What Treatment Options Are Available For Ra
There are medications that help manage RA symptoms and control inflammation, such as NSAIDs, corticosteroids, disease-modifying anti-rheumatic drugs, and biologics. However, there are non-medication treatment options as well. Non-pharmacologic treatment options include rest, exercise, physical and occupational therapies, dietary management, and, in some cases, surgery.
Why Read Death By Rheumatoid Arthritis
Early in Carlas story, she shares the dramatic moment when she read her mothers death certificate: Cause of Death: Rheumatoid Arthritis. We know from the title what killed Celia Veno. So why read the rest of the book?
Death by Rheumatoid Arthritis is more than a mystery story. It is Carla Jones passionate appeal to the world to pay attention. RA is a serious illness which can lead to death by several means, one of which is spinal cord instability. Carlas sincere writing could encourage RA patients to be more vigilant with the care of their cervical spines. It could also educate physicians and care givers that spinal involvement in Rheumatoid Arthritis is common and can become life threatening.
Weve reported here on the blog of studies showing that Rheumatoid Arthritis affects the cervical spine 83% of the time in the first two years of disease activity. Carlas book reports an even higher percentage. Unfortunately, weve also received numerous comments from readers whose doctors have told them that its rare for RA to affect the spine. They say things like, My doctor told me thats probably not happening with me since its rare. Carlas book shows how important it is for each of us to be vigilant on behalf of our own health.
Can Ra Be Fatal
RA alone is not fatal. Fatality occurs due to complications associated with the inflammation caused by RA. In severe cases, patients can develop other medical conditions. The other medical conditions that patients need to be aware when it comes to shortened RA life expectancy include:
- Heart disease
- Respiratory conditions like Chronic Pulmonary Obstruction Disorder
Off course, these are conditions that everyone should be concerned about. Keeping your body healthy through diet, exercise, and positive habits will go a long way to reducing the risk of fatality from any of these conditions.
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Complications Of Rheumatoid Arthritis That Can Kill You
1. Cardiovascular Disease
One of the most common effects of RA is an increased risk of contracting cardiovascular disease. In fact, this is the leading cause of death among patients who suffer from RA. They have an almost doubled risk of suffering from stroke or heart attack, and this increases to triple, once they hit the 10-year mark, however, they are also the ones who do not show much symptoms and experience sudden attacks without warning.
2. Metabolic Syndrome
Metabolic syndrome is the general name for a variety of factors that increase cardiovascular risk, such as obesity, hypertension, and glucose intolerance. These conditions can usually be predicted with the chronic use of glucocorticoids and in having higher levels of inflammatory markers.
Although the question of “can rheumatoid arthritis kill you” is not usually that concerning, RA patients have also been found to be at higher risk for atherosclerosis. RA and atherosclerosis have a few similar processes that operate in the same way, especially systemic inflammation. As a result, the occurrence of one usually leads to the occurrence of the other.
4. Serious Infections
5. Gastrointestinal Perforation
What Kind Of Medical Care Will I Need
If you have RA, you should still see your primary care doctor as needed. Youll also need to see a rheumatologist. Rheumatologists specialize in RA and other autoimmune, rheumatic, and musculoskeletal conditions. They may prescribe disease-modifying anti-rheumatic drugs, which can help reduce disease activity and prevent joint damage.
RA isnt the same for everybody. Your rheumatologist will assess your condition, form a treatment plan, and advise you on how to best take care of yourself. Theyll also monitor your disease progression and adjust your medications as needed. In time, you may have additional needs such as physical therapy, occupational therapy, or other types of treatments.
You should be aware of other possible serious complications from RA, including the following.
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Your Doctor Might Not Be Keeping Tabs On Your Cardiovascular Health
A large number of RA patients dont even get a cholesterol test, says Dr. Navarro-Millan. The problem, she says, is that many patients treat their rheumatologist as their main health care provider, but rheumatologists expect that primary care physicians, such as internists, are monitoring their patients heart health.
In the CreakyJoints survey, 20 percent of respondents said they were not monitoring their heart health with a doctor, such as getting regular cholesterol or blood pressure tests.
Rheumatologist Jeffrey Curtis, MD, MPH, Professor of Medicine at the University of Alabama at Birmingham, says that physician ownership or lack thereof is a huge problem when it comes to RA and co-occurring conditions like heart disease. There are some blurry domains in medicine for people with chronic medical conditions, he says. Many rheumatologists might say, My job is to take care of your RA. They may not have time to manage issues like high blood pressure, high cholesterol, diabetes, and other heart disease risk factors.
This disconnect means that the responsibility can fall on RA patients in a few ways. Not only is it essential to see a primary care doctor , but its important to bring up heart health with your rheumatologist.
Its too easy for, say, a nurse to take a blood pressure measurement, enter it into a patients health record, and then nothing else happens. Dont assume your doctor would tell you if there was a problem, Dr. Bartels says.
Why Heart Disease Is More Deadly For Those With Ra
Heart disease should be considered a serious cause for concern among people with RA, even those whove yet to reach middle age. The study authors found that people with RA under the age of 45 had almost a threefold increased risk of cardiovascular disease death compared with the general population, in large part because of the high-grade, systemic inflammation that goes along with RA. It doesnt only affect the joints, its throughout the body, and it attacks multiple organs, says Widdifield.
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RA treatments themselves may also play a role in leading to premature death, particularly because they can leave people more susceptible to infections. A lot of disease-modifying treatments have altering effects on the immune system, so people with RA should take mild infections seriously, says Widdifield. Talk to your doctor about the flu and shingles vaccines and about other preventive strategies. Even a mild infection can turn more deadly in , she says.
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Symptoms Of Disease Progression
Rheumatoid arthritis is a chronic, progressive disorder. Unless the underlying inflammation can be brought into remission, the disease will continue to advance, causing not only pain and stiffness but undermining the integrity of the joint itself.
Over time, the relentless autoimmune response can deteriorate joint cartilage, erode bone tissue, and cause the bonding of joints, further restricting the range of motion. This is especially true of weight-bearing joints in which damage can result in the loss of mobility, such as the knees.
Edema, the swelling of tissue caused by fluid retention, is also common. With rheumatoid arthritis, swelling is typically associated with inflamed joints of the feet, ankles, legs, arms, and hands.
Eventually, as their structural underpinnings are destroyed, the joints will begin to lose their shape and alignment, resulting in joint deformity.
Common examples of this include:
- Ulnar deviation: Deformity of the big joints in the knuckles
- Joint contracture: The restrictive foreshortening of muscles around a joint
- Wrist subluxation: Dislocation and misalignment of the wrist bones
It is usually at this stage that other, more potentially serious complications can develop.
How To Reduce The Appearance Of Bruising
Although it can be indicative of other health issues, bruising on its own isnt necessarily dangerous. However, it can take a toll on your self-esteem if bruises are large and frequent.
Bruising easily is a symptom that can be associated with lots of different problems, so even if youre pretty sure its happening because of rheumatoid arthritis or medications, bring it up with your doctor to be sure, suggests Mariah. I certainly understand how excessive bruising can impact a persons self esteem it didnt make me feel particularly good about my body but the alternative of getting off the prednisone wasnt practical until I found another treatment that could control my pain and fatigue.
There are a few ways you can prevent or reduce the appearance of bruising. The Mayo Clinic recommends following RICE techniques:
- Rest: If possible, rest the bruised area.
- Ice: Wrap an ice pack in a towel and apply to the bruised area for 10 to 20 minutes. Repeat several times per day for one to two days.
- Compress: If the bruised area is swollen, use an elastic bandage to compress it.
- Elevate: Raise the injured area.
Theres been some interest in rutin , which may be helpful for conditions in which blood vessels are lacking in support, says Dr. Saardi. Some people have try vitamin K ointment to help with bruising after dermatological procedures. There have been some studies that a compound in vitamin K ointment can resolve bruising a little more quickly.
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What Are The Signs And Symptoms Of Ra
With RA, there are times when symptoms get worse, known as flares, and times when symptoms get better, known as remission.
Signs and symptoms of RA include:
- Pain or aching in more than one joint
- Stiffness in more than one joint
- Tenderness and swelling in more than one joint
- The same symptoms on both sides of the body
- Weight loss
Types Of Cancer Linked To Rheumatoid Arthritis
If you have rheumatoid arthritis , you may be at increased risk for certain cancers because of RA medicationsor RA-related inflammation itself.The best thing you can do is to be aware, but don’t worry excessively. “The risk of all of these is very, very low,” says Stanley Cohen, MD, clinical professor of internal medicine at the University of Texas Southwestern Medical School and co-director of the division of rheumatology at Presbyterian Hospital, in Dallas. “When you look at the numbers, the relative risk is higher but the actual risk is low.”RA has even been linked to a lower risk of some types of cancer.
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Clinical Guidelines For Managing Ra
Although there is no cure for RA, treatments are available to help control the disease. Clinical guidelines for RA treatment, published in 2021 by the American College of Rheumatology, doubled down on previous guidance emphasizing the use of methotrexate as the main disease-modifying anti-rheumatic drug treatment before adding another medication.
On average, people with RA live about 10 years less than people without the disease.
Laura Porter / Verywell
When To See A Healthcare Provider
Rheumatoid arthritis can be scary, and not only because of the symptoms but because of the uncertainty of what lies ahead. Don’t let this stop you from taking action if you suspect you have the disease.
The advantage of an early diagnosis is that it allows you early treatment. Simply put, the sooner you take disease-modifying medications, the better your long-term outlook is.
This is especially true if you have a family history of rheumatoid arthritis. Having a sibling or parent with rheumatoid arthritis nearly triples your risk of the disease, while having a second-degree relative doubles your risk.
Possible RA symptoms that warrant a trip to the healthcare provider include:
- Pain, swelling, or stiffness in one or more joints
- Joints that are red or warm to the touch
- Regular joint stiffness in the morning
- Difficulty moving a joint or doing daily activities
- An episode of increased joint pain and stiffness lasting for more than three days
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Skin And Mucous Membranes
Around 20% of people with rheumatoid arthritis will develop hardened bumps beneath the skin called rheumatoid nodules. They most often develop on the elbows, knees, or knuckles.
Several skin-related symptoms may develop in later-stage disease, including:
RA is associated with a few problems involving the heart and circulation, including:
- Pericarditis, inflammation of the membrane surrounding the heart
- Vasculitis, constriction of capillaries that may cut off circulation
- Increased risk of stroke and heart attack
Your healthcare provider can help you find ways to lower your risk of these possible complications.
The long-term complications of RA translate to reduced life expectancy. People with RA may live 10 to 15 years less than they otherwise would if they didn’t have the disease. Cardiovascular disease is leading cause of death in people with rheumatoid arthritis.
Can You Change Your Risk
Your life doesnât have be shorter if you have RA. You can raise your life expectancy by getting your disease activity under control. If you lower your disease activity and keep it low, youâll have a better quality of life and may live longer, too.
Take these steps:
- Start treatment as early as possible. People who see a rheumatologist for diagnosis and treatment soon after they notice symptoms do better in the long term. The sooner you start treatment, the less damage RA can do.
- Follow your treatment plan. See your doctor regularly to watch for complications and keep an eye on your progress.
Other positive things you can do include:
Rheumatology International: âMortality in patients with rheumatoid arthritis: a 15-year prospective cohort study.â
Rheumatoid Arthritis Support Network: âRA Life Expectancy: Does Rheumatoid Arthritis Affect Life Span.â
Joint, Bone and Spine: âMortality in rheumatoid arthritis over the last fifty years: systematic review and meta-analysis.â
Annals of the Rheumatic Diseases: âMortality in rheumatoid arthritis: the impact of disease activity, treatment with glucocorticoids, TNFÎ± inhibitors and rituximab.â
Arthritis Foundation: âHow RA Inflammation Affects Your Heart,â âMeasuring Disease Activity in Rheumatoid Arthritis.â
Mayo Clinic: âRheumatoid arthritis.âClinical and Experimental Rheumatology: âDiabetes mellitus risk factors in rheumatoid arthritis: a systematic review and meta-analysis.â
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What Is The Outlook For Patients Living With Ra
RA research has come a long way over the past several decades. Historically, little was known about RA and the wide-ranging symptoms and complications which resulted from the diseases inflammatory processes.
Today, doctors understand that there are several conditions that may present themselves in RA patients. Patients who work closely with their rheumatologist can have these potential complications addressed early on, and pursue appropriate treatments to prevent symptoms from advancing.
Despite working proactively with medical specialists, there are cases where patients suffer from severe symptoms which do not respond to current treatments. Unfortunately these cases can lead to a shortened life expectancy.
Can Ra Affect My Mental And Emotional Health
Its possible that living with RA may affect your mental and emotional health. As many as 40 percent of people with RA experience symptoms of depression. The exact reasons for this arent known. Living with chronic illness, pain, and disability can lead to depression in some people. There may also be a link between depression and inflammation.
Depression can make you less likely to adhere to your treatment plan, which can make your RA worse. Depression also increases the likelihood of alcohol and drug abuse, and can harm your overall health. Symptoms of depression include:
- feelings of sadness or hopelessness
- feelings of anger or irritation, even over small things
- loss of interest in hobbies
- sleeping too much or sleeping too little
- lack of energy
- noticeable weight gain or loss
- repetitive negative thoughts
Depression can be treated with medication, as well as behavioral and talk therapy. If youre experiencing symptoms of depression, talk to your doctor or mental health professional.
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Causes Of Death In Rheumatoid Arthritis Patients
Mortality rates were increased for patients with rheumatoid arthritis relative to the general population across all causes of death in a recent Arthritis Care & Research analysis.
The study included 87,114 rheumatoid arthritis patients in Ontario and 348,456 age/sex/area-matched general population comparators from 2000 to 2013. During follow-up, 14% of rheumatoid arthritis patients and 9% of individuals in the general population died.
While the causes of death were similar in the two groupsmost frequently being circulatory system diseases, cancer, and respiratory conditions , patients with rheumatoid arthritis were dying at a younger age. The potential life years lost before the age of 75 years among rheumatoid arthritis patients was approximately double that among those in the general population.
“Our findings offer new insights into the importance of cardiovascular and respiratory contributionsincluding pneumoniato shortening patient lives,” said lead author Dr. Jessica Widdifield, of Sunnybrook Research Institute, in Toronto, adjunct scientist at the Institute for Clinical Evaluative Sciences and Assistant Professor at the Institute of Health Policy, Management & Evaluation, University of Toronto. She noted that deaths in patients with rheumatoid arthritis are largely attributed to complications of the disease and its treatment as well as to other comorbid conditions.
What Are The Complications Of Ra
Rheumatoid arthritis has many physical and social consequences and can lower quality of life. It can cause pain, disability, and premature death.
- Premature heart disease. People with RA are also at a higher risk for developing other chronic diseases such as heart disease and diabetes. To prevent people with RA from developing heart disease, treatment of RA also focuses on reducing heart disease risk factors. For example, doctors will advise patients with RA to stop smoking and lose weight.
- Obesity. People with RA who are obese have an increased risk of developing heart disease risk factors such as high blood pressure and high cholesterol. Being obese also increases risk of developing chronic conditions such as heart disease and diabetes. Finally, people with RA who are obese experience fewer benefits from their medical treatment compared with those with RA who are not obese.
- Employment. RA can make work difficult. Adults with RA are less likely to be employed than those who do not have RA. As the disease gets worse, many people with RA find they cannot do as much as they used to. Work loss among people with RA is highest among people whose jobs are physically demanding. Work loss is lower among those in jobs with few physical demands, or in jobs where they have influence over the job pace and activities.
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