Rheumatoid Arthritis ( symptoms and treatments )

 

Rheumatoid Arthritis

In Rheumatoid Arthritis, (RA) lymphocytes attack joints & cartilage. Normally the immune system targets microorganisms like virus, bacteria, fungi, and germs, etc. The immune system repeatedly subjected to infections leads to overproduction of antibodies - lymphocytes attack microorganisms but also attack host’s tissues - cartilage in the patient. RA is due to high levels of antibodies - these are like red flags which attach to bacteria but also to cartilage and synovium ( outer layer of cartilage.) The high level antibodies are significant because the intensity of the RA symptoms are less in patients when the antibodies are much lower.

•Cause of rheumatoid arthritis.

Rheumatoid arthritis is a result of interactions of your inherited genes and environmental exposures like cigarette smoke (dont know about other kinds of smoke and pollution as yet since the time lag between exposure and disease is huge making it difficult to use usual spatial epidemiology).

The greater your genetic risk, the lower environmental exposure you need and vice versa. The most important genetic risk factor in most people are genes in the histocompatibility region (MHC class II antigens) that share certain amino acid sequences in their antigen binding groove called the shared epitope. Those with the high risk shared epitopes are at tremendously increased risk of rheumatoid arthritis when they are exposed to cigarette smoke.

Factors that predispose to rheumatoid arthritis in other individuals are not known. Potential role of chronic viral infections (eg Epstein barr varus) is suspected but not proven due to historical changes in incidence of rheumatoid arthritis after the great transatlantic exchange.Role of other genes involved in immune regulation, important in some individuals who possess them, are not important at the population level.

In all these there is a huge element of change (stochastic factors) as those with the right genes and exposure are not guaranteed to get the disease.

•What is it like to live with rheumatoid arthritis?

RA is often badly misunderstood by those who’ve never been through the torture. They just expect that you can do this, walk there or lift that, and then look at you like you’re sub-human - or lazy - when you can’t. It gets even worse when fatigue and pain cause your memory to fail, and you can’t remember what you had for lunch come 5pm.

Life post-diagnosis largely consists of trying to figure out how much activity you can cope with… and then having to figure it out all over again as you get worse.

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Then there’s the pain. It comes at you randomly, hitting where and when you least expect it (hang on, my wrist was fine yesterday; now it feels like I just broke it). It shoots down your limbs. It drives you mental and leaves you in a serious grump, and then nobody wants to be around you. Then there’s the pain caused by the joint damage.

 It’s like a wild animal, all vicious teeth. It gets post-surgical in intensity (no kidding; I’ve woken up in so much pain some mornings, I’ve expected to find myself in a recovery room instead of my bedroom). Then there’s the sudden numbness/loss of limb control that comes when a nerve gets crimped by inflammation.

Then there’s the sense of inadequacy. It’s small wonder we sufferers are prone to bouts of depression. 

•How do I fight rheumatoid arthritis disease?

“Apart from current medications, I would say diet. I know of several people who have virtually eliminated the disease’s symptoms by changing what they eat. Eliminate artificial sweeteners, refined sugar, all gluten, all processed food. Some people avoid dairy. I would strip your diet down to plain beef, salt, and water, and see if it makes a pronounced difference in how you feel after a couple of weeks. Then reintroduce foods one at a time to see how they affect you.

I have virtually no symptoms after years of increasing pain and exhaustion. I take no medications for RA, nor do I want any. I currently eat meat, fish, plain vegetables, fruit, nuts, peanut butter, dairy (in moderation), eggs, corn grits and Cheerios. For sweetener I use honey. I drink tea, coffee, water, and I have a splash of whiskey instead of a beer in the evening. I take 4800mg of fish oil each day, and a multivitamin. If I stick to that, I feel like I do not even have RA. If I splurge and eat pizza or drink an IPA beer, I have RA-like symptoms for a day or two, but return to normal as I stick to my diet again.