Connected Rheumatology

First-class Rheumatology with a personalized approach

Rheumatoid Arthritis

Hospitalized with autoimmune disease

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The truth is, only a minority of patients with autoimmune disease will ever really need to put this information in action. When you are hospitalized with an autoimmune condition you feel scared and helpless. Knowing what to expect and how best to take care of yourself during and after your hospital stay BEFORE it ever happens is self-care every autoimmune patient needs. 

Regardless of the incredible advancements we’ve made in rheumatology, sometimes the safest place for an autoimmune patient is the hospital. This could be to receive IV (intravenous) treatments, to undergo certain tests quickly or to stabilize and monitor worrisome vital signs. Autoimmune patients, in particular, can find themselves needing the hospital as there is a wide variety of symptoms possible.

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When hands change: Hand Arthritis

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“My hands are deforming just like my grandmothers.”

We don’t think about how much our hands do for us until they start giving us problems. We assume we will be able grip our steering wheel, type on our keyboards and button our shirts. But for many of us, usually in our 40’s (although it can start earlier), we start to notice changes in our hands. A day of work at our computer ends with our hands sore. We can’t quite open jars as easily as before and we may notice seemingly random shooting pains and numbness in our fingers. These symptoms can go unnoticed until we start noticing our hands LOOK different and rings don’t fit. Shoot….time to see a doctor!

When someone ends up in my office worried about their hands, I know their number one concern is Rheumatoid Arthritis (RA). A quick visit to Dr. Google, informs everyone that RA could cause hand pain and lead to “deformities.” For most of us with hand pain (including myself), RA will not be the culprit, but instead, osteoarthritis (OA).

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Know the Prednisone Side Effects

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Let me be clear – I wouldn’t want to be on prednisone either. In fact, when suffering from a wicked case of vertigo, I fought my doctor buddies who advised I take a Medrol dose pack to ease the symptoms.

“I’m going to gain weight!” “I’m going to have anxiety!”

As a Rheumatologist, I am well-versed in all the possible side effects of prednisone (and similar meds) and feared the worse.

But I also know that there is a time a place for prednisone. Not only was I currently in need of the benefits of prednisone, many of my patients are as well. But there ARE side effects that need to be considered and discussed.

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Do you need Prednisone?

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“We are just wanting to know if we need to start steroids.”

Doctors will often make this comment when seeking out a rheumatology consultation. Prednisone has almost become synonymous with rheumatology. For years it was one of just a handful of treatments at our disposal to calm down the myriad of autoimmune and inflammatory conditions we came across. But the liberal use of prednisone by rheumatologists also served as education to all the harms the drug can cause. 

When facing a prescription for prednisone, one can have many mixed feelings. Relief at the prospect of having some respite from pain and fear at the idea of all the side effects. Prednisone use has become so ubiquitous, especially with autoimmune disease, it can be easy to think of it as simply another “Tylenol” or “Advil.” But it needs to be understood and respected in order to be best used.

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Rheumatoid Arthritis Treatment – pt 1

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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.

When approaching RA therapy, the treatment options reside in two categories: anti-inflammatory and anti-RA (or diseases modifying, as your doctor will call them). Anti-inflammatory medications, such as ibuprofen, naprosyn, diclofenac and even prednisone, help you feel better here and now. They decrease inflammation in your joints and consequently lower your pain. These medications are not specific for rheumatoid arthritis, as many reach for these medications for headaches, menstrual cramps and muscle soreness. 

The second category of medications, anti-RA, or disease modifying medications,  change the course of rheumatoid arthritis. They don’t simply bring down inflammation, but they actually modify the immune system, rendering RA less active. Both types of medications are necessary for a successful long term treatment strategy for RA.

Get inside the head of your Rheumatologist to understand how we treat RA
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