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Wednesday, March 28, 2012

Mental agility and RA

          I am really zeroing in on the number three these days as I am about to embark on three surgeries in three consecutive months starting in April.  
    The first two will correct cataracts in both eyes, courtesy of the long term use of prednisone.  Turns out that even low dose usage (I currently take only 4mg per day - and have been for about 4 years) can impact the development of cataracts.  
     Having said that, I am in my late fifties (58) and they are not unheard of at that age irregardless of other diseases.  In reading about cataracts I have discovered that there is some valid research that supports the notion that not wearing appropriate sunglasses can hasten the development of cataracts, particularly as Earth's ozone layer shrinks.  So now I tell my sons to wear their sunglasses all the time!  
     Of course anytime I have to have a procedure I tend to study it to the point of absurdity...that comes from years of managing a chronic disease. I suspect that many of my RA friends out there do the same thing...just judgement, just stating the facts.  The point is that I will come out of this with an implanted lens in place of the "cataract" lens and I will no longer need glasses for distance!!! That's right - after nearly 50 years of wearing corrective lenses I will be able to see the alarm clock from across the room in the middle of the night! Yippee!  The trade-off is that I will now need "cheaters" for reading most likely. I had hoped to get the implant that corrects for all distances but alas I was not a good candidate for that as I have Sjogrens  Syndrome and that combined with an astigmatism tossed me from the pool of folks likely to have success with it.  No worries though.  I am happy to be getting better vision back.  
     There are some signs of cataracts that those of us with RA and users of corticosteriods need to be aware of.  Without a doubt the worst symptom was the discomfort and distorted vision while driving at night into oncoming traffic.  
     For me this picture comes close but it was even more pronounced than this. Some folks see a blur, some halo's, but I saw a splintering/glare effect that was really horrible.  I live in a rural state where we primarily drive on two lane roads so oncoming traffic is the norm and that means that anytime I was out past dark driving I had to cope with compromised vision.  This symptom was the key reason I am getting the surgery.
     Another slow building but persistent symptom is the lack of clarity and sharpness with colors.  Clearly this is not pleasant and although it does not effect your actual ability to see, the truth is, that over time it really impacts your enjoyment of life.
     Additionally, having "clouds" or "fog" appear within your line of vision is another and often first sign of cataracts.  This photo shows it directly in the middle but in my case this is off to the side in both eyes and not quite this large an area...thanks goodness!
     Lastly, for me anyway, is the problem of looking into any type of light head on and having it literally block out whatever is in front of it.  The best example I can give is if you are talking to someone who is standing directly in front of a window and light is coming can barely see the person's face and it is almost painful.
     So, all in all, getting this simple corrective surgery done will be quite a blessing indeed and I am actually looking forward to it!  I will blog again post surgery to update you on how the procedure goes, what, if any, RA medication adjustments I need to make before the surgery, etc.
     The third and by far most complicated surgery is the foot reconstruction I am having done in June, first on the right foot and later in the year, the left one. 
     I, like many of my fellow RA sufferers, have seriously compromised foot mechanics.  Not only from years of RA, but also from having lousy feet to begin with!  In fact, when the orthopedic surgeon looked at my xrays he was pleasantly surprised by the almost total lack of joint erosion, which was welcome news to me as well.  We both concurred that this was a real endorsement of the treatment and medication choices that I and my RA Support team have made over these last 15+ years.   That was the really good news....
     Then we got down to business about what this would actually involve and I quickly realized that this is a major challenge I am undertaking.  For me that instantly translated into 1) ask every question you can possible think of that needs answered 2) plan ahead for all contingencies 3) panic 4) now calm down 5) call everyone who is willing to listen to you talk about this and finally 6) reflect on how this will be a successful and positive step you are taking (pun intended) with good outcomes.
     I will have to tell you that despite being an upbeat person who usually is unafraid to take on a challenge no matter the size, this really did overwhelm me initially.  When I think back on it I think it was because I was naive about the aftermath and recovery more than anything else.  I did know what the procedure would involve (will share that in a future post) but I did not truly understand the limitations on my mobility short term (if you consider 8 weeks of no driving short term!) nor did I understand how long the recovery will be until I am able to resume normal activity.
     The point of this is that when you are dealing with RA and all of the challenges and "opportunities"  (AKA obstacles) associated with it, you have to keep in mind that flexibility, not physically but mentally :)  is absolutely critical to successfully managing chronic diseases like RA.  Don't misunderstand me, I had my moment(s) of self-pity and crying and still do.  That is an important outlet and quite healthy in my opinion.  What I am referring to is being "agile" mentally.
     If you can achieve the skill of adapting to rather sudden changes and/or unexpected barriers or obstacles it will serve you well in handling the day to day challenges of RA in all its glory!  Being resilient is a huge asset in dealing with RA and a wonderful tool/trait to add to our RA toolbox.  I have learned to refine this over the years and feel it is perhaps my greatest achievement in dealing with RA.  I encourage anyone with a chronic disease to explore strategies to enhance resiliency and mental agility.  
     I have no doubt that my belief that I can defy the odds like the flying cow pictured above is largely responsible for the successful and positive way I have managed RA for 15+ years and...I know it will get me through these next challenging months.  I will keep you posted.  


Mom's Small Victories said...

Good luck with the surgeries Nan. i have had RA for the past 10 years and i try to look on the bright side too of this disease. i had foot surgery 4 years ago and it was definitely tough physically and emotionally (since my 2nd son was only 1 at the time). i thought my foot would heal better than it has. so i won't be signing up for the half marathon for the arthritis foundation anytime soon. i don't know what your doc recommended but i could not use crutches..too much pressure on my shoulders. i rented a roll-a-bout so i rested my knee on it and rolled with my bad leg and walked with the good one. it helped me greatly, just thought i would pass along. i wish you the best for speedy recoveries for your eyes and feet!!

Nan said...

I just got my knee scooter/walker and I think it will be a life saver! I hope I am not sorry that I am doing this!!!!

Wren said...

That's a lot of surgeries in a short time, Nan, wow! I haven't had cataract surgery myself (knock wood!) but my mom has, my uncle has (just last year) and I was the official driver/temporary caretaker for an elderly family friend a few months ago when he had them removed from both his eyes in a couple of separate appointments. Which is the long way of saying: you'll get through yours with flying colors (if not actually flying cows). The foot surgery is another thing, though. That's going to take a lot of courage and resilience--and of course, you've got plenty of both. If the end result is relief of pain and better mobility, then it will be worth it, eh?
Like you, I've also developed the ability to adapt to changing circumstances (although I call it "rolling with the punches"). It's not always easy, but staying flexible is much easier, I think, than digging in my heels and fighting what I can't control. It's an excellent skill to learn.
Keep us posted on your upcoming adventures, 'K?

Carla said...

Nan: I know you'll do well with all surgeries and have faith that your life will be greatly improved once you get through the recuperation. Take care and keep us posted on your progress. (I'm looking at cataract surgery one of these days and am anxious to hear your experiences.) Sending you hugs and healing thoughts.

Marianna Paulson said...

I've had reconstructive foot surgery, and am I ever glad I did. What a difference that has made to me!

On my other blog, I've posted a picture of my foot - if you've squeamish, you may not want to look. (

I wish you well on all of them!

Marianna Paulson said...

Congratulations, Nan!

I just wanted to let you know that you won my giveaway on for a pair of Comfort Mocs from L.L. Bean!