Cover Story

1. A supplement to
®
Focus on joint pain
vol. 1, no. 2
FREE
3
Ta ke-Home
Copy
Moves that
make your
mornings easier
is psoriatic
arthritis
behind
your joint
pain?
Model turned fashion designer
Tools to get Juretha Lawson tells how...
more from your
next checkup
“RA led to
Compliments of your doctor
my dream
job”

2. Rheumatoid Arthritis basics
inside Joint pain can’t Take back control from
RA
3 pain and stiffness!from RA
Take back control
Find your best
keep ME down!
On your horizon: Plenty more
treatment—and your pathway to relief
“I reframed my good days! The latest treatments
5 Joint pain? Why psoriatic
thinking!”Biologic medication will have you feeling better and
arthritis might be to blame was relieving Shelly Spence’s RA, yet the
Get the facts about this condition, which 31-year-old from Vancouver, more energetic than ever
affects up to 30% of people with psoriasis WA, still put limits on
7 UseJuretha’s herself—until a woman
“ I found my dream
style tips to asked her to run in a
A
job thanks to RA!” look—an
How RA inspired Juretha feel—gread t!
charity marathon. “ ‘I
few days after giving birth to her son, Lana Lana says. “I was happy because I finally had an answer,
can’t; I have RA,’ I said. Barhum woke up and couldn’t move. “I was but defeated because there was no cure. Here I was, 32
Lawson to become a
The woman’s reply: ‘But isn’t unable to walk or even wiggle my fingers,” says years old and feeling like I was 80.” Little did she know,
clothing designer
RA the reason you should do it?’ That the now 35-year-old legal assistant from Ohio. she would soon find her road to relief.
12 Make your mornings easier question has shifted my perspective ever “I picked up the phone and called my sister
What is RA?
since. I’ve now completed 10 marathons, and told her that I needed her,” Lana remembers. Her sis-
Try these soothing moves before ter wound up staying for two months. “If not for her, I am
you even get out of bed! finished 100-mile bike rides and scaled Mt.
not really sure how I could have taken care of a newborn When you have RA, your immune system—which
Hood! There’s no limit to what I can do.” when I could barely hold a fork.” normally fights healthy invaders—starts attacking your
Although she had been suffering with strange aches joints, causing inflammation, stiffness, and the loss of
and pains for years, the flare after her pregnancy was cartilage and bone. Although the medical term is
definitely the worst she’d ever experienced. “After years rheumatoid arthritis, it’s more appropriate to call it
“I found a doc who’s of frustration at the lack of answers, I started to wonder if
as type A as me!” what was wrong with me was all in my head,” Lana says.
“It took time but eventually the answers came.” Lana’s
15
“It was about 10 years ago and I’d been family doctor referred her to a rheumatologist. After a
H
ow does joint pain affect your life?
fighting psoriatic arthritis since high few tests, the rheumatologist confirmed she had rheu-
Fill out this worksheet and ask your doctor matoid arthritis (RA), a condition that affects more than
school,” recalls Carl Brody,
these questions at your next appointment 1.3 million Americans. “I felt both happiness and defeat,”
42, of the first time he
met his current doctor.
STAFF Vice President, Associations
and Business Development
“He stood very close
Editor-in-Chief
Maria Lissandrello
Dave Dolton to me and said, ‘We’re
Vice President, Marketing and
Copy and Projects Manager
Lindsay Bosslett
New Product Development gonna fix you.’ A surge
Alex Dong
Senior Art Director Chief Financial Officer of adrenaline rushed
John Angelini Ding Yu
Senior Graphic Designer
through my body—I knew this was
President
Helene Elek Kenneth Freirich someone who would be my advocate.”
Production Director Chief Executive Officer
Kimberly H. Vivas Eric Jensen During exams, Carl and his doctor would
Reviewed by Health Monitor’s arthritis expert: Elinor Mody, MD—Assistant discuss new research and medications,
Professor, Harvard Medical School Director, Women’s Orthopedic and Joint
Disease Center, Brigham and Women’s Hospital, Boston, MA ultimately leading them to biologics in
Health Monitor Network is the nation’s leading patient-education publish-
2003, a decision Carl credits for giving him
ing company, with publications, including Arthritis Health Monitor, available
in doctors’ offices and in homes. For more information, contact: Health
his life back. “I’m a guy who always wants
Monitor Network, 650 From Road, Paramus, NJ 07652; 201-391-1911;
healthmonitor.com ©2011 Data Centrum Communications, Inc.
an action plan, so to feel hopeful about
This publication is not intended to provide advice on personal
the future, I needed a doctor with an
medical matters or to substitute for consultation with a physician. equally proactive approach.”
2 Focus on Joint Pain Supplement to Arthritis health monitor 3

3. “
Rheumatoid Arthritis basics Psoriatic Arthritis basics
For me, it’s The pathway to relief
never been The good news is, you don’t have to just live with the
pain and inflammation of RA—and Lana is proof.
about coping.
“I still work and maintain a work-home life balance,
but I have learned to include my family in tasks that I
used to take on alone,” she says. “There are days when I
It’s been feel physically and emotionally drained. On those days,
all I have to do is look at my sons and see how indepen-
about thriving
dent, strong and empathic they are despite RA in our
A
lives. While my kids think they need me, they don’t
realize that I need them, too.” manda Steyer struggled with
despite RA.” And Lana’s feeling pretty great these days, thanks to
medication, three or four sessions of yoga a week,
joint pain and swelling for so
much of her life, she thought
meditation and prayer. She’s also built a solid, trusting it was normal. “When I was
relationship with her doctor. She was frank about her younger, doctors chalked it up
rheumatoid disease, as it can affect almost every organ. symptoms and provided details (like what her pain felt to growing pains,” says the mother of five
Many cells play a role—and not everyone will experience like, what might have triggered it and what might from Bristol, CT. In addition to the joint
problems with each type of cell. For some, T cells (white make it feel better) that helped him determine the pain, she’d been getting strange rashes on
blood cells that normally help the body fight infections) treatment path that made sense for her. her skin, and was diagnosed with what she
Is
or B cells (which normally produce antibodies) will go “I often tell fellow sufferers that they have the power thought was a separate condition: psoria-
haywire and cause problems. Sometimes cytokines to advocate for themselves,” Lana says. “They can do sis—an autoimmune condition that causes
psoriatic
(proteins that normally regulate the immune system) mal- this by learning about their condition, expressing their patches of thick, red spots on the skin that
function. Various treatments take aim at problem cells. needs and concerns clearly, and opening up about burn and itch.
how the disease affects them. For me, it’s never been “Then I had a very bad flare of arthri-
Why does RA hurt? about coping. It’s been about thriving despite RA. That
means accepting that sometimes there are things—like
tis in my feet and had a lot of testing
done.” Over the next 11 years, Amanda’s
arthritis
During an RA flare, the immune system cells listed the physical aspects of the disease—that are out of your symptoms came and went, and she found
above target your synovium—the delicate lining that control, but knowing that how you respond and fight herself too busy taking care of her fam-
surrounds and cushions your joints and produces fluid back are always in your control.” ily—including her five kids—to figure out
that lubricates the area. As a result, your synovium why the aches and pains never seemed to
becomes swollen and inflamed, putting pressure on go away for good. Then, one morning in
your nerves, which then transmit pain signals to your February 2011, everything changed.
brain. What’s more, the swollen synovium also
protrudes into the joint, where it releases chemicals
Gentle exercise,
like walking, helps
“I woke up and my left ankle wasn’t
working. I had almost no range of behind your
joint pain?
that eat away at the bone. motion. My primary care doctor discov-
keep joints limber ered not only severely limited range of
and reduces pain, motion in my left ankle, but substantially
limited range in my right ankle.” Her
according to a
doctor eventually referred Amanda to
study in Arthritis a rheumatologist, who, after several
Rheumatism. months and many tests, diagnosed her
with psoriatic arthritis (PsA). About 30% of people with
Affecting an estimated 500,000
Americans, PsA is not as well known as
psoriasis develop psoriatic
other forms of arthritis, yet raising aware-
ness is critical. That’s because treatments
arthritis. Luckily, with the right
are now available to control the disease. treatment plan, you can live
And left untreated, PsA can cause perma-
nent and irreversible joint damage. a full and active life.
4 Focus on Joint Pain Supplement to Arthritis health monitor 5

4. “ “W
Psoriatic Arthritis basics COVER story
For me,
humor is the
What you can do RA opened the door
to my dream career!”
If your doctor diagnoses you with PsA, take heart: Many
of today’s medical options can treat both the psoriasis
best coping
and the psoriatic arthritis. Talk to your doctor about
trying one of the many medications available, such as:
skill”  Nonsteroidal anti-inflammatory drugs
(NSAIDs) corticosteroids These can ease pain,
inflammation and stiffness, but don’t prevent joint damage. by Katie Alberts
 Systemic “body-wide” medications These atching Juretha Lawson pose for the camera, you’d
help relieve symptoms and can limit joint damage. never guess she has rheumatoid arthritis (RA). At
57, she exudes serenity and style and has a long,
 Biologics These medications, such as TNF-alpha lean figure women half her age would envy. Her
inhibitors, block a protein called tumor necrosis factor secret? “I eat right, exercise and am lucky that
(TNF) that causes inflammation. Biologics can help medication keeps my RA symptoms in check.”
prevent further joint damage. But things weren’t always so rosy for the model, entrepreneur
What is PsA? and former schoolteacher from Chicago. “Around my 50th
About 30% of people with psoriasis eventually develop Relief is possible! birthday, I began experiencing mysterious pains and unrelenting
fatigue,” she recalls. “I canceled on friends, skipped parties and
PsA, according to the National Psoriasis Foundation. Amanda isn’t letting PsA bring her down. In addition watched my social life go from vibrant to nonexistent. I assumed
Psoriasis is an autoimmune disease that causes scaly to homeschooling and raising her five children with her it was menopause until one morning I woke up unable
skin patches that itch and burn, while PsA is an husband, Jim, she also provides child care for friends and to stand. The bottoms of my feet were so tender
autoimmune disease that causes joint pain. Turns out, neighbors, and is the cofounder and president of Mindful I couldn’t put weight on them, never mind
the same miscommunication between cells that causes Village (fclct.org), a nonprofit organization that provides walk across the room.” With a scarf tied
scaly patches to form on the skin can also cause joint an online community for parents. around her neck and arm to
damage, bringing with it pain in fingers, wrists, knees, “For me, humor is the best coping skill,” Amanda says. stabilize a throbbing shoulder,
hips, ankles, toes, spine and other joints. “My kids help a lot with that aspect of ‘Sporadic Artie,’ as Juretha made it to see her
Most people with PsA develop psoriasis first— we refer to ‘him,’ thanks to my 3-year-old who can’t quite doctor. “Looking back, it
sometimes as early as 10 years before—and then wrap her mouth around ‘psoriatic arthritis.’ was crazy that I drove
develop psoriatic arthritis. But sometimes the joint “Having lots of little kids in the house is also a helpful myself—I could barely
problems begin before skin lesions appear, which coping skill—they keep my joints moving, but also allow steer the car—but I
can delay diagnosis. for a nice balance of cuddling and reading time. During was desperate for relief.”
times my body is acting up, I don’t always mind laying Luckily, relief came quickly
Could you have PsA? there to read them their favorite book over and over and
over again so I don’t have to move!”
once she was diagnosed with
RA. “After I started on my
If you have joint pain, a careful evaluation by a rheumatol- What’s also helped Amanda is staying in touch with medications, I felt much better,
ogist can help you determine the cause. In PsA, a “sausage- her doctors to make sure she is up-to-date on her tests and improved more each day.”
like” swelling of the fingers and toes often accompanies the and to get answers to any questions she might have. “I Juretha did lots of research and
pain. It’s also common to have problems with your nails— found doctors who took the time to really get to know me found out about what she should
they may start to separate from the nail bed, or develop and discuss things fully with me, and whom I can contact eat and what were the best exer-
small depressions on their surface. Morning stiffness and just about any time of day. My rheumatologist has even cises for RA. The one thing she
fatigue are also signs of the illness. In addition to having called me from home to discuss test results!” couldn’t find were clothes that
psoriasis, several factors can increase your risk, including: Amanda also chose to “make friends” with PsA instead fit her new life. “I wanted piec-
 Having psoriatic lesions on your nails of fighting with it. “PsA has allowed me to get to the es without zippers and but-
 Having a parent or a sibling with the disease heart of what’s really important and let go of the rest. It tons so they were easy to put
 Being between ages 30 and 50. Although people has encouraged me to slow down and enjoy the beauty on and take off if my hands
of any age can develop psoriatic arthritis, it occurs around me, and it’s taught me to see the world through swelled up. And they need-
most often during those years. my blessings instead of my hardships.” ed to be ultra-soft, wrinkle-
6 Focus on Joint Pain Supplement to Arthritis health monitor 7

5. If you have psoriatic arthritis or moderate to severe rheumatoid arthritis
“Don’t let joint pain keep you from the things that matter most.”
Phil Mickelson
Champion golfer
ENBREL psoriatic arthritis patient
“In the summer of 2010,
I experienced intense joint pain and had trouble
walking. My rheumatologist diagnosed me
with psoriatic arthritis and prescribed ENBREL,
a medicine that can relieve pain and stiffness,
improve physical function, and help stop joint
damage from worsening. Now I’m back to doing
the things I love.”
Your results may vary.
ENBREL is the #1 prescribed biologic by rheumatologists. ENBREL is also Ask your rheumatologist if ENBREL may be right for you,
approved for adults with moderate to severe rheumatoid arthritis (RA). At six months, ENBREL if you have joint pain, stiffness, or swelling, and think you may have psoriatic arthritis or RA.
was shown to be effective in about 50% of psoriatic arthritis patients who used it. Call 1-888-4ENBREL or visit www.enbrel.com. Prescription ENBREL is taken by injection.
ENBREL is indicated for reducing signs and symptoms, to fight infections. Serious infections have happened • Are taking any medicines, including herbals These infections may develop or become more severe • Have recently received or are scheduled for any autoimmune reactions, including a lupus-like syndrome
keeping joint damage from getting worse, and improving in patients taking ENBREL. These infections include • Think you have, are being treated for, have signs of, if you take ENBREL. If you don’t know if these vaccines. All vaccines should be brought up-to-date and autoimmune hepatitis.
physical function in patients with psoriatic arthritis. tuberculosis (TB) and infections caused by viruses, fungi, or are prone to infection. You should not start taking infections are common in the areas you’ve been to, before starting ENBREL. Patients taking ENBREL Common side effects include: Injection site reactions,
ENBREL can be used in combination with methotrexate or bacteria that have spread throughout the body. Some ENBREL if you have any kind of infection, unless your ask your doctor should not receive live vaccines. upper respiratory infections (sinus infections), and
in patients who do not respond adequately to patients have died from these infections. Your doctor doctor says it is okay • Have or have had hepatitis B • Are allergic to rubber or latex headache. These are not all the side effects with
methotrexate alone. should test you for TB before you take ENBREL and monitor ENBREL. Tell your doctor about any side effect that
• Have any open cuts or sores • Have or have had heart failure • Are pregnant, planning to become pregnant,
ENBREL is indicated for reducing signs and symptoms, you closely for TB before, during, and after ENBREL bothers you or does not go away.
treatment, even if you have tested negative for TB. • Have diabetes, HIV, or a weak immune system • Develop symptoms such as persistent fever, bruising, or breastfeeding
keeping joint damage from getting worse, and improving If you have any questions about this information, be sure
• Have TB or have been in close contact with someone bleeding, or paleness while taking ENBREL • Have been around someone with chicken pox
physical function in patients with moderate to severe There have been some cases of unusual cancers reported to discuss them with your doctor. You are encouraged
rheumatoid arthritis. ENBREL can be taken with in children and teenage patients who started using who has had TB • Use the medicine Kineret® (anakinra), Orencia® What are the possible side effects of ENBREL?
(abatacept), or Cytoxan® (cyclophosphamide) to report negative side effects of prescription drugs
methotrexate or used alone. tumor necrosis factor (TNF) blockers before 18 years • Were born in, lived in, or traveled to countries where ENBREL can cause serious side effects including: New to the FDA. Visit www.fda.gov/medwatch, or call
of age. Also, for children, teenagers, and adults taking there is more risk for getting TB. Ask your doctor if you • Are taking anti-diabetic medicines infections or worsening of infections you already have;
IMPORTANT SAFETY INFORMATION 1-800-FDA-1088.
TNF blockers, including ENBREL, the chances of getting are not sure • Have, have had, or develop a serious nervous disorder, hepatitis B can become active if you already have had it;
What is the most important information I should lymphoma or other cancers may increase. Patients with • Live, have lived in, or traveled to certain parts of the seizures, any numbness or tingling, or a disease that nervous system problems, such as multiple sclerosis, Please see accompanying Medication Guide
know about ENBREL? RA or psoriasis may be more likely to get lymphoma. country (such as, the Ohio and Mississippi River valleys, affects your nervous system such as multiple sclerosis seizures, or inflammation of the nerves of the eyes; on the next page.
ENBREL is a medicine that affects your immune system. Before starting ENBREL, tell your doctor if you: or the Southwest) where there is a greater risk for or Guillain-Barré syndrome blood problems (some fatal); new or worsening heart ©2011 Amgen, Inc., Thousand Oaks, CA 91320 and
ENBREL can lower the ability of your immune system • Have any existing medical conditions certain kinds of fungal infections, such as histoplasmosis. • Are scheduled to have surgery failure; new or worsening psoriasis; allergic reactions; Pfizer Inc. All rights reserved. MC52324-A-1 03-11

6. • have or had a nervous system problem such as multiple sclerosis
or Guillain-Barré syndrome.
the virus can become active while you use Enbrel. Your doctor may
do a blood test before you start treatment with Enbrel and while you COVER story
• have or had heart failure. use Enbrel.
“
• are scheduled to have surgery. • Nervous system problems. Rarely, people who use TNF-blocker
• have recently received or are scheduled to receive a vaccine. medicines have developed nervous system problems such as multiple
Medication Guide Enbrel® (en-brel) (etanercept)
✓ all vaccines should be brought up-to-date before starting Enbrel.
✓ people taking Enbrel should not receive live vaccines.
sclerosis, seizures, or inflammation of the nerves of the eyes. Tell your
doctor right away if you get any of these symptoms: numbness or Take the 15-minute
Read the Medication Guide that comes with Enbrel before you start
✓ ask your doctor if you are not sure if you received a live vaccine.
• are allergic to rubber or latex.
tingling in any part of your body, vision changes, weakness in your
arms and legs, and dizziness.
• Blood problems. Low blood counts have been seen with other
fitness approach”
using it and each time you get a refill. There may be new information. ✓ the needle covers on the single-use prefilled syringes and the
This Medication Guide does not take the place of talking with your TNF-blocker medicines. Your body may not make enough of the blood “I know I can’t make it through an entire exercise class, but
single-use prefilled SureClick® autoinjectors contains dry cells that help fight infections or help stop bleeding. Symptoms include
doctor about your medical condition or treatment. It is important to natural rubber. fever, bruising or bleeding very easily, or looking pale. I’ve developed a habit of going to the first 15-20 minutes,”
remain under your doctor’s care while using Enbrel.
Enbrel is a prescription medicine called a Tumor Necrosis Factor (TNF)
• have been around someone with varicella zoster (chicken pox). • Heart failure including new heart failure or worsening of heart failure reveals Juretha. “The instructors don’t mind, and I get to
• are pregnant or plan to become pregnant. It is not known if Enbrel will you already have. New or worse heart failure can happen in people who
blocker that affects your immune system. harm your unborn baby. use TNF-blocker medicines like Enbrel. If you have heart failure your enjoy the atmosphere of working out with a group.” And
What is the most important information I should know ✓ Pregnancy Registry: Amgen has a registry for pregnant women condition should be watched closely while you take Enbrel. Call your she has a similar strategy when it to comes to walking, her
about Enbrel? who take Enbrel. The purpose of this registry is to check the health doctor right away if you get new or worsening symptoms of heart failure
Enbrel may cause serious side effects, including: of the pregnant mother and her child. Talk to your doctor if you are while taking Enbrel, such as shortness of breath or swelling of your favorite type of exercise. “I’m never sure how far I’ll be able
1. Risk of infection pregnant and contact the registry at 1-877-311-8972. lower legs or feet. to make it on a walk, so I watch walking DVDs at home.
• are breastfeeding or plan to breastfeed. It is not known if Enbrel passes • Psoriasis. Some people using Enbrel developed new psoriasis or
Enbrel can lower the ability of your immune system to fight infections.
Some people have serious infections while taking Enbrel. These infections into your breast milk. You and your doctor should decide if you will take worsening of psoriasis they already had. Tell your doctor if you develop Some days I can do half a mile, other days it’s three—and
red scaly patches or raised bumps that may be filled with pus. Your
include tuberculosis (TB), and infections caused by viruses, fungi, or Enbrel or breast feed. You should not do both.
doctor may decide to stop your treatment with Enbrel. I never have to worry about having the stamina to make it
bacteria that spread throughout their body. Some people have died See the section “What are the possible side effects of Enbrel?”
from these infections. below for more information.
• Allergic reactions. Allergic reactions can happen to people who use back home.”
“
TNF-blocker medicines. Call your doctor right away if you have any
• Your doctor should test you for TB before starting Enbrel. What is Enbrel? symptoms of an allergic reaction. Symptoms of an allergic reaction
• Your doctor should monitor you closely for symptoms of TB during Enbrel is a prescription medicine called a Tumor Necrosis Factor include a severe rash, a swollen face, or trouble breathing.
treatment with Enbrel even if you tested negative for TB.
• Your doctor should check you for symptoms of any type of infection
before, during, and after your treatment with Enbrel.
(TNF) blocker.
Enbrel is used to treat:
• Autoimmune reactions, including:
✓ Lupus-like syndrome. Symptoms include a rash on your face
Try a ‘light touch’ massage”
You should not start taking Enbrel if you have any kind of infection unless • moderately to severely active rheumatoid arthritis (RA). Enbrel can and arms that gets worse in the sun. Tell your doctor if you have this Like many people with autoimmune arthritis, Juretha was
be used alone or with a medicine called methotrexate. symptom. Symptoms may go away when you stop using Enbrel.
your doctor says it is okay.
• psoriatic arthritis. Enbrel can be used alone or with methotrexate. ✓ Autoimmune hepatitis. Liver problems can happen in people who nervous about having someone touch her swollen joints.
2. Risk of cancer • ankylosing spondylitis (AS). use TNF-blocker medicines, including Enbrel. These problems can But it turns out massage is one of the best ways she’s found
• There have been cases of unusual cancers in children and teenage • chronic moderate to severe plaque psoriasis in adults ages lead to liver failure and death. Call your doctor right away if you have You can find more chic, comfortable clothes
patients who started using TNF-blocking agents at less than 18 years and older. any of these symptoms: feel very tired, skin or eyes look yellow, poor from Juretha’s line (which she is modeling in the to ease pain and improve flexibility. “I started by asking
18 years of age. appetite or vomiting, pain on the right side of your stomach (abdomen).
• moderately to severely active polyarticular juvenile idiopathic
photos seen here) at Juretha.com. my husband to carefully rub my back and feet with
• For children, teenagers, and adults taking TNF-blocker medicines, arthritis (JIA) in children ages 2 years and older. Common side effects of Enbrel include:
including Enbrel, the chances of getting lymphoma or other cancers You may continue to use other medicines that help treat your condition • Injection site reactions such as redness, swelling, itching, or pain. mentholated oil. It felt so good that I started going for
may increase.
• People with rheumatoid arthritis or psoriasis, especially those with
while taking Enbrel, such as nonsteroidal anti-inflammatory drugs These symptoms usually go away within 3 to 5 days. If you have pain, monthly professional massages. The key is asking for a
(NSAIDs) and prescription steroids, as recommended by your doctor. redness, or swelling around the injection site that doesn’t go away or
very active disease, may be more likely to get lymphoma.
Enbrel can help reduce joint damage and the signs and symptoms of gets worse, call your doctor. free and, above all, flattering—outfits I could proudly wear ‘light touch’ anywhere that might be sensitive and ‘deep
Before starting Enbrel, be sure to talk to your doctor: the above mentioned diseases. People with these diseases have too • Upper respiratory infections (sinus infections). to a photo shoot.” So Juretha set out to design her own line: tissue’ on other areas. I think of it as mix-and-match
Enbrel may not be right for you. Before starting Enbrel, tell your doctor much of a protein called tumor necrosis factor (TNF), which is made • Headache.
about all of your medical conditions, including: by your immune system. Enbrel can reduce the effect of TNF in the These are not all the side effects with Enbrel. Tell your doctor about any Juretha Chic Classic Comfort Wear. “I started working massage—and nothing makes me feel as rejuvenated!”
Infections – tell your doctor if you: body and block the damage that too much TNF can cause, but it can side effect that bothers you or does not go away. with pattern-makers and manufacturers to get all the details Juretha’s experience is supported by research, which
• have an infection. (See “What is the most important information also lower the ability of your immune system to fight infections. See Call your doctor for medical advice about side effects. You may report side
I should know about Enbrel?”) “What is the most important information I should know about effects to FDA at 1-800-FDA-1088. just right and shared my idea on Facebook. Turns out many suggests that massaging RA-affected joints reduces
• are being treated for an infection. Enbrel?” and “What are the possible side effects of Enbrel?” How should I store Enbrel? women with RA had the same wardrobe wishes I did!” muscle tension for days afterward.
“
• think you have an infection. Who should not use Enbrel? • Store Enbrel in the refrigerator at 36° to 46°F (2° to 8°C).
• have symptoms of an infection such as fever, sweats or chills, cough Next on the horizon? Juretha plans to expand her busi-
Do not use Enbrel if you: • Do not freeze.
or flu-like symptoms, shortness of breath, blood in your phlegm, weight ness to accessories. “If it hadn’t been for my diagnosis, I
Be direct with your doctor”
• have an infection that has spread through your body (sepsis). • Do not shake.
loss, muscle aches, warm, red, or painful areas on your skin, sores • Keep Enbrel in the original carton to protect from light.
on your body, diarrhea or stomach pain, burning when you urinate How should I use Enbrel? • Keep Enbrel and all medicines out of the reach of children. never would have discovered my talents as a designer—I
or urinating more often than normal, and feel very tired. • Enbrel is given as an injection under the skin (subcutaneous or SC). General Information about Enbrel joke that all my clothes should have a silver lining!” “The first time I was prescribed medication for my RA, my
• have any open cuts on your body. • If your doctor decides that you or a caregiver can give the injections of
• get a lot of infections or have infections that keep coming back. Enbrel at home, you or your caregiver should receive training on the right Medicines are sometimes prescribed for purposes not mentioned in a Since Juretha’s a fashion pro, we asked her to spill the rheumatologist said to start taking it the following morn-
• have diabetes, HIV, or a weak immune system. People with these Medication Guide. Do not use Enbrel for a condition for which it was not
conditions have a higher chance for infections.
way to prepare and inject Enbrel. Do not try to inject Enbrel until you
prescribed. Do not give Enbrel to other people, even if they have the style secrets that let you stay chic despite joint pain—and ing. I got home and was in so much pain that my husband
have been shown the right way by your doctor or nurse.
same condition. It may harm them. reveal the other ways she stays confident and healthy. suggested I call to see if I could start that night. So I called
“
• have TB, or have been in close contact with someone with TB. • Enbrel is available in the forms listed below. Your doctor will prescribe
• were born in, lived in, or traveled to countries where there is a risk for the type that is best for you. This Medication Guide summarizes the most important information
getting TB. Ask your doctor if you are not sure. about Enbrel. If you would like more information, talk with your doctor. and, sure enough, my doctor said it was fine. I got a good
• live, have lived in, or traveled to certain parts of the country (such as the
Ohio and Mississippi River valleys, or the Southwest) where there is a
° Single-use Prefilled Syringe
° Single-use Prefilled SureClick Autoinjector
° Multiple-use Vial
You can ask your doctor or pharmacist for information about Enbrel that
was written for healthcare professionals. For more information call, Shop for femininity night’s sleep, woke up feeling much better and promised
myself I’d always ask whatever questions I needed to.
and functionality”
greater risk for getting certain kinds of fungal infections (histoplasmosis, 1-888-4ENBREL (1-888-436-2735).
• See the detailed “Patient Instructions for Use” with this Medication
coccidioidomycosis, blastomycosis). These infections may happen or
Guide for instructions about the right way to store, prepare, and give What are the ingredients in Enbrel? Now my doctor and I discuss everything from my work
become more severe if you use Enbrel. Ask your doctor if you do not Single-use Prefilled Syringe and the Single-use Prefilled
know if you live or have lived in an area where these infections are common. your Enbrel injections at home.
SureClick Autoinjector: It is possible to dress stylishly and comfortably even schedule to how my skin and hair are looking.”
• Your doctor will tell you how often you should use Enbrel. Do not miss
“
• have or have had hepatitis B. if you’re in the midst of an RA flare-up, says Juretha.
any doses of Enbrel. If you forget to use Enbrel, inject your dose as soon Active Ingredient: etanercept
Also, BEFORE starting Enbrel, tell your doctor: as you remember. Then, take your next dose at your regular(ly) scheduled Inactive Ingredients: sucrose, sodium chloride, L-arginine hydrochloride “Drawstring waists can be chic when they’re covered
• About all the medicines you take including prescription
and nonprescription medicines, vitamins and herbal
supplements including:
time. In case you are not sure when to inject Enbrel, call your doctor
or pharmacist. Do not use Enbrel more often than as directed by
and sodium phosphate
Multiple-use Vial: with a fabric sash. Pants with wide, pull-on legs drape Set your own pace”
your doctor.
✓ Orencia® (abatacept) or Kineret ® (anakinra). You have a higher • Your child’s dose of Enbrel depends on his or her weight. Your child’s Active Ingredient: etanercept beautifully if they aren’t too bulky at the hips. Designers “Running my own business has helped me manage my RA.
chance for serious infections when taking Enbrel with Orencia® doctor will tell you which form of Enbrel to use and how much to give Inactive Ingredients: mannitol, sucrose, tromethamine are making gorgeous bracelets and rings that are elasticized Instead of working on someone else’s schedule, I space out
or Kineret ®. your child. v5
✓ Cyclophosphamide (Cytoxan®). You may have a higher chance for so they can slip on and off swollen fingers. With so many my meetings and tasks to preserve my energy. I’ve also had
What are the possible side effects of Enbrel? Issue Date: 10/2010
getting certain cancers when taking Enbrel with cyclophosphamide. Enbrel can cause serious side effects, including: options, there’s no reason not to look great!” Elegant no- a chance to meet wonderful people in the arthritis commu-
✓ Anti-diabetic Medicines. If you have diabetes and are taking This Medication Guide has been approved by the US Food and
medication to control your diabetes, your doctor may decide you
See “What is the most important information I should know Drug Administration. closure tunics, dresses and pant sets, done up in luxurious nity and encourage their dreams. I always say, ‘If there’s a
about Enbrel?”
need less anti-diabetic medicine while taking Enbrel.
• Infections. Enbrel can make you more likely to get infections or make
neutrals and metallics, like the kind Juretha designs, are product or service you wish you’d had after your diagnosis,
Keep a list of all your medications with you to show your doctor and any infection that you have worse. Call your doctor right away if you have perfect for anything from work to entertaining. chances are others feel the same way, so go for it!’ ”
pharmacist each time you get a new medicine. Ask your doctor if you are any symptoms of an infection. See “Before starting Enbrel, be sure
not sure if your medicine is one listed above. to talk to your doctor” for a list of symptoms of infection.
Other important medical information you should tell your • Hepatitis B infection in people who carry the virus in their blood. If
doctor BEFORE starting Enbrel, includes if you: you are a carrier of the hepatitis B virus (a virus that affects the liver), © 1998–2010 Immunex Corporation. All rights reserved. Printed in the USA
11
©2010 Amgen Inc., Thousand Oaks, CA 91320 and Pfizer Inc. All rights reserved.
Supplement to Arthritis health monitor

7. 3
wake up right
moves to make mornings easier
If waking up is difficult due to pain and stiffness, you’re not alone. According to the
National Institutes of Health, morning stiffness is one of the most common symptoms of
rheumatoid arthritis and psoriatic arthritis. To the rescue: These gentle stretches you can
do before you even get out of bed!
Lengthen your neck and shoulders
Lie flat on your back with your knees bent and your head
comfortably relaxed on a pillow. Carefully straighten and raise
your arms with your palms facing each other. While keeping
your head on the pillow, exhale and reach both arms to the
ceiling, allowing your shoulders to lift off the bed. Hold this
stretch for 30 seconds and repeat 10-15 times.
Tip! Keep your neck relaxed through the entire range of
motion to allow your arms to fully lengthen both your neck
and shoulder muscles.
Release your neck and back Tip! As you
shift forward and
Sit tall at the edge of the bed carefully arch backward as
back, keep your
and cross both arms behind your you pass through the starting
abdomen tight to
head. Exhale and gently tilt your position and hold for an additional
protect your lower
head and shoulders forward and 5 seconds. Repeat the range
back and strengthen
hold for 5 seconds. Inhale and of motion 12-15 times.
your core.
Tip! Too Check
hard? Simply
rotate wrists
with your
outward and doctor
inward without Get your
incorporating rheumatologist’s
the fist okay before
contraction. starting any
Too easy? new exercise
Remove the program!
pillow and hold
Wake up your hands and wrists your elbows
in the air at a
Sit tall and rest your forearms Rotate both wrists outward as you
90-degree angle
comfortably on a pillow with your stretch all 10 fingers open. Turn both
while doing the
palms facing downward and your hands inward and return fingers to a
move.
hands loosely grasped in a fist. closed fist. Repeat 15-20 rotations.
Exercises developed and modeled by Lisa Robins. Photography: Steven Trujillo of
12 Focus on Joint Pain Trudge Photo, Phoenix, AZ, October 2011. Supplement to Arthritis health monitor 13

8. tear-out tool
How does joint pain
Affect your Life?
Knowing how joint pain affects your ability to do everyday tasks
helps your healthcare provider determine how well your current
He doesn’t stop.
A
N
O
treatment is working. Fill out this worksheet and review it with
ot
re
nl
y
al
a
your doctor to make sure you’re getting the best possible relief.
a
ly
pr
And with the right support,
A
sm for
bi
ob
bi
g
all
le
g
pr
m
pr
pr
neither do I.
ob
ob
ob
Problems created by arthritis
le
le
le
m
m
m
m
e
Getting out of bed in the morning
Getting dressed (doing buttons or zippers, tying shoelaces, etc.)
Showering
Getting on and off the toilet
Reaching above my head
Reaching forward
Bending down to pick something up
Opening doors or cabinets
Turning lamps on and off
Turning faucets on and off
Opening jars
Getting in and out of the car
Getting up or down from chairs
Doing household chores like vacuuming or dusting
Holding cups or silverware
Walking up or down stairs
Find the FUTURO Support that’s right for you.
™
Walking on flat ground
Our FUTURO Energizing Wrist Support combines compression,
stability and comfort. Developed in collaboration with medical Falling or staying asleep
professionals and backed by 50 years of 3M health care experience, Unable to do activities I once enjoyed (hobbies, sports, etc.)
it’s ideal for Carpal Tunnel Syndrome, sprains and tendonitis.
Unable to go out with friends or loved ones
WATCH THE VIDEO NOW Unable to keep working
Scan the tag to learn more about this product.
Visit futuro.com/coupon and save $3.00. Feeling self-conscious about how my swollen joints look
Get the free app Supplement to Arthritis health monitor 15
for your phone at
http://gettag.mobi/ © 3M 2011. 3M, FUTURO and LIVE MORE are trademarks of 3M.