How Fallible Are We? RA and Life Expectancy/Mortality
No doubt, discussing our increased fallibility due to RA is at best, challenging and, at worst, overwhelming. I think we tend to push this to the back of our minds, deep into the recesses. That said, I do believe it is worthy of some discussion.
Previous knowledge on RA life expectancy
I remember quite clearly that during the early days following my diagnosis, I did do some research into the increased mortality rate for those of us with RA.
I recall at the time, back in 1996, that my physician told me that you can take about 10 years off your life expectancy. Well, that was not a fun thing to consider! However, times have changed. “A 15-year study showed that the mortality in patients with RA is still higher than that of the general population, but seems to decrease over time.”1
Improvement in mortality for people with RA
I was not overly aware of the improvement in mortality over the last 20 years. The improvement in treatment, better control, and overall management of the disease have all been factors. This is very encouraging for all of us who struggle with our own mortality due to RA.
“The decrease in mortality coincided with changes in medication policy. Hence, tight disease control is also important to lower the high mortality risk in RA.”1 In addition, it makes sense that age of onset, comorbidities, etc. would all factor into the impact on life expectancy for us.2
This is encouraging news to me
So, the encouraging news to me is that given the latest and greatest approaches to management and treatment of RA, life expectancy is improving for RA patients. On a deeper level, it also tells me that we have some control over this now. By addressing our management and treatment, etc., and being our own best advocates, we can exercise some control over this.
Addressing the quality of life factor
So that is all of the technical aspects but what about the mental and emotional aspect of confronting our own life expectancy/mortality as it relates to RA? That is much more personal. I know that this has bubbled up for me a few times over the span of my journey with RA.
For instance, when I first contemplated taking a biologic back in the '90s, there was fear about the potential side effects, both short and long term. I spent a great deal of time, reflecting, researching, and discussing with my physician all of the aspects of this treatment in an effort to sort out the best course of action. One of those considerations was mortality. It seemed clear to me that not treating my RA aggressively would be a mistake for me.
I was 40 years old, working full-time, a wife and mother of three sons with a full and rich life. I determined that I would do whatever took to have a quality of life, even if that meant a lower quantity of life. I have never regretted that decision for one moment.
Our decisions are based on our own circumstances
That said, everyone has their own personal considerations to reflect on. That is why the decisions we make as RA patients need to be individualized and tailored to our own set of circumstances. Only then, can we put our minds at ease knowing we have made the best decisions in that moment. We really cannot ask any more of ourselves than that.
Do you find the pain scale is an effective tool?