arthritiszone.com

Living with rheumatoid arthritis

By KELLY DONOVAN

Staff Writer

BARSTOW – The notion that arthritis only affects the elderly is incorrect, and Jill Chalkley is living proof of that.

Since she was 26, the native of England has been living with rheumatoid arthritis – a disease that affects the lining of the joints and gets progressively worse.

She was able to maintain somewhat of a normal life initially, although she never had any job after getting the disease, because working in an office wouldn’t have been feasible. She gradually became less physically able over the years.

Now 71, she gets around her mobile home in south Barstow with a walker. She uses a wheelchair when a doctor’s visit or other excursion involves too much walking – like if there is a large parking lot.

She can no longer drive, mainly because of problems she has had with her right leg. Her femur has broken twice, the most recent time in 2003.
Story Photo

“They didn’t know if I’d even learn to walk again,” she said.

Chalkley, who lives alone, also has had to undergo hip surgery three times in the past decade because of the effects of the disease.

As for her arms, she can no longer extend them all the way; her elbows are always somewhat bent.

Chalkley said she is in pain constantly. Different body parts will hurt at different times, and sometimes the pain is all over her body, she said.

“(Rheumatoid arthritis) is a slow torture,” she said.

Stress makes the pain worse, a phenomenon Chalkley experienced after the death of a close friend a year ago.

To manage the pain, Chalkley takes a powerful painkiller three times daily, but only takes a low dosage because she doesn’t like the idea of taking any more.

Still, Chalkley, Barstow resident for nearly 40 years, said she has learned to live with the disease.

“You don’t think of the negative things – you think of the positive things,” she said. “That’s the only way to handle this disease.”

One positive thing, she said, is the new drugs for the treatment of rheumatoid arthritis that weren’t available when she was first diagnosed with it. Then, there was nothing, she said.

Now, she said a diagnosis of rheumatoid arthritis isn’t as bad. People getting the disease now have a much better chance of not ending up crippled, she said.

Also, one service she said has been helpful to her is a worker from the county’s Department of Aging and Adult Services who comes to her home to assist with her personal care and housework each weekday.

She also said she enjoys spending time with her family; she has three grown sons.

CONTACT THE WRITER: (760) 256-4122 or kelly_donovan@link.freedom.com

Arthritis Pain Relief and Prevention Plan

A great place to begin taking charge of you arthritis pain relief and prevention planning is by making an appointment with your healthcare provider and finding out more about your condition and treatment options. Make sure to jot down questions ahead of time, and take them along in your journal or notebook, armed with a pencil to fill in his or her replies. Some questions to begin with may be centered around these:
1. Do I have a form of arthritis? If not, what is wrong & what do I do next?
2. If so, which type is it? And what can I expect short-term and long-term?
3. What pain relief treatments are available? Which have side affects & what are they?
4. What self-care solutions do you advise?
5. Are there any limitations I should know about; i.e. special dietary issues, special activities to avoid, any OTC meds to NOT mix, etc.?
6. What resources do you have to help with my diet and exercise planning?
7. What other arthritic and other health resources do you have for my family and me?
When you take in your questions, also take in a description of your symptoms so that your doctor can help better understand your situation and health. Make sure to note:
- Where you have pain (same joint both limbs?)
- When you feel pain – with certain activities, in the morning, when it rains, etc.
- How long you have had the pain
- If the pain increases or decreases, comes and goes, etc.
- The type & intensity level of pain – stabbing, dull, cramping, stiffness…and low, mild or high pain
- Note any limitations – can’t bend over too far without pain, can’t get out of car, etc.
- Share any family history of arthritis
- Tell about any OTC or prescription medications or other treatments you currently take or use.
- Discuss any special diet you are on and exercise programs

So try the different options available for arthritis pain relief and prevention. Give your joints a break as soon as possible from any excess weight they’re hauling around, even if it’s the weight of excess stress. And lighten up and make pain relief and prevention care part of your normal, everyday routine.

Arthritis Organizations
– Turn to worldwide, federal, state and local associations to stay informed about arthritis. Get on their mailing lists and stay tuned to the latest information about new treatments, drug therapies, OTC medication, surgeries and other pain relief and prevention solutions. Keep their information handy in a file cabinet and online in your computer for quick, handy reference in times of pain and stress. Here are some places to begin gathering information from:

American Academy of Orthopaedic Surgeons (AAOS)
http://www.aaos.org
6300 North River Road Rosemont
Illinois 60018-4262
Phone (847) 823-7186 or (800) 346-AAOS
Fax (847) 823-8125
The AAOS offers educational and facility management services for orthopedic surgeons and allied health professionals. This organization, with over 16,000 members, also serves as an advocate for improved patient care. And they educate the general public about orthopedic science. Check out their “Public Education” area online for public service announcements, educational and other opportunities.

American College of Rheumatology (ACR)
http://www.rheumatology.org
1800 Century Place, Suite 250
Atlanta, GA 30345-4300
Phone: (404) 633-3777
Fax: (404) 633-1870
ACR is the professional organization of rheumatologists and associated health professionals; including psychologists, practicing physicians, nurses, research scientists, physical and occupational therapists and social workers. They focus on healing, preventing disability and curing over 100 types of arthritis and related disabling, sometimes fatal, disorders of the bones, muscles and joints. Visit their Patients and Public section online for educational, assistance and other information and articles.

American Pain Foundation
http://www.painfoundation.org/default.asp
201 N. Charles Street, Suite 710
Baltimore, Maryland 21201-4111
Toll-Free: 1-888-615-PAIN (7246)
The American Pain Foundation is a nonprofit information resource and patient advocacy group. They help people with pain. Their mission is to improve the quality of life of people with pain by providing practical information for patients, raising public awareness and understanding of pain, and advocating against barriers to effective treatment. Subscribe to their print and online newsletters; back issues are archived online. And check out their online resource library with a specific section on arthritis and their free online Pain Action Guide.

Arthritis Foundation
http://www.arthritis.org
P.O. Box 7669
Atlanta, GA 30357-0669
(800) 283-7800
The Arthritis Foundation works to improve lives through leadership in the prevention, control and cure of arthritis and related diseases. They supports the more than 100 types of arthritis and related conditions with advocacy, programs, services and research. And they provide large number of community-based services including: grant opportunities,
self-help courses, water and land-based exercise classes, support and home study groups,
instructional videotapes, public forums, free educational brochures and booklets, a national, bimonthly consumer magazine Arthritis Today, and continuing education courses and publications for health professionals. Join in their online communities, learn about upcoming events and programs and more.

Centers for Disease Control and Prevention (CDC), National Center for Chronic Disease Prevention and Health Promotion, Arthritis Division
http://www.cdc.gov/nccdphp/arthritis/index.htm
1600 Clifton Rd, Atlanta, GA 30333, U.S.A
Tel: (404) 639-3311 / Public Inquiries: (404) 639-3534 / (800) 311-3435
The organization mentions lists arthritis in “The Nation’s Leading Cause of Disability” section. Check out their health communications, state-funded programs and research. Check out their most recent statistics on arthritis. Sign up for their free email alerts in English or Spanish.

Hospital for Special Surgery &
Division of Rheumatology, Hospital for Special Surgery
http://www.hss.edu
http://rheumatology.hss.edu
Hospital for Special Surgery
535 East 70th Street
New York, NY 10021
Phone: (212) 606-1000
The Hospital for Special Surgery specializes in orthopedics, rheumatology, and rehabilitation in the United States. The Division of Rheumatology of The Hospital for Special Surgery features patient care, clinical training research methodology and community programs to educate and assist patients. They are specialists in joint replacement and share up-to-date medical musculoskeletal information to patients, physicians and caregivers. Check out their online listing of Conditions and Treatments in alphabetical order, in text, video and audio files, all available at the click of your mouse.

Johns Hopkins Arthritis Center
http://www.hopkins-arthritis.org
Johns Hopkins Bayview Medical Center
5501 Hopkins Bayview Circle
Baltimore, Maryland 21224
Phone: (410) 550-2400
FAX: (410) 550-5601
The Johns Hopkins Arthritis Center provides a easy-to-navigate, top-quality, interactive, educational site about arthritis, focusing mainly on rheumatoid arthritis and osteoarthritis.
Click and Ask the Expert questions, communicate on their message board, head to the drug corner for the latest Drug Information Sheets, and more.

National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS)
http://www.nih.gov/niams
National Institutes of Health
1 AMS Circle
Bethesda, MD 20892-3675
Phone: (301) 495-4484 or (877) 22-NIAMS (226-4267) (free of charge)
TTY: (301) 565-2966 / Fax: (301) 718-6366
This group is a clearinghouse for information about forms of arthritis and rheumatic disease and bone, muscle and skin diseases. They distribute patient and professional education materials and refer people to other sources of information. Get help in English or Spanish about arthritis health topics, patient studies, outreach programs, their coalition members, press releases, upcoming events and publications.

Physical Therapy
– Check with your healthcare provider about finding a physical therapist to help with various exercises based upon your diagnosis.
Stress Management Techniques – Regardless of arthritis, 70- to 90-percent of the general population reports being stressed, which can sure add to pain and ill health issues. So prevention and self-care are in order. Here are many ways to deal with stress:
Assertiveness Training – For some reason, especially if others are older than you, at the mention of arthritis, people can try to minimize what you’re going through, thinking they are older and you shouldn’t be complaining about your “aches and pains.” Well, tough. Age has nothing to do with arthritis or your pain. And others may get caught up in their own lives too much from time to time to notice, but you are important. And so is your health and your pain relief. So take charge and take care of yourself. Learn to say “no” to unhealthy activities that strain your joints. Slow down and use aids where you to need to like grips in the stairways, a walking cane or athletic shoes instead of heeled dress shoes. Your health and pain relief is very important.
Coping Skills Training - Learn to cope better by improving three areas: your thinking, behavior and lifestyle. Thought-wise, start thinking more about the positives instead of negatives. For example, there are many more treatment options available today for arthritis. And that’s a very positive ideology to focus on. For help with more, check our positive thinking inspirational nonfiction from the library. And be a volunteer for those less fortunate than you are to get a different perspective on life.
Behavior-wise, get more organized. Allow time to plan, shop for and prepare your meals and menus. Allow time for activities, exercises and other self-care necessities. Use a planner or notebook and pencil to jot down daily goals and things to do so that they get done. And do allow time for venting and sharing your frustrations with a close friend. Work in humor whenever possible to lighten the load and make life more enjoyable. And Plan fun things into your life; trips, hikes, etc. And lifestyle-wise, shuffle some of these into your routine:
- Pet Therapy - get a animal companion
- Meditation - take a time out
- Deep Breathing - stand and focus on your feet pressing the floor, grounding you
- Pace - go at it for awhile back and forth
- Leisure - read a good book, hum, just do nothing…
- Rest – sleep or take a quick nap or just rest
- Nature – Take a hike, stop and smell the roses
- Hydrotherapy: Enjoy a soothing, warm or hot bath with your favorite bubbles or oil(s) added. Dim the lights, light a candle, play soft music….
- Music Therapy – Enjoy soothing tunes in your favorite lounge chair, on the porch, in the bath, resting in bed.

Yoga
– Yoga has helped arthritic patients with improving confidence, mood, self-awareness, range of motion, relaxation, blood circulation, concentration, stress and pain reduction, health of bones, tendons, muscles and joint ligaments. Classes and instruction are often offered at health and fitness centers; check out public library resources, too (books, videos, audio cassettes, DVDs, etc.) Not much is required to begin: pillows and a mat, some type of blanket or carpet piece for padding and comfort. “Let’s Do Yoga,” an article by Christina DiMartino published in Arthritis Today, mentions six basic yoga positions that offer a wide range of benefits (don’t perform any that cause strain and remember to confirm with healthcare provider):
Mountain Pose – This position is for helping develop posture. With feet a comfortable distance apart, legs and knees straight, stand and distribute weight evenly, tightening thigh muscles. Keep pelvis in a neutral position, not arching the back, not leaning forward, and expand ribcage by opening chest and shoulders. Hold head comfortably straight with arms loosely hanging at your sides, body vertically aligned.
Child Pose – This position is for help with stretching the back and neck, and for stomach stress, for improving digestion. Begin by sitting in a chair, draping your torso over your knees. After strength and endurance build over time, gradually extend this position by
sitting on bent knees with feet and toes straight behind you, and spread knees wide enough to allow the torso to fall forward between your legs. Gently release tension by inhaling and exhaling slowly, falling forward, using pillows and blankets for padding and support.
Down Dog Variation – This position is for alignment, balance upper and lower body strength and flexibility. In a standing position, with feet parallel and straight beneath the hips, pointed forward, face a wall. Point knees straight ahead, bend them slightly and place your hands against the wall, slightly higher than your shoulders, shoulder-distance apart. Gently drop your head forward till the ears are between the elbows, while pressing with your arms and pushing back with your hips.
Cat-Cow - This position aids in stress reduction, increasing circulation and range of motion in the spine. With hands and knees shoulder-length apart, squat down on all fours.
Breathe in slow, steady and deep while gently arching the back, tilting the pelvis upward, and stretching the neck and head forward. Exhale while tucking the head. Repeat, focusing on movement and breathing coordination.
Reclined Twist – This position stretches and opens the hip joints, massages the sacral area and back, and stretches the spine. In bed or on your mat or blanket, lie on your back with knees bent and feet flat. Lift hips, shifting them slightly to one side, and place knees one on top of the other, falling in the opposite direction of your hips as you inhale. Exhale, turning the head opposite the knees. Wait 30 to 60 seconds, then release. Then raise knees back to the center and stretch in the opposite direction, using other side. Tip: Beginners may want to extend one leg at a time and bend and twist the other.
Deep Back Rest – This position is to help with relaxation. Usually the final pose in yoga classes and performed in bed before sleeping, it aids in mind and body relaxation. Flat on your back with feet comfortably apart and facing out, place arms a comfortable distance from the body. Face palms whichever way are most comfortable for your wrists. And dim lighting or place something over your eyes.
Some people combine their favorite soothing music or sound tracks, like nature or ocean sounds, with the positions. And some vary lighting colors, depending upon the season and their mental and physical health. For more techniques and information, check with additional resources from your public library and medical clinics.

Dietary & Exercise Planning
– Consult your healthcare provider for guidelines, recipes and menus to help establish a tailor-made diet and exercise plan. If there are other family members with you, make sure to include them in your plans so that there is less stress regarding food decision-making at mealtime. Ask about any vitamins and other supplementary items as well.
Activity – Plan regular physical activity on a daily basis. This is for the rest of your life, too, not just to lose 10 lbs, then stop. So plan accordingly, keeping in mind your monthly budget, seasonal weather changes, any equipment and attire needs, etc. Planning ahead avoids the stress of the unexpected; for example, on rainy days when you can’t go jogging or walking. Instead, with advanced preparation, you can simply pop in an exercise video or cassette, borrowed from the public library for that month. Keep a journal and note your progress and see which type activities you like best, which make you feel better and which help you with your overall health plans that may include weight loss or maintenance, and just getting out for some fresh air and sunshine.
Heat / Cold – Alternate with hot and cold packs to help with any pain and stiffness that tries to pop up. (When alternating, allow body temperature to return to normal before switching pack treatments.) And nice hot showers or baths in the morning go a long way in helping loosen up those morning muscles and joints.
Pain Relievers - Check with your healthcare provider for any over-the-counter and
prescription pain relief medications and ointments that may be available to you. Then have supplies on hand. Search online for discounted rates, coupons and specials. Better an ounce of prevention than… running to the store while suffering painful joint problems on a cold, snowy morning for some Tylenol.
Ultrasounds – Check into the possibility of having an ultrasound via your healthcare provider or a physical therapist. An ultrasound is a recommended method of helping with pain reduction in an easy, painless manner. Sound waves are sent or generated into the area joint region in pain.
TENS Treatment - Transcutaneous Electrical Nerve Stimulation or TENS for short, is another pain-free alternative to pain relief. In a nutshell, light electrical pulses travel via a tiny TENS unit or device, resulting in a vibrating or tapping sensation, to nerves in the painful joint area. Ask your healthcare provider for more information.
Fashion – Forget about focusing on fashion and leaving safety behind. Instead opt for comfortable shoes like a tennis shoe that offers good support. Focus on comfort; so that you can move your toes around a little; rubber soles to help from slips and falls; and low heels to prevent undue stress on knees.
Journal – Keep a journal. Don’t be afraid of misspelling words or lousy handwriting. Just be free to jot down your feelings, progress, thoughts, good days and bad. Add stickers and use colored markers or pencils to be more creative. And note any questions you may have, maybe list them at the end of the journal, so that you can take the journal along on medical appointments and ask your healthcare provider.
Safety – Don’t worry what others think or say here. If you need and can have safety bars installed and other safety equipment in your home, bathroom areas especially, good for you. Focal points include: safety bars for tub and shower areas, stairways (indoor and out), walkways / driveways that ice up during wintertime and any swimming areas.
Network – Team up with a fellow arthritis sufferer or two and meet for walks, chat breaks and fun. Cyber-buddies are great, too. With your favorite search engine, surf for arthritis forums and reach out to meet new people, find new resources to share and more.
Get up and Garden – Multiple rewards here! You enjoy this fun outdoor activity and benefit from healthy sunshine and exercise. You’ll harvest plant, fruit and /or vegetable crops to enjoy, share, sell for extra income, donate and leave for local wildlife.
Take Breaks – Especially if your job involves a lot of sitting, get up and stretch your legs every 30 minutes or so. Shake out the stiffness.
Wrist Aids – If you’re at a keyboard all day, check out the latest wrist rests for your keyboard.
Massage – Treat yourself to a massage to relief painful stress. Arthritic patients have found that massage therapy and gentle stretching helps to relieve pain, relax muscles, reduce swelling and aid in range of motion in joints. No funds available? Check out a library book on how to give yourself a message. Here are some basic guidelines.
For osteoarthritis:
Gently massage around the painful area with a little vegetable oil or massage oil on your fingertips, making small, gentle circles with your fingertips. Avoid massaging directly on the joint. Instead, work right above and below it with your fingertips. Repeat daily for three to five minutes each time.
For rheumatoid arthritis:
Apply oil or cream to your fingers and use a rhythmic or effleurage massage on the muscle and tissue around the afflicted joint. Repeat daily for five to 10 minutes each time.

ARTHRITIC PREVENTION & SELF CARE

To help with the prevention and relief of arthritis, prescribe a proactive plan for yourself. Take charge of your lifestyle and see where improvements can be made, like with regards to any of the following, listed in no particular order of importance or affect.
Acupuncture / Acupressure - Acupuncture or therapeutic ‘needle piercing” is the insertion of fine needles into the skin in order to stimulate targeted places in the body, referred to as acupoints. Along with the needles, the acupuncture practitioner also generally applies any of the following to stimulate the points; suction, friction, heat, pressure or electromagnetic energy impulses. The treatment goal is to stimulate the acupoints in order to balance the body’s movement of energy (qi) and restore health. Ask your healthcare provider for practitioner referrals or look in directories under holistic services.
Acupressure, also referred to as Relief with Fingertips, is similar to acupuncture, but uses the hands for healing technique instead of needles and other devices. Depending upon the afflicted area and type of arthritic condition, a combination of knuckles, fingers, thumbs and palm massage techniques are use in the surrounding areas. Note that traditional Chinese described four types of arthritic conditions that work alone or in combinations; wind, cold, heat and damp:
Wind – Presents itself in the body with moving aches and pains that are worsened by the wind.
Cold – Presents itself with swollen and painful joints sensitive to fog, rain and high humidity conditions.
Heat – Presents itself in areas reddish in color and inflamed; may feel hot when touched.
Damp – Presents itself with aches during colder, decreasing temperatures and storms, i.e. extreme weather changes.
Consult your healthcare provider for practitioner referrals or look in directories under holistic services for charts and more information.
Aromatherapy – Aromatherapy or “treatment using scents,” is another holistic treatment used by some arthritic sufferers for pain relief, skincare and revival, rejuvenation and stress management. Treatment focuses on using pleasurable aromatic botanical oils by either massaging them into the skin, adding them to the bath water, inhaling them directly or diffusing their scents into the surrounding environment. The oils have been known to affect moods, help with relaxation, lessen or end fatigue and anxiety, and help the brain and nervous system via olfactory nerves stimulation when inhaled.
Aromatherapy is reportedly one of the fastest growing fields in alternative medicine, used in home, clinical and hospital environments for pain and stress relief.
Aromatherapy treatments for arthritis vary and essential oils used can include:
Cinnamomum Camphora (Camphor)
Cupressus Sempervirens (Cypress)
Eucalyptus
Ginger
Hhyssopus Officinalis (Hyssop)
Juniperus Communis (Juniper)
Lavandula Officinalis (Lavender)
Matricaria Chamomilla (Chamomile)
Rosmarinus Officinalis (Rosemary)
Styrax Benzoin (Benzoin)
Recipe for Arthritis Aromatherapy:
Add six drops each of rosemary and chamomile oils to four ounces of a base oil like almond, avocado, sesame or soybean. Massage oil into sore arthritic joints. For added pain relief, relax for about 10 minutes in a warm tub of water in which ten drops each of rosemary and chamomile oils are added.

Other Aromatherapy Oil Applications:
- Mix oil with hot water and inhale the vapor that rises from the bowl.
- Add the oil in with a base oil and massage arthritic areas.
- Lightly dab and wear as a cologne or perfume
- Add to bath water