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Monday, September 19, 2011

Rome wasn't built in a day.....

     So how does this famous phrase tie into RA?  Well, this post is all about patience and the need for anyone with a chronic disease to possess this trait if they are to successfully manage RA.
     Anyone who know me personally can tell you that I am a person who likes things to get done yesterday.  As a full blown type A person, I am one of those people who does not handle "puttsy" folks who just take their time accomplishing tasks.  I have always envied those who can "take it in stride", "smell the roses", and all those wonderful attributes associated with patience.  I have to wonder if the lack of patience is there from birth...must be cause I don't remember every having it!  

         Having said that, there are times that my non stop, get it done now approach has proved valuable and all things considered it has served me well.  BUT....when it comes to managing RA impatience is a disaster waiting to happen!  
We are told to "wait" from the first moment we step into the first appointment with the first physician.  
     Waiting becomes the catch phrase - we wait months, often years for a diagnosis of RA.  We go through trial and error with medications and treatments to see what might work.  We are told to "wait" 4-6 months to see if a medication will work.  We wait for lab results, CT scan, MRI's, etc. to find out if we have joint erosions or other nasty problems associated with RA. We wait for years to see what lovely side effects might be unfolding in our bodies from the wonderfully evil medications we take.  Case in point - my current battle with longstanding GERD.
     I have had reflux for many years as have most of us with RA who have been on NSAIDS and other GI irritating medications.  It is one of those other really bothersome issues we have to handle along with all of the "normal" aspects of RA.  Thanks to being on a corticosteroid for 6+ years the GERD I was having has recently blossomed into an ulcer.  The syptoms of GERD versus heartburn are distinctive.
     Unlike heartburn, which is treatable with OTC medications and goes away, Reflux requires ongoing treatment guessed it...another my case Prevacid -60mg a day.  For a variety of reasons some of which I touched on in my previous posts, I suffered a nasty GERD flare starting in July with nausea and a nearly constant upset stomach.

 In August abdominal pain joined the crowd followed by all the other "bathroom" associated activities you can imagine.  I am certain that the long term use of Celebrex, Medrol and aspirin are the main culprits.
The common use of NSAIDS in the "general population" is astonishing enough!  I would guess most if not all RA patients are on some type of NSAID and will be for the rest of their lives.  So it not surprising we suffer from GERD and represent a huge percentage of those with GERD which is surprisingly common in our world today.
     One of the really annoying aspects to this is the fact that RA folks NEED Non Steroidal Anti-Inflammatory Drugs (NSAID's) as part of our arsenal of weapons to combat RA.  Unfortunately, this particular weapon happens to be a double edged sword.
     While it helps us on the one hand, it wreaks havoc on our GI tracts.  By its very chemical nature, it induces the production of acid in the stomach that is toxic to our body's digestive system.

 So much so that it requires we avoid certain foods that can irritate like chocolate, caffeine, mint, fried foods, alcohol, and the list goes on...and on...and on.  Sadly, many of the GERD inducing foods are items I enjoy and so the fact is that now and then I "cheat" and hope that I will not have to pay the price.  When will I learn?

We are told to "raise the head of our beds" by at least 6" and to avoid eating 3-4 hours before much for my evening munchies. 
     This latest bout has left me so sick that I am not yet able to eat "normal" foods.  So my diet currently consists of:
      Lots and lots of water....I mean I love water but a nice diet Pepsi would taste soooo good right now.   
     Bottom line - I need to make a fresh start and get re-focused on this GERD business because the fact is I have not been as sick as I have been with this in a long, long time and I do not want to go through this again!  
     I hope my memory serves me well so that I recall this discomfort and pain when I am tempted to eat at 10PM or have a big bowl of chocolate mint ice cream.    
     Once again it is crucial that I look on the bright side of I have lost 7 pounds thanks to the spartan diet I outlined above.  And I stopped taking Celebrex and the baby aspirin with no bad outcomes as of yet.  Two less medications is fine by me!
     By choosing to see the bright side of this I find it easier to comply with the lifestyle changes I need to make and it occurs to me that this approach works in other areas of RA management.  This patience trait that I so struggle with is beginning to worm its way into my personality it can become yet another tool in our RA management toolbox.  
     I have discovered that the ability to be patient breeds postivity since you are naturally more optimistic and relaxed.  I am determined to not allow myself to sink into negative thoughts and attitudes as studies show that having a negative approach to life leads to poor outcomes health wise.   Staying positive and leading our battle against RA with a strong, purposeful and yes, patient approach will help us reach our goal of successful management that much sooner! 


Wren said...

That having RA and coping with it successfully takes monumental patience is absolutely true, Nan. I'm naturally the patient type, one of those people who annoy you by moseying along through life. But let me assure you that even I get frustrated having to wait so long for appointments, for meds to work (or not work, unfortunately), etc. Your advice to stay positive is really important; it makes a huge difference in coping with the pain and disability of RA while we wait. And wait...

I hope that your current efforts to overcome the NSAID-induced ulcer are proving successful, Nan. Adding nausea, etc. to RA sounds just miserable. That you seem so upbeat and cheerful in your posts and comments is very inspiring, so THANK you!

Hugs for you...

deb aka murphthesurf said...

So well said! Patience with ra is such a key component in surviving and living with ra. When I was taking the same combo of "pain relievers" as you I had the worst stomach problems. Any chance you and your ra doc can look into different pain relievers. Have you tried ultram yet in lieu of celebrex and the OTC stuff? Just a thought. I can't remember if you have tried other pain medications in the past or not.

Lana said...

No, Rome wasn’t built in a day and you know what, it fell and then, it was rebuild – talk about that as a metaphor for living with RA. You are right about RA being a process that involves a lot of patience. I am a Type A person too. Ironically, many RA sufferers are. Stomach/GI issues, just RA and the overuse of medications – no doubt about it. From your description, RA sufferers sound like a unique group of people – but we are, aren’t we? Patience, optimism, relaxation are factors in staying strong and all of that is a learning process. RA isn’t just about the disease but it is also about the lessons that come with it.

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