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Rheumatoid Arthritis
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Discovery :
What is Rheumatoid Arthritis?
Original symptoms and visiting a GP
Referral to a rheumatologist, tests & diagnosis
Impact of the diagnosis
Ideas about causes
Impact of diagnosis on family & others
Tests and treatments :
Choosing treatments & taking part in trials
Painkillers
Anti-inflammatory drugs
Disease modifying anti-rheumatic drugs (DMARDs)
Steroid tablets, injections & intravenous pulses
Biologic treatments: anti-TNF and B-cell therapy
Long term use of drugs
Regular monitoring and other diagnostic tests
Physiotherapy & hydrotherapy
Occupational therapy
Other hospital specialists
Surgery - introduction
Surgery - upper limb and neck
Surgery - lower limb
Outpatient clinics
Complementary and alternative approaches
Living with rheumatoid arthritis :
Diet & food supplements
Exercise
Personal life and changes to the home
Social life & relationships
Mobility, driving & transport
Work
Financial implications & financial support
Sources of support
Body image
Attitude to RA & facing the future
Self-management
Ongoing symptoms- flares, stiffness & sleep disturbance
Ongoing symptoms- pain, fatigue, depression, weight change
Pregnancy & breastfeeding
Parenting & childcare
Messages to others with RA
Messages to health care professionals
Finding information about RA
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Rheumatoid Arthritis
Subject index
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Bones & joints
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Rheumatoid Arthritis
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Disease duration 11-15 years
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Interview 29
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Access to Work helped her to obtain voice-activated soft ware and other office equipment.
RA diagnosed '90 & Juvenile RA age 8-11. Significant DMARD side-effects. Had breast cancer '98 & drugs also relieved RA. Methotrexate 15mg/week, folic acid 5mg 6/7 days, daily Diclofenac, Tamoxifen 20mg & Nibedipine 20mg. Paracetemol & Zantac as required.
Bones & joints
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Rheumatoid Arthritis
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Disease duration 11-15 years
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Interview 29
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Found out about useful organisations and aids to help her work and was surprised that her OT and rheumatologist didn't know about them.
RA diagnosed '90 & Juvenile RA age 8-11. Significant DMARD side-effects. Had breast cancer '98 & drugs also relieved RA. Methotrexate 15mg/week, folic acid 5mg 6/7 days, daily Diclofenac, Tamoxifen 20mg & Nibedipine 20mg. Paracetemol & Zantac as required.
Bones & joints
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Rheumatoid Arthritis
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Disease duration 21-25 years
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Interview 04
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She finds Incapacity Benefit invaluable and wishes she had known about it earlier.
Diagnosed '79 with rapid onset after glandular fever. Various foot surgery undergone and hand surgery planned. Symptom relief from physio/ hydrotherapy & some complementary therapies/diets. Currently Coproxamol, Methotrexate, folic acid & occasional NSAID.
Bones & joints
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Rheumatoid Arthritis
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Disease duration 21-25 years
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Interview 05
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Her parents helped her with the housework, shopping and childcare.
RA diagnosed as significant symptoms after birth of 2nd child. Complementary treatments used. Takes Diclofenac 15mg & 2 Coproxamol daily. 10 operations: hips, knees & shoulder replacement/revision; neck, ankle & toe fusions, and removal of bone in 1 elbow.
Bones & joints
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Rheumatoid Arthritis
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Disease duration 26 years plus
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Interview 22
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Suggests that people must learn to change, perhaps work fewer hours or give up work if necessary but remain busy.
Diagnosed 1964 Juvenile Chronic Arthritis. 11 years of steroids limited growth. NSAIDs 'til age 37. Now Methotrexate 10mg/wk + folic acid, daily Prednisolone 5mg, Naproxin 100mg, Niozadadine (anti-ulcer) & iron. 2 hips replaced age 26 & 2 knees, age 30.
Bones & joints
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Rheumatoid Arthritis
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Disease duration 11-15 years
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Interview 29
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Access to Work helped her to obtain voice-activated soft ware and other office equipment.
RA diagnosed '90 & Juvenile RA age 8-11. Significant DMARD side-effects. Had breast cancer '98 & drugs also relieved RA. Methotrexate 15mg/week, folic acid 5mg 6/7 days, daily Diclofenac, Tamoxifen 20mg & Nibedipine 20mg. Paracetemol & Zantac as required.
Bones & joints
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Rheumatoid Arthritis
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Disease duration 6-10 years
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Interview 30
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His company got him a motorised scooter to help him get around the workplace more easily.
Diagnosed '95 after severe ankle pain (maybe virus triggered). Subject in Anti-TNF trial. Pneumonia due to RA. Regular steroid injections prior to ankle fusion. Methotrexate/folic acid, Celebrex, Tramadol, Diazapan, Tomazapan, Prozac, Atenolol, Dothiepin.
Bones & joints
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Rheumatoid Arthritis
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Disease duration 6-10 years
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Interview 32
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She believed she faced discrimination when applying for jobs.
Diagnosed seronegative RA '97 but symptoms since '77 after flu-like virus. Took Opren but side-effects so chose homeopathy. Mid '90s significant disease progression & began DMARDS, but side-effects. Now 6 weekly Depomedrone injections (120mg), physio & hydrotherapy.
Bones & joints
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Rheumatoid Arthritis
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Disease duration 21-25 years
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Interview 13
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At his job interview he didn't tell them about his arthritis, but usually he found it easier to be open about his RA.
Diagnosed '78 after various joint pains. Knee synovectomy age 18; then 8 years quite symptom free; since RA in many joints. Some steroid pulses/joint injections. Now Gold injected 50mg/month, Meloxicam 15mg/day & Coproxamol if required. Thumb fusion operation.
Bones & joints
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Rheumatoid Arthritis
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Disease duration 26 years plus
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Interview 22
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She thinks that her disability made it easier to get some jobs.
Diagnosed 1964 Juvenile Chronic Arthritis. 11 years of steroids limited growth. NSAIDs 'til age 37. Now Methotrexate 10mg/wk + folic acid, daily Prednisolone 5mg, Naproxin 100mg, Niozadadine (anti-ulcer) & iron. 2 hips replaced age 26 & 2 knees, age 30.
Bones & joints
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Rheumatoid Arthritis
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Disease duration 6-10 years
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Interview 30
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He is sure there is discrimination in his place of work.
Diagnosed '95 after severe ankle pain (maybe virus triggered). Subject in Anti-TNF trial. Pneumonia due to RA. Regular steroid injections prior to ankle fusion. Methotrexate/folic acid, Celebrex, Tramadol, Diazapan, Tomazapan, Prozac, Atenolol, Dothiepin.
Topic
Bones & joints
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Rheumatoid Arthritis
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Work
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Work
Work
Bones & joints
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Rheumatoid Arthritis
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Disease duration 6-10 years
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Interview 26
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The symptoms were really getting him down, so he saw a specialist privately.
Diagnosed '94 after flu like symptoms & joint problems for 6 weeks. Gold injections 50mg/week, slow release Voltarol 75mg/day, pain killers, Prozac 20mg/day (depression). Steroid injections when required. 3 bone removal operations from toes and ankle.
Bones & joints
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Rheumatoid Arthritis
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Disease duration 6-10 years
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Interview 30
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He had been shocked at the impact of RA on different aspects of his life.
Diagnosed '95 after severe ankle pain (maybe virus triggered). Subject in Anti-TNF trial. Pneumonia due to RA. Regular steroid injections prior to ankle fusion. Methotrexate/folic acid, Celebrex, Tramadol, Diazapan, Tomazapan, Prozac, Atenolol, Dothiepin.
Bones & joints
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Rheumatoid Arthritis
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Disease duration 21-25 years
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Interview 13
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Has learnt to take painkillers before doing something strenuous to counteract the pain before it happens.
Diagnosed '78 after various joint pains. Knee synovectomy age 18; then 8 years quite symptom free; since RA in many joints. Some steroid pulses/joint injections. Now Gold injected 50mg/month, Meloxicam 15mg/day & Coproxamol if required. Thumb fusion operation.
Bones & joints
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Rheumatoid Arthritis
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Disease duration 26 years plus
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Interview 16
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Slow release anti-inflammatories help with early morning stiffness and the working day.
Diagnosed 1977 after shoulder pains. Diclofenac retard 100mg/day, Methotrexate 15mg/week & 5mg/day folic acid. Partial wrist & 2 finger joints replaced, thumb tendon repairs, 6 toe joint operations, ankle fusion & a back operation (not due to RA).
Bones & joints
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Rheumatoid Arthritis
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Disease duration 21-25 years
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Interview 13
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He tries to keep mobile by moving around the office and by gardening.
Diagnosed '78 after various joint pains. Knee synovectomy age 18; then 8 years quite symptom free; since RA in many joints. Some steroid pulses/joint injections. Now Gold injected 50mg/month, Meloxicam 15mg/day & Coproxamol if required. Thumb fusion operation.
Bones & joints
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Rheumatoid Arthritis
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Disease duration 6-10 years
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Interview 30
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Rheumatoid arthritis affected his marriage because he had to spend so much time resting.
Diagnosed '95 after severe ankle pain (maybe virus triggered). Subject in Anti-TNF trial. Pneumonia due to RA. Regular steroid injections prior to ankle fusion. Methotrexate/folic acid, Celebrex, Tramadol, Diazapan, Tomazapan, Prozac, Atenolol, Dothiepin.
Bones & joints
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Rheumatoid Arthritis
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Disease duration 21-25 years
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Interview 04
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She would have liked to have been an artist but didn't have the physical strength to make it her profession.
Diagnosed '79 with rapid onset after glandular fever. Various foot surgery undergone and hand surgery planned. Symptom relief from physio/ hydrotherapy & some complementary therapies/diets. Currently Coproxamol, Methotrexate, folic acid & occasional NSAID.
Bones & joints
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Rheumatoid Arthritis
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Disease duration 16-20 years
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Interview 15
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She felt depressed and had to retire early because she couldn't cope with the work.
Diagnosed '85 after 2 hospital stays for groin pain; decreased mobility & sleep disruption. Side-effects on Gold injections & Methotrexate. Has steroid pulses/joint injections & daily Meloxicam 7.5mg & 2-4 co-codamol. Starts Anti-TNF in 2 wks. Operation on toes planned.
Bones & joints
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Rheumatoid Arthritis
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Disease duration 16-20 years
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Interview 25
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She sacrificed leisure time so she could continue working.
Juvenile chronic arthritis diagnosed '85, on steroids since. Hip replacements age 23 & 32, 2 knees together at 36 & wrist/hand ops. Currently Methotrexate, Prednisolone, Rofecoxib & Tramadol. Cinnarizine & Stemetil for side effects - balance loss & nausea.
Bones & joints
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Rheumatoid Arthritis
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Disease duration 0-5 years
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Janet - Interview 56
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Janet was diagnosed in late 2006 and her illness has affected the type of work she can do. Sometimes feels depress by the limitations impose by RA on
Diagnosed in 2006. Janet takes Methotrexate 15 mg but experiences severe sickness and nausea. She will start taking Methotrexate in injection form and hopes this will reduce its side effects. She also takes: Tramadol with paracetamol; folic acid and amitriptyline at night when needed.
Bones & joints
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Rheumatoid Arthritis
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Disease duration 0-5 years
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Charlotte - Interview 55
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After her diagnosis her employers and family have each helped her in different ways to manage her working life.
Charlotte was diagnosed with rheumatoid arthritis in July 2007. The first time she saw her consultant was as a private patient because on the NHS there was a waiting period of three months. She is on Methotrexate. She feels more tired than before her diagnosis.
Bones & joints
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Rheumatoid Arthritis
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Disease duration 11-15 years
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Michelle - Interview 51
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When applying for jobs she lets them know that she is disabled. She thinks that nowadays if you meet the job criteria employers have to offer you an i
Michelle is currently on anti-TNF treatment: Humira. She has taken Methotrexate for a number of years but has had breaks in between following a biopsy that revealed liver scarring. Michelle was diagnosed with osteopenia (a milder form of osteoporosis) in her spine and needs to take calcium tablets regularly.
Bones & joints
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Rheumatoid Arthritis
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Disease duration 0-5 years
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Charlotte - Interview 55
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Her previous school allowed her to arrive late on those days when she had free periods in the morning. Her new school has asked if there is anything t
Charlotte was diagnosed with rheumatoid arthritis in July 2007. The first time she saw her consultant was as a private patient because on the NHS there was a waiting period of three months. She is on Methotrexate. She feels more tired than before her diagnosis.
Bones & joints
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Rheumatoid Arthritis
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Disease duration 0-5 years
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Sandra - Interview 63
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Sandra’s employers have been supportive and agreed for her to return to work part-time but she was expected to work mornings and it was not negotiable
Sandra was diagnosed in April 2010 and her current rheumatoid arthritis treatment includes: Cimzia (certolizumab pegol), Methrotrexate, Sulfasalazine and Hydrochloroquine. Sandra’s consultant talked to her about reducing and eventually phasing out the last two drugs. She also takes painkillers; Diclofenac and Co-Codamol and Amitriptyline at night time.
Bones & joints
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Rheumatoid Arthritis
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Disease duration 0-5 years
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Emma - Interview 61
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Emma works in the same hospital but in a less demanding ward. Previously, she worked in the A&E department.
In 2008, aged 21 Emma was diagnosed with rheumatoid arthritis (RA). Currently, she is on a combination therapy that includes Sulfasalazine, Methotrexate and Naproxen as a painkiller and a new biological drug called Cimzia (certolizumab pegol). The plan is to eventually reduce her RA medication to Methotraxate and Cimzia only.
Bones & joints
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Rheumatoid Arthritis
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Disease duration 16-20 years
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Pearl - Interview 62
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Pearl’s employers provided her with what she needed to work around her RA but she decided to take early retirement. It was just too difficult to cope
Pearl was diagnosed with rheumatoid arthritis (RA) in 1991, aged forty and was put on methotrexate. Eighteen months ago and initially as part of a clinical trial, she started to take a newer anti-TNF therapy; Simponi. Her current treatment also includes methrotrexate, but in a smaller dosage.
Bones & joints
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Rheumatoid Arthritis
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Disease duration 0-5 years
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Linda - Interview 60
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Linda’s RA has responded very well to Simponi, but she is unsure whether her PCT will provide the funds for her to continue on it once the trial is ov
Linda was diagnosed with rheumatoid arthritis (RA) in April 2010 and she is currently taking part in a clinical trial for Golimumab. This therapy, has significantly improved Linda’s quality of life. She no longer has flares ups that had previously affected her working life. She is awaiting a decision from her PCT as to whether they will pay for her to continue having this treatment.
Bones & joints
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Rheumatoid Arthritis
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Disease duration 0-5 years
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Linda - Interview 60
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Linda has responded so well to anti-TNF therapy and talks about the difficulties she experienced coping with work when her RA wasn’t been controlled b
Linda was diagnosed with rheumatoid arthritis (RA) in April 2010 and she is currently taking part in a clinical trial for Golimumab. This therapy, has significantly improved Linda’s quality of life. She no longer has flares ups that had previously affected her working life. She is awaiting a decision from her PCT as to whether they will pay for her to continue having this treatment.
Bones & joints
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Rheumatoid Arthritis
>>
Disease duration 11-15 years
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Interview 29
>>
Found out about useful organisations and aids to help her work and was surprised that her OT and rheumatologist didn't know about them.
RA diagnosed '90 & Juvenile RA age 8-11. Significant DMARD side-effects. Had breast cancer '98 & drugs also relieved RA. Methotrexate 15mg/week, folic acid 5mg 6/7 days, daily Diclofenac, Tamoxifen 20mg & Nibedipine 20mg. Paracetemol & Zantac as required.
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