一个Rheumatolog的5件事ist Wants You to Know About Rheumatoid Arthritis

If you’ve just been diagnosed with类风湿关节炎（RA）, you probably have a lot of questions about the condition and what it may mean for your future health and quality of life.

This inflammatory autoimmune disease affects many people: 1.5 million U.S. adults (or 1 percent of the adult population),根据关节炎基金会.

类风湿关节炎的严重程度因人而异，可能是轻度，中度或严重的。

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When you have rheumatoid arthritis, your immune system mistakenly attacks the linings of your joints (called synovium), causing them to become inflamed and painful.

RA can begin at any age — most commonly in the forties, fifties, and sixties — and typically causes joint pain, fatigue, andstiffness持续了一个多小时。Elaine Husni, MD, MPH, arheumatologistat the Cleveland Clinic in Ohio and director of the Arthritis and Musculoskeletal Treatment Center there.

As with any condition, a number of important questions arise among the newly diagnosed, ranging from the nature of RA itself to treatment options.

Husni博士回答了其中一些问题，并解决了她和其他风湿病学家最常听到的疑问。

Here's what she has to say:

1. It’s Not Your Fault That You Have Rheumatoid Arthritis

There's a tendency among newly diagnosed patients to blame themselves, says Husni.

“One of the most common misconceptions about RA is that you did this to yourself,” she says. “We don’t really know the cause of自身免疫性疾病，但很多时候患者会问：“我做了什么来得到这个？”

Thecause of rheumatoid arthritisitself also remains unclear, but like other autoimmune diseases, it’s triggered when the body’s immune system malfunctions and attacks healthy tissues and cells,according to the American College of Rheumatology.

自身免疫性疾病，从RA到多发性硬化症和1型糖尿病, are fairly common; in fact, the美国卫生与公共服务部reports that autoimmune disorders affect more than 23.5 million Americans.

2. You’ll Want to Educate Yourself About Rheumatoid Arthritis

Another important step when you’ve beendiagnosed with RAis to become informed about the condition, says Husni.

The fears and ideas that newly diagnosed patients often have about RA usually come from the internet or somebody they know, says Husni, “so patients sometimes get misinformation. Also, I think autoimmune disease is a difficult concept to grasp.

RELATED:专家解释了关节炎和自身免疫性疾病

"Patients often ask me, ‘What does autoimmune mean? I’ve never heard this before. I was healthy my whole life.’”

Understanding RA can be a bit difficult, she adds, and patient knowledge about the condition tends to fall along a spectrum. “The first phase upon diagnosis is giving patients the correct information that they need,” Husni emphasizes.

3. Ask Your Doctor How Active Your Rheumatoid Arthritis Is

Before you can make treatment choices, you have to determine how active your RA is, which includes your disease burden, says Husni. “We now have many treatment choices in RA, and this allows us to personalize the process for each patient.

Although we do not have a cure, we are better at controlling the signs and symptoms to allow patients to return to their normal lives. We still have patients who do not respond to treatments, but this is rare and there is ongoing research to continue to improveRA treatment.”

“The three things rheumatologists normally do are a physical exam, someblood tests, and examineX射线changes in the affected joint," says Husni. "Those are the three pillars that we look at, and based on whatever they show, we can usually categorize you as having mild disease, mild to moderate disease, or moderate to advanced disease. We also want to know about the psychosocial aspects — how else does the disease affect you? This could be disturbing your sleep or mood or ability to work. We weigh all these aspects when treating an RA patient.”

RELATED:Early Rheumatoid Arthritis Treatment: Why Is It So Important?

How active the disease is will affect yourRA treatmentplan. “One of the first things we do is try to figure out where you are on that spectrum, because treatment and advice will change for somebody with mild RA versus somebody with severe RA,” she adds.

4. Other Health Conditions May Affect Your Rheumatoid Arthritis Treatment

The CDC reports that about 47 percent of U.S. adults with arthritis also have at least one other condition, referred to by doctors as a comorbid condition.

So another crucial step intreating RAis to find out if you have any comorbidities. “It’s very important to see if you haveany associated diseases or disordersthat yourrheumatologistneeds to take into account,”says Husni.

If you have depression, for example, your rheumatologist may not want to prescribe certainRA medications, because they could make your depression worse.

RELATED:6 Things About Rheumatoid Arthritis That Are Difficult to Explain or Understand

“Another example is if you have a family history of multiple sclerosis. In that case, there are some other medications that can’t be prescribed [for RA],” Husni notes.

It's also important to have a primary care physician who oversees all aspects of your health, and who can help treat any comorbid conditions you may have, along with the rheumatologist.

5. Eat Well, Stop Smoking, and Do What You Can to Stay Healthy

养成健康的习惯可能使生活在RAeasier, says Husni, adding that you’ll want to keep up with and even improve the healthy habits you already do have.

她说：“例如，现在不是增加吸烟的好时机。”quit smoking. Smoking is the strongest modifiable risk factor for RA, according to the CDC, increasing your risk by 1.3 to 2.4 times; the habit also interferes with the effectiveness of someRA medications.

“If you are overweight, this might be the time to lose some weight, because it may contribute to excess stress on your joints in addition to the RA,” she notes.

Dietis another modifiable risk factor. “Healthy eating can’t necessarily stop or cure RA,” but it can help you live better with it, says Husni.

There aren’t many studies that have a strong connection between what you eat and how well you feel with RA. Existing research is either based on small numbers of people or don’t show definitive advice on what to eat long-term. Still, if you check with your physician, you may find some relief by following aMediterranean diet, which is high in vegetables, fruit, and seafood, according to astudy published in May 2018 inRheumatology International.

Although there’s not a lot of evidence right now that diet specifically helpsRA症状, she says, “I think there will probably be a lot more information about nutrition in the years to come. I think it’s already happening, and I do believe that it will probably play a bigger role in treating RA.”