When I first began to experience joint pain, morning stiffness, and fatigue it was easy to chalk it up to getting older, even though I was only 37 years old. I tried not to push my body too hard, but the symptoms only got worse and I noticed that I was constantly running a low-grade fever that concerned me.
I decided to meet with my primary care physician to address my symptoms. He ordered a litany of blood tests; one of which showed a positive rheumatoid factor. After meeting with a rheumatologist, I was officially diagnosed with rheumatoid arthritis (RA). I immediately felt overwhelmed with the prospect of living with rheumatoid arthritis—a condition I knew little about—for the rest of my life. Arthritis? Isn’t that what older people get?
What is rheumatoid arthritis?
Rheumatoid arthritis is an autoimmune disease in which the body’s immune system mistakenly attacks the joints. It can cause joint damage and deformity that cannot be reversed and can also affect the cardiovascular or respiratory systems. “While the exact cause [of the disease] is unknown, it is thought that some trigger in genetically susceptible people causes an autoimmune phenomenon that drives the joint pain and destruction,” says Adam Meier, MD, of Intermountain Budge Clinic in Logan, Utah.
It’s not age-based
When I tell people that I am living with rheumatoid arthritis often their response is, “But you are too young to have arthritis!” I felt that way, too! There are, however, many different types of arthritis. When most people think of arthritis, they are really thinking of osteoarthritis, which occurs when the protective cartilage that cushions the ends of your bones wears down over time. According to Dr. Meier, “Osteoarthritis is much more common [than RA] and is not an autoimmune disease that requires immunosuppression to prevent joint damage.”
RA most commonly begins in middle age, but it can happen at any time. It affects more than the joints. “While joint pain is often the initial and most obvious symptom of rheumatoid arthritis, it is a systemic inflammatory condition,” says Dr. Meier, who notes that “fatigue, muscle pain, anemia, bone loss, and dry eyes or dry mouth (known as Sjögren’s syndrome)” are common, and that less common symptoms such as “serious lung complications, vasculitis or even atherosclerosis” are also possible with RA.
How to treat RA
In many ways, I was relieved to receive my diagnosis because it explained why I was feeling so sore and run down. I was grateful to have options for rheumatoid arthritis treatment. I had a Vectra Da test (a multi-biomarker disease activity test) and ultrasounds that showed that I am in the beginning stages of the disease. So, my rheumatologist recommended I get through the winter months and flu season (because I have young kids) if possible before going on immunosuppressor medications.
The drugs commonly used to treat RA include NSAIDS (ibuprofen, naproxen, aspirin, etc.) for pain and corticosteroids. According to Rory Smith, Pharm.D., at Cedar Drug and Gift in Cedar City, Utah, these drugs should be used “short term and sparingly.”
“The standard of care is the disease-modifying anti-rheumatic drugs (DMARDs),” says Dr. Smith. There are two types of DMARDs: conventional and biological therapies. “Methotrexate and similar oral DMARDs are the most commonly prescribed treatments,” says Dr. Smith, who notes that “biologics are gaining more popularity all the time.” These drugs are not pain relievers, but work to decrease or even reverse joint damage. Dr. Smith also stresses the importance of non-drug therapies for RA patients such as staying active with gentle exercising.
Patients with RA are at an increased risk for developing osteoporosis, a disease with weak bones that can result in fractures. Although osteoporosis generally occurs in elderly patients, RA medications also increase the risk of osteoporosis.
Living with rheumatoid arthritis (RA)
Over the last few months, my symptoms have continued to grow in severity so I made an appointment with my doctor who administered steroid-based, Depo-Medrol injection to help decrease inflammation and also prescribed Methotrexate injections. It will take several weeks to know if the medication is working, but I have been pleased that the side effects (some nausea and fatigue) have been manageable thus far. If the Methotrexate proves to be ineffective, my doctor says we will move to biologics.
I want to be aggressive with RA treatment for a better quality of life. As a writer, it has also become my mission to be a voice to those who face chronic illnesses every day (no matter the person’s age) that are often “invisible” to everyone else.