INFO - RA Myths and Misconceptions

[Guest guest]

HealthTalk.com

" RA Myths and Misconceptions "

January 21, 2004

Dr. Markenson:

What are some of the misperceptions about rheumatoid arthritis, which is an

inflammatory type of disease? There's definite inflammation. Systemically it

involves other organs. We think that [if] we control the symptoms, [if] we

control fatigue and pain, you're going to do well. We know now you have to

look at X-rays and control actual damage. Early treatment should be

conservative. [if] you only use the anti-inflammatory - " Take a little

Advil, it's arthritis, it will go away. " Wrong! You lose time. You don't

prevent damage. We know now that it's better to be [treated] like you would

be treated if you had a lymphoma or a cancer. You blast the medication; you

blast the disease progress immediately and as it gets into remission you can

peel back those drugs that you use.

Elevated rheumatoid factor makes the disease? No, it's only a marker of that

and other diseases. RA is a disease of post-menopausal women, elderly

people? Wrong! It affects everybody, more in the ages of 20 to 45. It's

inevitably progressive regardless of what therapy? Wrong! We've got better

therapies now. There are certain percentages of patients that are going to

do poorly no matter what you do, but nevertheless, the majority of patients,

I won't tell you we're going to cure you but will be under control. You

won't be disabled and you'll be able to work and carry out your activities

of daily living. RA does not affect the mortality rate. Very wrong!

Rheumatoid arthritis you're marked for having more heart disease, more lung

disease and more co-morbid events; other things can happen to you. And that

the adverse affects of the medications limit their usefulness and they

worsen the disease? Absolutely wrong! I can tell you that for disability,

the average happens that within five years of this disease most people will

be earning 50 percent of what they were able to earn when they started with

the disease. In five years!

Think of how much money any of you may be able to do in your jobs and bring

home. And consider if you were getting a 10 percent cut, what problems you

would have. These people have to undertake close to 50 percent. It's a

disabling illness. And so the obstacles we have to early diagnosis are that

patients delay seeking medical attention because they don't feel that

anything can be done. I should add some physicians don't understand the

disease and inappropriate early treatment does occur. How can we slow the

disease? [With] early diagnosis. I'm not going to go over that and over

that. But 70 percent of patients, their X-rays become damaged after the

first two years of the disease. Early treatment [is important]. And what we

can do is reduce joint erosion with our new medications. We can cause less

disability and improve the quality of life. When [should you] ask your

physician to get a rheumatological consultation or to partner with a

rheumatologist? Well, you wake up in the morning and you are stiff for

greater than an hour and it's lasting for more than a week or two. You have

joint pain that's now lasted for greater than two to three months. You have

symmetrical swollen joints. You have greater than three of these swollen

joints. And you have maybe morning stiffness and fatigue. Speak up. Ask your

family doctor. You want a consultation. Why is it important for your

physician to call up doctors who are rheumatologists and partner with them?

It's nice to confirm the diagnosis because that leads to the appropriate

therapy. You can initiate early therapy and begin to slow the disease

progression.

http://www.healthtalk.com/rheumatoidarthritis/programs/012104/page04.cfm

I'll tell you where to go!

Mayo Clinic in Rochester

http://www.mayoclinic.org/rochester

s Hopkins Medicine

http://www.hopkinsmedicine.org