Archive for March, 2011

MEDICATIONS FOR RHEUMATOID ARTHRITIS (RA): CORTICOSTEROIDS

Posted on March 29, 2011, under Arthritis.

Corticosteroid medications, better known as cortisone or steroids, are useful in treating rheumatoid arthritis (RA) and a variety of other conditions such as asthma and allergies. There are several types of corticosteroids in current use. The steroids used illegally by athletes to gain extra strength differ vastly from the cortisone injected into a joint to provide relief from inflammation.
What steroids and cortisone do have in common is chemical makeup. In fact, corticosteroid medications, which are artificially manufactured, also resemble the body’s own natural hormones in chemical makeup. Cortisone and hydrocortisone are two such hormones that are produced naturally by the adrenal gland. These hormones have a protective function: when a person suffers any kind of stress, the levels of these hormones increase to help the person cope physically with the particular situation.
When medications resembling the body’s natural cortisone are taken in larger amounts than the body normally produces, inflammation is markedly decreased. For this reason, corticosteroid medications can be an important part of the treatment of RA.
*103/209/5*

MEDICATIONS FOR RHEUMATOID ARTHRITIS (RA): CORTICOSTEROIDSCorticosteroid medications, better known as cortisone or steroids, are useful in treating rheumatoid arthritis (RA) and a variety of other conditions such as asthma and allergies. There are several types of corticosteroids in current use. The steroids used illegally by athletes to gain extra strength differ vastly from the cortisone injected into a joint to provide relief from inflammation.What steroids and cortisone do have in common is chemical makeup. In fact, corticosteroid medications, which are artificially manufactured, also resemble the body’s own natural hormones in chemical makeup. Cortisone and hydrocortisone are two such hormones that are produced naturally by the adrenal gland. These hormones have a protective function: when a person suffers any kind of stress, the levels of these hormones increase to help the person cope physically with the particular situation.When medications resembling the body’s natural cortisone are taken in larger amounts than the body normally produces, inflammation is markedly decreased. For this reason, corticosteroid medications can be an important part of the treatment of RA.*103/209/5*

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OVERCOMING BARRIERS TO BDD TREATMENT: OVERCOMING RELUCTANCE TO TRY PSYCHIATRIC TREATMENT

Posted on March 19, 2011, under Anti Depressants-Sleeping Aid.

Some people are reluctant to try psychiatric treatment. The reasons vary. Sometimes, it’s a concern about stigma. For others, it’s fear of the treatments themselves, which is often based on a misunderstanding of them and possible side effects. Others insist that surgery is the solution. Sometimes this reluctance stems from a desire to “do it on my own,” and the person feels like a failure if they accept psychiatric care. While reluctance may be understandable, it shouldn’t keep you from getting treatment and getting better. Although SRIs can have side effects and CBT can be challenging, most people fare well with these treatments and easily tolerate them. You shouldn’t feel or look “drugged” while taking an SRI, and these medications aren’t addictive. If medication sjde effects occur, or CBT is too difficult, a good doctor or therapist will work with you and probably succeed in making them tolerable. I’ll say more about surgery in chapter 15, but as best we know it usually doesn’t work for BDD and may even make you worse. It isn’t a good substitute for psychiatric treatment. And trying to get better on your own is unlikely to work. Perhaps, if your BDD is mild, you may benefit from trying accepted CBT techniques on your own. But most people—and certainly those with moderate or severe BDD—will need professional help. As best we know, herbs, diet, “natural” remedies, and other strategies (other than SRIs or CBT) are unlikely to work.
When you overcome these barriers, the stage is set for a successful—in some cases a lifesaving—outcome. Anne, who had an excellent response to Celexa (citalopram) told me, “I’m feeling terrific, for the first time in 30 years.” Like some people I’ve treated who responded to medication, Ann “tested” the medication by trying to bring her obsession back. But she couldn’t. Sandy told me something similar: “The medication definitely curbs the obsession. It released a logjam. My life felt like a stream that had thousands of huge boulders and logs in it—the water couldn’t flow through smoothly. Now it flows with ease. I feel full of energy and creativity.” And after CBT, Jason felt that he—not the BDD— was in change of his life.
*239\204\8*

OVERCOMING BARRIERS TO BDD TREATMENT: OVERCOMING RELUCTANCE TO TRY PSYCHIATRIC TREATMENT  Some people are reluctant to try psychiatric treatment. The reasons vary. Sometimes, it’s a concern about stigma. For others, it’s fear of the treatments themselves, which is often based on a misunderstanding of them and possible side effects. Others insist that surgery is the solution. Sometimes this reluctance stems from a desire to “do it on my own,” and the person feels like a failure if they accept psychiatric care. While reluctance may be understandable, it shouldn’t keep you from getting treatment and getting better. Although SRIs can have side effects and CBT can be challenging, most people fare well with these treatments and easily tolerate them. You shouldn’t feel or look “drugged” while taking an SRI, and these medications aren’t addictive. If medication sjde effects occur, or CBT is too difficult, a good doctor or therapist will work with you and probably succeed in making them tolerable. I’ll say more about surgery in chapter 15, but as best we know it usually doesn’t work for BDD and may even make you worse. It isn’t a good substitute for psychiatric treatment. And trying to get better on your own is unlikely to work. Perhaps, if your BDD is mild, you may benefit from trying accepted CBT techniques on your own. But most people—and certainly those with moderate or severe BDD—will need professional help. As best we know, herbs, diet, “natural” remedies, and other strategies (other than SRIs or CBT) are unlikely to work.When you overcome these barriers, the stage is set for a successful—in some cases a lifesaving—outcome. Anne, who had an excellent response to Celexa (citalopram) told me, “I’m feeling terrific, for the first time in 30 years.” Like some people I’ve treated who responded to medication, Ann “tested” the medication by trying to bring her obsession back. But she couldn’t. Sandy told me something similar: “The medication definitely curbs the obsession. It released a logjam. My life felt like a stream that had thousands of huge boulders and logs in it—the water couldn’t flow through smoothly. Now it flows with ease. I feel full of energy and creativity.” And after CBT, Jason felt that he—not the BDD— was in change of his life.*239\204\8*

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FATIGUE AND RHEUMATOID ARTHRITIS (RA): SETTING PRIORITIES

Posted on March 9, 2011, under Arthritis.

Your energy is most limited when your RA is flaring, and at these times it may not be possible for you to do everything you would like to do or feel that you should do. At these times you need to be honest with yourself about what you can and cannot do. Start by setting priorities. Make lists of things to do, and then prioritize those things. Decide to do first what absolutely must be done, and cross out everything that has the word should connected to it: “I should iron my dress.” Instead, select a dress to wear that doesn’t need ironing, even if you just wore it last week. Being fashion conscious at the expense of energy is a low priority. “I should do some dusting tonight.” The dust isn’t going anywhere! Put that task aside until you have more energy, or consider assigning that task to someone else.
After you have thrown out the shoulds, divide the remaining tasks into steps. Discard the all-or-nothing philosophy. (Cleaning day -”I must do all my cleaning in one day so my whole house is clean at one time”-is an example of an all-or-nothing item you may find on your list.) Do a little each day, and eventually it will all get done.
*49/209/5*

FATIGUE AND RHEUMATOID ARTHRITIS (RA): SETTING PRIORITIES Your energy is most limited when your RA is flaring, and at these times it may not be possible for you to do everything you would like to do or feel that you should do. At these times you need to be honest with yourself about what you can and cannot do. Start by setting priorities. Make lists of things to do, and then prioritize those things. Decide to do first what absolutely must be done, and cross out everything that has the word should connected to it: “I should iron my dress.” Instead, select a dress to wear that doesn’t need ironing, even if you just wore it last week. Being fashion conscious at the expense of energy is a low priority. “I should do some dusting tonight.” The dust isn’t going anywhere! Put that task aside until you have more energy, or consider assigning that task to someone else.After you have thrown out the shoulds, divide the remaining tasks into steps. Discard the all-or-nothing philosophy. (Cleaning day -”I must do all my cleaning in one day so my whole house is clean at one time”-is an example of an all-or-nothing item you may find on your list.) Do a little each day, and eventually it will all get done.*49/209/5*

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