Arthritis Mom

I have been dealing with rheumatoid arthritis since 2002 (diagnosed in 2003) and I have always sought out online resources to learn about my disease, treatment options and the experience of other people with RA. I am always surprised when I read about individuals treating rheumatoid arthritis without medication. I realize that some may have mild rheumatoid arthritis that can be effectively handled with diet and exercise, and I think that is awesome. I admit I should do a better job understanding the connection between diet and RA flares. I know I feel better when I exercise regularly. And I totally understand the desire to avoid medications. Who would want to have a daily regimen of pills and pill bottles if they could avoid it?

There are some RA patients for whom the medications are simply not effective. For those who can be treated effectively with medication, there is one very important and undeniable reason to take that path - to avoid long-term joint damage. My mom had rheumatoid arthritis before there were effective treatments. She had aspirin at high doses and prednisone, both of which have serious side effects and did not control her RA symptoms effectively. She tried a series of other treatments that varied from having no affect, to allergic reactions. After several years of struggling daily to function as a single working mother with untreated RA, she was prescribed methotrexate. It was a significant improvement over aspirin. As soon as Enbrel became available her rheumatologist prescribed that and for her just like many others, it was a miracle drug. The closest thing an RA patient can have to a cure. Unfortunately the joint damage was already severe. Severe joint damage is extremely painful, an added layer of pain and difficulty on top of rheumatoid arthritis.

Since we first speculated I had rheumatoid arthritis, my goal was to get on one of the biologic drugs like Enbrel. I knew from my mom's experience that the biologics gave me the best chance of leading a normal life with rheumatoid arthritis. I knew after watching her struggle in pain for so many years, and seeing her hands and feet become disfigured, that I wanted to do everything possible to avoid that outcome.

A normal life to me was good daily function (being able to do my regular activities) and prevention of joint damage. It took a while to get there. Since there is no test to determine if you have rheumatoid arthritis, it took 9 months to get an official diagnosis. Once I was diagnosed, I had to wait for the disease to progress to the point it could not be controlled with methotrexate alone before my insurance company would pay for one of the biologic drugs. When I reached that point, my rheumatologist and I agreed to start me on Humira.

In the past when an RA patient started on a biologic drug they stopped taking methotrexate, but the more common treatment option now is to stay on both methotrexate and one of the biologics. There have been studies to show the combination gives you the best chance at preventing joint damage. The study results were surprising because doctors and patients assumed if you were not experiencing pain and swelling then your joints were fine. It turns out that is not true. You can be functioning fine on a daily basis and still be experiencing joint damage.

Regardless of what treatment option you take, even if you are not on any medications, is vital that an RA patient be monitored for joint damage. My rheumatologist does this through periodic x-rays of my hands and feet. If you have RA and you are not being monitored for this, ask your rheumatologist or find a new rheumatologist! Do not wait until it's too late, preventing joint damage is too important. You don't get a second chance to do it over.