When you hear the word "arthritis" you think of a few stiff joints in the
morning, or all the commercials on TV, when the woman says to her husband
"the Dr says it's only arthritis." Only arthritis. Only ARTHRITIS?!? What
kind? There are more than 100 different types of arthritis and the cause
of most types is unknown. Rheumatoid Arthritis [RA] isn't going to be
relieved by "Aleve" or "Tylenol."
RA is a painful and physically debilitating chronic disease. It affects
2.1 million Americans. When measured in terms of direct costs, usually
defined as medical costs such as physician visits, hospitalizations,
medications, transportation, and specialist aids, our nation spends $12
billion each year on RA. An additional $12 billion is lost through indirect
costs, which include costs to the individual, employer, family, and
society from lost productivity and lost production due to premature death.
That's over $11,000 per person. Due to age or disability, approximately
900,000 persons with RA rely on Medicare for their health insurance
coverage[1].
It has enormous socio-economic impact[2]:
- 90% of patients have significantly reduced function after 10 years
- 50% of patients are severely disabled after 10 years
- 80% of patients are moderately disabled after 17yrs
- 30-50% of patients are able to work after 15 years
It is a mistake to think that this is a benign disease, and there is
significant mortality associated with the disease. Mortality at 10 years is
26.7% vs. 15% for the average population. Cause of death in patients arises
from :
- Cardiovascular causes/disease 40%
- Malignancy 14%
- Infection 9%
- Renal Disease 8%
- Respiratory Disease 7%
- Extra-Articular Disease 5%
- Gastro-Intestinal Disease 4%
- Therapy Itself 3%
All of this pales in comparison to the devastation of my family, and most
importantly, my wife. This disease has ravaged my body to the point I can
barely move and function in a way to contribute to the housework. Lifting,
pushing, pulling, sweeping, mopping all exhaust me. As an example: for Social
Security & my new Rheumatologist, I had to scan 400 pages of my medical
records into our computer. I did this over the course of 4 days. To copy each
page, I had to stand up. So I stood up and sat down over 100 times a day. When
I was done, I went to bed, and slept over 24 hours straight.
One of the drugs I take are also used for chemotherapy, i.e. anti-cancer
drugs. I take them once a week, on Saturday night, and then I am lucky to
get out of bed by Monday morning. Another weekend missed. One of many that
never existed for me. Everyday, for the last 10 years, I have had to take
one painkiller or another. No respite at all. I have to get blood tests done
every 6 weeks, to make sure my liver hasn't shutdown due to drug toxicity.
One of my blood vessels is so scarred, they can no longer get blood from it.
In 2000, the pain in my back was so bad, the only way for me to move was
in a wheelchair. Standing up was excruciating, and walking was virtually
impossible. I was in the wheelchair until October 2003, when I had back
surgery to fuse my lower 3 vertebrae, and there's a 50% chance I will need
surgery again.
Now I can barely work, if at all, and my wife has to do everything. Since
the kids are grown & moved out, she has no assistance for daily chores. I
have no income, so now my wife is working 3 jobs, to try & make ends
meet. It can take up to 2 years to get Social Security -- Disability, and
if you are unable to work, you are not eligible for unemployment benefits...
According to the American College of Rheumatology, it costs between
$12,000-30,000 dollars a year for the medications. A steep price to pay
when you have no income, and haven't won the lottery.
Today, my wife finally got to bed at 4am, and left for work by 8am. She'll
do this everyday during tax season. Every night when I go to bed, I pray to
God to get my wife to work, and back home safely. She doesn't know how many
times I have woken up during the night, to hear her crying in her office,
or how many times I have laid in bed crying myself to sleep, because I can
not do a thing to help her. She is paying an even steeper price for my
disease than I am. Even when I was in better health, she still had to fight
with the insurance companies, and now it is even worse. Our coverage is
about to end, and there are no miracles, or jobs, in sight.
"Oh, it's only arthritis" ... if that were only true.
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End Notes:
- source: The National Arthritis Foundation
http://www.arthritis.org/
- source: Dr David Gotlieb, MBChB FCP(SA).
Rheumatologist & Specialist Internal Medicine
http://www.arthritis.co.za/
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