Author Archives: expressenchere

Treatment for Foot Blisters – the Right Way

expressenchere   July 24, 2017   Comments Off on Treatment for Foot Blisters – the Right Way


Visiting your general physician is always a good idea if you are the prey of frequent foot blisters that are infectious and painful. Blisters occurring due to chemical reactions or other substances also require proper and intense care.

Precautionary treatment for blood blister on foot is better than treatment that a person undergoes after his/her foot blisters have popped and reached their severity. It will surely save you from the unbearable pain which foot blisters can cause sometimes. Each treatment will vary with the severity of each condition; hence it is necessary to rely on an expert’s opinion rather than trying out every antibiotic.

Early treatment, on the other hand, doesn’t require an expert’s opinion and you can start treating a foot blister as soon as you feel it emerging. Early detection and taking care accordingly is a key to prevent from pain of a mature blister. As soon as you feel an itch and feel a blister, here is what you should do:

  • Take off your shoes and your socks if you are wearing any, and wash your feet with cold water. Make sure that no particles of sand or gravel are stuck on your feet.
  • Let your feet dry and cool down. Avoid using a towel, but if you decide to use one, then dabbing is going to be a better option than scrubbing the affected area.
  • Cover the affected area with either a surgical tape or a band aid. However, it is best to wrap it with the special blister moleskin which you can easily purchase from a drugstore.
  • Remove the band aid or moleskin before hitting the sack, and let your skin breathe and re-grow during the night. If you do not notice any improvement the next day, head to your physician without any delay. Closely judge the improvement, and if the irritation is under control, you may repeat the same procedure and hope for improvement before the next dawn breaks.

If your blister is puss-filled, reddish and painful and you assume it is a blood blister or an infected blister, don’t waste time as it could require an intense foot blister treatment. Such treatments involve sterilized needles and expert hands to pierce the foot blisters and pump out the fluid. Puncturing this can rupture the skin around the blister, therefore the expert will be required to carefully cut and clean the underlying new skin with the help of alcohol or a suitable antibiotic. This procedure can be followed with moleskin dressing to keep the affected area clean.

Causes of Staph Infection-Learn How it is caused

expressenchere   March 22, 2017   Comments Off on Causes of Staph Infection-Learn How it is caused


The staph infection is caused by the bacterium named Staphylococcus aurous, people usually get this infection and the common case is staph infection in nose or other skin. It belongs to a group of bacteria called Staphylococcus. Amongst the group of 30 Staphylococci it is mostly the Staphylococcus aurous which causes infections in humans such as boils, impetigo, food poisoning, cellulitis, toxic shock syndrome, scalded skin syndrome and mastitis.

Such infections can affect almost anyone but there are some people who are vulnerable to this bacterial infection. Such people include:

  • Lactating women
  • Newly born babies
  • People suffering from chronic ailments such as diabetes, vascular disease, cancer, lung problems, intravenous catheters and surgical incisions.
  • People who suffer from a weak immune system.

The staph bacteria may be present in the nasal chambers, groin and the rectum of healthy people too. This bacterial colonization is harmless and does not create any health problems. However, in certain cases the skin, which is resistant to such germs gets ruptured by cuts, abrasions, bruises etc. This gives a byway to the prowling bacteria which need a breeding ground. Once they enter into the skin they get favorable conditions for multiplying and start an infection.

The cause of staph infection:

  • Eating food which has been contaminated with toxins produced by the bacterium, Staphylococcus aurous.
  • Not keeping a safe distance with those people who have been infected by the staph bacteria.
  • Not using low- absorbency tampons during menstruation by women and not changing them frequently.
  • Not taking adequate care to prepare and handle food with clean hands.
  • Keeping cuts and wounds open and not disinfecting them with an anti-bacterial lotion.
  • Not keeping ones facial skin well scrubbed.
  • Sitting for prolonged hours without taking a break in between.
  • Wearing skin fitted cloth and fabrics which do not absorb sweat.
  • Not taking a well balanced diet. Without the required vitamins and minerals the body’s immune system gets weakened.
  • Living in unhygienic and crowded conditions.
  • Cutting hair too close to the skin which results in ingrown hair which brings about a staph infection.
  • Exposing one’s skin to dust and dirt.
  • Using perfumed soaps instead of an anti-bacterial one.

The causes of staph infections which bring about drastic consequences are as follows:

  • Biting of lips with a boil nearby.
  • Squeezing of boils can spread the infection internally to some organ or the blood.
  • Not paying heed to the boil which shows no signs of recovery even after a couple of weeks.
  • Not getting a bacterial culture done to ascertain who the carrier of the staph bacteria is, in case the infection spreads within a family. Lack of proper diagnosis and timely treatment can have serious consequences.

The Methicillin-resistant Staphylococcus aurous, better known as MRSA, is a type of bacterium that is resistant to the antibiotic methicillin and some other drugs in this category. The diagnosis of this MRSA is necessary to control the spread of the infection. Once the tests determine the severity of the MRSA infection, the most suitable antibiotic treatment is given to the patients. MRSA infections can be treated with topical, oral, or intravenous antibiotics, depending upon the severity of infection.

Advantages of Sage Tea

expressenchere   March 11, 2017   Comments Off on Advantages of Sage Tea


Sage is a valuable addition to every garden, it’s uses are to numerous to mention all. Besides being a wonderful spice to use in almost any recipe, it also has many medicinal purposes as well.

Sage tea is an essential tonic for women who suffer from the mood swings and night sweats associated with menopause. If taken on a regular basis. It can remedy depression that women frequently experience because of menopause.

Sage is know as an astringent and an antiseptic herb, it also has antioxidant properties that promote better circulation in people experiencing circulatory issues. The teas also provides the drinker with better digestion capabilities, the sage tea works to break up food for easier digestion in the intestines.

Drinking sage tea can also provide relief for people experiencing congestion, it has the ability to clear nasal passages, allowing the person drinking this kind of tea to breathe freely without have any restrictions.

The herb sage is known widely for it’s ability to enhance the body’s immune system, it is for this reason that sage is often included in herbal remedies, tonics and ointments. Because of it’s anti inflammatory properties, sage is considered ideal in the treatment of inflammations and infections located in the mouth and throat.

Drinking sage tea with honey in it is also effecting in suppressing coughs. Strangely enough drinking sage tea has also been known to help in cases of excessive sweating, women drinking sage tea can also expect relief from the hot flashes experienced during the menopausal stage of life.

It is also used by women to reduce or even stop lactation, for some women this can be their saving grace. Speaking from experience, when you are unable to breast feed, producing milk that has no use can be a very big nuisance.

Sage teas have also been known to help with cases of Dyspepsia, that’s is just a fancy medical term for acid indigestion. The sage tea neutralizes the stomach acids that can cause acid indigestion.

Sage tea can also be helpful to reduce febrile conditions, for those of you out there like me who didn’t know what that meant, it is another fancy word for fever. The tea had been known to bring the body temperature down from high temperatures to normal.

So in essence sage tea is a very effective drink and when it is drank frequently, it can prevent numerous ailment. So in conclusion, drink up!

Source:

Sage: Health Benefits, Facts, Research – Medical News Today

Sage | NCCIH

Get Rid of Double Chin Fat

expressenchere   January 15, 2017   Comments Off on Get Rid of Double Chin Fat


Chin fat, double chin, fat face, call it whatever you want, if you have it chances are you hate it. And of course as you age it gets to be flabby chin fat. The question is what do we do on how to get rid of double chin?

When I started to learn more about food and how it affects my health, one thing was made very clear to me, I had to lose fat all over my body. Trying to isolate losing in just one area was not going to work. The same holds true for losing a double chin.

I will say that I really did not need to remove you chin fat before I started eating well and losing fat. My weight was really from the neck down. However, after I lost 20 lbs my not so bad double chin became a turkey neck double chin. So, now I had an additional area to work on.

I was already eating a more healthy diet and exercising, but I had to find out what to do to tighten the fat under my chin. Getting that all important metabolism revved up so your body gets rid of some of the stored fat is good for the whole body. Changing from coffee to green tea in the morning is a very good way to give your metabolism a morning boost.

I would like to add a bit more about green tea. I am not by any means telling anyone that green tea is a cure all, but I can’t help but notice how many articles have been written and how often the experts mention it’s benefits. Although like many other studies there are two sides. The side that thinks it is great and the one that says it needs more study.

For me, anything that helps me to reach all my health goals and to help loose your fat being one of them, is worth a try. Although most of the results have come from lab testing, there has been human testing. All the findings point to the benefits of green tea antioxidants. The antioxidants search for free radicals that may damage DNA, which can contribute to cancer and blood clots.

The evidence has also shown that green tea helps to fight obesity and lower our LDL or bad cholestrol. Both of which are major contributors of poor heart health. Green tea affects our blood vessels in such a way that it makes them less abt to clog.

The part of drinking green tea that does not seem clear is how much green tea to consume. I have read anywhere from 2 to 6 cups a day. Whatever you choose the evidence certainly does support adding some amount of green tea to your healthy lifestyle. You never know, it may be the magic bullet to get rid of double chin fat.

Drink extra fluids

I always weigh myself in the morning because as the day goes on I naturally retain fluids. If you get bloated it will affect the way your face looks. It is necessary to cut the amount of sodium in our diet. Sodium causes our body to become inflamed. We retain fluids so our body can try to dilute the excess sodium.

Excess carbs in our diets act in the same way, which causes us to retain fluids. The fat deposits actually enlarge and cause bloating. To rid of chin fat caused by carbs and sodium, drink at least 8 glasses of water a day. I still find that very hard to maintain.

As with the other areas of our body, the foods we eat are a big part of the effort to lose fat. Stay away from, or greatly reduce foods that are white. These foods are the bad carbs, white sugar, white flour, white pasta, etc. All the foods that get calories from refined white sugar and white flour making it hard to remove the fat.

Choose your carbs when trying eat a more healthy diet, however, carbs are necessary for good health. Too few carbs have been shown to cause depression in some people.

Incorporate at least 3 servings of low fat dairy in your diet. There have been scientific findings to show that people who do this lose more weight. It is necessary to reduce saturated fats. However, unsaturated fat, or “good fats”,help boost our metabolism. Things like salmon, olive oil, olives also help us to feel full longer.

Finally, learn to read labels, that one change helped me to know exactly what I was consuming in a day. Once I figured out how much I was supposed to have in a day, I was able to think less about food as an enemy or a crutch, and more about enjoying food. All the information you can gather will help to get rid of double chin fat and start your journey to get healthy.

I stared this journey to get my cholestrol under control so I wouldn’t have to take pills.  Once I started to understand just what I was eating and when, it gave me the incentive to learn more. That is why I write these articles, to give others the same incentive.

The best Pizza Recipe

expressenchere   June 16, 2016   Comments Off on The best Pizza Recipe


Pizza is one of the best comfort foods in the world; I worked at a very well respected pizza place for 3 years and this is the recipe we used-only scaled down.

325g White flour.

50 ml Olive or vegetable oil.

200 ml Lukewarm filtered water.

2 Tsp Dry yeast/ 1 oz fresh yeast.

2 Tsp Sugar.

2 Tsp Salt.

1. Combine warm water, yeast and sugar in a bowl and leave to ferment  in a warm draught-free area, covered by a tea towel.

2. Meanwhile, sift flour and salt together.

3. When the yeast mixture becomes frothy with large bubbles; add the flour, salt and oil.

4. Combine until the mixture comes of the bowl into a soft dough-if too dry or too wet add more water or flour respectively.

5. Turn onto a well floured surface and knead the dough until it is soft and stretchy. When you push the dough and it springs back quickly it is ready.

6. Put dough into a well oiled bowl and cover with a tea towel-before leaving in a warm draught free place.

7. Leave for 30-45 minutes or until the dough has doubled in size.

8. Knock the dough back down and cut into 2 large balls or 3 small balls.

9. Roll the balls on a floured surface into circles to fit the oiled pizza trays.

10. Add napoli; cheese and whatever toppings you feel like.

11. Cook in a very hot oven-260-270 degrees for 8-10 minutes or until crispy and cooked.

The mechanism of both salt and sugar is important to the final outcome of the pizza. Sugar feeds the yeast and is the catalyst to the yeasts growth and the rising of the crust. On the other hand, salt retards the yeast and the sugar, slowing down the formation of carbon dioxide bubbles that raise the bread. That’s why the salt and sugar in this recipe are in equal amounts. For higher quality dough always use warm filtered water and is possible fresh yeast.

A few different delicious recipes to try:

Bacon and banana-think of the concept of a hawaiian pizza.

Spinach, tandoori chicken; red pepper and yogurt.

Caramelized onion, pear and lamb.

Prawns/shrimp and chilli flakes.

Spinach, roast tomatoes, onion, ham and mayonnaise.

Spinach, olives, fetta, red peppers; chorizo and ham.

Spinach, pumpkin, pine nuts, dry herbs and fetta.

Chicken; onions, mushroom, pesto and asparagus.

Don’t be afraid to create your own recipes with whatever you like on them-pizza is one of the most versatile foods in the world.  Hope you enjoy these recipes, have fun!

Guilt Free Blueberry Muffins

expressenchere   June 16, 2016   Comments Off on Guilt Free Blueberry Muffins


This is a classic and simple blueberry muffin recipe with healthy wholesome ingredients! They are delicious and perfect for a sweet treat! Satisfy your sweet tooth without breaking your diet!

Makes 8 servings

Ingredients:
1 1/2 cups whole wheat flour (almond flour, all purpose flour)
1 egg
1/2 cup applesauce instead of butter and oil
1 cup blueberries
1/4 cup sugar
2 tbsp honey
1 tsp cinnamon
1/2 tsp salt
2 tsp baking powder
1/4 cup milk
1/4 cup Greek yogurt
1 ripe mashed banana
*Optional: chopped nuts

1. Combine flour, salt, and baking powder in a bowl and stir.
2. Mix together milk, yogurt, applesauce, and egg.
3. Mix the two mixtures together in one bowl and add blueberries and cinnamon.
4. Fill muffin liners halfway.
5. Top with chopped nuts like almonds or walnuts if desired.

Cook at 400 degrees F for 20-25 minutes.
Test the muffins with a toothpick and when ready it should come out clean.
Muffins are ready when they look golden brown.

These homemade blueberry muffins are a guilt-free dessert that is moist and soft from the yogurt and the banana. You can either buy store bought applesauce or make your own by boiling an apple and blending it until it is in a liquid form. You will get the best results if you use a very ripe banana that is browning. It’s a perfect way to use up your overripe bananas so you won’t have to waste them and it makes your muffins sweet and gives it a great texture.

I used Fage Greek yogurt, whole wheat flour, and skim milk but you can also use plain yogurt, almond flour, white enriched flour, and 2% or whole milk. These muffins are so much healthier than anything you can buy at the store and very simple to make!

5 Double-Duty Toning Moves for Your Body

expressenchere   June 11, 2016   Comments Off on 5 Double-Duty Toning Moves for Your Body


When starting a new fitness regimen, half the battle is finding the time and energy to get to the gym. The other part is making your workout worth it, and that doesn’t consist of just spending a half hour on the elliptical during Wheel of Fortune. Brett Hoebel, founder of Hoebel Fitness and creator of Rev Abs has a key philosophy that consists of “anaerobic exercises,” which translates to “without air exercises,” meaning you don’t have to have a super cardio system to do these moves. The beauty of anaerobics is that they still get your heart pumping so you’ll break a sweat. Here are five moves that will have you working at least two body parts at once so you can maximize your workout in half the time, plus burn more calories.

Training Variables
– Perform the following five exercises as a circuit, 10-12 repetitions each, with little-to-no rest between each exercise.
– Complete two-to-three circuits, resting 60-90 seconds between each.
– You’ll need two pairs of dumbbells. A trick to knowing what weight is right for you: Choose an amount where the last three repetitions of each exercise are very challenging.

Exercises
1. Squat + Press: Works Legs, Arms, Back, Abs, and Hips
– Stand with feet shoulder-width apart, hold dumbbells together at chest level, with your palms facing in, forearms vertical, and fists pointing to ceiling.
– Move into a squat until hips are just above knee level, making sure your knees don’t pass over the tips of your toes. Keep your chest high, and make sure that it doesn’t sink down into your thighs.
– As you come out of the squat, press through your heels to stand back up, all while you press your arms above your head, keeping your palms facing each other, until your arms are completely straight like you’re reaching for the ceiling. (The whole move should be almost like an explosion.) End the repetition by bringing your dumbbells back to chest level.

2. Plank + Row: Works Back, Shoulders, and Core.
– Holding a dumbbell in each hand, start in a push-up position with your arms straight and your feet in a wide stance. Make sure your palms are facing in and your fists are pointing down towards the floor.
– Keeping your hips very still, perform a “row” by pulling one dumbbell back, arm bent, and keeping your elbow close to your ribs until the weight reaches your armpit. Try to keep your body as still as you can to challenge your core muscles even more.
– Repeat on opposite side to complete one repetition.

3. Knee Lift + Hammer Curl: Works Abs, Biceps, and Quads.
– Stand with feet together, and hold dumbbells at your sides with palms facing toward each other.
– Lift one knee to waist level while simultaneously curling dumbbells to shoulder level and keeping palms facing in (a hammer curl) instead of toward your shoulder, (which would be a bicep curl). By standing on one foot, you’re also making your abs kick in to stabilize your body.
– Repeat on opposite side for next repetition.

4. Booty Bridge + Overhead Row: Works Glutes, Triceps, and Shoulders
– Lie on floor face up with knees bent, feet hips-distance apart and close to body. Bring yourself into a bridge by lifting your hips until they’re just below knee level. With your arms straight out in front of you, hold dumbbells up towards the ceiling with your palms facing each other.
– Press through your heels keeping hips lifted while reaching arms straight back over your head until the dumbbells lightly tap the floor. Don’t let your hips dip—keep them in a straight line.
– Squeezing armpits, keep your arms straight as you lift the dumbbells back to the starting position above your chest. keeping arms straight to lift dumbbells back above chest.

5. Ab Jackknife + Twist: Works your entire core from obliques, to lower ab muscles.
– Lie on floor face up with arms extended out to your sides to make a “T,” your body and legs extended out straight together.
– Squeezing your abs, press your right arm into floor while lifting your left arm and right leg up toward each other.
– Repeat on opposite side for next repetition.

Satyriasis an Excuse for Poor Behavior

expressenchere   June 11, 2016   Comments Off on Satyriasis an Excuse for Poor Behavior


It’s what Bill Clinton, Newt Gingrich, Tiger Woods and Arnold Schwarzenegger all have in common. Satyriasis is defined as excessive desire for sex in the human male.  Maybe it’s a failure to grow up; certainly it seems to result in older men behaving like 13 year old boys who have lost all inhibitions.

Some people might call this sexual addiction, which can afflict men or women but is more prevalent among men. The DSM IIIR (Diagnostic and Statistical Manual of Mental Disorders) recognizes this as a legitimate diagnosis. Treatment usually begins when excessive sexual behavior disrupts the person’s finances, career, self esteem and intimate relationships.

As a general rule, the behavior becomes “disruptive” when the sex addict is caught, as in “I did not have sexual relations with that woman.” This may often lead to job loss, public humiliation, and divorce. Not to mention an inconvenient disease here and there.

Whether this condition is simply an excuse for poor behavior is a question for Newt, not much. He explains his ventures to have resulted from his extreme patriotism, which somehow left him vulnerable to temptation. This is an interesting concept, maybe even creative, but hardly seems adequate reason to start discussing divorce with your wife when she is in the hospital battling cancer.

Causes of sexual addiction are often discussed by therapists as stemming from childhood trauma, and sometimes as the result of an imbalance in brain chemistry. Excessive sexual behavior may also be related to a different underlying condition such as bipolar disorder. Treat the condition by correcting brain chemistry and the behavior is controllable. How excessive patriotism fits here is difficult to imagine.

It seems certain that some individuals have trouble with impulse control, and some do have extremely strong sex drives that are difficult to cope with. They would be the ones who might become sex “addicts.” The pleasurable aspects of sex become addictive, and are used to cover pain in the person’s life. Or the behavior results from chemical imbalances in the brain.

On the other hand, some guys just want to misbehave. The difference is that addicts feel guilt and try to change their behavior. Men who simply like to take advantage of other people have their own reasons. Telling the difference is the job of a professional. In many cases, only the perpetrator knows for sure.

You may have noticed that Dominique Strauss-Kahn and his recent peccadilloes have not been included in the line-up here. This is because attempted rape is not the same as consensual sexual offenses. That is a crime, and is more about domination than about sex.. It is not in the same category.

How to Treat Head Lice with Rubbing Alcohol

expressenchere   June 11, 2016   Comments Off on How to Treat Head Lice with Rubbing Alcohol


Lice are small parasitic wingless insects with piercing mouth parts that live on the hair and skin of mammals, including humans. They feed off of small amounts of blood from the scalp. The bite to get blood from the scalp is what causes the extreme itching, and the scratching to relieve the itching further inflames the scalp. While crawling through the hair the louse will lay eggs called nits along the hair shaft primarily close to the scalp.  The nits will look like dandruff but they can not be brushed out or shaken out of the hair. The nits quickly hatch and are full grown in 1 to 2 weeks. They will also begin to feast on the blood of the scalp leaving more saliva from their piercing mouth parts to cause more intense itching.

It is imperative to kill the lice quickly as soon as you are aware of them. The longer a person waits to begin treatment may increase the likelihood of damage to the scalp or the lice infecting other people in the household, at work, or at school.

A quick and inexpensive way to kill lice and nits is with rubbing alcohol. This kind of alcohol is available at drugstores, pharmacies and even many grocery stores.  A large bottle of rubbing alcohol can usually be purchased for less than $2.00, far less costly than shampoo treatments made specifically for lice or prescriptions from a physician.

Once home with the bottle of rubbing alcohol, begin treatment right away by wetting hair and pouring the rubbing alcohol onto the hair. It is important to keep the rubbing alcohol out of your eyes by tipping your head back while applying the rubbing alcohol. Carefully massage the rubbing alcohol through the hair and scalp. Rinse hair thoroughly after this treatment. Use a hair brush, comb or special lice comb to remove the nits. The rubbing alcohol will cause the hair to be very dry.  Bottled hair conditioner can be used to remoisturize the hair.

Clean hair brushes and combs with rubbing alcohol.  Wash towels, sheets, pillowcases and clothing in hot water to kill the lice and nits that may have attached to them.  A bleach solution can be used on floors, sinks, countertops and bathtubs to kill the lice and nits.

It may be necessary to repeat this process several times to make sure all the lice and nits are gone.

Diagnosis and Treatment of Rheumatoid Arthritis

expressenchere   June 11, 2016   Comments Off on Diagnosis and Treatment of Rheumatoid Arthritis


The diagnosis and treatment of rheumatoid arthritis (RA) is a team effort between the patient and several types of health care professionals. A person can go to his or her family doctor or internist, or to a rheumatologist — a doctor who specializes in arthritis and other diseases of the joints, bones, and muscles. As treatment progresses, other professionals often help: nurses, physical or occupational therapists, orthopedic surgeons, psychologists, and social workers.

Education is Important

Studies have shown that people who are well informed and participate actively in their own care experience less pain and make fewer visits to the doctor than do other people with RA. It is important to learn about RA and its treatments, exercise and relaxation approaches, patient/health care provider communication skills, and problem solving. Educational and support programs help people understand the disease and reduce their pain, to cope mentally and physically with the disease, and to have a greater sense of control.

Diagnosing Rheumatoid Arthritis

Rheumatoid arthritis can be difficult to diagnose in its early stages. There is no single test for the disease. In addition, symptoms differ from person to person and can be more severe in some people than in others. Also, symptoms can be similar to those of other types of arthritis and joint conditions, and it may take some time for other conditions to be ruled out as possible diagnoses. Finally, the full range of symptoms develops over time, and only a few symptoms may be present in the early stages. As a result, doctors use a variety of tools to diagnose the disease and to rule out other conditions.

Medical history: This is the patient’s description of symptoms and when and how they began. Good communication between patient and doctor is especially important here. For example, the patient’s description of pain, stiffness, and joint function and how these change over time is critical to the doctor’s initial assessment of the disease and his or her assessment of how the disease changes.

Physical examination: This includes the doctor’s examination of the joints, skin, reflexes, and muscle strength.

Laboratory tests: One common test is for rheumatoid factor, an antibody that is eventually present in the blood of most RA patients. An antibody is a special protein made by the immune system that normally helps fight foreign substances in the body. Not all people with RA test positive for rheumatoid factor, especially early in the disease. And some others who do test positive never develop the disease. Other common tests include one that indicates the presence of inflammation in the body (the erythrocyte sedimentation rate), a white blood cell count, and a blood test for anemia.

X rays: X rays are used to determine the degree of joint destruction. They are not useful in the early stages of RA before bone damage is evident, but they can be used later to monitor the progression of the disease.

Treatment of Rheumatoid Arthritis


Doctors use a variety of approaches to treat RA. These are used in different combinations and at different times during the course of the disease and are chosen according to the patient’s individual situation. No matter what treatment the doctor and patient choose, however, the goals are the same: relieve pain, reduce inflammation, slow down or stop joint damage, and improve the person’s sense of well-being and ability to function.

Rest and exercise: Both rest and exercise help in important ways. People with RA need a good balance between the two, with more rest when the disease is active and more exercise when it is not. Rest helps to reduce active joint inflammation and pain and to fight fatigue. The length of time needed for rest will vary, but in general, shorter rest breaks every now and then are more helpful than long times spent in bed. Exercise is important for maintaining healthy and strong muscles, preserving joint mobility, and maintaining flexibility. Exercise can also help people sleep well, reduce pain, maintain a positive attitude, and lose weight.

Care of joints: Some people find that using a splint for a short time around a painful joint reduces pain and swelling by supporting the joint and letting it rest. Splints are used mostly on wrists and hands, but also on ankles and feet. A doctor or a physical or occupational therapist can help a patient get a splint that fits properly. Other ways to reduce stress on joints include helpful devices like zipper pullers, and shoe horns, devices to help with getting on and off chairs, toilet seats, and beds.

Stress reduction: People with RA face emotional challenges as well as physical ones. The emotions they feel because of the disease – fear, anger, frustration – combined with any pain and physical limitations can increase their stress level. Stress may also affect the amount of pain a person feels. Regular rest periods can help, as can relaxation, distraction, or visualization exercises. Exercise programs, participation in support groups, and good communication with the health care team are other ways to reduce stress.

Healthful diet: Studies have shown that the omega-3 fatty acids in certain fish or plant seed oils may reduce RA inflammation. However, many people are not able to tolerate the large amounts of oil necessary for any benefit. Other than these, there is no scientific evidence that any specific food or nutrient helps or harms most people with RA. However, an overall nutritious diet with enough, but not an excess of, calories, protein, and calcium is important. Some people may need to be careful about drinking alcoholic beverages because of the medications they take for RA. Patients should ask their doctors for guidance on this issue.

Climate: Some people notice that their arthritis gets worse when there is a sudden change in the weather. However, there is no evidence that a specific climate can prevent or reduce the effects of RA. Moving to a new place with a different climate usually does not make a long-term difference.

Medications

Most people who have RA take medications. Some are for pain relief; others are used to reduce inflammation. Still others, called disease-modifying antirheumatic drugs, or MARDs, are used to try to slow the course of the disease.

RA therapy traditionally involved an approach in which doctors prescribed aspirin or similar drugs, rest, and physical therapy at first, and then prescribed more powerful drugs later if the disease became much worse. But recently many doctors have changed their approach, especially for patients with severe, rapidly progressing RA. This change is based on the belief that early treatment with more powerful drugs, and the use of drug combinations in place of single drugs, may be more effective ways to halt the progression of the disease and reduce or prevent joint damage.

Surgery

Several types of surgery are available to patients with severe joint damage. These procedures can help reduce pain, improve the affected joint’s function and appearance, and improve the patient’s ability to perform daily activities. Surgery is not for everyone, however, and the decision should be made only after careful consideration by patient and doctor.

Joint replacement: This is the most frequently performed surgery for RA, and it is done to relieve pain, improve or preserve joint function, and improve appearance. In making a decision about replacing a joint, people with RA should consider that some artificial joints function more like normal human joints than do others. Also, artificial joints are not always permanent and may eventually have to be replaced. This may be an issue for younger people.

Tendon reconstruction: RA can damage and even rupture tendons, the tissues that attach muscle to bone. This surgery, which is used most frequently on the hands, reconstructs the damaged tendon by attaching an intact tendon to it. This helps to restore some hand function, particularly if it is done early, before the tendon is completely ruptured.

Synovectomy: In this surgery, the doctor actually removes the inflamed synovial tissue. Synovectomy by itself is seldom performed now because not all of the tissue can be removed, and it eventually grows back. Synovectomy is done as part of reconstructive surgery, especially tendon reconstruction.

Routine Monitoring and Ongoing Care

Regular medical care is important to monitor the course of RA, to determine the effectiveness and any negative effects of medications, and change therapies as needed. Monitoring typically includes regular visits to the doctor. It may also include blood, urine, and other laboratory tests and x rays.

Osteoporosis prevention is one issue that patients may want to discuss with their doctors as part of their long-term, ongoing care. Osteoporosis is a condition in which bones lose calcium and become weakened and fragile. Many older women are at increased risk for osteoporosis, and their RA increases the risk further, particularly if they are taking corticosteroids such as prednisone. These patients may want to discuss with their doctors the potential benefits of calcium and vitamin D supplements, hormone replacement therapy, or other treatments for osteoporosis.

Alternative and Complementary Therapies

Special diets, vitamin supplements, and other alternative approaches have been suggested for the treatment of RA. Although many of these approaches may not be harmful in and of themselves, controlled scientific studies either have not been conducted or have found no definite benefit to these therapies. Some alternative or complementary approaches may help reduce some of the stress associated with living with a chronic illness. As with any therapy, patients should discuss the benefits and drawbacks with their doctors before beginning an alternative or new type of therapy. If the doctor feels the approach has value and will not be harmful, it can be incorporated into a patient’s treatment plan. The Arthritis Foundation (800-283-7800) publishes material on alternative therapies as well as established therapies.