Rheumatoid Arthritis (RA) is a chronic autoimmune disease characterized by an impairment of your immune system which attacks the healthy synovial lining found in between the joints. This often presents itself with inflammation which causes joint pain and stiffness. It affects both sides of the body with a similar pattern and normally affects the small joints in the hands and feet. Part of why this disease is serious is that if it is not monitored correctly and treated adequately, it can affect the heart, lungs, and eyes as well as temporarily affecting the joints leading to disability. This condition can affect people at any age, although it normally tends to develop in people over 40 years old. Young people who develop RA, are characterized as having an “early-onset” of this disease. Currently, it is estimated that over 23 million people worldwide live with RA, with 400,000 people in the UK being affected by it.
Q: Could you give me a brief introduction about yourself?
A: My name is Alejandro, I am 21 years old and am currently a Sports and Exercise Science undergraduate student at a Spanish university. I was diagnosed with Rheumatoid Arthritis when I was 13 years old and have been dealing with it ever since.
Q: When did you start developing your first symptoms and what were they?
A: I was 10 years old when I broke my radial bone. During my treatment, I wore a plaster cast on my arm and after removal, the doctor noticed my left wrist was swollen, painful, and had a small bump. At first, they thought it could be due to a ganglion cyst which was suspected to be due to trauma although they were unsure of the cause. Several days passed until one day, I awoke to find that my right wrist had also swollen to the same extent as the other one with the same intensity of pain. Therefore, my doctor decided that several tests should be done to see if it could be due to Rheumatoid Arthritis (RA).
Q: Did that significantly impact your life? If so, how long did it take you to adapt?
A: At first, as I was very young, it did impact my life in some way. In the first few years, I had to make several visits to the hospital to do all the tests needed to confirm the suspected diagnosis and to be treated accordingly by specialists. As this condition can make you susceptible to infection, (especially when you take medication), doctors had to ensure I had all my vaccines up to date. I would say it took me several years to properly understand my condition and how to deal with it. Nowadays, I feel I have a normal approach to it and I don’t feel as confused as before. I often go for check-ups in the hospital, where they do the usual blood tests and check if I need any extra immunisation (e.g. a vaccine due to seasonal flu).
Q: What is the current medication you take? Are there any precautions?
A: The name of the medication I use is HUMIRA®(adalimumab)*. It is used as a subcutaneous injection. Initially, the administration of the injection was very painful for me, as the medication was very new and harsh. I remember I started using this medication as soon as it was marketed here in Spain. Regarding any precautions, when
administering my RA medication I need to ensure the area of my leg where I administer it is disinfected and clean, before and after the injection.
*The active substance of HUMIRA® is adalimumab, which is a human monoclonal antibody which targets the tumor necrosis factor (TNFa), a multifunctional proinflammatory cytokine secreted by macrophages/monocytes that affects the immune system response. This protein is found elevated levels in conditions such as Ulcerative colitis, psoriasis, and rheumatoid arthritis, among others. By targeting TNFa, HUMIRA® significantly decreases inflammation caused by those diseases.
Q: What precautions do you need to take in order to avoid a relapse?
A: It is very important to follow all the instructions provided by your doctor and to self-administer your medication when it is due. Some people need to take their medication every 15 days, whereas in my case, I need to take mine every 21 days. It varies depending on age, how developed the condition is in your body as well as many other factors. Another thing that can impact or worsen RA is temperature. I have noticed that the cold or sudden changes in temperature make my joints very stiff. This increases pain in that area. Therefore, I feel this is something people with RA should be mindful of, especially if they are living in cold environments.
Q: What advice would you give to people suffering from the same condition as you?
A: My first advice for young people experiencing this is that they should not feel scared, as that is the initial reaction most people would have as soon as they are diagnosed with RA. I would also like to say that your mindset is very important to deal with this condition. The best thing to do is to try and stay positive whilst putting things in perspective. Your life will indeed change, but I can guarantee that with medication, it will reduce the joint pain enough so that you can continue with it.
This interview was made to raise awareness of autoimmune conditions and how these can impact the lives of people worldwide, especially amongst young people. Although RA currently has no cure, pharmaceutical companies work every day around the clock to thoroughly understand this condition and come up with treatments that can significantly reduce the impact and morbidity of Rheumatoid Arthritis. If you are interested in knowing more about this condition, many societies offer information online such as:
The National Rheumatoid Arthritis Society (NRAS): https://www.nras.org.uk/what-is-ra-article
Arthritis Foundation: https://www.arthritis.org/