Many people hear ìrheumatoid arthritisî and think they have a good idea of what that means: bad joints for one; but joints are just a small part of the systemic disease.Valeska Davis, a 28-year-old rheumatoid arthritis patient from Colorado Springs, Colo., said many symptoms of her disease are invisible. ìPeople just don’t want to accept it,î she said. ìBecause you look fine, people think you must be fine.î However, the disease has affected her physical health way beyond joint pain. Kevin Deane, MD/PhD, is an associate professor with the Division of Rheumatology at the University of Colorado School of Medicine. Deane said rheumatoid arthritis is ìan autoimmune disease, where the immune system attacks joints.î He said itís not ìmechanicalî like osteoarthritis. ìThe particular inflammation damages joints in a hurry and can be irreversible,î he said, adding that, although the disease primarily affects joints, it also affects the heart, lungs and eyes.Kelly Young, founder of the Rheumatoid Patient Foundation and author of the Rheumatoid Arthritis Warrior blog, often states on her blog that arthritis is just one of many symptoms manifested by the disease. The American College of Rheumatology redefined rheumatoid arthritis in October 2009, and Young wrote on her Oct. 21, 2009, blog that the new criteria no longer emphasizes the involvement of the hands and wrists because of the widespread symptoms of the disease. Young echoed Deaneís statement that the disease affects the heart, lungs and eyes as well as the voice. Young said she would like to see rheumatoid arthritis renamed as rheumatoid disease because the name often confuses patients ñ and doctors.Davis was diagnosed at age 23 with rheumatoid arthritis, but she said she can pinpoint her symptoms as early as high school. ìWhen I had them so noticeable that I absolutely had to go seek treatment, I was probably 21,î she said, adding that it took a ìvery longî two years to determine a diagnosis. ìUnfortunately, it was a very typical experience for people in a younger demographic.î Many doctors attribute younger peopleís symptoms to athletic injuries. ìIt’s easy to interpret pain and swelling in someone as active as I was as injury,î Davis said. ìIt’s a logical conclusion. But injuries (that are) so widely across the body: shoulders, wrists, feet, ankles; (which are) presenting consistently ñ I wish doctors would pay more attention to that but they don’t, necessarily.îDeane said in the United States, many patients are not diagnosed with the disease until about 10 months after the onset of symptoms. ìPeople don’t go to the doctor fast enough, or the doctor doesn’t get the diagnosis in time,î he said.ìWe need to be making people aware that joint symptoms can be more than wear and tear, so they seek help; and, when they go to their P.C., they know it can be something else. Pain, stiffness, swelling in hands and feet that doesn’t seem related to injury needs to be checked out.îDavis said she doesn’t respond well to medication. ìI’ve had a lot of problems handling the medications,î she said. There have been two drugs that were effective for her, but one she quickly built up a resistance; she was allergic to the other. Drug therapy for rheumatoid arthritis includes methotrexate, prednisone and biologics infusions, Davis said.ìThe same treatment doesn’t work for everyone,î she said. ìEven though there seems to be a fair number of drugs out there, depending on how your immune system functions and your genetics, something that works for you might not work for someone else.îA roller coaster is how Davis described the daily effects of the disease. Some days she is able to do daily activities, and others days sheís bedridden.ìThe stuff I can’t do depends on the day,î Davis said. On a bad day she said picking up a full cup of liquid or brushing her hair can be challenging. ìGetting up and down from something, like from a chair ñ on bad days that becomes really, really difficult,î she said.Ken Davis, the father-in-law of Valeska Davis, also suffers from rheumatoid arthritis. Diagnosed in 1998, Ken Davis said tests indicate his symptoms are worse than most, but he responds well to drug therapy. ìI do have flare-ups, but they are infrequent,î he said.Those flare-ups usually correlate with an allergic reaction to something or a physical injury. ìMy immune system sees the injury and goes crazy,î Ken Davis said. ìBut a five-day course of prednisone will shut it down.î He said in the past 15 years treatment options have improved a great deal. ìI couldn’t dress myself without medication, and would be confined in a wheelchair. I’m very thankful. My disease is straightforward in the way it presents itself.î Deane said in the last 10 years theyíve made huge advances in treating rheumatoid arthritis. ìIf we catch it early, especially in the first three months of onset, we can put it in remission,î he said. Deane said it is tricky catching the disease that early. Early treatment is critical.Valeska Davis said there isn’t a specific foundation that supports research, although there are foundations for patient support. She said she hopes for further research. ìAutoimmune diseases have the same root,î she said. ìThe immune system is treating something in the body as an invader that isn’t. If we can arrest the process or reverse that process without destroying the immune system of the person involved, that would solve a lot of problems.îìWe don’t really know what causes it,î Deane said. ìWe’re trying to delve into that. We think most autoimmune diseases have a common pathway in development, and finding a cause in one can lead to treatment in other diseases.î He said rheumatoid arthritis is ìone of the most common autoimmune diseases out there.î It can affect men and women, but about 75 percent of the diagnosed cases are women, he said. ìThe average age of onset is 50,î Deane said. ìBut it can happen any time.î
