I realise that I write about my health a lot, but my disease has such a misleading name, and has caused confusion for patients with RA and with OA that I think I need to try and clarify just why I am on drugs used in Chemotherapy and to treat disease people think of as totally unrelated. Other inflammatory diseases that cause joint inflammation as a symptom are also covered by Rheumatologists so it can be very confusing, and very worrying to patients who do not have these diseases t be treated by the same specialist!
I have Rheumatoid Disease. My disease is a systemic one, all starting with my immune system being derailed and turned against a tissue that is very common in the body: synovium. This not just in the joint spaces but around tendons.But it also can be active in other tissues.
Most of these are a direct result of the one disease process, so they all respond to a greater or lesser degree with the Disease Modifying drugs used to control inflammatory diseases.
(I have tried to summarise a bit so I do recommend reading this page in full)
Skin
Nodules- (I have these- seem to be devolping more) The same pathology as in the joints, about 50% of patients develop them Can be controlled by some DMARDs
Vasculitis- (I may have a spot of this, would need to get it confirmed) one of those diseases I mentioned above! Inflammation of blood vessels
Ulcers– (mine were caused my Methotrexate) again with the immune system directing this disease process you have cells being killed and bacteria can take advantage of wounds
Bones
Thinning- (yes, I get infusions every 18 months for this, also Vit D, and I keep up calcium in my diet) Not just at active sites but throughout the body. Goodbye stable teeth, hello gumloss. Steroids speed this up, but can control the disease systemically as well. Exercise can slow and speed this process up! It’s a difficult balance.
Eyes
Scleritis- (probably not)-weirdly scleral lenses can potentially help treat this.
Dryness- (yes, I use very viscous eyedrops) RA can lead to other autoimune disorders, Sjogren’s is one.
Mouth
Dryness- (very much so, I stay very hydrated and drink a lot of milk and sour drinks to stimulate saliva)- again could be Sjogren’s. I also have terrible oesophageal dryness and I can have terrifying moments of my food getting stuck and the spasms that follow. Mouth hygiene is super important- finding a balance between brushing enough and toomuch can be difficul
Lungs
Inflammation and scarring.(maybe?) Up to 80% of patients.
Rheumatoid Nodules. (would never know) Same as those in the skin.
Heart and Blood Vessels
Atherosclerosis- (no, but this is part of my health that is helped by diet and exercise, but again by my medication) the disease can cause inflammation of endothelial cells, this can cause more absoption of cholesterol!
Heart attack and stroke- (ditto, again, lower the risks through what I can control) One study shows 60% increase in risk after one year of disease.
Pericarditis- (I don’t think so.) Again, the disease can cause inflammation outside the joints and this includes the pericardium!
Blood
Anemia- (my biggest ongoing issue, getting enough iron but not too much) Inflammation uses iron and in RA this process also causes another system check, which is to store iron in the joints so that it can’t be used. It is the body trying to damp down the inflammation.
Blood clots- Inflammation can cause an increase in platelets.
Felty syndrome. Very rare, but real risk of developing lymphoma-
Nervous System
Pinched or compressed nerves– (yes! I am dropping and throwing things every day now) With joint swelling and deformations this can happen. It’s not a direct result of the disease on nerves through!
It’s not that these can happen, it’s how frequently they occur and how to treat them.
This is why I am vigilant about any health weirdness and why I get very frustrated when my disease is dismissed as a personality type (still happens, and may be why I have trust issues with switching medical specialists) and as not really that serious!