Tuesday, September 22, 2009

"What do I Have?" - Overlapping Symptoms & Coexisting Conditions - Ashley Boynes, Community Development Director, WPA Chapter

One problem that arthritis patients have in getting an affirmative arthritis diagnosis is that many forms of arthritis imitate one another, and even mimic other conditions. This makes it a difficult task for doctors to diagnose certain types of arthritis, and can often lead to frustration in patients, as well.

For one thing, there are over 100 types of arthritis. Additionally, some forms, such as Rheumatoid Arthritis, share many common characteristics with other diseases – specifically chronic and invisible autoimmune illnesses.

With so many symptoms overlapping and so many coexisting conditions, it is no wonder that patients and doctors are sometimes left in a state of confusion over the actual cause of the problem, or problems, at hand.

Conditions such as Rheumatoid Arthritis, Lupus, Fibromyalgia, Sjogren’s Syndrome, and Multiple Sclerosis, for example (just to name a FEW!) have many of the same symptoms: aching joints, muscle tenderness, overall pain and discomfort, stiffness, severe fatigue, headaches, a feeling of weakness, and so on. Many patients with these symptoms have an elevated rheumatoid factor and coexisting symptoms such as vision/eye problems, gastrointestinal issues, etc. Additionally, many of these conditions’ symptoms lull and flare, and are not consistent on a day-to-day or even hour-to-hour basis, which makes it a hit-or-miss situation when visiting a doctor to try to “show” them your symptoms upon physical exam. All of the above conditions are autoimmune in nature, causing a weakened immune system that attacks itself, and that can cause other illness, as well. In fact, many medications and natural courses of treatment overlap for all of the above-named conditions, too. Even more perplexing is that these conditions often coexist in the same patient, at the same time!

With all of this being said, you may wonder why it matters to get an official diagnosis, if many of the symptoms, outcomes, and courses of treatment are the same. Getting an official diagnosis is important because, although many aspects of these illnesses do overlap, each has its own exclusive set of symptoms, as well. For instance – someone with RA may have swelling – but no swelling or inflammation is typically present in fibromyalgia by itself. Depression, while a common factor in any chronic illness, is more closely associated with MS than any of the other aforementioned conditions. Likewise, patients with MS and RA may have vision issues, while someone with Lupus may not. People with Sjogren’s deal with severely dry eyes and mouth, which isn’t always common to the other conditions. Rheumatoid Arthritis is closely associated with certain forms of cancer, heart disease, low-grade fevers, and thyroid problems; and MS is associated sometimes with musculoskeletal issues and food allergies. Lupus patients typically get a red butterfly rash on the face, as well as occasional edema in the lower legs. As you can see, it is important to treat each illness on its own, in order to take care of each individual symptom, despite so many of them overlapping.

All of the similar traits of these types of illnesses can often lead to misdiagnosis, or, a “missed” diagnosis. This is why it is important to share EVERY symptom or change in your health – even if you think it is irrelevant – with your health care professional, so that they can make a reasonable assessment and an accurate diagnosis. The one symptom that you neglect to tell your doctor may be the key in proper diagnosis of your condition.

So how DO they know what you have? In diagnosing forms of arthritis and related conditions, a doctor usually couples a physical examination with bloodwork. Additionally, they also factor in the patients’ personal description of ailments. In many cases, the lab work is used to rule out other conditions, and a diagnosis is often made using a “process of elimination” of sorts. Unfortunately, people who have one form of arthritis (for example, RA) often have another co-existing form (i.e. osteoarthritis or fibromyalgia.) Likewise, patients with one autoimmune condition typically have more than one – often, three, overlapping conditions at once.

Other reasons for coexisting conditions and overlapping symptoms in arthritis patients include medications and lifestyle. Arthritis patients with a more sedentary lifestyle are more prone to obesity which can then lead to diabetes or heart problems. Additionally, many medications can cause nasty side effects ranging from partial blindness to neurological and gastrointestinal problems – and even cancer.

It is important to stay proactive in your health. If you are unsure “what you have” – see a doctor.  A helpful tip is to keep a health journal, and, before your appointment, document every symptom that you have – even if you aren’t sure it is a concern. If you are unsatisfied with a diagnosis, seek a second or even third opinion until your issue is resolved. Do not ever write anything off. If you have these types of conditions, you need to be aware of everything that is going on with your body. Educate yourself on your disease. For instance – if you have arthritis, do you know what type you have? Is it rheumatoid, which is autoimmune in nature? Or, is it osteoarthritis, which is more mechanical; more “wear-and-tear”? Is it another rheumatic condition – bursitis, myositis, gout, Sjorgen’s, Still’s Disease, ankylosing spondylitis? Make sure you understand your illness and the array of symptoms associated with it. If anything new pops up, let your doctor know – it is better to be safe than sorry.

For your information, here are a few quick facts and tips to keep in mind:

  • There are 117 types of arthritis. You can read about them from the Arthritis Foundation here: http://www.arthritis.org/types-arthritis.php
  • There are over 100 known autoimmune diseases – many of which are also considered – you guessed it – forms of arthritis and rheumatic disease.
  • A symptom common to all of these conditions is severe, debilitating fatigue. Another is widespread weakness and pain.
  • Another attribute common to all of these types of illnesses is the fact that they are chronic. A chronic illness is one that is ongoing, long-standing, and typically, permanent. Often, chronic illnesses may be treatable to an extent but have no cure.
  • If you have a chronic illness like arthritis, be certain not to neglect the needs of your spouse/partner, family, and loved ones. It is sometimes all too easy to concentrate on yourself and your symptoms and overlook the needs of others.
  • People with these types of diseases are prone to anxiety and depression. Be on the lookout for any signs of mental or emotional distress.
  • An accurate and official diagnosis is often needed in order for health insurance to cover your condition and provide benefits.
  • The Arthritis Foundation provides brochures and literature on the 117 types of arthritis. Contact us if you need any types of resources or support.
  • Keep in mind that all of these illnesses CAN AFFECT CHILDREN, too! If your child’s pediatrician gives you a diagnosis you disagree with, keep tabs of his/her symptoms and seek out a second opinion.

Please note, too, that we will not be airing a new episode of Arthritis Radio this week, due to the G20 Summit being in town here in Pittsburgh. However, in correlation with this blog, we encourage you to go back and browse our archives – you will learn a lot from episodes 1-8 about rheumatoid arthritis, osteoarthritis, juvenile arthritis, fibromyalgia, and overall wellness.

Check it out here:  http://arthritisradio.podbean.com or search, “Arthritis Radio” on iTunes!

As always, thanks for reading, and be well!

Best,

~ Ashley Boynes

Community Development Director

WPA Chapter

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