We’ve all heard the importance of living a balanced life, being sure to focus on the health of the body, mind and emotions. This couldn’t be truer for the millions of Canadians diagnosed with arthritis, who must learn to balance acceptance and hope, give and take, rest and activity. Fortunately, The Arthritis Society has resources available to help you live vibrantly with arthritis. THE EXPERTS SAY Caring for body, mind and emotions Living with a chronic illness like arthritis can affect every aspect of life. The added challenges of increased pain, stress and fatigue can make things more difficult. Ruth Tonon, registered social worker with The Arthritis Society, wants you to know you are not alone. According to Tonon, a social worker’s first step is to help determine the services available that are of benefit. Often practical issues like income and benefits, medication coverage, housing and employment issues are of foremost importance. Later, Tonon and her clients address the emotional impact of arthritis, including credibility issues presented by the ‘invisible disease’; feelings of sadness, depression and helplessness; fearing the future; feeling a loss of the old self; and living with unpredictability. Tonon suggests that keeping a journal about the arthritis journey is an empowering exercise, as it identifies patterns that may lead to flare-ups. FROM THE SOCIAL WORKER

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THE EXPERTS SAY Prevention with food Achieving a healthy body weight is one of the best ways to help reduce the risk of osteoarthritis. Milton, Ontario registered dietitian Pam Piotrowski reports that losing just one pound of excess weight will reduce the load on your joints by four pounds. Eat a well-balanced diet from all food groups of Canada’s Food Guide, while picking leaner cuts of meat and lower fat dairy products. Incorporate more fish and vegetarian protein foods; choose whole grains and plenty of fruits and vegetables to help manage most types of arthritis. Protect your heart Inflammation is at the very heart of arthritis, and certain types of inflammatory arthritis are considered an independent risk factor for developing cardiovascular disease. Whether you have been told you have high cholesterol levels or not, following a heart healthy diet is wise. Piotrowski recommends choosing fatty fish like salmon, mackerel, Atlantic herring, sardines or trout at least twice a week as sources of omega 3 fats. Eat four to five servings of vegetables and three to four servings of fruit daily. Boost fibre in your diet; choose whole grains, including whole grain breads, high fibre cereals, brown rice and whole grain pasta. Add ground flax seeds or nuts to salads, baking or breakfast cereal. Supporting your body with healthy food choices feels good in so many ways! FROM THE DIETITIAN Helping your body heal Medications are an important part of many arthritis pain management strategies, and Piotrowski believes that choosing what and when to eat can help support healing while minimizing certain drug side effects. For example, non-steroidal anti-inflammatory drugs (NSAIDs) may trigger nausea and increase the risk of gastritis and gastric ulcer. To reduce the chance of stomach upset when using these medications, Piotrowski recommends avoiding having an empty stomach. “Eat smaller meals more frequently, and enjoy room temperature foods. If they’re too hot, too cold, spicy or fragrant, they can cause discomfort.” She also recommends consuming fluids separate from meals, ideally having beverages 15-30 minutes before or after food. Avoid alcohol and caffeine, as they can stimulate gastric secretions. Corticosteroids are known to increase fluid retention, impair glycemic control as well as contribute to osteoporosis. To manage these possible outcomes from corticosteroid use, avoid added salt and choose low sodium foods. Reduce intake of all forms of sugar and sweets; opt for fibre-rich foods to help keep blood sugar healthy. Foods high in calcium and Vitamin D are important for strong bones. Michele Walsh Creating a life of balance “If you expect people to accommodate you, you have to be prepared to accommodate them. It has to be a balanced exchange.” Michele Walsh Michele Walsh of St. John’s, Newfoundland, was 27 when she was first diagnosed with rheumatoid arthritis (RA), but it was another five years before the disease had a significant impact on her life: in September 1998, just a few months after walking down the aisle for her June wedding, she could barely walk across a room. Walsh took an extended leave of absence from her job at Newfoundland Power, and soon became depressed as her busy life ground to a halt. Yet, Walsh considers herself one of the lucky ones, because after an initial three years of trial and error following her wedding, she found the right combination of medications and pain coping techniques to keep her RA manageable. Walsh shares, “Discovering the Arthritis Self-Management Program offered by The Arthritis Society was the turning point in my life, especially the recommendation to create small goals.” Before long, Walsh was walking to her mailbox and back; next, she walked around the block. She also became part of the Patient Partners in Arthritis program, designed to teach doctors and medical students how to perform a proper muscle-skeletal exam. Walsh emphasizes the importance of the compassion and support she received from her employer on her return to work after three years. With input from her occupational therapist, physiotherapist and doctors, she eased into full-time work over a 12-week period. She’s grateful for her customized work station and the laptop computer provided for those days when a flare-up has her working from home. Now teaching the Arthritis Self-Management Program and Chronic Pain Workshops for The Society, Walsh also gives public lectures and leads her son’s Beaver colony. She’s busy, but notes, “there’s always a way to do something if you really want to.” Juvenile arthritis isn’t child’s play Affecting one in 1,000 Canadians under the age of 16, juvenile arthritis (JA) is a leading chronic disease among children in this country. For kids with JA, their immune system fails to recognize healthy body tissue and attacks it, leading to excruciating pain and inflammation in the joints. Depending on the severity of the JA, it may limit their ability to participate in regular childhood activities, like sports and recreation, or prevent a child from easily performing tasks that are taken for granted, such as buttoning clothing and carrying books to school. Kimberly Dyck’s family knows all too well the impact JA has on kids. Her son Matthew and his younger sister Hannah were both diagnosed with JA when they were only 10 years old. “When Matthew was first diagnosed, The Arthritis Society put us in contact with a family also going through the same thing.” Kimberly says, “It was nice to hear that we were not alone and to talk to someone who understood.” Help-full strategies While there is no cure for JA, effective therapies are available to help many parents and children manage the disease. Matthew and Hannah use a combination of medication, nutrition and exercise to help with pain management. “Without the medication, they’d both struggle to maintain a good quality of life,” Kimberly explains. “But, as a family, we are very careful to eat properly and maintain a very healthy diet.” The Dyck children are all extremely active, including their youngest son, Rylan. Matthew plays hockey and enjoys mountain biking, and Hannah is a competitive dancer. Says Kimberly, “As a family, we spend time together hiking, biking, walking and snowboarding. Staying active is key to pain management, so we try to set the example for all the kids.” The children also have their own coping mechanisms when discomfort sets in. Matthew likes to walk or bike ride to take his mind off of it, while Hannah prefers to relax in the hot tub. In school, they set up secret codes with their teachers if they need to leave the classroom to go for a walk or stretch when they get stiff. Now 16, Matthew struggled to come to terms with this disease and hid it for a long time. “As he gets older,” Kimberly reports, “he’s learning to accept who he is and that everyone struggles with something.” Hannah has chosen to help others and works as a spokesperson for The Society. Though free of JA, Rylan has also had to learn to cope with the impact of the disease. The Dyck family understands the power of a healthy attitude. “As a family, we believe that you can do anything you set your mind to,” Kimberly shares. “Matthew and Hannah don’t let this disease stop them from doing what they enjoy or from being normal kids. We have encouraged them to try it before they say, ‘I can’t.’ Everyone has to overcome obstacles, and this should never discourage you from trying things.” Living life fully police detective with over 27 years of experience, John March has always enjoyed singing in a band to let off steam, and lacing up hockey skates has been a regular part of his life for as long as he can remember. About five years ago, however, he started to experience back pain, discomfort in his hands and feet, and chronic fatigue that would keep him in bed up to three days at a time. When his fingernails and toenails began to lift, he headed to the doctor. Knowing is best “I was diagnosed with psoriatic arthritis,” 47-year-old March shares. “Receiving a concrete diagnosis was a huge relief, because my doctor and I were able to find a treatment that helped manage my symptoms.” Psoriatic arthritis occurs in some patients who have psoriasis, which is a chronic skin condition. Symptoms are typically a combination of skin symptoms and joint inflammation, and may include nail lesions, as well as inflammation and swelling in and around the joints in the hands, feet, wrists, ankles, knees and lower back. The condition can also affect a person’s emotional well-being. Unfortunately, psoriatic arthritis often goes undiagnosed, especially if symptoms are mild. According to The Arthritis Society, psoriatic arthritis can develop at any time, but it most commonly appears between the ages of 20 and 50, affecting men and women equally. In fact, John has learned of several colleagues with the same diagnosis. Fortunately, the men and women in blue receive support from their employers to manage their condition. Strategic changes Getting out of bed used to be painful for John, and he is now grateful for the biologic medication he receives via injection. He also pays attention to what he eats. “Like most guys when they’re young, I used to eat whatever I wanted. Now I avoid fried food and junk food.” John also encourages those with arthritis to exercise. “If you’re not moving,” he states, “you’re going to seize up.” March believes that acceptance of your condition is the first step, because then you’re ready to learn every option for living your life fully – as John is doing. His career as a police officer is in ‘full swing’, right along with his golf club and hockey stick. He is also board president of a First Nations non-profit housing provider, proving that he lives by the motto “To serve and protect.”