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Rheumatoid Arthritis: Explore Your Treatment Options

By

Sandra Edwards

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sandra edwards, psn, ra, The Rheumatoid Arthritis Diaries

Sandra Edwards has rheumatoid arthritis. She sits on the Leadership Council of the Arthritis Foundation.

For the first six months after my rheumatoid arthritis diagnosis, I relied on a single medication to relieve my symptoms of pain and stiffness. I definitely noticed a difference, but it didn’t fix everything. It may have slowed down the disease’s progression, but I still felt like my joints were deteriorating.

It clearly wasn’t enough.

My rheumatologist said the next step was to try a second medication called a biologic. The biologic classification includes drugs that are produced through natural processes instead of chemical synthesis. They’re recommended fairly frequently to treat rheumatoid arthritis. But the treatment shouldn’t be taken lightly; biologics can suppress the immune system. And—as with any medication—there’s a chance of side effects.

My doctor didn’t push me to take the biologic, by any means. But if there’s a treatment available and the risks aren’t huge, then I’m willing to give it a try. There were four or five different options available when I first agreed to start biologic treatment—that was four years ago. Now, there are many more options on the market.

Some of the biologics are self-injectable, others are intravenous (IV) infusions. For the infusions, you have to go to the doctor’s office so they can hook you up to the IV while you relax in a comfortable recliner chair. Depending on the biologic, this process can take anywhere from an hour to all day. For me, it takes about two hours and I go every six weeks.

But the dosage and frequency vary from person to person. As my doctor explained to me when I started the treatment, they can’t immediately predict what will deliver the best results. Finding that perfect balance between dosage and frequency of treatment is a matter of trial and error.

At first, my rheumatologist gradually increased the length of time between my infusions until I was only going in every eight weeks. But eventually eight weeks proved to be too long; I’d find myself in pain before my next treatment. So my doctor dropped me down to a six week schedule.

I know my immune system may be weaker, but I don’t find myself becoming sick more often. Physically, I feel great. Of all the possible side effects, the only one I’ve experienced is fatigue—and fatigue could simply be a product of the rheumatoid arthritis itself and not the medication.

A downside to my immune system being compromised is that traveling to exotic destinations may not be wise. Yes, I would love to go on safari in Africa, I would love to go see orangutans in Indonesia, but it’s not a necessity. If it jeopardizes my health, then to me it’s not worth the risk.

My rheumatologist and his staff are excellent at monitoring my condition. I see him every three months. If my desire to explore wilder countries becomes insatiable, I can bring up the idea with him. Maybe it would require temporarily weaning off of the biologic treatment; I’m not sure. But these are decisions we’ll make together, and it all depends on how my body is reacting. For now, tamer trips to the UK or national parks here in the US satisfy my travel urges.

Every day is a new day with rheumatoid arthritis. Every day that I can wake up and say, “OK, I’m doing great." is a reminder of how lucky I am; because you never know exactly what to expect. But if one day my body stops responding to my current treatment, my doctor and I will determine the next course of action.

We won’t give up.

Having rheumatoid arthritis means learning to be resilient. If what you’re doing is working, keep doing it; if it’s not, take action! You and your doctor will figure out what’s best to do. There are more options at your fingertips every single day.

Sandra Edwards takes life one day at a time in Atlanta, Georgia, with her husband, Bob, and their mini schnauzer, Otto.

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Medical Reviewers: William C. Lloyd III, MD Last Review Date: Feb 7, 2014

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