Developing a Treatment Plan
I am a planner. For example, my husband will tell you that I love planning trips and visits or dinners. In fact, I have the bad habit of asking him what’s for dinner tomorrow night while we are eating dinner tonight. So yes, I am a planner.
Rheumatoid arthritis, however does not bend to the will of my planning ways. It doesn’t inform me that a flare up next week will prevent me from going to work, cause me to cancel plans, or make me feel terrible and exhausted.
Despite the disagreeable and disorderly behavior of my RA, I do my best to plan around it. When I visit my doctor, I talk with him about my treatment plan and if it is helping me reach my goals. Over time, the plan and goals have changed dramatically, but I still find it helpful to keep them in mind and work toward them (no matter if they are small and modest).
As a child I was not in charge of my treatment plan when I was first diagnosed, but my parents and my doctor would talk to me about it so that I understood what we were trying to do. Obviously, I had a better grasp and more responsibility for following my treatment as I aged.
Early treatment focused on stopping the aggressiveness of my RA. Unfortunately, we had very limited tools at the time. We tried me on the medications we could and I had frequent physical therapy, plus a regimen of exercises to perform at home. The goal was to keep me as active as possible and work on reducing long-term joint damage.
After more than 37 years of living with RA, both my treatment plan and goals have changed drastically. Not only are there more treatment options that are also more effective, I have acquired damaged joints and related issues that I must also manage.
So when my doctor first prescribed a biologic a couple years ago, I wasn’t imagining that I would run marathons again or go mountain climbing. My hope was to have a little less joint pain and stiffness, and hopefully slow further damage from the disease.
I bring this up because the same treatments can be prescribed for very different goals, depending on the specific circumstances of the person with rheumatoid arthritis. I don’t advise comparing yourself to others, but instead having an honest conversation with your doctor about your treatment program and expectations for what you may be able to achieve.
When I talk treatment planning with my doctor, I am looking at the goal of managing my disease. I do not expect drastic improvements, but am hoping to slow the progression of my RA. Increasingly, I also want to reduce my fatigue and gain a little bit more energy for my day.
While medications are the heart of my treatment plan, I also look at it more holistically. I am thinking about my day, how I get my physical activity, and how much rest I need. For me, medications are part of the picture but not the whole thing. Doing my aquatic therapy regularly is important for making my joints happy, keeping up my strength, and contributes to better energy levels. If I need too much rest, that is an indication to me that my RA activity has increased and I need to look at my treatment plan again.
In my case, my treatment plan is not written down but lives inside my head and with conversations I have with my husband day-to-day. RA can be a moving target and it is one that I have never felt I have hit perfectly, but I keep at it every day and with commitment to maintaining a treatment plan while gradually working toward my goals.
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