Last winter, after spending a few afternoons shoveling snow, Heather Miceli, 27, woke up in the middle of the night and couldn’t get out of bed. “My joints had swelled up so much that I couldn’t move without crying,” she says.
Two months later, the college professor at Johnson and Wales University in Providence, R.I., who had always been healthy, was diagnosed with rheumatoid arthritis (RA) -- a debilitating autoimmune disease that causes inflammation and swelling in the joints and surrounding tissues, most commonly in the wrist, fingers, knees, feet, and ankles. Other organs such as the lungs, skin, and eyes can also be affected.
Studies have shown that people with rheumatoid arthritis who see a rheumatologist regularly (several times a year) do better than people who visit erratically or not at all. The first step is finding one!
Your primary care doctor can refer you to a rheumatologist. If you like your doctor and have a good relationship, chances are good you'll get along with the rheumatologist your doctor recommends.
You may be able to see a rheumatologist directly without a referral; check your insurance plan...
“It came out of nowhere,” says Miceli, who started experiencing severe fatigue, joint pain, and stiffness. “My husband had to dress me. My hands were so swollen that I couldn’t wash dishes or grade papers. I was so scared. I didn’t know what was happening to me.”
RA in Young Adults: How Common?
Miceli’s plight is more common than you may think. RA, which affects 1.3 million people in the U.S., is typically diagnosed between ages 30 and 80, but also occurs in young people.
“The chance that a young adult will develop RA is more common than previously thought,” says Cynthia Crowson, MS, a Mayo Clinic biostatistician and RA researcher who recently published a paper in Arthritis and Rheumatism on the lifetime risk of developing several autoimmune rheumatic diseases. Crowson says that the odds of someone in their 20s developing RA is 1 in 714 for women and 1 in 2,778 for men.
Certain factors can increase that risk. According to Rebecca Manno, MD, MHS, a rheumatologist at Johns Hopkins University School of Medicine, smoking increases the chance of developing RA if a person is already genetically susceptible to the disease. Family history, she says, is another important risk factor, because autoimmune diseases tend to run in families.
Manno says young adulthood is a particularly difficult time to be diagnosed with RA, both physically and emotionally. For many patients, the pain and joint destruction the disease causes can be managed with medications such as disease-modifying antirheumatic drugs, anti-inflammatory drugs, and steroids. Many can have side effects such as liver damage, weight gain, and increased susceptibility to infection.