Yoshimi Fukushima writes:
Yoko Kashiwagi is a 42-year-old media executive. She is busy and has much stress. Over the last two years she has stopped exercising altogether, has taken up smoking cigarettes, and has gained 7 or 8 kilos. She was marathon runner in her college days and injured her left knee during her running practice. Her father underwent ACL reconstruction surgery.
Since I want to give her a sound diagnosis, I want to tell her what kinds of data I need. The information I want to know is as follows. First where it hurts. Second, when it hurts. Knowing the location of her pain and the time of day when her pain is most severe can help me determine the type of arthritis she has had and, possibly, the cause. Third, when the pain first started. This information can help me determine if her arthritis is caused by an injury, an illness, or general wear and tear on her joint. It will also help me evaluate how much damage to her joint or bones has occurred since the disease started. Fourth, if there is any swelling. Then which daily tasks are hard to do. This information tells me which joints are most affected by the arthritis, providing another clue to the type of arthritis she has.
If the joint has been injured or overused: has she ever done physically strenuous work that included repeated movements of certain joints? What types of exercises, sports, and hobbies has she engaged in? Does she spend or has she spent long periods during an average day moving very little? Then, her family health history. In addition to her symptoms, I will ask about any serious illness, operations, allergies, or injuries she has had, because some forms of arthritis tend to run in families, I will ask whether one of her parents, grandparents, or brothers and sisters has had arthritis. And, any medication she is taking. If she has any allergies to any medications. This is essential information for me to know before I prescribe something for her arthritis.
Then I will give her a physical examination. I will feel the affected joints for swelling or for bony growths. I may also move or even stretch her sore joints to see if their movement is limited and to listen for crackling sounds. In addition, depending on theÅ@symptoms she reports and on her medical history, I may take X-rays of the affected joints. I may also want to test a sample of her blood or of fluid withdrawn from inside the affected joints.If the type of arthritis she has isn't clear immediately, I may recommend more testing or refer her to a specialist.
If she has osteoarthritis, she will require the following treatments. Osteoarthritis cannot necessarily be prevent, but the symptoms can be managed. And it cannot be cured, but can be treated. Beginning treatment as early as possible can help reduce long-term damage to her joints and bones. Weight loss and exercise are usually the first treatment recommended. Because of the potential side effects of many drugs that are used for treating osteoarthritis, medication is usually recommended only weight loss exercise have not been effective in relieving symptoms. Surgery is recommended only for severe, disabling arthritis that interferes with a person's ability to carry out ordinary daily activities, such as dressing, bathing, or walking up stairs.
Then I will suggest special things she can do now to relieve her condition. Considering what she has told me, that over the last two years she has stopped exercising altogether, has gained 7 or 8 kilos, and also considering her symptom stage, It think it is best for her to exercise. Exercise helps her reach or maintain a healthy weight, which reduces the stress on her joints. And regular exercise is known to be very effective for relieving the pain and stiffness of osteoarthritis and may help slow the progression of the disease.
Because of her busy work life, her exercise should be able to done anywhere, at any time, conveniently. One such exercise is walking. Going for regular walks with a friend or family member is a good way to develop the habit of staying active. And the chances of exercise exist everywhere in a day. So she doesn't have to have special time to exercise. Just fitting more activity into her daily routine, such as taking the stairs instead of the elevator and walking or riding her bike instead of driving, can provide many benefits. If she has the time, she had better swim. Swimming is especially good for her knee because the water supports her weight, which reduces stress on those joints.
Although she is fearful of becoming more isolated if her knee causes her much more trouble, and fearful of surgery as well, there are many ways to solve her problem. Learning about osteoarthritis and its effects and treatment is the first step in managing the disease. She needs to check with doctors, physical therapists, nurses, local hospitals, senior citizen centers, health clinics, and health clubs about classes, organizations, or meetings concerning arthritis. Then one of the most powerful weapons against arthritis is a positive attitude. Arthritis can make her feel angry, sad, resentful, irritable, helpless, frustrated, or afraid. These feelings are normal. But taking an active approach to her illness can help her overcome these feelings and cope in a more positive way. It is sure that she is afraid of surgery. Although, surgery is usually done only in severe, disabling cases of arthritis for which other treatments have failed (it is said that, in fact, most people who have osteoarthritis will never need to have surgery), her condition is still in the first stage. So as long as she takes care of herself and exercises to lose her weight, her condition may not get worse.
She is also afraid of isolation. But she never needs to be isolated. There are her family members, friends, doctors, nurses, physical therapists, and other patients who have a similar condition. So she should ask from help them when she needs it. They can play a critical role in helping her learn to live with arthritis. People who have the loving support of others do better in all areas of managing their illness. Talking with loved ones about the difficulties she is having can help prevent depression and improve her ability to cope with her illness.She should not be afraid to ask for help whenever she needs it. People are willing to help. They usually just need to be asked.
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