Friday, July 24, 2009

Can I Delay Treatment for Rheumatoid Arthritis? part 2

Is it safe to delay treating Rheumatoid Arthritis?

If you re-phrase this question six different ways, and search using Google, you will get a lot of good information about why Rheumatoid Arthritis treatment should NOT be delayed. So, I guess that’s the Google-vote. But most of us do not make decisions based upon a Google-vote. We need more rationale than that.

So, why do some delay treatment for Rheumatoid Arthritis? Let’s examine a few reasons.


The side effects to RA medications are startling to behold. Perhaps there is fear that the medication will be worse that the Rheumatoid Arthritis. There may also be a misconception that RA medications are all addicting and will cause lifelong dependence.

Most of the time, the best therapy for fear is information. For example, medicines prescribed for disease control (DMARDs) for RA are not considered addictive. And learning about what Rheumatoid Arthritis can do to a body goes a long way toward making the medicines sound downright safe.

Of course they are not completely safe; but neither is driving a car, walking across the street, or eating rare meat. However, all of them are safer that living with untreated Rheumatoid Arthritis.


Not knowing what to do can make any problem worse. So much is unknown when it comes to Rheumatoid Arthritis. We don’t know what causes it. And we can’t say why some fare so much better than others.

However, evidence is piling up that early and aggressive treatment of Rheumatoid Arthritis may be our only hope to reduce future disability. Listen to the doctors at the University of Kansas Hospital: “Early treatment may significantly control the course of the disease…” And NIH says: “Early, aggressive treatment for RA can delay joint destruction.”

No, they can’t tell you why you have RA. They can’t tell you how bad it will get. The cause and the cure are both uncertain. The only thing that is certain is that studies have shown that for some RA-ers, early treatment can slow damage.

Remitting RA:

Rheumatoid Arthritis that remits is more difficult to track. For those who have remitting RA, the disease can lessen at times so that life seems normal. Palindromic Rheumatism (or Palindromic RA) can remit for even long periods. One can go crazy trying to figure out what brings on flares or remissions. However, if Rheumatoid Arthritis symptoms are recurrent, it is important to get thorough exams to determine whether damage is occurring.


Sometimes it seems like relief is an impossible dream. Going on the RA meds is akin to wrestling with windmills. Even the folks we know who are using DMARDs have not gotten well. Why take all the risks if it might not even help?

That’s a really tough one. There is NO promise that the medicines will even work! But, some things are sure: Hope can grow stronger if we work at it. And it is worth the trouble because God has a purpose for each of us. Your loved ones need you to survive. Every life is worth living.


As I explained in yesterday’s post, it is actually very easy to convince yourself that you are not sick enough to need treatment. Of course, nobody really wants to believe that they are sick enough to need chemotherapy. Actually, you can get a lot of help in this: others would also prefer to believe that you are not that sick.

Denial is useful as a mechanism for managing crises. It is an excellent temporary help in times of tragedy. However, it tends to wear out its welcome… When the time has come to deal with a problem, we might have to throw denial out like bad food.


Maybe you know other reasons. Please use the comment box to tell us about them.

Also Recommended:
What Makes Diagnosing RA So Difficult?
How Is RA Diagnosed?
Hope in a Spray Can

Remember: 60-2-3. That’s 60%; 2 years; 3 months
“Studies have shown that damage to joints occurs in 60% of people with rheumatoid arthritis within 2 years. Because irreversible joint damage, chronic pain, and long-term disability can occur if rheumatoid arthritis is not diagnosed and treated early, it is now recommended that a person with rheumatoid arthritis see a …rheumatologist within the first 3 months after symptoms appear. As soon as rheumatoid arthritis is diagnosed, early treatment includes medications known as …DMARDs.” (University of Kansas Hospital)


MissDazey said...

My was no insurance and too many other things to deal with.

Kelly, Thanks for your comment on my arthritis blog. Bruce was his first wife's caretake for 14 years with 2 different cancers. He never complains, I just wish he didn't have to take care of me too.

Kim H said...

I find the quotation from UK (KU??) ironic ("Because irreversible joint damage, chronic pain, and long-term disability can occur if rheumatoid arthritis is not diagnosed and treated early, it is now recommended that a person with rheumatoid arthritis see a …rheumatologist within the first 3 months after symptoms appear.")

I saw a rheumatologist. In fact, I moved to a different state and saw another one. Both diagnosed me with and treated me for "fibromyalgia" (even though I complained only of intense pain in my hands and feet). The second RD even did some ultrasounds, which he told me revealed "inflammation."

So, I was diagnosed and treated for "fibromyalgia" for over two years.

Finally, I sought yet another opinion. In requesting all of my records from the second RD, I discovered that the ultrasounds actually also revealed pannus and bone erosions. WTF? It was clear I had RA. WHy didn't he treat me for it?

The 3rd RD read the ultrasounds and declared I had RA right away, regardless of my negative blood results.

So, a lot of good seeing an RD did me during the first two years of my disease....

Kelly said...


I have talked with lots of people who have your experience. Hence my campaign to improve the ACR guidelines and educate the "whole world" - including physicians - to be able to recognize RA. There are enough sad stories to fill some books...