Monday, January 23, 2012

Cricoarytenoid Rheumatoid Arthritis

Rheumatoid Arthritis can affect any join in the body, including the joints that make up the larynx or voice box. (Click on photo below to enlarge)

2008 Trailsight Medical Media

 The cricoarytenoid joint is the joint between the cricoid and arytenoid cartilages. This joint is rotated by the vibration of the vocal cords thus changing the tone of the voice. 


While cricoarytenoid arthritis is typical in RA, (between seventeen and seventy-five percent of RA sufferers develop it) a large number of RA patients do not realize their symptoms of hoarseness, pharyngeal fulness in the throat when speaking or swallowing, pain in the ears, and shortness of breath may be directly related to laryngeal RA. Hoarseness is the most frequently noted symptom.



Emergent airway closure is not seen often but can develop in patients with CA joint involvement. Patients with persistent hoarseness, pain when swallowing, talking or coughing, shortness of breath, or a sensation of fullness in the throat should contact their physician.



Thursday, January 5, 2012

Blood Tests in Rheumatoid Arthritis

There are a myriad of lab tests associated with Rheumatoid Arthritis. What do these tests mean and why are they done?

One test your rheumatologist will probably order is the Rheumatoid Factor (RF). In seventy to eighty percent of people diagnosed with RA this test will be positive but twenty to thirty percent of RA sufferers will have a negative RF. Results may also change over the course of the disease.

Another test you may have done is the Anti-CCP Antibody test. This test may or may not be positive in RA but if it is positive, the likelihood of having RA is around ninety percent. The anti-CCP also indicates that the disease is likely to progress more rapidly.

The ANA or Anti-nuclear Antibody tests measure the immune-system chemicals that indicate autoimmune disease. Around thirty to forty percent of RA patients test positive for ANA. This test may also be positive in many other auto-immune diseases.

ESR or Erythrocyte Sedimentation Rate tests for inflammation by measuring how quickly red blood cells separate out of the blood and settle to the bottom of the tube.

Another test for inflammation is the CRP or C-Reactive Protein. This is a protein produced in the liver during periods of high inflammation or infection. These levels change more quickly than the ESR so this is a test used to measure the effectiveness of treatment.

A CBC or complete blood count is another test usually done. This gives the rheumatologist information regarding your hemoglobin, red blood cell count, platelet and white blood cell count. In RA, the platelets may be increased and since the white blood cells indicate immune system activity, they may also be increase. The hemoglobin may be decreased, indicating anemia.

A fairly new test on the market is the Vectra DA test. This test is a multi-biomarker blood test for RA disease activity. It measures twelve proteins associated with RA disease activity and integrates them into a single objective score. It has been validated for adults diagnosed with RA and is not a diagnostic tool but rather a disease activity indicator.

This list of tests is not all inclusive as your rheumatologist will determine which blood tests are appropriate for you. Other tests that may be done include, liver enzymes and kidney function tests, just to name a few.

Your rheumatologist will use all of the testing done in conjunction with your clinical picture to work with you and determine a plan of action for your treatment.

Sunday, January 1, 2012

Assistive Devices

Assistive devices not only make life easier for the person suffering from autoimmune arthritis but they can also protect the joints from further damage.

Here are some of the devices that I either use or think would be helpful.





I have a bottle opener that I use on a daily basis. On one end it is flat so that it will slide under the pull tab on a drink can and the other end has a sharpish bag opener. (Well mind did have that until I dropped it and broke it.)


The Good Grips peeler is another device I have. Before I got this, my hubby had to do all of the veggie peeling. Now I can do some of it but I still have trouble chopping up a lot of the veggies.



The gas cap turner will probably be the next device I buy. At the gas station the other day, I came very close to asking a man in the bay next to me for help because I had trouble removing the gas cap.





 I also use a medication cap opener similar to the one above. Mine has a magnifier in one end so you can see the name of the medication without too much trouble.


I used to have wax bath for hands but it wouldn't work for feet. The large wax bath system is on my RA wish list since they are large enough for feet, hands and even elbows.


I have used the bird pen in the past when I had many hours of nursing documentation to do by hand. It did help relieve the stress on my fingers.





For those who have trouble getting in and out of bed, a bed cane can be a great benefit.




Carry handles for grocery bags can make bringing the groceries in a little less painful. The bags have such thin handles that they cut into the poor painful hands and this alleviates that problem.




Arthritis gloves keep the joints warm and provide light compression for those inflamed joints. In the winter, I wear mine under my regular gloves to help keep my hands even warmer.





Gripping playing cards can cause pain in arthritic fingers and these will help alleviate that pain.




Door knob turners help prevent undue stress on fingers and hand joints. They also make it a little easier to open doors.




Canes can be beneficial for those times when the feet, ankles, knees or hips are flaring and mobility is limited. I keep a cane in my car even though I don't use it much. I have learned to use it more when we travel to help prevent falls.

I do recommend getting a cane with a gel grip. I have two. One with a wooden handle and one with the gel grip. The gel grip cane was purchased after using the wooden handled cane in Disneyland. The hard wooden handle made my hands ache.

 
There are many more devices that can make the life of the RA sufferer a little easier. These can be found on the internet and many local drug stores carry quite a few of these devices.

Try out some of them and I think you'll find that they make life much easier.