Doctor holds key to keyholes featuring healthcare team, nurse, physician, PCP

My Healthcare Team: More Than Just Rheumatology

When you have a chronic illness — and more specifically, a rheumatic illness — your rheumatologist is your eventual first point of contact after working with your primary care doctor. Your rheumatologist helps diagnose your condition, prescribes medicines, answers questions, and more.

Other doctors that are part of my RA care

One thing that I haven’t thought of before though was that the people taking care of my health — besides myself — are not just rheumatologists. My eye doctors, my dentists, my primary care doctors, and more all became intricately connected when I was diagnosed with rheumatoid arthritis. Why is that?

An eye doctor for regular eye care

First, I was on Plaquenil for a long time after first being diagnosed with RA. One of the requirements of being on Plaquenil is that you have to get your eyes regularly checked since the medicine can cause increased retina toxicity in the form of a bulls-eye ring.

This sounds scary, and it is: without getting your eyes checked, you can end up with a detached retina or worse. It was interesting to go to the eye doctor and have to explain that something that was wrong with my entire body — but primarily manifested in my joints/body — also affected my eyes.

Seeing my dentist for RA complications

Perhaps the most idiosyncratic intersection between my healthcare team and rheumatoid arthritis was with my dentist. It's been shown that having RA can increase inflammation, which causes a bunch of dentistry problems, including increased cavities, periodontia, and other gum diseases.

Also: being immunocompromised means that dental fillings, surgery, etc., are trickier, often requiring taking antibiotics before the procedure to prevent any possible bacterial growth. Yet another intersection where RA affects more than just the joints!

My primary care doctor

Finally, my primary care doctor has also been affected by my having RA — probably the most out of all my healthcare team besides my rheumatologist. With my primary care doctor, there are so many more considerations that have to be factored into consideration for treatment.

Managing vaccines and medication interactions

For thinking about vaccines, I have to make sure to not take any live vaccines since I'm immunocompromised. In addition, any new medications that have to be added to my treatment plan can't conflict with my RA medications, which can trouble things.

For instance, the Plaquenil that I used to be on interacted with some of the antidepressant medications by affecting the QI interval of my heart. This required finding a medication that wouldn't affect my interval and/or dropping the Plaquenil (and I ultimately ended up dropping the Plaquenil since I'm on Humira already).

As you can see, RA affects every aspect of your life, including aspects of your health that you wouldn't think would be affected.

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