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Living with chronic disease is all about supportive relationships

Posted Apr 09 2011 12:00am

Is RA worse than OA?

I recently received an email from a husband who was concerned about his wife who was diagnosed with rheumatoid arthritis (RA).  He wondered if it was both to have both RA and osteoarthritis and which one of the two was worst.

Here is my response:

I also have RA and I was diagnosed about three years ago. First, Rheumatoid Arthritis (RA) is worse than osteoarthritis (OA) and it is not usual for someone to have both conditions. Both RA and OA are serious but they have both have the possibility of being manageable. RA can also be very serious.  This is because RA is a long term disease that leads to inflammation of the joints and surrounding tissues.  It can also affect the organs.

The cause of RA is not known but infection, genes, and hormones are believed to be contributors to the disease.  It is an autoimmune disease where the body’s immune system attacks itself.  A normal immune system fights off infections and viruses but with autoimmune diseases, the body attacks healthy cells because it mistakes them for unhealthy ones.   RA can happen at any age and women are more often affected than men.

Doctors believe that RA affects joints on both sides equally but that there are cases where one side is affected and the other not, or one side of the body is worse. However, at some point, it does eventually affect both sides.  The wrists, fingers, knees, feet, and ankles are most commonly but other joints can be affected. The course and the severity differs of the disease differs from person to person.

The disease often begins slowly with symptoms similar to those in other illnesses.  These include fatigue, loss of appetite, low grade fever, swollen glands, and weakness.    Eventually, joint pain appears.  This includes morning stiffness that lasts more than one hour. Joints can be warm, tender and stiff when not used for as little as an hour.  Joints are often swollen and feel warm and boggy/spongy to touch.  Over time, joints can lose range of motion and become deformed.

Other symptoms include chest pain when taking a breath (pleurisy), eye burning, itching, dryness, and discharge, nodules under skin (these indicate that the disease is severe), and numbness, tingling, or burning in hands and feet.  Joint destruction may happen within 1 to 2 years after the disease appears.

RA usually requires lifelong treatment including medications, physical therapy, exercises, education and possibly surgery.  Early and aggressive treatment for RA can delay joint destruction.  Medications include diseasing modifying drugs, anti-inflammatory medications, anti-malarial drugs, corticosteroids, and biologic agents.

Again, the course of RA differs from person to person.  For some patients, the disease becomes less aggressive over time and symptoms improve.  Other people develop a more severe form the disease.  People with a rheumatoid factor, an anti-CCP antibody, or subcutaneous nodules seem to develop a more severe form of the disease.  Persons who develop the disease at younger ages seem to get worse more quickly.  Treatment has improved in the last 10 years.  Many people continue to work fulltime.  I am not saying that life with RA is not a painful – it is a very painful disease and it can make life difficult.  After several years, ten percent of persons with RA are severely disabled and unable to do simple daily tasks such as washing, dressing, and eating.

RA can cause severe complications for some people.  It is not only a disease of joint destruction.  It can also involve all organs. More severe problems include anemia due to failure of the bone marrow to produce enough new blood cells, damage to lungs, injury to the spinal cord when the cervical spine becomes unstable from the RA, Rheumatoid vasculitis (inflammation of the blood vessels), which can lead to skin ulcers and infections, bleeding stomach ulcers, and nerve problems that cause pain, numbness, and swelling and inflammation of the outer lining of the heart (percarditis) and the heart muscle (mycarditis).   Both percarditis and mycarditis lead to congestive heart failure.   Sjogen’s syndrome and fibromyalgia are secondary conditions that come after an RA diagnosis and further aggravate RA symptoms.   Moreover, RA treatments are strong and cause some major side effects.

It is very possible for RA patients to have normal lives – not easy, but very possible.  It depends on the degree to which RA affects a person’s daily activities and how well that person can hope.  Coping strategies are important but it takes time to find ways that work for each person.  There is no one solution for all approach with RA.  Patients must take control of their health, work their doctors, and work on a trial and error approach to find what best works for them.  It is also important to know limits: i.e., resting when you are tired because RA can make a person prone to fatigue and muscle weakness.  It is also important to connect with others and to make time for oneself.

Why I Advocate

One of things I often wonder about is whether spouses and significant others actually understand the physical and emotional tolls that that RA and other chronic pain bring to the sufferer and their relationships.   As sufferers, we all know that chronic disease can destroy a marriage, a relationship or a friendship.   We all have come across people that just don’t understand.  It is one of the reasons I keep going even one I can’t because I don’t really have time to deal with people who just don’t get it.  In fact, I am not alone here.  We are all faced with the pressure of appearing healthy when we are not.

I don’t want RA or fibromyalgia to limit me but they are both pretty serious and painful diseases.  They affect every aspect my life.  I have lost my share of friendships and other relationships as a result of my health.  As a result, I have learned to take a proactive view on life with these conditions.  I am not alone and one thing I know that is that there are people in my life who actually are willing to make the effort to understand.  Moreover, I have learned to forget about the ones that don’t.

While for me, it was not that easy, I wish for others that relationships don’t end because of disease.  I wish that spouses, significant others, family members and friends would make the effort to understand.  That is why I advocate – not just for me but for all of you who need support and understanding. No one has to go at this alone.  In addition, I advocate because I want to set an example for my children that relationships are not just about convenience but about truly being there for the people we love.

My goals didn’t seem so clear in the beginning but they become so much clearer as my watched my brother struggle with a terminal illness.  I saw what it did to him on both an emotional and a physical level and all I could do was stand by and hold his hand.  While I know that it may have not been enough, it was enough for him so that he didn’t feel alone.  Loneliness when you are chronically or terminally ill is a powerful thing.  So, for those of you are fortunate enough to be healthy, know that support is the greatest gift you can offer. It means the difference between happiness and sadness. It is what love is really and truly about.

I never knew how important love was until my siblings and I held on to one another through my brother’s illness and his passing.   Love means you won’t have regrets.  My relationship with my brother wasn’t as strong or as close as it should have been but he became sick, it was like we knew what we had to do so that we wouldn’t have regrets.  While I wished that he and I had a better relationship before he became sick, we made up for it the last two months of his life.  I am very grateful to have had that chance and I know that so many don’t.  Supporting those you love, especially when they are ill, is the best gift you can offer to them and that you can offer to yourself.

***If you a question related to RA, Fibro or chronic illness you would like me to answer, please feel free to send me an email to livingit-lovingit@live.com and I would be happy to answer your question.  Be sure to put “Blog Question” in the subject line so that it does not end up in my junk folder.

 

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