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Gary S. Firestein, MD

Gary S. Firestein, MD is Founding Director of the Clinical and Translational Research Institute and the Senior Associate Vice Chancellor of Health Sciences at UC San Diego. Dr. Firestein joined the faculty at UCSD School of Medicine as Assistant Professor of Medicine in 1988. Four years later, he was recruited by Gensia, Inc. to be Director of Immunology where he supervised drug discovery efforts focusing on the potential role of purines in inflammation. In 1996, he returned to UCSD where he served as chief of the Division of Rheumatology, Allergy and Immunology from 1998 until 2010.

Dr. Firestein's research interest focuses on the pathogenesis and treatment of rheumatoid arthritis. He was among the first to map the cytokine profile of RA and demonstrate the dominance of macrophage and fibroblast products. These studies played a pivotal role in the development of highly effective anti-TNF and other anti-cytokine therapies for RA. More recently, he helped define the role of signal transduction and epigenetics in RA. In 1998, Dr. Firestein received the Carol-Nachman Prize, which is an international award given for outstanding contributions to rheumatology research. In 2006 and 2009, he received the Arthritis Foundation Lee C. Howley Sr Prize for Arthritis Research and the American College of Rheumatology Distinguished Investigator Award, respectively. Dr. Firestein received the Arthritis Foundation's Jane Wyman Humanitarian Award in 2010 for contributions to rheumatology. He has been elected to the American Society for Clinical Investigation and the Association of American Physicians. In 2019, he received an honorary Doctor of Science degree from the University of Glasgow.

Dr. Firestein has written over 370 articles and chapters and has edited or written several books. He served as the Deputy Editor of Arthritis & Rheumatism and is the Editor-in-Chief of the Firestein and Kelley's Textbook of Rheumatology. He was chairperson of the FDA Arthritis Advisory Committee and has served on the ACR Committee on Research, the ACR Committee on Journal Publications, the ACR Committee on Nominations, the Arthritis Foundation Research Committee, NIAMS Advisory Council and the Board of Directors of the Veteran's Medical Research Foundation, ACR Rheumatology Research Foundation, and the American College of Rheumatology.

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Doctor examining senior woman's arm for Symptoms of Rheumatoid Arthritis
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How to Talk to Your Health Care Professional about the Symptoms of Rheumatoid Arthritis

Ask the Expert

Q:

I want to make sure my rheumatologist knows about the pain and stiffness rheumatoid arthritis (RA) is causing, but I'm afraid of being thought of as a complainer. What is the best way to discuss the RA symptoms I am experiencing?

A:

It's not you, it's RA.

Your rheumatologist knows that a chronic, painful disease like RA demands lifelong treatment and carries a high risk of continual symptoms if the condition is not treated optimally. Never feel ashamed or embarrassed to bring your concerns to your rheumatologist's attention. Rheumatologists are trained to evaluate pain associated with RA and need to know how you are feeling. Managing RA requires open communication and a partnership with your doctor.

If pain and stiffness caused by RA are interfering with your daily routine, do not hesitate to consult your rheumatologist. Waiting too long to consult a doctor about pain caused by RA, may cause symptoms to worsen. Your rheumatologist will want to ensure that you get the most from your treatment through the appropriate combination of medication, rest, exercise and other healthy habits.

Research shows higher levels of patient awareness and greater willingness to participate in treatment plans can lead to decreased pain and fewer visits to doctor’s offices for RA patients. You should be commended for speaking up and being proactive about your health. Your attention to your body should never be perceived by your health care providers as complaining.

There are approximately 1.3 million people in the United States with rheumatoid arthritis. Know that you are not alone and do not be concerned with burdening your rheumatologist. Instead, see this as an opportunity to help in the diagnostic process and development of a treatment plan.

Remember, your health care providers cannot read minds. Be honest, specific and direct about what's bothering you. This will help ensure the best outcome for you and the best preparation for your rheumatologist.

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