Write to us at: Inspire, 1 Cambridge Technopark, Newmarket Road, Cambridge, CB5 8PB, or email inspire@versusarthritis.org Ask the doctor Q Whether its a health niggle or emotional problem, DR SARAH JARVIS gets straight to the point I have rheumatoid arthritis and have recently been diagnosed with lung fibrosis. The doctor has said theyre connected, but I thought arthritis just affected your joints? Dr Sarah Jarvis answers: While most people think of rheumatoid arthritis as a joint condition, it can affect many other parts of your body your lungs, heart, kidneys, skin and gut to name just some. In fact, up to two in five people with rheumatoid arthritis have a complication called interstitial lung disease or ILD. The interstitium of your lungs is a network of tissue responsible for allowing oxygen from your lungs to enter your bloodstream and carbon dioxide to leave. Different types of ILD affect the interstitium. Some cause inflammation (which can settle down without permanent damage). Others cause scarring, known as fibrosis, which cant be reversed. Lung fibrosis (aka pulmonary fibrosis) is a type of ILD that affects about 1 in 10 people with rheumatoid arthritis. If you have this, you should be referred to a specialist hospital team there are about 23 such services in the UK. If you smoke, you should definitely try to quit the NHS website has lots of support, including a free NHS Quit Smoking app. If you need it, youll be prescribed oxygen therapy. Pulmonary rehabilitation advice and exercises to help you manage your breathing and reduce breathlessness may be offered. Many people with rheumatoid arthritis are already having immunosuppressive therapy. This group of medicines damp down inflammation caused by your overactive immune system. Such therapy is also often used to treat pulmonary fibrosis; your lung and rheumatology teams will liaise to agree which medicine would work best for you. The treatment options for pulmonary fibrosis have been fairly limited in the past. However, the past few years have seen some exciting advances, with the development of anti-fibrotic medicines to reduce progression of fibrosis. Depending on your individual case, your doctor may discuss one of these drugs, called nintedanib or pirfenidone. Ask the expert Q NICKY WHELAN is a Helpline Advisor for Versus Arthritis As spring approaches and everyone is getting outside more, I feel sad as my osteoarthritis and anxiety makes it hard for me to go out. How can I overcome this? Nicky answers: Research shows osteoarthritis can increase the risk of isolation. You can boost wellbeing by creating a list of things you enjoy, and do one thing that makes you happy each day, be it baking a cake, sitting in the garden, listening to music or mindfulness. Go for a short walk or plan to meet family or friends in a local park with seats and facilities close by. Make simple plans, in advance, that are manageable, so you dont feel too overwhelmed. Finding local groups to meet others at a local caf or a gentle exercise class for example can reduce isolation and build friendships. Use walking aids or find a walking partner if you are concerned about mobility. Do reach out to talk to others if you are struggling, and try to look forward to the warmer weather arriving. Stepping outside for a bit of fresh air can instantly boost a low mood and relieve anxiety, too. 12 Inspire Spring 23 pp12 Ask.indd 12 15/02/2023 09:21