13 Pointers for a New Rheumatoid Arthritis Diagnosis
When you’ve just been diagnosed with rheumatoid arthritis (RA),there’s a lot to process. You may not be sure how to feel about this new label, and you're probably worried about how it's going to impact your life.
But at the same time, the diagnosis may put your mind at ease, as your doctors will finally be able to treat the condition that’s been causing your symptoms. As you begin to find your new normal with rheumatoid arthritis, these suggestions may help you navigate more easily.
Try to Drop Expectations Before Appointments
You may want a rheumatologist who listens, but when you meet initially, be prepared to hear what your doctor has to say.
“Come with an open mind,” says David Batt, M.D., a rheumatologist at Indiana University Health in Indianapolis. “A lot of patients research on their own ahead of time, which is great, but for your appointment, we’re going to focus on your history and your symptoms. The diagnosis or treatment might be different than what you were expecting.”
Bring any medications you take, plus past X-rays or test results, to share your full health history.
Plan on Blood Tests (Lots of ‘em)
Initially, your blood tests may lead to a formal diagnosis of rheumatoid arthritis.
“Each patient is different,” says Lynn Ludmer, M.D., medical director of rheumatology at Mercy Medical Center in Baltimore. “Some patients are very easy to diagnose because they have typical physical findings and bloodwork, while others may be more of a challenge. But every patient should expect bloodwork.”
Going forward, your doctor should perform blood tests periodically to check for inflammation in your body and to see if RA is affecting your organs.
Rely on Imaging Tests
Your rheumatologist can get a better sense of how RA is affecting your joints by getting baselines images at diagnosis then following up with new scans periodically, as needed. “You can expect X-rays of your hands, wrists, and feet,” Dr. Batt says. “If your joints are swollen, we may tap the area to test the fluid.” Some doctors order more sensitive imaging tests, like CT scans, ultrasounds or MRIs, but this is less common. “It is the minority of patients that need MRIs,” Dr. Ludmer says.
Take Your Meds. They Really Can Help.
Rheumatologists typically prescribe medication for RA, and they (and you) have many options to choose from, depending on the severity of your symptoms, your history, and other conditions you may have, says Dr. Ludmer.
The goal always is to slow the disease and prevent further joint damage. To do that, your doc may prescribe anti-inflammatory drugs to ease pain; steroids to control a flare; disease-modifying anti-rheumatic drugs (DMARDs), which can slow RA’s progression, and/or biologics, which target proteins that create inflammation in the first place. Work with your doctor so you know what you’re taking and why.
Be Cautious With Natural Remedies
Some people pursue complementary therapies such as acupuncture or tai chi when they’re diagnosed with a chronic condition.
If you’re seeking a nontraditional avenue, don’t keep it a secret from your rheumatologist, and keep in mind that no treatment will be as effective as what your doctor prescribes.
Be especially wary of herbal remedies. “There are some alternative therapies that could be dangerous and worsen your symptoms,” Dr. Batt says. “It’s important to tell your doctor everything that you’re doing. Personally, I don’t have a problem with alternative therapies as long as they’re done in tandem with traditional treatment, at the same time.”
Allow All the Feelings
It’s normal to feel emotional after a rheumatoid arthritis diagnosis. You just found out you have a lifelong condition, something that 100-percent qualifies as a Big Deal.
But if you find that you’re feeling anxious, depressed, or just having trouble coping with the news, it’s smart to seek out counseling, says Dr. Ludmer. “Mindfulness techniques can also be helpful in dealing with the anxiety aroused by this diagnosis,” he adds. And don’t forget about support groups IRL or online. Simply knowing you’re not alone can help you find your way forward.
Eat More Plants
No diet has been shown to improve rheumatoid arthritis, but a healthy eating plan may have benefits. If you’re overweight and lose weight by eating healthfully, you may relieve joint pressure and alleviate some symptoms. Focusing on plant-based foods and limiting meats may help.
“I have seen studies that show eating food high in animal fat may intensify inflammation, so there is the subtle chance that eating more fish and less beef will help,” Dr. Batt says. “At the very least, it will help with your cardiovascular health, which is important for people with RA.”
Strive for Exercise
Your doctor will recommend physical activity to keep your joints and muscles in optimal form and to maintain your flexibility. You may not feel like moving much when you’re in pain, but seeing a physical therapist, occupational therapist, or personal trainer with experience working with RA patients can teach you safe ways to move.
“When patients are acutely inflamed, they may need to rest their joints, but as the inflammation improves with medications, it is important to get back to regular activity,” Dr. Ludmer says. “Keeping muscles strong can help prevent joint deterioration.”
Talk to Your Boss
Some days, when your symptoms flare, you may have trouble performing at your best or even making it into the office. “Patients may have fatigue, especially early on in the disease, and need to plan their day appropriately,” Dr. Ludmer says.
It may help if you talk with your manager about working from home on certain days or asking for other accommodations to help you perform your job more effectively. Asking early on, before your condition has a negative impact on your job performance, may help you maintain your work quality over time.
Share Your Experience With Your Partner
If you’re coupled up, the dynamic with your partner may change if you begin to view yourself differently because you have a chronic condition. Some people even develop a negative body image, which impacts their sex life. The key to getting through this? Being able to talk openly about your feelings and asking for help when you need it.
Also: Invite your partner to go with you to the rheumatologist, who can help explain what you’re going through. “Bringing spouses to visits can allow them to share in appropriate expectations,” Dr. Ludmer says.
Hold On to Family Plans
While pregnancy and parenthood can be taxing even in the best of circumstances, advances in treatment make it possible for those with well-controlled RA to have children and enjoy raising them while managing their condition.
“We’re in a very different place with RA than we were 20 years ago,” Dr. Batt says. A recent review of 10 studies found that for 60% of women, RA improved during pregnancy, although nearly half had a flare postpartum. (All those hormone shifts may play a role.) Team with your obstetrician and rheumatologist in advance to ensure a healthy outcome for you and baby.
Have a Comeback at the Ready
Once you tell people about your rheumatoid arthritis diagnosis, they may share uninformed opinions. If they aren’t familiar with the symptoms, they may not realize the effect that the disease can have on your life.
“It is always hard to adjust to having a chronic disease, especially when individuals may look well to the outside world,” Dr. Ludmer says. Having something prepared to say to well-meaning friends will make interactions less stressful. Here’s one to steal: “I might not look any different to you, but some days when my RA flares up, I’m in a lot of pain."
Look Forward to Your Future
An RA diagnosis isn’t as life-limiting as it was in the past, and more progress may be on the horizon. “There is ongoing research into the causes and cures for the disease, so it is important to stay positive,” Dr. Ludmer says. “The goal in 2020 is to reduce permanent damage and, of course, improve symptoms and return to normal function.”
Today, rheumatologists work with newly diagnosed patients to put their rheumatoid arthritis into remission, which would have been unheard of 20 or 30 years ago. And that’s definitely something to feel good about.
Treatment Options for RA: National Institute of Arthritis and Musculoskeletal and Skin Diseases. (2019). “Treatment of Rheumatoid Arthritis.” niams.nih.gov/health-topics/rheumatoid-arthritis/advanced#tab-treatment
Complementary Therapies and RA: National Center for Complementary and Integrative Health. (2019). “Rheumatoid Arthritis: In Depth.” nccih.nih.gov/health/RA/getthefacts.htm
Pregnancy and RA: The Journal of Rheumatology. (2019). “Does Rheumatoid Arthritis Really Improve During Pregnancy? A Systematic Review and Metaanalysis, jrheum.org/content/46/3/245?ijkey=a2f460313707d4a774c7d5fc1125fe0cd1f0a68e&keytype2=tf_ipsecsha