Feeling lucky.. autoimmunity ..do we trigger flares ourselves?

Hi All. Just wanted to share some excitement and ask a question. We've just booked a week abroad in October (when Scotland gets a 2 week school holiday) - going to Italy to stay with a friend after installing an artwork (that has taken us 2 years to create- only a little more work to go) in a grand location in central London!

All too exciting to me for words really - and this comes just when the antibiotics have seen off a fluey sinus thing and my lower MTX dose seems to have got me back on track and nausea free! So I'm almost feverish with excitement about the whole trip I admit. Last time we had a proper holiday was 2 years ago when the four of us went to Berlin for a week. It was great but unfortunately, looking back, this was the start of my RA and each day I got back to our self catering flat hardly able to walk for pain in my feet and then I got a very bad bout of vomiting on flight home - stayed in Edinburgh for a few days sick as a dog and got back home to land myself with swine flu!

I know things will be different now I'm on MTX and Hydroxy - haven't flared since early June now and that was only in my knees and ankle and I didn't feel ill with it at all. But this has made me wonder whether, because RA is an autoimmune disease, feeling happy and excited enough about something will keep it away somehow? I know when I've had flare ups in the past year that they have usually been triggered by stress - so does the opposite apply to when we are happy and excited or do people find that it is entirely random and can hit us when we least expect it to? I am not going to worry about flaring because it will be well worth it but this thought about feeling angry or low triggering flares has just made me wonder about the reverse being true too so wanted to learn more from your experiences.

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  • oh, this is a great question! and one I asked years ago to someone I consider an expert in how emotions effect our wellbeing and immunity before RA for reasons which is too long a story but I asked something like; 'so if negative feelings cause the our immunes system to go into overdrive, what about excitement, joy ect' (as you yourself is asking) she reply that because happyiness is not a negative emotion it does NOT trigger our immune sytems as it is a good emotion'

    she explained it like, if you stick a needle in your skin, it hurts and you remove it...

    then she made me think of something someone has done that was hurtful (in the emotional sense not physical) asked me how that felt, I told her it felt like someone had kicked me in the stomach, emotional pain.....she expained that the stress or hurt from that sends signals to brain saying body is under attact, we can't remove the 'needle' therefore boosts the immune system instead; for us with RA sending our RA into overdrive......

    hope I'm making sense, she explain that many emotions cause this boost, all negative, jealousy, guilt, hurt ect

    so, in theory, when we are excited, happy ect we don't experience that awful gut feeling of emotional pain like being kicked in the stomach, just the nice rush of happy emotions....

    My theory, although my RA was showing little slow signs for months before diagnosis, it was after the birth of Amy when she was 5 weeks old and admitted into hospital with swine flu, the stress, fear and worry and not to mention my own immune system going into overdrive fighting of the flu was what brought on my flare from head to toe within days....

    great news about the holiday! I'm jealous but in a happy way!! :) xx

  • Hi, there is certainly a connection between stress and the Adrenalin response. And Adrenalin has some impact on our Immune systems.

    I have read that severe stress can cause heart disease, cancers and other health problems. So I feel that is part of the background to my RA.

    The most exciting thing I have read in the context of your question was in a fairly recent New Scientist magazine which supports the real power of the placebo effect. The mind over matter idea. Here is a quote:

    "optimism seems to reduce stress-induced inflammation and levels of stress hormones such as cortisol."

    I will be interested to hear other ideas about this. Meanwhile I am watching Jessica Ennis and she has really cheered me up with her perfomance. Which is why I don't hurt so much today. Cheers Jessica! Good luck tonight.

  • Thanks Williby and Phoebe - I'm really interested in this area of medicine relating to RA and other stuff just now. I suppose if we are feeling full of joy or just plain old content (less exhausting than euporia?!) then we are much less likely to focus on pain - which is not to say it doesn't exist or the RA isn't still active. But then if your New Scientist article is right then happiness can actually influence disease activity too by reducing inflammation. I heard a GP who had researched the Placebo effect on the radio a while ago but unfortunately came to it a little too late while driving and then couldn't find it again but the gist was that the mind is much underrated in how much it influences our physical health and there should be no shame attached in doctors prescribing placebos more often if they bring about the same results.

    It certainly is an intriguing area and I suppose I'm very mindful of it just now when I'm on all these medicines including antibiotics and wondering how much the nausea I feel after taking certain medicines such as hydroxy is psychological. Also wondering what it means to have a consistently high ESR even though quite often I feel very well when the results have been highest and yet when I was flaring quite badly last year they were much lower? Perhaps my ESR is contrary enough to rise with my spirits?! TTx

  • I have a book based on what I wrote that explains much better than I can if you want it Tilda? I was recommended a book called 'when the body says no' which I thikn is similiar in this subject, when I read it I'll get back to you (I have to finish my 50 shades first! zzzzz) x

  • Yes please Williby that does sound interesting - if you can cope with 50 Shades (have managed them myself with difidence culminating in deep dislike and boredom mixed!) then let me know how this book is for you afterwards anyway. Hey that's quite a toxic mix re 50 Shades followed by "when the body says no" you know?!! TTx

  • I've only had one flare - just everything going into meltdown - and I kind of had the feeling it was better out than in. I think I'd been lying to myself about a lot of things for years, forcing myself to do things that just weren't me and that's never going to happen again if I can help it. I'm really quite well at them moment, as you probably know, I can feel the arthritis sort of stirring in the deep but it hasn't surfaced and bitten me since that flare. I think there is an emotional component to all this.

    Also, re. what Phoebe says about adrenalin - these days I wake most nights about 3am with a funny feeling in the pit of my stomach that stops just short of pain. Took me months to realise where I recognise it from: it's fear, fear stripped of the emotional component, just the physical adrenalin feeling on its own. I reckon I'm pumping out adrenalin for some reason. Weird.

    Success, holiday, excitement - potent cocktail! Why shouldn't it prove even better than MTX at keeping you well? Hope it does,

    Christina x

  • I understand - not actually 100% sure about what is meant by flare up myself. At the start, about 15 months ago, I couldn't get up and down the stairs for a few days at each stretch because of the searing pain in my knees but I was very overweight at the time- which perhaps indirectly means I wasn't happy in myself.

    Later last year I had several episodes where the pain in shoulders, knees and wrists woke me and made me cry out in the night and stages when everything locked and to unlock was hell - got stuck in bath twice (you would have thought I'd have learned my lesson the first time?) and couldn't turn key in the car ignition or change gear a for a period. That's one kind of flare up I think. These didn't appear to be stress related to me - but then looking back I think I've had quite a lot of stress and bereavements over the past two years so it could be that flares were the outcome without me even being aware of this I suppose.

    Then earlier this year I started getting Reynauds and had several day long episodes of feeling terribly cold and finger joints and knuckles being very painful, very limited range of motion with them and unable to work or prepare food - with wrists excruciating so I was screaming into my pillow a couple of times - which I do count as flare ups for certain.

    Since then I've had a few days when I've just ached and felt awfully tired and sore and extremely stiff - like being in slow motion with fingers going white and blue and purple at the joints. These episodes have only lasted for a day or so and I didn't realise that they might be flares at all until someone from this site explained that this was the case and my GP agreed. On each occasion I had been quite stressed about something I'd been asked to do or about stuff with work, lack of money whatever... so I conclude there are different types of flares for each of us and I've only really had swelling and redness that I can see a few times - generally at the tail end of a flare up.

    My ESR has just flourished regardless of any symptoms or signs over the past year and has ended up pretty much at the high mark where it started in the first place so I can't use that as any indication of disease activity or flare ups - it's proving unreliable for me.

    Increasingly for me the pain seems to be in the far background where the feeling of tiredness seems to be growing daily. Could be meno could be drugs or could be that I'm just getting used to living with pain possible so can't even identify it any more perhaps?

    And really my question is how much do others on here feel they contribute to keeping pain and inflammation to a minimum and whether anyone has felt really pretty happy, life going according to plan, good job and life and still had a flare up of the various types I mention, despite having an overall sense of wellbeing? Tilda x

  • Might your natural endorphins have a role to play here? I tend to think that exercise does more than just keep my muscles/ligaments strong but also by helping produce natural endorphins that mimics having opiates so helps keep pain at bay. And strong positive emotions also stimulate endorphins, so being on a super happy high could well damp down your RA, or at least make sure you don't feel it as much? So no worrying after lunchtime but lots of exciting, happy things instead..... Pollyx

  • Yes yes yes you are so right (as usual) Polly! I do really believe that much of the credit for keeping my RA at bay is because of my diet and exercise regime. It's taken me in such a new direction and is so damned time consuming but it is addictive. So that tonight on a grey, damp night when my joints are starting to stiffen and ache a little I know that I've got to take the dog up over the hill for a mile long walk to keep us both well and happier. But if I were locked up or got some of that fluey cold back for a prolonged period say - I would flare and flare I'm sure. If I can't get those endorphins rushing then I find myself getting really low, and when I get low I get sick or flare - that's how it seems to work. So roll on afternoons (unfortunately I'm at my worst in the afternoons generally- should have lived in a med country and had siestas I think!) but generally happiness seems to come from this new found activity for me (the most unsporty of creatures ever known). TTX

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