b. Signs/Symptoms of Rheumatoid Arthritis. Included are the following:
(1)
Easily fatigued and general feeling of being unwell.
(2)
(3)
Weight loss and general weakness. Anemia.
(4)
Painful joint swelling.
(5)
Subcutaneous nodules over bony prominences such as knuckles of the
hand.
(6)
Enlarged lymph nodes.
c. Treatment of Rheumatoid Arthritis. Initially, the patient must understand
that this is a chronic disease necessitating a major change in life-style. The patient will
need to learn how to perform daily activities without putting undue stress on arthritic
joints. Follow this treatment:
(1) Instruct the patient to rest at specific periods of the day on a regular
basis to control fatigue.
(2)
Apply splints carefully to provide rest for painful joints.
(3) Refer the patient to a physical therapist--who can, among other things,
teach the patient how to function without putting undue stress on his joints.
(4)
Control the patient's pain by these methods.
(a) ASA--high dosage can be given. Salicylates reduce inflammation
and relieve joint pain. Stop when the patient hears ringing in his ears. Most adults can
tolerate 4-6 g daily.
(b) Nonsteroid anti-inflammatory medication can be given; for example,
indomethacin (Indocin)
(c) Gold compounds. These are effective against active joint
inflammation only. Nonanalgesics can produce remission. Water soluble gold
compounds can be given intramuscularly weekly.
(d) Moist heat. Hot soaks, paraffin baths, and whirlpool therapy are
usually effective for patients with chronic arthritis.
MD0577
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