I’m Back

Dear Friends,

has been hard be far away from all of you, but It was  and still it is hard for me, but I’m a warrior and I have to fight to be well in my body and in my mind.

I will do my best to search and share with you any tips can be helpful.

I wish you a wonderful night and I hope i can blog soon .

A virtual hug to all you

Adriana

 

Pregnancy with Ankylosing Spondylitis

 

Does ankylosing spondylitis (AS) worsen with pregnancy?

Pregnancy tends to improve AS in 20-30%, worsen AS in 20-30% while it remains unchanged in 50-60%. In general, spinal disease remains unchanged during pregnancy while peripheral arthritis and uveitis are suppressed during gestation and tend to exacerbate after delivery. Women carrying a female foetus fare better than those carrying a male foetus. Those with active spinal disease are advised not to plan pregnancy unless the disease is controlled.

When can one plan pregnancy with ankylosing spondylitis?

Your arthritis must be reasonably controlled for a period of at least 3-4 months before planning pregnancy. You should not have had any flare during these months.
Always speak to your Rheumatologist before planning pregnancy as he may have to make changes in your medicines. He would be the best person to guide you regarding the timing of your decision. Please speak to him well in advance as Methotrexate has to be stopped at least 3 months prior to planning to conceive.Those with active spinal disease are advised not to plan pregnancy unless the disease is controlled.

Is the pregnancy outcome different in patients with ankylosing spondylitis?

No. Ankylosing spondylitis doe not affect the course of pregnancy or the fetal well-being. The risk of fetal loss, prematurity or low birth weight does not increase with AS. Women with Ankylosing spondylitis are more likely to require a cesarean section as inflammed/ ankylosed sacroiliac joint is a mechanical hindrance to childbirth.

What to expect after delivery?

50-80% of the AS patients experience aggravation of symptoms 4 to 12 weeks after delivery. Episodes of uveitis & peripheral arthritis are more common after delivery.

Does Ankylosing spondylitis impair fertility?

No. Ankylosing spondylitis does not impair fertility. Sulfasalazine can impair the maturation of sperm cells and thereby impair the fertility of men. However, this generally settles after stopping the medicine (after an average of 2 ½ months). Sulphasalazine does not affect fertility in women.

Does Ankylosing Spondylitis start during pregnancy?

Ostenson & colleagues studied 939 patients & found that AS starts during pregnancy in about 21% patients.

What is the risk of your child inheriting AS?

The risk of your child inheriting AS is higher if you are HLA-B27 positive. If you are HLA-B27 positive & your partner negative; the chance of your child being positive is 50%. However that does not mean that he/ she has to develop AS. The chances of developing AS are even lower; probably 5- 20%. The chances are higher If you have any other family members affected by AS.

Family Planning and Rheumatoid Arthritis

Although anyone can get rheumatoid arthritis, women with RA outnumber men by about three to one. Many women with rheumatoid arthritis are diagnosed in their 20s and 30s, just when marriage and family start to take life’s center stage.

With pain, fatigue, and medication side effects to consider, there’s no question rheumatoid arthritis makes family planning more complicated. But RA doesn’t have to put your dreams of having a family out of reach. If you’re thinking about starting a family while living with rheumatoid arthritis, consider these tips.

1. Don’t Worry That Rheumatoid Arthritis Could Hurt Your Baby

Rheumatoid arthritis itself doesn’t seem to harm the developing baby, even if RA is active during pregnancy. In fact, 70% to 80% of women with RA have improvement of their symptoms during pregnancy. Although some women with RA may have a slight risk of miscarriage or low-birth-weight babies, the vast majority of women have normal pregnancies without complications.

However, many drugs for rheumatoid arthritis — including methotrexate and leflunomide — can cause birth defects. These same medications may also cause birth defects if they are taken by men who father children. Therefore, it’s important to talk to your doctor about altering treatment several months before you or your spouse try to get pregnant.

With the right treatment and prenatal care, babies born to moms with rheumatoid arthritis are as healthy and happy as any.

2. Have Patience As You Try to Get Pregnant

Experts disagree whether rheumatoid arthritis reduces fertility in women or men. It’s true that many women with RA take longer to conceive than women without rheumatoid arthritis. Inconsistent ovulation, decreased sex drive, or having sex less often due to pain and fatigue are possible explanations.

For men, acute flares of rheumatoid arthritis temporarily reduce sperm count and function, and can cause erection problems and decreased libido. For both men and women, effective treatment for RA improves sexual symptoms and function. In well-treated rheumatoid arthritis, fertility in most men and women is probably normal.

3. Know That the Future Looks Bright for Rheumatoid Arthritis Treatment

New biologic drugs for RA have created a new era of treatment for rheumatoid arthritis, according to rheumatologists. With early and aggressive treatment, most people with RA can avoid joint deformities and major disability.

For most women, that means being present and active throughout your children’s years at home. While bad days from RA symptoms may be unavoidable, doctors believe most women will keep their independence for decades, and possibly their lifetimes.

4. Alter Rheumatoid Arthritis Treatment Well Ahead of Your Pregnancy

As soon as you’re considering starting a family, see your rheumatologist. Some drugs need a months-long “washout” period before trying to conceive. And that goes for men as well as women; although unproven, methotrexate might result in sperm problems that could cause birth defects.

If you’re taking leflunomide for RA, even more advance planning is necessary. Due to its long half-life, leflunomide needs to be stopped two years before trying to conceive a baby, although there are ways to “wash” it out of your system quicker.

5. Work With Your Doctor on Rheumatoid Arthritis Treatment During Pregnancy

Your rheumatologist will help you decide on a treatment plan that includes both control of your RA symptoms and safety for your baby.

Low-dose prednisone, for example, is generally considered safe during pregnancy. Hydroxychloroquine (Plaquenil) and sulfasalazine are also considered safe. While evidence is limited for biologic medicines like Enbrel and Remicade, many rheumatologists are confident in their relative safety during pregnancy.

One way to avoid the risk of pregnancy problems from RA medications is to simply not take any. Under a doctor’s supervision, some women quit RA drugs “cold turkey” when they begin trying to conceive, through delivery and breastfeeding.

This method has its own risk, of course: possible progression of joint damage from flares during the time when you are off treatment. In certain women, though, some rheumatologists endorse the approach, with close monitoring for disease activity.

6. Expect Improvement in Rheumatoid Arthritis Symptoms During Pregnancy

Interestingly, pregnancy usually has a positive effect on rheumatoid arthritis symptoms, albeit temporary. About 70% to 80% of women experience improvement in their RA symptoms during pregnancy.

In many of these women, drugs for RA may be safely reduced or even eliminated during pregnancy. For about one-quarter of women, though, rheumatoid arthritis activity continues during pregnancy, or gets worse.

Unfortunately, the respite from RA symptoms during pregnancy is short-lived. Most women relapse after delivering their babies.

7. Until You’re Ready to Get Pregnant, Use Contraception

Again, remembering the potentially harmful effects of some rheumatoid arthritis drugs on the fetus, it’s essential to avoid pregnancy until you’re ready. Experts say that used properly, a variety of methods are appropriate and effective, such as:

  • Condoms
  • Oral contraceptives
  • Vaginal ring
  • Intrauterine device (IUD)

Although controversial studies have suggested oral contraceptives might prevent rheumatoid arthritis in some women, there is no evidence that they help control RA symptoms.

Thanks to webmed

Diagnosing Ankylosing Spondylitis in Women

Ankylosing spondylitis has often been considered more of a man’s disease, yet the reality is that it affects some women, too.

The genetic marker for ankylosing spondylitis, HLA-B27, is found equally in men and women. However, ankylosing spondylitis is two or three times more common in men than women, said Rodney Tehrani, MD, a rheumatologist at Loyola University Medical Center in Maywood, Ill.

Ankylosing Spondylitis Diagnosis in Women: Why the Difference?

Many experts believe several factors may explain why it’s harder to reach an ankylosing spondylitis diagnosis in women. Some women may have milder symptoms, so ankylosing spondylitis symptoms may not be as obvious. Progression also may be slower, and symptoms can seem like other ailments, such as rheumatoid arthritis or fibromyalgia. The area of discomfort also can interfere with making the correct diagnosis. Along with back pain, women also might experience soreness in the neck and peripheral joints, in contrast to men who mainly tend to note back pain.

When to Suspect Ankylosing Spondylitis in Women

Getting the correct diagnosis is critical to getting started on the right treatment. “Clinicians should suspect the disease in women who complain of back pain, particularly when associated with any or all of the following: morning stiffness or stiff back after resting, psoriasis, inflammation of the eyes, frequent canker sores, irregular nails, swelling of the joints, painful joints, particularly shoulders and hips, and frequent abdominal pain and diarrhea,” said Ali D. Askari, MD, chief of the rheumatology division at University Hospitals Case Medical Center and a professor at the Case Western Reserve University School of Medicine in Cleveland.

Symptoms also should be carefully studied. For example, back pain from ankylosing spondylitis typically lessens with movement and exercise and gets worse with rest — a feature that sets it apart from some other ailments, like degenerative arthritis.

The Progression of Ankylosing Spondylitis in Women

Anyone with an ankylosing spondylitis diagnosis is naturally concerned about what comes next, but “there is no set course for this disease,” Dr. Tehrani explained. “It is variable in every individual, whether male or female.”

Most often, people with ankylosing spondylitis experience flares — painful episodes — mixed with times of remission when symptoms lessen. As the disease progresses, some of the vertebrae in the spine may fuse together, which makes the back more rigid and at greater risk for fracture.

How Ankylosing Spondylitis in Women Is Treated

Treatment options are similar for women and men. Medications for ankylosing spondylitis symptoms include non-steroidal anti-inflammatory drugs (NSAIDs) as the first line of attack to help address stiffness, neck pain, and back pain in women. When something stronger becomes necessary, most doctors turn to disease modifying anti-rheumatic drugs like corticosteroids and sulfasalazine. Biologics or TNF blockers are the latest additions to the treatment option arsenal.

Exercise also is important to retaining flexibility and keeping pain at bay. For example, Pilates has been shown to improve physical capacity and endurance in ankylosing spondylitis. A physical therapist can offer other suggestions.

Maintaining good posture, using heat to reduce soreness and using cold to lessen swelling also can help. Those with very serious cases might need to consider surgery.

Regardless of your symptom level, it’s important for women — and for men, too — to see a rheumatologist at least once a year to make sure you aren’t developing any other issues

Source Everyday Health

How to Talk About Sex and Ankylosing Spondylitis

 

Have an honest, open talk with your partner, one in which you share your desires as well as any limitations you’re feeling. Let your partner know how your diagnosis is affecting you at the moment. Don’t try to project into the future. There’s nothing to be gained from trying to predict how the condition will affect you in five or 10 years. Approach sex as a collaborative, creative, problem-solving team and focus on what you would each like to do to stay sexually active.

If your partner is distressed by your diagnosis or by talking about new sexual positions and techniques, he or she might need some time to adjust to the necessary changes. It may help for your partner to speak privately about concerns with a sex therapist or marriage and family therapist in a confidential setting.

Tips for Enjoying Sex for Ankylosing Spondylitis Patients

 

You and your partner have the opportunity to look at the challenges AS poses as a way to creatively explore sex. Here are some actions you can take to help rekindle sexual enjoyment:

  • Treat AS. First of all, you’ll feel best if your ankylosing spondylitis is well-managed. Talk with your doctor about medications that can reduce pain and stiffness.
  • Focus on your partner. Sex is not limited to mutually satisfying intercourse. There will be times when you’re not feeling aroused, but it’s still appropriate to enjoy touching, massaging, and giving pleasure to your partner through oral sex or by using sex toys. Likewise, there may be times when your partner just wants to please you.
  • Touch and connect. Pain, disability, and challenges to your sense of self can all result in feeling disconnected from your partner. Tepper advocates intimate touching, holding and caressing in a position that is comfortable without necessarily aiming toward intercourse or orgasm.
  • Identify your best time of day. “All of us have times when we have the most energy,” Tepper says. If you wake up with unsexy stiffness, morning sex might not be an option. Share this information with your partner so that he or she isn’t guessing about when the time is right. “Sex as spontaneous is something of a fantasy,” he says.
  • Stay active. Staying physically active keeps your whole body ready for sex. Light exercise could be a good warm-up. If it’s comfortable for you, try working out with your partner, taking a shower, and then engaging in sex.
  • Try standing or kneeling. Experiment with a variety of positioning options. Tepper’s website includes videos that may inspire you. For example, men with lower back pain might enjoy sex (vaginal and oral) more if they are standing or kneeling instead of lying flat. One option is for the man to stand at the base of the bed and his partner to use cushions to raise her pelvic area to the appropriate height.
  • Try sitting. Another option is for the person with ankylosing spondylitis to sit in a chair with firm, comfortable lower back support. Hold your partner on your lap, either facing you or facing away.
  • Use cushions. There are a number of foam bolsters designed specifically to help people be more comfortable having sex. Other options include inflatable pillows or cushions that allow you to control the pressure, bean bag chairs and regular bed pillows ranging from body pillows to small pillow rolls that can help provide the right amount of support for sore joints.
  • Consider specially designed furniture. Items such as swings and unique chairs not only support one or both of you but also assist with thrusting. A sex therapist can help you decide whether this kind of investment is right for you.
  • Use lubrication. Vaginal dryness increases as women age, and lubricants can help ease this lovemaking challenge.
  • Create a sensual mood. “I am a big believer in atmosphere,” Tepper says. Music, candles, scented oils, and videos you both enjoy can help make sex play more fun.
  • Take a soak. A hot tub or bathtub for two may be another location for sex. “The warm water could be soothing,” Tepper says.
  • Play with toys. Vibrators can help both partners enjoy sex. There are many styles available — just shopping together can be sexually exciting.
  • Do some research. Tepper’s website includes a number of short videos that demonstrate positions for people with disabilities. He also recommends the book “The Ultimate Guide to Sex and Disability” as a resource.

Source Everyday Health

Rheumatoid Arthritis and Sex

The pain of RA does not have to mean the end of sexual intimacy.

Your sex life (or the lack of one) is probably not high on the list of topics when you’re discussing your rheumatoid arthritis (RA) with your doctor. Even if you didn’t have a ton of other topics to talk about, such as side effects of your medicines, morning stiffness and pain, and that promising new drug you just read about, talking about sex can be just plain embarrassing.

But the fact is one out of every three people with RA says that rheumatoid arthritis has had a considerable impact on their sexuality. And one out of every 10 people with RA says that sex is out of the question.

But the reason that people with RA often avoid sex has less to do with pain from achy joints associated with this autoimmune disease than the overwhelming fatigue and difficulty moving that are also hallmarks of the disease. That observation comes from research presented in 2006 at the 7th Annual European Congress of Rheumatology in Amsterdam, Netherlands.

But experts tell that improving your sex life — and your intimate relationship — is not only possible, but can also improve your arthritis symptoms.

“The good news,” says Ava Cadell, PhD, “is that being intimate will take your mind off of everything else — including your arthritis.” Cadell is a clinical sexologist based in Los Angeles. “There is scientific evidence,” she says, “that when you have an orgasm, you release morphine-like, feel-good chemicals that override the pain. Sex is the best prescription for good health.”

Martin J. Bergman, MD, is chief of the division of rheumatology at Taylor Hospital in Ridley Park, Pa. He agrees with Cadell and adds, “Sexuality is part of the human experience — a very important part.”

Source webmd

Therapeutic Yoga : Yoga Poses for Rheumatoid Arthritis

 

Hello everyone,

here I’m back with my tips… Have you ever try to do yoga ? I love it, here some new tips  to share with you.

Try it and give me feed back…

I promise one day I will record my own video just to exercise together.

Ciao a tutti,

Eccomi qui con dei  nuovi  consigli…. Avete mai provato a fare Yoga?  A me piace tanto, per questo voglio condividere con voi questi consigli e attendo i vostri feedback.

Vi prometto  prima o poi giro anch’io un video così da praticare insieme Yoga.

9 -Tips for Traveling With Arthritis

Whether you’re traveling for business or pleasure, you know arthritis is one thing you can’t get away from. But it doesn’t have to derail your travel plans.

Try these tips for taking care of your Arthritis and avoiding joint pain while you’re on the road.

Traveling With Arthritis: Before You Go

1. Do your homework. Find out as much as you can about your destination and plan all the details you can ahead, including what places you’ll go, how you’ll get there, and what your travel companions can do when you need a rest.

2. Time it right. Choose a time when you are most likely to be feeling your best. If you are prone to flares during the heat of the summer or the hustle and bustle of the holidays, for example, try to avoid traveling during those times.

3. Don’t rush. Although vacations can be fun and restful, they can also be stressful. Try to plan an extra day at the start of your vacation to prepare and another at the end to rest and recuperate before going back to work or regular activities.

4. Ask about immunizations. If you will be traveling overseas, ask your doctor about any immunizations you may need. Keep in mind that some immunizations are not advised if you are taking medications that suppress your immune system.

What to Pack

5. Select the right suitcase. Purchase a suitcase or carry-on with wheels, and push instead of pulling it. Use both hands. Doing so will conserve energy and avoid strain on your hands and shoulders.

6. Pack light. A lighter suitcase is easier to push — and lift, if necessary. If you find that you must lift your suitcase — into your car trunk or the overhead bin on a plane, for example — find someone who can help.

7. Don’t forget your health info. Write out a brief medical history and list of medications you take. Include contact information for your primary care doctor and rheumatologist, as well as your health insurance information.

8. Mind your medications. Pack more medicine than you think you will need and divide your medications among your different bags. If one bag is lost, you should still have enough medicine to get by. Leave a copy of your prescriptions at home with a friend or family member. If you lose your medications or are gone longer than expected, have them fax you your prescription.

On Your Way

9. Don’t just sit there. Sitting for hours in a car, plane, bus, or train can lead to stiff joints. When driving, stop once an hour to stretch and walk. When flying or riding a bus, try to get an aisle seat so you can stretch and get up and walk.