This expert plan can help take you from “Now what?” to “I’m on top of it!”
Finding out you have rheumatoid arthritis (RA) can set you on a roller-coaster ride of emotions. You’ve probably felt everything from relief (“I finally know what’s wrong”) to anxiety (“Will I have to give up my job?”) to utter frustration (“My spouse/kids/boss just don’t understand”). And that’s in addition to the pain and mobility problems you have!
How to get a handle on it all? First, commit to partnering closely with your rheumatologist. Then focus your energy by reading the tips below, provided by Madelaine Feldman, MD, a New Orleans rheumatologist who’s been treating RA patients for nearly 25 years.
Demystify the disease. “When you’re first diagnosed with RA, it’s very important to become knowledgeable about it,” says Dr. Feldman. “But the information needs to come from reputable sources.” Besides your rheumatologist, two other good places to start are the National Institutes of Health (niams.nih.gov) and the American College of Rheumatology (rheumatology.org).
Realize that RA is systemic. That is, it can affect the whole body and cause problems other than joint pain, such as fever, extreme exhaustion and flu-like symptoms. The disease also leads to chronic inflammation throughout the body, which can affect the skin, eyes, lungs and heart. In fact, RA is a known risk factor for heart disease.
Start treatment as early as possible. “Getting the disease under control in that first six months to a year is important,” says Dr. Feldman. And it’s not just about controlling your symptoms. Early treatment with certain medications can help prevent further joint damage and put the disease in remission. That will help keep you as mobile and pain-free as possible. And don’t be afraid to aim high, stresses Dr. Feldman. “Expect the best from treatment, and ask your rheumatologist what the goals are.”
Pay attention to everyday functioning. Pain relief is only part of the goal. Ask yourself this: Can you still perform everyday tasks like getting dressed and turning a doorknob? How about getting in and out of the car? If you have to avoid certain activities or constantly ask for help, let your doctor know.
Remember that your situation is unique. “Although your symptoms may be like a neighbor’s or friend’s symptoms, it’s not the same disease and won’t always respond to the same meds,” notes Dr. Feldman.
Know what to expect when starting a new med. Ask your doctor what the medication is supposed to treat and when you can expect to see results. Some meds can take up to three months before the full effects are seen. Also, find out which potential side effects require a call to your rheumatologist and which ones are expected to gradually go away.
Get an education—for your family members. “Many times a patient’s family members don’t realize how sick their family member is because the joints are not always swollen,” says Dr. Feldman. “They think, Mom is ‘tired’ or ‘lazy,’ or, She always feels bad. There’s more than the eye can see with this disease.” A good way to educate? Bring family members to your next rheum appointment (alert your doc ahead of time) so they can hear firsthand what having RA entails.
Don’t ignore the nonphysical aspects. “RA can take its toll mentally, especially since the chronic pain and fatigue are so emotionally draining,” says Dr. Feldman. Let your doc know if you’re feeling depressed or lack energy to do things that you used to enjoy. These feelings are common when dealing with any chronic illness, and there’s no need to suffer. Many people have found relief with antidepressants, psychotherapy and RA support groups.
You can fight RA fatigue. Dr. Feldman notes that exhaustion is one of the most difficult RA symptoms to treat, but don’t give up hope. In addition to the usual recommendations—get at least eight hours of sleep and eat a healthy diet—one especially great fatigue-buster is exercise. Dr. Feldman’s pick? “Muscle strengthening with light weights or resistance bands can increase your metabolism and energy by increasing muscle mass. The key is not to do too much or too little.” In fact, any movement—even just walking around the block—is helpful. Ask your doc what exercises are appropriate, and remember that RA isn’t the only energy stealer: Stress, anemia, certain meds and depression are common culprits as well.
If you smoke...Quit! “Not only does smoking make RA harder to treat—in susceptible individuals it may even trigger onset of the disease,” says Dr. Feldman. Ask your doctor about smoking-cessation programs, and don’t stop trying. The more you try, the more you increase your chances of kicking tobacco for good!