Why Rheumatoid Arthritis Should be Treated Aggress | Arthritis Information

I posted this in the AP thread but to be sure it is seen and read, thought that I would also post it separately.

Why Rheumatoid Arthritis Should be Treated Aggressively

Multiple studies have demonstrated that early aggressive management of rheumatoid arthritis (RA) is beneficial.

These cytokines lead to insulin resistance, abnormal function of cells that line blood vessels, and abnormalities of cholesterol metabolism, causing increases in total cholesterol, low density lipoproteins (LDL- “bad cholesterol”), and triglycerides. The end result is a marked tendency to atherogenesis- “hardening of the arteries”.

This hardening of the arteries is associated with cardiovascular disease leading to a marked tendency to stroke and heart attack. The insulin resistance also contributes to other metabolic disturbances. These metabolic problems can be aggravated by the natural tendency for patients with poorly controlled RA to be subject to stress, poor dietary habits, and less than sufficient exercise. The bottom line is that the life expectancy of a patient with rheumatoid arthritis is shortened by ten to fifteen years compared with age-matched controls.

One study demonstrated a two-fold higher risk for coronary heart disease in patients with rheumatoid arthritis compared with people who did not have rheumatoid arthritis (Satter N, McInnes IB. Curr Opin Rheumatol. 2005; 17: 286-292).

Another study showed that women with rheumatoid arthritis who had had rheumatoid arthritis for at least ten years were three times more likely to have had a heart attack compared to women without RA (Solomon DH, Karlson EW, Rimm EB, et al. Circulation. 2003; 107: 1303-1307).

So... it is this important but little emphasized complication of the disease that must be emphasized to patients.

Fortunately, most of the data that has been accumulated related to the cardiovascular issues from RA were collected before the advent of biologic therapy. There is increasing evidence that aggressive management of RA employing the newer biologic agents can help reduce the increased cardiovascular complications related to RA. One example is a study showing that female patients with RA treated with TNF-inhibitors had a reduced overall mortality rate. Unfortunately, the same was not true for men in this one example (Jacobsson LT, Turesson C, Nilsson JA, et al. Ann Rheum Dis. 2007; 66: 670-675).

However other studies have demonstrated a lower rate of cardiovascular problems such as heart attack, stroke, and congestive heart failure) in patients with RA treated with TNF-inhibitors (Dixon WG, Watson KD, Lunt M, et al. Arthritis Rheum. 2007; 56: 2905-2912).

So what should the approach be?

There is still a great deal of ignorance among patients with rheumatoid arthritis regarding the above mentioned complications. Currently, many patients are under the misimpression that natural remedies are good and that drugs are to be avoided, condemned, and are all-in-all, bad. What a mistake!

What rheumatologists must do is explain the reasoning behind the need for aggressive management. It should be explained that there is a narrow “window of opportunity” that makes treatment critical.

Patients should be educated as to the pathophysiology of RA and the terrible consequences that may arise as a result of less than optimal therapy.

While an open mind toward natural therapies is important, an open mind towards the value of proper medical therapies is just as critical.

It is particularly important that patients and physicians become strategic allies together to combat this medical scourge. The aim should be to induce complete remission.

About Author Nathan Wei :

Nathan Wei, MD FACP FACR is a nationally known board-certified rheumatologist. For more info:  http://www.arthritis-treatment-and-relief.com/arthritis-treatment.html Arthritis Treatment and Tendonitis Treatment Tips

I'm a believer of aggressive medications as well Lev, but leave the door open for others to try what they think is best for them. Thank you Stephen. I have tried all aggresive meds to no avail, now im on AP and Im having a better result wit it than with any of the TNF's etc....so the door should always be left open where meds are concernedNice article Lev...Thanks for sharing "There is still a great deal of ignorance among patients with rheumatoid arthritis regarding the above mentioned complications. Currently, many patients are under the misimpression that natural remedies are good and that drugs are to be avoided, condemned, and are all-in-all, bad. What a mistake!"

That, to me, speaks to the treatment of RA with non prescription drugs... something I would not recommend anyone do.
Bodak,

I have never shut the door to anyone or suggested anyone not try what they want. If you want to try horse manure Bodak, I'd highly recommend it for you. I don't know of any member here that shut's the "door" or their minds to any treatment to any member. Members here have strongly requested the truth when others talk of the effectiveness of treatments. But then Stepen Issell, what does truth mean to a thief, right?

LEV

I agreed with the article that you posted Lev, why the negative response? As a TNF foot dragger this article gives me some food for thought. Heart attacks run on both sides of my family- my mother having her first and very serious heart attack at age 60. This study shows a greater incidence of heart attack after having RA for 10 years. For me that will be at age 57. My cholesterol is high, I have HBP although it is controlled. I have been wondering if my CRP is elevated due to RA or cardic reasons? Good question WTBF. I posted on another thread how I wondered if the degeneration of my heart valve is due to RA. I didn't think I would need a surgery on the valve until I was much older. It is a nasty disease that we have. I think that so many rheumatoid arthritis sufferers still don't realize how very dangerous our disease really is. That is why I get so very offended by people that do not have our disease coming here trying to tell us how to live our ra lives. Our disease can very well end our lives. It is a deadly disease, not just a crippling disease. It is so important to have a medical team that stays way ahead of our possible ra related health issues, including heart and artery problems. I think that as hard as it is to make our friends and relatives understand how very serious our disease is, I think that many ra sufferers themselfs, still don't understand how very sick they really are and just how very serious ra really is.

LEV

[QUOTE=levlarry]Our disease can very well end our lives. It is a deadly disease, not just a crippling disease. ... I think that many ra sufferers themselfs, still don't understand how very sick they really are and just how very serious ra really is.[/QUOTE]
Although I thought that I was pretty knowledgable about RA and it potential for organ involvement it was not until I found myself in the center of the chaos of discovery that I realized just how ignorant about this disease I am.

I am paying a rather steep price for my ignorance and my stubborn refusal to accept that my initial choice of therapy was neither adequate nor appropriate for prevention.

Thanks for this important reminder Lev.

RA is very serious but so it flying, crossing the road, and getting in a car. As long as you see a good Rheumy, listen to his/her advice , treat your RA with respect then its no more serious than the above. Just make yourself knowledgeable about it but dont let it scare you. Have regular check ups and ask your DR lots of questions. We celebrated my Aunts birthday last night, she has had RA for 40 odd years now and she was 45 when she got it, she has never had any other complications other than the pains and swellings of RA and only ever taken meds that are now not used in severe RA so it doesnt always mean an early death sentence or a life with other problems. I know it does happen as others on here can testify but to any newbies on here please dont think its going to kill you. If you are sensible and know your body well then you will be okay.

I would consider your aunt a lucky woman, Pin.

maybe it doesn't always mean an early death sentence... but why risk it?

I won't be unaggresive in my treatments...... I feel I can't... I've had the disease already 40 plus years..... not in it's worst stages all that time... but IDK what it's been doing internally.......

I want the big guns..as is my option...

and to not use them... is anyone's.....

we all have our choices based on our experience and expectations...

that's what I need .......having the options....

babs102009-06-21 07:54:52 [QUOTE=Mrs Pincushion]RA is very serious but so it flying, crossing the road, and getting in a car. As long as you see a good Rheumy, listen to his/her advice , treat your RA with respect then its no more serious than the above. Just make yourself knowledgeable about it but dont let it scare you. Have regular check ups and ask your DR lots of questions. We celebrated my Aunts birthday last night, she has had RA for 40 odd years now and she was 45 when she got it, she has never had any other complications other than the pains and swellings of RA and only ever taken meds that are now not used in severe RA so it doesnt always mean an early death sentence or a life with other problems. I know it does happen as others on here can testify but to any newbies on here please dont think its going to kill you. If you are sensible and know your body well then you will be okay. I am not a spokesman for any drug therapy or drug company, all I am saying is early, agressive treatment is proven to be the way to go in getting ahead of this disease. RA should scare you... you should be aware of all the complications of this disease and know they are not that rare! I know I would have treated it differently if I had been more educated about RA when first diagnosed.

Babs I didnt say be unaggressive my point was dont spend half your life worrying that its going to kill you. Yes be sensible in your treatment I agree there but to worry that you could get "this or that" from the disease is like handing yourself a life long full of worry. Cancer doesnt always kill you but its a serious disease with serious side affects and has to be treated aggresively. RA is like any serious disease, treat it, respect it but enjoy life.

Waddie. Im sorry about your grandmothers and yes RA can cause complications that can be life threatening but not always. Again Im not saying dont treat it , thats paramount but it doesnt always cause complications and id hate newbies to come on here and think they are going to die due to RA. My father died at 66 from a massive heart attack, this had nothing to do with RA, My hubbys father died at 44 from a lung condition that also had nothing to do with RA so any thing can kill you. I refuse to worry that Im going to die just because I have RA. I see my Rheumy often, I can not take TNF's I have tried everything else so my only option is Antibiotics I dont have another choice and I live my life with lots of changes but I still refuse to worry, worry will kill me.

This is with no disrespect to anyone elses thoughts on RA

[QUOTE=Mrs Pincushion]

[/QUOTE]

no worries, Pinnie..... 99% of my day is not spent thinking about this disease... I am living my life and loving every minute of it... but in that one percent? I take my meds... think about my diet.. and plan my exercises..... I make the choice to be aggressive so that in my future........ I dont' have to think much about it either... [QUOTE=waddie] [QUOTE=Mrs Pincushion]RA is very serious but so it flying, crossing the road, and getting in a car. As long as you see a good Rheumy, listen to his/her advice , treat your RA with respect then its no more serious than the above. Just make yourself knowledgeable about it but dont let it scare you. Have regular check ups and ask your DR lots of questions. We celebrated my Aunts birthday last night, she has had RA for 40 odd years now and she was 45 when she got it, she has never had any other complications other than the pains and swellings of RA and only ever taken meds that are now not used in severe RA so it doesnt always mean an early death sentence or a life with other problems. I know it does happen as others on here can testify but to any newbies on here please dont think its going to kill you. If you are sensible and know your body well then you will be okay.

[/QUOTE]

Pinny, I am afraid I respectfully disagree. I, too, have been through the drug merry-go-round and had complications from said drugs. However, one should treat this disease as if it has the potential to kill you - because it does. The more I have read about heart complications, not just in this article but many others, early death due to cardiac complications is very, very real.

Both of my grandmothers had RA, one died at the age of 76 with complications due to RA, the other died of a massive heart attack at age 58. RA? Possible, this was in '70, so awareness of such things didn't go that far, but knowing what I know now, I suspect so. Neither were ever on any medications for RA.

I think this article also brings to light how some RD's are also complacent in speaking frankly with their patients about the true consequences of this disease. It is easy to give someone a prescription and tell them everything will be alright, especially in a busy practice. I had one RD, my second, who told me in '99 she would not prescribe Enbrel because I could still walk and talk... she reserved the drug for extreme cases because too little was known about it then. We moved and my new RD asked why I was not on Enbrel and put me on it right away. I already had lung involvement at the time.

I am not a spokesman for any drug therapy or drug company, all I am saying is early, agressive treatment is proven to be the way to go in getting ahead of this disease. RA should scare you... you should be aware of all the complications of this disease and know they are not that rare! I know I would have treated it differently if I had been more educated about RA when first diagnosed.
[/QUOTE]

Very wise and powerful words Waddie.......Thank you for sharing them [QUOTE=waddie]I am not a spokesman for any drug therapy or drug company, all I am saying is early, agressive treatment is proven to be the way to go in getting ahead of this disease. RA should scare you... you should be aware of all the complications of this disease and know they are not that rare! I know I would have treated it differently if I had been more educated about RA when first diagnosed.[/QUOTE]
Well said, thank you. I absolutely agree, I do not live my life in fear nor shrouded in worry about RA nor any of its co-morbidities. However, I NEED to be fully cognizant of the possibilities and the potentials. As you so eloquently remind us, complications are not that rare and yes, those complications can be deadly.

I too wish that I would have been more aware, more astute, more knowledgable about RA when I first began treatment. I would have done things differently.

To the power of knowledge!
[QUOTE=Spelunker] [QUOTE=waddie]I am not a spokesman for any drug therapy or drug company, all I am saying is early, agressive treatment is proven to be the way to go in getting ahead of this disease. RA should scare you... you should be aware of all the complications of this disease and know they are not that rare! I know I would have treated it differently if I had been more educated about RA when first diagnosed.[/QUOTE]
Well said, thank you. I absolutely agree, I do not live my life in fear nor shrouded in worry about RA nor any of its co-morbidities. However, I NEED to be fully cognizant of the possibilities and the potentials. As you so eloquently remind us, complications are not that rare and yes, those complications can be deadly.

I too wish that I would have been more aware, more astute, more knowledgable about RA when I first began treatment. I would have done things differently.

To the power of knowledge!
[/QUOTE]

Ladies.... you are SO right!! Pincushion,

Equating the dangers of everyday life as the same as the dangers of rheumatoid arthritis gives me some insight into how someone (you) can collapse from the fatigue and pain from a shin and a finger. Lucky you don't have the pain and fatigue I have in practically every joint, your feeble heart would probably just overload and explode or you could at least fake it pretty good. I say it on a constant basis. Rheumatoid arthritis is a very serious, dangerous disease that can/may very well kill us. Rheumatoid arthrits sufferers, newbies or us oldies all need to be scared just as those that live in the jungle stay scared of the lions and those along the rivers fear the croc. I really can believe you posted this, it's so you: "If you are sensible and know your body well then you will be okay." You need to get to know your body, because then maybe you will be okay. Newbies and oldies alike need to be scared, very scared. It is a deadly disease. Got it?

LEV

So you are now a mind reader Lev...how the heck do you know how much pain I have you moron. This isnt a "lets see who has the most pain contest. Im not scared of my RA Lev nor will i let you scare monger others....Cancer is a deadly disease but my friend who is fighting it is genuinly not scared of it . To live in fear is to not live, its to survive and i will take good care of my RA as i know my medical team are doing everything to help me. To scare people like you are doing is cruel.

edited to add. rather educate people than scare them

Mrs Pincushion2009-06-22 14:35:33[QUOTE=Mrs Pincushion]

edited to add. rather educate people than scare them

[/QUOTE]

Maybe I'm not reading this post correctly, does it say to educate people rather than scare them is cruel? Or is there another way to read this post? I hope that it's not alluding that education is cruel or that posting information, clinical studies and personal information about complications is cruel.

Like Waddie and Shug, if I had known 12 years ago about the complications caused by RA I would have continued my meds when I started to feel better, instead of stopping them for several years. During that period of time I developed ILD. Wish I could turn back the clock on RA and it's complications. but I can't. I can and will continue to teach people about RA and it's complications by talking with them, facillitating a chronic disease group, and posting relevant information and sites. I don't want to see people do what Shug, Waddie and I did - not take this disease as seriously as we should have. Lindy

"Newbies and oldies alike need to be scared, very scared. It is a deadly disease. Got it?"

No Lev, they do not need to be like you and run around scared to death.
What a load of rubbish comes out of your filthy little pea brain at times.
You are not a leaders arshole.

People need to be educated, not scared to death as Mr no brain Lev would have you.

Now I'm going to grab the camera and do something that is healthy and constructive.
Anyone wishing to tag along is welcome..

[QUOTE=LinB]I don't want to see people do what Shug, Waddie and I did - not take this disease as seriously as we should have. Lindy [/QUOTE]

Exactly. I am always appreciate of a link, article, item, personal anecdote that adds on more piece to the puzzle. If gaining knowledge about RA scares me, it is because it should.

Repeating myself, I do not live my life in fear but I want to fully understand all the possibilities.
I'm with the scared group.... and I believe, with good reason...... and time will tell if it is worth it to be concerned and frightened and worried enough to maximize treatments.... worried enough to read anything I can to help myself learn, understand, and utilize the tools given to us by research!! Every single person on this Earth is terminally ill...we are all going to die. Some of us painfully, some of us earlier than we would hope, some of us suddenly, some of us alone and some of us surrounded by loved ones.

It goes without saying I would have thought, that educating yourself on ANY affliction you may have would be the norm. I dont believe anyone here has said anything other than that.

I am not the slightest bit ' scared' of my dis- ease, rather, I respect it and try to understand it. I dont like the drugs, or how it makes me feel, but I am not scared. Fear is a wasted, damaging emotion and I would hate to think anyone will spend the rest of their lives in that state. Even you Lev!

And another thing....I know Im going to go astral travelling when Im done on this Earth. Whats to be scared about?

I don't "fear" RA, but I respect it...I want to know everything I can about my illness so that I can make informed choices about my treatment and my meds. I'm in a partnership with my RD. I want to make decisions based on facts, research, what I feel is right for me and my RD opinions.........Knowledge is power!

I did say respect it and educate yourself LinB and that Lev scaring everyone is stupid .

I agree that to ignore things and not to do do anything about them is taking your life into your own hands but education goes a long way over sittting around being scared by the words of wisdom from Lev

a good healthy dose of fear is a good thing.....

good forr you...Lyndee going off w/ your terminal illness..

I'll be leaving kicking and screaming and fighting it all the way.... I like it here ;) and I have lots of friends and precious family that I am not ready to leave...... whether it be my choice to stay or someone greater's...... I'll do what I can to have it my way... and have my time here on earth be the best it can be.....

Babs......Nascentes morimur.

Lyndeenz my father had that tatooed on his arm.....very good saying. so inbetween we live it to the full[QUOTE=babs10]

I know that, Lyndee....... but you certainly don't have to be assisting

[/QUOTE]

Huh?? Assisting in what? Oh I get it...I should talk about immortality maybe?? Sheesh..toughen up Babs.

Carpe diem quam minimum credula postero I think we have to trust in tomorrow, its what keeps us focused, its why we plan things. If I didnt trust in tomorrow I would never have had chuldren.I do trust in the morrow... but I feel that fate is not certain.... and that we make choices that aid in our lives and living...

I have been scared, very scared, of the diagnosis of an extra-articular manifestation of RA and have had moments of deep regret that I did not follow a more aggressive regime early in the disease process.

If being scared at a diagnosis of kidney failure is a sign of either mental or emotional weakness, then I am a weakling. I can accept that.
[QUOTE=Spelunker]I
If being scared at a diagnosis of kidney failure is a sign of either mental or emotional weakness, then I am a weakling. I can accept that.
[/QUOTE]

That's not a sign of weakness at all! And I never meant to imply in any way that it was.....

[QUOTE=babs10]I do trust in the morrow... but I feel that fate is not certain.... and that we make choices that aid in our lives and living...

[/QUOTE]

Fate is never certain or as my Mother used to say..."You could get hit by a bus tomorrow...Enjoy the day!"

I've seen way too many people with RA who don't understand how serious uncontrolled disease can be...they equate the absence of pain with absence of disease. If scareing someone about potential consequences means they will take their disease seriously then I'm all for itWhy scare someone into realisation. why not give them the facts and the info . My Rheumy explained everything to me in great detail, gave me lots of reading material, I belong to a support group who meet once a week, I am on the volunteer list at the childrens hospital for mobility problems and speak to some amazing people who are so clued up about their illness, even the kids know whats what. If you dont know enough about your illness and that goes for all illnesses its up to an individual to make sure their doctor and medical team explain it and the side effects.

If you scare someone they are more likely to stick their head in the sand and not want to know.

Who smokes here? What do you do when you see an advert for stopping smoking, you ignore it as they are trying to scare you into giving up. If you go and see your doctor and talk to him/her about it , speak to other smokers who have lung conditions then it hits home more.

Pincushion,

That's a good thing? Not scaring them into saving their lives? We can introduce our children to male on male sex but let's not show the devastaing effects of unprotected male on male sex. Let's not try to scare our kids by showing dead people and prisoned people who died and are incarcerated because of drugs. Certainly we don't want to scare them. If our schools would give even equal time to sexually transmitted disease as the same time given to homosexuallity, there would be much less promiscuity. We don't want to show the children a picture of a female genitalia infected with sexually transmitted warts so thick that no one can tell what it is, we may scare them to a long life. It's not scaring anyone to death, it's scaring them into living a long life. And to use even your reasoning, "Why scare someone into realisation. why not give them the facts and the info ." Newsflash, the facts and info, it's gonna scare 'em, it's a scarey, deadly disease. You just want to argue. Had I taken the stance that ra isn't scary, you and the rest of the EULOIALL and the fly that follows the smell, would have the opinion that I have now. It's just that simple and that's pretty simple stuff.

LEV

Lev you are sick..really sick...really really sick and I think you need help

You are perverted. who was on about sex and children..Im reporting this .This is a RA associated board and you have gone beyond the limit of tolerance and anyone who agrees with Lev you are as sick as him

Pincushion,

You aren't going to report me to the Queen again are you? Or maybe Sandra? Now I'm really, really scared.

LEV

you think this is funny Lev.....you are a pervert through and through

Well Pin, I have thought that for years about Lev. One time he wrote about feeling all good down there, or something like that. I thought he was a perv at that time. I think he writes some of this stuff and then reads it to get off. I think it is sick and I hope you do report him. I wouldn't be surprised if he doesn't run a ** site.

Lev, you don't have to scare children when teaching. You present them the facts. You show them what can happen through whatever aids they learn by. They ultimately will decide what they want to use and not use. You seem to forget that at some point in a childs life, they develop a sense of thinking nothing can happen to them. This happens during the years when they are at the height of puberty. This is when much of the teaching goes out the window. You can reintroduce the info but it is up to them if they want to learn it. But to scare them is wrong. Fear does not equate to a good eduation. Oh, and another thing. You teach them that it is OK to use condoms. You don't teach them that they will go to hell if they have sex. It is not realistic.

who is sick?

Babs

We were talking about RA and agression and how we felt about it. Lev then started talking about children and male on male sex, show ng school children picture....and you ask who is sick. Well if you agree with him that its a decent post you are as sick as him

Hey Lorster,

I have a thousand dollars with your name on it if you can find a thread where I made a comment about "feeling all good down there". I don't talk that way in my actual life and not in my virtual life. You are dog vomit. Just like your good friend Pincushion told that nasty filthy lie about me making racist statements against her mixed/black godchildren because they are black/mixed, she still can't post that lie. How filthy is your friend Pincushion? Just about as filthy as you. Birds of a filthy feather stick together. And Lorster, it's been my experience in life that people that talk about sex and others sex, usually are getting none. It's no surperise that two lowlife liars are good AI buddies. Please, both of you, report me. You two are just a couple of filthy, nasty liar pigs. Now you can report that too. And Lorster, Phats is right, every patient that you come in contact with is certainly in danger.

LEV

I wonder how anyone can educate themselves about the horrific things that RA "might" do and not be at least temporarily scared by what they are learning.

However, I am willing to admit that it is not only possible, but also probably that statements such as, [quote]One study demonstrated a two-fold higher risk for coronary heart disease in patients with rheumatoid arthritis compared with people who did not have rheumatoid arthritis (Satter N, McInnes IB. Curr Opin Rheumatol. 2005; 17: 286-292).

Another study showed that women with rheumatoid arthritis who had had rheumatoid arthritis for at least ten years were three times more likely to have had a heart attack compared to women without RA (Solomon DH, Karlson EW, Rimm EB, et al. Circulation. 2003; 107: 1303-1307).

So... it is this important but little emphasized complication of the disease that must be emphasized to patients.[/quote] are only scary to me.

Personally, I do not find such information to be 'scare-tactics', but yes the potential for extra-articular harm does alarm me. The article that opened this topic also states, [quote]There is increasing evidence that aggressive management of RA employing the newer biologic agents can help reduce the increased cardiovascular complications related to RA. One example is a study showing that female patients with RA treated with TNF-inhibitors had a reduced overall mortality rate.[/quote]

I have read and reread the article and find it to be well-balanced and accurate.
Spelunker,

This is the truth. I thought it amusing for at least my first year of ra if not longer. As my disease progressed, I became more and more aware of all the parts of my body that rheumatoid arthritis can attack and damage which is almost every thing and part. When I had a part of my colon removed, the only scar on my body, I then realized that I can die. At that time, I became scared of rheumatoid arthritis because rheumatoid arthritis can kill me, slowly or quickly. So I stay scared and aware. It is extremely important to catch every bullet that rheumatoid arthritis shoots at me. I have aggressive severe rheumatoid arthritis. I used to think that rheumatoid arthritis was like a walking rigormortas for people like me that had died but were too stubbern or too scared to leave. I am scared. I am scared. And I have that right.

LEV

Lev,

You know no such thread exists. She proved that she is a liar and filth. Don't worry about her, she just needs her meds adjusted.

Phats

[QUOTE=levlarry]Hey Lorster,

LEV

[/QUOTE] Quote from Lev.
" It is extremely important to catch every bullet that rheumatoid arthritis shoots at me. I have aggressive severe rheumatoid arthritis. I used to think that rheumatoid arthritis was like a walking rigormortas for people like me that had died but were too stubbern or too scared to leave. I am scared. I am scared. And I have that right."

Lev, while you are running around scared and trying to scare everybody else, you will not see the bullet that finally gets you.
For goodness sake man, go and do something that is more beneficial to your health, both physicaly and mentally rather than spew your tripe at others.

You should be a member of good standing Lev, about time you started to act like one.
[QUOTE=Bodak]Quote from Lev.
" It is extremely important to catch every bullet that rheumatoid arthritis shoots at me. I have aggressive severe rheumatoid arthritis. I used to think that rheumatoid arthritis was like a walking rigormortas for people like me that had died but were too stubbern or too scared to leave. I am scared. I am scared. And I have that right."

Lev, while you are running around scared and trying to scare everybody else, you will not see the bullet that finally gets you.
For goodness sake man, go and do something that is more beneficial to your health, both physicaly and mentally rather than spew your tripe at others.

You should be a member of good standing Lev, about time you started to act like one.

[/QUOTE]

Lev go back a few posts...it was you who brought up sex!!! No one else mentioned it before you posted that vulgar post[QUOTE=Spelunker]I have been scared, very scared, of the diagnosis of an extra-articular manifestation of RA and have had moments of deep regret that I did not follow a more aggressive regime early in the disease process.

If being scared at a diagnosis of kidney failure is a sign of either mental or emotional weakness, then I am a weakling. I can accept that.
[/QUOTE]

Shug! It is the strong who can look the lion in the eye!! You are not weak at all!! my heavens!! initial fright is expected...but taking the animal by the fur and shaking it up and vowing to fight the good fight as you are is a strong person!! A weak person hides their eyes and hopes the lion will leave them alone, denies he exists, goes on about his business like it's not something to fear!!

No.. you are not weak my friend.

Stephen Issell,

I'll keep dodging the rheumatoid arthritis bullets and you just keep dodging the government officials that you are fooling in order to get your 75 dollar a week welfare/disability check. Why don't you get a job and quit mooching off of your government? What a lowlife. You are nothing but a thief. I certainly would not accept advice from a common criminal and lowlife such as you stephen Issell. Don't you think that you should write to the author, Doctor Wei a tell him to quit scaring ra sufferers, he is the one that talks about some of the scarey sides of ra. Stephen Issell, when you quit stealing from this forum, maybe I will have some respect for you. I know you complained that the government only gives you seventy five dollars a week so you "can't afford to advertise, but hey, GET A JOB. Quit being a "mooch" stephen issell.

Pincusion,

It was not sexual , it was anti-sexual. You and the rest of the EULOIALL are some very weird people. How's that reporting going?

To everyone else, I was scared of the drugs and then found that the drugs are quite safe. It's the disease itself that is scarey because it is so dangerous.

LEV

Stephen- dont worry im doing the same, fooling my government for my disability money and my car that I get...My doctors reports are false and he too is conning the government so i can get my disability money......NOT!!

Jealousy now lev???? so many emotions are coming out in you. Im sure your respect is the last thing Stepehen or anyone else is bothered about. I wouldn t respect you if you turned out to be george clooney in disguise.

Pincushion,

You are an idiot, no offense.

LEV

Levlarry....

you make me laugh so I thank you for that if nothing else.

And....

Clueless to the core, and brave as befits your lack of intellect
I bet you think that a quarterback is a refund
You wouldn't know a clue if it walked up to you, bit you on the ass, and announced I AM A CLUE
If there's an idea in your head, its in solitary confinement
You'd sell your car to buy gas
Have i gone deaf? I don't hear any right answers
In the land of the witless, the half-wit is king
They say an empty vessel makes the most noise. Well, its deafening in here right now
You not only sound like an imbecile, but I'll hazard a guess you look exactly like one too
Don't let your mind wander - it's far too small to be let out on its own
You are as quick as a slug stuck in a molasses spill
I don't know what your problem is, but I'll bet it's hard to pronounce
Next time you go to a mind reader try and remember that you are entitled to a substantial discount.
Do you ever wonder what life would be like if you'd had enough oxygen at birth?
I'd like to slap you senseless but I see someone already has
Apparently the only time you have something on your mind is when you wear a hat
Surely you can do better than this
Anyone caught cheating at trivia will be banned from it
Computers should come with a lock-out option for people like you that can only be unlocked by getting above 90 on an IQ test
If your IQ was two points higher, you'd be a rock
I would like to insult you, but the sad truth is that you wouldn't understand me
Isn't it dangerous to use one's entire vocabulary in a single answer?
Your incompetence is an inspiration to idiots everywhere.
If there was a Pandora's Box of stupidity, you would be its contents
You must lose arguments with inanimate objects.
Your gates are down, the lights are flashing, but the train isn't coming
A thought crossed your mind? Must have been a long and lonely journey
I hear that some people get questions right and score points
I'd explain it to you, but I left my crayons in my other jacket
If brains were dynamite, you wouldn't have enough to blow the kneecap off a flea
You all sounded reasonable...Time to up my medication
I'm not being rude. You're just insignificant
I'm glad to see you're not letting your education get in the way of your ignorance
Why make a fool of you when you are doing such a fine job of it yourself?
Could you use your brain for something besides holding the stupid haircut up?
How can I keep an idiot in suspense? I'll tell you later

lolol. xxxxxxxxxxxxxxxxx

LyndeeNZ2009-06-24 05:28:59Oh and Pincushion,

Do I believe that you are low enough to lie to get the government to pay you. Yes. I don't think there is anyone from this forum that doesn't know that you are a big fat liar. It doesn't even seem to bother you when you get caught and so that shows that you are an habitual liar.

LyndeeNZ,

I didn't read what you wrote. You are aliar too as I showed in one of my posts with a repost from you making you a liar too. What a surprise that you flock with birds of a lying feather. Look at the surprise on my face. Another scumbag that thinks that posting other members personal information is good fun and then terrorize their familiy. You certainly deserve to be a member of the EULOIALL.

LEV

Lev chickadee......

ETA: You forgot Filthy! Dont forget that Im Filthy!! lolol

Sad man.

Sorry Lev but you got that fact wrong about me too, never felt the need to lie about anything in life...Liars always get caught out in the end......

Treatment Approaches

The question of how early and how aggressively to treat RA has been the subject of great debate. Among patients with RA, some will go into remission and remain in remission for the length of their lives even in the absence of treatment, while others will go on to develop active, sometimes severe RA.

Current practice has moved towards treating the disease aggressively while it is in its early stages to help prevent it from reaching a more severe and chronic state. Studies have found less joint damage in patients with early, aggressive treatment, particularly with the use of DMARDs and TNF modifiers in combination with methotrexate. Intensive early dosing of methotrexate may help slow progression of rheumatoid arthritis. Early combination therapy with DMARDs and corticosteroids is also showing good results.

Patients who have not been helped by one drug often benefit from a combination of drugs. However, over a longer period of time, it is not clear whether a drug combination approach offers many advantages over single drugs. It is also not certain which combination of drugs works best. Depending on your particular health condition, and how you respond to the drugs prescribed, your doctor may try various treatment strategies.

Current DMARD guidelines from the American College of Rheumatology recommend:

Single DMARD. Methotrexate or leflunomide as initial therapy for most patients with RA
Dual DMARD Therapy. Methotrexate plus hydroxychloroquine for patients with moderate-to-high disease activity
Triple DMARD Therapy. Methotrexate plus hydroxychloroquine plus sulfasalazine for patients with poor prognostic features and moderate-to-high levels of disease activity.
Anti-TNF DMARDs. For patients with early RA (less than 3 months), etanercept, infliximab,or adalimumab (along with methotrexate) should be reserved only for patients with high disease activity who have never received DMARDs. For longer duration RA, anti-TNF drugs are recommended for patients who have not been helped by methotrexate.
Other Biologic DMARDs. Abatacept and rituximab should be reserved for patients with at least moderate disease activity and poor disease prognosis who were not helped by methotrexate and other nonbiologic DMARDs.

http://health.nytimes.com/health/guides/disease/rheumatoid-arthritis/treatment.html

EARLY, AGGRESSIVE THERAPY BEST FOR RA

Twenty years ago, doctors believed the best protocol for treating rheumatoid arthritis (RA) was to start slow and build gradually until an adequate level of pain and inflammation control was reached. This way of thinking has changed over the years, and physicians now treat RA much more aggressively from the time of diagnosis. With the advent of new biologic medications, the treatment possibilities for people with RA are many and their appropriate use is still being established.

Several key studies released data in 2008 provide physicians with more information on which to base their treatment decisions. Two of note showed that traditional disease-modifying antirheumatic drugs (DMARDs) can be used with excellent effect. Three others showed effective uses of adalimumab (Humira) in the treatment of RA.

One study used traditional DMARDs, comparing a step-up approach to therapy (sulfasalazine alone; then after 3 months, methotrexate was added; and when the maximum tolerated dosage of methotrexate was reached, hydroxychloroquine was added) against parallel triple therapy (giving the three drugs at the same time from the beginning). The research team found that highly effective control of disease activity can be achieved using conventional DMARDs as part of an intensive disease management strategy. In this study, step-up therapy was as effective as parallel triple therapy.

Another study found that people with RA who respond well to methotrexate therapy – achieving a low disease activity score within four months – continue to have very good clinical responses throughout the first year. An initial good response to methotrexate defines a sub-population of people with early RA who can expect excellent one-year clinical prognoses.

Now that the biologic adalimumab has been on the market for several years, long-term study results are being released. Five-year results of the ongoing PREMIER study were released at the American College of Rheumatology Annual Scientific Meeting in October. This study compared the effectiveness of adalimumab in people with early RA (less than 3 years’ duration) by comparing initial adalimumab plus methotrexate therapy, adalimumab alone, or methotrexate alone for two years. After the first two years, participants were able to continue taking adlimumab either with methotrexate or not. After a total of five years, combination therapy led to the best long-term inhibition of radiographic progression, best clinical remission rates, and best reduction of inflammation as measured by C-reactive protein.

For more information on medications used to treat RA and other forms of arthritis, visit www.arthritistoday.org.

http://www.arthritis.org/topten2008.php[quote]aggressively while it is in its early stages to help prevent it from reaching a more severe and chronic state. Studies have found less joint damage in patients with early, aggressive treatment, particularly with the use of DMARDs and TNF modifiers in combination with methotrexate.[/quote]
[quote]This way of thinking has changed over the years, and physicians now treat RA much more aggressively from the time of diagnosis.[/quote]

The mantra: early, aggressive treatment; tight control; remission.
[QUOTE=Spelunker][quote]aggressively while it is in its early stages to help prevent it from reaching a more severe and chronic state. Studies have found less joint damage in patients with early, aggressive treatment, particularly with the use of DMARDs and TNF modifiers in combination with methotrexate.[/quote]
[quote]This way of thinking has changed over the years, and physicians now treat RA much more aggressively from the time of diagnosis.[/quote]

The mantra: early, aggressive treatment; tight control; remission.
[/QUOTE]

MINE TOO, Shug..... I want to beat this animal!!

Count me in. LI *hope* everyone is listening! Listening Waddie, but what do you do when all these aggressive meds dont work for you or you are allergic to them? You go back to taking mtx then when that doesnt work you try AP....

Yes, Pinny, you try AP, as you are doing and me too! IDK if you know I am also on minocycline? I feel very lucky to have it in my arsenal! AP, from what I have read, can be quite an aggressive treatment when taking several abx at the same time or with IV abx. Most assuredly, you have been treating your RA as aggressively as possible.

No one has said on this thread anything negative concerning AP, only to pay attention to how aggressively your RD treats your RA, no? I really see no conflict here.
Oh Waddie I wasnt causing conflict with you or AP , was stating what I have done as far as my treatment and agressiveness....there seems to be no other alternative at the moment, but I live in hope. xI'm listening and am glad that my RD believes in aggressive treatment, especially for the newly diagnosed. I'm feeling pretty good for the most part, still working and taking part in things. Had I not move onto a biologic early, I'm not so sure that would still be the case.

Would I try AP if all other meds didn't work or I was allergic to them? I would think yes, especially if the alternative was no meds. Would I start with AP first? No, I wouldn't. I'm not knocking anyones choice of treatment as it's an individual decision, it just wouldn't be my first choice of treatment.

Aw Pinny, I am so sorry! I didn't mean to imply you were causing conflict!

Waddie,

What kind of reactions do you get when you take other dmards? I'm just curious. I guess those of us who have a lot of options are lucky.

Phats

[QUOTE=waddie]Aw Pinny, I am so sorry! I didn't mean to imply you were causing conflict! . Please read this information if you are new to RA. TTT, although the discussion took some few unexpected turns, it is certainly worth revisiting, re-evaluating, reassessing, and pondering upon.

[QUOTE=levlarry]I posted this in the AP thread but to be sure it is seen and read, thought that I would also post it separately.

Why Rheumatoid Arthritis Should be Treated Aggressively