Read Online The Autoimmune Connection: Essential Information for Women on Diagnosis, Treatment, and Getting On With Your Life by Rita Baron-Faust, Jill Buyon - Free Book Online
Authors: Rita Baron-Faust, Jill Buyon
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estrogen can influence the activity of immune cells in a number of ways. However, the peak onset of rheumatoid arthritis is between ages 40 and 60, when estrogen levels are declining. So it’s still unclear what role estrogen may actually play.
Kathleen’s story continues:
I was about two years into the RA, and I kept on working despite the pain.
I had no choice. If I didn’t keep working my career would be over. I was offered a play, Indiscretions, and I thought I’d be able to do it because the character was a diabetic, and the first and the third acts took place in her bedroom . . . I figured I’d be lying around a lot. It didn’t turn out that way.
In the second act of the play, there was a three-story spiral staircase that went up to a catwalk. . . . We would sit up there until we heard the cues and start back down. By the time I got up to the catwalk I was sobbing every night—the pain was so terrible. So I kept tissues, powder, and a lipstick and a mirror up there so I could fix my face before I went back down. I only missed a few performances in the run. I didn’t make my disease public at the time . . . because we didn’t know at this point how much I was going to recover and if I was going to recover. And people don’t understand rheumatoid arthritis. I was put on a whole cocktail of drugs, and that was almost worse than the RA. I was on Plaquenil, I was on gold salts, I was on methotrexate, I was on prednisone, large doses of prednisone. It blew up my body, blew up my face. And the press had a field day—they decided that I had a drinking problem because I was so puffy. And I didn’t even care if people thought I had an alcohol problem. I mean, they hire drunks, they hire repeat drug offenders every day in this business. But I knew they wouldn’t hire me if they knew I had this disease.
Symptoms of Rheumatoid Arthritis
The first symptoms of RA may be swelling and pain in the joints along with morning stiffness. In 90 percent of people, the first areas affected by rheumatoid arthritis are the hands and feet. The disease often affects the wrists andfinger joints closest to the palm, as well as joints in the jaw, neck, shoulders, elbows, hips, knees, ankles, and toes. Any joint in the body can be a target except the low back, which is rarely involved.
Inflammation can cause body-wide symptoms such as low-grade fever, flu-like body aches, and a general feeling of not being well (doctors call it malaise ). You may also lose your appetite, lose weight, and feel like you have no energy. A majority of RA patients experience fatigue. 10 However, fatigue in RA is different from just feeling tired; fatigue often means you can’t function at all. It’s unclear whether fatigue is related to inflammation. 11 It may also be a symptom of anemia, which often accompanies RA. Inflammation can affect the tear-producing glands in the eyes and saliva-producing glands in the mouth, so you may experience dry eyes and dry mouth. You can have muscle pain and stiffness after sitting or lying in one position for a long time. Depression is also common.
At first, these symptoms may not add up to much. There are other medical conditions, both rheumatic and nonrheumatic, that can look a lot like rheumatoid arthritis, especially in the early stages, such as lupus and hypothyroidism. In fact, any infection that produces joint aches can look like rheumatoid arthritis. Often a woman will complain of joint pain to her doctor, and all that can be seen is puffiness of the hands, with none of the obvious redness or warmth that typically characterizes RA.
“The reason the patient comes in is usually that they are feeling pain. Maybe it’s not rheumatologic, but it has to be taken seriously and investigated,” stresses Yusuf Yazici, MD, an assistant professor of medicine at the New York University School of Medicine and the NYU Hospital for Joint Diseases. Some studies find that almost one-quarter of RA patients may already have
Kathleen’s story continues:
I was about two years into the RA, and I kept on working despite the pain.
I had no choice. If I didn’t keep working my career would be over. I was offered a play, Indiscretions, and I thought I’d be able to do it because the character was a diabetic, and the first and the third acts took place in her bedroom . . . I figured I’d be lying around a lot. It didn’t turn out that way.
In the second act of the play, there was a three-story spiral staircase that went up to a catwalk. . . . We would sit up there until we heard the cues and start back down. By the time I got up to the catwalk I was sobbing every night—the pain was so terrible. So I kept tissues, powder, and a lipstick and a mirror up there so I could fix my face before I went back down. I only missed a few performances in the run. I didn’t make my disease public at the time . . . because we didn’t know at this point how much I was going to recover and if I was going to recover. And people don’t understand rheumatoid arthritis. I was put on a whole cocktail of drugs, and that was almost worse than the RA. I was on Plaquenil, I was on gold salts, I was on methotrexate, I was on prednisone, large doses of prednisone. It blew up my body, blew up my face. And the press had a field day—they decided that I had a drinking problem because I was so puffy. And I didn’t even care if people thought I had an alcohol problem. I mean, they hire drunks, they hire repeat drug offenders every day in this business. But I knew they wouldn’t hire me if they knew I had this disease.
Symptoms of Rheumatoid Arthritis
The first symptoms of RA may be swelling and pain in the joints along with morning stiffness. In 90 percent of people, the first areas affected by rheumatoid arthritis are the hands and feet. The disease often affects the wrists andfinger joints closest to the palm, as well as joints in the jaw, neck, shoulders, elbows, hips, knees, ankles, and toes. Any joint in the body can be a target except the low back, which is rarely involved.
Inflammation can cause body-wide symptoms such as low-grade fever, flu-like body aches, and a general feeling of not being well (doctors call it malaise ). You may also lose your appetite, lose weight, and feel like you have no energy. A majority of RA patients experience fatigue. 10 However, fatigue in RA is different from just feeling tired; fatigue often means you can’t function at all. It’s unclear whether fatigue is related to inflammation. 11 It may also be a symptom of anemia, which often accompanies RA. Inflammation can affect the tear-producing glands in the eyes and saliva-producing glands in the mouth, so you may experience dry eyes and dry mouth. You can have muscle pain and stiffness after sitting or lying in one position for a long time. Depression is also common.
At first, these symptoms may not add up to much. There are other medical conditions, both rheumatic and nonrheumatic, that can look a lot like rheumatoid arthritis, especially in the early stages, such as lupus and hypothyroidism. In fact, any infection that produces joint aches can look like rheumatoid arthritis. Often a woman will complain of joint pain to her doctor, and all that can be seen is puffiness of the hands, with none of the obvious redness or warmth that typically characterizes RA.
“The reason the patient comes in is usually that they are feeling pain. Maybe it’s not rheumatologic, but it has to be taken seriously and investigated,” stresses Yusuf Yazici, MD, an assistant professor of medicine at the New York University School of Medicine and the NYU Hospital for Joint Diseases. Some studies find that almost one-quarter of RA patients may already have
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