it to crystallize in joints such as the big toe and also raising the risk of kidney stones. CPPD occurs when calcium salts form in the joints and are engulfed by white blood cells, provoking inflammation − most commonly in the wrists and knees.

Other autoimmune diseases can cause inflammatory arthritis as a symptom. Examples include Sjogren’s syndrome and lupus.



You and your rheumatologist: A lifetime partnership

If you have inflammatory arthritis, it is imperative that you see a rheumatologist on a regular basis to monitor your health and customize your treatment. Rheumatologists are medical doctors with special training in the care of people with joint diseases and autoimmune diseases. They are different from orthopedists, who are trained in surgery and who may also be involved in the care of people with inflammatory arthritis when medical treatments are not enough.

How do you know whether to start with a rheumatologist or orthopedist? If you have ongoing joint discomfort without chronic swelling or other symptoms, such as fatigue, you may be able to see an orthopedist first. But if your joint pain is accompanied by warmth, swelling, other signs of inflammation, fatigue or discomfort in other parts of your body, a visit to a rheumatologist may be in order. Your primary care physician can guide you.

Because inflammatory arthritis is an autoimmune disease that can affect multiple parts of your body, you may need to see other specialists, too, to keep your symptoms in check and maintain the best quality of life possible.



To prepare for your visit with a rheumatologist:

·     Bring in a full list of your medications, including vitamins and supplements.

·     If you are already taking medications for inflammatory arthritis, make any notes about reactions or side effects you may be experiencing.

·     Provide a list of all health conditions you have had, prior surgeries, and symptoms you may be experiencing.

·     Prepare a list of questions you may have for your doctor.

Your rheumatologist may choose from a variety of treatment options for inflammatory arthritis, depending on the type and severity of your disease, such as:

·     Nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen and naproxen.

·     Steroid medications (corticosteroids) such as prednisone, which are typically used for shorter periods of time because of their side effects.

·     Traditional disease-modifying antirheumatic drugs (DMARDs), such as methotrexate, hydroxychloroquine, sulfasalazine, minocycline, and leflunomide.

·     Biologic DMARDs, which target the proteins driving inflammation, such as infliximab, etanercept, abatacept, adalimumab and rituximab. These medications have revolutionized the care of people with inflammatory arthritis, sparing many from surgery.

·     Surgery may be indicated for specific joints with damage that can no longer be controlled by medications.

 



A diagnosis of inflammatory arthritis can initially feel overwhelming. It can take weeks or even months to come to terms with and understand what having this disease can mean in your life. By developing a close working relationship with your rheumatologist and other caregivers, however, there is much you can do to control inflammatory arthritis and maintain an independent and active lifestyle.

The Old Sailor,

May 2, 2011

The day that I nearly lost everything.


Dear Bloggers,

So here's the scenario. About a year ago I was diagnosed with Fibromyalgia and I did get the the Talk. The doctor in question gives a lot of these talks, and is determined that we shouldn't miss a single word. We are shown a figure with red dots for the trigger points, and she begins to describe what's happened, in mind-numbing detail. I mention that I'm a guy that learned some Latin and Medical terms had my interrest for a long time, and I knew about Rheumatic problems already quite a few things as I have been strawling through medical books and of course on the internet. We have to listen. To all of it. She is, she tells us, the expert, and no-one for miles around knows as much about Rheuma as she does (My doc at home does probably know nothing at all at least I share that opinion).


I kind of loose my temper a bit as I realize that I am stuck on this bloody sickness for the rest of my days, The doc ignores me and disappears for a short while. We might need her again in the future whispers my wife and I am ashamed of myself. Due to the fact that there will be not much progress in the coming year, I will definately lose my job and have less income. My boss is giving me notice and I can sense that this is difficult for both of us. I had so much fun doing this job but my body decided in a hard way that this was not going o work any longer. I hated myself for quite a while and had to get my feet back on the ground and suite myself with a new style of living. A slower and more balanced life would do myself good. I will compare to someone that is stuck in a body of an eighty years old man who has been working hard all his live but now his worn out body is holding him back due to pain all over. Accepting it is not that easy, the pain is something you learn to live with. My wife told me one day that no one is getting happier when I am complaining, I guess that she was right so I stopped doing that.

The doctor returns, I apologise very nicely (as I have been instructed by my wife), and we proceed. We are told again that we need to come back for some more tests on Monday. We are given some booklets to read ourselves and that was it. Totally devistated we leave the doctors room. All of a sudden some horrific pictures of the worst case scenario run through my brain (a man like me with what looks like a wheelchair and his head is hanging down on his chest; I'm still not sure what that was supposed to be).

In the time being at home, I worked myself back up to certain level and got back to work. I started a job to become a bus driver on a commuters bus for the summer season. If it would not work out with my body and brain, I could simply pull the plug as I am hired through a temps office. In the beginning it was hell as I had to stick a lot of information into my brain which was still foggy due to the amount of medication that I have been using to settle the pain level. I look at it as a drug user that becomes clean, that also takes a couple of weeks before the brain is clear again. 

The money is coming back in although the amount is lower and deducted from my dole money of course. Our holiday? we can simply skip as I am hired for the summer season. Again I feel tears burning as I cannot spend money on my loved ones. That's ok, says she and my kids are fine with it, I still feel like that I am failing somehow. We cannot go on our holiday, maybe next year. Whe sat down one evening when I was still home, we decided to sell this beautiful house and buy something a bit smaller as cleaning and doing the garden became to much for me and for my wife it is too much too handle on her own. Certainly we like to get a reasonable price for it, but still it is not been sold. But what about the housing market after the recession banks do not dare to take any risks anymore. In the mean time we are still living here and although the garden is getting more and more a mess. I mow the lawn and my eldest daughter is helping me with it. The rest of the garden is not in a great condition. Ah, That's ok, because we can sell it for abit less and move on. Hmmm......sounds like my wife gave up on it too. We have seen a nice house on internet with enough space for all of us and with a suitable garden. We would get on a lower mortgage and we could save a few euros to go out for a long weekend. That would be at least long enough for me. 

Well, at least we can sit at home and read... 

The Old Sailor,

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