All About Telehealth for Ankylosing Spondylitis Telehealth allows doctors to care for people virtually over a phone call, text message, or most commonly, video chat. Although some situations require an in-person visit, telehealth is a great option when you can't get to the doctor's office for your ankylosing spondylitis. If you're new to telehealth, here's what you need to know. Medicare will cover telehealth visits just like in-person visits, but state Medicaid programs and private insurers vary, so confirm your coverage in advance. With telehealth, even though you're not in the doctor's office, your private health information is still covered by HIPAA, so it will remain confidential and secure. Although your rheumatologist can't give you a physical exam via telehealth, they can write prescriptions and offer quality care, especially if you prepare in advance. Before your telehealth appointment:- List any symptoms (including dates and severity), such as pain and stiffness in your low back, hips, neck, heels, ribs, or joints-or eye and vision issues- Keep note of triggers, especially if your pain improves with exercise and worsens with rest- Document any side effects from your ankylosing spondylitis medications, including infections or gastrointestinal upset- Compile a list of your health conditions and all medications- Record your vital signs if you own a thermometer, blood pressure monitor, or another device- Charge your computer or phone- Make sure your internet is reliable- Download any telehealth apps your specific provider may require- Write down any questions you have for your rheumatologist- Find a quiet, private space to conduct the call- Be prepared with pen and paper or a note-taking app Turn to Healthgrades to connect with the right rheumatologist to treat ankylosing spondylitis via telehealth. And share this video to spread the word!

Dr. Johnson: Ankylosing spondylitis is a type of arthritis that's an autoimmune inflammatory disorder that can cause pain in the low back and the hips as well as stiffness. To treat a flare-up for ankylosing spondylitis, we typically will have them take a nonsteroidal anti-inflammatory medication. Dr. Hoffman: Ibuprofen is a nonsteroidal anti-inflammatory drug. Naproxen is a nonsteroidal anti-inflammatory drug. Dr. Tieng: If a patient with ankylosing spondylitis did not respond to at least two different nonsteroidal anti-inflammatory drugs, or NSAIDS, for at least two to four weeks each, then I would prescribe a biologic. Biologics are genetically engineered medications that closely resemble proteins that naturally occur in the body. They target parts of the immune system that fuel inflammation. Dr. Hoffman: This group of medications dramatically changes the quality of life. It controls their pain significantly. Dr. Tieng: Some people with ankylosing spondylitis require surgery if they have severe hip pain with limited range of motion. Dr. Johnson: In the worst-case scenario, the spine is very brittle. Patients can fracture. Sometimes they end up having spinal surgery because they have a fracture in the back. So we recommend that patients avoid contact sports such as football. Dr. Tieng: Remove any clutter on the floor, loose rugs, or any electrical cords that might cause them to trip. Dr. Hoffman: One of the most important social recommendations to patients with ankylosing spondylitis is don't smoke. Dr. Tieng: I strongly encourage patients with ankylosing spondylitis to follow regularly with a rheumatologist and also to take their medications as prescribed. Dr. Hoffman: We are ages and ages ahead of where we ever were before. Dr. Tieng: It is absolutely possible that patients with ankylosing spondylitis can live a fulfilling life, pain-free and without stiffness and without fatigue as well.

Kelsey: I say, "It's an inflammatory autoimmune disease." Because if I open with, "I have ankylosing spondylitis," I get blank stares. Kelsey: I was diagnosed with ankylosing spondylitis when I was 18 or 19 years old, but I was symptomatic starting back when I was 15. Katy: They found it after I had the two hip surgeries, and then they realized the pain wasn't going away. Kelsey: The main symptom I started having was pain in my back and neck and it spread to other joints and I lost some flexibility. Katy: There is typically a pain anywhere from my joint at the bottom of my back to my chest area and right up through my neck. Kelsey: I was frustrated because I had seen so many people who either told me, "Oh, it's in your head. It's growing pains." So by the time I was actually diagnosed, the initial response was actually relief. Later came the, "Oh my gosh, there's actually something wrong with me that we need to treat." Katy: I was scared because at the time, I was in my early 30s and I liked being physically active, I danced. Kelsey: It was very difficult to be so limited physically when I was still so young because some things would drain my energy faster and some things would cause me more pain. Katy: You constantly have to think about how you're moving and what seat you're going to be sat in on the plane. And if the dishwasher's on the ground, I have to bend down and that hurts. It's just learning to live with all that and not let it take over you. Kelsey: Treatment for this illness has come so far in such a short period of time. And eventually, I realized that this is not the end of the world for me. Katy: This is manageable. Keep calm and carry on.

Kelsey: If I met someone that was newly diagnosed with ankylosing spondylitis I would say, "Don't panic. A lot of the major aspects of your life are not going to change and you don't have to let it stop you from doing what you love." Dr. Johnson: Eating a healthy diet in general is good. There's no specific diet that's been linked to ankylosing spondylitis or inflammation. Kelsey: I ended up going gluten-free which has worked significantly. Dr. Hoffman: Try not to be overweight. Try to remain functional. Dr. Tieng: I do recommend a physical therapist to teach the patient different exercises and stretching techniques. Katy: She really focuses on ensuring my joints are in the right positions, ensuring that I'm mobile and flexible. Kelsey: Walking, I found is the best exercise for me. Dr. Johnson: Pilates and Tai Chi are very popular. Dr. Tieng: Patients with ankylosing spondylitis have low bone mineral density. I would encourage my patients to avoid contact sports to avoid any risk of fracture. Contact sports include boxing, mixed martial arts, football. Kelsey: I take a lot of baths, which helps with my joints. Dr. Hoffman: Don't smoke. If you want some wine, you can have a little wine. Don't smoke. Dr. Tieng: If a patient is feeling anxious or depressed there are support groups. Kelsey: I've gone to multiple meetings. I met some really great people. It's really fun to be surrounded by people who understand what I'm going through. Katy: Really do your research in terms of finding a rheumatologist that works for you. Dr. Tieng: Follow with a rheumatologist regularly to take medications as prescribed. Katy: Make sure you move, because the easiest thing to do in this disease is stop moving when the pain is the most acute, because if you don't, you'll fuse, and none of us want to end up hunched over. Dr. Hoffman: Basically keeping an open mind and not giving up on yourself. Kelsey: You have to be a little bit smarter about the decisions you make in terms of participating in certain things but you don't have to give anything up.

Dr. A. Tieng: Ankylosing spondylitis is a disease that can cause pain and stiffness in the back. It's a type of spinal arthritis, meaning that it's an inflammatory arthritis of the spine. Dr. B. Johnson: You have an immune system in a normal person that fights cold and infections. In the person with ankylosing spondylitis, your own immune system is attacking your spine and your hips, and causing inflammation and pain. Dr. A. Tieng: Some people believe that the cause for ankylosing spondylitis starts in the gut. In the gut, you can have immune cells that are activated and then they migrate to the joints where they lead to an inflammatory process. Dr. B. Johnson: Ankylosing spondylitis has a genetic component, but not in the sense of, there's one gene that if you have it you will have ankylosing spondylitis. But patients who have this genotype, called HLA-B27, are more likely to develop ankylosing spondylitis. Dr. A. Tieng: The gene for HLA-B27 can be detected in the blood. Dr. B. Johnson: The symptoms of ankylosing spondylitis are pain and stiffness in the low back. Dr. A. Tieng: Including arthritis in the shoulders, hips, knees, ankles, and also can cause pain in the heels. Dr. B. Johnson: It typically occurs in younger individuals, aged 45 and under, and it tends to affect men more than women, although women can also get it. Dr. A. Tieng: Because it affects patients who have symptoms in their teenage or young 20s, they may brush off the back pain as from another cause and not really seek medical attention right away. Dr. B. Johnson: The difference with ankylosing spondylitis is that it's usually low back pain that goes on for three months or longer. The other clue is that the pain is worse in the morning and it gets worse with rest and better with activity. Dr. A. Tieng: There is no one test to diagnosis ankylosing spondylitis. Dr. B. Johnson: There are different diagnostic criteria that your doctor would use. X-rays, the types of symptoms, as well as blood work. Dr. A. Tieng: If someone is untreated for ankylosing spondylitis, that patient can develop kyphosis, which can look like a hunchback posture. Dr. B. Johnson: Their spine will kind of hunch forward and they'll be stuck in a position where they're basically looking at the ground. So I think it's very important for patients with AS to maintain a positive outlook. Dr. A. Tieng: They can lead a comfortable life if they seek treatment.

5 Ways to Make Life Easier With Ankylosing Spondylitis Ankylosing spondylitis (AS) can be stressful and painful, but the right strategies can help make your life easier. 1. Use your energy wisely. AS can zap your energy quickly, so it’s important to prioritize your to-do list and see which tasks you can delegate. 2. Prioritize sleep. AS can make it hard to sleep. Go to bed at the same time each night and put screens away one hour before bed. 3. Eat smart. AS raises your risk of osteoporosis, so get plenty of calcium and eat a well-balanced diet low in meat and high in veggies. 4. Get active. AS can make it hard to move, but stay active to improve pain and stiffness. Ask your doctor about the best exercises for you. 5. Put your care in the right hands. The right rheumatologist can help make AS easier to manage and live with. Turn to Healthgades.com to find the best doctor for you.

What Not To Say to Someone With Ankylosing Spondylitis #1. “You just need to get a massage.”#2. “I have arthritis, so it’s basically the same.”#3. “You should exercise more.”#4. “My cousin with AS can’t walk anymore.”#5. “Have you tried taking supplements?” Turn to Healthgrades to find a doctor who knows just what to say.