And now to conclude this series.
I'm going to try to make this as brief and clear as possible. There's a bunch of different medicines available, and different types of medications - I'll be getting to that in a second. Treatment is a lifelong thing. Again, there's no cure and so the goal is remission; to treat the symptoms and slow down the progression. To put the breaks on it, so to speak. Aside from medication, treatment can include things like physical therapy, proper nutrition and exercise (provided you are able to; some are not). It can involve surgery, the most common type probably being joint replacement. From the sounds of it, joint replacement has come a long way. Obviously, you want to never get to the point where you need it, but at least they're finding better ways to do it. Many of which are much less invasive than they used to be. Joint splints and supports can be very helpful as well. As can ice or heat.
In terms of medication, if you're diagnosed with RA odds are that you'll be put on a combination of kinds of medicines. I can't really explain how it works, but many of these work better when taken with others. A lot of times they might try one kind of medicine to see how it works before pulling out the big guns. And the first line of defense is usually a disease modifying antirheumatic drug or a DMARD. The most common by far being Methotrexate which is a chemotherapy drug that works by killing new cells being formed in the body, in the hopes of reducing disease activity. The doses used for RA will be much less than those used to treat cancer. These are serious medications we're talking about here.
Another kind of medicine you might find yourself put on if you have RA is an NSAID or a non-steroidal anti-inflammatory drug that, as you may have guessed, primarily work to reduce inflammation. They tend to work pretty well, though caution must be used while on them as they can lead to stomach problems, some severe. Many have been linked to heart disease and stroke. Some have been pulled off the market due to that. Which I personally don't agree with. Yes, the side effects of these, and all of the kinds of drugs I'm talking about, can be very serious. But so is RA. Most people are willing to take a gamble on a medicine that could possibly cause major problems if it means slowing down a disease that, left untreated, will eventually lead to major problems. Many patients will be put on a corticosteroid like prednisone which will reduce swelling and inflammation, but should really only be used short term. Antimalarial medications may be used as well.
And then we have the biologics, otherwise known as the big guns. These tend to be started when other medicines have failed; in my opinion, the best doctors will try to get their patients on them early because these are the top of the line when it comes to medication. Odds are that you've seen commercials or ads for one of these, if not several. There's at least eight of them with more being developed and studied. These drugs, as this website defines them, are "genetically engineered proteins derived from human genes". Or derived from mouse genes if we're talking about Remicade. Many of these; like Cimzia, Enbrel and Humira; work by blocking something called the tumor necrosis factor (TNF) which is a chemical that activates inflammation. Others, like Kineret or Actemra, work to stop the action of other chemical messenger related to inflammation.
These are given one of two ways - either by infusion or injection. The infusions take anywhere from one hour to three depending on which one you are on. Some of these are given every six to eight weeks depending on how well you're doing - if you're doing well, you can go longer between doses. Conversely, if you're not doing so well, there could be a shorter time between infusions. Some, like Orencia (infusion) or Simponi (injection), are given monthly. If it's Humira, it's usually given two weeks, but can be given every 10 days or every week in some cases. Enbrel is given once or twice a week. These drugs are crazy expensive though many, if not all, do have assistance programs in place that can help with the cost. These are really the top of the line when it comes to RA treatment, though again, they are serious and heavy duty medications. They pack quite a wallop, let me tell you. Many people are understandably afraid to try them out and a lot of times you might find an RA patient debating what scares them more: the medicines or the disease.
I really hope that I've done a good job in conveying how serious this all is. Living with something like this is not for the fainthearted. I can't tell you how many times I've seen people wondering how they can go through another day with this illness. Sometimes it's not about the next day; sometimes people wonder how they can possibly make it through the current day. Or maybe, you're worse off than that, maybe you don't know how you're going to make it through the hour. Or the minute. For some people it can come down to the second.
It is my belief that rheumatologists should strongly encourage newly diagnosed patients to seek therapy. Ignoring all the physical components which are enough of a problem om their own, living with something chronic like RA is very much an emotional roller coaster. One that can be very hard, if not impossible, to get off of. Most people with RA will struggle with things like depression, anger, guilt, fear, embarrassment, confidence and so. Many will struggle with feeling overwhelmed with it all, especially at the beginning. If not dealt with properly, these can lead to all sorts of other issues. This truly does affect every aspect of a person's life. A lot of people struggle with when they should tell friends or possible love interests about their illness, if they do at all. Some will go through great lengths to try to hide it.
One of the things I see and hear the most from other people with RA is how they feel like no one cares, they feel alone and it's like no one understands what they are going through. And really, you'll never know what it's like unless you have it yourself. Thankfully these days we have things like Facebook and other online support groups, not to mention all the support groups out there in the real world. It makes it so much easier for these people to reach out and it's something I'd recommend looking into if you have something like this. Sometimes the best medicine is talking with other people who have it and knowing that you're not alone. That can be more precious and valuable than the most expensive medication. So, if you are reading this and you happen to have RA yourself and have not looked into support groups I encourage you to do so. If you are struggling with anything in the last paragraph and want someone to talk to about it, you can feel free to talk to me. Whether via a comment on here, on my new Facebook page for this blog (https://www.facebook.com/CountryMusicAccordingToKim, or on twitter (@countrymusicATK). If anything in the above paragraph applies and you, understandably, don't want to talk about it out in the open where other people can see it, you can email me at countrymusicATK@hotmail.com as well.
I mean it. I know what it's like and I know how it feels, especially in the beginning, and I can't even tell you how much seeking out other people who have it helps. Hopefully you have people in your life that you can talk to, but even the most loving and understanding person in the world can't relate if they don't have it too. I said it in the first part of this, but I have met some of the most amazing people since I got diagnosed over ten years ago. Please don't be afraid to reach out. I want to add that I know it's scary and painful, but the right treatment plan can work wonders.
My advice to anyone who has it? Know that life with RA is difficult and a lot of things will change. Once diagnosed, you set off on a completely new chapter of your life. But it doesn't have to be a bad one. If there's one thing I've learned it's that good things can come out of any situation. When you have RA, you learn how strong you are and odds are you're stronger than you think you are. You might think you can't handle it, but you can. It's not always easy, but it's possible. Yes, you might not be able to do everything you used to and that can be hard, but you can adjust. You will adjust. If you have RA, know that the emotional roller coaster you're on is normal. Deal with the emotions as they come and take it one day at a time. Know that you are not alone and that there's people out there willing to support you. It's serious and needs to be treated as such, but it's not all bad.
Now, if you're reading this and you don't have RA, but feel like you want to help somehow? Well, first things first, if that's you, you rock. There's a lot of ways to get involved. For instance, check out, http://www.arthritis.org/programs-events.php. That is the link to the Events & Programs page on the Arthritis Foundation's website. I'll also link you to the Advocacy section of the site if you find yourself really inspired, http://www.arthritis.org/advocacy.php. You can also feel free to link this and any and all my arthritis posts so that others can read it. Though really, if you have actually read all three of these posts, that's definitely something. Out of everything I've written about, all of this stuff is the most important to me personally. I've said it and I'll say it again, I appreciate anyone taking the time to read anything I write, but especially these. And again I thank you so much for that.
This wraps up my posts for Arthritis Awareness Month. I'm going to try to get a couple more album reviews up as this has also ended up being album review month for me. I know it's been a lot, but I've been trying to catch up. Lee Brice and Carrie Underwood reviews are coming and then some more song ones. So stay tuned.
Thanks!
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