It takes a medical degree, a 3 year Internal Medicine residency and Rheumatology fellowship to learn how to best treat Rheumatoid Arthritis. There are many nuances and caveats and even seasoned rheumatologists find themselves asking for help from colleagues. But it doesn’t serve anyone to leave all the decision making to the doctor. Although the topic can get complicated, there are concepts that everyone with RA should be familiar with. Understanding the strategy behind why your doctor prescribes certain medications can ensure that you continue to have productive and effective conversations.
[Read more…] about Rheumatoid Arthritis Treatment – pt 1General Rheumatology
Know the Facts: Rheumatoid Arthritis (part 2)
We’ve discussed what it is, who gets it and how we make a diagnosis (and if you missed it, check out our previous post). But WHY does this happen? And can it be avoided? Rheumatoid arthritis is truly life changing. Getting the right rheumatoid arthritis information and understanding how and why our bodies do this can help us gain back control.
So why Rheumatoid Arthritis? What causes it and why did this happen to you? Well, as with most things rheumatic, it’s complicated. Genetics most definitely plays a big role. Having a family member with RA will put everyone in the family at higher risk for developing, not only RA, but any autoimmune condition. This is why it’s so important to know your family history.
[Read more…] about Know the Facts: Rheumatoid Arthritis (part 2)Know the facts: Rheumatoid Arthritis (part 1)
When getting a new diagnosis of Rheumatoid Arthritis, I find that most people need to start with the basics. It can be overwhelming. I know that not much beyond “You have Rheumatoid Arthritis” is heard and that everyone will need time to digest all the information out there.
So let’s talk about some Rheumatoid Arthritis facts and start with “What is Rheumatoid Arthritis?” RA is an autoimmune, systemic, inflammatory disorder. Seen in almost 1% of the US population, RA is more often seen in women compared to men and usually happens during middle age.
[Read more…] about Know the facts: Rheumatoid Arthritis (part 1)Know the facts about Ankylosing Spondylitis
I had to learn to always have a “high level of suspicion” for Ankylosing Spondylitis (AS) while a rheumatologist-in-training. This meant, I needed to “unlearn” most of what I was taught about back pain as an internal medicine resident. As an internist or primary care provider, you see a lot of patients with back pain. It is very common. In order to keep costs down and not overly worry patients, doctors are trained to treat back pain with common anti-inflammatory medications before jumping to x-rays and MRIs. And this isn’t JUST to keep costs down. The overwhelming majority of those with back pain will have resolution of that pain within 2 months. Hence, doing an MRI on every patient just doesn’t make sense. But as a rheumatologist, we are trained to look at back pain differently.
[Read more…] about Know the facts about Ankylosing SpondylitisRaynaud’s Syndrome
(Pause while everyone looks down at their own nails)
I learned to include this little pause during my medical student lectures on Raynaud’s Syndrome and Scleroderma. As opposed to many of the other conditions I treat and teach, there is actually a very high likelihood that a handful in the audience will have Raynaud’s. This isn’t surprising given how common it is, especially amongst women between the ages of 15 and 30. It is when discussing the connection between Raynaud’s and Lupus or Scleroderma, that the wave of concern washes over some faces in the audience. What the audience members are looking for are changes in the nail bed capillaries. These changes, can be a sign that their Raynaud’s Syndrome is part of a larger autoimmune condition. Thankfully, most, if not all, will have perfectly normal nail bed capillaries and be able to sit through the rest of the lecture panic-free. But it is always a reminder that even when speaking to trainees and students, I am speaking to patients.
[Read more…] about Raynaud’s Syndrome