Tags: anti-TNF, arthritis, flare, hospital appointment, NICE, nurse practitioner, physical therapy, physio, physiotherapy, R.A., RA, RA flare, Rheumatoid arthritis
I was on my way to my six-monthly (ish) hospital appointment this morning, and feeling distinctly glum, most definitely not wanting to go, when the news came on the radio and cheered me up slightly. Some excellent news for UK RA patients generally, I’m delighted to say: NICE has reversed its ludicrous policy of refusing to treat patients who failed on one anti-TNF with another. Anti-TNFs are not all the same, so saying that because a patient fails on one they won’t benefit from a different one is patently absurd, but that’s exactly what NICE, the patently absurd National Institute for ‘Clinical Excellence’ had decided to do. From later this year though, patients who fail on one anti-TNF will be allowed another go. (I think only one more go, but that’s better than none!)
Hopefully I shall never need to worry about this from a personal point of view as I seem to be doing well on the methotrexate. Inevitably the three-week flare I’ve just come through has now passed (just in time for the hospital appointment, of course) and didn’t show up in the bloods, so it’s not being taken at all seriously. Still, on the bright side it DOES seem to be over, so next time I shall just have to gird my loins and nag the hospital while I’m HAVING a flare, if only so they get to see it!
So that was the mildly irritating.
The bad is physio – not my physio of course; she’s still lovely. But apparently, ‘In order to be in line with private practice’ they are going to restrict all patients to a maximum of six appointments before a re-referral is required. It’s a very confusing system which I’ll explain in another post, but I can probably get re-referred. However, if I normally have physio twice monthly, I’ll have to get rereferred every three months and then wait around five weeks for an appointment, where presumably I won’t be guaranteed to see my lovely physio and will be reassessed each time, even though after a couple of years I think between the two of us we have a pretty good idea of what works! (Anyway, more about this whinge later!) The bright side is that I have at least had her for around two years, and when I started seeing her I thought then that they’d kick me out after six appointments, so I suppose I can’t complain. (Oh wait – yes I can …)
Tags: butterflies, flare, Me, orchids, Rheumatoid arthritis, walks, Weeny
Flare notwithstanding, I managed to get myself up to the north Norfolk coast again to stay with Weeny and her hubby and go orchid hunting last weekend. I had several rest and stretch stops on the drive up, and once there we stuck to relatively local places to keep the drives short, and pottered slowly! We were particularly on the hunt for Bee Orchids and Early Marsh Orchids.
Well we found Early Marsh Orchids in abundance, and Common Spotted Orchid, and possibly another one I haven’t identified yet but might be Southern Marsh Orchid, but not a Bee Orchid in sight. Since we have a bad habit of dismally failing to see what appears to everyone else (usually in the butterfly line, as at least orchids can’t fly away) we assumed it was just us being dense, but after spending all morning at it Weeny wandered off to get a couple of ice creams (handily sold in the nature reserve building) and got chatting to one of the volunteers who told her the Bee Orchids were late this year and there’d been no sign of them at Holme so far.
The chirpy chappy then said, ‘But if you want to see some pyramidal orchids, there’s loads of them just down that path, at the end of the pine trees on the right … ‘ Well … they’d done the butterfly thing and flown away I reckon, or as Weeny suggested pulled up their roots, packed their suitcases and wandered off when they saw us coming!
Clearly it wasn’t going to be our day for orchid hunting …
Cut to Wednesday night -hubby and I are off for the weekly shop. Hubby is frowning at the lawn and starting to mutter about mowing it. This happens about once a month – the rumbles start a few days before the actual mowing as a rule, and I was trying to persuade him to see sense and leave it another two or three days until the gardener comes. Not sure comments like, ‘It’s so long already that another few days won’t make a difference’ really helped my cause! Anyway, I’d dragged myself off to the car, and suddenly heard a yell behind me, only to see hubby squatting on the front lawn going, ‘Penguin – come here a sec … is this what I think it is?’
Can you guess what it was?
Yes, we’ve only gone and got Bee Orchids growing in our front lawn!!!
We’ve only found two so far but there might be more if I can just keep hubby and the gardener away from their manly mowing duties. What is it about men and an obsession with short grass? The one that hubby spotted first, which is in flower (will post photos later) has clearly already been mown once – you can see part of a leaf and the top of the flower spike has been cut off!
Tags: aches, arthritis, depression, doctor, fatigue, flare, flare-up, GP, hospital, hypothyroidism, joint pain, methotrexate, MTX, pain, R.A., RA, rhematoid arthritis, Rheumatoid arthritis, rheumatoid arthritis (RA), sleep, stress, T3, T4, thyroid, thyroxine, tiredness, TSH
I went for monthly MTX blood tests today and remembered to ask if the thyroid results were normal – I’d assumed they were, since no one at the surgery had bothered to contact me. They weren’t.
Having said that, they weren’t all that abnormal either, so what are we doing about it? In their case nothing as yet, in my case getting rather confused …and cold …and tired … and achy … but mostly just confused. Until I went in and asked for the results I thought a thyroid test was just that, one test, one answer – OK, not OK, whatever. But no … it turns out there’s a test for thyroid stimulating hormone (TSH) which is produced by the pituitary gland and stimulates thyroxine production from the thyroid gland. Then there’s tests for the two types of hormone the thyroid gland itself produces, thyroxine (T4) and the other one whose name I can’t remember (T3). Counter-intuitively, if you have lots of TSH sloshing about it means your thyroid might be UNDER-active, because you have to produce a lot of TSH to get the thyroid to do anything at all. If you have loads of T3 and/or T4 (produced by the thyroid gland itself) then you obviously have an overactive thyroid as the thyroid is producing loads of the stuff. If you have very little then clearly you have an under-active thyroid.
Symptoms of the latter include feeling cold when it isn’t (box ticked), weight gain or difficulty in losing weight (box ticked), muscle aches (box ticked), abnormal menstrual cycles (oh yeaaaah!), decreased libido (what’s libido again, somebody?), irritability (well … erm … guilty) and memory loss (not sure, can’t remember). However, my levels of T-whatever – not sure if they tested for T3, T4 or both, are in the normal range. My level of TSH though is just outside the normal range – just a smidge too high. As a consequence the docs have decided to wait and see. I can totally understand the logic of this – apparently it does fluctuate and it’s not as if it’s wildly off the scale, so try again in another month and see if it’s still high, and if the levels of T-whatsit have decreased or not.
Really – I can totally understand that – but it’s just sooooo frustrating, as I sit here grumpily shivering, with period pains! (Oh yeah, and a flare just to increase the fun.)
One interesting thing – apparently the most common cause of hypothyroidism (under-active thyroid) is an autoimmune problem. Surprise, surprise!
As to the confusion – I’ve just about got it straight in my head that there are all these tests and roughly what they’re for, but nowhere can I find clear guidance as to what is and isn’t normal range for any of these tests – it seems that for TSH it used to be considered that up to 5.5 was OK, now they reckon about 4.5, or maybe 3.5, or sometimes 2 depending on who you ask, and apparently some authorities in the UK reckon up to 10 is fine! I’m just going to go off and find a nice sandpit to bury my head in for the next month.
Tags: flare, R.A., RA, relaxation, Rheumatoid arthritis, sleep, stress
In the spirit of this blog being positive, here’s the antithesis to the post below. Ten good things to do during a flare – but of course it only applies if you’re me, ’cause everyone’s flares are different!!
1. Take it easy.
2. Take time off work.
3. Really – take time OFF work.
4. Listen to your own excellent advice about taking time off work.
5. THINK – try to be slightly more aware of hands and feet BEFORE you do dumb things!
6. Keep as active as possible – but don’t force yourself.
7. Do everything you can to get to sleep and stay that way at night! E.g. Take 5HTP, take paracetamol just before going to sleep even if you’re not sure you need them, listen to Bill Bryson reading one of his books in his gentle, soporific voice (or Tim Piggot-Smith reading David Starkey, or anything by Stile Antico)
8. Eat sensibly and TRY not to comfort eat!
9. Learn to count.
This flare I have managed to take note of 1-4 and 6-7 this time, and I am feeling A LOT better. I’ll try harder next time and see if I can manage all ten … well nine … well eight really …
Tags: arthritis, flare, R.A., RA, RA flare, Rheumatoid arthritis
1. Say “Of course I can carry the tray!”
2. Run downstairs wearing only socks. (It feels like you’re walking on marbles.)
3. Say, “No – don’t you come up. I’ll bring the dress down for you to look at.” (’cause then you have to take the dress back up to keep it away from the cats … and then come back down.)
4. Tell yourself a browse around the local garden centre won’t hurt a bit.
5. Push a big, heavy door open with the flat of your hand.
6. Assume you can overtake the little old lady with two sticks walking in front of you along the street.
7. Get depressed when you can’t overtake the little old lady with two sticks walking in front of you along the street.
8. Swing your arm up without thinking to get something off a top shelf.
Actually I think that’s all the dumb things I’ve done over the last two days pertaining to my flare, but I think eight is enough – don’t you?
Tags: cancer, cold, de-stress, flare, floret, holiday, hot flashes, hot flushes, RA, Rheumatoid arthritis, stress, thyroid, work
It’s been ages since I posted! First of all I was on holiday (fab) and then I was back (less fab) with intrays (both virtual and paper) bulging at the seems, even though ‘the boss’ was doing a sterling job of dealing with stuff while I was away. My stress levels weren’t helped by the tax office sending out wrong info about maternity pay just when I needed to look into it, as ‘the boss’ is nearly half way to having a baby! Their calculator told me I could claim back about 10% of what I paid out in statutory maternity pay – which worried me a bit, since I’d thought I could claim back 100%. Turns out I CAN claim back 100% – but I had a stressful week or two before I found that out. Then they decided to keep me on my toes by telling me I’d not paid April’s PAYE, so I had to waste time phoning them up, only to be told ‘Oh sorry – the computer is accidentally sending out non-payment notices every time someone sends in an end of year tax statement.’ Marvellous!! Work itself has been pretty stressful too – but at least busy, which as usual I have to keep reminding myself is GOOD THING!
On top of all this I’ve recently heard that a good, and local, friend of mine has just been diagnosed with breast cancer. She also has RA! As my friend Weeny would say, ‘You really must stop going for those buy one, get one free offers!’ Seriously though – you’d think RA would be enough to cope with!
As to the good ol’ RA, it’s MOSTLY been behaving itself. I thought I was in for a holiday flare as I watched my hands getting redder and redder and more and more swollen as hubby drove us down to Dorset, but a few hours after we had reached our friend’s house, where we were to stay the week, they’d settled right back down. Perhaps my body suddenly went ‘Hey, chill out penguin – you’re on holiday!’ Had a blipette (florette, flarette?) this week, probably due to finding out about my friend’s cancer, but again it hasn’t materialised into a flare, thank goodness.
I’ve also just had a thyroid test (again) because I’m feeling tired and FROZEN all the time. While this MIGHT have something to do with the fact it’s bloody cold and we’re getting early April weather in mid May, I’m frozen even when it’s quite warm, so I think there’s more to it than that. The only time I’m really warm, in fact, is when I’m having a hot flush. Imagine the fun of dressing for a day of being 90% frozen and 10% boiled – it’s kinda tricky!
I think there’s about six things that could be expanded on in separate posts here, not to mention an interesting bit of info about blood tests that Maggie sent me before I went away and that I’m still planning to blog on at some point. But meanwhile it’s nose back to the grindstone – a rather grim mixture of interviews on child abuse and prostitution, and a disciplinary hearing! Oh well – it can’t be chocolate every week – last week was mostly all about chocolate, so I suppose I shouldn’t complain!
Tags: aches, arthritis, flare, flare-up, pain, R.A., RA, rhematoid arthritis, rheumatoid, Rheumatoid arthritis, rheumatoid arthritis (RA), rheumatology, sleep, stress, tiredness
On the plus side, at least a yo-yo goes up as well as down! I’ve had another mini-flare (fizzle, floret?) since I last posted, which is why I’ve been so quiet lately … well, that and the fact that work has been insanely busy lately. I rather strongly suspect the two are connected!
I have posted before, once or twice :-) on the importance of pacing yourself and a week or so ago I gave a great demonstration of exactly how now to do that! Worked long hours, worked part of the weekend, ignored the warning signs, took paracetamol or rubbed in magic herbal rub stuff and just kept on working … and of course woke up one morning almost unable to get out of bed. I did get out of bed … still had deadlines to meet, but came home early in a LOT of pain.
So, what would a sensible person do at this point? Take some painkillers, go to bed and have a bit of a snooze probably. I thought, ‘Well, I don’t feel well enough to work but I still have all this City and Guilds embroidery stuff I need to do, so I’ll go to bed with some research books for that …’
Eventually I reached a point where I HAD to go to sleep, but was still trying not to as I thought that would mean I wouldn’t sleep at night. I got to the point where I realised that I’d need matchsticks if I was going to keep my eyes open and gave in.
At this point I was still in a LOT of pain but did drift off to sleep … and woke up an hour later feeling fine! I know sleep is important, but that’s a really extreme example! And I did sleep well that night too. I must have been really sleep deprived and not even realised it!
Mind you, waking up with five to ten hot flushes (flashes) per night is not exactly helping on the sleep front.
Still, things are looking up – work is now steady (which means that I’ll be panicking in a week or two that there’s not enough), apart from one odd twingey pain in one knuckle I’m not bad on the RA front … the yo-yo is on the upswing again … and will hopefully sit at the top for a while at least!
Tags: aches, arthritis, computers, computres, exercises, flare, joint pain, neck pain, physio, physiotherapy, R.A., RA, rhematoid arthritis, rheumatoid, Rheumatoid arthritis, rheumatoid arthritis (RA), stiffness, stress
I’ve got two different rather odd pains to add to the usual mix at the moment! One is a burning pain that I get intermittently in my spine, a few vertebra down from my neck. It’s not too bad, just a bit odd, a bit burny and a bit tingly. Bizarrely, my physio thinks this is a sign of a bit of stiffness. Does anyone else get stiffness manifesting as burning?! Well, she’s given some exercises for flexing the upper thorax, and if they work then I guess she’s right.
The other one is that, having found ultrasound fantastically helpful for ages now, I’m suddenly finding it incredibly painful on my acromioclavicular joint. (Excuse my showing off my knowledge of joint names – it took ages for my physio to teach me this one and I rarely get the chance to use it … it’s the little insignificant (until it hurts) joint between the shoulder and color bone, right at the front.) It starts off alright and then it very quickly gets incredibly sore and painful. Physio says she’s come across this happening before but she doesn’t know why, and she wonders if it’s just a bit more inflamed than usual.
I hope it’s NOT more inflamed than usual. Did I speak to soon about averting a flare? Today certainly didn’t help on the stress reduction front – all clients want their work now (if not last week), and one thought I could proofread 90,000 words in two weeks. Well, I could if I had nothing else to do … grrrr… Oddly enough I feel more stressed now with both computers working than I did yesterday with both computers not working. Does this say something about computers, I wonder?
Tags: computers, flare, RA, rhematoid arthritis, rheumatoid, Rheumatoid arthritis, rheumatoid arthritis (RA), stress, Ulric Computers
As someone in the office said today, ‘I love what they do … I just wish they did it better’. I had an unbelievable computer day yesterday. My work computer finally died. We won’t go into the fact that I’ve been saying ‘the C drive’s dying’ for a couple of months and the IT guy’s been going, ‘Oh no it isn’t …’ Suffice it to say, it did.
After one HELL of a day I went out for a very pleasent evening of sewing and chatting with the local quilting group (where I don’t quilt but do sew and chat), came home and thought ‘ better check my email’ … so I turned on my laptop and it broke. Honest – just like that. The on button became an ‘in button’ – permenantly pressed in and fallen down inside the computer.
I really thought that was the end of my computer, but I’d gone through stressed and out the other side yesterday and I was, extraordinarly, completely calm! I just decided I didn’t have room or energy to worry about anything else and what would be would be.
I did think all the stress was bringing on a flare last night, but it hasn’t happened – whether that’s because of my determination not to get stressed about this latest thing and to calm myself down, or whether it was never going to happen anyway I shall never know.
Anyway, to ‘cut stories long and short’, I phoned the local IT shop this morning, explained the situation, got a very poor prognosis but ‘bring it in and we’ll look at it …’ I did, he did, he jammed a screwdriver in a place I wouldn’t have dared tamper with and yanked off part of the top and then stood there going, ‘But … but, but, but, but… but …’ interspersed with ‘That’s not supposed to be able to happen …’ and ‘In all my forty years in the business I’ve never seen anything like this …’
Astonishingly the story has a happy ending – or perhaps a happy middle as it’s not totally resolved yet. He showed me where I needed to apply some superglue (of all things!) and then how to put on the bit he’d yanked off, and showed me that the laptop still works! Woohoo! He didn’t charge me a penny and even said if I was nervous about putting the bit of cover back on I could bring it back in and he’d do it for me. That’s customer service for you – and I’ve never even been a customer in there. But you know what – if I want a PC in the future, that’s the first place I’ll look, for sure! A ‘big shout out’ for Ulric Computers!
I shall leave hubby to do the supergluing – feeling far too fumble-fingered after all that, although really I’m sure none of it was anything I did!
Tags: birthday, consultant, flare, occupational therapy, OT, physio, physiotherapy, RA, RA flare, Rheumatoid arthritis
At last I’m on my way out of a rather prolonged flare! While I’m sure that my consultant would be pleased to point out that it wasn’t much of a flare – I mean I didn’t even need a steroid shot – it was quite enough of one for me, thank you!
I had a very good birthday this year, in spite of being in the middle of the flare. Hubby had the day off too, which he doesn’t often manage, or at least not to coincide with mine, and we had a leisurely morning in Norwich including a trip to the Castle Museum and lunch at ‘The Waffle House’. Because of the whole flare thing we decided to come straight after an early lunch and I spent the afternoon lounging around in bed reading some of the many great books (mostly embroidery-related) that I’d got for presents, before heading off to Mum’s for a yummy meal in the evening. While I’d have liked to have been able to DO more on my birthday, it was still a jolly good day!
I suppose at least I’m finally learning to pace myself. Talking of which, the OT is NOT in my good books at the moment. I drove for forty minutes in stinking traffic through rain and hail and sleet and snow and fog (and semi-darkness for part of it) to get to my OT appointment only to be told, ‘She’s gone home’. Luckily for both of us I suppose a) I like her and b) I know she wouldn’t do that deliberately and c) she phoned and apologised profusely this morning.
I told her she could make it up to me by fitting me in between physio and a hair appointment next week, which she is doing. I shall come away feeling thoroughly pampered after all that: not quite a luxury spa treatment, and believe me, our local hospital doesn’t bear much resemblance to a luxury spa, but the closest I’m likely to get to one for a while!