Finding Relief for Rheumatoid Arthritis

At 84, Elaine Sisto is no stranger to health issues.

“I had a Whipple procedure twelve years ago,” she says, referring to an extremely complex surgical procedure to treat tumors and other disorders of the pancreas, intestine and bile duct. “My two hips, two knees and one ankle are fake, and for two years now, I’ve had peripheral neuropathy and lost control of my balance, so I have to use a walker.”

But it wasn’t until last year, when her hands had become so swollen and painful she couldn’t use them, that she came close to giving up.

“It’s like my hands were on fire, all puffed up so that my knuckles were three times their normal size,” the Chicago resident relates. “When I told my daughter about it, I started to cry. In order to use my walker, I need my hands, but if they hurt so bad, how was I going to walk? It was nearly impossible to wash or wipe myself, and I didn’t want to be a burden to my kids. I took all sorts of ibuprofen, but nothing helped.

“I was at my wits’ end,” she admits.

Even the doctors she saw in Chicago said they couldn’t — or wouldn’t — help her.

“One of them said it was just wear and tear [osteoarthritis], and there was nothing he could do,” Sisto recalls. “The other one basically said, ‘You’re old, what do you expect?’ And they gave me medications for the pain.”

Relief in the desert

Then, during a winter visit to her daughter here in the desert, a neighbor suggested that Sisto see her “nice rheumatologist at Eisenhower Health.” So last March, Sisto scheduled an appointment with Kam Newman, MD, Board Certified in Internal Medicine and Rheumatology.

“You’d think this man had no other patients because he acts like you’re the only person in the room,” Sisto says. “He listens, he looks you in the eye, and he makes sure you understand everything he says. He’s such a great doctor.”

After running extensive blood tests and taking X-rays, Dr. Newman determined that what was causing the problem in Sisto’s hands was rheumatoid arthritis (RA), not just wear and tear, or old age.

In RA, the body’s immune system, which normally protects our health by attacking foreign substances like bacteria and viruses, mistakenly attacks the joints. This triggers inflammation that causes the tissue lining the inside of joints (the synovium) to thicken, resulting in swelling and pain in and around the joints.

The golden age of rheumatology

According to the Arthritis Foundation, about 1.5 million people in the United States have RA, with nearly three times as many women having the disease as men. In women, RA most commonly begins between ages 30 and 60; in men, it often occurs later in life. Having a family member with RA increases the odds of having it yourself; however, the majority of people with RA have no family history of the disease.

“If diagnosed late, RA can cause joint deformity, and this unfortunately can’t be reversed,” Dr. Newman points out, underscoring why early diagnosis and aggressive treatment are so crucial.

“So while we can’t do anything about Ms. Sisto’s deformed joints at this point, we do have treatments that reduce inflammation, stiffness and pain,” he says.

In fact, Dr. Newman calls this the golden age of rheumatology.

“Today we have many biologics for treating the range of rheumatic diseases,” he explains. “This is a new generation of medications that target only a small portion of the immune system, and with fewer side effects and greater effectiveness than older medications like steroids, which have a lot of side effects.”

“My knuckles are half the size they were.”

In Sisto’s case, she receives a weekly subcutaneous injection (in her stomach) of methotrexate. It’s one of the most effective and widely used medications for treating RA and other inflammatory types of arthritis. She undergoes blood work every six to eight weeks to monitor her calcium levels, and liver and kidney function.

Sisto also gets a once-a-year intravenous infusion of a bone-building medication to help prevent her osteoporosis, another rheumatic disease, from worsening. “My bones are like glass,” she says.

It has made a world of difference in her daily life and outlook.

“I thought my world had ended,” she says. “I was getting so depressed before, and didn’t know what to do.

“But then I found Dr. Newman,” she continues. “My knuckles are half the size they were. And to be pain-free — to pick up a pot, brush my teeth — I can do all that now. I can get dressed, go out to lunch or to a show. I may be 84, and I may have the body of a 104-year-old, but I think like a 24-year old. It’s all due to Dr. Newman, and I am just so grateful.

“I didn’t think doctors like him existed,” she adds. “I just had to go to California to find him.”