Being a rheumatoid arthritis patient or someone who lives with any chronic illness, really, leads us to sometimes have to make tough decisions that others may not have to face. Some of these decisions may be difficult or disheartening, and, like most life decisions, need to be considered carefully.

One major decision that RA (and other) patients are faced with is the treatment decision. There are many things to consider. Some important questions to ask yourself when facing this decision:

• Are you going to follow a treatment plan of traditional Western medicine? Will you try an alternative or holistic approach, going all-natural or drug-free? Or, will you utilize a combination: pharmaceutical drugs integrated with natural remedies?
• When it comes to medications, does the benefit outweigh the risk? Are the side effects worth it?
• Which medications or treatments can you afford? Is the treatment you want covered by medical insurance?
• Which medications can you rule out?
• Does your treatment plan fit with your moral, religious, and ethical beliefs?
• Does your doctor respect you enough to let you have the final say in whatever option(s) you choose? Or, do you feel pressured?

The way in which you answer these questions should help you to make the best choice for you. Finding the right treatment may involve getting second or third opinions, doing research on your own, and talking with fellow patients who have tried whatever it is that you are considering trying.

Another big decision that RA patients deal with is the issue of working. Usually, this is a decision that is made with a great deal of difficulty. Things you should consider when facing the decision of employment include:

• Are you able to continue working full-time? Or, do you need to cut back to part-time hours? Can you work at all?
• Does your company offer telecommuting options? How about flex hours? (If not, you may want to contact a lawyer, counselor, or HR professional to see what your options are for accommodation under the Americans with Disabilities Act – ADA.)
• Will your company allow for time off to tend to treatments, sick days, or medical emergencies? (Again, if not, you are legally entitled to talk to someone about FMLA or the Family Medical Leave Act.)
• Does your employer offer temporary or long-term disability benefits?
• Are you eligible for federal SSDI or social security disability benefits if you are unable to keep working?
• Is there any way that you can work for yourself, being your own boss and allowing for a flexible schedule and comfortable surroundings?
• Is your health getting in the way of your career? Or, is your job negatively affecting your health?
• What does your doctor think about your work situation? What does your boss think?
• Can you afford to stop working? Can your body afford to keep working?
• Is there another type of job or field that would be easier for you, considering your condition? Can you physically do your job?
• What are your options for medical benefits — whether employed or unemployed?

Again, these are all crucial points to consider. Ask yourself these questions if you are facing the decision of whether to start working, keep working, or stop working. Stress is known to exacerbate autoimmune and inflammatory conditions, so cutting back hours (and stress!) on the job may also cut back on flares. However, the fulfillment of a job could boost your mental and emotional state, which can also have positive health effects.

Exercise is something that is hotly debated among patients with chronic pain and rheumatic conditions. (In fact, I’ve gotten some hateful comments on this very blog for promoting exercise! 😉 ) That said, MOST rheumatologists these days will say that exercise, even if very simple and mild, is crucial (or at the very least, not forbidden!) for patients with arthritis and autoimmune illness. But, like anything, there isn’t a one-size-fits-all solution to the exercise conundrum — and moderation is key. So, here are some ideas to think about when it comes to fitness and physical activity.

• Are there any workouts or exercises that you can do with your current condition? Are there any that you absolutely cannot do?
• If exercise is out of the question, how about gentle stretching? Chair yoga? Resistance bands?
• What does your doctor say on the topic of exercise and physical activity? Each patient is different regarding levels of ability and disability.
• Is yoga an option? Aquacise or water aerobics? Walking?
• Are there any sports you can play?
• Is there a gym in your area that you could join? Speaking with a trainer and explaining your condition may alleviate some tension and anxiety about exercise.
• Would physical therapy be an option? It is recommended for many arthritis patients.
• What kinds of exercise do you truly enjoy? If it is something you can no longer do, is there a way to adapt an activity that you like to your needs now?
• If your doctor tells you not to exercise, is there another doctor you could consult for a second opinion? Most doctors will encourage some form of physical activity.

Basically, when it comes to exercising, it is all about finding something that you like AND can do, staying within your ability levels, listening to your body, and doing it in moderation. Don’t expect to run a marathon if you were a couch potato for a year. And if you have rheumatoid arthritis, you’ll probably be better off with low-impact exercises. That said, it doesn’t mean you can’t TRY new things. So, take that Zumba class, swing that kettlebell, go horseback riding, become a yogi.  Your body will surely let you know if it is something you can handle or not — and you may be pleasantly surprised. Within reason, you should do whatever you are able to do — without OVERDOING it. Always be careful, though, to avoid injury. Safety is key. And remember — everybody and every body is different. Be sure to take your doctor’s opinion into consideration, too — but let your body be your guide.

Other concerns that may come up for patients with rheumatoid arthritis are decisions surrounding: getting married, having children, how much or how little to sleep, what to eat, if surgery is necessary, whether to participate in clinical trials, how much to share with others about your disease, and so on. Many of these decisions will be guided by personal preference, based on your own experience and the recommendations of professionals.

So good luck with whatever decisions you face in life. Whether they are health-related or not, here are some articles to refer to about making a good decision:

• 5 Tips for Lightning-Fast Decision-Making
• How to Make a Difficult Decision
• Health Decision Tool

Be Well,

Ashley Boynes-Shuck

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