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Rheumatoid arthritis can take years to develop. However, it also happens that it attacks unexpectedly and rapidly changes the patient’s life. The most important thing, however, is the attitude of the patients themselves to RA. Because it’s their fight.
Side 2007
A heat wave outside. Not only was it difficult to endure anything due to the high temperature, there were also strange swelling around the ankles. They do not hurt, but the second day they do not come off. What’s worse, I have the impression that they are a bit larger and I think my knees and wrists are also swollen. Tomorrow I’m going to the internist. It’s probably just circulation problems, but I’d rather check it out.
When Agnieszka finally managed to see a rheumatologist, it turned out that her ailments were not related to bad circulation. “You have rheumatoid arthritis,” the doctor said. She couldn’t believe her ears. – Rheumatism? I? My grandmother, I understand that, she is old, but me?
The doctor quickly explained to her that the disease that affected her was one of two hundred rheumatic diseases (popularly known as rheumatism) and mainly affects women of her age – between 30 and 40 years of age. For her, the patient’s explanation of the rheumatologist was not very comforting … She learned that her disease came from nowhere (genetic predisposition, prolonged stress, considerable physical exertion, childbirth and even microbes could not be cured) and that she could not be cured. But she couldn’t concentrate on what the doctor was saying. In her mind’s eye, she saw her grandmother with her shrunken, disfigured hands, struggling to hold a frosted cookie. Grandma complained that it hurts that it is difficult … Agnieszka woke up only at the doctor’s words: – Agnieszka, it really is not the end of the world. You’re young. Believe me, further progression of the disease can be prevented. And most importantly, it is possible to live normally with RA.
Apart from the increasing swelling of the ankles, Agnieszka initially did not notice any other symptoms of RA. She hadn’t had any problems with her joints before. She was a healthy 35-year-old full of energy. Happy married and mother of two sons – 12- and 4-year-old. The swelling and symptoms quickly followed – pain, crunching in the knees, stiffness of the fingers were a total surprise. – My feet started to look like balloons overnight, it was hard for me to get up, let alone take a few steps. They became so swollen that my skin felt like it was about to burst. Later, the wrists and knees also turned into balloons, she recalls.
She was terrified, she did not know what was happening to her body. It was slowly changing into the body of some strange, sick woman. The family doctor referred her to basic blood and urine tests and prescribed anti-inflammatory and painkillers. The results were flawless, but her condition worsened day by day. A visit to the hospital did not help, where, after a cursory examination, Agnieszka was given another prescription for another anti-inflammatory drugs that were not to help again. A quick appointment with a public rheumatologist in Warsaw is a dream of a severed head. She would have to wait for months. The condition was so serious that she could not afford to wait several weeks. Today she is sure that a visit to a private clinic saved her life. The rheumatologist had no doubts it was an RA attack. He prescribed steroids and strong painkillers. The diagnosis was better than ignorance and fear anyway. At last she knew what to fight. She went to bed in the evening, hoping to get out of bed in the morning on her own. And the first thing she did when she woke up was straightening her fingers…. Just to be sure that it still can.
Fall 2007
In the morning, after breakfast. 8 milligrams of Metyprette and something for the covering of the stomach. I feel great physically, after just a few weeks of using steroids, I have relieved myself of pain and swelling. Everything is OK, except for the horse’s appetite. No matter how much I eat, my stomach would like more. And that round face in which I try to find my old features. Mentally – total pit. I didn’t know that such a tiny pill could do so much.
Laboratory tests are important in the diagnosis of rheumatoid arthritis. X-ray, ultrasound, magnetic resonance or computed tomography of the structures of joints, muscles and tendons are also used. These tests allow the detection and determination of the severity of inflammation of the synovial membrane of the joints. As a result of RA, infiltrates of lymphocytes and plasma cells are formed in the membrane. Then the synovium thickens, and the joint exudates, which limits joint mobility. Unfortunately, many patients do not undergo testing until several months after the onset of symptoms. Because only then are some people able to accurately diagnose.
Agnieszka had all the tests done when the steroids did their job, the swelling and stiffness disappeared. The treatment regimen of a patient with RA in Poland is steroids, and then Methotrexate (MTX) – a drug used in higher doses in chemotherapy. Methotrexate is terrifying in RA patients. On the one hand, it inhibits the damage to the joints seen on x-rays of hands and feet, but the list of side effects it causes can be nauseous.
It is also possible to use biological drugs – TNFα blockers. These drugs are commonly used in RA in the West. Unfortunately, in Poland there is no guarantee that it will be possible to continue the therapy due to unstable regulations and treatment costs. The adjunctive therapy of RA is the use of non-steroidal anti-inflammatory drugs (NSAIDs). Treatment can be supported with Bioherb’s Linseed Oil, which has anti-inflammatory properties.
Exercise and physical therapy (electrotherapy, cryotherapy, ultrasound, magnetic field, massage) are of great importance. Agnieszka uses a magnetic field, iontophoresis, DD every day. She waited over two months for treatments. This is the only convenience he can count on without reducing the home budget. He goes to the doctor privately and pays for the tests.
Winter 2007
I’m starting a new day. And same thing again. Drugs, breakfast, medications, carrot juice, coffee. Nothing changes, well, maybe the body doesn’t look like it used to. Or maybe I just look at myself differently in the mirror? My husband says I’m still beautiful and attractive.
Many women with RA face loneliness in addition to their disease. Few partners can cope with the specter of their partner’s disability, constant pain, and taking medications. Many are leaving. Agnieszka can still count on her husband’s love and care. – It gives me a lot of encouragement and confidence in myself and that it will be better. When it was really bad and I couldn’t get out of bed, my husband would pick me up, lead me to the bathroom, help with basic activities. He tied shoes and looked after the house and children. He massaged the sore joints and rubbed them with a warming tincture – he says. She had already decided that as soon as she recovered from the worst, she would try to stop taking steroids. – I saw what steroids do to my body and psyche, I did not want to poison my body with them for a day longer than it was necessary. Steroids must be discontinued for a very long time and slowly, under the supervision of a doctor and according to his instructions. We reduced the dose by 2 mg every three weeks, plus herbal remedies, homeopathy and a special diet.
Sugar comes first in the prohibited products in RA. You should limit the consumption of salt, fats and pork. In a word, you must do everything possible not to gain weight and not to put additional strain on the joints. – I remember that initially I did small purchases for an hour and a half. Because sugar is almost everywhere. In cold cuts, herring in cream and ketchup. Second: no wheat (also makes you fat) and you have to be careful here, because it turns out that wholemeal rye bread contains wheat. Third: as little pork as possible, he says. By strictly following these few nutrition rules, Agnieszka feels better and her joints hurt less, although there are seizure pains. Suddenly, for no reason, for example in the wrist. Then he reaches for a warming tincture and an elastic bandage. She laughs that, unlike other women, she carries a bottle of the drug in her purse instead of lipstick.
Spring 2008
I’ve been clean for two months, so no steroids !!! I am now trying to adjust my life to this new situation.
Before her illness, Agnieszka took care of the house. Two children (now 13 and 5 years old) made her not think about work. But the younger son has reached such an age when he can easily go to kindergarten, and she could finally think about finding a job. And that became the goal. – Firstly, I was very militant towards this disease, and secondly, I wanted to work terribly, because I want to achieve something else in my life. I am not talking about some dizzying career, but simply having the motivation and mobilization to get out of bed, take care of yourself and organize your time better – he recalls.
Statistics show that every fourth patient with RA requires implantation of a large joint endoprosthesis, and half of the patients lose their ability to work after 5 years of illness. One third of them becomes disabled as a result of joint changes. – But diarrhea is the worst thing you can do to yourself and your loved ones with a disease such as RA. The fear and phobia that the disease will strike again at the most inopportune moment can lead to depression. Therefore, the most important thing in RA is the approach and not figuring out what would happen if.
Side 2008
Still no steroids! I follow 80% of the diet recommendations so as not to go crazy. From time to time I will have a glass of wine or eat something sweet. To improve your mood.
Many people with RA think that living with RA is unpleasant, incomplete, and it is not. Agnieszka is an example of this. – You cannot forget about yourself, about your passions and interests. I mean something that really makes us happy and takes our minds off. It happens that such a temporary improvement in well-being is much more beneficial for the course of therapy than conventional medicine – he says with a smile.
Agnieszka knows that, compared to other patients, she was very lucky. Because although you cannot be a hurray optimist in this disease and you never know what will happen next, she nevertheless managed to achieve a state in which she functions normally and enjoys life. – I was diagnosed quickly, I do not take any medications now, apart from adjuvants and ad hoc analgesics and anti-inflammatory drugs.
Since April, it has been organizing music concerts for children from Warsaw kindergartens. She proved that RA does not cancel plans and dreams, that you can get your own way. You just want it very much. Admittedly, she had to give up high heels, although she used to wear them all the time before her illness, but she still drives a car, and a few days ago she even dared to get on a bicycle for the first time. The only things he loses with a healthy person is opening jars, squeezing lemon juice or squatting. But who said that squatting is the most necessary thing in the world …
Text: Joanna Krupa
Consultation: prof. doc. dr hab. n. med. Krystyna Księżopolska-Orłowska, rehabilitation specialist, Head of the Rehabilitation Department
Source: Let’s live longer