Comorbidity Overload With RA

I actually had no idea what the word comorbidity meant until I was a few years into my rheumatoid arthritis (RA) journey.  As I recall, it came up when I began to have symptoms of Sjogren’s syndrome.

My rheumatologist said that Sjogren’s is a fairly common "comorbidity" of rheumatoid arthritis. I asked what that meant. He explained that, for those of us with RA, it means having more than 1 chronic or lasting condition simultaneously.

What is a comorbidity?

According to the CDC, "Comorbidity means more than 1 disease or condition is present in the same person at the same time. Conditions described as comorbidities are often chronic or long-term conditions." This was a term I was completely unfamiliar with at the time.¹

Years into my diagnosis, I now realize that RA has a number of common comorbidities that include hypertension, diabetes, obesity, lung disease, osteoarthritis, and many others. What this means is that those of us with RA have some type of predisposition to having these or other conditions. They manifest for a variety of reasons such as the RA medications we take or simply the inflammatory nature of RA.¹

How can we prevent or manage comorbidities?

So, the obvious next question is: How do we process this information?  What can we do to counter this, if anything?

Lifestyle adjustments when possible

The good news is that there are lifestyle adjustments and choices we can make to potentially offset some of these. One is obesity. By eating a balanced, healthy diet and participating in regular exercise, we can prevent obesity. This strategy also helps with preventing heart disease issues, such as hypertension.

An informed, patient-centered care team

If you develop 1 of these, Sjogren’s for instance, get treatment promptly. I have especially dry skin and dry eyes. I consider my dermatologist and ophthalmologist key members of my care team. I want to stop here and mention how crucial it is that ALL members of your care team be well informed and kept up to date on your health status. This may be 1 of the most crucial strategies you follow to successfully manage RA.

Each member of your care team must be aware of your current treatments, medications, procedures, surgeries, and conditions. Without that information, we are putting them in an impossible situation in terms of treating the condition we are seeing them for. That is not only unfair to them but completely detrimental to our own health.

Treatment considerations for your unique situation

Now, back to getting treatment. How best to handle comorbidities is not easy and requires some careful consultation with your physicians. There is actually a lot to consider.

For instance, how might the treatment for the secondary condition influence the effectiveness of my RA treatments, if at all? What are the potential interactions of the medications suggested? Should I even treat it or is it best to do a wait-and-see approach? Might my current treatment protocols be responsible for this new condition and if so, what can I do to mitigate it, if anything?

For instance, I developed premature cataracts thanks to my long-term (albeit small dose) of prednisone. Try as I might, I could not get below 1 to 2 milligrams of prednisone a day.  The end result is that I got cataract surgery and it was quite successful. Not an easy choice, but it worked for me.

I remain on a small dose of prednisone to this day and my rheumatologist and I agree that it has been crucial to my treatment protocol. Sometimes, we have to make decisions that are difficult but appropriate for our own unique situation.

Having an awareness of the potential for comorbidities is useful information to have to deal with them as they arise. In consultation with your care team, they can be successfully managed.

Nan