Sister in Law just diagnosed with Rheumatoid arthritis - advice?

[twobone]

She is only in her late 40s and has 3 very active kids.

Any real world advice from this community would be great.

She also has Crohn's disease so I think some of the traditional pain killer treatments may not be possible.

If folks have had experience with certain drugs or alternative treatments that I can pass on it would be greatly appreciated

Thanks

[Zeke]

I don't know how she eats, but a complete diet overhaul is what I would do.

[twobone]

zeke, can you be more specific?

She is not over weight and eats like a normal person.

[J P Stein]

Crohn's and arthritis come to us in lock step. The treatments for Crohn's are the same as used for arthritis and the new ones actually work on both......ask me how I know.

The newer drugs are pricey as hell(4-5K per month). I probably have the spelling wrong but Remicade, Humira, and Centex are all effective.....Ive used them all but the side effects chased me away......internal Lupus type symptoms.......bad juju.

[twobone]

She is a pharmacy technician and works at a hospital so she will probably have access to the "good stuff".

I appreciate the comments!

[Groesbeck Hurricane]

Diet. Is she eating high in fat foods or fresh fruits and veggies? Maybe less red meat. Can she grow her own meat? What is sold in the stores has so much added to it... Maybe find a grower who does not use steroids, hormones, etc in the growth of their cattle/chickens. I'd suggest looking at Highlands and Belted Galloway and Gilbveths. Good meat!

Also, she should look into cutting out gluten. It is easier to do now than years ago. She could cut down by shifting to semolina flour.


What about exercise? Stretching and endurance. Do not need bulk, need to be able to go for distances.


I wish her the best! Not easy I am sure!

[Zeke]

Originally Posted by twobone

zeke, can you be more specific?

She is not over weight and eats like a normal person.

Not really. Just break a lot of habits. Most of it is common sense. My wife has the worst diet I've seen and it doesn't help having all the crap around. They don't call if "comfort" food for nothing.

[Bill Douglas]

An easy thing to do is no dairy products for two weeks. Don't worry about it in cooked things, just no drinking it. Then two weeks of no oranges (all citrus).

[Bobbi66]

Hi twobone, I was diagnosed when I was 29 with chronic inflammatory arthritis (now 45). Long story short is that the new TNF blocking medications have done wonders for me. The drugs are usually administered through injection or IV. Basically they suppress your immune system to a certain degree in order to keep your body from attacking itself. Of course with all drugs there are pros and cons. Only your SIL and her physician can make the choice that is best for her.

I have been on Humira for about 7 years with no side effects to date. Prior to that I was on Enbrel for a few years. While the drugs minimize the effects and destruction of the disease, they do not eliminate all symptoms and "flare ups". I learned to live with the ebbs and flows so to speak. I posted about 18 months ago how well I was, challenging my fiance in P90X. Currently for the past 4 months I've dealt with constant chronic pain and various joints swelling, lucky to feel well enough to walk around a mall for a short time. But I'm optimistic enough to know that this too shall pass.

Watch the diet especially sugar and alcohol. Get LOTS of QUALITY sleep. There is a difference. I wish her luck and she is not alone...

[steves31]

my first gf had that at the age of 11. diet is so important plenty of liquids and research. the pain in incredible and medication is very harsh on the body.

[J P Stein]

The ignorance is nearly over powering.

Crohns is an auto immune disorder....in these cases it is an over active immune system that attacks healthy tissue. With Crohns the large & small bowel comes under attack.....most often beginning at the Ilium....the check valve between the two. The "flare ups" cause scar tissue (for lack of a better word) to build up and as the disease causes more of such damage the passage becomes narrowed & inflexible....leading to a blockage....a flare up at it's finest.

What you eat has no effect on the disease but it can sure as hell have an effect on what passes thru.
A normal person should be able to pass a marble. A person with Crohns can have trouble passing a well chewed corn kernel. Vegetables are among (nuts are another) most difficult things to digest and as such arrive in the lower end of the small bowel semi intact.....no problem if you can pass a marble but for a Crohns suffer a chunk of lettuce can ruin your day.

I've seen the pictures of my gut with the size of the opening at around 1/16th on an inch for 3-4 inches. Time to get out the knives. This happened twice, once at 40 and again at 50. Ones immune system activity falls off as one ages....one good thing about getting old. I'm 66 now and hanging in there......for now.

The drugs that do the trick are immunosuppressants. The side effects are many & varied but some tolerate them better than others.....I am not one of the "some".

[kevin993]

Don't know about Crohns specifically, but someone in my family has fought with RA and had a lot of luck with Celebrix and Enbrel. Pricey stuff, but it has worked.

[wdfifteen]

I'm so sorry to hear this. RA is bad, bad stuff.
The friend I support has RA and it is hell for her. She can't keep a job because she never knows when she'll have a flare and be unable to work. She'll feel fine for a couple of weeks, but out of nowhere her foot will swell to the point where she can't put her shoes on or he wrists will swell and become excruciatingly painful. She can't drive long distances because a couple of ours at the wheel almost guarantees a flare in her wrists. She'll get soft tissue inflammations every couple of weeks. She takes methotrexate and has Remicade infusions every 5 weeks (over $4,000 each) and has tried all the naturalpathic stuff. She's big on that. She was has strong, independent, hard working woman until this disease struck her. After working and being productive for 40 years she has lost everything she owns and is in constant fear of losing what health insurance she has. Everything she manages to scrape together goes to co-pays and overdue doctor bills. She was a proud, strong woman until RA came along. It has ruined her life.

[Bill Douglas]

I should add I have had RA since I was a little boy then went to an allergy doctor to try to stop a skin rash. He said don't eat this and don't eat that. In two weeks the RA stopped for the first time in my life.

[J P Stein]

Originally Posted by wdfifteen

I'm so sorry to hear this. RA is bad, bad stuff.
The friend I support has RA and it is hell for her. She can't keep a job because she never knows when she'll have a flare and be unable to work. She'll feel fine for a couple of weeks, but out of nowhere her foot will swell to the point where she can't put her shoes on or he wrists will swell and become excruciatingly painful. She can't drive long distances because a couple of ours at the wheel almost guarantees a flare in her wrists. She'll get soft tissue inflammations every couple of weeks. She takes methotrexate and has Remicade infusions every 5 weeks (over $4,000 each) and has tried all the naturalpathic stuff. She's big on that. She was has strong, independent, hard working woman until this disease struck her. After working and being productive for 40 years she has lost everything she owns and is in constant fear of losing what health insurance she has. Everything she manages to scrape together goes to co-pays and overdue doctor bills. She was a proud, strong woman until RA came along. It has ruined her life.

The joint swelling as described was a side effect of Remicade (and the other 2 medications I mentioned) for me......the Lupus type symptoms. "Things" were going swimmingly for about 10 months of the treatments till I awoke one morning to my right hand swollen up like a blown up surgical glove. Painful to boot.
It was Lupus like like as the swelling moved from my hand to my forearm, shoulder then down to the other hand over a period of a few weeks. To make a long story short the swelling traveled down thru my abdomen (that was exciting) and into my feet....this all took about 3 months and I had stopped taking the Remicade.
The swellings were in my feet for about 6 months, then finally ceased.

About a year later I started Humira which was good for 4-5 months then we went thru the whole routine again. Them did it again with Centrix ...So much for that class of drugs. I was too stupid to quit work and just kept on truckin on......

[Tobra]

Find the best Rheumatologist she can, maybe go to Buffalo.

[jhynesrockmtn]

Sorry to hear this. My Mom is at my house now getting ready to go home after a short visit that got longer due to a bad ear infection. She has lived with RA for over 30 years.

I'm no expert but I would suggest a dedicated form of exercise as an aid. Keep weight as low as reasonably healthy. Yoga is great, water aerobics, bike riding, low impact type stuff. Every day.

Mom hasn't done this and it shows. She will talk about feeling so much better when she does, then doesn't stick with it.

Her biggest issues have been illnesses that got worse due to suppressed immune system. Legionnaires, years of sinus stuff, several hospitalizations with pneumonia, sudden hearing loss, etc.

Now, having said all of that she is a trooper. Just got back from 2 weeks in Mexico, traveled to Greece and Turkey for 3 weeks in November, pretty active for a 76 year old who never exercised and smoked heavily until she was in her late 40's, early 50's.

[Tobra]

good call on the yoga, low impact range of motion stuff, if you don't use it you lose it is particularly true with joints.

For hands, those paraffin baths are pretty awesome

[azasadny]

We're going to visit my wife's aunt at the UofM hospital in Ann Arbor, MI tomorrow. She's a long time RA sufferer and she's not doing well on the meds. I'll ask her if she has any advice for your wife. I have liver disease, gout and osteoarthritis and I've found a few things that have helped me, but I don't know if they would be effective against RA, as it's a completely different animal. Good luck!!

[NY65912]

I've got Crohn's and have been on Humira for almost 2 years. Humira is also for RA. It has absolutely changed my life! Tell her to speak to her doc.

I had a perianal fistula, two surgeries and the Humira cleared it up in 3 days. This stuff works!