Dr. Michelle Teo
Collaborating and communicating openly with their healthcare provider helps RA patients reach their goals.
Julia Chayko woke up one day feeling achy and sore. Her joints were stiff and swollen. Then she felt better later that afternoon. This went on for a couple of weeks, with Chayko waking up feeling unwell and recovering later in the day. Her general practitioner sent her to see a rheumatologist, who diagnosed Chayko with rheumatoid arthritis.
Rheumatoid arthritis (RA) is an autoimmune disease, where the immune system attacks the lining of the joints.1 RA affects about 1 in 100 Canadians, most often women.2,3 Researchers do not know why some people develop RA, although it is believed to be a combination of genetics and environmental triggers.4 RA causes joint pain, stiffness and swelling, particularly in the hands and feet, as well as the wrists, knees, shoulders and ankles.5 This can make even everyday tasks difficult.
A writer, dancer and actress, Chayko was surprised by her diagnosis. “I was quite young and incredibly fit. I ate the right things. My parents didn’t know anyone in our family who had the disease. So, it took a bit of time to get used to the whole idea,” says Chayko, who was diagnosed at 38, about a decade ago.
Dr. Michelle Teo, a rheumatologist in Penticton, BC, says this can be the greatest challenge for many patients. “It can be hard to accept, that despite living a healthy life, you have this condition that you don’t have any control over,” she says. “Our job as rheumatologists is to communicate to patients how this is not their fault and to find a way to develop that trusting relationship where they are willing to try to live a well-balanced life.”
Managing the disease
Chayko said it took a few tries to find the right plan that worked for her. In addition to treatment, she relied on other strategies to manage her condition, including seeking the advice of an occupational therapist to help make everyday tasks easier and exercise guidance from a physiotherapist. With time and the support of her physician, Julia’s condition stabilized.
“It’s really important that you have a plan and feel comfortable to say, ‘This isn’t working for me, is there something else we can try?’ Finding those answers relies on a really collaborative professional relationship with your healthcare team.”
Dr. Teo agrees. “This is a lifelong condition. We are all hoping for the day when there is a cure. But until that time, it is important that we incorporate goal setting into patient care—to get the inflammation under control and for the patient to preserve their quality of life.”
While Dr. Teo applauds today’s treatment, she says what works is individual to each patient. Condition management plans must be tailored to a patient’s specific symptoms, lifestyle and goals. Dr. Teo says she works with her patients toward their specific goals, whether that means getting back to their favourite hobbies or even day to day activities without pain.
Showing yourself some grace
“It can be overwhelming, especially at the beginning,” says Dr. Teo. “A lot of the initial appointments can be spent just wrapping your head around what it means to have this disease. But once that has been digested, I think patients should really ask themselves, ‘What are my goals?’ or ‘What are my hopes through treatment?’”
Chayko says she was lucky to be able to move to part-time work and have more time for exercise and rest. But even if this is not possible, she urges others with RA to take time to move every day and to prioritize what needs to be done—and let go of everything else.
“Be patient with yourself, because you’re going to get frustrated. You’re going to have days where you might feel really awful,” she says. “It takes time to learn how to live with this. But there are a lot of options that can help us. Be kind to yourself.”
This article was made possible with support from Pfizer Canada
1Rheumatoid Arthritis. Arthritis Society. 2020. https://arthritis.ca/about-arthritis/arthritis-types-(a-z)/types/rheumatoid-arthritis
2Rheumatoid Arthritis. Arthritis Society. 2020. https://arthritis.ca/about-arthritis/arthritis-types-(a-z)/types/rheumatoid-arthritis
3The Truth About Arthritis. Arthritis Society. Available at: https://arthritis.ca/about-arthritis/what-is-arthritis/the-truth-about-arthritis
4Rheumatoid Arthritis. Arthritis Society. 2020. https://arthritis.ca/about-arthritis/arthritis-types-(a-z)/types/rheumatoid-arthritis
5Rheumatoid Arthritis. Arthritis Society. 2020. https://arthritis.ca/about-arthritis/arthritis-types-(a-z)/types/rheumatoid-arthritis