Rheumatoid arthritis was the chief cause of our older sister's death in August of 2020. Susan was barely 64 years old when she died of a massive infection around her spine brought on by her RA medication.
I can't remember the name of the medication that she took for over a decade, I only know she had to inject herself once a week IIRC, and that it had to be refrigerated. It slowly destroyed her immune system, and somehow she developed an infection that spread along her spinal column and began to grow. It started as back pain, until she couldn't move due to the pain.
She spent a month in 2 hospitals before they realized what had happened. Surgery wasn't an option. She ended up having a stroke from a blood clot in her brain that effectively killed her. My brother in law broke the terrible news to my wife and I after telling their kids first, then he told my 2 other sisters.
Susan was still breathing, but she was gone, which meant that he had to pull the plug, but he chose to wait a day to do so because this all happened on their daughter's birthday. Not a good day to remember your mom's death.
When this garbage was all over, we were talking with her husband about what had happened, and he told us something we didn't know. Susan's doctor's told her that they could treat her RA, but that it might come at the expense of living a shorter life. The drugs used to treat it may damage the immune system over long periods of time, and she needed to make a decision about what she wanted to do. So she and Tom talked about it, and she chose to accept the treatment option rather than deal with the condition on her own.
I wish she had told us this, when she went into that hospital in July of 2020, we never saw or heard from her again.