At 33 years old, a doctor diagnosed Tara A. with rheumatoid arthritis, after painful swelling in her knees and feet made it difficult to walk. Some mornings, it was such a struggle to get out of bed and dress herself, the New Jersey-based home healthcare nurse had to call out of work. A few years after the diagnosis, Tara is managing her illness with oral medication, a healthy diet, and consistent, low-impact exercise. She hasn't had a flare up (a painful exacerbation of the disease's symptoms) in over a year, and lives a normal, active lifestyle.
Rheumatoid arthritis is a chronic autoimmune disease that affects over 1.3 million Americans, which can cause inflammation in joints and, ultimately, damage joint tissue. Common symptoms range from fatigue and joint stiffness to pain, weakness, and difficulty walking. While there's no cure for the disease, Dr. Joshua Baker, a rheumatologist at Penn Medicine in Philadelphia, says there are some things patients can do to help keep flares to a minimum. Read on for five tips to help minimize an RA flare.
Keep Taking Your Medications
The Covid pandemic has brought unexpected challenges for patients who manage an autoimmune illness.
Some common RA drugs work by suppressing the immune system, prompting some patients to worry about how taking them might impact their health during the pandemic. According to Dr. Baker, studies have been published this year indicating there's an uptick in RA patients discontinuing their medication without talking with their healthcare provider first, and he's seeing it firsthand.
"Some people have stopped their medicine throughout this time, either because they're worried about getting COVID, or because it's harder to get their medicine," says Dr. Baker. The doctor cautions his patients against discontinuing medication now, "because there's a real risk to stopping, and the benefit of stopping is unclear."
What that means is that, even though some types of RA medications can suppress the immune system, there's no evidence to suggest that continuing to take them can make a patient more likely to contract COVID, or have a worse outcome from the disease. However, there is evidence that stopping treatment can negatively impact your health.
Another potential risk of tapering off medication, even if you've been feeling well: If anything changes, it may be difficult to reverse course. "It's just harder to get access to your doctor, and it's harder to come in to get your joints evaluated, so I've been avoiding rocking the boat right now," says Dr. Baker.
The bottom line: keep taking your medication, and refrain from making big changes to your healthcare plan until you have more consistent access to your doctors.
Try to Reduce Stress
Medications are important, but so is overall wellness. It's no secret for RA patients that stress can tend to worsen RA symptoms, and—since stress can affect sleep patterns, diet, and more—just make you feel worse overall.
In the midst of a global pandemic, when life is upended and we're coping with so much unpredictability, it's a laughable time to prescribe "less stress." But it's also crucial to dealing with a chronic illness.
"People can do a lot to prevent flares through managing their stress, and through other healthy things like exercise and diet," says Baker. To reduce stress, prioritize getting a good night's sleep, aim for 30 minutes of low-impact exercise daily, and try a meditation app.
Maintain a Healthy Diet
According to Dr. Baker, there's not one specific nutritional plan or type of food that helps combat the symptoms of RA, but general healthy eating habits can have a positive influence on how you experience your disease.
In a time when a global pandemic may have thwarted your healthy habits—maybe working from home means you're moving less, or snacking and stress-baking more—it's even more important to pay attention to the foods you're eating. A heart-health focused or Mediterranean diet, rich in vegetables, fruit, legumes, and other plant-based foods is a good option. Sugar has also been linked to increased inflammation in the body, too. In general, Baker says to just be aware of what you're eating, and how it makes you feel.
Designate a Support Person
As with so many other things in life, RA is much easier to navigate with help. "I always ask people when I first meet them: who's your support person?" says Dr. Baker. The doctor suggests bringing a trusted family member or friend to clinic visits so a second person understands your illness. (Since COVID restrictions might mean a no-visitors policy at your doctor's office for the time being, enlist someone who can Facetime in to the appointment and take notes.)
Because, in some cases, hospital systems are overburdened, or doctors are recommending a pause to routine checkups while COVID cases spike, "you may not always have access to your doctor," to ask questions, explains Dr. Baker. "So having somebody else who hears what [the doctor is] saying, and who you can bounce things off of, that can be helpful."
Stay On Top of Other Health Issues
Lastly, don't forget about the rest of your body. RA patients can have other medical problems, including neuropathy (numbness or pain in the hands and feet caused by nerve damage) or osteoarthritis (when the protective tissue covering the ends of your bones wears down), that can contribute to how they experience RA.
"If patients are falling behind on their normal health care, it can contribute to feeling worse," says the rheumatologist. Dr. Baker suggests making sure to manage any other health problems, and stay in contact with other care providers.
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