What you need to know about rheumatoid arthritis

It started with stiff ankles and a little difficulty with walking. It was June, and Liz Duma was waking up each morning just a little bit slower, a little bit stiffer. Then the stiffness spread to her hands, her feet, and her back.

While not easy for anyone, these changes were particularly tough for a physical education teacher. This was in 2008, and at 50 years old, Duma was still a long way away from retirement at her school in Halfmoon.

“I remember it like it was yesterday,” Duma says. “At the end of June, I had gone to Myrtle Beach and when I was in the ocean I was boogie boarding. I was doing everything I could but at nighttime all my joints just stiffened up. Each day I was there it got worse.”

When she got back home, Duma went to her doctor. Bloodwork revealed she had “the rheumatoid arthritis factor.”

According to the National Library of Science, “Rheumatoid arthritis is a multigene disorder with a substantial genetic component and a heritability estimate of 60 percent.” Duma, despite not remembering any family members who struggled with the autoimmune disorder, carried the gene. (An autoimmune disorder is one in which your immune system mistakenly attacks your own body.)

“Rheumatoid arthritis is an autoimmune disease that is characterized by joint pain that more commonly affects the small joints, such as hands and wrists, feet, et cetera,” says Dr. Janaki Patel of Community Care Rheumatology in Mechanicville. “The cause is thought to be multifactorial from a combination of genetics and certain environmental triggers that causes an inflammatory cascade.”

Duma didn’t know it, but the cascade was in effect. As she waited for an appointment with a rheumatologist, “each day progressed to the point where I needed help to get out of bed,” she says. “I just had no strength in my body to lift myself out of bed and then I had to walk in the house very gingerly.”

At last, in August 2008, she was able to see the rheumotologist. “They gave me a regiment of prednisone and said in three days you’ll be able to get yourself out of bed and walk around,” Duma says. “And sure enough by the third day I was able to get out of bed and walk. It was amazing.”

Dr. Patel says the treatment for rheumatoid arthritis varies based “on the severity of the joint symptoms. Long-term treatment is aimed at preventing chronic deformities that are irreversible and can be detrimental on quality of life.” The treatment options are all immunosuppressant agents like the steroid Duma originally received.

The medications Duma received enabled her to continue teaching physical education and resume her daily activities. But in 2017 Duma started having trouble with her lungs. “I developed nodules in my lungs and had to have major surgery,” she says. “I didn’t realize arthritis doesn’t just affect your joints but your organs, too.” Because rheumatoid arthritis is an autoimmune disease, her immune system is compromised, making her vulnerable to other conditions. The nodules caused her lungs to fill with fluid, which the surgery fixed. But then the same problem arose nine months later. Since that second surgery, though, Duma says things are better.

Today, she can do most of the activities she always did. While she can’t run much, she golfs frequently and walks two miles a day.

“I’ll be 64 on July 4,” says Duma, who’s now retired. “I go on vacations. I’ve never felt like rheumatoid arthritis has prevented me from doing what I want to. Well, maybe jumping off a rope swing … I don’t do that anymore.”

Patel says early warning signs of rheumatoid arthritis include prolonged morning stiffness in your small joints lasting more than an hour, swelling and difficulty making a fist. If you experience any of that, she advises getting in touch with your doctor right away.

The news ultimately doesn’t have to be scary, Duma says. “My philosophy is to smile and enjoy each day because you just don’t know what the next day is gonna bring,” Duma says. “I love to take pictures. I love selfies! In a selfie everybody smiles, so it makes you feel good mentally and physically. It’s just one of those things.”

Liz Duma and friend
Duma’s philosophy is to smile and enjoy each day. “I love selfies,” she says. “In a selfie everybody smiles.” (Photo provided by Liz Duma)

For information about rheumatoid arthritis, visit the Arthritis Foundation website.

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