Normalcy in an Arthritic World

People With Disabilities - Living In A "Normal World"
From Carol & Richard Eustice
www.arthritis.about.com

Overcoming Annoyances

People With Disabilities Want To Live Life

People with disabilities live in a world designed primarily for the able-bodied. People with disabilities want to live life no differently than anyone else. They want to be able to go shopping, go to the movies, go out to eat, work, and enjoy life, fully realizing that must be done within the boundaries of their limitations.

Acceptance

Accepting disability and redefining life within the limitations imposed by disease is the biggest hurdle for people with disabilities. There are harsh realities. Expensive equipment and medications may be required. Mobility scooters, adapted vans, voice-recognition software, orthotics, medical treatment, and myriad types of assistive equipment improve daily living for people with disabilities but it all comes at a price. While life becomes more expensive, too often the ability to work diminishes. Financial security takes a big hit. An uncertain future can make a person fearful.

Arthritis: Fearing The Future

Adjust And Adapt

Adapt and adjust becomes the mantra of a person living with a disability. People with disabilities may be forced to change careers or not work at all. They may be forced to relinquish some of their independence.

There are experiences some able-bodied people may take for granted which people with disabilities must forgo. Disabled people may miss out on:


the joy of rough-housing with children
playing competitive sports
traveling
long road-trips

Crowded events become daunting, social situations become uncomfortable. Do you put yourself out there or risk being covered by the veil of isolation?

The Veil Of Isolation

Subtle Realities Vs. Harsh Realities
What can be more frustrating than harsh realities are subtle realities for people with disabilities. Living with disability is difficult but can sting even more when people encountered are:

impatient
rude
insensitive
inconsiderate
pessimistic
unhelpful

Impatient people try to rush people with disabilities through life. A man who was behind me in the grocery line one day tried to unload my cart for me. The gesture would have been welcome if it had been rooted in kindness, but it was obvious I was moving too slow for him in this fast-paced world we live in.


Arthritis Can Create Awkward Situations

Inconsiderate people can be found using handicapped bathroom stalls and handicapped parking spots, facilities specifically designated for people with disabilities. Inconsiderate people do not hold doors open, a simple action that can make things much easier for a disabled person.

Rude and insensitive people are often found staring at people with disabilities. They seem to not like what they see, or imagine themselves in the role of the disabled person. It creates an uncomfortable situation unless you ignore the person who is staring.


What's Behind The Stare?

Demanding people and those who lack understanding about the realities of your disability can also be provoking. A friend of mine had a surgical procedure which restricted her driving for a period of time. My friend's mother called to tell her she needed to go to the store, disregarding the restrictions that were given to my friend. She had to tell her mother she couldn't help her.

Pessimistic people can annoy and be hurtful. Pessimistic people focus on the negative aspects of having a disability instead of trying to build up, encourage, and praise the accomplishments of people with disabilities. Pessimistic or negative people don't want to learn about the realities of living with disability. They have preconceived ideas and often treat physically disabled people as if they are faking or lazy. Even worse, negative people sometimes treat physically disabled people as if they have no abilities at all.

Unhelpful people are yet another category of people who can annoy and frustrate disabled people. For able-bodied people, most tasks are effortless. The same task for a disabled person is perhaps an impossibility. Changing lightbulbs or air conditioner filters, scrubbing showers, getting a large load of groceries - it's just part of daily living. Who does it for the disabled person, especially one who has collected on all of the favors owed to them?


Declare Your Independence

Surround Yourself With Positivity

What you can control, whether you are able-bodied or disabled, is yourself. All humans face challenges, it's just that people with disabilities face different challenges. You will not rid the world of impatient, rude, insensitive people, but you can control how you react to them.


Impatient people cause you to be more patient.
Insensitive people cause you to be more sensitive.
Negative people cause you to react with positivity.

For each negative person you encounter, you have many more positive encounters. Surround yourself with people, things, and experiences which make you feel good and do good. Do you deserve less than that?

Arthritis Rising

Arthritis Rising: Are You at Risk?

Extra Pounds, Idle Lifestyles May Make Arthritis More Likely
By Miranda Hitti
WebMD Medical News www.webmd.com
Reviewed By Louise Chang, MD on Thursday, October 12, 2006

Oct. 12, 2006 -- Arthritis is on the rise in the U.S., with no signs of a slowdown. But you might be able to buck that trend, says the CDC.

First, the numbers. Picture a graph with a line headed upward, and you've got the basic idea.

More than 46 million U.S. adults -- over 21% -- say they've been told by a doctor that they have arthritis, gout, lupus, or fibromyalgia.

About 8% of U.S. adults -- more than 17 million people -- say arthritis or joint symptoms hamper their activities.

That's according to CDC statistics from national health surveys done from 2003 to 2005.

Those figures were lower in 2002.

Back then, nearly 43 million adults said they had doctor-diagnosed arthritis, gout, lupus, or fibromyalgia; slightly less than 8% said arthritis or joint problems limited their activities.

By 2030, arthritis will affect 67 million U.S. adults, the CDC predicts.

Those statistics appear in the CDC's Morbidity and Mortality Weekly Report.

Who's Affected

Arthritis is most common in the following groups:

Women
Older adults
Whites (compared with blacks and Hispanics)
People who are overweight or obese
People with sedentary lifestyles
After adjusting for age, people with low education levels and people who are obese or physically inactive were the most likely to say arthritis and joint problems limited their activities.

Remember, the CDC's findings are based on self-reports of doctor-diagnosed arthritis.

The researchers didn't check participants' medical records. They also don't know how many people have undiagnosed arthritis.

What You Can Do

Shedding extra pounds and becoming more active may give you an edge against arthritis.

For instance, 31% of obese adults and 21% of overweight (but not obese) adults said they'd been diagnosed with arthritis, compared with 16% of leaner adults. (Not entirely true...I weighed less and was in more pain than the weight I am at now about 50 pounds heavier.)

A quarter of those who were physically inactive said they had doctor-diagnosed arthritis, compared with nearly 20% of physically active adults.

The surveys didn't directly test weight lossweight loss or physical activity as ways to prevent arthritis. But other studies have.

Extra weight puts more stress on joints. And joints that get little use may feel more stiff and painful than if they get used.

Of course, you shouldn't pound your joints with overblown exercise, and you shouldn't sacrifice nutritionnutrition to lose weight. So check with your doctor before starting a new diet or exercise program.

If you already have arthritis, ask your doctor what you can do to manage your condition.


--------------------------------------------------------------------------------

SOURCES: CDC, Morbidity and Mortality Weekly Report, Oct. 13, 2006; vol 55: pp 1089-1092. News release, CDC.

Anxiety and Chronic Illness

Anxiety Disorders Closely Linked to Physical Conditions, Study Finds
From Cathleen Henning,Your Guide to Anxiety & Panic Disorders. www.panicdisorder.about.com

People with anxiety disorders have an increased chance of developing physical conditions, particularly thyroid diseases, respiratory diseases, gastrointestinal diseases, arthritis, allergies, and migraine disease, researchers report in the October 23, 2006 Archives of Internal Medicine. Additionally, the presence of a physical condition along with an anxiety disorder increases the chance for disability and poor quality of life.

Researchers at the University of Manitoba in Winnipeg, Canada, led by Dr. Jitender Sareen, decided to explore the connection between anxiety disorders and physical conditions. Although depression has been linked to physical illness for quite some time, the association between anxiety and illness is much more recent. Additionally, according to the researchers, a number of the existing studies were limited in different ways, thus possibly affecting the outcomes.

Sareen and his colleagues decided to use the results of the German Health Survey (GHS), a survey of 4181 adults ages 18 to 65, conducted between 1997 and 1999, to assess the association between anxiety and illness. The survey used several tools to assess physical health, psychological health, and quality of life. These questionnaires and interviews were conducted by physicians and psychologists; additionally, medical tests were conducted to evaluate participants for illnesses.

The GHS showed that 8.4 percent of the participants had an anxiety disorder. This is consistent with the National Institute of Mental Health's finding that approximately 8 percent of the population has an anxiety disorder. Using the GHS, Sareen and his colleagues discovered several significant associations between anxiety disorders and physical illnesses:

Anxiety disorders were associated significantly with physical conditions. Below are the percentage of people with each physical illness who also had an anxiety disorder:
Respiratory diseases - 15.2
Gastrointestinal diseases - 18.8
Arthritis - 10.7
Allergic conditions - 12.0
Migraine disease - 20.3
Thyroid diseases - 14.8

Of the individuals with both anxiety disorders and physical conditions, the majority developed the anxiety disorder first.

Those with both anxiety disorders and physical conditions were more likely to have a poorer quality of life as well as be disabled (unable to perform normal daily activities) at some point.
Although the researchers point out a need for future studies (particularly as the age range in this study was 18-65), they did offer some possibilities for why anxiety disorders and physical conditions may be so closely connected:
A physical illness, particularly if life-threatening, may cause increased anxiety eventually leading to an anxiety disorder.

An anxiety disorder may lead to an increased chance of illness as the result of biological changes caused by the anxiety disorder.

An anxiety disorder may lead to another disorder, such as substance abuse, which in turn causes a physical illness.

A medication for a physical illness may bring on or increase anxiety symptoms.

There may be common genetic, environmental, and/or personality factors that connect anxiety disorders and certain physical conditions.
Whatever the reasons are for these connections, the researchers make clear that physicians need to assess for anxiety as well as depression when treating patients for physical conditions. "Although there have been increased efforts to recognize and treat depression in the medically ill, our findings underscore the need to create similar programs to recognize and treat anxiety disorders in the medically ill," the researchers wrote in the Archives of Internal Medicine.

References:
1) "Facts About Anxiety Disorders." 11 May 2006. National Institute of Mental Health. Accessed 20 Oct 2006 .
2) Sareen, Jitender, et al. "Disability and Poor Quality of Life Associated With Comorbid Anxiety Disorders and Physical Conditions." Archives of Internal Medicine 166(2006): 2109-2116.

Updated: October 23, 2006

Psychiatric ills common in adults with fibromyalgia

Psychiatric ills common in adults with fibromyalgia
Wed Sep 20, 2006 4:52 PM BST
By Amy Norton

NEW YORK (Reuters Health) - Many people with the chronic pain disorder fibromyalgia have also suffered from depression, anxiety or other psychiatric conditions at some point in their lives -- suggesting, researchers say, that the disorders have some common causes.

In a study of 336 adults with and without fibromyalgia, researchers found that those with the condition were substantially more likely to have ever had depression, bipolar disorder or an anxiety disorder. They also had higher rates of eating disorders and substance abuse problems.

In most cases, the psychiatric condition preceded the development of fibromyalgia, making it unlikely that the mood disturbances were simply a reaction to having chronic pain.


Fibromyalgia is a syndrome marked by widespread aches and pains, fatigue and sleep problems, among other symptoms; the cause is unknown, and there are no medications specifically approved for the condition. Treatment usually involves a combination of approaches, such as painkillers, antidepressants, behavioral therapy or exercise therapy.

The new findings, published in the Journal of Clinical Psychiatry, are based on a comparison of families with members affected by either fibromyalgia or rheumatoid arthritis, another condition marked by chronic pain.

Between both groups of families, there were 108 adults, nearly all women, with fibromyalgia and 228 without the condition.

Overall, those with fibromyalgia were almost three times more likely to have ever had major depression and nearly seven times more likely to have suffered an anxiety disorder. They also had a two to three times greater risk of eating disorders and substance abuse problems, and a much higher risk of bipolar disorder.

The associations between fibromyalgia and these psychiatric conditions suggest that there is some "shared vulnerability" at work, according to study chief Dr. Lesley M. Arnold, an associate professor of psychiatry at the University of Cincinnati College of Medicine.

"We are not saying that fibromyalgia is a psychiatric disorder," Arnold told Reuters Health.

Rather, some people may be vulnerable to developing both fibromyalgia and certain psychiatric disorders -- possibly because of genes, Arnold explained, or because of environmental factors such as chronic stress. But no one yet knows for certain.

Still, the evidence suggests that people with fibromyalgia should be screened for psychiatric disorders, according to Arnold. Even when people aren't currently suffering any psychiatric symptoms, their mental health history can influence how their fibromyalgia is treated, she noted.

For example, Arnold explained, medication with both antidepressant and pain-relieving effects might be the first choice for people with a history of depression. Another option is cognitive behavioral therapy, which addresses harmful thought patterns and behaviors; this approach, Arnold said, might help fibromyalgia patients with a history of depression or anxiety disorders.


SOURCE: Journal of Clinical Psychiatry, August 2006.

© Reuters 2006. All Rights Reserved.

Tips for Treating Pain

Thanks msnbc.com
Tips for Treating Pain
An estimated 50 million Americans have chronic pain and nearly 25 million suffer acute pain each year. How to find relief.

Web Exclusive
Newsweek
Updated: 2:01 a.m. ET Oct 8, 2006
Oct. 8, 2006 - Practice Healthy Habits
Get adequate rest, eat a healthy diet and engage in regular exercise. (Ask your doctor which exercises are safe for you.) Relaxation techniques like meditation, visualization, hypnosis, and biofeedback may also help you feel better.

Care for your Emotional Health
People in chronic pain have been found to have an increased incidence of depression, anxiety and sleep disturbances. Your physician may want to prescribe medication or may suggest cognitive behavioral therapy (like relaxation techniques and psychological therapy). It may also help to share your thoughts and feelings with loved ones and to join a support group. (The American Chronic Pain Association, among others, has support groups throughout the country).

Know Your Treatment Options
There are many options for treating your pain beyond prescription and over-the-counter medicine. Complementary and alternative therapies include biofeedback, meditation, relaxation techniques, yoga, acupuncture and physical therapy. There are also interventional treatments for specific types of pain (like electrical stimulation and injections). Ask your doctor which is best for you.

See a Pain Specialist
You can ask for a referral from your primary care physician. Many professional physician organization web sites also have listings of their members available (see the links below).
Source: The American Pain Foundation

Other helpful links:
American Academy of Pain Medicine
American Academy of Pain Management
American Academy of Neurology
American Board of Pain Medicine
American Medical Association
American Pain Society
American Society of Interventional Pain Physicians
American Chronic Pain Association

© 2006 Newsweek, Inc.

Thanks to some new medicine....

I have been down for the count since Thursday. Between PT and new mental health providers I have been a very busy girl. You see, my old psych nurse practitioner decided to stop prescribing medication and has also slimmed down her practice for counselling. She was only available two days a week and on top of that I was only able to see her once a month. Nice huh? Well I started with two new professionals last week on top of trigger point shots with a new doc (my regular doc is away for Ramadan) and PT right after.
Oh the price of Fibromyalgia. I may be on disability but my full-time job is going to doctor's appointments.