Living With Rheumatoid Arthritis.

Shlotzhauer TL, McGuire JL. Baltimore, MD 21218-4319, The Johns Hopkins University Press, 1993, hardback, 216 pp, illus, $22.95.

This book is written for individuals who have rheumatoid arthritis (RA). The authors are careful to inform the reader that the recommendations made in the book are not meant as substitutes for appropriate health care providers, but rather to help the patient gain further understanding about living with RA.

The authors present information to enlighten the patient and help him or her cope with having a chronic illness. They divide the book into six sections: Part 1, "Learning about Rheumatoid Arthritis"; Part 2, "Coping with Rheumatoid Arthritis"; Part 3, "Exercise and Rehabilitation"; Part 4, "Medications"; Part 5, "Beyond Medications: Other Treatments"; and Part 6, "Practical Matters." In addition, there is a section devoted to suggested resources that are available from the Arthritis Foundation and other agencies. A glossary is provided and will be needed by individuals who are unfamiliar with the vocabulary of the rheumatology community.

The book has current information that could be very useful to the patient with RA. Part 3, "Exercise and Rehabilitation," is primarily geared to joint protection and exercise guidelines. if a therapist were to recommend this book to a patient with RA, it would be important to review which exercises are appropriate for that individual. Although the coverage of exercise is generically approached in some respects, it does give general guidelines the patient should follow to prevent increased pain, fatigue, and muscle soreness.

The section on coping strategies should be useful to the patient with RA. To the authors' credit, in part 5 they address the current thinking on nutrition, diets, and fish oil. The coverage of surgical intervention is very brief but adequate for this book. They also address insurance, hidden costs, and alternative forms of treatment that patients sometimes seek. The latter topic is very brief; however, the authors do outline patient how to recognize an unproven practice that should be avoided.

This book is meant to be a self-help text for those individuals with RA. The authors are well known in the rheumatology community and they have tried to write a balanced book addressing concerns of persons with IRA The chief weaknesses of the book are the paucity of illustrations for visual learners, and the written text is about a 12th-grade to college reading level. it does not address issues related to cultural or ethnic differences.