Is There Advice for Patients With Long-term Rheumatoid Arthritis?

Question: Is There Advice for Patients With Long-term Rheumatoid Arthritis?

There is a lot of advice for newly diagnosed rheumatoid arthritis patients, mostly regarding early diagnosis and treatment. What advice can you offer to patients who have lived with the disease for 5 or 10 years and will live with it long term?

Answer:

Deal With Active Symptoms

While rheumatoid arthritis patients have the best chance for a good outcome with early treatment, patients who have the disease for 10 years or longer can still benefit from aggressive treatment if they have active symptoms such as joint pain and joint swelling.

Be Mindful of Long-term Risks Associated With Rheumatoid Arthritis

Rheumatoid arthritis is now recognized as a risk factor for heart disease due to chronic inflammation. It is important for rheumatoid arthritis patients to manage their heart risk by monitoring blood pressure, cholesterol, and weight, and making an effort to keep each one at healthy levels. Advice from a physician will help each patient manage their risk individually.

Make Healthy Lifestyle Choices

Aerobic exercise is helpful for fighting fatigue and improving mood. Depression and fatigue are common with rheumatoid arthritis, especially long-term.

Weight-bearing exercise, if physical limitations don't preclude it, may help prevent osteoporosis, a secondary condition that can accompany rheumatoid arthritis. Along with weight-bearing exercise, adequate amounts of vitamin D and calcium are important for healthy bones. Most doctors now recommend:

• 800-1000 IU of vitamin D per day
• 1200-1500 mg of calcium through food or supplement (if there is no history of kidney stones)

Generally, recommendations which will help long-term rheumatoid arthritis patients do their best are recommendations that will help anyone achieve better health:

• Get adequate sleep each night.
• Be as active as possible and avoid a sedentary lifestyle.
• Eat a well-balanced diet.
• Avoid foods that you think might aggravate your condition.

To summarize, it's important to deal with current active symptoms as well as long-term risks associated with the disease. Also, it's essential to make healthy lifestyle choices for overall good health.

_{Answers provided by Scott J. Zashin, MD, clinical assistant professor at University of Texas Southwestern Medical School, Division of Rheumatology, in Dallas. Dr. Zashin is also an attending physician at Presbyterian Hospitals of Dallas and Plano. He is a fellow of the American College of Physicians and the American College of Rheumatology and a member of the American Medical Association. Dr. Zashin is author of Arthritis Without Pain - The Miracle Of TNF Blockers. The book is useful for anyone on one of the biologic drugs (Enbrel, Remicade, Humira) or considering the biologic drugs. Read my review of the book and also visit Dr. Zashin's website.}