General Rheumatology

Sjogren’s Syndrome: know the facts

September 7, 2021 ·

You’ve been waiting for this appointment for months. Your mind races as you wait for your name to be called. This all started when you made an appointment with your doctor on your dentist’s recommendations. You had more cavities than usual and your dentist recommended you get checked for an autoimmune condition. An autoimmune condition? Really? Sure, you have been tired the last few months, but life is busy and who isn’t tired these days? Your doctor did some tests and said you have rheumatoid arthritis. WHAT? You are given a copy of your labs, the name of rheumatologist and told to take Advil.

The four-month wait for the rheumatology appointment gives you plenty of time to investigate your labs, and to your dismay, you find you are ANA positive. Dr. Google immediately informs you that you likely have lupus. Let the spiraling commence. Why didn’t my doctor mention this? How could this happen? Am I going to die?

They call your name and usher you back. Blood pressure is a little elevated – not surprising given what you are bracing yourself to hear. Waiting again. Finally, the doctor arrives. She looks over your labs, does a physical, and says “You don’t have lupus or RA.” A wave of relief washes over you. Your future suddenly becomes clear again. “But you have Sjogren’s Syndrome.”

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Rheumatoid Arthritis Treatment – pt 1

July 28, 2021 ·

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.

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Know the Facts: Rheumatoid Arthritis (part 2)

July 23, 2021 ·

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.

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Know the facts: Rheumatoid Arthritis (part 1)

July 21, 2021 ·

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.

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Know the facts about Ankylosing Spondylitis

June 29, 2021 ·

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.

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