Thursday, June 27, 2013

Taking the gloves off!

First thing this morning, I realized I'd overslept--by a lot! Looking at the time, and having an "Oh, s***" moment, I got in and out of the shower in just enough time for Esmeralda to arrive for Mom's day care.

After this burst of adrenaline subsided, I centered myself and allowed a few things to register. 1) I'd slept more soundly last night than I had for several weeks; 2)I had experienced no shoulder pain last night; (3) when looking at my hands and wrists, there was only a small amount of swelling; and (4) there was almost none of the discomfort I'd come to expect first thing in the morning.

Okay...when's the other shoe going to drop?

As elated as I was by this turn of circumstances, I was able to pull myself back down to earth. This would be, after all, only my second day on my new medication regimen. It's treatment, not a miracle cure.

But, I still allowed myself to savor the first wave of symptom relief.

Remembering my extensive session yesterday with Dr. La, I deliberately retired the compression gloves to a drawer. He had said that RA needs to be treated from the inside out, and gloves were obviously not going to achieve that effect. Going out without them, though, was actually scary. It amazes me how I had ascribed to the gloves some kind of protective power. Without them, I was thinking that my hands and wrists would be too vulnerable. I took deep breaths each time I called upon my hands to do something, like dressing myself, or turning the key in my office door lock.

At no time today did my hands "break." And as I type this post at day's end, they're still intact, and attached to the rest of me. Yes, my right index finger is looking like a sausage right now, and I did wince when I braced myself with my left wrist a couple of hours ago. But that's part of the process, and I need to be prepared for some setbacks, big or small.

I also found that my mixture of euphoria and anxiety especially enriched my professional empathy today. It reminds me of how both resilient and fragile we humans are. We can fight whatever battle presents itself, and know when it's prudent to call allies to our side. Take, for example, the common reluctance to ask for or accept help from others. This is addressed in several places in the Arthritis Foundation website.

Many blog posts ago, I proclaimed my intention to become a wholly self-sufficient urban homestead woman, who, among a long list of other things, was going to continue to cut the front lawn by herself, manage all the household tasks, run my practice, tend to my mother, and have spare time for a social life.

Painfully (yes,pun intended), I have learned the wisdom of dialing things back a bit. Perhaps the old "work smarter, not harder" would be useful here.

I'll let you know when I've figured out how I'll apply it to my own life. I'm a stubborn creature, set in my ways (sign of my age?).

Wednesday, June 26, 2013

Hope -- the best remedy there is.

The following song reflects my current mood:

Make no mistake, this week had rocky beginning. I had desperately purchased some compression gloves, and wore them nearly constantly, without any pain relief. My RA symptoms seemed to peak in intensity, as if my body were rebelling against me. Hands swollen like mittens in the morning, struggles to open doorknobs, turn the key in my car's ignition, get dressed in the morning, and participate in my mother's care, pain without let up. And the fatigue...

My dear gentleman friend, bless his heart, waited on me this week, encouraging me to rest in between shifts of clients, making me food ("You've got to eat something, dear"), and keeping me company. Things did get strained, though, when at times he got visibly exasperated hearing my cries and groans. "It really bothers me to see you in pain." I responded by trying to muffle these sounds, or make any statement that contained "hurt," "pain," or any of their synonyms.

I wanted to send him packing.

Two nights ago, I hit bottom. I'd taken an Ultram before bed, and tried desperately to sleep, with countless variations of positions, and several pillows for support. At nearly midnight, I took a second Ultram, apologized to my dearie, and fled to the sofa. By 1:30, I added an inflamed left shoulder to my woes. Pillows, ice bags, sleep. I don't know what's worse--being awake all night, or the early morning TV programming. Despair set in, and I thought of the scripture quote, "...for dust you are and to dust you will return." (Genesis 3:19, New International Version).

Beginning on Tuesday night, I began counting down the hours until my rheumatologist appointment. Please, relief, that's all I'm asking for. My dearie came with me, for support, and, I suspect, to seek his own peace of mind.
As it turns out, Dr. La is the answer to my prayers, and I'm not just using hype here. After telling me that my rheumatoid markers are "off the charts," (gee, surprise, surprise!) I got a massive shot of cortisone in my shoulder, and a new medication regimen. Prednisone is the initial, and purposefully aggressive, first line of treatment. Dr. La was firm about this not being a long-term medication due to its side effects, but it should halt the progression of the pain and swelling. The methotrexate sodium, per the handout I received, "...also can reduce damage to joints and the risks of long-term disability." (sold!) Folic acid is to mitigate the unpleasant side effects of the other stuff.

Dr. La was emphatic about instructing me to begin taking these pills, especially the methotrexate sodium, right away. Hey, absolutely! I was also told to rotate my left shoulder as much as possible. We will see tonight how well it responds to the injection.

While on the Arthritis Foundation website this afternoon, I read that early treatment can actually encourage remission. What a beautiful word! It makes me think of another quote, "I praise you because I am fearfully and wonderfully made..." (Psalm 139:14, New International Version).

Stay tuned.

Sunday, June 9, 2013

Shifting Gears, and Getting my Edge Back

I've been wondering where to take the direction of this blog. Yes, I want to keep it real, but I also don't want to start being some kind of self-appointed poster person for RA (rheumatoid arthritis). A big yawn, indeed.

Above is a picture of my newest accessory, which has replaced my beloved old briefcase. It became clear recently that I'm past the point of juggling -- crammed briefcase in my right hand, commuter mug in my left, purse on my left arm, and my Aladdin thermos-full of coffee cradled in the crook my left arm. How did I then manage my back door keys, and then those to my car? Good question. All I know is that, if Burbank had been hit by some freak tornado, I might have had enough added weight to keep me grounded, while everything else blew away.

After my knee surgery, I shifted to a baby-diaper-backpack, but somehow managed to keep lugging around the same poundage, while hobbling around on The Cane. Not good, either.

I've been using my new wheelie-tote for almost a week, and I can't believe I didn't make the change sooner. There's lots of storage for files, my make-up, my lunch, AND the industrial-sized thermos--perfect for my 8 AM to 6 PM Friday. My back and my hands thank me.

Recently, I got some wise feedback from a high school friend. She suggested that if there is any benefit to having a injury, it's that it makes us more aware of our bodies' workings and our environment -- mindfulness, one could say. Maybe that's why a lot of these "owies" visit us in later years. Youth is for moving fast, whereas middle age and beyond is for down-shifting, to appreciate what we've experienced so far. Our bodies remind us, "Really, what's the rush?"

Still, there are some, like me, who stubbornly bridle at this getting-older stuff. A few days ago, I got very melancholy while driving through parts of Glendale and Burbank. Looking at buildings and neighborhoods, I saw what has changed (or not), and how this reflects my aging, and that of my 1972 BHS cohort. I suddenly felt physically mortal, and emotionally vulnerable. I don't want to "just fade away," like that line that the Who sang in "My Generation."

So, I want to take my recent setbacks as a challenge. I took a class in my doctoral program about the psychology of disease, and wrote a paper on how certain conditions can be seen as a trickster. This trickster could be seen as malevolent, bent on making someone's life miserable. It could be perceived as a taunter, a bully, to crush one's optimism about life. Or it could be a challenger, saying, "Okay, here's some obstacles. What are you going to do about them?"

Okay, one thing I could do more of is laugh-- at myself, and the absurdity of my situation. For example, how many of you ladies have struggled with dressing when your hands are stiff? Those hooks and straps can be pretty frustrating. I recently googled "arthritis bras," and came up with lots of images that reminded me of the training bras we wore in the sixth grade...plain, white, and nondescript. Really?? In today's multi-billion-dollar, international fashion industry, it's ridiculous that ladies would have to choose between functionality and femininity? Please...

And then there's the perspective of gratitude. A few days after my RA diagnosis, I was walking beside two ladies about my age. One wore a teeshirt with a logo urging continued efforts toward an eventual cure of rheumatoid arthritis. She greeted me with a bright smile.

She also struggled greatly with her walking, aided by crutches. As I was accompanied only by The Cane, I felt a bit ashamed for my recent grumblings about my own condition. I want to toughen up, or, as the now-popular 1939 English saying goes, "Keep Calm and Carry On." Hope and optimism need to be vital parts of my daily regimen.

Maybe a better song for this post would be one from Fleetwood Mac: