La artritis reumatoide es más que una enfermedad de las articulaciones. Es un evento que cambia la vida y puede hacer que tu mundo se convierta en una caída en picada. Si te enfrentas a estas emociones, lo primero que debes recordar es que no hay un curso establecido y que las acciones que tomas ahora pueden marcar una gran diferencia en la forma en que te enfrentas, y superas, los desafíos de vivir con la enfermedad.
Después de recibir la noticia de que tiene artritis reumatoide , su primer instinto puede ser acurrucarse bajo las sábanas. Y eso está bien. Preparar la cabeza en algo como esto puede llevar tiempo, y encontrar un lugar tranquilo para pensar puede ser un comienzo saludable.
Pero entonces, lo primero que debe hacer es encontrar apoyo: funcional, financiero y emocional.
El soporte funcional es aquello que lo ayuda en cada etapa de su tratamiento. El objetivo es formar un equipo de profesionales de la salud con los que pueda interactuar como un socio activo en su propio cuidado. Pueden incluir:
- Su médico de atención primaria (PCP) , que supervisa su salud general y coordina a los médicos especialistas.
- A rheumatologist, who specializes in musculoskeletal diseases and autoimmune disorders like rheumatoid arthritis
- A physical therapist, who will help you regain your strength, mobility, and range of motion
- An occupational therapist, who can provide you the tools, strategies, and “workarounds” to overcome physical barriers in daily life
- A psychologist or psychiatrist, who can help you better deal with the stress, anxiety, and depression that can come with living with the disease
- A social worker, who can help you navigate the healthcare system
For live support, information, or referrals, call the Arthritis Foundation’s 24-hour hotline at 1-844-571-HELP (4357).
Rheumatoid arthritis can be expensive, especially if you’ve been getting treatment for a while and need newer generation biologic drugs or JAK inhibitors. Even if you have health insurance, deductible and copay costs can often be exorbitant.
To defray some of the major expenses of treatment, there are financial assistance programs available to both uninsured people and those with insurance who have a difficult time covering drug costs. To access these programs, consider turning to these two organizations:
- Partnership for Prescription Assistanceis a non-profit organization that can help you obtain free or nearly free rheumatoid arthritis medications if you are uninsured, underinsured, or financially eligible. Eligibility is typically based on an annual income of less than five times the Federal Poverty Level (FPL) for an individual, couple, or family.
- Patient Advocate Foundation Co-Pay Relief is another charitable organization that can help you obtain co-pay assistance. Assistance is offered by all major pharmaceuticals. Eligibility is far less stringent and only excludes those whose medications are covered by Medicare, Medicaid, and other low-income subsidies. Eligibility is typically not based on income.
The emotional impact of rheumatoid arthritis can be every bit as profound as the physical aspects. Especially when starting treatment, there can be ups and downs that may be difficult to deal with.
Remember that telling a loved one what you are going through is not “complaining.” It helps them understand what you are dealing with and open their eyes to your needs and concerns. It is only by sharing that you give others the information they need to help you.
It also helps to reach out to others affected by rheumatoid arthritis. Support groups are great places to find solace, seek advice, and interact with others who know exactly what you are going through.
If you can’t find a group near you, contact the Arthritis Foundation to get connected to a support network in your region. They can provide you the training to start a member network of your own too if that interests you.
Other support options include:
- Linking to a rheumatoid arthritis support group on Facebook
- Starting a live support group of your own on Meetup
- Searching support group listings on the non-profit CreakyJoints website(or listing your own support group)
If feelings of depression or anxiety persist despite support, ask your doctor for a referral to a psychologist or psychiatric experienced in chronic diseases.
Two of the key modifiable risk factors for rheumatoid arthritis are obesity and smoking. To mitigate these risks, you need to incorporate weight loss, exercise, and smoking cessation into your treatment plan.
While there is no rheumatoid arthritis “diet,” per se, there are a number of principles that can guide you in your effort to lose weight and control your rheumatoid arthritis symptoms:
- Start with a well-balanced diet in which two-thirds of your intake comes from fruits, vegetables, and whole grains, while the other third comes low-fat dairy products and lean sources of protein.
- Try to include plenty of coldwater fish in your diet (such as tuna, salmon, mackerel, trout, and herring), which is rich in anti-inflammatory omega-3 fatty acids. If you’d rather take a fish oil supplement, avoid overuse as it can interfere with certain drugs, including high blood pressure medications.
- Extra virgin olive oil contains a substance called oleocanthal, which blocks the same inflammatory enzyme as nonsteroidal painkillers.
- A high-fiber diet may reduce levels of C-reactive protein (CRP) in your blood. This is one of two primary compounds used to measure inflammation in rheumatoid arthritis blood tests.
When first starting out, consider meeting with a qualified nutritionist who can help you establish realistic weight reduction goals.
Rapid weight loss can cause metabolic stress that may increase the risk of a rheumatoid arthritis flare. Slow and steady is always the best approach.
You may be able to achieve weight loss with diet alone, but you will be unlikely to sustain it without routine exercise. Whatever the stage of your disease, exercise is extremely beneficial, enhancing joint flexibility and range of motion while lowering the risk of relapse. As with diet, a moderate approach will do you far more good than pushing hard and promoting inflammation.
According to the American College of Rheumatology, there are several goals you should set for yourself when embarking on a fitness plan:
- Moderate-intensity aerobic activity should be performed every week for a total of 150 minutes spread out over several days. Swimming and walking are examples of low-impact, cardio activities that won’t overexert your joints.
- Stretching exercises should be done at least three to five days a week; hold each stretch for 15 to 30 seconds.
- Strength building should be performed two to three times a week and involve eight to 10 exercises with eight to 10 repetitions per exercise. Older people may want to do 10 to 15 repetitions with lower weights.
- Range-of-motion stretches can either be performed five to 10 times in the morning, to get the joints moving or the evening. You may want to include gentle rotator cuff, elbow, and knee stretches as part of your routine.
Your physical therapist can provide you with a complete workout plan appropriate for your age and condition.
Quitting cigarettes is never easy but is something you must do if you are suffering rheumatoid arthritis symptoms. As a rule, a combination of counseling and smoking aids will provide you a far better chance of success than going cold turkey. In addition to over-the-counter nicotine patches, gum, and lozenges, the U.S. Food and Drug Administration has approved four prescription drugs able to aid you in your quest:
- Nicotine inhalers
- Nicotine nasal sprays
- Zyban (bupropion)
- Chantix (varenicline)
Smoking cessation treatment is covered by Medicaid, Medicare, and most private insurance plans.
If you are in need of support, call the American Cancer Society at 1-800-227-2345 to be connected to a telephone quitline is your state. They can also link you to a support group in your area.
Don’t let rheumatoid arthritis stand in your way of living a productive life. Sometimes all it takes is a few adjustments to overcome the physical and emotional challenges you may be facing.
Here are a few tips that can help:
- Reorganize your shelves. If you have trouble reaching high or bending low, place the things you use most on the lower shelf of a cabinet or in the top drawer. Don’t confine yourself to “rules.” There is no reason why you can move the items from under the sink to a reachable shelf if it saves your body stress.
- Change positions often. When writing, release your grip every 10 minutes or so to keep your hand from stiffening up. When watching television or working at your laptop, get up at regular intervals to stretch your legs.
- Find tools you can use. There are plenty of utensils and tools that are made for people with arthritis. There are ratcheted kitchen scissors that do all the work for you and anti-vibration gloves that allow you to grip handles without pain, for example. Explore technology with voice-controlled devices that allow you to go hands-free.
- Conserve energy. Balance periods of rest and activity whether you are at work or play. Schedule your day in advance so that you can run around or go to meetings when you have the most energy and find quiet time in between to recharge.
- Use heat to treat joint stiffness. Instead of reaching for pills, explore other ways to get yourself moving in the morning. Heat increases blood circulation and relaxes tissues. An electric or microwaveable heating pad can usually help overcome any morning stiffness you may be experiencing.
- Use cold to treat an acute attack. Cold alleviates swelling while numbing the pain. If using an ice pack, do not place the ice directly on your skin or leave it in one place for more than 15 minutes. Doing so can lead to frostbite.
- Explore mind-body therapies. Mind-body therapies recognize that our thoughts and moods influence both our reaction to pain and our overall state of well-being. Some of the techniques commonly used to support rheumatoid arthritis therapy include meditation, guided imagery, biofeedback, progressive muscle relaxation (PMR), and deep breathing exercises (pranayama).
I am Dr. Christopher Loynes and I specialize in Bone Marrow Transplantation, Hematologic Neoplasms, and Leukemia. I graduated from the American University of Beirut, Beirut. I work at New York Bone Marrow Transplantation
Hospital and Hematologic Neoplasms. I am also the Faculty of Medicine at the American University of New York.