Tag Archives: RA

Once Burnt, Twice Shy

“Pain changes everything.”

That’s what my wonderful and amazing physical therapist said to me. She was having me walk side by side with her while she held her hand up, palm towards me, and had me lean my left shoulder against it as we walked. It was to retrain my brain, though she didn’t specify that, I knew that was the purpose of the exercise.

I tend to favor my left leg, therefore, I walk crooked. My gait is off, with the resultant muscle cramps on that side. Muscles screaming at me, hey, this is not our regular job!

But that’s what naturally happens with an injury, you subconsciously splint whichever part of the body has suffered, to protect it. It is primal, it is reflex, it is the survival instinct.

After the horrific pain I experienced for weeks, due to sciatica and a slipped lumbar disc, my brain wants to avoid a repeat. I don’t even have to think it. It’s like breathing. I limp when I don’t have to.

Now, I have to interrupt the distress signal that’s automatically being sent out. I have to teach my brain that it’s OK now. It’s OK to put my full weight on my leg. It’s OK to walk normally. It’s OK to climb one step with it, and step back down with it. I won’t crumble.

Now at the end of week 6 since this saga began, I am doing much better with medication and even better with PT, after only two sessions so far. I thought for sure there would be hell to pay the morning after my first session, but amazingly there was almost no pain in the morning, which is when I suffer the worst pain of the day, usually.

My therapist is showing me what my leg can still do, putting it through a workout, which even includes pedaling a stationary bike. At first, I was skeptical, but I got on the bike, put my feet on the pedals and got going, and it was like: Look, Ma, no pain!

I have to admit that my favorite moments of that hour and a half are the heat treatment in the beginning, followed by massage to my sore left side and leg, and the ice treatment, along with lower back muscle stimulation, at the end.

In between those moments, I could very well be at a gym with my own personal trainer coaching me through one exercise followed by another and then another. Everyone is masked, given the age we live in now, and everyone is pleasant and accommodating.

I actually look forward to going to my twice-a-week sessions, and I’m thankful to having my leg back in action and my pain mostly gone. And I do my exercises faithfully every day to strengthen my leg and my core. And hopefully, I will need no further intervention.

As I hope all is well with you.

My new exercise ball with which I do stretches while sitting in a chair. My grandkids will have fun with it as well.

Sigh-Atica Part 2

My pretty IV. Never had one that’s pink and purple before.

just like I never had sciatica land me in the hospital before.

it’s been a wild two weeks. I had faith that my doctor’s conservative treatment of steroids and nerve pain medication at bedtime would do the trick.

just like I had faith in him. For the past twenty years or more.

Exactly one week later on Monday, I returned to his office, after making it clear to his staff that it was either his office or urgent care.

Can you be here within the hour? they said. I could and I did. He suggested that we increase the nightly nerve pain medication dose and that I start a narcotic to treat the pain that had settled like hot daggers in my calf. Plus Motrin 600 mg every 8 hours for pain as well. And he would order an MRI.

I said, what about the inflammation? He said since the steroids didn’t work, why repeat them? He said that the Motrin would help with that too. Now, he knows who he is talking to. I gave him a look and all he said to me then was, “OK, Irma?”

Since this wasn’t McDonald’s, I couldn’t change my order at will. I took my prescriptions and limped to my car where my husband waited. I scheduled the MRI, the soonest was Thursday, while in the car waiting for prescriptions to be filled.

The pain was doing me in. Especially in the mornings. I don’t cry easily, but I did a lot of crying Tuesday, Wednesday, and Thursday morning. Bent over whatever countertop I could get to, I bawled with the pain, a walker at my side. We ended up with two of them from when my husband had an MI five years ago, and boy, did they come in handy now.

I ended up taking one Motrin 600 mg. It tore my stomach up. I took it with trepidation, but I was desperate so I took the plunge. I lived to regret it. The narcotic he put me on was like taking water for the pain I had. I sought relief from hot showers, letting the water soothe my leg. And from my trusty heating pad, half expecting to incur 3rd-degree burns before it was all over. Sleep? What was that?

I made it to the MRI on Thursday evening. I was glad it was an evening appointment because that was when my pain was near tolerable, but still, lying in that constricting tube with my eyes tightly shut, my ears plugged with soft foam plugs, and covered with heavy headphones that were supposed to provide music, music that was overpowered by the loud clicking and clanging noises of the machine, all I could think of was that my leg was hurting me. I had to lie flat on my back, and that position was not the most forgiving. And I had to lie still, 30 minutes the tech said. I couldn’t move, even if I’d been able to, wedged in as I was.

That night I made an effort to sleep, but by 4 a.m., when I’d struggled to the bathroom, I lay in bed and cried. I knew the gig was up. It was time for the ER. I took one of my fake pain pills, and gave it an hour. Meanwhile, my husband was up and ready to go. Don’t push me, I said.

We got to the ER at 7 a.m. and it was blissfully empty. Not a soul except the staff. That was a bonus in this covid age. I was in the back getting an IV started within 10 minutes. My nurse was this cute little guy that could have been my son. He pushed Dilaudid and Decadron into my vein and smoothly removed those boiling, hot daggers from my leg. I almost cried again with relief. They’d been in there for over a week.

I had a barrage of doctors come by. They all agreed on the treatment, steroids to reduce the inflammation around the nerve, potent narcotics for pain, a strong muscle relaxer, double the administration of the nerve pain medication, among other meds, and admission until pain controlled sufficiently to go home.

A neurosurgeon had been called and he was the first to arrive. I saw the MRI, he said. You have a slipped disc which is causing pressure on the nerve. It’s a slight protrusion he said, but you have degenerative changes and I would not want to go in there to fix it. Thanks, RA! was my first thought. But I didn’t want him to go in there to fix it, either.

An injection into the nerve was also suggested, but I decided to make that plan B. We would go with the meds, body mechanics, exercises, and physical therapy first.

Last night, I had another great nurse. We spent half the night talking. When the day nurse had asked me what I wanted to share about myself on the info board in my room, I said I have RA, thinking clinically. And she said no, something personal, so I blurted out what I like to do best, reading and writing. He noted that and the conversation started from there and went on most of the night.

He held my hand on the way to the bathroom and back. This was an observation unit where the rooms do not have their own bathrooms. It wasn’t far from my room, but it might as well have been miles away. And once on the way back, which was the most painful part as my nerve was now awakened to the fact that I was upright and moving, I said the bad word that rhymes with truck.

I immediately said sorry, but he started laughing. By this time we felt we knew each other, and he said, I never thought I would hear that word from you. And then I started to laugh, in-between gasps of pain.

I fell asleep between 3 and 6 a.m., when he woke me up for my meds. And later, when I managed to get to the bathroom alone as the day nurse didn’t respond to my call, I discovered that half my pain was gone! It only hurt from the knee down and that was cut in half as well. It was hallelujah time, and time to arrange for going home. The meds had made progress in less than a day.

The board in my room.

Needles and Pins

Needles have factored in my life ever since I was ten years old when I hand sewed clothes for my rescue Barbie. I call her that because that is what she was; my father rescued her on his sanitation department rounds. Picked her right out of someone’s trash and brought her home to me. She was dirtied and naked, but I cleaned her up, and dressed her, and loved her.

I come from a long line of women who sew, by choice or necessity, or both. A lot of my clothes were made by my mother, who made many of her own dresses as well. My much older sister also contributed to my wardrobe by making for me a green plaid skirt that came with attached suspenders. I was surprised because she seemed to always have it out for me, accused me of being the pampered one, once proclaiming that I got to have new shoes, but she only got new soles. Perhaps it had to do with the fact that I was growing and she was grown.

I guess the suspenders were her way of getting even. But if that was her plan, it failed. I liked the skirt and wore it often. Working with needles was ingrained in us, as demonstrated by her choice with which to do battle. Of course, I ended up picking a profession in which needles factored greatly. In days past, I could get an IV into the tiniest and rolliest of veins. It was nothing laudable, just part of my job, just something my limber, strong, young fingers could do.

Today, I am retired from my profession and am an active sewer and quilter. And my fingers are not so limber and stealthy anymore thanks to RA, and the osteoarthritis that comes from wear and tear. But I blame RA more. Always more.

This year, I found myself getting pricked too frequently by the straight pins that I would use to hold piecework together so that the seams and the corners turn out perfectly even as they are sewn. I know my poor fingers weren’t stabbing themselves on purpose, but I got pretty darn tired of it.

I decided to retire the straight pins and switch to these darling little clips. They have almost a death grip and hold the pieces tightly together. But they are a little hard to open if I don’t grasp them just so. And they do pinch me on occasion, but it hurts a lot less than a needle stab. I love them. Not going back to pins unless there is some particular instance why it must be a pin that is used.

So no more this.

The moral of the story is, I suppose, adapt or (hobbies) die.

Yes, please

One of my projects in progress, safety-pinned and ready for quilting. I decided to make myself a scrap quilt using 2-by-2-inch squares out of each of the fabrics I’ve worked with. I reached the size I wanted (just covers the top of my queen-sized bed) without running out of all the fabrics I’ve used for many other projects. But there’s always more scrap quilts to come.

Perhaps I will plan a quilt for my sister. I should incorporate some green plaid fabric, and maybe a shoe print fabric.

Y’all take care now.

Hello, Again

I have been away so long, I forgot my login. Thankfully, I don’t rely on the old noodle. I write it down. I write just about everything down. It’s like a nervous tic. Or a need. Or something.

Right now I’m listening to cry-in-your-beer mariachi music. I was in the mood. Not for beer, never beer, some Moscato maybe. Not in the mood for crying either. It’s just that sometimes I get homesick, I miss Texas. Can you imagine? Missing Texas! Maybe it’s true what they say, you can never go home again.

Just feeling a little nostalgic perhaps. Wishing for some do-overs. Some time travel. I always think what if. What if I’d chosen this, what if I’d chosen that, maybe I would have missed the turn that took me straight into RA’s arms.

Maybe, maybe, maybe.

These past eighteen or so months have been eventful and at the same time uneventful. It was January, 2020, when my gallbladder tried to kill me. I showed up septic at the emergency room. It worked so quickly, in hours I went from epigastric discomfort to hardly being able to drop from the car into the wheelchair my husband had trotted over to get for me.

My son surprised me the day of my surgery. I was holding an icepack to my head for the unrelenting headache and had my eyes closed. I heard the door and thought it was my angel of a nurse with my pain med. I opened my eyes and saw him pulling his carryon into the room. “What are you doing here?” I asked.

He was supposed to be in San Francisco where he had been setting up a hospital with their digital documentation system. He smiled and said, “What are you doing here?”

The next day, he sat at my bedside and said there was a new virus out west that he was concerned about. And the rest, shall we say, is history. He made one final trip and has been working from home since.

I didn’t leave my house once between March and September 2020. I’m a homebody at heart, but that was somewhat in excess. I made somewhere between 500 and a 1,000 masks. I lost count. They are all over the country, literally from coast to coast. I’m still making them, though not as many.

I make them with a filter pocket and I stuff a blue paper surgical mask, sans ear loops, in there, so I brave the world with six layers between me and whatever is out there. Not often though. Still sticking close to home.

Two days ago I did venture out after another two months of hibernation to go to my trusty CVS for my third vaccine. I read if you are immunosuppressed or on Methotrexate, you should get a third one. That’s me, so I did.

I had such high hopes, but well, we shall continue to be vigilant.

Boy, Linda Ronstadt could sure belt out mariachi songs. Wow!

If anyone needs masks, I’d be happy to send you some. Here’s a pic of what they’re like.

Y’all take care, now.

Journal: The Undertow

It’s something I’m not really conscious of, yet realize I live with on practically a daily basis. Anxiety. What will today bring? What new ache, on what new spot, old spot? How bad will it be? How long will it last? How will I treat it? Will I have to drag out my old friend and foe, Prednisone?

I’m sure every day can be a little anxious for anyone, but we who have RA are accompanied by this evil scourge, just lurking and waiting to whack us one more time for good measure. Arthritis and Anxiety, not a good combination. But they can become an undercurrent in our daily life and we must not let them become an undertow that drags us down.

 

*(I’m working on a writing project and ran across this. I was surprised to see that I had written it five years ago. Surprised in that it still applies, and that I continue to remain free of the undertow.)

Osteo and RA and Age, Oh My!

So, my hands.

In the past few years, I’ve tended to buy the lightest cookware and dishware because the heavy ones hurt my hands. Last Christmas my daughter-in-law, bless her heart, gave me the most beautiful cast iron dutch oven cookpot, ruby red.

It looks lovely on my countertop.

Someone, don’t know who, left a clear plastic drinking glass in my kitchen. If you didn’t know better, you’d swear it was made out of sheer sparkling glass. I hefted it, it weighed nothing. I went out and bought some.

One day at one of my favorite shopping haunts (Target), I ran into a back-to-the-dorm sale of cheap dishes. I lifted the bowls. Again, nothing. I bought eight. My ceramic bowls are now backbenchers. Nice to serve in, but not to hold up and eat from.

So as time went on, I made allowances for my hands. After all, I’d say, you’re not getting any younger. RA is not gonna disappear. Osteoarthritis is gonna get you, each day a little more. Can’t let it get you down. Gotta go with the flow.

But now, weight doesn’t matter because nowadays I can’t touch anything. I have what the dermatologist calls “a problem with no solution.” My fingertips split (fissures) and bleed. For no reason that we can determine. I don’t think he even gave me a diagnosis. I meant to ask, but forgot. I guess he’d already named it.

It’s nothing new. This has been happening off and on for a long time. Twenty years ago, that dermatologist told me to stay away from soap and hot water. Right! I was working in an ICU and had young children. My hands were always being washed, gloved, scrubbed, and alcohol-rinsed.

Then I transferred to a desk job. Then my children grew up and left home. Then RA got worse before it got better, before I quit work. Or as I believe, it got better because I quit. And then my hands got lots better; the scourge mostly disappeared for years and years. If my skin broke down, it recovered within a few days. And then, wham!

About three months ago, my affliction returned. Perversely. Persistently. Stubbornly. Tenaciously.

It’s been three months now of pain and suffering. As I told my doctors, it’s almost disabling. And so depressing. Most days I can’t type. I can’t sew. At times, I can’t exert pressure on anything that I hold or the skin on my fingertips will either split or shred. (Sorry for the imagery.)

It’s like death by a thousand paper cuts. Feels like it too. We have so many sensory receptors in our fingertips. It’s what makes touch so thrilling, or so distasteful, depending.

I’ve tried everything in the book. Every cream. Every ointment. Every prayer. I even bought a box of exam gloves, just like the ones I used at work. Back then I considered them a culprit. Now I consider them a protective framework to hold my skin together.

I hit upon an answer by accident. One of my RA treatment modalities is to do a Prednisone hit whenever something physically taxing is on the calendar. I was going to have all my kids (4) and all my grandkids (4) in the house for a week. So I started Prednisone on day 1. And by day 7, my fingers, bless the ground they all step on, were practically healed.

I had a dermatology appointment and his eyes lit up when he saw my hands spread out like a stop sign before him. “Don’t get too excited,” I said. “It’s not your ointment. It’s Prednisone.”

He slumped back down on the stool. “But you can’t be on that forever,” he said.

Truth. And since I was on weaning doses, my fingers broke down just in time for my rheumatology appointment one week later, this past Wednesday.

He agreed. We will do a Prednisone treatment, not prophylactically this time. But again weaning down, though on a more gradual descent, till we get to zero. And healthy fingers. I hope.

“I leave it to you,” he said, in regards to the pace of weaning.

“It’ll be like titrating drips at work,” I said.

He smiled as he tapped away on his laptop. And I smiled as I padded out the door.

 

 

Nightgowns and Shoes

I’ve been on a nightgown-and-shoe-buying kick lately. I know, strange bedfellows. I don’t think I want to know how many nightgowns I’ve bought, but I know how many pairs of shoes, three.

Why this particular bent? It does go deeper than mere materialism and is far more consequential than just acquiring more to stuff in my closet, for I soon realized I’d been subconsciously heeding the call for rest and comfort.

What triggered this consumption? The Great Prednisone Failure of 2015. My failure, my 2015. The experiment was a total bust. The pain came back. The hands, the feet, the general malaise. After a few weeks off Prednisone my body sat up and noticed. Hey! What happened to Pred?

It didn’t just beg the question; it screamed it. So I scurried into the safety zone, the metaphorical orange-cone ring made up of little white pills.

“You know what to do,” my rheumy said when I confessed my shortcoming. He proceeded to share how he handles flares with the help of our common little frenemy.

I nodded. Yes, the tiny, precious pills that can wreak havoc within your body in so many ways, and in the process grant you the ability to get up in the morning without feeling like a tin woman who needs a squirt of oil into every single cell.

“I want quality,” I said. “Not quantity.” Now it was his turn to nod. I’d rather have five good years and not twenty bad ones. He understood.

In the midst of renewed pain, sleep took supreme importance. Sleep is a great pain reliever, if you can get it. And so in direct correlation, I concentrated on updating my sleepwear.

Nightgowns are the only thing I like to sleep in. Sometimes I prefer silky soft, sometimes cottony soft. The style must needs be flattering, comfortable, and not bunch up under me. Sometimes I swear I’m related to The Princess and the Pea character. Every little wrinkle in the sheets drives me mad and I have to pull it straight. I’ve made my husband promise that he will keep my bed tidy when the day comes that I can’t do it myself. I doubt he will, but it makes me feel better to know he promised. 🙂

The brand matters not, so much as the cut and the fabric. Color matters in that it affects mood. I tend toward black, so refined, so elegant and sexy, too, because why shouldn’t you look nice while you’re sleeping?

And if sleeping is important, getting up and staying up is much more so, and that’s where the shoes come in.

I mentioned in a previous post that I am partial to Clarks. One day, I came across the most comfortable pair in the entire universe, not hyperbole I assure you, at least according to these feet of mine.

Their only drawback was that they were only available in white and it was way before Memorial Day, when I would have license to wear them according to fashion dictum. I couldn’t remember the last time I owned a pair of white shoes. It might have been back when I was wearing saddle shoes to grade school.

But there they were, on sale, and they fit deliciously. Or as Billy would say, they felt mahvelous. I took them home and when I went online to search for a pair in my signature black, there were none to be had in my size. I did find a similar style with the same cushioned footbed.  When they arrived I was pleased to discover they fit just as mahvelously. Since then, I’ve added a third pair in beige and am debating whether I need the navy ones, too.

Perhaps I don’t, after all black goes with everything, and pain-free feet go with eeeeverything. My heels don’t hurt anymore, no matter how much I walk in these shoes. And they were. The pain intense, indescribable, every step jarring needles poking me.

These sandals take me everywhere. I dress them up and dress them down. Whether it’s a leisurely stroll down the Art District, a dinner/movie/drinks date or just chugging up and down the grocery store aisles, these babies come through.

I am back on a very low dose of Prednisone, a tiny buffer between me and the pain. He mentioned injectable Methotrexate as a possibility. I said I would take it under advisement. We shall see, but we shall see in comfort.

"I wanna put on my, my, my, my, my, boogie shoes." -- K.C. and The Sunshine Band

“I wanna put on my, my, my, my, my, boogie shoes.” — K.C. and The Sunshine Band

My Buddy

The culture I come from has a special term for someone with whom you can identify. A someone who can commiserate with you, who can empathize, who can feel what you feel, almost.

The strictest translated definition of the word is co-parent. It describes the person who baptizes your child and becomes their godmother or godfather. With this process they become your comadre or compadre.

In casual use, in the slang form perhaps, it means something much richer. Your best buddy is your comadre or your compadre. You do not need to have a child needing baptism to acquire a compa.

This insightful post by J.G. Chayko made me stop to think about who I have to share my RA trials and tribulations with face to face. Sharing in the sense that they don’t just hear me grouse, but totally get it.

Not my husband, who at first gave me a wide berth, sailor that he is. He thought, since I was in so much pain, that his backing away and not placing demands on me of any kind was the kindest thing to do.

It wasn’t. And though he is now supportive to the nth degree, he cannot know what I feel.

Not my children from whom I hid my disease with a passion for many years. I did not want to let them see me sweat. Must be strong, must be strong for those whom I brought into the world and depended on me.

Now I educate them as to what RA can do when it decides to do it.

Not my coworkers who absolutely depended on me, especially when the buck stopped with me. My pride wouldn’t allow me to let them know how much pain I was in, though I did eventually enlist two of them to help me with Humira injections to my arms, an area that I could not reach myself.

This problem ended when I retired from nursing. Sadly, but I knew it was time to pass the baton. My oldest son is now the R.N. in the family. Though he and his wife, a pharmacist, can relate to the theory of RA and its treatment modalities, they cannot know what it is really like.

So I closed my eyes and searched. Who was there for me? Who was my compa?

And it hit me like a lightning bolt. Of course! I’d just seen him today when we’d put our heads together once again and shared war stories about ways to defeat and one-up RA. We do that every two months, more frequently if RA is being more horrid than usual to me.

He is there for me, always. I can call. I can email. I can visit. My rheumatologist is my compa, for he has RA and he knows.

The Body Shop

It feels like I never leave the body shop. The shop that keeps my body going. It’s not one location; it’s many. I’ve been adding dates and building new relationships.

It used to be only my bimonthly visit to the rheumatologist. This year, I have renewed my relationship with my primary care physician. I have met and learned to trust a new ophthalmologist, new to me at least.

Now I can add an endocrinologist to the list. I swear I’ve been his patient before but they can’t find my name in the system. Perhaps I’m confusing my visits there with my daughter’s because I know I’ve been there before. She just had a second body scan ten years after her thyroid cancer, all clear, thank goodness.

Thyroid problems are part of my inheritance from my mom. Who knows how far back it goes in our history. Two of my sisters and myself have thyroid problems, my older daughter had thyroid cancer at 19 and my younger daughter has a couple of nodules that they’re tracking.

It goes without saying that I trust this endocrinologist. He checked me out and proclaimed me healthy. Funny, I feel healthy too. In fact, I feel great. I’m down to two weeks of Prednisone and then finis. My last dose is scheduled on my daughter’s birthday, so two things to celebrate in NYC that day.

But of course proclaiming me healthy wasn’t the end of it. “I like data,” he said.

I nodded. I already knew I wasn’t leaving that office without a long list of testing orders. I don’t present with any symptoms of hyperthyroidism so it’s unclear what’s causing my TSH levels to bump around.

We’re checking that again, delving deeper into the mysteries of my metabolism. Also ordered are a thyroid ultrasound and a CAT scan. And since it’s time, a bone density scan. More dates, more appointments, more waiting in waiting rooms. Sigh.

But I suppose it’s these visits to the body shop(s) that keep me humming along, operating at full capacity. My motor revs up at the touch of a button and I kick into gear the moment I hop out of bed. Luckily, the few permanent dents I do have are not readily visible.

And there’s no denying I have RA as my daily companion. My rheumatoid factor came back 294, normal is below 14. My rheumy doesn’t check this on a regular basis, but since it’s been ten years since diagnosis, I suppose he just wanted to make sure. Yep, my anchor is dragging along.

I’m reminded of a poem I wrote several years ago, called If I Were Slightly Dented.

If I were slightly dented
and came to you “as is”
would you find it in your heart
to accept me as I am?
There’d be no pretty box
No tissue wrap or twine
to disguise any scratches
or signs of others’ touch

If you were slightly dented
I’d want to know your scars
to trace them with my lips
and to whisper my hello
for it’s those nicks and flaws
that make you who you are
And for that very reason
I’d love you all the more