Learning to Live With Arthritis
By Awake! correspondent in Britain
David, 72 years old, moves with difficulty. Deformed elbows and wrists reflect the crippling effects of a disease all too common among the aged.
Peggie, in her late 60’s, walks with difficulty. She too suffers, as her deformed hands show. Yet, she manages to do a little housework and enjoys crocheting.
Isa, who had been confined to her wheelchair for 37 years, could do little for herself. However, her infectious smile conveyed a remarkable vitality.
DAVID, Peggie, and Isa—three among some six million Britons who have suffered from arthritis. According to The Times of London, every year this disease “accounts for the loss of 88 million working days . . . , far more than the losses caused by strikes.” Arthritis is Britain’s “largest single cause of disability.”
Wherever you live, arthritis can attack. No area of the world is immune. Of this malady, medical doctor Vernon Coleman writes: “Few diseases affect as many people . . . Few cause as much pain and disablement, and few are the subject of so many myths and so much misunderstanding.”—See box on page 14.
It is not surprising that many arthritics, like David, find life depressing. On the other hand, Peggie, Isa, and others came to grips with their disabilities, even being optimistic. How can this be? What about you? If you are arthritic, or think you are, what steps can you take that can help you to cope successfully with the disease?
If You Are a Victim
First, obtain an early diagnosis. “It cannot be stressed too strongly,” says The Arthritis Book, “that early diagnosis can help to minimize later pain and disability.” Yes, treatment of arthritis is indeed “a fight for time.” Dr. Coleman concurs: “If . . . treatment is initiated early and with enthusiasm the outlook is greatly improved.”
So do not procrastinate. Find out the details of your health problem. Then, if it is arthritis, make arrangements to start treatment without delay.
Coping With Pain
For arthritis sufferers, the minimizing of pain is of high priority. Yet, in some cases of osteoarthritis, certain doctors give this advice: ‘Keep taking the pain.’ Why? Because pain-numbing drugs suppress the body’s natural alarm signals. Ignoring these signals may lead to irreparable joint damage.
The possible side effects of such pain-killing medication should also be considered. The Lancet warned that the “risk of [hospital] admission with bleeding peptic ulcer . . . substantially increased in takers of NANSAID [nonaspirin nonsteroidal anti-inflammatory drugs].” Thus, many prefer to keep their use of drugs to a minimum. Some find pain relief by concentrating on matters that capture their interest. Nursing Mirror notes: “Distraction can be used as a sensory shield by diverting attention and focusing on something unrelated to the pain.”
This is not to say that avoidance of all pain suppressants is advisable. In some cases failure to suppress pain may discourage the use of painful joints, leading to stiffness, atrophy, and eventual loss of joint function. NANSAID and aspirin are widely used for pain relief. They are also prescribed to reduce swelling and inflammation. Both are considered effective by many arthritis sufferers and their doctors.
In view of the potential dangers, however, know as much as possible about a treatment before embarking on it. Find out what the risks are. Speak to your doctor about this.
Though extreme cold and dampness do not cause arthritis, climatic factors do appear to influence the degree of pain felt by sufferers. Thus, for some, moving to a warm, dry climate has brought relief. But if such a change is impractical, there are some alternatives.
Dr. Frederic McDuffie, a leader in research on rheumatoid arthritis, notes that direct “application of cold and heat can also be useful.” In one study, patients applied an ice pack for 20 minutes to knee joints afflicted with rheumatoid arthritis. They did this three times a day for four weeks, and they reported more pain-free movement and increased muscle strength. They showed greater agility and slept better. Why? McDuffie explains that “cold reduces the nerve transmission of pain impulses.”
Unfortunately, what works well for one person may prove ineffective for another. Many arthritis sufferers find a gentle massage helpful. Isa related: “When my pain troubles me, I get my husband to rub the area really hard. This hurts, but sometimes it relieves the pain.”
Heat therapy is also considered beneficial. Some doctors recommend the use of a hot-water bottle or a heating pad for pain relief. Rheumatologist Dr. F. Dudley Hart explains: “Heat relaxes the muscles, lessens stiffness and eases pains.”
‘Use or Lose!’
“One of the most important things . . . to help your arthritis is . . . exercise,” states The Arthritis Helpbook. ‘Yes,’ you say, ‘but that is so painful.’ True, but aim for balance.
Walking, swimming, and cycling are the favorite forms of general exercise. However, for your exercise to be really effective, you will need a program tailored to your type of arthritis. Discuss this with your doctor or physiotherapist to ascertain which movements will best help you.
When you experience pain during periods of exercise, take a brief rest. If your affected joints are hot and inflamed, you should discontinue the exercise at that time—it may be too strenuous. Remember, your goal should be mobility rather than strength. Moving the joints through as full a range of motion as possible at least twice daily can be a help in continued free movement.
A Cure in Sight?
“Cure for arthritis ‘very close,’” announced Liverpool’s Daily Post back on May 28, 1980. The report that followed noted, however, that “no definite time scale has been set.”
Over 12 years later, research continues. For rheumatoid arthritis, attention now focuses on designing drugs to manipulate the “faulty” genes believed to be its cause. Professor Ravinder Maini of the Arthritis and Rheumatism Council hopes that these will become available “in five to 10 years.”
In the meantime, to restore mobility and relieve suffering, some arthritis victims have opted for surgical joint replacement. Others find that certain diets help. Acupuncture, homeopathy, and osteopathy all have their champions in this field.
Opinions about the proper treatment vary greatly. Some types have been labeled “quackery” by medical professionals solely because such treatments are considered unorthodox, not because they lack effectiveness. Nevertheless, a host of so-called cures of questionable worth are offered to arthritis sufferers.
At present, the medical profession has not found a cure for this crippling disease. It is, therefore, wise to weigh carefully all factors when selecting a particular form of treatment. Once this has been done, stick with what works best for you.
How Others Can Help
If you have an arthritic relative or friend, there is much you can do to help that one cope with the limitations experienced. How?
Though living alone, Peggie finds her children very supportive. They keep in close touch by letter and telephone. Whenever her daughters, who live abroad, visit, they gladly help with decorating and other household chores that she now finds too difficult. Her teenage granddaughter stops by every week to care for the heavy housecleaning.
David’s wife now takes a more active interest in caring for him. With instruction from a community nurse, she has learned how to help him with his personal hygiene. David now feels happier, and the two of them are able to do more things together.
“Most things other people do,” Isa said before her death, “I cannot do for myself.” How welcome, then, the loving care of her husband, who washed her, dressed her, and even did her hair!
Arthritis sufferers usually treasure any independence their disease still allows. Relatives and friends should avoid undermining this. What is needed most, according to Dr. Hart, is “practical sympathy and reassurance.” Do something for the sufferer, then, that he cannot do for himself. Brief visits, encouraging words, and help with chores and shopping elicit the greatest appreciation.
Develop an Optimistic Outlook
‘With a disease like arthritis, that is easier said than done,’ you may say. True, but much depends on what you, your relatives, and your friends envisage for the future.
Consider Peggie and Isa. Isa said: “I’ve stopped worrying about my disability.” Instead, she and Peggie sought out opportunities to help others. Peggie spends time making encouraging visits on her neighbors. Isa, with the help of her children and grandchildren, shared full-time in telling others of the promises foretold in the Bible. Peggie is one of Jehovah’s Witnesses, as was Isa.
Yes, Peggie and Isa found much comfort in the soon-to-be-fulfilled promise that “no one who lives in our land will ever again complain of being sick.” (Isaiah 33:24, Today’s English Version) For arthritis sufferers, what a happy day that will be!
[Box on page 14]
Rheumatism or Arthritis?
All of us experience aches and pains from time to time. We may dismiss them as “a touch of rheumatism.” Medically, rheumatism is a general description of 200 or more painful conditions, though only about half fall into the category of arthritis. Four common kinds of arthritis are:
Osteoarthritis (degenerative arthritis or osteoarthrosis) occurs mainly in older persons and is characterized by degeneration of joint cartilage, enlargement of bone at the margins of the joint, and changes in the synovial, or fluid-producing, membrane of a joint. “By the time we are 65 years old, 80 per cent of us can expect to have osteoarthritic changes in one or more joints; a quarter of us will suffer more or less pain and disability from them.”—New Scientist.
Rheumatoid arthritis is usually indicated by the inflammation of numerous joints and their fluid-producing membranes and by atrophy, or wasting, of the muscles and bone that surround a joint. At times, this can result from an injury. “May start at any age but is more common in women than men in a ratio of about 3:1.”—Nursing Mirror.
Ankylosing spondylitis (or spinal arthritis) “affects the spine chiefly leading to a stiff or ‘poker’ back. . . . more common in males.”—101 Questions and Answers About Arthritis.
Gout is a hereditary form of arthritis characterized by an excess of uric acid (hyperuricemia) in the blood that results in attacks of acute arthritis usually involving a single joint, followed by complete remission. “Men are affected about 20 times as frequently as women.”—Nursing Mirror.
[Box on page 15]
A DIET FOR ARTHRITIS?
The following excerpts from books and news reports reveal the wide disagreement among experts. Individual appraisal and decision is therefore necessary.
“It’s what you don’t eat that counts. . . . Do not eat: Meat in any form, including broth; fruit of any kind; dairy products . . . ; egg yolks; vinegar, or any other acid; pepper . . . of any variety; hot spices; chocolate; dry roasted nuts; alcoholic beverages, particularly wine; soft drinks . . . ; all additives, preservatives, chemicals, most especially monosodium glutamate.”—New Hope for the Arthritic, 1976.
“The best possible diet for an arthritic condition is wholesome food that includes essential nutrients—proteins, carbohydrates, fats, vitamins, and minerals—eaten at regular, well-spaced intervals. Raw fruit, leafy vegetables, and whole-grain cereals should be included if you are not allergic to them.”—Arthritis—Relief Beyond Drugs, 1981.
“True allergic arthritis is rare but does occur occasionally with sensitivity to wheat flour (gluten) or milk products (cheese) or other substances. If in doubt it may be desirable to keep a food diary to note what has been eaten on the days arthritis flares up or worsens.”—101 Questions and Answers About Arthritis, 1983.
“The Special Arthritis Diet. Forget it. There isn’t any. There is no scientific evidence that arthritis can be helped or made worse by any vitamin, mineral, protein, fat, or carbohydrate. If patients decide to embark on a diet of yoghurt, organic foods, vegetable juice, alkaline foods, or acid foods, it probably won’t hurt them.”—The Arthritis Book, 1984.
“Researchers have discovered that a diet of fish and lean meat, with fish-oil supplements, reduces stiffness and pain in the joints caused by rheumatoid arthritis.”—The Sunday Times, London, 1985.
On one matter authorities do agree: Avoid being overweight, which only exacerbates joint problems, especially in the hips, knees, and ankles.