Rheumatoid arthritis
October 11, 2011 3:33 PM   Subscribe

Someone I know was recently tentatively diagnosed with rheumatoid arthritis and I have two questions: what should he know going in to this and who are some good rheumatologists in the NYC area?

What can a physically active 30 year old man expect with a (still tentative) diagnosis of rheumatoid arthritis?

Who is a good MD in the area who he should get a referral to?
posted by sciencegeek to Health & Fitness (10 answers total) 2 users marked this as a favorite
I think general consensus is that Hospital for Special Surgery is the best place to go for a Rheumatlology referral in NYC.
posted by JPD at 4:27 PM on October 11, 2011 [1 favorite]

I have a slightly different but similar form of inflammatory arthritis and was diagnosed at age 32. What he should know is that arthritis sucks a lot. Many people don't understand that inflammatory disease is more than just pain--the chronic fatigue is more annoying and the joint damage is more concerning.

He should also know that there have been some amazing medical advances which mean that people with these conditions have much better quality of life than in the past. The biologic drugs, like the TNF inhibitors, have been life changing for me and many other people. Exercise is amazingly important for maintaining health and mobility, and these drugs have allowed me to exercise.

Finally, he should know that he is not alone. Most people tend to only hear of osteoarthritis and think about senior citizens, but inflammatory arthritis affects little kids and autoimmune diseases in general are most commonly diagnosed in people in their 30s. There are so many online and in person support groups that he should check out for advice. Although it sucks for my disease, the Artnritis Foundation has fantastic resources for people with RA.

Good luck to your friend. I know what he is going through.
posted by hydropsyche at 4:47 PM on October 11, 2011

I was diagnosed at 17 (originally RA but my diagnosis has changed over the years as the diagnostic tools have improved) and would like to second everything hydropsyche has said. In particular, remaining active is key, as fatigue and pain will make it much harder to get back to exercising if he falls off the wagon. Best of luck to your friend.

(As his friend, please remember that his inability in future to do things with you doesn't mean he doesn't like you or doesn't value your friendship. There will almost certainly come a time when he has to make hard choices about what he can and cannot do. Sometimes folks with chronic illness have to turn down opportunities they'd love because they physically can't manage it all. I know you didn't ask that question, but I hope this knowledge helps you anyway.)
posted by immlass at 4:57 PM on October 11, 2011

NYU is another good place to look for rheumatologists. They have a very useful referral service.
posted by the young rope-rider at 6:09 PM on October 11, 2011

Oh, and NYU/the Hospital for Joint Diseases also has a center for arthritis and autoimmunity. I plan to check it out but can't endorse it yet.
posted by the young rope-rider at 6:14 PM on October 11, 2011

If he's had RA for a while undiagnosed, he may find a medicine that helps him feel a lot better. So how he feels right now isn't necessarily going to be the way he feels for the rest of his life. On the other hand, I've found doctors can sometimes talk as if rheumatoid arthritis is something that can be cured--not using that word necessarily--but in the beginning they can talk as if it were possible to get you back up to 100% of your old healthy self and then stay there forever, and I don't think that's ever really true. Anyway, I think you have to try and find a balance between hoping for the best and being realistic, and that can be hard to manage on top of all of the new info getting thrown at you. RA Warrior is an imperfect blog, but it's got some useful information on it that helped me at the beginning.

Also: SWIMMING! Swimming has pretty much become my favorite thing ever, because it's one of the few physical activities that makes me feel noticeably better afterwards. It's even nicer if your pool has a hot tub as part of the pool complex, because hot tubs are like a heating pad for your whole body. A good massage is one of the other things that makes me feel better, although that good feeling doesn't last as long as the after-effects of swimming do.

And, he should make sure he has good shoes (or at least good insoles), because I know my feet at least hurt pretty much all the time and I've found a good pair of shoes really does make a big difference between being noticeably in pain and being able to ignore it more often. Also, I think it's easy for people with RA to get related foot problems like plantar fasciitis, and so I think it's worth it to try not to compound your problems.
posted by colfax at 6:41 PM on October 11, 2011

That it's an autoimmune disease, that because of HIV we know a lot more about the immune system than we did 20 or 30 years ago and, as a result, there are a lot of treatment options now that didn't exist five or ten years ago.
posted by Kid Charlemagne at 8:27 PM on October 11, 2011

Try Dr. Dalit Ashany at the Hospital for Special Surgery.
posted by foxy_hedgehog at 6:06 AM on October 12, 2011

Swimming, swimming and swimming - in warm water of course
posted by nickji at 6:34 AM on October 12, 2011

Update of sorts:

His insurance doesn't cover practitioners at the Hospital for Special Surgery so he's going to someone associated with NYU.

He's had his first rheumatologist appointment and is happy to hear that there is little damage at this point so at least he will be starting treatment early on in the disease.

I also suffer from a fun autoimmune disease, psoriasis, so he and I are fairly familiar with the idea of playing around with medications to find one/several which work for you and the fact that a chronic condition is chronic.

I will try to get him to sign up for a gym membership that includes a pool.
posted by sciencegeek at 2:59 PM on October 18, 2011

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