5 questions to ask your rheumatologist if you have rheumatoid arthritis

It is important that you can implement the treatment and recommendations of your specialist.

The inflammation associated with rheumatoid arthritis is what can also damage other parts of the body. Photo: Shutterstock.

The medical literature defines rheumatoid arthritis as a chronic inflammatory disorder that can affect more than just the joints. In some people, the condition can damage various body systems, including the skin, eyes, lungs, heart, and blood vessels.

This autoimmune disorder occurs when the immune system mistakenly attacks the body’s tissues. Unlike the wear and tear damage of osteoarthritis, rheumatoid arthritis It affects the lining of the joints and causes painful swelling that can eventually lead to bone erosion and joint deformity.

The inflammation associated with rheumatoid arthritis it is what can also damage other parts of the body. Although new medications have greatly improved treatment options, rheumatoid arthritis Severe can still cause physical disabilities.

Learn about the five most important questions to ask your rheumatologist:

What is the risk of permanent damage to my body from rheumatoid arthritis?

The rheumatoid arthritis it is a condition associated with persistent inflammation. This inflammation occurs most intensely in the joints, but can cause damage to other parts of the body. Between the joints, sustained inflammation causes destruction of both cartilage and bone, and can also damage other structures near the joint, such as tendons and ligaments. Sometimes patients can develop complications that affect other areas of the body such as the eyes, lungs, kidney, skin, blood and even the nervous system.

Not all patients experience severe damage, as the disease can have mild manifestations. It is important to comply with pharmacological treatment to reduce and in some cases stop the progress of damage to the joint and avoid other complications that may occur. With proper treatment, patients can experience remission, which is nothing more than effectively stopping or controlling the disease.

What are the available treatments, their risks, and how likely am I to experience a side effect?

There are many treatments available to manage RA and control the disease. These therapies range from conventional medications such as methotrexate, sulfasalazine (azulfidine), Hydroxychloroquinine (plaquenil), Azathioprine (Imuran). These are known as synthetic disease-modifying drugs and are usually the first line of treatment.

There are also biological drugs that block substances called cytokines and finally those that block enzymes that promote inflammation by affecting the immune system.

Each of these medications has its possible risks and potential side effects. Risks and side effects are constantly talked about, but sometimes the infrequency with which these problems can be experienced versus the risk of permanent joint damage is lost sight of.

There are ways to lower the risks associated with medication use. The most important is to have a rheumatologist oversee your treatment, choose the appropriate medication for your care, and carefully monitor your labs and overall health.

Do I need to make any lifestyle changes to help control the disease?

Patients may think that there is nothing they can do to help them manage RA, but that is not the case. There are lifestyle changes that can have a big impact on symptoms: stop smoking, lose weight, exercise, eat healthy, manage anxiety and depression, promote proper rest, lower stress levels, seek help and have a good support system at home.

Smoking, for example, is a habit that is modifiable. Smoking is a behavior that aggravates arthritis and predisposes to serious complications, increases the risk of side effects from some of the medications used to manage RA, and ultimately increases the risk of heart disease.

Being overweight makes the joints that support your weight, such as the hip, knee, ankle, and small joints in the feet, more painful.

Lack of physical activity increases the experience of tiredness or physical fatigue that is commonly associated with RA. Lack of restful sleep can cause more tiredness and less tolerance for pain. By modifying these elements of your lifestyle, you can feel better and this relief would be of help beyond that offered by medication.

Can I do exercise?

There are several studies that have shown the benefit of exercise for RA patients. The best evidence exists for low-impact aerobic exercise, joint movement exercises, and strengthening exercise. Cardiovascular exercise helps increase oxygenation in the tissues, it will give you more energy, you will be able to sleep better. Joint movement exercises help you preserve better mobility and flexibility in your joints.

Examples of aerobic exercises are: walking, stationary cycling and aquatic exercises, among others. With regard to joint strengthening and mobility exercises, it is advisable to visit a physiatrist or physical therapist to be educated on the correct techniques and necessary modifications so that you can exercise effectively without injuring yourself.

You should consult with your rheumatologist before starting an exercise program. It is important that your disease is reasonably controlled and that a personalized program is designed. It is possible to experience more pain when beginning an exercise routine, this should improve with time. If your pain doesn’t improve after two weeks, see your doctor.

Every exercise routine should include a warm-up and stretching period. It is important to hydrate before, during and after exercising.

What vaccines are appropriate for me?

Immunosuppressed patients due to drug use should not receive live vaccines. Some examples of live vaccines are Herpes Zoster (shingles), nasal influenza vaccine, and polio vaccine. However, injectable influenza and pneumococcal vaccines are appropriate and necessary in RA patients receiving therapies that predispose them to increased risk of infections.

According to the guidelines established by the “American College of Rheumatology” (ACR) and the “Center for Disease Control” (CDC), these are the recommendations for influenza and pneumococcal vaccines:

The injectable influenza vaccine should be administered to all RA patients who are or will be treated with immunosuppressants, regardless of when their treatment is started or started, unless there is a contraindication.

The pneumococcal vaccine should be administered to all RA patients who are or will be treated with immunosuppressants and should be vaccinated again 5 years after their last pneumococcal vaccination.

The Hepatitis B vaccine should be administered to patients who are going to use methotrexate, leflunomide or any biological if they have risk factors. Risk factors include history of multiple sexual partners in the last 6 months prior to treatment, contact with people with Hepatitis B, intravenous drug use, or patients working in health-related areas.

Source consulted here.

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