“I encourage my patients to join local support groups through the Arthritis Foundation, [such as] Silver Sneakers, which is a fitness group for seniors, and to also look at local exercise groups that offer arthritis-friendly yoga or aquatic exercise,” she says. “I try to view each patient as a whole and take into account their stress, work, family circumstances, sleep hygiene and depression. If needed, I refer [patients] to other specialties, including psychologists, physical therapists and nutritionists, to help with their care.”
Knowing that patients with rheumatic diseases often have comorbidities, including hypertension, diabetes and osteoporosis, Dr. Pagnussat strives to look beyond each patient’s initial diagnosis to determine how to optimize the management of these diseases while also improving patient outcomes.
“Patients with any chronic condition get depressed because of their condition and how it affects their life on a daily basis,” she says. “Many can’t pursue hobbies and sports they used to enjoy, because they’re now in pain,” Dr. Pagnussat says. “It’s a vicious cycle because pain also leads to fatigue and depression, and I’ve found that if all these factors aren’t addressed, they can negatively impact a patient’s overall health.”
Empower Patients
Rather than relying solely on pain-relieving medications, Dr. Pagnassat encourages her patients to be proactive about self-managing their chronic conditions and improving their quality of life. “I stress the importance of exercise therapy, managing stress and getting adequate sleep,” Dr. Pagnassat says. “I encourage my patients to follow a diet containing anti-inflammatory food, lots of fish and vegetables, and cut out processed, high-fat foods. Some patients don’t realize that even a modest weight loss of 5–10 lbs. can help with weight-dependent joints like hips, knees and ankles.”
Dr. Pagnussat manages her own RA though a combination of medical treatments, diet and exercise.
“I don’t like to talk about my specific treatment regimen because RA affects each individual differently, and treatment needs to be tailored to each patient’s individual case,” she says. “I do try to educate my patients about such topics as diet because some believe diet alone can cure arthritis. [Although] I don’t believe diet alone is effective in treating RA, I do avoid fatty, processed foods and sodas that have been linked to an increase in inflammation.”
Working with each patient to develop a treatment plan ensures that both parties are on the same page when it comes to managing their rheumatic disease, says Dr. Pagnussat, and identifying measurable targets to determine their disease is well controlled.
