Is arthritis fatal?

As a big group of diseases, lumped as one in common knowledge as "rheumatism" -  no, arthritis do not kill. Surely, it can mame and relegate the arthritic to a life of pain, but in the lay mind's mind, nobody dies of arthritis.

However, there are arthritides that can cost a life. Mostly, these are the untreated, undiagnosed  ones, albeit, rare, still, a fact that one should be vigilant about. The key to avoiding the fatal effects of some rheumatic diseases is early diagnosis and treatment.

Here is a short list of serious types of rheumatic diseases that may directly cause death if left untreated for long:
1. Uncontrolled/untreated lupus
     nephritis or kidney inflammation
     lupus lung hemorrhage
     lupus blood disorders
     lupus brain inflammation
2. Lung and brain hemorrhage of Bechet's syndrome
3. Vasculitis or inflammation of blood vessels especially those in the heart, lungs and brain
4. Blood clots in the lungs in hypercoagulable conditions like APS (antiphospholipid antibody syndrome), and catastrophic APS when many other organs of the body are involved
5. Progressive systemic sclerosis (generalized form of Scleroderma) and  CREST syndrome with their associated pulmonary hypertension

List of complications of arthritis and/or treatment that have proven fatal in the long run:
1. kidney disease of gout
2. Stomach and intestinal bleeding due to unsupervised intake of pain medicines
3. Kidney disease from unsupervised intake of pain medicines
4. Presence of other diseases in the arthritic individual, like diabetes, infections anywhere in the body, heart failure, liver disease, high blood pressure
5. Intake of alternative medicines that can have kidney and liver side effects

It is therefore prudent advise to see a rheumatologist early in a disease with symptoms of joint swelling and pain. 

Some like it hot!

Have you noticed how achy joints get stiff on a cold morning?

This is a major dilemma for many arthritis patients who plan to travel to a colder country. You see, in most parts of the Philippines, a cold December or January means a 25 degrees centigrade and summer is easily a 37. And for many of my patients, at 25 C, the joints complain!

This observation is common and hypotheses abound as to why the so-called "gelling phenomenon" of arthritic joints happen. It is said that the lesser motion during sleep may cause inflammatory elements to remain in the joint areas and cause more tightness and consequently, pain, as the patient starts to move on awakening. Pain on the other hand, is chronic in most of the arthritides, and chronic pain can make an individual sensitive even to a slight touch, temperature/weather change or anything at all, that ordinarily should not cause pain. This is called allodynia, a close equivalent to lowered pain threshold. So, we happily "blame it all on the weather".

The association of cold and achy joints is very strong for some patients and yet, in my experience, as soon as these patients from the tropics get to the colder countries, many if not all, report back that their arthritis has not intensified, or even, that the pain had gone altogether. 

The explanation? Your guess is as good as mine. I do tell my patients who worry about such trips to temperate countries to go and enjoy their visit, because, the weather may not matter after all. Still, the standard advise to get that extra warm mitten or socks, just in case, is still to be given, just in case.