I'm encountering several people who seem to want to put me in the "RA" camp, since "it's all the same anyway." What concerns me the most, though, is that my primary care doctor just did it. She told me about one of her other patients (with that patient's permission) who has the same thing as me (she even called my disease psoriatic arthritis) and asked if I would reach out to her (she didn't give that patient my name). So, I did. Turns out she has RA. When I told my primary doc about it, she said, "both are connective tissue diseases that are autoimmune." So, in her mind, there wasn't much difference.
I guess this is my question: is there that much difference between the two? I've been trying to learn as much about this disease as I can since my diagnosis just four months ago, but I'm not sure how to explain -- either in layman's terms or to my primary doc, what the differences are.
Any help? And is it even worth trying to explain it? People seem so much more familiar with RA than PsA. I'd sure like my primary to know the difference:(
Well, your primary knows that RA and PsA are usually treated in much the same way. But they are distinct diseases. Interesting and informative article –
I’m attaching one of the charts in the article, but I’m having trouble getting the whole image to appear. Better to read the article and look at the chart there.
I think you should gift your primary with a copy of the Gladman & Chandran book. 304-image.jpg (64.7 KB)
This drives me crazy!! I get sooooo tired of trying to explain to people that I do not have RA. I have started to tell people that I have an autoimmune arthritis or I say I have the same thing Phil Mickelson has and they will still say something about my rhuematiod arthritis.
I don't know if that helped any but it felt good to get that off my chest :)
Seenie, I'm ordering her a copy today:) Thanks for the article.
Seenie said:
Well, your primary knows that RA and PsA are usually treated in much the same way. But they are distinct diseases. Interesting and informative article -- http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1798388/ I'm attaching one of the charts in the article, but I'm having trouble getting the whole image to appear. Better to read the article and look at the chart there. I think you should gift your primary with a copy of the Gladman & Chandran book.
For me and a lot of PsA people, one of the main differences is that while RA affects the joints, PsA attacks tendons, and the points at which tendons attach to bone (entheses) Of course, this is well as attacking the joints. And that (enthesitis) hurts. Is it any wonder that, having 20 foot muscles, each with tendons attaching them to bone, that so many of us have feet that hurt?
Another “benefit” of PsA is the way it can cause joint linings to vascularize. Here is a lecture given by a London rheumatologist, Dr. Arvind Kaul, in which he describes how PsA can cause the joint to develop extra blood supply – http://m.youtube.com/watch?autoplay=1&v=ZF7uYMwyh5E
It’s a very good lecture, but very long, so make a pot of tea and get comfortable.
In my view. most of the differences are important to medical professionals, especially rheumatologists, but not so much to lay people. Both cause chronic pain, both damage joints, both are treated with the same drugs, both hit people of all ages, both are autoimmune.
You should be flattered that your PCP asked you to reach out to someone recently diagnosed with RA. It means she respects your knowledge, your attitude towards your disease, and sees you as someone who has compassion for another person in the same leaky boat. You and the RA newbie were probably not discussing the best surgical technique to repair a damaged shoulder. The conversation was most likely about how to cope with chronic pain, how to minimize the nausea from methotrexate, how to get the lid off a jar, overcoming fears about biologic drugs, which shoes are really comfortable- all things that are common to PsA and RA patients.
I have recently had questions from acquaintances along the lines of "What the heck has happened to you?" I've found the best answer is to say that I have an autoimmune disease, very similar to rheumatoid arthritis, that is attacking my joints. People do tend to get that. RA is much more familiar, and rather than give them info they don't need, this answers the question: no, I didn't throw out my back, no car crashes, etc. If anyone wants more information, I'll happily provide it. I know several people who have RA, or who have a friend or relative with it, but I haven't met anyone yet with PsA (or much knowledge about it.)
Thanks so much, Seenie. Good information. By the way, is it OK if I make a cup of coffee instead of a pot of tea??
Seenie said:
For me and a lot of PsA people, one of the main differences is that while RA affects the joints, PsA attacks tendons, and the points at which tendons attach to bone (entheses) Of course, this is well as attacking the joints. And that (enthesitis) hurts. Is it any wonder that, having 20 foot muscles, each with tendons attaching them to bone, that so many of us have feet that hurt? Another "benefit" of PsA is the way it can cause joint linings to vascularize. Here is a lecture given by a London rheumatologist, Dr. Arvind Kaul, in which he describes how PsA can cause the joint to develop extra blood supply -- http://m.youtube.com/watch?autoplay=1&v=ZF7uYMwyh5E It's a very good lecture, but very long, so make a pot of tea and get comfortable.
Niel, coffee is fine as long as it isn’t too late in the evening. LOL You will like Dr. Kaul: he’s a thoughtful, gentle empathetic person.
Niel said:
Thanks so much, Seenie. Good information. By the way, is it OK if I make a cup of coffee instead of a pot of tea??
Seenie said:
For me and a lot of PsA people, one of the main differences is that while RA affects the joints, PsA attacks tendons, and the points at which tendons attach to bone (entheses) Of course, this is well as attacking the joints. And that (enthesitis) hurts. Is it any wonder that, having 20 foot muscles, each with tendons attaching them to bone, that so many of us have feet that hurt? Another "benefit" of PsA is the way it can cause joint linings to vascularize. Here is a lecture given by a London rheumatologist, Dr. Arvind Kaul, in which he describes how PsA can cause the joint to develop extra blood supply -- http://m.youtube.com/watch?autoplay=1&v=ZF7uYMwyh5E It's a very good lecture, but very long, so make a pot of tea and get comfortable.
Good advice, Louise. And well taken. What threw me off a little was the text I got from my primary that she had another patient with PsA. And, since I've also not known anyone else with our disease, I was surprised to find someone so soon and so close. I think this patient was as surprised as I was when I reached out to her, expressing my desire to help since she just recently received the diagnosis of PsA. But, she is also a friend of mine so we can easily find connecting points. I truly appreciate your response, Louise.
Louise said:
In my view. most of the differences are important to medical professionals, especially rheumatologists, but not so much to lay people. Both cause chronic pain, both damage joints, both are treated with the same drugs, both hit people of all ages, both are autoimmune.
You should be flattered that your PCP asked you to reach out to someone recently diagnosed with RA. It means she respects your knowledge, your attitude towards your disease, and sees you as someone who has compassion for another person in the same leaky boat. You and the RA newbie were probably not discussing the best surgical technique to repair a damaged shoulder. The conversation was most likely about how to cope with chronic pain, how to minimize the nausea from methotrexate, how to get the lid off a jar, overcoming fears about biologic drugs, which shoes are really comfortable- all things that are common to PsA and RA patients.
I have recently had questions from acquaintances along the lines of "What the heck has happened to you?" I've found the best answer is to say that I have an autoimmune disease, very similar to rheumatoid arthritis, that is attacking my joints. People do tend to get that. RA is much more familiar, and rather than give them info they don't need, this answers the question: no, I didn't throw out my back, no car crashes, etc. If anyone wants more information, I'll happily provide it. I know several people who have RA, or who have a friend or relative with it, but I haven't met anyone yet with PsA (or much knowledge about it.)
Louise, your short explanation about “an autoimmune disease similar to rheumatoid arthritis is attacking my joints” is exactly the line that I’ve found the most useful and which I use most often.
Understanding that enthesitis is unique to PsA, and different from RA, was crucial for me. When I was still (mis)diagnosed as having OA, I could not understand why my shins hurt and the backs of my ankles ached. I really did think that was all in my head. Once I was diagnosed with PsA and I understood about the enthesitis, I recognized that kind of pain as being the disease as well, and not proof that I’m a crazylady.
