My Blog

Posts for tag: Rheumatoid Arthritis

Hearing your Rheumatologist or other physicians say that you have a chronic condition such as rheumatoid arthritis can be a very difficult rheumatoid arthritisexperience. While there is no cure for this condition, you must also know there are now very effective and successful treatments for this condition that has been so devastating to patients in the past resulting in disability, chronic pain, joint surgeries, loss of employment,  and inability to perform the usual activities of daily living (ADLs). 

Learning to control and manage your chronic symptoms can help you lead a normal and active life. Understanding and recognizing the symptoms of rheumatoid arthritis early can enable you to seek the treatment you need before your condition progresses into more advanced stages. Find out more about rheumatoid arthritis with our own Board Certified Rheumatologist  Mark Fisher MD  FACR in Haddon Heights, NJ.

What is rheumatoid arthritis?
Rheumatoid arthritis is a chronic autoimmune condition causing the body’s immune system to activate a multitude of inflammatory substances in your body. This causes inflammation, swelling, and discomfort and occurs most often in the hands, wrists, elbows, knees, and ankles and almost any joint in the body. It usually occurs in a symmetrical distribution, affecting both large and small joints. If left untreated or inadequately treated, rheumatoid arthritis begins damaging the cartilage and bones themselves, causing the space between the bones to lessen, erosions in the bone can occur, deformities result, pain and swelling worsen and function deteriorates. 

Symptoms of Rheumatoid Arthritis
One of the most common early warning signs of rheumatoid arthritis development is pain, stiffness, and tenderness in the joints. Patients in the earliest stages of this disease often do not notice any redness or swelling, but this does occur as the condition advances. Common signs of rheumatoid arthritis include:

  • joint pain
  • prolonged morning joint stiffness, lasting 1/2 hour to many hours
  • joint tenderness, swelling, or redness
  • symptoms usually occur in multiple joints
  • symptoms frequently occur symmetrically in similar joints on both sides of the body (i.e: both ankles, both wrists, hands, knees, shoulders )
  • symptoms  last longer than six weeks
  • Of course, other medical conditions such as Lyme disease and others can sometimes give similar symptoms and this is the reason that early medical evaluation by your primary or Rheumatology physician is so important
  • Early intervention has been shown to give the best results for joint protection and preservation, and the best response to treatment, avoidance of surgery, and maintenance of good function and activity

Rheumatoid Arthritis Treatments
Treatment for rheumatoid arthritis varies from patient to patient and depends on the stage and severity of the condition and other existing medical conditions. The main goals of treatment are to manage pain, reduce and stop inflammation, relieve and eliminate symptoms, and prevent long-term joint damage and disabling disease. It is very important to begin treatment early to start reducing inflammation. Some medications work to reduce the inflammation and symptoms of the disease while others work to slow down and prevent joint damage.

Non-steroidal Anti-inflammatory Agents (NSAIDs) - These medications work to help reduce symptoms of stiffness and pain, but do not protect the joints from damage. These can be both over the counter or prescription.

Corticosteroids - are generally used on a more short term basis and can be helpful in reducing inflammation acutely and short term while an effective medical program is developed with discussion between the patient and the treating physician. These medications can be very helpful to quickly reduce symptoms of pain and swelling and do have risks for many serious side effects. This is the reason they are used primarily for acute management while the long term program is instituted.

Disease Modifying Anti-rheumatic Drugs (DMARDS) - help reduce the signs and symptoms of RA. They work by slowing down joint damage and reducing inflammation. The conventional DMARDs can be very helpful in reducing the inflammatory activity and potential damage in joints. More aggressive and more successful management with biological DMARDs or monoclonal antibodies and others that have been placed in use over the past 20 years have made huge strides and fantastic differences in the management of this once devastating illness and improved the lives of millions of patients worldwide.

Of course, all medicines have potentially serious risks and must be discussed and understood, and these are very important concerns.

Other aspects of the treatment program may also include physical and occupational therapy, exercises, and proper nutrition. Some nutraceuticals such as omega 3s, flaxseed oil, turmeric/curcumin can add some further anti-inflammatory activity as a supplement but not a replacement for these overwhelmingly successful treatment programs

In severe cases, surgery to repair or replace the joint may become necessary. However, early visits and treatments can help reduce the need for surgery.

 Current treatments and medication offer very effective ways to manage this condition successfully.

For more information on rheumatoid arthritis and its treatment, please contact our Board Certified Rheumatologist  Mark Fisher, MD FACR in Haddon Heights, NJ. Call (856) 547-8004 to schedule your appointment today! He does serve the Southern NJ area in Burlington, Camden, Gloucester, Atlantic, and Cumberland Counties area.

By Rheumatoid Arthritis
October 29, 2018
Category: Rheumatologist

Find out the best ways to manage your joint pain and inflammation for the long term.

Have you been diagnosed with rheumatoid arthritis? This chronic autoimmune condition attacks the rheumatoid arthritislining of the joints, causing stiffness in your joints, joint swelling and pain that can lead to complications such as deformity and bone loss and functional impairments. This is the reason it is so important that those with Rheumatoid Arthritis have a Rheumatologist like our own Board Certified Rheumatologist, Dr. Mark Fisher in Haddon Heights, NJ, who can provide the effective treatment plan you need to manage symptoms and to prevent complications and most importantly to try and keep you active and enjoying the activities you love.

Even though there is currently no cure for Rheumatoid Arthritis, our Haddon Heights, NJ, Rheumatoid Arthritis Doctor can create a treatment plan and help you determine the right medication (or medications) to help you manage your symptoms and improve your quality of life. Our goal is to make living with RA easier for you. Make no mistake about the fact that No Cure DOES NOT MEAN there is no effective life-changing treatments!!  There are good effective treatments available to you!!

Here are the most common treatments that our doctor may prescribe:

ALL Medications have potential risks and the benefits vs risks of medications must always be taken into account for your condition and other medical problems if present.

Nonsteroidal Anti-Inflammatory Drugs (NSAIDs)

This includes those over-the-counter medications like ibuprofen or naproxen, which can help alleviate mild inflammation and discomfort. Of course, our rheumatologist may also prescribe stronger NSAIDs if these OTC medications aren’t enough.

Corticosteroids

One of the most commonly used steroids for treating RA is prednisone. This is a very strong medication that can handle more severe forms of inflammation while also slowing down joint damage. Of course, this medication should only be used for a short period of time and not long term. This is always to be considered only for temporary care where possible.

Disease-Modifying Antirheumatic Drugs

These medications do several  things: they slow the progression of RA ; they help to  protect the joints and tissues around the joints from serious and long-term damage and deformity; they reduce ongoing pain and symptoms of the arthritis by reducing the inflammation caused by this disease; and most importantly, they help to keep patients maintaining their quality of life.

Biological Monoclonal Antibodies and Small Molecule Medications:

These medications act on specific areas of the immune system that are responsible for triggering an inflammatory response in the body and damage from this chronic inflammatory disease. By suppressing these areas of the immune system, the medications can reduce inflammation, joint damage and deformities from occurring, and also other systemic effects of RA. New such medications are becoming available all of the time. These medications, in particular, have been life-changing for so many patients with RA.

These are very costly and the expense can be prohibitive. Fortunately, most insurances do help with these costs.

Also, the pharmaceutical companies do offer financial assistance for most patients requiring it, making it more affordable to many patients.

Other Treatment Options for Rheumatoid Arthritis:

Medications aren’t the only modality needed to treat rheumatoid arthritis. Your Rheumatologist may also recommend exercise or physical therapy to help keep joints feeling their best and keeping mobility optimal. Regular physical therapy can help keep joints supple and flexible. A physical therapist can also provide a list of advice and tips for how to execute certain everyday tasks to make it easier on you and your body.

In severe cases, it might be necessary to have surgery to repair joint damage and keep a patient active. Surgery may also be the only way to restore functionality within certain damaged joints or to correct deformities as a result of RA. Fortunately, the need for surgery has been significantly reduced in patients being treated early with a Rheumatologist with the newer medications currently available.

If you are suffering from rheumatoid arthritis, or if you are experiencing symptoms that you believe to be RA and you are living in or around Haddon Heights, NJ, or Southern NJ in Burlington, Camden, Gloucester, Atlantic, and Cumberland Counties, please give our office a call today to learn more about the different ways in which we can help you treat your long-term condition early and effectively. Call our Board Certified Rheumatologist 

Mark Fisher MD FACR at 856-547-8004 today.

Most major health insurances and Medicare are accepted.

 

Announcement from the American College of Rheumatology(ACR):

Dear ACR/ARHP members,

Early this morning we watched as Congress passed a sweeping spending agreement and sent the package to the White House for the President's signature. Along with a two-year agreement on spending, the package accomplished four of the College's top policy priorities: 
• Fixed the CMS rule that would have applied payment adjustments to Part B drug reimbursements and penalized physicians for providing high-cost drugs;
• Permanently repealed the arbitrary Medicare therapy caps, which could have affected millions of patients' access to vital rehabilitation services;

• Repealed the Independent Payment Advisory Board (IPAB), which would have had the power to impose cuts on providers without the review and deliberation of the regular legislative process; and
• Eliminated the Medicare Part D "donut hole," supporting our patients' ability to adhere to treatment plans. 
These are incredible victories for the Rheumatology, arthritis, and general medical communities that come after months of sustained advocacy efforts of the ACR and the participation of countless ACR/ARHP members. In particular, the rheumatology community led the charge to stop Medicare payment adjustments on Part B drugs. To those of you who contacted congressional offices, submitted letters to the editor to your local paper, and gave money to RheumPAC - your efforts paid off today. Because of your investment of time, talent, and money to magnify the College's voice on Capitol Hill, Congress heard us loud and clear. Thank you!

Even as we celebrate these victories, there is still much work to do to ensure that the 54 million Americans living with RA and other rheumatologic conditions can continue to access innovative, medically necessary, and life-sustaining care. Stay tuned as we continue to advance policies that provide relief from administrative hassles, boost rheumatology research and training, minimize our workforce shortage, and reduce drug costs so that patients can access innovative, critical treatments.

To address the challenges that lie ahead, it will take all of us pulling together to protect our patients and our profession. Thank you to all members of the ACR and ARHP who regularly take action on behalf of our patients. Thank you also to those members who are contributors to RheumPAC. Investing in RheumPAC is critical to help the ACR build the relationships with Congress that lead to these victories.

The ACR will continue to work for you, so you can be there for your patients.

Thank you,

David Daikh, MD, PhD
ACR President


© 2018 American College of Rheumatology | 2200 Lake Blvd NE | Atlanta, GA 30319 | US

 

This will be a huge help in preserving the needed access to care for patients with rheumatic diseases, especially those requiring some very costly drugs and other prescriptions to maintain a high quality of life and well controlled arthritic conditions and joint protection. 

Good to see much needed help and cooperation from the Congress, Senate , and President.
Mark Fisher MD

 
 

Coming soon.

 

This an old blog from Jack Kush, MD from his "RheumNow Week in Review" published 1/19/2018:

This past weekend I was fortunate to lecture at the Harvard Advances in Rheumatology Course, where I reviewed the safety issues surrounding the use of biologic therapies. In discussing infections, cancer, cardiovascular events, etc., it became very clear to me that these problems, while worrisome, are often escalated in their importance – all at the expense of what is most dangerous: RA itself."

 

I do agree with this blog from Dr. Kush. We must alway keep the proper and correct perspective

when we evaluate our conditions and make decisions on accepting and seeking treatment. There are always

potential risks with treatments of diseases AND ALSO NOT treating diseases!

We must remember this and keep the proper balance and appropriate judgements in optimizing our health care and wellness.

By Mark Fisher MD
January 02, 2018
Category: Rheumatologist

Find out more about this inflammatory autoimmune disease and how to treat it.

Have you or a loved one recently been diagnosed with rheumatoid arthritis? If so, then chances are good that you are looking for more rheumatoid arthritisinformation about this condition and the treatment options available to you to reduce your painful symptoms, reduced your risks for joint damage, and preserve your overall functioning. Our Haddon Heights, NJ, Rheumatologist, Dr. Mark Fisher, is here to answer all of your questions about rheumatoid arthritis so you can understand more about this chronic condition and what you can do about it.

What is rheumatoid arthritis (RA)?

This chronic condition is an autoimmune disorder that attacks the joints of the body. This can lead to a thickening of the tissue around the joint known as synovitis. This thickening leads to widespread pain and swelling and potential damage to the joints. Joint deformity and malfunction can result and a disabling, progressive arthritis affecting multiple joints in a symmetrical fashion ensues. 

If RA is left untreated, it can cause permanent damage to the joints, tissue and cartilage, which is why it’s so important to visit our Haddon Heights rheumatoid arthritis doctor right away for an early diagnosis. The sooner we can start treatment the better. Early diagnosis and management is always the key to the best success!!

What are the symptoms?

Those with RA will experience a variety of different joint-related symptoms including,

  • Swelling, stiffness and joint pain (lasting longer than six weeks). 
  • Prolonged morning stiffness more than 1-3 hours distinguishes RA from the usual arthritis we may experience with age known as osteoarthritis.
  • Widespread joint discomfort, usually in a symmetrical distribution
  • Pain and swelling within smaller joints 
  • (e.g. joints within the hands or feet)  and also can include larger joints ( e.g. shoulders, hips, and knees)

Along with joint pain, swelling, and inflammation, those with RA may also have a lack of an appetite, weight loss, chronic lethargy,  fever, lumps or nodules over the elbows and other areas. RA symptoms may flare-up and is characterized by such exacerbations of pain and swelling of joints, and can last several months; however, this also means that there are periods of lesser activity of symptoms where you might experience fewer symptoms.

Since RA is an autoimmune disorder it can affect everything from the eyes and skin to the lungs and even the blood.Patients with such a disorder can also have higher risks for internal problems such as cancer, cardiovascular complications, anemia, and other medical problems.

How is RA treated?

While RA cannot be cured, but there is a very effective treatment for it. The inflammation and pain can be managed and complications (e.g. joint damage and other risks) can be greatly reduced through early diagnosis and with the proper medication. Common RA medications include,

  • Nonsteroidal anti-inflammatory medications (to reduce pain and inflammation)
  • Corticosteroids (to manage severe inflammation flares
  • Disease-modifying anti-rheumatic drugs (DMARDs) such as methotrexate, antimalarials, sulfasalazine
  • Biologic monoclonal antibodies and these have made phenomenal changes in the course of this illness for many and life-changing impact on patients' lives and functionality

During your visit, we will discuss which medications will help your symptoms and offer the best overall plan to maintain your function and joint protection with the least risks.

If you are looking for a Rheumatologist in Haddon Heights, NJ, who can help your RA symptoms and to improve your quality of life, then look no further than our very own Dr. Fisher. Our compassionate, caring team is here to help you every step of the way, so you can enjoy what really matters in life.

Call 856-547-8004



Camden County, NJ Rheumatologist
Mark Fisher, MD 713 Station Ave
Haddon Heights, NJ 08035
(856) 547-8004