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16 May 2012

Autoimmune vs Degenerative


Just a few more days and WAAD will begin! Knowing the difference between autoimmune and degenerative arthritis is so important to understand why both are painful, but one can lead to severe consequences up to and including death. I don't say that as a scare tactic. I say it in an effort to  get people to see how serious the autoimmune types of arthritis can be. Arthritis, no matter the type sucks. But there are types that are treated with drugs that also treat cancer (albeit in lower doses), which should tell you how serious they are. Autoimmune arthritis can range from mild to severe. It can cripple a person from an early stage. It can affect your eyes, your voice, your lungs, your heart, your circulatory system, your digestive system and I am likely leaving something off as I am exhausted right now. Oh it can cause fevers, rashes, extreme fatigue, and body-wide pain.  But what, oh you say the word arthritis means inflammation of the joints? Well yeah it does that too, in addition to all the other things I've mentioned. In some of us, while we have pain and inflammation and stiffness in our joints, it can be less of a problem for us than the other ways that autoimmune arthritis affects us. Just because you hear the term arthritis, it doesn't mean it's something easily treated. Off the top of my head, I cannot remember the statistic, but a certain percentage of people with rheumatoid arthritis are considered disabled within 10 years of diagnosis. That is a scary thought. It tells me that treatments are not always as effective as television commercials make them out to be. I don't have Psoriatic Arthritis (another form of an autoimmune arthritis) but I find the Phil Mickelson commercials for Enbrel absolutely LAUGHABLE. Sure for some people biologic response modifiers (BRMs) like Enbrel, Humira and the others work in an almost miraculous way from the first dose. But those people are few and far between. I think commercials like that one give people false expectations. But drug companies just want to sell their meds. And who can blame them with how profitable those meds are! But I also think they have a responsibility to be more accurate in the picture they paint of the success of their meds. But that isn't likely to happen anytime soon. 

The world definitely needs to understand. They need to understand just how autoimmune arthritis can affect not just the person who has the disease itself, but all of their family, friends, co-workers, and employers. It can be devastating for some people. But most  people who hear the word arthritis, equate it with a degenerative type such as OA. While OA can affect multiple joints, it just does NOT have the systemic effects that the autoimmune types of arthritis have. I am not saying that one hurts more than the other. Pain is objective and difficult to measure. But the types of autoimmune arthritis are more difficult to treat, are more serious is nature, are treated by medications that are heavy duty, full on scary for some people. Left untreated, RA is almost guaranteed to cause serious joint damage. But treated, the damage can be slowed and minimized, especially if one can find a drug that treats the disease itself and not just the symptoms, that one reacts well to. For so many, they only get moderate or even minimal response to a drug, but many choose even a small amount of response over none. I know I do. I know that I will NOT, by choice at least, be without a DMARD at the very least. A DMARD is a disease modifying anti-rheumatic drug. I was without a DMARD for too long during the months I was in the hospital and ended up with contractures in my ankles, toes, most of my fingers, wrists, and elbows. Thankfully the ones in my fingers, wrists and elbows have reversed, minus my left pinkie finger. My ankles and feet did not reverse. My PT was able to get a tiny bit of flexion in my ankles but not much. He and others have said to fix the ankles will require surgery. Now, having spent 11 months in a hospital and 2 years in a nursing home, there is NO WAY I want to even consider anything that would send me back to either place any time in the near future. And I loved the staff at both places. I got to know the nursing home staff better since I was alert the whole time I lived there and was there two years. But as much as I love both the staff and residents, I do NOT want to go back to stay anytime soon. Sorry guys! I'll gladly visit, but I wanna go home at day's end and sleep in my own (hospital) bed!


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