my health | my life

SUMMER 2011

FIVE PAINS YOU SHOULDN’T IGNORE.INSIDE THIS ISSUE:Conquering Rheumatoid Arthritis 8

Events Pullout Calendar 11

Q&A: Carotid Artery Disease 20

remember my first symptoms of arthritis. I’d walk up the stairs, or lift something, and feel achiness

in my joints,” recalled Debora Baird, a resident of St. Louis. “Shortly thereafter, I was on a cross-country driving trip with a friend. By the time we reached Kansas the aches in my joints worsened, I couldn’t make a fist and I wasn’t sleeping well. I chalked it up to physical stress, so I took aspirin. At one point it got so bad, I feared I’d have to fly back home.”

Baird’s symptoms escalated. “I had dif-ficulty grasping a cup — then my steering wheel,” Baird remembered. “Next, my right index finger mirrored the stiffness in my left, and I wasn’t able to bend my thumbs. It seemed impossible that I was experiencing these symptoms because I’ve always been very active. I didn’t under-stand what was going on with my body, so I called my primary care physician.”

Her physician diagnosed rheumatoid arthritis (RA). She was just 32 years old.

Baird’s doctor explained that there are nearly 100 types of arthritis and many treatment options. “I decided I wasn’t going to take any medication – I’d work

through the pain,” says Baird. “But when the inflammation spread to other joints, becoming even more inflamed, I decided to try medications. Some worked for a while. Then, they didn’t.”

Then, it hit her wrists. “That’s when I visited Dr. Steven Lauter, a rheumatolo-gist on staff at Missouri Baptist Medical Center,” said Baird.

“I couldn’t zip my dress or button a but-ton without excruciating pain. Dr. Lauter proposed two options – a non-invasive approach of sleeping in wrist braces, using cold packs and getting me on the right medications, or permanently fusing the bones of my wrists with sur-gery. I chose the non-invasive option. It worked. Then the rheumatoid arthritis moved to my feet. I was exhausted and unable to continue dance classes, which was depressing since I loved it so much.”

Arthritis continued to attack her mo-bility. “I couldn’t make it through the grocery store,” said Baird. “I’d get there and couldn’t walk the entire store, so I’d shop a few aisles, then I’d have to leave. That’s when I applied for a handicap tag for my car.

Climbing the Hills of Rheumatoid Arthritis.A personal story of victory.

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“When the disease began to affect my feet, I told Dr. Lauter I could get through most symptoms, but I needed my feet. He recommended trying a newer biologic medication.”

NEARLY IN REMISSION.

Baird said, “I’m now 95 percent pain-free. I’ve been on this treatment for eight years and it’s working fabulously. I feel like a new person and have a brighter outlook on life. In the last year, I’ve become extremely active. I’ve lost 32 pounds walking and going to the gym five days a week. Not too bad for 57!

”Recently, I spent three weeks in Spain, where amazingly, I was able to get on and off buses and trains with my luggage, walked over 50 miles, and hiked down to the Rock of Gibraltar.”

CAUSES OF RHEUMATOID ARTHRITIS.

Although the cause is not yet known, researchers do know that the body’s immune system plays an important role in the inflammation and joint damage. The Arthritis Foundation reports that the body’s own immune system mistakes cells found in the joints as foreign cells and wants to attack them to protect the body.

SYMPTOMS.

• Persistent joint pain, swelling,warmth or tenderness.

• Lossofrangeofmotionorflexibility.

• Extremefatigue, lossofappetite, low-grade fever.

• Nodulesmayappearundertheskin,often over bony areas exposed to pressure, i.e. around elbows, fingers, over the spine or on the feet.

ARTHRITIS

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“I’m now able to travel again,” said Debora Baird, who is conquering RA.

www.missouribaptist.org

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Dr. Lauter said, “Always visit your pri-mary care physician at the onset of any discomfort or stiffness in the joints and/or muscles, because many symptoms are due to other conditions, such as viral or bacterial infections, including hepatitis, or to metabolic abnormalities, such as thyroid, calcium or potassium irregulari-ties. Appropriate screening tests often help make the correct diagnosis.”

DIAGNOSIS.

“When patients are first diagnosed with arthritis, they typically know something is going on, so they’re not surprised,” Dr. Lauter explained. “Often, there’s an element of depression. But I tell patients that even though there’s no cure, highly effective treatment is available and they can be fully functional – if they’re com-pliant with their treatment plan.”

TREATMENT.

“Today, we understand the need for keeping active to ensure a good range-of-motion in joints,” Dr. Lauter said.

“A patient’s normal response is not to move the joint, creating more stiffness and weakness. I encourage my patients to keep joints and muscles active – keep moving.”

Starting a treatment plan early is key to long-term success. This helps to con-trol symptoms, and prevent deformity and disability. Careful monitoring by a patient’s rheumatologist is important to prevent adverse side effects.

Steven A. Lauter, MD, is board-certified in internal medicine and rheumatology and on staff at Missouri Baptist Medical Center. He re-ceived his medical degree from Wayne State Uni-versity in Detroit and completed his internship and residency in internal medicine at Barnes-Jewish Hospital. He also completed a fellowship in rheuma-tology at McGill University in Montreal, Canada. He is an assistant professor of Clinical Medicine at Washington University.

BAIRD’S ADVICE.• Go to your primary care physician early.

• Be your own advocate.

• Keep a positive attitude.

• Discuss coping advice with your doctor and family.

• Keep moving.

• Take your medications.

• Try other medication, until you find one that works.

• Know the latest research.

• Use a reliable source, such as www.arthritis.org