My Pain

Pain,Pain, please go away
dont come back another day
I am laying here wide awake, i just can not sleep
I am in so much pain, i just want to weep
I ask god to help me, to see me through the day
Just to be pain free, all i can do is pray
The pills i take to ease the pain, it really is a battle
I take so many now, i am sure i will start to rattle
I will stay here for a while, until i can get going
My joints are all gnarled,and now its really showing
Operations i have had are plenty ,to many for me to say
So i will just lay here for a bit until i feel ok

(c)R.Rolls


Rheumatoid Arthritis


What is it

Rheumatoid arthritis is a chronic inflammatory illness.
It is an autoimmune disease in which the immune system
attacks normal tissue components as if they were invading pathogens.
This illness affects about one percent of the world's population.
The inflammation associated with rheumatoid arthritis primarily
attacks the linings of the joints. However, the membranes lining
the blood vessels, heart, and lungs may also become inflamed.
The hands and feet are most often affected,
but any joint lined by a membrane may be involved.
The inflammation can be controlled by medication. If the
inflammation is not controlled the joints may become deformed.


Rheumatoid arthritis usually manifests itself over a period
of a few months. However for some, the disease may
appear over night. Rapid onset does not mean
the individual is at greater risk of disease progression.


Rheumatiod Arthritis may have different affects on
different people. Some individuals may experience extreme
pain while others may not. Patients often suffer
cycles of severe and light symptoms.



What are the symptoms

joint swelling. Especially in the small joints of
the hands and feet. joint tenderness, stiffness,
and pain. Especially in the morning.

With proper treatment, many people newly diagnosed
with rheumatoid arthritis can prevent or delay the more
disabling and feared complications of the disease.


Affects of Rheumatoid Arthritis

Hardened Lumps. About twenty five present of rheumatoid
arthritis patients develop hardened lumps under
the skin. These hardened lumps are called rheumatoid nodules.
Development of hardened lumps usually develops in the later
course of the disease. Often times, the nodules
are found on bony sites such as
elbows, hips, heels, and back of the head.
However, they can also form under the skin
in the finger, toe or heel pads, or in tendons.

Cartilage and bone destruction. If joint inflammation
persists, cartilage and bone destruction can occur.
When cartilage and bone destruction occurs, the joint becomes
deformed and immobile. Inflammation and deformity
are most often seen in the hands and feet.
Nonetheless, the knees, hips, and shoulders may
also be affected. In addition to joint deterioration,
people more severely affected may also experience weight
loss, low-grade fever, and malaise because of
the disease's effects on the whole body.


Risk factors

Women suffer from it two to three times more than men.
Relatives of people with rheumatoid arthritis
have an increased risk of developing the disease.
The siblings of severely affected rheumatoid
arthritis patients are at highest risk.

How is it diagnosed

Most patients suffering from rheumatoid arthritis
have antibodies called rheumatoid factors
in their bloodstream that are part of the inflammatory
process of the disease. The presence of rheumatoid factor
is used by doctors to help confirm a diagnosis
of rheumatoid arthritis. However, rheumatoid factor
may not be a definitive test for rheumatiod arthritis.
Rheumatoid factor is also found in cases of chronic
infection and in some other types of autoimmune disease.
High levels of rheumatoid factor are often
seen in severe cases of rheumatoid arthritis.


The cause

The cause of rheumatoid arthritis is not yet known.
However, it is known that RA is an autoimmune disease.
The body's natural immune system does not
operate as it should, resulting in the immune system
attacking healthy joint tissue and causing inflammation and
subsequent joint damage.

Researchers suspect that agent-like viruses may trigger
RA in some people who have an inherited tendency
for the disease. Many people with RA have a certain
genetic marker called HLA-DR4. Researchers know
that there are other genes that influence the development of RA.

How is it treated

Rest, splinting of affected joints and exercise programs.
Good nutrition is also very important. It is important
because patients with a more advanced disease often
experience anemia and weight loss. Medication to
control pain and stiffness and reduce the risk of joint deformity.

Treatment Options

Highly effective drug treatments exist for rheumatoid arthritis.
Early treatment is critical. Current treatment methods
focus on relieving pain, reducing inflammation, stopping
or slowing joint damage, and improving patient function
and well-being. Medications can be divided into two groups

Symptomatic medications, such as NSAIDs and aspirin,
analgesics, and glucocorticoids, help reduce joint pain,
stiffness and swelling. These drugs may be used in combination.
Disease-modifying medications include low doses of
methotrexate, leflunomide, D-Penicillamine, sulfasalazine, gold therapy,
minocycline, azathioprine, hydroxychloroquine (and other antimalarials),
cyclosporine and biologic agents.
People with moderate to severe RA who have not responded
well to disease modifying anti-rheumatic drugs
(DMARDs) may opt to try Prosorba therapy.

In addition, treatment most often involves some combination
of exercise, rest, joint protection, and physical and
occupational therapy. Surgery is available for joints
that are damaged and painful. A balance of rest and
exercise can help conserve energy and maintain
range of motion and use of the joints.

A small number of patients will go into remission,
usually within the first two years.