Rheumatoid Arthritis Care

The core goal of rheumatoid arthritis care has never been the so-called "radical cure", but to delay the progression of joint damage to the greatest extent, reduce the risk of disability, and allow patients to maintain the same quality of daily life as healthy people through standardized treatment and refined daily management.

I met 32-year-old Ms. Lin for a follow-up consultation a while ago. When she was first diagnosed two years ago, she was sitting in the consultation room crying. She said that she had just given birth to a baby and was afraid that she would not be able to hold the baby in the future. Now she can still take half a day a week to take her baby for a walk in the suburbs. Her joints are basically not in pain, and the inflammation indicators in the follow-up examination are all within the normal range. She herself said that she took a lot of detours at the beginning, but later figured out how to deal with the disease and found it less scary.

The biggest dilemma for many newly diagnosed patients is: Should they rest or move more if they have joint pain? We have seen both extremes in clinical practice before: some were so painful that they lay in bed for half a month without getting off the ground. As a result, the muscles atrophied and the joints became even more stiff. ； Some people are so painful that they break into cold sweats and still run a marathon. Originally, there was only slight swelling, which directly turned into joint effusion. In fact, there is no unified answer to this question. It depends on what stage you are in: If you are in the acute stage and your joints are red, swollen, hot, painful, and painful when you touch them, you must reduce the load on the affected joints. If necessary, you can wear a soft brace to fix it for 3-5 days. Do not move at all. Take it for three to five minutes every day, and slowly do several small movements such as finger grasping and ankle rotation to avoid joint adhesion. ； After the acute stage, when the joints are only occasionally sore and stiff without obvious swelling and pain, moderate activities should be encouraged. Swimming, Tai Chi, Baduanjin and other exercises that put less pressure on the joints are suitable. I know an old aunt who has been ill for 12 years. Before, she was too afraid to move for fear of pain. Within half a year, her finger joints contracted to the point where she could not hold chopsticks. After practicing with the community Tai Chi team for three years, she can now thread needles and threads without any problem.

In addition to the question of movement, the most frequently asked question is whether there are any taboos? There are a lot of things to say on the Internet. Some say that seafood, beef, mutton, and even soy products cannot be touched because eating them will induce inflammation. Others say that there are no restrictions on eating them. Judging from the current evidence-based medical evidence, there are no foods that absolutely need to be avoided in rheumatoid arthritis itself. Unless you clearly experience worsening of joint swelling and pain after eating something, then just add it to your personal taboo list. On the contrary, I would like to remind you not to buy the so-called "specific rheumatoid medicines" and "ancestral secret recipes" on the Internet. I just admitted a patient last month and took the "radical cure" recommended by a relative for half a year. The pain was temporarily suppressed. When I came for a follow-up examination, I had gastric bleeding and early necrosis of the femoral head. I saw that a large dose of hormones and analgesics were added to the folk prescription, which is equivalent to drinking poison to quench thirst.

Many people are also very worried about taking medication, especially when they hear about hormones and biological agents. They think they have serious side effects, will make them fat, and will harm their body, so they often secretly reduce or even stop taking them. There was a 60-year-old Aunt Zhang who took low-dose hormones for two weeks and felt her face was a little swollen. She stopped all the medicine without telling the doctor. She was already able to go downstairs to buy groceries. However, after stopping the medicine for a week, she was in so much pain that she couldn't get out of bed, and her inflammation indicators tripled. Later, the doctor adjusted her hormone dosage, along with stomach-protecting and calcium-supplementing medicines, and slowly reduced the dosage. Now, not only has the swelling gone, but the inflammation has also been controlled very well. In fact, the medication regimen for rheumatoid arthritis is now very mature. Doctors will adjust the dosage according to your situation to minimize side effects. Do not adjust the medication yourself, which will turn a small problem into a big trouble.

There are many inconspicuous little details in daily life, and if you do them well, you can avoid a lot of sins. For example, don't touch cold water directly in winter. It's best to install a constant-temperature water heater when washing dishes at home. When going out, wear protective gear on joints such as wrists and knees that are prone to cold. Don't face the direct blowing of air conditioners and fans. Many people suffer from morning stiffness. When they wake up in the morning, their joints are as hard as rust and they can't move. Don't try hard at this time. First, lie on the bed and rub your hands and joints slowly for three to five minutes. Wait for the joints to warm up, then move slowly, which will make you feel much better. When lifting heavy objects, try to use your large joints to exert force. Do not use your fingers to hook heavy objects to avoid excessive stress and deformation of small joints.

In fact, rheumatoid disease is no longer the "immortal cancer" that everyone talks about. As long as they follow the doctor's instructions and take more snacks every day, most patients can control it well and can work normally, get married, and have babies without delay. Really, I have seen too many patients who have been ill for more than ten or twenty years, and their lives are still prosperous, with nothing difficult to do.