A diagnosis of RA comes with a new vocabulary. Getting a diagnosis of a chronic illness is a confusing time — while you’re trying to adjust emotionally, there’s also a steep learning curve to figure out what life with RA involves. Knowing what your doctor is talking about is the first step to getting control of the situation. In this post, I’ll try help you get a handle on some of the basic terms related to RA.
Our immune system protects us by attacking bacteria and foreign objects. In autoimmune diseases, such as RA, lupus and MS, the immune system malfunctions and attacks healthy tissue. In RA, the attack is focused on the synovium tissue in joints, as well as other systems in the body, such as tendons, blood vessels and internal organs.
In healthy immune systems, inflammation can help heal the wound or injury. In RA, the immune system malfunctions, causing inflammation in previously healthy tissue. With RA, this inflammation is most visible in joints that become swollen, warm and painful. The inflammation of active disease erodes the cartilage in joints, causing damage that can result in deformity.
Treating RA is beyond the scope of a primary care physician — it needs an expert. If your family doctor suspects you may have RA, you will get a referral to a rheumatologist. This is a specialist who focuses on the diagnosis and treatment of arthritis and other types of rheumatic diseases that involve joints, muscles, bones and sometimes internal organs.
A number of blood tests are used in diagnosing and managing RA. ESR (or sed rate) and CPR measure levels of inflammation – the higher the numbers, the higher the inflammation. CBC counts white and red blood cells and platelets in your blood, giving clues to what kind of condition you may have. Rheumatoid Factor tests for an antibody often found in people with RA. The anti-CCP test is a newer, more sensitive test that can indicate the presence of RA: when it’s positive, 90% have the disease.
When the blood test Rheumatoid Factor (RF) is positive, it’s often an indication that you have RA. However, in up to 30% of people with RA, RF is negative. This is called having seronegative RA. Many family doctors do not know that it’s possible to have RA, even with a negative RF. This can lead to delay in referral to a rheumatologist and therefore delay in diagnosis and treatment. If you feel you have symptoms that may indicate you have RA, but your family doctor tells you your RA ex is negative, push for a referral to a rheumatologist.
Medications to Manage Pain
NSAIDs (nonsteroidal anti-inflammatory drugs) treat the symptoms of inflammation and pain, but not the disease itself. They include Celebrex, Mobic and naproxen and can be hard on the stomach. Opioids are narcotic painkillers, such as oxycodone, fentanyl and codeine that can be used to treat severe chronic pain. When opiods are prescribed and taken correctly, the risk of addiction is fairly low.