Jennifer Pratt

ENG 101

Prof. Kerr

Dec. 4, 2003

I. Overview of the DiseaseA. What is it?B. What causes it?C. What are the symptoms?D. How is it diagnosed?E. Who is at risk?II. Effects on a JointA. Anatomy of a jointB. Effects of the diseaseC. Systemic effectsIII. EducationA. PlanningB. Emotions and stressC. QuackeryIV. TreatmentA. How to prevent disability and preserve joint functionB. CAM methodsC. Pharmacological optionsD. Surgical options

●autoimmune disease

●affects 1% of population

●chronic, systemic, inflammatory

●adverse effects on joints

●psychological, social, and financial effects

●Viral Infections

●Genetics

●Weakened Immune Systems

●loss of appetite

● fever

● energy loss

● anemia

● side-effects in other parts of the body

● joint swelling and painful movement

● development of rheumatoid nodules on or close to the joints and other joint deformities

Criteria

●morning stiffness

● arthritis in three or more joint areas

● symmetric arthritis

● presence of rheumatoid nodules and rheumatoid factor.

Doctors analyze all symptoms, medical history, and lab tests and do a physical examination and radiograph testing. Specialists consider a white-blood cell count and a complete blood-cell count

●Usually found in adults between the ages of 40 and 60.

●Women are affected three times as much as men.

●Children can be affected in the most damaging ways.

●Rheumatoid arthritis has the potential to affect people of any age, and the severity of the disease varies among them.

● joint capsule that separates the joint from surrounding tissue

● cavity formed by the capsule

● a synovial membrane that lines the inside of the cavity

● synovial fluid that lubricates the joint.

● bones and cartilage that are joined together.

Effects on the Joint

●synovial lining cells begin to multiply and grow to form a diseased tissue called pannus

● synovial fluid that is supposed to lubricate the joints also undergoes a transformation

● Digestants form in the fluid, and they attack surrounding tissues as well

● the main components of the joints are altered, they are unable to perform their original joint-preserving functions

● pathology of the nervous system - leads to sensory loss

● Eye lesions or dry eyes

● skin problems (fragile and bruise easily)

● Lung disease and other cardiopulmonary disorders

● Major body organs such as the spleen and lymph nodes may also be affected as a result of RA

Planning

●Patients experience good and bad days.

● patients and family work closely with a physician to obtain a complete understanding of the disease and its nature.

● all activities and rest periods should be planned

● disease could flare at any time due to overworking the joints or extreme physical stress

● Rest cannot be overemphasized.

● Patients may find that they become fatigued easily

● After any period of vigorous activity, a rest period should be planned

● When sleeping, position changes should be in two hour intervals.

Emotions, Stress, and Quackery● relationship between emotions and exacerbations● stress, such as sporting events and driving in bad whether ● devices and gizmos that claim to cure arthritis ● vitamins and other pills will make a patient disease-free.

Preventing disability and preserving joint function● plan exercise and develop a routine to help maintain joint function ● Range of motion (ROM) can be preserved through careful evaluation and a healthy exercise program. ● A common type of exercise, Isometric, targets specific muscle groups while avoiding joint motion. ● schedule regular check-ups with their doctor and discuss any concerns openly so that the doctor can best evaluate their condition.

Symptomatic treatment

● applying direct heat to an area of swelling or stiffness

● There is no evidence that these methods alter the progression of the disease in any way.

● hot packs, paraffin wax, heating pads, and whirlpool baths.

● cold packs as an alternative to heat therapy.

CAM Methods (Complementary and Alternative Medicine)

● herbal treatments

● vitamins

● minerals

● ointments

● magnets and copper bracelets

● Diets

● praying

● meditation and relaxing activity

Pharmacological Options● NSAIDs (nonsteroidal anti-inflammatory drugs) reduce joint pain and swelling, but they do not affect the progression of the disease. ● relieve pain and inflammation. ● DMARDs (disease-modifying antirheumatic drugs) are the basis for most RA treatments due to their reputation for impeding joint destruction. These drugs should be implemented into a combination therapy immediately after diagnosis because joint deterioration begins early on. The patient and physician should make a decision about which DMARD to use based on the severity of the disease. Surgical Options● Tenosynovectomy will remove the tendon sheaths. ● Synovectomy is performed to remove diseased parts of the synovium before any cartilage destruction takes place. ● Joint arthoplasty involves the replacement of the joint end with man made parts called prosthesis. ● Arthrodesis, a surgical fusion of the bone, has proved very effective in patients with wrist pain.