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Rheumatoid Arthritis
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Discovery :
What is Rheumatoid Arthritis?
Original symptoms and visiting a GP
Referral to a rheumatologist, tests & diagnosis
Impact of the diagnosis
Ideas about causes
Impact of diagnosis on family & others
Tests and treatments :
Choosing treatments & taking part in trials
Painkillers
Anti-inflammatory drugs
Disease modifying anti-rheumatic drugs (DMARDs)
Steroid tablets, injections & intravenous pulses
Biologic treatments: anti-TNF and B-cell therapy
Long term use of drugs
Regular monitoring and other diagnostic tests
Physiotherapy & hydrotherapy
Occupational therapy
Other hospital specialists
Surgery - introduction
Surgery - upper limb and neck
Surgery - lower limb
Outpatient clinics
Complementary and alternative approaches
Living with rheumatoid arthritis :
Diet & food supplements
Exercise
Personal life and changes to the home
Social life & relationships
Mobility, driving & transport
Work
Financial implications & financial support
Sources of support
Body image
Attitude to RA & facing the future
Self-management
Ongoing symptoms- flares, stiffness & sleep disturbance
Ongoing symptoms- pain, fatigue, depression, weight change
Pregnancy & breastfeeding
Parenting & childcare
Messages to others with RA
Messages to health care professionals
Finding information about RA
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Rheumatoid Arthritis
Subject index
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Bones & joints
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Rheumatoid Arthritis
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Disease duration 26 years plus
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Interview 16
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Has complete faith in her doctors and has never felt a need to get involved in treatment decisions.
Diagnosed 1977 after shoulder pains. Diclofenac retard 100mg/day, Methotrexate 15mg/week & 5mg/day folic acid. Partial wrist & 2 finger joints replaced, thumb tendon repairs, 6 toe joint operations, ankle fusion & a back operation (not due to RA).
Bones & joints
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Rheumatoid Arthritis
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Disease duration 0-5 years
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Interview 24
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Likes to find out information herself about new treatments suggested by the doctor.
Diagnosed April 1997 after sudden onset of symptoms and admission to hospital. RA widespread leading to initial depression. Side-effects from Methotrexate so now taking Leflunomide 20mg/day, Rofecoxib 12.5mg/ alternate days and pain killers as required.
Bones & joints
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Rheumatoid Arthritis
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Disease duration 21-25 years
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Interview 04
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Asserts that patients should take an active role in making treatment decisions.
Diagnosed '79 with rapid onset after glandular fever. Various foot surgery undergone and hand surgery planned. Symptom relief from physio/ hydrotherapy & some complementary therapies/diets. Currently Coproxamol, Methotrexate, folic acid & occasional NSAID.
Bones & joints
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Rheumatoid Arthritis
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Disease duration 6-10 years
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Interview 09
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Was not happy with some of the treatments and chose to stop taking anti-inflammatory medication.
After several months of wrist/hand pains treated with NSAIDs and physiotherapy by GP, RA diagnosis made by private consultant. Mother had RA. Currently RA controlled on Sulfasalazine. Has returned to being active, playing golf, tennis, dog walking etc.
Bones & joints
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Rheumatoid Arthritis
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Disease duration 11-15 years
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Interview 33
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Had side effects from taking methotrexate and wanted to stop taking it, but her consultant was reluctant for her to do so.
Juvenile chronic arthritis diagnosed 1990. Initially NSAIDs, then methotrexate but nausea & then oral steroids from age 15. Finger tendon repair & hip replacement (01) Currently Anti-TNF Humira injected 2/month, indometacin, co-codamol & Lansoprazole.
Bones & joints
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Rheumatoid Arthritis
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Disease duration 21-25 years
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Interview 05
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Having private treatment she could choose surgeons who were skilled with a particular joint.
RA diagnosed as significant symptoms after birth of 2nd child. Complementary treatments used. Takes Diclofenac 15mg & 2 Coproxamol daily. 10 operations: hips, knees & shoulder replacement/revision; neck, ankle & toe fusions, and removal of bone in 1 elbow.
Bones & joints
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Rheumatoid Arthritis
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Disease duration 6-10 years
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Interview 32
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The treatment options were all explained. She was given information and an opportunity to talk to other people about methotrexate.
Diagnosed seronegative RA '97 but symptoms since '77 after flu-like virus. Took Opren but side-effects so chose homeopathy. Mid '90s significant disease progression & began DMARDS, but side-effects. Now 6 weekly Depomedrone injections (120mg), physio & hydrotherapy.
Bones & joints
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Rheumatoid Arthritis
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Disease duration 16-20 years
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Interview 23
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Successfully chose to do strengthening exercises instead of having joint surgery.
Psoriasis age 17. Rapid onset RA diagnosed seronegative '86. Various DMARDS tried and complementary therapies/diet helped. Stroke '00, blood disorder & Sjogrens. Currently Steroids, Dihydrocodeine, Vioxx. 2 new knees/1 hip/2 shoulders & right thumb fusion.
Bones & joints
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Rheumatoid Arthritis
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Disease duration 21-25 years
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Interview 04
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Patients should be involved in treatment decisions at every stage and continuity of care is important.
Diagnosed '79 with rapid onset after glandular fever. Various foot surgery undergone and hand surgery planned. Symptom relief from physio/ hydrotherapy & some complementary therapies/diets. Currently Coproxamol, Methotrexate, folic acid & occasional NSAID.
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