Coping with Rheumatoid Arthritis
Rheumatoid arthritis is a chronic auto-immune disease, in which the
immune system essentially attacks the body's joints, causing pain,
swelling and joint damage over time. It's not known at this time what
causes RA nor is there a cure. It affects more women than men. The
progression of the disease is also different for each person, meaning
what works for one individual may not work for someone else. There's
also no set treatment plan, and sometimes that's a confusing and
frustrating part of the treatment of this disease.
I was diagnosed with RA in 2000, following a year of mysterious
come-and-go symptoms and missed work. After several visits to my family
doctor, I was eventually referred to a rheumatologist, who made the
diagnosis.
Rheumatoid arthritis can be difficult to diagnose. There are several
blood tests that can aid in diagnosis, but not every person with RA
tests positive for any of the tests that can confirm a diagnosis, particularly at the onset of the disease.
To aid in making a diagnosis, my rheumatologist needed from me very
specific information about my symptoms; what parts of my body were
affected, when the pain and stiffness started and how long it lasted,
if it was preceded by anything else, such as a cold or flu, what I did
that might make it better, or worse.
I was diagnosed in my early 40's, so my disease progression has been
much slower than someone who may have been diagnosed in their 20's and I feel very
fortunate. The earlier the disease starts, the more aggressive the disease can be and the longer time for
severe joint damage.
So if you've recently been diagnosed with RA or have had the disease
for some time, I hope the following things I've learned living with
this disease can help you.
One of the primary things I've learned is to keep a diary of symptoms.
Mine happens to be a Google document, since I spend most of my time on
the computer, but anything that is easy for you to maintain will work.
BRAIN FOG: A common symptom of many RA sufferers is "brain fog." It's
more than just forgetfulness. Difficult to describe to those who've
never experienced it, the closest I've ever come is to envision your
brain wrapped in a thick blanket. Not much gets in and not much gets
out and what does just feels muffled. Whether caused by fatigue or the
disease itself, it's frustrating.
You can cope with this by first acknowledging it exists. Don't try to
tough it out or make the effort to "just try to remember." It strains
your already taxed mind and body even more. Learn strategies to make it
easier on yourself.
As an Administrative Assistant, people were always stopping me away
from my desk with requests. I got in the habit of always carrying pen
and paper...or more often I would ask they send me an email with the
request. I have sent emails from work to home, home to work, left
myself voice mails, invested in sticky notes by the score, put pen and
paper in any place I might need it, including the car and my bedside
table.
I have put my car keys in my brown bag lunch, so I would remember the
lunch, because car keys were something I didn't forget--even though I
still misplaced them--because I can't go anywhere without them. I set up as
many bills as I could for online payment: I would literally forget the
bill arrived, and forget to pay it; days just got away from me.
RECOGNIZE A FLARE UP: Rheumatoid arthritis sufferers usually have flare
ups of the disease. These can last anywhere from days to months,
followed by long periods of disease inactivity. Sometimes it's hard to
recognize a flare up. Symptoms can start off like the flu, with joint
and muscle pain, fever, loss of appetite and fatigue. But unlike the
flu, the symptoms don't resolve in 24-48 hours, and may return over the
course of several weeks. If you keep a journal or diary, you can track
the symptoms, determining if you really did have the flu or if it is a
flare up.
WORK AND RHEUMATOID ARTHRITIS: The year before I was diagnosed, I
missed work with enough frequency because of the "flu" that my
supervisor felt the need to talk about my attendance. It was only
seeing it from her side, that I realized something was wrong, that people
usually do not feel ill enough to stay home two days one week, and
three days two weeks later, followed by more episodes of "flu" over
several months. The symptoms felt like flu...aches, pains, fever,
exhaustion...but put in context of RA, they made more sense.
Rheumatoid arthritis can have devastating effects on your work life,
and attendance is one of the things first noticed. However, the
Family and Medical Leave Act, which helps protect employees with
serious health conditions, can help
protect you in your job because of intermittent absences due to your
disease. Your Human Resource department can provide forms that your
primary physician fills out. Contact them as soon as you are diagnosed,
before your attendance becomes an issue.
DEPRESSION: Living with chronic pain can sometimes lead to depression.
And in the midst of treating RA, it's sometimes hard to distinguish
between RA symptoms and those of depression. Tired all the time?
Forgetful? Sleeping too much, or not sleeping well? Emotional? They
sound like symptoms of both diseases.
My nurse practitioner was the first to recognize my depression. As she
said, living with chronic pain can make anyone depressed. Left
untreated, depression can sap your remaining energy and make treating
your RA more frustrating. Don't be afraid to bring ALL your physical
and mental symptoms to your physician. Let them help you.
FAMILY: Rheumatoid arthritis can take its toll on your family life as
well. It's a confusing disease for those who do not suffer from it, or
do not know how it progresses. It's baffling to see someone in pain and
unable to function one day, but be up and seemingly well the next, only
to have this cycle be repeated over the course of weeks or months.
Particularly before the disease is diagnosed, and in the early stages
before treatments start to take effect, it is vital to have good
communication with your family, keeping them as much information about
RA as possible. The Arthritis Foundation website (www.arthritis.org) has a
wealth of excellent resources for both patient and family to help
understand this disease.
ADAPT: Some things in your life may have to change as your disease
progresses. You may be an ardent stair taker, but you might find you
need an elevator for only one floor. Writing might be painful; I tend
to type most things in my life, even notes at home. And to make that
easier, I search for keyboards that have "soft" touch keys. Certain
manufacturers seem to make keyboards that have keys that are easier to
depress than others.
EXERCISE: Keeping up an exercise routine is vital to maintain muscle
strength, which makes you feel better overall and helps support painful
joints, along with helping maintain a healthy weight. There's a fine
line that exists for those with RA of knowing when to exercise, and
when to rest and take it easy. Finding a program that you can adapt to
those times when you have a flare up is crucial. I walk, lift weights
and use a weight machine when I'm not having pain; however, during a
flare, sometimes walking becomes painful. I know through experience
when to stop using weights, to take slower paced walks, and when to
stop all together to let my body rest. It's a delicate dance RA
sufferers learn to maintain strength and flexibility, which not
contributing to further joint damage.
DIET: Diet plays a key role in managing any chronic disease, and
rheumatoid arthritis in particular. Since the main action of RA is
inflammation, diets low in sugar and saturated fats, basically no junk
or fast food, can have a huge impact on reducing inflammation. Others
have found reducing or eliminating foods from the nightshade family of
plants such as potatoes, eggplants and tomatoes, can have a positive
effect on their RA.
Increasing foods such as fruits and vegetables, particularly brightly
pigmented fruits like blueberries, cherries or deep green vegetables
like kale or spinach, can help reduce inflammation. Soy products also
help some RA sufferers reduce the inflammation caused by the disease.
Green tea is also added to many anti-inflammatory diets because of the
large amounts of anti-oxidants it contains.
I hope this article has provided some insight and advice on coping with
rheumatoid arthritis. I am not a medical professional, but someone who
suffers from rheumatoid arthritis. Please consult with a medical
professional if you feel you have symptoms of RA.


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