Multiple joints are usually inflamed in symmetrical pattern and joints of both hands and wrists are often affected. Simple tasks such as turning door knob and opening jars can be painful. Rheumatoid arthritis can also affect joint responsible for tightening of vocal cords to change tone of voice although rarely. But when this happens, it can cause hoarseness of voice.

As mentioned before, rheumatoid arthritis is a systematic disease which can affect organs and areas of body other than joints. Sjorgen's syndrome is inflammation of glands of eyes and mouth which causes dryness. Rheumatoid inflammation of lung lining can cause chest pains because lung tissue itself is inflamed and nodules of inflammation also develop within lungs. Rheumatoid arthritis can also reduce number of red blood cells which can result to anemia and white blood cells which can result to increase risk of infections. A rare, serious complication of rheumatoid arthritis is blood vessel inflammation which can impair blood supply to tissues and lead to death of tissues.

A rheumatologist is a doctor who specializes in arthritis and other related diseases. The rheumatologist reviews history of symptoms, examines joints, and other parts of body for inflammation. The diagnosis is usually based on pattern of symptoms, distribution of inflamed joints, and blood and x-rays obtained.

Until now, there is no known cure for rheumatoid arthritis. Reducing joint inflammation and pain, maximizing joint function, and preventing joint destruction is current goal in treating rheumatoid arthritis. Early medical intervention has been found to improve outcomes in treatment. Optimal treatment includes combination of medications, joint strengthening exercises, joint protection, and patient education. Treatment is customized according to many factors such as disease activity, types of joints involved, general health, age, and occupation. But treatment is most successful when there is close cooperation between doctor and patient.

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3/ Save up your drinks if you’re going to need them. If you know you are going to an event where temptation to drink more fluid that you should will be strong, save up your drinks beforehand. For example – if you get off dialysis at lunchtime on Wednesday (meaning that you go back to dialysis on Friday Morning), and you have a function to attend on Thursday night, try to drink as little as possible between Wednesday lunchtime and Thursday evening, telling yourself that your reward will be fact that you will be able to drink (nearly) as much as a “normal” person at function.

4/ Keep yourself busy! Any dialysis patient will tell you that when they’re busy, they’re not thinking about drinking. It could be a gentle walk, send an email to a friend, jump on phone, or play with your kids. It doesn’t matter, as long as it keeps your mind occupied.

5/ Frozen water. Freeze a bottle of water, containing amount you have allowed yourself to drink that day, and drink it as it defrosts. This has benefit of drink being ice-cold, as well. The down-side of this is that if your bottle melts too quickly, you could find yourself at 3pm, with all your water gone!

6/ Spray bottle. Get yourself a spray bottle, and fill it with water (maybe with a little lemon juice or mint flavouring), and spray it into your mouth when you feel urge to have a drink. Whilst this won’t completely sate your desire for fluids, it may help you wait a little longer before indulging!

7/ Mints and toothpaste. Try sucking a strong mint, or even brushing your teeth. The feeling of a clean, fresh mouth will often lessen desire to blow your fluid limit. (This method will make you nicer to kiss, too!)

I hope that these suggestion will help you in dialysis patient’s eternal quest to keep their fluid gain under control. But remember, life is for living too, and we, as dialysis patients more than most need to adhere to this edict. So whilst keeping your fluid gain under control is important for both your immediate and long term health, remember that if you’ve blown your fluid this time, there is always next time, so keep trying!