FIRST: I took the WebMD Fatigue Fighter Tool Test. The results were less than I had hoped, but what else is there? The Tool says I should have little fatigue because I’m doing all the right things. BUT – despite trying to manage my RA inflammation and conserving my energy in all the ways the Fatigue Fighter Tool suggests, I am still flattened by my fatigue. Just flattened. I have days when I can hardly move. But I will admit I try to push through the fatigue to get some things done – like running Emmy on the treadmill and taking her outside and hanging out with her. The fresh air outside does me good on the one hand, but on the other, the sun makes me flare. Maybe I’m a bit toward the Lupus side of things? [OMG, I hope not! Not another inflammatory disease!]
I don’t want to have to “manage” my fatigue. I want to have no fatigue!
I expect this is the same way most of the others with autoimmune diseases feel. The fatigue factor is some big secret that we don’t find out about until we develop an autoimmune disease(s) – and many of us have more than one.
Autoimmune diseases means attack our own bodies – the connective tissues like joints, ligaments and tendons, the muscles, and our vital organs: heart, kidneys, lungs, liver, spleen. Certain diseases have different affinities, but actually, any of them can attack any organ or system of organs. Fatigue is just one indicator of the severity of the disease. If fatigue is severe, the disease likely is more active – even if the lab tests say otherwise, and the physical exam says otherwise.
So, if someone is continually flattened by fatigue, we can assume their disease continues to be active despite the DMARDS (disease-modifying antirheumatic drugs) they take. If so, it may be time for a change – to a biologic.
SECOND: I was amazed to read a new WebMD article about RA Treatment Options. For once, the authors didn’t make RA sound like a walk in the park. They didn’t tell all the truth, of course, but there is hope for there being at least somewhat truthful authors writing about RA. The article says that 20 years ago MDs used NSAIDS and steroids as first line medications, while today DMARDS and biologics are the first line of attack, with NSAIDs and steroids in supporting roles.
I wish that were really the case. Too many family practitioners and internists – and even rheumatologists – are still starting out with NSAIDS and steroids instead of attacking the inflammation up front with the most effective drugs. At times, they are still creeping up on the whole thing for weeks to months before moving to the most effective drugs. Those docs REALLY need continuing education big time!