Understanding How Rheumatoid Arthritis Impacts Beyond Just Your Joints
Arthritis isn't just about swollen knees or aching fingers; it's more far-reaching than that. Rheumatoid arthritis (RA), for instance, is a systemic condition which means it can impact not only your joints but also other areas such as your skin, eyes, and lungs.
Additionally, while the medications used for RA are beneficial, they can have side effects. Some of these, like bone thinning or shifts in kidney function, might not be immediately noticeable. That's why regular check-ups and lab tests are crucial. On the other hand, if you notice symptoms like skin rashes or a persistent dry mouth, it's essential to keep your doctor in the loop. They can pinpoint the cause and tweak your treatment as needed.
Being proactive and knowledgeable about potential RA-related issues allows for timely treatment, helping you maintain your best health
Skin
Nodules: Many individuals with RA, around half, may notice rheumatoid nodules. These are soft tissue lumps typically forming under the skin, often appearing on areas like fingers or elbows that face regular pressure. Most of the time, if these nodules aren't causing discomfort or interference (like where you grip a pen), they might not need treatment. Some nodules can even fade away naturally or with certain treatments like DMARDs.
Rashes: In RA, if blood vessels undergo inflammation (known as vasculitis), it can lead to a skin manifestation of small red dots. In more pronounced cases, this can also result in skin ulcers, especially on legs or beneath nails. To manage these symptoms, it's essential to address the root inflammation.
Drug effects: It's worth noting that certain medications have side effects. For example, corticosteroids, which are given for inflammation, may lead to thinner skin prone to bruising. NSAIDs, used for pain and inflammation relief, alongside methotrexate (a common DMARD), can increase sensitivity to sunlight. Additionally, those on biologics, a specific type of DMARD, might notice a rash where the medicine is injected.
Bones
Bone Health in RA: Persistent inflammation from RA can result in decreased bone density, affecting not just the areas around the joints but the entire body. This can make bones more fragile. To support bone health, it's beneficial to engage in regular exercise, consume a calcium-rich diet, and ensure adequate vitamin D intake. Sometimes, your doctor might suggest specific medications to promote bone growth or protect against bone loss. It's also worth noting that corticosteroids, which might be prescribed, can contribute to bone thinning.
Eyes
Eye Complications and RA: Understanding the Connection:
1. Inflammation and Potential Scarring: For some RA patients, the whites of their eyes (known as scleritis) might become inflamed, potentially leading to scarring. Common signs of this are pain, redness, blurriness, and sensitivity to light. Although usually managed effectively with prescribed medications, in uncommon instances, there could be permanent eye damage. Additionally, RA might trigger uveitis, an inflammation in the eye's middle layer. Left untreated, uveitis could pose a risk of blindness.
2. Dry Eyes: Sometimes, RA's inflammatory actions might affect the glands responsible for tear production, leading to a condition named Sjögren’s syndrome. This can cause eyes to feel dry and irritated. Over-the-counter artificial tears or doctor-prescribed treatments can offer relief and help prevent further complications.
3. Medication-related Eye Concerns: Certain medications like corticosteroids can, in some instances, contribute to glaucoma and cataracts. Additionally, hydroxychloroquine might, though rarely, result in retina pigment changes, which can impact vision. Hence, as a best practice, those with RA should consider annual eye exams to ensure optimal eye health.
Mouth
Dryness Concerns: Inflammation might affect the glands responsible for producing moisture in the mouth and eyes, causing them to feel dry. Fortunately, many find relief using over-the-counter artificial saliva solutions or self-care remedies. If those don't work, your doctor can recommend a medication to boost saliva production. It's essential to maintain good dental hygiene since a dry mouth can encourage bacterial growth, which can lead to tooth issues and gum problems.
Medication Side Effects: Sometimes, Methotrexate may lead to mouth sores or oral ulcers. If you experience this, consider using a topical pain relief gel or consult your doctor or dentist about a suitable prescription mouthwash.
Lungs
Understanding RA and its Effect on the Lungs:
Did you know that a significant number of people with RA - about 80% - experience some lung involvement? Often, it's mild and doesn't manifest in noticeable symptoms. However, continuous intense inflammation in the lungs might result in pulmonary fibrosis, a lung condition that can affect breathing and sometimes poses treatment challenges.
A Few Things to Note:
Nodules: It's not uncommon for rheumatoid nodules to appear in the lungs, but they're typically harmless.
Medication Concerns: Some medications, like Methotrexate, can lead to lung complications. Commonly known as methotrexate lung or methotrexate pneumonia, this issue generally resolves once the medication is paused. A couple of other less common medications, including injectable gold and penicillamine, might cause similar lung issues. In most cases, after a brief break, patients can restart their medication.
Infection Risks: Since treatments like corticosteroids, DMARDs, and biologics can suppress your immune system, they may raise your susceptibility to tuberculosis (TB) – a lung-specific bacterial infection. It's a good practice for your doctor to test for TB before starting these treatments and to check periodically as you continue.
Remember, open communication with your healthcare provider ensures you're well-informed and can make the best choices for your well-being
Heart and Blood Vessels
Understanding the Heart's Connection to RA:
Atherosclerosis: Persistent inflammation can harm the cells lining our blood vessels. This makes these vessels more prone to accumulating cholesterol, leading to plaque formation.
Heart Attack and Stroke Risk: When these plaques get dislodged, they can obstruct a vessel, potentially causing a heart attack or stroke. Notably, a 2010 study from Sweden discovered that individuals diagnosed with RA had a 60% increased risk of experiencing a heart attack within a year of their diagnosis.
Pericarditis: This is an inflammation of the heart's lining called the pericardium. It can lead to chest discomfort, but the good news is that treatments that manage arthritis often alleviate pericarditis too.
Medication Considerations: While many RA treatments like methotrexate, DMARDs, and biologics may help in decreasing cardiovascular risks, some medicines, particularly NSAIDs, might raise the chances of heart-related events. It's crucial for your doctor to assess these risks when deciding on the best treatment strategy for your RA.
Liver
Medication Considerations: While RA itself doesn't impact the liver, some treatments for it might. For instance, prolonged use of pain relievers like acetaminophen (Tylenol) can be challenging for the liver. Additionally, extended use of methotrexate can present liver concerns. It's essential to collaborate with your rheumatologist and regularly check your blood levels to ensure your liver's health and well-being.
Kidneys
Medication and Kidney Health: Just as some medications can impact the liver, certain arthritis treatments might affect the kidneys. Commonly, cyclosporine, methotrexate, and NSAIDs are among these. If you're on these medications for an extended period, your doctor will keep a close eye on your kidney health to ensure everything's in order.
Blood
Understanding RA-related conditions in a friendly manner:
Anemia: Persistent inflammation can sometimes decrease the number of red blood cells, leading to symptoms like fatigue and headaches. A combination of inflammation-control medications and iron supplements typically helps address this.
Blood Clots: Elevated platelet levels due to inflammation can result in blood clots.
Felty Syndrome: It's rare, but individuals with long-term RA might experience Felty syndrome. This involves an enlarged spleen and a drop in white blood cells, increasing the risk of infections and a type of cancer called lymphoma. Commonly, immunosuppressant medications are prescribed for treatment.
Medication Side Effects: Using corticosteroids to robustly treat inflammation can sometimes lead to thrombocytopenia, which is a reduced count of blood platelets.
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