Dr. Tagomata - Internist & Rayuma Specialist

23/12/2025

Grateful to see patients with psoriatic arthritis, spondyloarthritis, rheumatoid arthritis, lupus, and osteoarthritis during this December clinic in Virac. Thank you, CDHI!

18/12/2025

Wishing you a blessed Christmas and a happy 2026! Clinic resumes on January 3 (Saturday).

17/12/2025

Around 50 percent of adults with lupus will develop lupus nephritis. Head to the link in comments to learn more about lupus nephritis stages, treatment, and more.

16/12/2025

16/12/2025

Dactylitis can be a symptom of psoriatic arthritis where fingers or toes swell and become painful.
Understanding what it feels like and how it relates to your condition can help you talk with your care team and manage symptoms better.
Click the link in the comments.

16/12/2025

Feeling Tired? The Connection Between RA and Fatigue

If you have rheumatoid arthritis (RA), symptoms like joint pain and swelling are a given. But you may also be in the grip of a less tangible symptom: chronic fatigue. In fact, fatigue is one of the most common and frustrating RA symptoms.

“RA fatigue is a symptom that we rheumatologists really struggle with understanding well," says Yousaf Ali, MBBS, a professor of medicine at the Icahn School of Medicine and chief of the division of rheumatology at Mount Sinai West Hospital in New York City. "It is a systemic type of exhaustion, meaning it affects your whole system instead of just a certain body part."

People who have RA often describe their fatigue as a deep tiredness or slowing down, akin to the feeling someone might have while recovering from the flu.

It’s also worth noting that there are other potential causes of fatigue, outside of RA. “You should be evaluated for reversible causes of chronic fatigue, such as depression, anemia, sleep apnea, and hypothyroidism,” Dr. Ali says. Depression in particular can also take a toll on energy levels and create a snowball effect, as having RA can cause depression, and having depression can also make RA symptoms worse. Other underlying causes of exhaustion may include side effects from your medications or poor sleep.

Once you’ve determined what’s causing your fatigue, you can work with your doctor to eliminate it or get proper treatment. You’ll likely need a strategy that addresses multiple fronts and goes beyond the basics, like taking rest breaks, to start feeling energized again.

Strategies to Boost Your Energy
Any plan to fight fatigue begins with taking good care of yourself. Start with these tips to help you manage chronic RA fatigue and regain energy.

1. Talk to your doctor about controlling RA inflammation. You don’t need to battle fatigue on your own; working with your doctor to get any underlying RA-related inflammation under control can help significantly. “Cytokines — proteins produced by cells — can amplify inflammation, which may have a direct influence on brain receptors to cause fatigue. So the first step is to work with your rheumatologist to get inflammation under control," Ali says. "Medications that decrease inflammation often decrease fatigue."

2. Kick-start your exercise routine. “Inactivity can be a vicious circle — RA fatigue makes it hard to get moving, and inactivity makes fatigue worse," Ali explains. "Most people with RA do feel energized after exercise. It may help to work with a physical therapist to get started." The best exercises for people with RA are often low-impact activities like stationary cycling, swimming, and walking.

3. Nix the naps. A good night’s sleep requires healthy sleep habits. If possible, avoid napping during the day. You need to be awake for about 16 hours in order to sleep well at night — for example, getting up at 7 a.m. and going to bed at 11 p.m. When you do turn in, keep your bedroom quiet, dark, and comfortable and avoid making it an entertainment center (that means no electronics). Also, skip the alcohol and heavy meals before bedtime and limit caffeine after noon. Going to bed and waking up at the same time every day can also help you establish a quality sleep routine that leaves you feeling refreshed.

4. Try assistive devices. Using certain devices can help cut down on the energy you use every day at home and at work. Home devices include zipper pulls, buttonhooks, electric can openers, gripping and reaching tools, and bathroom bars, and handrails. Workplace devices may include a height-adjustable chair and work surface and a hands-free telephone headset. An occupational therapist can help you identify the right tools to try and adjustments to make to help you save energy and feel more comfortable throughout the day.

5. Consider cognitive behavioral therapy (CBT). Having a chronic and unpredictable physical condition is exhausting in itself, and it can take a toll on your emotional health. CBT, which is a form of talk therapy, teaches you to change the way you think about fatigue — and changing your thinking can alter the way you feel and act. A study published in May 2017 in the journal Current Opinion in Rheumatology suggested that RA-related fatigue may often be due to causes outside the condition itself — and that the best ways to reduce fatigue might be cognitive, such as cognitive behavioral therapy, as well as behavioral, such as getting exercise.

6. Ask your doctor about medications for fatigue. Certain medications may help chronic fatigue, such as modafinil. However, "you need to use these with caution, because once you start taking them, it may be hard to stop," Ali says. "Tramadol is a pain medication that can help improve sleep that’s disrupted by RA pain. As another option, a low-dose antidepressant, also given at bedtime, has been shown to reduce pain, increase sleep, and reduce fatigue in some people with RA," he says.

The chronic fatigue of RA may not be as clear-cut as pain and swelling, but it can take a toll on your physical and mental well-being. To fight fatigue, a team approach is best, meaning you should enlist the help of your rheumatologist, a physical therapist, an occupational therapist, and a mental health specialist.

Remember, the most important member of your care team is you. Be sure to learn as much as you can about RA and work with your care team to get fatigued under control so you can get your energy back.

helpfightra.org

11/12/2025

Nakaramdam ka na ba ng ganito sa mga kamay mo?

07/12/2025

“Should I stay or should I go?” Chances are you’ve grappled with that question during an apparent lupus flare, trying to suss out if your symptoms could be

05/12/2025

ATM: Attending lectures on constipation, diarrhea and other gastro issues for my patients

04/12/2025

Rheumatoid Arthritis in the Elbow: What to Know...

It affects smaller joints in the body as well as larger ones. When there’s involvement of smaller joints, it commonly develops in the elbow. Elbow involvement is often symmetrical, affecting both the right and left arms in about 20% to 65% of people living with RA.

Elbow pain can start in the early stages of the disease. As RA progresses, other parts of the body become affected, too. This includes the joint lining in the hips, knees, and hands.

How RA affects the elbow

Rheumatoid arthritis can gradually damage or destroy soft tissue. It primarily causes inflammation and swelling in the joint lining of the elbow. Some people even develop a noticeable bulge near their elbow where the inflamed joint lining has pushed out.

Pain and swelling aren’t the only complications of RA in the elbow. Severe swelling can also lead to nerve compression. If so, you may have a pins and needles sensation in your elbow. Or, you might have complete or partial numbness in your elbow and distal arm.
Uncontrolled inflammation in the elbow may also cause cartilage and bone damage.

Pain from rheumatoid arthritis in the elbow is often symmetrical and best described as a dull ache or throbbing pain. In the beginning stages, you may have intermittent pain that comes and goes, or you may only feel pain with certain movements like bending your elbow. As your disease progresses, elbow pain can become persistent, or the slightest movement can trigger discomfort.

Pain from RA in the elbow differs from pain caused by an injury. With an injury, pain can be short-term and gradually improve. RA pain does not improve on its own. Instead, pain can become progressively worse if left untreated. RA in the elbow may also feel worse at certain times of the day, such as in the morning.

What are elbow nodules?

Along with pain, you may also develop rheumatoid nodules. These are firm, tender lumps that form under the skin. They’re typically associated with rheumatoid arthritis in the hands, feet, and elbows.
Nodules can occur as RA progresses. They vary in size and typically take a circular shape. These lumps form during a flare-up. They’re also associated with a more severe disease type.

Up to 20 percent of people with RA develop nodules; the exact cause of these lumps is unknown, but they tend to occur in people who smoke, those who have a severe form of the disease, and in people who have other inflammatory conditions.

RA in the elbow can affect mobility, making it difficult to extend or bend your arm. Your elbow joints may also lock in place or you may have periods of instability. This is when the elbow joint gives out and it becomes difficult to complete activities. Elbow pain may occur mostly on the outer side of the joint. As your disease worsens, you may have pain that interferes with sleep.

Treatment options

Treatment doesn’t cure RA in the elbow, but it can reduce inflammation, stiffness, and swelling. The goal of treatment is to slow the progression of the disease and bring about remission.
Your medical treatment depends on the severity of your condition and might include nonsurgical or surgical options.

Nonsurgical treatments are the first line of the defense for rheumatoid arthritis in the elbow.

Medication

Medication options include:
•OTC pain medication. Nonsteroidal anti-inflammatory drugs (NSAIDs) can block inflammation and reduce swelling. These medications provide short-term relief and include naproxen sodium (Aleve) or ibuprofen (Motrin). Topicals containing this type of medication are also available.
•Corticosteroids. Steroids can be taken orally or by injection into the elbow, and effectively reduces pain and inflammation. Oral steroids are used sparingly due to potential side effects.
•DMARDs. Disease-modifying anti-rheumatic drugs (DMARDs) work to block inflammation of the joints.
•Biologics. These medications target specific parts of the immune system that lead to inflammation.
Bottom line is pain in the elbow is typical with RA. There’s no cure, but with treatment it’s possible to block inflammation and reduce symptoms like swelling, stiffness, and loss of movement; pain may not improve on its own, speak with your doctor to discuss an effective treatment plan. The sooner you treat the condition, the sooner you can achieve remission/relief.

helpfightra.org

03/12/2025

FYI: Updated clinic schedule of our IM-Nephrologist at Klinika. You may book a consult via +639926579937 (Maam Gracel).