11 Frequently Asked Questions about RAby Lene Andersen, MSW Patient Advocate
Here are some of the questions commonly asked by our HealthCentral community members about living with RA and the answers provided by our patient expert Lene Andersen.
What are the symptoms of RA?
Q: Becky asks: for the past couple of months, I've been stiff and sore and soooo tired. My wrists and ankles are swollen. Could I have RA?
A: Common signs of RA are morning stiffness, swelling and pain in joints, especially symmetrical (i.e., on both hands, both ankles, both knees). You may have RA, but only a rheumatologist will be able to say for sure. Talk to your primary care physician about getting a referral.
Can you have RA if your blood tests are negative?
Q: Sarah asks: I think I have RA, but my family doctor says my blood tests are negative
A: Up to 20-30 percent of people who have RA are seronegative. That means their Rheumatoid Factor — a common blood test for RA — is negative. Other blood tests, such as the anti-CCP, are more reliable. However, most good rheumatologists will make a diagnosis based on your medical history and physical exam, using blood tests only to confirm a diagnosis.
Do you have to take medication?
Q: Don asks: I'm worried about taking medication for my RA. If I want to stay healthy, shouldn't I avoid chemicals?
A: For most people, medication is necessary to suppress RA. Without medication, your disease will progress, causing damage to your joints that can affect your mobility in the future. Medication can also protect you from the systemic effects of RA, such as an increased risk of heart attack and stroke.
Do the meds have a lot of side effects?
Q: Pamela asks: I read the side effects to my medication and I'm scared. What do I do?
A: Pharmaceutical companies have to list every single possible side effect and it can be scary to read. Common side effects of most RA meds are fatigue and gastrointestinal symptoms for a few days following the medication. Most people find a way to manage the side effects and go on with their life (also see Managing Stomach Side Effects and RA Meds and Alcohol).
The financial aspect of RA
Q: Francis asks: How will I be able to afford all these doctors appointments and medications?
A: There are options for you to get medical care if you don't have insurance. As well, there are a number of programs that offer financial assistance for medication and tips you can use to lower your prescription costs. Your doctor or pharmacist may also be able to help you get the medical care and medication you need.
Will the RA ever go away?
Q: Teresa asks: Well I really have RA for the rest of my life?
A: RA is a chronic illness and at this time, there is no cure. However, there are now many more treatments for this disease then ever before. That means that more people can go into remission and lead a pretty normal life. Not everyone goes into remission, but may achieve low disease activity.
Dealing with pain
Q: Ann asks: I have a lot of pain and it’s difficult for me to work. What can I do?
A: Talk to your doctor about how much your pain is affecting your life. If you're having trouble getting good pain control, ask for a referral to a pain management specialist who treats pain with a multidisciplinary approach.
RA vs. OA
Q: Sam asks: How is RA different from osteoarthritis?
A: RA is very different from osteoarthritis. Osteoarthritis is also called "wear and tear arthritis." It happens as people age or after injuries. RA is a chronic autoimmune disease that usually develops between the ages of 30 and 50 but can develop at any age. This means that the immune system isn't working right and attacks itself. It is often treated with immunosuppressant drugs.
Staying active with RA
Q: Nancy asks: I used to love going to the gym, but stopped after my diagnosis. Can I still exercise with RA?
A: Staying active is an important way of staying healthy and keeping your joints mobile. Ask your rheumatologist for a referral to a physical therapist who can develop an exercise program that can help you stay fit, while protecting your joints from extra stress.
What can you do about RA fatigue?
Q: Tom asks: I'm exhausted all the time. Do I really have to live like this?
A: RA itself comes with chronic fatigue. On top of that, pain and the medications can also make you tired. Managing your energy and working within your limits can help you live more normally. A number of things can help you build and maintain your energy, including controlling your RA, getting enough sleep, using vitamins D and B12 and finding emotional support.
Depression and RA
Q: Maria asks: I feel sad, hopeless and alone. Do other people with RA feel like this?
A: Being diagnosed with RA is hard and it's normal to feel depressed. You have to grieve the loss of your health before you can move on and it may be a good idea to find a counselor to help. Cognitive behavioral therapy can be especially helpful. Reach out to your family, friends for support.