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Home > Health > Chronic Conditions > Arthritis

Arthritis
What is ARTHRITIS?

Arthritis is a general term for more than 100 diseases and conditions that affect the joints of the bones. It is a degenerative bone disease. Many people with arthritis do not have any symptoms in the early stages.
Later, as it progresses, arthritis symptoms may include joint pain, swelling, and stiffness. Swelling may cause the skin to look tight, smooth or shiny. The muscles surrounding the joint may be sore, too.
Some common forms of arthritis are osteoarthritis, gouty arthritis (a.k.a. gout), rheumatoid arthritis, psoriatic arthritis and fibromyalgia.
While not all of the causes of arthritis are known, several factors that may contribute to a person’s risk of developing the condition have been identified, including…
Heredity: A person’s family history may determine the shape of the bones or whether there is weak cartilage in the joints.
Weight: Being overweight puts extra stress on joints, especially the hips and knees.
Age: Arthritis can occur in people of all ages, including children, but it affects a large number of seniors.
Injury and/or disease: Joints may be injured when doing the same activity repeatedly, such as sports injuries. In addition, breaking a bone and/or having surgery on a joint can increase the risk of developing arthritis in a joint, for example, breaking a wrist or forearm bone near the wrist could lead to arthritis in the wrist later on in life, earlier than otherwise might have occurred. Infections in the joint may also cause harm.
Lack of physical activity: Activity is important in strengthening the muscles that support the bones, for helping joints move, and controlling body weight.
Stress: Arthritis pain may flare during times of emotional stress.
What is OSTEOARTHRITIS?
Osteoarthritis or OA, is a chronic “non-inflammatory” arthritis affecting the joints of the bones, particularly the hips, spine, knees, feet and fingers. It is typically caused by mechanics of the joint.
Osteoarthritis occurs when cartilage wears down and thins exposing the ends of the bones. Small bumps (spurs) of new bone may form decreasing the space in the joint and limiting its movement. Bits of cartilage can break off causing pain and inflammation. Eventually, the cartilage can wear away completely leaving the bone ends to grind together.
Symptoms of osteoarthritis include painful, stiff or mildly swollen joints, developing slowly over time. Pain is often worse in rainy weather and after exercise.
Treatment of osteoarthritis includes pain medication but there is no cure. Acetaminophen and nonsteroidal anti-inflammatory drugs such as ibuprofen and naproxen are often used to treat arthritis pain. Cortisone injections into the joint can reduce inflammation and arthritis pain but are not a cure. Many natural remedies are available which may help with the symptoms of arthritis. Be sure to talk with your doctor or pharmacist before taking supplements. Ice or cold packs are useful to reduce swollen joints and help with arthritis pain due to swelling. In severe cases, surgery may be recommended to replace a damaged joint.
If you are suffering with arthritis, look for ways to make your life easier around the house. For example, if you have arthritic hands, try using an electric can opener instead of fighting with a manual can opener, purchase easy to open containers, consider adding a large zipper pull to your jacket. There are many products on the market designed to help in this way. A splint that protects your hand(s) may be helpful during times of painful flare-ups. Some patients wear a split during the day, others find it more helpful at night.
What is GOUTY ARTHRITIS also known as GOUT?

Gout or gouty arthritis involves repeated attacks of acute inflammatory arthritis primarily of the big toe. Specifically it is the metatarsal-phalangeal joint at the base of big toe that is primarily affected. Other joints that can be affected include the heels, knees, wrist, fingers and elbows.
Symptoms of gout include severe pain in the affected joint and may include swelling and redness. The most common presentation is big toe pain, that wakes you up in the night, and lasts 2-3 hours. Gout is most commonly found in men over the age of 30, and is seldomly found in women and children.
Gout is not a new disease, in fact, it has been documented for thousands of years. Historically, gout was referred to as the “rich man’s disease”. It was linked to diets that only the rich could afford — high in alcohol and meat.
The true cause of gout is an excess of uric acid in the body, called hyperuricemia. Uric acid crystals, called Tophi, are formed in the body and these settle into joints such as the big toe. If you could picture a miniscule snowflake constructed out of daggers, this would describe what is settling into the joint during an acute attack of gout and why it is so extremely painful.
Hyperuricemia causes gout, and hyperuricemia can be caused by:
• Diet
• Genetics
• An inadequate ability to excrete the uric acid from the body
Treatment of gout is initially focussed on pain management. For pain, icing the affected area for 20 minutes at a time, several times per day is recommended. Also, taking non-steroidal anti-inflammatory drugs such as acetaminophen or ibuprofen will ease the pain.
In addition to pain management, there are a variety of drugs your doctor may prescribe to help with the underlying cause of the gout. If you have hyperuricemia, s/he will prescribe medication to help your body properly manage uric acid levels.
It is easy to see why gout used to be referred to as the “rich man’s disease” when you look at the list of foods that are high in purines. Avoid eating these foods if you are suffering with gout:
• Organ meats, such as liver, kidneys, sweetbreads, and brains
• Red meat such as beef, pork (including bacon), lamb and wild game
• Anchovies, sardines, herring, mackerel, scallops, lobster, shrimp and tuna
• Alcohol, but especially beer
• Asparagus and mushrooms
What is RHEUMATOID ARTHRITIS?

Rheumatoid arthritis (RA) is an auto-immune disease, meaning the body’s own defense system is attacking itself. RA mostly affects the wrist, fingers, knees, ankles and feet, but can also affect the skin, blood vessels, heart and lungs. The immune system attacks the joint lining of otherwise healthy joints (for reasons we don’t yet know) causing painful inflammation of the joint.
Rheumatoid arthritis symptoms often begin with flu-like symptoms, fatigue and fever. Joints become stiff, painful and swollen as time passes. Pain is worst in the morning after inactivity.
Rheumatoid arthritis treatment includes medication, exercise, physiotherapy, and possibly surgery. The joint swelling is treated with nonsteroidal anti-inflammatory drugs, and oral corticosteroids or cortisone injections into the joint. Disease-modifying anti-rheumatic drugs (DMARDs) are powerful drugs that can prevent further damage by suppressing the immune system, so that it won’t attack itself. However, this makes it harder to fight off infection.
If you think that you may be showing signs of rheumatoid arthritis, there are two very important things you should know:
1. See your doctor, get diagnosed and start treatment right away. Early treatment of RA can prevent a lot of irreversible joint damage and disability. RA may be difficult to face, but if you think you may have it, don’t delay in taking action.
2. In most cases, rest is not what is best for painful joints. In fact, it’s more of a move it or lose it situation. The muscles around the joint need to be exercised to stay strong. Unless you are in a major state of flare-up, keep those joints moving.
What is PSORIATIC ARTHRITIS?

Psoriatic arthritis (PsA) is an inflammatory arthritis associated with the skin condition psoriasis. Psoriasis causes a red, thick, scaly rash with silver-white patches.
Symptoms of psoriatic arthritis can appear about 10 years after the onset of psoriasis and includes: joint pain and swelling, tenderness where muscles or ligaments attach to bones, especially in the foot, nail changes, morning stiffness, general fatigue, eye redness.
There are 5 kinds of psoriatic arthritis, and treatment differs depending on which type is presenting:
Symmetric psoriatic arthritis (this resembles rheumatoid arthritis)
Asymmetric psoriatic arthritis (involves one to three joints in the body)
Distal interphalangeal predominant (DIP) psoriatic arthritis (this involves the small joints in the fingers and toes furthest from the torso, and can resemble osteoarthritis)
Spondylitis (affects the spinal column and ligaments)
Arthritis mutilans (a rare, but severe, deforming form of psoriatic arthritis affecting fingers and toes)

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Why We Need to Teach Financial Literacy in Schools

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Suzanne McGeeThe Fiscal Times
March 12, 2013
What’s the difference between stocks and bonds?
When I started asking the question, it was only idle curiosity. I assumed that anyone who was interested enough in the world of finance to sign up for a course I taught entitled “Wall Street 101” would have a working knowledge of the basic concepts. So, I calculated, perhaps three-quarters of the well-educated 20- and 30-something New Yorkers who tended to be in my three-hour classes would feel comfortable explaining what made a stock a stock, and why it was different from a bond.
Not so. Most of the time, I was lucky to have half of the students tell me that they understood the distinction. And even that ratio wasn’t bad, judging by some studies on financial literacy. (If you’re among those wondering, I’ll provide the answer at the end of this column.) A recent online survey by the Treasury Department of 30,000 Americans revealed that only 15 percent of the respondents were able to correctly answer five basic questions about financial literacy, with only about half agreeing that a stock mutual fund was generally safer than investing in a single stock, and only 28 percent understanding that when interest rates rise, bond prices fall.
That’s why it was interesting to listen to Nan Morrison, president and CEO of the Council for Economic Education, talk to a small group of journalists and others recently about the effort to make financial literacy part of the curriculum nationwide. Currently, the organization notes that only 14 states require students to take a personal finance course in high school; 22 require a course in economics. It’s not so much that Morrison wants to insist that personal finance be taught as a class, like English, math or geography. “I’m not sure there’s that much material there to justify it,” she said. Rather, she’d like states to require teachers to incorporate elements of this as part of their teaching in other subjects, starting with basic decision-making skills in elementary schools (understanding concepts like risk and return and the idea of the tradeoff) and including analysis of events like the 1929 stock market crash and the Great Depression in high school.
Part of the problem is getting state governments to agree. If anything, the trend is going the wrong way: Since 2002, the number of states that require students be tested on their economics coursework has dropped from 27 to 16. And, Morrison adds, the one element that is guaranteed to keep both teachers and their students focused on learning the concepts is some kind of assessment at the end of it. Only four states say that a one-semester course in personal finance is a requirement for high school graduation.
Morrison is correct to focus on school-aged children in her organization’s attempts to instill enough financial literacy to enable people to ask skeptical questions about “too good to be true” investment pitches or credit card and loan offers. That, along with a degree of skepticism and a good bullshit detector, would go a long way toward avoiding another financial crisis. Having the tools to realize that buying a house with no down payment and an interest-only mortgage with a variable rate is a bit like renting it from the bank, and giving the bank the right to charge 50 percent more rent after two years, may well have helped us avert the most recent crisis. Understanding how your neighbor really earned a 20 percent return in a year when the market went up 8 percent may help you avoid risky investments or even a Madoff-style fund.
It isn’t about giving kids rules, Morrison points out: Just telling them to save 10 percent of their income is about as useful as telling an overweight child to eat less and exercise more. What helps more is teaching that child to make healthy choices and discover the rewards of physical activity. Similarly, helping a child to become fiscally fit means giving them tools to make sensible decisions on a day-to-day basis, not just putting aside an arbitrary percentage of their income.
Morrison and her group – a committed and enthusiastic bunch of people – do face some uphill battles. First of all, there will likely be apathy on the part of the state legislators, more focused on first principles than on financial literacy. While some financial institutions – and individuals who run them – back the organization’s work, others (whom she won’t identify) have declined to help unless they can use her organization as a way to provide teenagers and others with their own “educational” (read, marketing) materials.
Ironically, some of the more intractable problems may demonstrate just why this kind of push is so important. Only about 20 percent of teachers the group has surveyed feel confident teaching this material – a generally high number, given the level of financial literacy nationwide and the fact that they are being asked not just to understand these concepts but to communicate them to students. But it’s too low for comfort. Also, what happens if the kids get mixed messages; if, while they are being taught at school about the virtues of saving and budgeting, at home their parents and grandparents are behaving in irrational ways? Because, as with any attempt to instill certain kinds of values or behavior – as opposed to learning or knowledge – what happens in the home can be vital. How would you react to your 12-year-old asking you what mutual funds you own, how you decided on the asset allocation in your 401(k) plan, or whether you can really afford to pay the high interest on that store-issued credit card if you buy another flat-screen television?
This won’t be a smooth and straightforward process, but it’s a vital one. Ultimately, a nation of consumers all making smarter choices about their personal finances will make as much difference to the country’s wellbeing as a collection of elected representatives bickering over fiscal policy in Washington. It may even mean – in time – that those elected representatives are themselves more financially literate and able to make wise decisions about when, whether and how to regulate financial markets.
So, to all the elected representatives in the 46 states that don’t yet require some kind of course on personal finance in order to receive a high school diploma, isn’t it time to get moving?
*The answer to my opening question: A stock gives its holder an ownership interest in the business, while a bond makes its holder a lender to the company. The former participates in the company's upside potential, as higher earnings lead to a higher share price; the bond's owner is entitled only to a string of interest payments and only if the company defaults on those can it acquire any ownership stake (via a bankruptcy proceeding) in lieu of recouping his loan and in place of the interest income.

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