I've just gone through my morning ritual of pill taking and have really stopped and looked and the number I am taking to get me through the day. It seems a ridiculous amount and yet I still feel so unwell, I wonder what the benefits are in taking them all.
I know I keep harping on about the link between the psychological and the physical but when I look back on my life with RA it seems that I am a lot more aware of it's impact on me now than I was then. Am I actually struggling more now, or was the drive to keep children and house together as a single parent the distraction that kept me going through the hard times ten years ago? Perhaps I have too much time to think about it these days but it is puzzling to relate my pretty stable bloods to the amount of pain and debilitation I feel present. So what is going on?
I think that a lot of the pain I experience now is the result of permanent damage to my joints both through RA and through general wear and tear. Apparently they are able to tell the difference between the joint damage (RA joint damage has a smoother surface) but I'm not sure how relevant that is from a treatment point of view - both hurt.
Arthritis in the spine, knees and ankles are the real killers for me at the moment and bring unspeakable pain and loss of mobility. Stiff fingers, wrists and shoulders pale into insignificance in the shadow of this. Of course, loss of mobility means weight gain and more pressure on the joints but I wonder whether I have stopped taking responsibility for making things better for myself, if I have stopped believing I can make a difference or even whether the pills I take leave me feeling too tired and fuzzy-brained to care. I suspect a measure of all three.
If there is one single thing I wish I had done for myself and to which I attribute much of my pain now it would be to have controlled my weight. Having got this far in my blog I have suddenly remembered that steroids helped me to maintain my lifestyle earlier on. I wasn't on massive doses (20mg a week maintenance) but it was for a long, long time - it kept me going and was invaluable in the years before I finally got the Anti TNF.
As we probably all know, steroids increase our appetite and food has always been a great source of comfort to me. Combine the two and the result is too much pressure on already inflamed weight bearing joints. I could go all Pam Ayres on you again here and echo her ditty about how she wished she had looked after her teeth which, in my case, would be joints but out of sympathy for Feather in particular and for many others I'll hold back from breaking into verse again as I'm pretty bad when I get going.
A combination of feeling miserable and leading a too sedentary a lifestyle undoubtedly contributes to the perception of pain - popping pills is unlikely to make much of a difference here and maybe this is where alternative or complimentary therapies come into their own. The reality of pain caused by bone grinding on bone is unquestionable though and to my mind should have everything done to alleviate it. It's a difficult one to know what to do for yourself. For RA inflammation the advice is rest but for osteo-arthritis the advice is movement - No wonder pills become the answer. The one single thing that would benefit both conditions though is not to put more pressure on them by gaining weight, it is sooooo difficult to get it off again once your mobility is compromised.
There is little point to this blog really other than sharing a few thoughts as I riffle through my bag of pills and to try to regain the incentive to get back on the diet after an appalling relapse during the 2 weeks my cousin was here.