SEATTLE — Living with Rheumatoid arthritis or any autoimmune, inflammatory or arthritic condition can be complex. The Polyclinic's Rheumatology department cuts through the confusion with their board-certified doctors whose expertise will increase the quality of your care.
The Polyclinic has undergone a variety of initiatives to improve care for their patients, including the selective, "Best Practices in Managing Rheumatoid Arthritis," effort and a project vaccinating those with immune conditions against pneumococcal pneumonia.
"There are over a hundred types of arthritis," explains The Polyclinic's Dr. Percy Balderia, "The most common autoimmune type is rheumatoid arthritis. This is when your immune system is not functioning as well as it should. It attacks your joints, and sometimes other organs, which causes inflammation."
Over 1.5 million Americans are affected by this disease, which Dr. Balderia said can affect any age, "The peak age of onset is between 30 and 60 years of age."
Dr. Balderia said that while the exact cause of rheumatoid arthritis is currently unknown, genetics play a huge role, as does environment and hormones. Women are at a higher risk.
"RA [rheumatoid arthritis] usually affects small joints. If you have pain, swelling, or limited mobility in your wrists/knuckles, or in the balls of your feet, then you should see a rheumatologist."
When left untreated, rheumatoid arthritis can cause serious damage, "You can have erosion in the cartilage, and that will lead to physical disability."
Due to the inflammation occurring in the systems of rheumatoid arthritis patients, they are at a higher risk of cardiovascular disease. It can also affect the eyes and lungs, in a condition called RA-Associated Interstitial Lung Disease.
The diagnosis for rheumatoid arthritis starts with patient history and a physical exam, "I want to hear a story that sounds like inflammatory arthritis. I want to make sure that it's not something else. I look for other potential idiologies, and then on the exam, I feel for joint swelling, tenderness, and I look for limited mobility."
The treatments available today have never been better, but it's not one-size-fits-all, "We have disease-modifying anti-rheumatic drugs. We have biologics, which are similar to naturally-occurring proteins in the body. And we have what we call 'small molecule inhibitors.'"
Determining which treatment plan is best suited to the patient hinges on several factors, "It depends on how long they've had the disease. How severe their symptoms are. Is there any evidence of joint damage? Do they have medical conditions; are they taking other medications that can affect their treatments options? And of course, treatment preference from the patient."
Dr. Balderia said that while joint replacement exists, he rarely sees patients resort to this due to the multiple treatment options available to them, "I rarely see patients who are not controlled in terms of their disease," he said. "It's rare for patients with RA, who are on treatment, to end up having joint replacement."
While the exact cause of RA is unknown, Dr. Balderia says a few things stand out, "Among patients who are at high risk for RA, maybe they have a relative with the condition, maybe they have antibodies related to rheumatoid arthritis. Those who smoke cigarettes and those who have recurring gingivitis with certain bacterial infections, they are more likely to progress to rheumatoid arthritis."
Dr. Balderia also noted that the disease is two to three times more common in women. He recommends asking your doctor if you exhibit any symptoms.
"Because of the several treatment options available to us, and because it can lead to irreversible joint damage and physical disability, you should see a rheumatologist."