Yukiko Kinoshita writes:
Yoko Kashiwagi is a successful 42-year-old media executive. She was a marathon runner in her college days, and continued to run and exercise regularly well into her 30s. But for the last five years, her business responsibilities have prevented her from getting much more exercise, and over the last two years she has stopped exercising altogether, has gained 7 or 8 kilos. Over the same period, 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. She is afraid that she might have rheumatoid arthritis or some other kind of arthritis. Her father, who was also an athlete, underwent ACL reconstruction surgery last year. She has been feeling more and more fatigued lately. And the crackling and stiffness in her left knee is sometimes very painful. In addition, her left knee gets swollen, especially when she has to work into the night. She will not undergo ACL surgery under any circumstances. She is afraid of becoming much more isolated if her knee causes her much more trouble.
Treatment for different kinds of arthritis varies considerably, so it is important to know which type of arthritis she has. X rays can show if a bone is damaged by osteoarthritis and, if so how badly. Test of blood or fluid withdrawn from inside the affected joints may help rule out other diseases and determine the type of arthritis that is causing her symptoms.
The following data are needed to complete Kashiwagi 's diagnosis.
1. Where it hurts - her left knee.
Should you have osteoarthritis, Ms. Kashiwagi, you have to take the following treatment. You say that you will not undergo ACL surgery. But surgery is usually done only in severe cases, when articulation is broken and articular cartilage is completely lost and you have lost the use of your leg, in other words, the most disabling cases of arthritis for which other treatments have failed. So you do not need ACL surgery immediately. First, you will take the following treatment. 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, medications are usually recommended only after weight loss and exercise have not been effective in relieving symptoms. 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. Exercise also helps you reach or maintain a healthy weight, which reduces the stress on your joint.
Osteoarthritis cannot be cured. So you must get along with osteoarthritis all your life. It may be possible to live with osteoarthritis. Most people with osteoarthritis live full active lives. Those who do best are managing their disease in partnership with their doctor. Once you accept that you have osteoarthritis, you can adapt your lifestyle to meet the challenges that damage to a joint can create. By taking charge of your treatment, you can learn how to manage your pain, control your weight and use exercise most effectively. You should also take advantage of the services in your community such as swimming exercises, that are designed specifically for people with arthritis.
2. When it hurts - her left knee gets swollen especially when she has to
work late into the night.
3. When the pain started - this information can help the doctor
determine if her arthritis is caused by an injury, an illness, or general wear and tear on her joint. It is also help the doctor evaluate how much damage to her joint has occurred since the disease started. Over the last two years, she has been finding it increasingly more difficult to move her left knee.
4. If there is any swelling - the absence or presence of swelling in her
joint can indicate the type of arthritis she has. If the swelling is caused by inflammation, she may have rheumatoid arthritis or other type of inflammatory arthritis. If the swelling is caused by growth of bone, she probably has osteoarthritis. Her left knee gets swollen especially when she has to work late into the night.
5. Which daily chores are hard to do - this information help the doctor
understand which joints are most affected by the arthritis, providing another clue to the type of arthritis she has.
6. If the joint has ever been injured or over used - she injured during her
running practice when she was in college.
7. Family health history - some forms of arthritis tend to run in
families. Her father, who was also an athlete, underwent ACL reconstruction surgery last year.
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