Back on the wagon

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Owie hands. Boring. Aggravating. Again.

Yesterday was a really rough day. I was hurting all over, but the RA was hitting my hands and wrists the hardest. Along with that, the chronic trochenteric bursitis I’ve had for several years now showed up again, making my hips feel like I had spikes in them.
So, I wore my compression gloves all day long. I counted down the hours between painkiller doses and wished, fervently, that they’d work better. I sat with ice-packs jammed against each hip and toddled around like an old lady.

It was no fun, but I’ve had worse flares. For instance, I was able to do most of what I needed to do in spite of the pain yesterday. I even managed to make a fresh salad for lunch by limiting the ingredients to Romaine lettuce, tomatoes and cucumbers because those veggies don’t require much effort to chop. Still, it was a long, miserable day. The RA and bursitis pain was constant and nagging. Ignoring it was a pipe dream. And pain like that simply wears me down.

What brought this nasty flare on? Hmm. The weather was clear and hot. I kept checking the barometric pressure, convinved that it must be rising or falling, prodding my rheuma-dragon and making him restless and irritable. Making him bite. But the barometer was dead-steady. That wasn’t it.

(An aside: I used to just accept that there was no rhyme or reason for flares. They just came and went, random as clouds. Since those early days I’ve learned that there may be triggers for RA flares, such as barometric pressure changes or fatigue, so I tend to look to those before I just give up and blame the pain on fate alone.)

So, the barometer was out. What else could have caused me to flare? Well, I took my uncle to the VA medical center to see his doctor and have some tests done the day before yesterday. I wore myself out. Could that be it?
Maybe, but with the exception of hefting unc’s wheelchair into and out of my car’s trunk a couple of times, most of the day was spent wheeling him from clinic to clinic, waiting through appointments, and driving there and back again. And then back home. It wasn’t exactly strenuous, though it did end up being a full, 8-hour day. Now that I look at it all written down like this, I’m not really surprised that I was pretty much whupped by the time I got home.
I went to bed about an hour early and fell asleep the moment I laid down. But I woke several times during the night. And when dawn arrived, my hands were stiff and throbbing, and the bursitis was shooting darts through both hips.

So, maybe I can blame Uncle’s Doctor Day for yesterday’s flare. But I can’t just quit helping him to avoid rousing the dragon. Beyond that fact that I love my uncle, helping him means that I help my sweet aunt (whom I love even more), too. She also has tronchanteric bursitis, she’s 79 years old, and caring for him has just about run her ragged. I can’t leave her without help.

Today, the bursitis pain is there but mild, thank goodness. And my hands are somewhat better. I’m glad the concentrated rest helped, but I’m not totally convinced that getting so tired the other day was the sole reason this flare happened.

There are other culprits.

Number One: I stopped being mindful about my nutrition and calories some time back. Like I’ve done time and time before, I was pleased with what I weighed and how I looked and felt, so I started cheating. I hate to admit this, because it’s just an excuse, but my mom is one of those lucky people who can eat anything she wants and never gain weight. She loves sweets and potato chips and fast food and keeps them on hand all the time. I got tired of always denying myself those goodies, and I got lazy, too. It’s a lot easier to eat like she does than make myself special meals (she doesn’t like what I eat when I’m being good to myself). It’s just plain hard to resist the constant temptation those cookies and bags of candy in the cupboard present me with, not to mention the ease of KFC and Carl’s Jr.

The result? I’ve once again regained the weight I worked so hard to lose—plus a little more for good measure. And while I don’t know what my blood-sugar levels are at the moment, I’m sure they’re high. I imagine the lipids and cholesterol levels don’t look very good, either. My blood pressure has been up a bit for awhile now, though my doc hasn’t suggested medication for it yet. And I know I’m once again looking squarely at the dreaded Metabolic Syndrome—excess fat around the mid-section, a proven cause of heart trouble (which RA can cause, as well)—complete with pre-diabetes, at least. Type 2 is waving coyly from the wings.
Crud. I’m frustrated—no, angry—with myself for being such a weakling, such a slacker. Sure, I know I’m not alone. Plenty of Americans are obese, their health compromised by their penchant for French fries and Keebler’s cookies, McMuffins and candy bars instead of nutritious breakfasts and lunches, and chips and microwave popcorn after dinner from Pizza Hut, munched in front of the TV at night. Still, being one of the crowd isn’t much to be proud of, is it.
So, today marks my first day back on the Real Food wagon. I know that the poor diet I’ve allowed myself to eat, and the excess poundage it packed back onto my smallish, five-foot-four-inch frame, has only made the rheuma-dragon stronger, meaner and harder to fight off. Yesterday’s flare was just a taste of what lies ahead unless I take action. Now.

Getting it all back under control is fairly simple (though much harder to do than it is to say): just cut out the processed foods; the junk and fast foods; the flour-and-simple-carbohydrate-based white foods; and of course, nix anything with sugar or high-fructose corn syrup in it. Eat whole grains only, but limit even those to as little as possible. Eat lots of green veggies—the darker green the better—along with veggies in most of the other colors, too. Severely limit dairy foods. Eat fruit,

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A good meal for RA, and easy to make.

but watch the sugar content. Since I like meat and don’t really want to give it up completely, I’ll limit it to fish and chicken breasts, which I like best anyway. And I think I’ll try chef Mark Bittman’s suggestion and only eat meat after 5 p.m. and choose one day a week to go completely meatless. It can only help.

The Number Two Culprit: I stopped even trying to exercise. Along with that, I spend a big chunk of each day planted squarely on my broadening behind. So I’ve got to get my body moving again. I’ll start out with a short walk early each morning, adding more time and distance as my body strengthens. I’ll do some gentle stretching and resistance exercise each day as well, including the ones I learned at physical therapy for the bursitis. Maybe it will help that, at least. And if I’m careful, it shouldn’t aggravate the RA much, if any. In fact, I keep reading that exercise helps RA, even if it’s just to strengthen the muscles that support the joints. That hasn’t really been my experience, but I tend to give up exercising easily if I start to flare. This time I’ll squash my inner-wimp and try to stick with it.
Diet and exercise really do have a beneficial affect on rheumatoid arthritis (and its co-morbidities, like bursitis). I’m only human—I’m good at denial and prefer the easy path to the hard. But I’d also like to live a long and productive life with a minimal amount of illness and disability. I know how. It’s time to get busy again.

NOTE: Andrew, who writes the blog Living With RA has written a three-part series of posts about RA and Metabolic Syndrome. They’re excellent: meticulously researched and written so that they’re easily understandable for the non-medical-type person, which most of us are. He’s also a very good writer, so do take a look at http://livingwithra.wordpress.com/2013/06/27/metabolic-syndrome-and-ra-increased-cardiovascular-and-diabetes-risks/

11 responses to “Back on the wagon

  1. Sounds like you were writing about me, Wren. I too am in the exact same spot as you. I got a little depressed and candy made me feel better. And since I started feeling worse because of the weight gain, I stopped doing my bike as regularly as I used to. I felt like a million dollars when I’d dropped in weight and worked out every day. Now I have a closet full of clothes two sizes too small, but I refuse to buy a new wardrobe. Instead I’m going to “buy” a new me. The cost will be smarter nutrition and more exercise. Here’s wishing you the best! And yes, the fatigue can cause a flare. At least in my experience. Rest is the best medicine for that. Take care!

    • I’m real familiar with a closet full of clothes two sizes too small. I gave my old fat-clothes to hospice and I don’t want to buy new ones, either! And I definitely felt better overall when those small clothes fit.
      So how’s this: I’ll offer my shoulder to you in support if you’ll offer me yours. Maybe we’ll both be back in our smaller bodies–and clothes–by New Year’s!

  2. I am so sorry that you had that flare. Even one flare day can feel like a week. It’s good that you can pinpoint your triggers too. I haven’t figured out mine yet but that said- reading yours I can say that my weight has slowly crept up to the point that I am at my highest ever. I rely far too much on pre-packaged and takeout and I let my exhaustion be an excuse not to exercise. Before I read your post I spent the last two days reading up on a 28-day Elimination Diet to prepare for gluten-free living to see if it would help at all. Reading your post added weight to giving this a try. Thanks so much for sharing and I hope that feeling a little better today is the beginning of a trend toward putting the dragon to sleep for a bit- even if it’s only for a nice long nap. Be well my friend!

    • Thanks, Jules. I hope the elimination diet works, and that if you do decide to try gluten-free, it improves how you feel. I don’t have much trouble giving up white-types of bread, but I don’t want to give bread up entirely, so whole grain, limited to a couple times a week, works for me. Let me know how it goes?

  3. So sorry to hear your dragon awoke and left it’s cave…here’s to feeling better soon and reigning in that untamed beast that leaves us so miserable.

    • Thanks for the kind wishes,Each day seems to be a little bit better–the dragon is dozing again. Hope you’re well!

  4. Hi Wren, I do hope your flare is over soon – you have my complete sympathy and understanding not just about the flare but about the weight/denial/getting busy etc. As Irma said above, you could be writing about me … I’ve been really eating well/watching what I eat etc. for three weeks now and started losing weight and now seem to have put it back on – but I have done NOTHING wrong in those three weeks. It’s soooooo frustrating. Hopefully it’s just a blip and hopefully your efforts will be much better rewarded!!!! I need to do the exercise thing too but of course we can’t do much while flaring or whatever. :-( GOOD LUCK!! You know you can do it – ’cause you’ve done it once already!

    • Aw, Penguin, that’s the hardest, right there: When you regain the weight you just lost or can’t seem to lose any more, even when you’re mindful every day. We just have to stick with it, I guess. And yes, I’ve done it before so I know I can do it again. Just mad at myself that I HAVE to. Grrr.

      Do take care of yourself. I hope that painful hip, RA-related or not, is feeling better. :)

  5. Wren, here’s to wishing you success with cutting back on carbs! It’s sooooo hard to do and seems so unfair when you see others enjoying a double scoop ice cream cone (my kids every summer day!). Metabolic syndrome is a nasty beast. And exercising when everything hurts and you have no energy…ha! Face the dragon squarely in the eyes and fight back!

    • Thanks so much, Andrew. I’ve known for quite a while now that I needed to get serious again, but it was your series on Metabolic Syndrome and RA that really gave me the motivational push I needed. So thanks again, for that. I’m going to give this effort my best St. George swordsplay!

  6. carlascorner

    So sorry that you had the flare. Don’t beat yourself up about falling off the wagon. You’re getting back on and that’s what counts. And don’t forget you’ve had a busy (i.e., stressful) summer which can also trigger all the things in your blog — flares, comfort eating, fatigue, etc. But I’m glad you’re working on taking better care of yourself. That’s the #1 thing any of us can do. I hope you get to feeling better soon.