How to Better Manage Your Rheumatoid Arthritis | Access Health

rheumatoid arthritis affects an estimated 1.3 million adults in the US for those affected by this debilitating condition day to day tests can be a struggle and if not managed effectively can progressively get worse today we will be discussing rheumatoid arthritis and what patients need to know if there are a is not under control i'm ereka vetrini access health starts now dr. grace Wright is a Rheumatologist who has dedicated the last 25 years of her career to treating patients with this autoimmune disorder I'm going to sit down with her in a bit but first she explains the basics of RA rheumatoid arthritis is an autoimmune disease which means that your own immune system attacks your body in this case it's attacking the joint primarily and it tends to attack the joints on both sides of the body some of the joints affected will include the hands the feet the wrists the shoulders the knees the hips the symptoms include pain aches morning stiffness tenderness swelling and fatigue in addition to that rheumatoid arthritis can affect other parts of the body such as the lung the heart various other tissues this is a systemic disorder with inflammation everywhere RA can be incredibly painful for patients and affect their quality of life whatever we do we're using all of our joints we're using our entire body if you have painful swollen stiff joints that impacts every action that you take patients also feel very isolated at times both from their families from their communities because it can't participate in the usual activities and in addition to that anxiety and depression often accompany this disease when we come back I'll meet with dr. right but first let's hear from Stephanie who has RA [Music] I'm Stephanie I'm 27 years old I live in Miami with my husband we've been married 7 years and we just had a baby I love being a mom to Santiago he's so much fun to be around he's the cutest thing the whole world when people look at me they just see an average 27 year old but I'm living with rheumatoid arthritis it's a rollercoaster having RA I never know how I'm gonna feel when I wake up in the morning and it affects every part of my body from my head to my toes morning stiffness all day stiffness night time stiffness just be in any place for an extended period of time makes it really difficult and it's sort of like a Tin Man feeling it's like you can't get loose you can't get limber and it gets to the point where it causes pain when my knees are swollen and painful it's difficult to walk and it's to the point that I don't even want to use the joint so it's sort of like having an area of your body that's painful you don't want to use it you want to protect it but that makes it difficult to do everyday things and tasks being a mom to a six-month-old is hard enough but having RA it's a different level of tired it's sort of like having the flu I feel weak and it's difficult because my mind feels a hundred percent and I'm a hundred percent there but it's like my body can't keep up coming up life after diagnosis and the importance of managing your RA stay with us once a patient is diagnosed via their medical history a physical exam along with blood and imaging tests doctors can start to create a care plan I met up with dr. right to better understand the collaborative approach to managing a patient's are a doctor right thank you so much for having me here oh thanks for coming so let's talk about why it's so important for your RA patients to develop a relationship or a partnership with their doctors this is a lifelong disease it's important to have lifelong relationships they have a collaborative approach so that this is a journey both you and your providers can take together and so then why is proper management of RA so vital RA can cause joint damage very early on 80% of patients can have damage within the first two years before they even realize that there is a problem if we get effective management early on we can limit joint damage and we can limit all of the other damage from inflammation as well so speaking to that what are your treatment goals for your patients so the treatment goals really are tailored to each patient but overall we want to make sure that we improve your physical function that we reduced your pain reduce your fatigue and really get rid of the tenderness and swelling in the joints that really impact your ability to engage in your daily life you need to be able to get up in the morning get ready and go to work and not take six hours for that process that makes it very difficult I also want to make sure that you're not having a flare every other day or every week because it's really hard to live when you're always under the burden of this inflammatory condition so how do you identify when patients don't have their RA under control I look at how frequently are you flaring how much as your physical function changed are you able to open the door you're able to get up and go to work as you used to when things like that change consistently then we know that things are not being managed appropriately the other things that we have to look at are your blood work within the levels of inflammation in the blood we can look at imaging studies things like x-rays and ultrasounds and MRIs that show us the structure of the joint will help me know are you forming erosion which is little holes on the bones that occur when the inflammation really targets those cells and damages those structures so there are lots of tools that we have to use and it's important for us to take a look at the whole picture so it's good to know that there is hope oh absolutely you have to have hope and when patients come in they're often just sort of thinking my life is over I'm never going to function the way I used to I never get back to normal my job is to help move you towards that path of normalcy it's important to always understand that control of your disease is important therapies may work they may stop working your doctor needs to know what works for you and what doesn't work and really get a care team together that's going to support you throughout the entire time on that note let's go meet Carla a patient living with RA in Dallas Texas [Music] I've always been an adventurer and I love to travel I've always been active cooking is one of my great passions and I still enjoy that as well as more sedate things like movies and I'm a devourer of books I work in corporate communications which allows me to work on some very interesting projects that range from marketing to executive speeches to videos to website coffee and it allows me to stay active and be engaged with very interesting projects I kept getting these weird symptoms sometimes the symptoms would range from just an ache or pain that would appear for no reason I would have strange rashes that the dermatologist didn't of what was the allergist didn't know what was but they would you know go away with some anti-inflammatory treatments I just and these would continue on and then go away over a period of probably three or four years I wasn't sure what was going on until I had a really bad flare my elbow blew up to the size of the grapefruit but more than that I started to continue to have all over you know problems with my joints and morning stiffness and fatigue and that I think gave the clue to my orthopedic professional that something more systemic was going on so as referred to the rheumatologists who did diagnostic tests and did confirm rheumatoid arthritis as my condition [Music] but I've been having joint damage and just two months later I had to have a full hip replacement and six months after that I had my first shoulder replacement it was a devastating time in my life first to deal with the diagnosis and understanding what that might mean in the future and then to go through two major surgeries in such a short period of time it completely turned my world upside down welcome back to access health we're talking rheumatoid arthritis with dr. grace right dr. Tommy when as a physician do you become concerned that the current treatment plan isn't right so if I see that for instance the drug is not working fast enough it's been six months it's been some nine months and they still have the same amount of swelling and tenderness the blood tests are still showing high levels of inflammation it may be time to switch therapies but I need to first step back and say what have you tried before what's worked how long has it worked is it because of side effects that you have sustained or is because the drug didn't actually work for you do you need diet exercise there's really all of those things put together to make sure that we're controlling the disease and moving you towards a state of wellness and health and no two patients are alike is that true I have yet to see two identical RA patients everybody has their own journey they have their own other medical history they have their own functional issues I have to work with everybody as an individual so then doctor what are the treatment options so if fortunately we have several treatment options available to us today and I'll talk about them in classes many people come on an anti-inflammatory so I nonsteroidal antiinflammatory you know like the ibuprofen 's and the the naproxen is of the world they start off with that because your soul and your stiff and many people start there or they may be on pain medicines which really just work on symptoms they don't actually work on the disease when we talk about targeting the disease there classes of drugs that we use and we'll talk about something called DMARDs or do these modifying antirheumatic drugs and those start off mostly as pills and some of those can be injections but those helped first start to target the underlying disease and then we have targeted synthetic DMARDs a newer class of agents which work on specific pathways and we'll think of those like the jack in hibbott errs or the Janus kinase inhibitors they inhibit pathways within the cell that are driving inflammation and then the large class is the biologics biologics are proteins in general and these target either cells or the chemicals in the blood that are driving inflammation so two of the cytokines that we target with our therapies would be TNF for tumor necrosis factor and al six or interleukin 6 both of these are elevated in patients who have rheumatoid arthritis and by restricting and limiting and sort of rebalancing those levels we can also limit that inflammatory response with interleukin 6 we know that it's enriched inside the joint and so by limiting and inhibiting the our six pathway we can help to decrease the amount of inflammation and again with strict joint damage and a lot of the functional issues that patients have so there are lots of choices and it's important to have a discussion with your doctor about which choice is right so doctor what are the concerns that patients may have in regards to their treatments sometimes it's as simple as saying I'm nauseous but taking a drug or my hair is thin or something makes me feel unwell and those are concerns that you should really communicate with your provider when I think about other concerns with some of the drugs we have some of them are given as injections and there may be burning or redness at the site some are also given by intravenous infusion which is putting an IV into a vein you're sitting in an office getting that infusion some of my concerns for patients include some of the side effects that we are worried about with our drugs so we're always concerned about the risk of infection that a particular patient may have or that a drug may predispose them to we're concerned about malignancies we're concerned about the heart some people already have cardiovascular disease and so we have to be careful with all of those things so again it's a conversation about not just being effective as therapies but also being safe for you as a patient thank you doctor so much now let's check in with Carla and Stephanie to see how they're managing their RA I was having difficulty managing my disease I still had a very full professional life and a very full travel life but eventually even working for myself it became impossible for me to work full-time just getting up in the morning getting ready and driving to work I was so exhausted by the time I got to work it was difficult for me to work then if I would have a flare and you never knew from one day to the next how you're gonna feel and I wound up retiring earlier than I thought I ever would but that gave me the opportunity to take a couple of years off and just focus on my health the diet the exercise the things that I could control [Music] one of the key parts of managing my condition is the great relationship I have with my rheumatologist I actually fired my first rheumatologist who diagnosed me because I just couldn't relate to him but now I found a doctor that treats me as a whole patient we collaborated on my healthcare and talk about what the symptoms are and what new things are going on in your life and what is working and also what's not working so you can get the best plan in place for bringing my life back to a level where I could once again enjoy those things that I enjoy that are important to me like working part time traveling a lot and enjoying life with my husband I was at an age where I had my whole life ahead of me I had a Rheumatologist before who literally saw me walking around with crutches because my knees were hurting so bad and he told me to my face you'll probably never work a day job I was lucky that I was at that appointment with my husband who is a great advocate for me because in that moment I felt completely defeated and I didn't know what to say and my husband just said how dare you and we stormed out of there I had an aha moment that being an advocate means advocating for your own health and being a contributing member of the medical team when I see my rheumatologist we talk about my treatment plan and being a patient advocate to me means being vigilant about how I'm feeling if I'm using leggings a lot because zippers are getting hard for me or if I'm brushing my hair less often because my hands are swollen I'm communicating that to my doctor so that we can manage my RA symptoms in the best possible way and make sure my RA is under control and we decide together whether it's time to switch therapies I can tell when a therapy is working when there's less fatigue throughout the day and I have the energy and the ability to do more because I'm in less pain this is my body this is my life and I have to live with it [Music] welcome back to access health we've been learning all about rheumatoid arthritis with dr. grace right doctor before you leave do you have any last takeaways for anybody who's watching today if you have symptoms that are persisting unchanged despite therapy speak up we have other choices for you to help manage your RA more effectively and most importantly never lose hope there are choices there are ways to get us moving back towards health and wellness doctor thank you so much for your time speak up and never give up hope absolutely Stephanie and Carla are perfect examples of patients that are thriving despite their RA it's hard for me to think about blessings that RA has brought into my life but connecting with other patients and helping other patients through my advocacy work is one of the great joys of my life that advocacy work has opened up a whole new world of fulfillment for me that I didn't have before when I was an 80-hour a weak professional I have a marvelous what they call a new normal I'm able to enjoy all of those things that are so important to me and feed that of interest spirit of mind having rheumatoid arthritis it doesn't mean that life stops there is hope there is the ability to continue doing those things that bring you joy and make your life worth getting up for every day having RA my life journey is different than the average 27 year old I move a lot slower and sometimes I get down on myself for not being able to accomplish everything that I aspire to complic but then I remember the story of The Tortoise and the hare and in the end the tortoise always wins and that's how I see myself going through life with RA I will get to it and I will accomplish my goals and my dreams it just may take me a little bit longer I want to thank dr. Wright for her time today educating us on rheumatoid arthritis if your RA is not under control speak to your doctor today about options to more effectively manage it a special thanks to Carla and Stephanie for sharing their stories for more information please visit ready to act are a calm and for more helpful information you can always visit our website at access health TV from new york city i'm ereka vetrini we'll see you next time [Music] [Applause] you

Channel: Access Health

Views: 147,456

Keywords: access health, lifetime television, nutrition, health, medical, fitness, Ereka Vetrini, AH0058 105424 1080P, Rheumatoid arthritis, rheumatologist, joint pain, IL-6, treatment for rheumatoid arthritis, rheumatoid arthritis flare-up, cause of ra, facts about ra, ra, ra autoimmune disease, ra disease, ra education, ra joint disease, ra symptom, types of ra

Id: 4lU_SUDAiGc

Length: 20min 10sec (1210 seconds)

Published: Thu Sep 12 2019