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Table Of Contents

Preface
Acknowledgments
Introduction: Defining Rheumatoid Arthritis
Part I: Learning About Rheumatoid Arthritis
1. The Joints and Rheumatoid Arthritis
The Joints
Rigid joints
Slightly mobile joints
Freely movable joints
What are the parts of a synovial joint?
The Joints in RA
What is inflammation?
How is the inflammation of RA different from normal inflammation?
The stages of RA: How does inflammation affect the joints?
Summary
2. The Course and Prognosis of Rheumatoid Arthritis
The Course of RA
How does RA usually start?
What course of arthritis can I expect?
Can a remission be brought on with medications?
The Prognosis of RA
Can arthritis be cured?
Will additional joints become involved over time?
Will I become disabled?
Does RA shorten a person's life?
Summary
3. Diagnosing Rheumatoid Arthritis: Why So Many Tests?
Clinical History
Physical Examination
Differential Diagnosis
What makes RA so difficult to diagnose?
Diagnostic Tests
What tests are used to diagnose or monitor activity of RA?
What tests are used to rule out other types of arthritis?
What tests are used to screen for complications of RA or medication side effects?
Summary
4. Outside the Joints: Other Symptoms of Rheumatoid Arthritis
Blood and Blood Vessels
How does RA affect the blood?
What about the blood vessels?
Eyes and Mouth
Nodules under the Skin
Nerves
Chest and Lungs
Vocal Cords
The Heart and Cardiovascular System
The Bones
Summary
Part II: Coping with Rheumatoid Arthritis
5. Lifestyle and Coping Strategies
Creating a Lifestyle and Attitude Aimed at Wellness
Kick bad habits
Eat right
Get fit
Get sleep
Think prevention
Go simple
Don't sweat the big stuff
Be your own best friend
Developing Success-Driven Methods of Problem Solving
Define and assess the problem
Set realistic goals and expectations
Develop methods for problem solving and negotiating
Use all available resources
Modify negative thoughts and behaviors
Be willing to reassess
6. Coping with Pain and Fatigue
Pain
What is pain?
Pain and your emotions
What is the pain message in RA?
Decreasing pain
Fatigue
Why am I so tired?
Controlling fatigue
For More Information
7. Coping with Emotions— Yours and Everyone Else's
Anger
Managing anger
Depression
Managing depression
Anxiety, Fear, and Stress
Anxiety
Fear
Stress
Relieving the tension of anxiety, fear, and stress
Dealing with Friends and Family
Asking for help
The special case of children
Love and intimacy
Friends and relatives
For More Information
Part III: Exercise and Rehabilitation
8. Protecting Your Joints
Joint Protection Guidelines
Protecting Specific Joints
Hands and wrists
Elbows and shoulders
Hips and knees
Ankles and feet
For More Information
9. Exercise and Rheumatoid Arthritis
Trends in Therapeutic Advice
Types of Exercise
Range of motion
Strengthening
Aerobic
Starting an Exercise Program
Warm-up
Workout
Cool-down
Exercises That Are Right for You
For people with very inflamed joints
For people with moderately inflamed joints
For people with controlled joints
Mind-Body Exercises
Tai chi
Qi-gong
Yoga
For More Information
10. Specific Exercises
Range-of-Motion and Strengthening Exercises
Neck range-of-motion exercises
Neck muscle-strengthening exercises
Shoulder range-of-motion exercises
Elbow range-of-motion exercises
Shoulder and elbow muscle-strengthening exercises
Wrist and finger range-of-motion exercises
Hip range-of-motion exercises
Knee range-of-motion exercises
Hip and knee muscle-strengthening exercises
Ankle range-of-motion exercises
Aerobic or Endurance Exercises
What is your target heart rate?
Taking your pulse
Beginning your aerobic exercise program
Guidelines for specific aerobic exercise
For More Information
Part IV: Medications
11. Medications Past, Present, Future
The Past: The Conservative Approach
The Present: More Aggressive Approaches to Therapy
The Future
Current Treatments: NSAIDs, DMARDs, Biologics, Kinase Inhibitors and Corticosteroids
For More Information
12. Aspirin, Nonsteroidal Anti-inflammatory Drugs (NSAIDs), and COX-2 Inhibitors
Aspirin
Side effects of aspirin therapy
Cautionary notes
Traditional NSAIDs
Side effects of traditional NSAIDs
Cautionary notes
COX-2 Inhibitors
Side effects of COX-2 inhibitors
Cautionary notes
Stomach Medications Frequently Used with NSAIDs
13. Disease-Modifying Antirheumatic Drugs (DMARDs)
Nonimmunosuppressant DMARDs
Immunosuppressants
14. Biotherapies: Biologics, Kinase Inhibitors, and a Biologic Medical Device
Understanding Cytokines and Inflammation
Using the body's secrets to tame inflammation: Balancing the cytokines
Redirecting the message makers: Calming the B cell and T cell
The Biologics: Practical Considerations
Subcutaneous injections: Can I give myself the shot?
Intravenous infusions: What to expect
Cost issues
Which biologic should I take?
Risk of infection: The most serious of biologic side effects
Biologic Agents against Tumor Necrosis Factor: The TNF Blockers
Important safety information regarding TNF blockers
Biologic Agents against Interleukin-1: The IL-1 Blockers
Biologic Agents against Interleukin-6: The IL-6 Blockers
Biologic Agents that Affect the T Cell: The T Cell Modulators
Biologic Agents that Affect the B Cell: The B Cell Modulators
The Oral Biotherapies—A Look inside the Immune Cell
The Kinase Inhibitors
A Biologic Medical Device for Protein A Immunoadsorption
For More Information
15. Corticosteroids
Oral Corticosteroids
Side effects of oral corticosteroids
Cautionary notes
Intra-articular Corticosteroid Injections
What to do after a joint injection
16. Osteoporosis Treatments
Dietary and Life-Style Treatments
Medicinal Treatments
For More Information
Part V: Beyond Medications: Other Treatments
17. Alternative and Complementary Therapies
Aromatherapy
Ayurveda
Oil pulling
Bodywork
Energy Work
Breathing Techniques, Breath Therapy, or Breathwork
Chinese Medicine
Acupuncture
Music and Sound Therapy
Other Mind-Body Therapies: Mindfulness and Others
Naturopathy
Spa Therapy, Hydrotherapy, and Balneotherapy
Homeopathy
Guidelines for Evaluating Unproven Treatments
For More Information
18. Nutrition: Diets, Nutrients, and Nutritional Supplements
Nutrition and RA
The Importance of Weight Management in RA
Specific Food Groups and RA
Fats and oils
Sugar
Bread, cereals, rice, and pasta
Fermented foods
Vegetables
Fruits
Meat, poultry, fish, and eggs
Legumes
Nuts and seeds
Milk, yogurt, and cheese
Special Diets
Elimination diets
Fasting
Vegetarians diets
Gluten-free diets
Recommendations
A Word on Nutritional Supplements
Guidelines for evaluating nutritional supplements
Vitamins and Minerals
Vitamins
Minerals
Herbs and Plant-Based Medicine
Other Supplements
Antioxidants
Glucosamine sulfate and chondroitin sulfate
Fish oil and essential fatty acids: EPA, DHA, ALA, and GLA
Probiotics, prebiotics, and fiber supplements
Recommendations regarding specific supplements
For More Information
19. Surgery for Rheumatoid Arthritis
Surgeons Specializing in the Treatment of RA
Types of Surgery
Arthroscopic surgery
Synovectomy
Tendon reconstruction or transfer
Joint fusion
Osteotomy and bone resection
Joint replacement
Preparing for and Recovering from Surgery
Before surgery
During your recovery
For More Information
Part VI: Practical Matters
20. Disability Benefits, Insurance, and Other Financial Matters
Disability Benefits
Commercial and employment disability programs
State disability policies
Social Security disability benefits
Vocational rehabilitation benefits
Health Insurance
Private health insurance
COBRA
Government health insurance
Veterans Administration Benefits
Income Taxes
Financial Help for RA Treatment
For More Information
21. Other Issues
Surfing the Net: Empowerment or Deception?
Clinical Research
What is clinical research?
How do clinical studies operate?
Should I participate in a clinical trial?
Travel Tips
Medical tips for travelers
Driving tips
When traveling by air
Pregnancy and Childbirth
Can I become pregnant?
How will pregnancy affect my RA?
How will my RA affect my unborn child?
Can I breastfeed my infant?
Will my child have RA?
Will I be able to care for my baby?
Immunization for the Person with RA
Should I get a yearly flu shot?
Are there other vaccinations that I may need to get?
For More Information
Closing Thoughts
Glossary
Bibliography
Index