When you hear the word "arthritis" you think of a few stiff joints in the morning, or all the commercials on TV, when the woman says to her husband "the Dr says it's only arthritis." Only arthritis. Only ARTHRITIS?!? What kind? There are more than 100 different types of arthritis and the cause of most types is unknown. Rheumatoid Arthritis [RA] isn't going to be relieved by "Aleve" or "Tylenol."

RA is a painful and physically debilitating chronic disease. It affects 2.1 million Americans. When measured in terms of direct costs, usually defined as medical costs such as physician visits, hospitalizations, medications, transportation, and specialist aids, our nation spends $12 billion each year on RA. An additional $12 billion is lost through indirect costs, which include costs to the individual, employer, family, and society from lost productivity and lost production due to premature death. That's over $11,000 per person. Due to age or disability, approximately 900,000 persons with RA rely on Medicare for their health insurance coverage[1].

It has enormous socio-economic impact[2]:
  • 90% of patients have significantly reduced function after 10 years
  • 50% of patients are severely disabled after 10 years
  • 80% of patients are moderately disabled after 17yrs
  • 30-50% of patients are able to work after 15 years
It is a mistake to think that this is a benign disease, and there is significant mortality associated with the disease. Mortality at 10 years is 26.7% vs. 15% for the average population. Cause of death in patients arises from :
  • Cardiovascular causes/disease 40%
  • Malignancy 14%
  • Infection 9%
  • Renal Disease 8%
  • Respiratory Disease 7%
  • Extra-Articular Disease 5%
  • Gastro-Intestinal Disease 4%
  • Therapy Itself 3%

All of this pales in comparison to the devastation of my family, and most importantly, my wife. This disease has ravaged my body to the point I can barely move and function in a way to contribute to the housework. Lifting, pushing, pulling, sweeping, mopping all exhaust me. As an example: for Social Security & my new Rheumatologist, I had to scan 400 pages of my medical records into our computer. I did this over the course of 4 days. To copy each page, I had to stand up. So I stood up and sat down over 100 times a day. When I was done, I went to bed, and slept over 24 hours straight.

One of the drugs I take are also used for chemotherapy, i.e. anti-cancer drugs. I take them once a week, on Saturday night, and then I am lucky to get out of bed by Monday morning. Another weekend missed. One of many that never existed for me. Everyday, for the last 10 years, I have had to take one painkiller or another. No respite at all. I have to get blood tests done every 6 weeks, to make sure my liver hasn't shutdown due to drug toxicity. One of my blood vessels is so scarred, they can no longer get blood from it.

In 2000, the pain in my back was so bad, the only way for me to move was in a wheelchair. Standing up was excruciating, and walking was virtually impossible. I was in the wheelchair until October 2003, when I had back surgery to fuse my lower 3 vertebrae, and there's a 50% chance I will need surgery again.

Now I can barely work, if at all, and my wife has to do everything. Since the kids are grown & moved out, she has no assistance for daily chores. I have no income, so now my wife is working 3 jobs, to try & make ends meet. It can take up to 2 years to get Social Security -- Disability, and if you are unable to work, you are not eligible for unemployment benefits... According to the American College of Rheumatology, it costs between $12,000-30,000 dollars a year for the medications. A steep price to pay when you have no income, and haven't won the lottery.

Today, my wife finally got to bed at 4am, and left for work by 8am. She'll do this everyday during tax season. Every night when I go to bed, I pray to God to get my wife to work, and back home safely. She doesn't know how many times I have woken up during the night, to hear her crying in her office, or how many times I have laid in bed crying myself to sleep, because I can not do a thing to help her. She is paying an even steeper price for my disease than I am. Even when I was in better health, she still had to fight with the insurance companies, and now it is even worse. Our coverage is about to end, and there are no miracles, or jobs, in sight.

"Oh, it's only arthritis" ... if that were only true.
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End Notes:
  1. source: The National Arthritis Foundation http://www.arthritis.org/
  2. source: Dr David Gotlieb, MBChB FCP(SA). Rheumatologist & Specialist Internal Medicine http://www.arthritis.co.za/

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