Kiyoshi Higa writes:
Yoko Kashiwagi is a successful 42-year-old media executive. She was a marathon runner in her college days. Into her 30s, she continued to run and exercise regularly. But over the last two years, she has stopped exercising altogether, has taken up smoking cigarettes,and has gained 7 or 8 kilos. She has been finding it increasingly more difficult to move her left knee, the same knee she injured during her running practice when she was in college. I want to give her an accurate diagnosis. But I cannot do it without more information. First, the information I need is "where it hurts." The location of her arthritis pain can help me determine the type of arthritis she has and, possibly, the cause. The second point of information is "when it hurts." Knowing the time of day when her pain is most severe will help me determine what types of arthritis, too. Third is "when the pain first started." Of course, this information can help me determine if her arthritis is caused by an injury, an illness, or general wear and tear on damage to her joints or bones has occurred since the disease started. Fourth is "her family health story." In addition, to her symptoms, I will ask about any serious illness, operations, allergies, or injuries she has had, because some forms arthritis tend to run in families, I will ask whether one of her parents, grandparents, or brothers or sisters has had arthritis. For example, Ms. Yoko Kashiwagi is familiar with complications from arthritis since her father, who was also an athlete, underwent ACL reconstruction surgery last year. This information is a very important. After I get this information, I will take X-rays of the affected joints. This X-rays can show if a bone is damaged by osteoarthritis and, if so, how badly. I also want to to test a sample of her blood or pf fluid withdrawn from inside the affected joints. These tests may help me out other diseases and determine the type of arthritis she has is not clear immediately. I may recommend more testing of refer her to specialist.
If I determine that Ms. Kashiwagi has osteoarthritis, she will need to know what kind of adjustments she must make to live with her condition. If her disease is osteoarthritis, she will have to follow these treatments. I want her to recognize that osteoarthritis cannot be cured, but it can be treated. Beginning treatments as early as possible can help reduce long term damage to her joints and bones. There are several general types of treatment for osteoarthritis. Weight loss and exercise are usually the first treatments recommended. Because of the potential side effects of many drugs that are used for treating osteoarthritis, medication is usually recommended only after weight loss and 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. Being overweight is the most common cause of excess pressure on the joints and can increase her risk of developing osteoarthritis. Of course losing weight can help relieve the pressure and strain on her joints, reducing the wear and tear that can cause damage to the tissues inside the joint. Weight loss can also help reduce the pain and stiffness in the affected joints, especially those in the knees. The best way to lose weight and maintain a healthy weight is to eat less, and exercise more. But she should eat the same healthy diet that is recommended for everyone. She needs to do more exercises, for example, swimming or walking is very good, because she can do this exercise anywhere at any time. There are other treatments for osteoarthritis, for example, medication and heart and cold treatments.
Although osteoarthritis causes fear, she might need to overcome her fears and sense of isolation in the future. Most people with osteoarthritis live full, active lives. So she can get life-enhanced payoffs from learning as much as possible about arthritis. Following an active lifestyle is often the most effective treatment for osteoarthritis. First step in managing the disease is learning about osteoarthritis and its effects and treatment. The more she knows about her own illness, the more control she will have over it. She should try to "educate herself." She needs to check with her doctor, physical therapist, nurses, local hospitals, senior citizen center, health clinics, and health clubs about classes, organizations or meetings concerning arthritis. This is very necessary, too. Then she may find it beneficial to join a support group of other people who have arthritis. In a support group, people learn from each other by sharing their experiences and insights. Finally, I want her to be optimistic. One of the most powerful weapons against the disease is a positive attitude. Having an optimistic outlook can increase her ability to control herself. Illness may make her unhappy, angry, sad, afraid and fearful. But she should overcome these senses. She should know that only if the other treatments have failed, would surgery be necessary. In fact, most people who have osteoarthritis will never need to have surgery under any circumstances. But she still needs to overcome her fear.
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