TAKINGCARE

of your

POCKET GUIDE

Use this g u i d e for info on caring for rheumatoid arthritis, to organize your data and as a quick resource.

TABLE of CONTENTSDEFINITIONS AND DIAGNOSIS1

MY CONTACTS6

RA MYTHBUSTING8

MY TREATMENT PLAN9

MANAGING MEDICATIONS1 3

DAILY MEDICINE SCHEDULE1 5

WHEN SURGERY IS NEEDED1 7

FIGHTING FATIGUE1 8

STAYING ACTIVE1 9

MY EXERCISE CHART2 2

RA AND NUTRITION2 4

MY HEALTHY SHOPPING LIST2 6

COPING AND SUPPORT2 7

DEALING WITH DEPRESSION2 9

THE FUTURE OF RA RESEARCH3 0

NOTES3 1

RESOURCES

DISCLAIMER. This book provides general information about rheumatoid arthritis and related issues. The information does not constitute medical advice and is not intended to be used for the diagnosis or treatment of a health problem or as a substitute for consulting with a licensed health professional. Consult with a qualified physician or health care practitioner to discuss specific individual issues or health needs and to professionally address personal medical concerns.

TAKING CARE OF YOUR RHEUMATOID ARTHRITIS

1

D E F I N I T I O N S AND D I A G N O S I S

WHAT IS RHEUMATOID ARTHRITIS (RA)?RA is a chronic (long lasting) health issue that affects the small joints in the hands and feet, causing pain and swelling. The disease can progress and cause deformity and stiffness in the hands, wrists, fingers, feet and ankles.

Anyone can get RA. It seems to affect women more than men, starting in middle age and is common in older adults. Cases of RA in children and young adults are rare but possible.

RA BY THE NUMBERSRA BY THE NUMBERS0.5%-1%Approximate

percentage of adults with RA throughout

the world

2-3Number of times

more likely a woman will develop RA over

a man

45-65Peak age

of RA onset

0.5% 2-3 45-65

RA Q & A

Q: What causes RA?A: Doctors don’t really know the exact causes.

With this type of arthritis, a person’s body tissues are attacked by his or her immune system. Researchers don’t quite know how and why this happens but are learning more all of the time. There is hope for a cure or prevention in the future.

Possible causes for RA:

Genes (passed to a child from a parent)

Environment

Hormones

-1%

RA DEFINEDRA DEFINEDRheumatologist A doctor who specializes in problems of

the joints, bones and muscles.

RISK FACTORSSex

Women are more likely to develop RA.

Age While RA can occur at any age, it commonly starts between the ages

of 40 and 60.

Family history If a member of your family has RA, your risk of the disease may be greater.

DIAGNOSISDYou r fa m i l y d o c t o r o r rheumatologist can diagnose RA. This can often be hard to do because there isn’t a standard test for RA. The symptoms may be similar to other joint diseases and may take time to develop in full. In order to diagnose the disease, your doctors will use:

Your medical history

A physical exam

X-rays

Lab tests

Unlike other forms of arthritis, RA affects the lining of the joints. The result is painful swelling that can lead to worn down bones and deformed joints. In time, permanent damage to the joints may take place.

SIGNS AND SYMPTOMSFatigue

Joint pain and tenderness

Joint swelling

Joint redness

Joint warmth

Firm t issue bumps under the skin of the arms

Fever

Joint stiffness, worse in the morning

Weight loss

Early RA diagnosis and treatment can lessen the risk of permanent joint damage.

IAGNOSIS

2

3

RA REVEALEDRA is a risk factor for heart attacks. Those with active RA, even those without high cholesterol, high blood pressure or diabetes are two to three times more at risk for heart attack.

WHAT TOWATCH FORRA increases your risk of developing:

Osteoporosis: Along with some meds used to treat it, RA can increase your risk of osteoporosis. This condition weakens bones and makes them more likely to fracture.

Carpal tunnel syndrome: If your RA affects the wrists, the swelling can squeeze the nerve that serves most of your hand and fingers.

Heart problems: RA can increase your risk of hardened and blocked arteries, as well as swelling of the sac that surrounds the heart.

Lung disease: Those with RA have a greater risk of swelling and scarring of the lung tissues. This can lead to shortness of breath and other breathing difficulties.

RA BY THE

NUMBERS

RA BY THE

NUMBERS

2.5Percentage of increase in RA cases in women

between 1995 and 2007, according to

Mayo Clinic research. Rates of RA cases among men during that time actually

dropped.

2.5

FIND OUT MOREHealthline:What Do You Want to Know About Rheumatoid Arthritis?healthline.com/health/rheumatoid-arthritis

http://www.healthline.com/health/rheumatoid-arthritis

YO U R F I RS T D O C T O R V I S I TIf you think you may be suffering from RA, schedule an appointment with your doctor. Fill out this form and take it with you to the visit.

Detailed description of symptoms:

Past medical problems:

Medical problems of parents or siblings:

4

5

Medications and dietary supplements taken:

Questions to ask the doctor:

Be ready to answer these questions your doctor may ask you:When did your symptoms begin?Have your symptoms changed over time?Which joints are affected?

Does any activity make your symptoms better or worse?Are your symptoms interfering with daily tasks?

During the exam, your doctor will check:

Joints for swelling, redness and warmth

Your reflexes

Your muscle strength

Blood testsA blood test may show the presence of an inflammatory process in the body, as well as look for certain antibodies. Antibody tests show up negative in 20 percent of cases.X-rays

X-rays can help track the progression of RA in your joints over time.

FIND OUT MOREWebMD: Diagnosing Rheumatoid Arthritiswebmd.com/rheumatoid-arthritis/guide/diagnosing-ra

http://www.webmd.com/rheumatoid-arthritis/guide/diagnosing-ra

6

MY CONTACTSMY CONTACTSMEmergency Contacts

Emergency response: 911

Name:

Relationship:

Cell Phone:

Home Phone:

( )( )

Name:

Relationship:

Cell Phone:

Home Phone:

( )( )

MedicalMy General or Family Doctor:

( ) Phone:Rheumatologist:

( )

Phone:

Other specialist:

Phone:

Hospital:

( )

( )Phone:Health Insurance Provider:

( )Phone: Website:

Case Manager:

( )Phone:

Y CONTACTS

7

MY CONTACTSMY CONTACTSMY CONTACTS

Other Professional Contacts

Name:

Service/Function:

Phone: ( )

Name:

Service/Function:

Phone:

( )

Name:

Service/Function:

Phone: ( )

Family Members

Name:

Phone: ( )

Name:

Phone: ( )

Name:

Phone: ( )

Name:

Phone: ( )

Name:

Phone: ( )

8

RA MYTHBUSTINGRA MYTHBUSTINGRA MYTH BUSTED!Rheumatoid arthritis is the same as regular arthritis.

RA is a chronic, progressive autoimmune disorder. Osteoarthritis–what we consider “regular arthritis”–is caused by injury to aging joints. With RA, the body makes antibodies that attack its own tissues. These attacks are known as flare-ups.

Only old people get RA.

The disease begins between the ages of 30 and 55 for most people with RA. It’s the peak group, but anyone can get RA.

Most people with RA end up in a wheelchair or nursing home due to the disease.

RA can be different for different people. Most will go on to live independently. The disease can progress and cause disability, but most people with RA these days do well with staying mobile and on their own.

RA isn’t that serious of a disease.

If it’s not treated in the right way, RA can be a threat to your health and mobility. When diagnosed quickly, a regular treatment plan can protect the joints from further injury. Long-term function and mobility for years to come is more likely for those who don’t wait to get treatment.

Having RA means you can’t work.

You may need to change or adapt some work tasks, but an RA diagnosis doesn’t equal lifetime disability. You may have to limit activities during flare-ups but most people with RA continue to work.

Most people with RA get cancer, too.

Those with RA are at slightly higher risk for developing lymphoma, but the overall risk is low.

Rest is best for painful, stiff joints for those with RA.

Joints feeling the pain and tightness of RA need stretching and exercise. Doctors encourage physical activity to keep joints mobile. While rest is necessary, people with RA should be moving more, not less.

9

M Y T R EAT M EN T P LA N !TREATMENT BASICSWhen it comes to treatment plans for RA, doctors have many options. Educating yourself is the first step in taking care of your RA. With your health care team you’ll be able to learn about:

Treatment optionsTypes of exercises to doRelaxation and stress relief techniques

How to talk to your doctorsProblem-solvingSupport groups

Education programs will help you learn about RA, lessen the pain, cope with the physical demands and the emotions, feel more in control and become more confident.

The goals of treatment are to:Reduce the painBring down swellingStop or slow down damage to the joints

Help people feel betterHelp people stay active

The overall goal is of course to lead a full and active life. Know your disease. Know your treatment plans. Know yourself. It all adds up to a better life.

TREATMENT OPTIONSTLifestyle changesA harsh reality of living with RA is the fact that you’re going to have to make some changes to everyday routines in order to cope with the demands of the disease.

Work exercise into your daily routine

Get enough rest

Take care of your joints

Find ways to lower stress

Focus on eating a healthy diet

If these things have not been part of your lifestyle, it will be necessary to change your routine and make them a priority each day.

REATMENT OPTIONS

10

MedicineThere is no cure for RA. Medications can ease the swelling in your joints. This will lessen pain and stop or slow down any damage to the joints. A lot of drugs that treat RA can have serious side effects. Doctors will most often first prescribe meds with the fewest side effects. You may need stronger drugs or a mixture if your condition gets worse. See the MANAGING MEDICATIONS SECTION for more details.

SurgeryPeople suffering from severe joint damage may seek out one of many kinds of surgeries. Surgery is used to:

Lessen the pain

Help an affected joint work better

Make daily activities possible againKnow that surgery is not always the best treatment method. You may or may not be a candidate for surgery. Only your doctor can make that determination. Talk with him or her about surgery options.

Regular doctor visitsSeeing your doctor on a regular basis will help track the progress of the disease. Doctors can also watch for side effects and change treatment when it’s needed. Your visits may include x-rays, blood, urine and other lab tests to fully diagnose and assign proper care for the disease.

RA REVEALEDSmoking may trigger RA. Research has shown that smoking can play a part in as many as a third of all severe RA cases.

EXPLORING THE ALTERNATIVESSome people use special diets, vitamins and supplements or other alternatives to treat their RA.Medication prescribed by your doctors is the best way to battle RA. While alternative therapies to augment regular RA treatment may not be well tested or proven to be affective, many of these natural ways help people ease stress. Always talk with your doctor before starting an alternative treatment program.These other therapies may benefit you.

EXERCISE RA causes you to use your joints in ways that add stress to other body parts. Therefore, it is important to stay flexible and strong with regular exercise.

PHYSICAL THERAPY

Physical therapy may help heal and strengthen a body part weakened by RA, or an area that’s causing you problems. To ease swelling and get people back in shape, physical therapists use:

HeatIce

Electrical stimulationRange-of-motion exercisesStrengthening moves

This short-term plan might have you going for treatment a few times a week for a few weeks until you feel better.

OCCUPATIONAL THERAPY

Occupational therapists help patients figure out problem areas during daily activities. They then come up with plans of action to deal with these problems. These therapists can modify your work area and habits in order to deal with pain and discomfort and to avoid injuries.

MIND-BODY THERAPIES

These therapies help you use your mind to make your body feel better. Meditation, biofeedback, breathing exercises, and guided relaxation, as well as exercises such as yoga and tai chi can help you focus your mind. This is often helpful when coping with pain, and can make strength and flexibility better.

COUNSELINGBehavioral psychotherapy can help people identify problems in the way they think and act. It encourages them to change their behavior and can be helpful for those with RA who suffer from depression. Counseling can also help you cope with the daily stresses of chronic illness.

11

HOT AND COLD TREATMENTS

Heat is one of the best and most basic home cures for RA relief. A hot bath or shower can help relax you and soothe joint and muscle pain. Alternating hot packs with cold packs can give you quick and lasting relief. A member of your health team can teach you how to use heat and cold safely.

ACUPUNCTURE This is the ancient Eastern healing art of stimulating points in the body by sticking in thin needles and leaving them in place for a while. Only a few studies have shown that acupuncture can help with RA symptoms. Many people swear by it. Unless the thought of needles piercing your skin bothers you, it might be worth a try.

REST If you have RA, it’s crucial that you don’t do too much. Take a rest whenever you need it. Pushing yourself too hard will make the fatigue even worse.

EXPLORING THE ALTERNATIVES

12

MY TREATMENT PLAN WILL INCLUDE:

FIND OUT MORENIH: Rheumatoid Arthritis and Complementary Health Approachesnccih.nih.gov/health/RA/getthefacts.htm

http://nccih.nih.gov/health/RA/getthefacts.htm

M A N A G I N G M E D I CAT I O N SMost people with RA take some form of medication to treat the disease. These drugs are used to:

Take away pain

Lessen the swelling

Stop the disease from getting worse

RA MEDICATIONS CHARTR

13

WHAT THEY ARE WHAT THEY DO SIDE EFFECTS

NSAIDsNonsteroidal

anti-inflammatory drugs (ibuprofen, naproxen sodium)

Take away pain

Ease swelling

Ringing in the ears

Stomach irritation

Heart problems

Liver and kidney damage

SteroidsCorticosteroid

medications such as prednisone

Reduce inflammation and

pain

Slow joint damage

Thinning of bones

Weight gain

Diabetes

DMARDsDisease-modifying

anti-rheumatic drugs (methotrexate

and others)

Slow the progress of RA

Save joints and other tissues

from permanent damage

Liver damage

Bone marrow suppression

Biologic agents(A newer class of

DMARDs)

Target parts of the immune

system that trigger inflammation that cause joint and tissue damage

Liver damage

Bone marrow suppression

A MEDICATIONS CHART

Your doctor will determine what drugs to prescribe based on:

Your general health

How serious your RA is

How serious your RA may become

How long you’ll have to take the drug

How well the drug works

The drug’s possible side effects

SIP WITH SAFETYSince some drugs that treat RA can be harmful to the liver, drinking alcohol is not advisable for people with RA. But research shows that people who drink alcohol run a lower risk of developing RA than those who don’t. Some medical experts suggest that one drink a day for women and one to two for men may lessen the risk for developing RA.

CAUTION: Make sure the alcohol doesn’t interact with other drugs. With some RA drugs, there is no safe amount of alcohol. Ask your doctor first.

FIND OUT MOREDrugs.com: Rheumatoid Arthritis Medicinesdrugs.com/condition/rheumatoid-arthritis.html

14

http://www.drugs.com/condition/rheumatoid-arthritis.html

15

ROTATE ME!D

AILY

ME

DIC

INE

SC

HE

DU

LE

Use this page to keep track of your m

edicines and when you take them

. Enter the name of the

medicine in the first colum

n and put a check mark in the b

oxes for the time(s) you take that

medicine each day. K

eep this chart with you w

hen you travel and go to doctor appointm

ents.

MED

ICIN

E

BEFO

RE

BR

EA

KFA

STEnter tim

e:

WIT

HB

REA

KFA

STEnter tim

e:

BEFO

RE

LUN

CH

Enter

time:

WIT

H

LUN

CH

Enter

time:

BEFO

RE

DIN

NER

Enter

time:

WIT

HD

INN

ER

Enter

time:

BEFO

RE

BED

TIM

EEnter

time:

AT

BED

TIM

EEnter

time:

DU

RIN

GN

IGH

TEnter

time:

ROTATE ME!D

AIL

Y M

ED

ICIN

E S

CH

ED

UL

EU

se thi

s pa

ge to

kee

p tr

ack

of y

our m

edic

ines

and

whe

n yo

u ta

ke the

m. E

nter

the

nam

e of

the

m

edic

ine

in t

he f

irst

col

umn

and

put a

chec

k m

ark

in t

he b

oxes

for

the

tim

e(s)

you

tak

e th

at

med

icin

e ea

ch d

ay. K

eep

this

cha

rt w

ith

you

whe

n yo

u tr

avel

and

go

to d

octo

r ap

poi

ntm

ents

.

16 MED

ICIN

E

BEFO

RE

BR

EA

KFA

STEnt

er t

ime:

WIT

HB

REA

KFA

STEnt

er t

ime:

BEFO

RE

LUN

CH

Ent

er

tim

e:

WIT

H

LUN

CH

Ent

er

tim

e:

BEFO

RE

DIN

NER

Ent

er

tim

e:

WIT

HD

INN

ER

Ent

er

tim

e:

BEFO

RE

BED

TIM

EEnt

er

tim

e:

AT

BED

TIM

EEnt

er

tim

e:

DU

RIN

GN

IGH

TEnt

er

tim

e:

WHEN SURGERY IS NEEDEDWHEN SURGERY IS NEEDEDWHEN SURSometimes medicine alone can’t slow the damage to joints caused by RA. If that’s true of your condition, you and your doctor may think about surgery to fix the damage. Surgery may restore the use of the joint, as well as easing pain and fixing deformities.

RA surgery types:

Total joint replacement: As u r ge o n r em ove s t h edamaged parts of the jointand puts in a metal andplastic prosthesis.

Tendon repair: A surgeonmay be able to repair theloose or ruptured tendonsaround the joint.

Joint fusion: When a jointreplacement isn’t an option, ajoint may be surgically fusedin order to stabilize or realigna joint and to relieve pain.

Surgery is not without risk.Bleeding, infection and pain canaccompany the procedure. Talkto your doctor about the benefitsand risks of surgery.

RA REVEALED

Geography may play a role in RA risk. Studies have shown the risk of RA grows higher the farther from the equator you live. In the US, people living in the Midwestern and Northeast states run a higher risk than those living west of the Rockies. Living in higher latitudes during ages 15-30 produces a greater risk later in life.

FIND OUT MOREEveryday Health™: Deciding on Rheumatoid Arthritis Surgeryeverydayhealth.com/rheumatoid-arthritis/rheumatoid-arthritis-surgery-decision.aspx 17

GERY IS NEEDED

http://www.everydayhealth.com/rheumatoid-arthritis/rheumatoid-arthritis-surgery-decision.aspxhttp://www.everydayhealth.com/rheumatoid-arthritis/rheumatoid-arthritis-surgery-decision.aspx

FATIGUE! FIGHTING

FATIGUE!FIGHTING

RELAX, REST, RESTORE, REPEATBecause RA affects your whole body and not just your joints, it can leave you feeling worn out and unwell. Sufferers describe the feeling as draggy, tired or like they’re dealing with the flu. Fatigue, pain and depression are traveling companions of RA. Sometimes calling a timeout to relax, rest and regain control are all you really need. For people with RA, this is mandatory.

PERMISSION GRANTEDGive yourself permission to take time off. Rest and feel better. “I need to rest now,” is all you need to tell family and friends who might not understand your need for a break. If you get mad or frustrated about it or try to ignore the fatigue, there’s a good chance you’ll make it worse.

18

DO THIS: Get enough physical activity.You normally don’t feel like exercising when you’re tired. But exercise can give you more energy. When you have RA, aerobic exercise can lessen your fatigue greatly. It also helps strengthen your muscles, bones and joints, and makes your mood better.

DO THIS: Take regular rest breaks every day.Staying in bed longer in the morning can just make you more tired. Instead, take regular breaks throughout the day. Look for some balance in your schedule. If you’re more productive in the morning, fit in an afternoon nap. Two or three brief breaks could restore the energy you need to get through the day.

DO THIS: Don’t eat heavy meals.Choose a light lunch instead. A healthy morning and afternoon snack will sate your appetite and keep you going.

DO THIS: Get a good night’s sleep each night.A busy schedule, stress, not enough time for sleep, pain, depression, caffeine, drugs and alcohol are all culprits getting in your way of quality sleep. RA pain may keep you awake or awaken you in the night. Minimize these elements and explore some sleep therapy techniques. Good nightly sleep can fight fatigue.

FIND OUT MOREHealthline: Tips and Cures for fatiguehealthline.com/health-slideshow/rheumatoid-arthritis-fatigue

http://www.healthline.com/health-slideshow/rheumatoid-arthritis-fatiguehttp://www.healthline.com/health-slideshow/rheumatoid-arthritis-fatigue

19

STAYING ACTIVETHE BENEFITS OF EXERCISETHE BENEFITS OF EXERCISEDuring an RA flare-up, exercise can be hard or even impossible. But keeping active is helpful and doesn’t have to hurt. Good exercise releases endorphins, the hormones that make you feel good. It also focuses your mind on the exercise and not your problems.

Exercise:Makes your mood betterHelps you sleep betterReduces stressEases joint pain, stiffness and swellingBoosts energy levelsMakes muscle strength and flexibility betterStrengthens bones to help prevent osteoporosisControls weightProtects against heart disease

RA REVEALEDAll women are prone to weaker bones after menopause, but it’s more common for those taking steroids to treat RA.

GETTING STARTED / GETTING MOTIVATEDGEveryone with RA can perform some form of exercise. If you’re not used to a regular exercise routine, there are small steps to start reaping the benefits.

ETTING STARTED / GETTING MOTIVATED

RA FITNESS TIPSRA FITNESS TIPSStart slowly.

Learn some stretching exercises. This will keep joints flexible with little effort.

Stay away from high-impact, intense exercising.

Set a goal. Figure out something to shoot for: Losing a few pounds, getting in shape for a certain event, walking a 5K event.

Set small targets along the way to your big goal to track your progress.

Reward yourself when you reach your goals.

S T E P 1 Talk to your doctor. Ask him or her what kinds of exercise would be best for you. The extent of your RA, your flexibility

and other conditions will inform the decision. If you’re worried about shoulder joint inflammation, for example, you may want to bike or walk instead of swim.

S T E P 2 Keep it real. If you don’t know where to begin or feel you don’t have much time to exercise, start with five minutes. The

next day, try to do a minute more, and so on. On the other hand, if you’re raring to go, be careful not to overdo it in the beginning. It’s less important where you start than where you end up.

S T E P 3 Make it easy. If getting to a gym is a hassle, work out at home or in your neighborhood. But if you like the energy

of a gym, try to find one that’s not off your beaten path. You’re more likely to stop in if you pass it every day.

S T E P 4 Get help to get going. If you can, start off with the help from a physical or occupational therapist, or a trainer who

has experience with arthritis -- don’t dive in on your own. They can teach you how to gauge your body’s response so that you don’t overdo it, end up in pain, and get discouraged.

S T E P 5 Listen to your body. Stay with your walking pace from the week before instead of ramping it up if you don’t feel

well enough. Feel free to change up the activity if you’re not feeling your best. Don’t be afraid to take a day off from exercising if you don’t feel well or your joints are sore or swollen. Choose some moves you can manage and keep moving.

20

RA Q & A

Q: What is the best exercise for RA?

A: The best exercise is the one you’ll actually do. Pick something you’re interested in trying. Make sure it won’t hurt your joints.

THE IDEAL FITNESS PROGRAM USES THESE WORKOUT TYPES:

Low- to medium-impact aerobicsSwimming, biking, walking,

aerobic dance, warm-water exercise, elliptical machinesStrength training

Light weightlifting (1-2 pounds), resistance bands

Flexibility exercisesStretching, yoga, tai chi, range-of-motion exercises

Incorporate all three to get the most bang for your exercise

buck. Always warm up and stretch before every workout.

WALKING 101WALKING 101It’s one of the simplest exercises you can do. The only gear you need is a decent pair of shoes. Look into the Arthritis Foundation’s 12-Week Walking Plan: arthritistoday.org/what-you-can-do/staying-active/walking/walking-plan.phpThis plan features weekly timelines for beginning, intermediate and advanced walkers. Starting slowly and building up to greater distances and speeds is the best way to master a regular walking plan.Finding a friend or friends to walk with can help you stay driven. Start a group and keep each other on track.

21

THE IDEAL FITNESS PROGRAM USES THESE WORKOUT TYPES:

MY FITNESS/ACTIVITY GOALS:

http://www.arthritistoday.org/what-you-can-do/staying-active/walking/walking-plan.phphttp://www.arthritistoday.org/what-you-can-do/staying-active/walking/walking-plan.php

MY EXERCISE CHARTMY EXERCISE CHART Use this chart to keep on track with your exercise routine.

Date Exercise Repetitions/Time Spent Finished

22

Date Exercise Repetitions/Time Spent Finished

FIND OUT MOREWebMD: Joint-Friendly Fitness Routineswebmd.com/rheumatoid-arthritis/patient-support-12/slideshow-ra-exercises

23

http://www.webmd.com/rheumatoid-arthritis/patient-support-12/slideshow-ra-exerciseshttp://www.webmd.com/rheumatoid-arthritis/patient-support-12/slideshow-ra-exercises

RA AND NUTRITIONRA AND NUTRITIONDIETARY GUIDELINESDIETTo promote health and keep disease away, nutrition experts suggest these general guidelines:

Eat a variety of foodsBalance food with physical activity Keep your weight at a healthy level Pack your diet with grains, veggies and fruitsStay away from foods high in fat, saturated fat and cholesterolLimit sugarsIf you drink alcohol, limit it

THE RA DIETOngoing studies seek to figure out a link between RA and diet. In the meantime, doctors urge RA patients to follow a healthy and balanced diet that leads to a healthy weight.

FOODS THAT CAN HELP FIGHT RADoctors and nutritionists recommend a diet with fish such as herring, mackerel, trout, salmon and tuna. The omega-3 fatty acids in these fish may prove to be the best anti-inflammatory in foods. Talk to your doctor about the right dosage if you choose to take a fish oil supplement.

Another way to possibly reduce inflammation is by getting more fiber from fruits, vegetables and whole grains. Fresh or frozen strawberries have been shown to benefit people with RA.

Extra-virgin olive oil may also help to lessen the inflammation that goes with RA. Use this oil as a low-fat alternative to higher fat cooking oils and butter.

24

ARY GUIDELINES

25

RA REVEALEDWhile extra-virgin olive oil doesn’t contain omega-3 fats, it does have some anti-inflammatory properties.

Many diets and fitness programs suggest a healthy diet based on plenty of plant foods, healthy fats and having fish a few times a week. This food plan has been known to help fight the risk of heart disease, high blood pressure, diabetes and weight gain. Try it for your RA. It just might help ease your symptoms.

RA Q & A

Q: I heard that fasting was a good treatment for RA.

Is it true?

A: Fasting is high-risk and not an acceptable method of treating RA. The effects, if any, are short-term, with symptoms coming back within a week of resuming a normal diet.

BEWARE OF…BEWARE OF…

Fad diets

Fast fat burning claims

Miracle cures

MY HEALTHY SHOPPING LIST

MY HEALTHY SHOPPING LIST

GRAINSGRAINS

VEGGIESVEGGIES

FRUITSFRUITS

DAIRYD PROTEINPR

FIND OUT MOREHealthline: Anti-Inflammatory Diet for Rheumatoid Arthritishealthline.com/health-slideshow/anti-inflammatory-ra-diet

26

AIRY OTEIN

http://healthline.com/health-slideshow/anti-inflammatory-ra-diet

COPING AND SUPPORT

Coping with the effects of RA is rarely easy. But working with your doctors and health care team will help you come up with a strategy for coping. Give it time and learn the strategies that work best for you.

COPING TIPSTake control: Create a plan for managing your RA with your doctor and nurse. Mastering a plan will help you feel in charge of your disease.

Know your limits: RA can bring on fatigue and muscle weakness. Rest when you’re tired. Short naps can refresh you but make sure they don’t keep you from sleeping well at night.

Make time for yourself: Block out time to do what you like. Go for a walk, read, write in a journal, listen to music. Quietly think about your feelings and unwind from stress during this time.

Connect with others. Let your family know how you’re feeling. They care, even if they don’t know how to talk to you about your pain. Find a trusted family member or friend you can talk to when you feel overwhelmed. You can also connect with other people who have RA, through a support group nearby or online.

27

28

SUPPORT GROUPSSupport groups can be helpful for people living with RA. They can make your mood better, teach coping skills and pain relief methods, ease fears and provide a forum for people with the same condition. Seek out teaching groups led by professionals and run in a more formal way. These support sessions will work to empower you and teach you useful coping skills.

Types of support groups:

Closed: Participants must be registered and have to be at all sessions.

Group therapy: Sessions are led by a mental health professional with a set purpose and time limit to reach a certain goal. Coping and relaxation skills may be taught.

Peer: Informal sessions led by fellow patients, with a focus on shared experiences.

Educational: Formal sessions that use presentations and question-and-answer periods.

Online: Internet chat sites attended by peers.

Your local Arthritis Foundation office, area hospitals and your health care team can direct you to RA support groups.

UP TO 75RA BY THE NUMBERSRA BY THE NUMBERS

UP TO 75Percentage of people with RA whose condition

goes into remission during pregnancy. After delivery, flare-ups usually come back.

FIND OUT MOREWebMD: Rheumatoid Arthritis Communityexchanges.webmd.com/rheumatoid-arthritis-exchange

http://exchanges.webmd.com/rheumatoid-arthritis-exchange

D E A L I N G W I T H D E P R E S S I O N

RA REVEALEDRA and depression go together. The pain and stress of living with a chronic illness can plainly cause depression. But high levels of an inflammatory protein linked to depression is found in RA sufferers. The good news: RA meds often block the

depression-causing protein.

BATTLING THE BLUESDepression often goes along with RA, due to the pain, discomfort, fatigue and lifestyle changes one is forced to make. People with the disease are often twice as likely to feel the effects of depression as those without it. Talk with your health care team if you think you might be depressed. Your doctors may suggest antidepressants. These can sometimes fight the depression and the fatigue. Other nondrug options—like talk therapy or counseling—can present alternative methods for battling the condition and teach you ways for dealing with the pain.

THE BAD NEWS: Depression can double the risk of deathfor those with RA. More than just a bad mood, depressioncan be downright dangerous. Your doctor may realize that

treating the depression is as important as treating the RA.

If you’re feeling sad or hopeless, tell your doctor. He or she can’t treat your depression if you don’t share the info. Your depression may be related to your level of pain. Taking away the pain may also get rid of the depression.

Counseling and antidepressants are effective in treating depression. Talk to your doctor.

FIND OUT MOREHealthline: How Do I Cope with Rheumatoid Arthritis and Depression?healthline.com/health-slideshow/rheumatoid- arthritis-depression

29

http://healthline.com/health-slideshow/rheumatoid-arthritis-depressionhttp://healthline.com/health-slideshow/rheumatoid-arthritis-depression

30

THE FUTURE OF RA RESEARCHTHE FUTURE OF RA RESEARWhile there is no cure for rheumatoid arthritis, and doctors don’t know exactly what causes it, each day researchers keep looking for answers.

RA REVEALED

RA doesn’t have a long history. There’s no evidence of the disease being around in ancient times or even during the time of Columbus’ discovery of the Americas. This suggests the disease may be environmental.

Areas of RA research:

Genetics

Immune systems

Families with RA

New drugs or drug combinations

RA and disability

Preventing related health problems

Quality of life for people with RA

Researchers keep building on what they know about the disease. They look to find cures and better treatment plans that address the pain and swelling of joints and tissues. They hope that someday the pain and suffering of RA is a thing of the past. For you and countless others.

FIND OUT MOREMedShadow: The Future of RA Treatments?medshadow.org/medshadow_blog/ looking-future-ra-treaments/

CHTHE FUTURE OF RA RESEARCH

http://medshadow.org/medshadow_blog/looking-future-ra-treaments/http://medshadow.org/medshadow_blog/looking-future-ra-treaments/

NOTES

31

NOTES

32

RESOURCESRESOURCESNational Institute of Arthritis and Musculoskeletal and Skin Diseases

(NIAMS) 877-22-NIAMS (877-226-4267)

niams.nih.gov

Arthritis Foundation®404-872-7100arthritis.org

U.S. Food and Drug Administration888-INFO-FDA (888-463-6332)

fda.gov

NIH: National Center for Complementary and Integrative Health

nccih.nih.gov

American Academy of Orthopaedic Surgeons (AAOS)

aaos.org

Johns Hopkins Arthritis Centerhopkins-arthritis.org

© 2016 Centene Corporation. All rights reserved. All materials are exclusively owned by Centene Corporation and are protected by United States and international copyright law. No part of this publication may be reproduced, distributed, displayed, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise, without the prior written permission of Centene Corporation. You may not alter or remove any trademark, copyright or other notice. MCARE16-00028E

http://niams.nih.govhttp://www.arthritis.orghttp://www.fda.govhttp://nccih.nih.govhttp://www.aaos.orghttp://www.hopkins-arthritis.org

RA. Rheumatoid arthritis. It just sounds painful. The good news is that it doesn’t have to be. This pocket guide will give you some background on the disease and prepare you with proven ways of dealing with RA. From diagnosis to treatment options and coping skills, use this guide to teach yourself and find relief.

DIAGNOSIS

CONTACTS

TREATMENT OPTIONS

MANAGING MEDICATIONS

FITNESS TIPS

RA AND NUTRITION

DEPRESSION AND COPING SKILLS

SUPPORT GROUPS

AND MORE

MADE IN THE U.S.A.

Because Where’s It @? Media cares about the environment, this book was printed on recycled paper.

Created by MICHELLE BAINDesign by SAM WASHBURN

ISBN: 978-0-9862116-2-1

TAKING CARE OF YOUR RHEUMATOID ARTHRITISTABLE OF CONTENTSDEFINITION SAND DIAGNOSISWHAT IS RHEUMATOID ARTHRITIS (RA)?RISK FACTORSDIAGNOSISSIGNS AND SYMPTOMSRA REVEALEDWHAT TO WATCH FORFIND OUT MORE

YOUR FIRST DOCTOR VISITFIND OUT MORE

MY CONTACTSEMERGENCY CONTACTS

RA MYTHBUSTINGMY TREATMENT PLAN!TREATMENT BASICSTREATMENT OPTIONSRA REVEALEDEXPLORING THE ALTERNATIVESMY TREATMENT PLAN WILL INCLUDE:FIND OUT MORE

MANAGING MEDICATIONSRA MEDICATIONS CHARTSIP WITH SAFETYFIND OUT MORE

DAILY MEDICINE SCHEDULEWHEN SURGERY IS NEEDEDRA REVEALEDFIND OUT MORE

FIGHTING FATIGUE!RELAX, REST, RESTORE, REPEATPERMISSION GRANTEDFIND OUT MORE

STAYING ACTIVETHE BENEFITS OF EXERCISERA REVEALEDGETTING STARTED/GETTING MOTIVATEDRA FITNESS TIPSRA Q & AWALKING 101MY FITNESS/ACTIVITY GOALS:

MY EXERCISE CHARTFIND OUT MORE

RA AND NUTRITIONDIETARY GUIDELINESTHE RA DIETFOODS THAT CAN HELP FIGHT RARA REVEALEDRA Q & A

MY HEALTHY SHOPPING LISTFIND OUT MORE

COPING AND SUPPORTCOPING TIPSSUPPORT GROUPSFIND OUT MORE

DEALING WITH DEPRESSIONRA REVEALEDBATTLING THE BLUESFIND OUT MORE

THE FUTURE OF RA RESEARCHRA REVEALEDFIND OUT MORE

NOTES

RESOURCES

Hospital: Medicine_1: Before Bedtime_1: OffWith Dinner_1: OffBefore Dinner_1: OffDuring Night_1: OffWith Lunch_2: OffWith Lunch_1: OffBefore Lunch_4: OffBefore Lunch_3: OffBefore Lunch_2: OffWith Breakfast_5: OffWith Breakfast_4: OffWith Breakfast_3: OffWith Breakfast_2: OffWith Breakfast_1: OffBefore Breakfast_5: OffBefore Breakfast_4: OffBefore Breakfast_3: OffBefore Breakfast_2: OffBefore Breakfast_1: OffMedicine_4: Medicine_3: Medicine_2: At Bedtime_1: OffBefore Dinner_2: OffWith Dinner_2: OffBefore Bedtime_2: OffAt Bedtime_2: OffDuring Night_2: OffWith Lunch_3: OffBefore Dinner_3: OffWith Dinner_3: OffBefore Bedtime_3: OffAt Bedtime_3: OffDuring Night_3: OffWith Lunch_4: OffBefore Dinner_4: OffWith Dinner_4: OffBefore Bedtime_4: OffAt Bedtime_4: OffDuring Night_4: OffBefore Lunch_5: OffWith Lunch_5: OffBefore Dinner_5: OffWith Dinner_5: OffBefore Bedtime_5: OffAt Bedtime_5: OffDuring Night_5: OffTime_05: Detailed description of symptoms: Past medical problems: Medical problems of parents or siblings: Medications and dietary supplements taken: Questions to ask the doctor: Relationship1: Relationship2: Cell Phone1: Cell Phone2: Home Phone1: Home Phone2: My General or Family Doctor: Phone1: Rheumatologist: Phone Rheumatologist: Other specialist: Phone2: Health Insurance Provider: Health Insurance Provider Phone: Website: Case Manager: Case Manager Phone: Name2: Phone3: Name1: Service/Function: Phone4: Name3: Name4: Service/Function1: Service/Function2: Phone5: Phone6: Family Member Name1: Family Member Name2: Family Member Name3: Family Member Name: Family Member Name4: Family Member Phone1: Family Member Phone2: Family Member Phone3: Family Member Phone: Family Member Phone4: My treatment plan will include: Medicine_5: Medicine_6: Medicine_7: Medicine_8: Medicine_9: Before Breakfast_6: OffBefore Breakfast_7: OffBefore Breakfast_8: OffBefore Breakfast_9: OffTime_01: Time_02: Time_03: Time_04: Time_06: Time_07: Time_08: Time_009: With Breakfast_6: OffWith Breakfast_7: OffWith Breakfast_8: OffWith Breakfast_9: OffBefore Lunch_6: OffBefore Lunch_7: OffBefore Lunch_8: OffBefore Lunch_9: OffWith Lunch_6: OffWith Lunch_7: OffWith Lunch_8: OffWith Lunch_9: OffBefore Dinner_6: OffBefore Dinner_7: OffBefore Dinner_8: OffBefore Dinner_9: OffWith Dinner_6: OffWith Dinner_7: OffWith Dinner_8: OffWith Dinner_9: OffBefore Bedtime_6: OffBefore Bedtime_7: OffBefore Bedtime_8: OffBefore Bedtime_9: OffAt Bedtime_6: OffAt Bedtime_7: OffAt Bedtime_8: OffAt Bedtime_9: OffDuring Night_6: OffDuring Night_7: OffDuring Night_8: OffDuring Night_9: OffMy fitness/activity goals: Exercise Date2: Exercise Date3: Exercise Date4: Exercise Date5: Exercise Date6: Exercise Date7: Exercise Date8: Exercise Date9: Exercise Date10: Exercise Date11: Exercise Date12: Exercise Date13: Exercise Date14: Exercise Date15: Exercise Date16: Exercise Date17: Exercise Date18: Exercise Date19: Exercise Date20: Exercise Date21: Exercise Date22: Exercise Date1: Exercise1: Exercise2: Exercise3: Exercise4: Exercise5: Exercise6: Exercise7: Exercise8: Exercise9: Exercise10: Exercise11: Exercise12: Exercise13: Exercise14: Exercise15: Exercise16: Exercise17: Exercise18: Exercise19: Exercise20: Exercise21: Exercise22: Repetitions/Time Spent1: Repetitions/Time Spent2: Repetitions/Time Spent3: Repetitions/Time Spent4: Repetitions/Time Spent5: Repetitions/Time Spent6: Repetitions/Time Spent7: Repetitions/Time Spent8: Repetitions/Time Spent9: Repetitions/Time Spent10: Repetitions/Time Spent11: Repetitions/Time Spent12: Repetitions/Time Spent13: Repetitions/Time Spent14: Repetitions/Time Spent15: Repetitions/Time Spent16: Repetitions/Time Spent17: Repetitions/Time Spent18: Repetitions/Time Spent19: Repetitions/Time Spent20: Repetitions/Time Spent21: Repetitions/Time Spent22: Finished1: OffFinished2: OffFinished3: OffFinished4: OffFinished5: OffFinished6: OffFinished7: OffFinished8: OffFinished9: OffFinished10: OffFinished11: OffFinished12: OffFinished13: OffFinished14: OffFinished15: OffFinished16: OffFinished17: OffFinished18: OffFinished19: OffFinished20: OffFinished21: OffFinished22: OffExercise Date24: Exercise Date25: Exercise Date26: Exercise Date27: Exercise Date28: Exercise Date29: Exercise Date23: Exercise Date31: Exercise Date32: Exercise Date33: Exercise Date34: Exercise Date35: Exercise Date36: Exercise Date37: Exercise Date38: Exercise Date39: Exercise Date40: Exercise Date41: Exercise Date42: Exercise Date43: Exercise Date30: Exercise Date44: Exercise23: Exercise25: Exercise26: Exercise27: Exercise28: Exercise29: Exercise30: Exercise31: Exercise32: Exercise33: Exercise24: Exercise34: Exercise35: Exercise36: Exercise37: Exercise38: Exercise39: Exercise40: Exercise41: Exercise42: Exercise: Exercise43: Repetitions/Time Spent23: Repetitions/Time Spent24: Repetitions/Time Spent25: Repetitions/Time Spent26: Repetitions/Time Spent27: Repetitions/Time Spent28: Repetitions/Time Spent29: Repetitions/Time Spent30: Repetitions/Time Spent31: Repetitions/Time Spent32: Repetitions/Time Spent33: Repetitions/Time Spent34: Repetitions/Time Spent35: Repetitions/Time Spent36: Repetitions/Time Spent37: Repetitions/Time Spent38: Repetitions/Time Spent39: Repetitions/Time Spent40: Repetitions/Time Spent41: Repetitions/Time Spent42: Repetitions/Time Spent: Repetitions/Time Spent43: Finished23: OffFinished24: OffFinished25: OffFinished26: OffFinished27: OffFinished28: OffFinished29: OffFinished30: OffFinished31: OffFinished32: OffFinished33: OffFinished34: OffFinished35: OffFinished36: OffFinished37: OffFinished38: OffFinished39: OffFinished40: OffFinished41: OffFinished42: OffFinished: OffFinished43: OffGRAINS: GRAINS1: VEGGIES: VEGGIES1: Fruits: Fruits1: Dairy: Protein: Notes1: Notes2: Medicine_10: Medicine_11: Medicine_12: Medicine_13: Medicine_14: Medicine_15: Medicine_16: Medicine_17: Medicine_18: Before Breakfast_10: OffBefore Breakfast_11: OffBefore Breakfast_12: OffBefore Breakfast_13: OffBefore Breakfast_14: OffBefore Breakfast_15: OffBefore Breakfast_16: OffBefore Breakfast_17: OffBefore Breakfast_18: OffWith Breakfast_10: OffWith Breakfast_11: OffWith Breakfast_12: OffWith Breakfast_13: OffWith Breakfast_14: OffWith Breakfast_15: OffWith Breakfast_16: OffWith Breakfast_17: OffWith Breakfast_18: OffBefore Lunch_10: OffBefore Lunch_11: OffBefore Lunch_12: OffBefore Lunch_1: OffBefore Lunch_13: OffBefore Lunch_14: OffBefore Lunch_15: OffBefore Lunch_16: OffBefore Lunch_17: OffBefore Lunch_18: OffWith Lunch_10: OffWith Lunch_11: OffWith Lunch_12: OffWith Lunch_13: OffWith Lunch_14: OffWith Lunch_15: OffWith Lunch_16: OffWith Lunch_17: OffWith Lunch_18: OffBefore Dinner_10: OffBefore Dinner_11: OffBefore Dinner_12: OffBefore Dinner_13: OffBefore Dinner_14: OffBefore Dinner_15: OffBefore Dinner_16: OffBefore Dinner_17: OffBefore Dinner_18: OffWith Dinner_10: OffWith Dinner_11: OffWith Dinner_12: OffWith Dinner_13: OffWith Dinner_14: OffWith Dinner_15: OffWith Dinner_16: OffWith Dinner_17: OffWith Dinner_18: OffBefore Bedtime_10: OffBefore Bedtime_11: OffBefore Bedtime_12: OffBefore Bedtime_13: OffBefore Bedtime_14: OffBefore Bedtime_15: OffBefore Bedtime_16: OffBefore Bedtime_17: OffBefore Bedtime_18: OffAt Bedtime_10: OffAt Bedtime_11: OffAt Bedtime_12: OffAt Bedtime_13: OffAt Bedtime_14: OffAt Bedtime_15: OffAt Bedtime_16: OffAt Bedtime_17: OffAt Bedtime_18: OffDuring Night_10: OffDuring Night_11: OffDuring Night_12: OffDuring Night_13: OffDuring Night_14: OffDuring Night_15: OffDuring Night_16: OffDuring Night_17: OffDuring Night_18: Off