This post was going to be an update on how I’m feeling, etc. But when I sat down at the computer to start drafting, I bought a goat instead. I thought about a water buffalo, but there was just something about the goat that I liked.

I got a catalog the other day from Heifer International (www.heifer.org/gift). They provide farm animals to impoverished regions all over the world. A goat can lift a family out of poverty, provide milk for protein, manure for fertilizer, and baby goats that can be sold or used to increase the herd. There are gifts of all price ranges from a flock of chickens ($20) to a gift ark with a pair of everything (except the guinea pigs, rabbits and ducks — they come in threes for some reason). Or you can purchase a share of animals. A share of a goat costs $10. It’s nice to think that somewhere a goat is going to go to a new home just in time for Christmas.

I also ran across the following article indicating that there is a Chinese  herb that has shown to reduce inflammation in RA patients. I’m a bit wary of mixing supplements with prescription meds, but this is really fascinating:

(HealthDay News) — An ancient Chinese herbal remedy called “thunder god vine” helps reduce inflammation in people with rheumatoid arthritis, a new study shows.

The remedy is an extract of the medicinal plant Tripterygium wilfordii Hook F (TwHF)—known in China as “lei gong teng”—and has been used for centuries to treat a variety of inflammatory diseases.

The study compared reduction in joint swelling among people with rheumatoid arthritis who took either the herb or an anti-inflammatory drug.

Rheumatoid arthritis causes chronic and painful inflammation of the joints that, over time, can lead to joint damage and loss of function.

The 121 participants in the study all had at least six swollen joints. One group took 60 milligrams of TwHF root extract three times a day, and the others 1 gram of sulfasalazine (Azulfidine), a prescription anti-inflammatory drug, twice a day.

After 24 weeks, about 65 percent of those taking the herbal extract showed at least a 20 percent improvement in their joints, based on American College of Rheumatology criteria, a standard measure of the effectiveness of arthritis treatments. About 33 percent of those taking sulfasalazine improved to that degree.

A report on the findings is published Aug. 18 in Annals of Internal Medicine.

“This study is a reminder of the potential importance of supplements and herbs in the management of arthritis,” said Dr. John H. Klippel, president and chief executive of the Arthritis Foundation. Even so, the study involved a relatively small number of people, Klippel noted. Clinical trials for pharmaceuticals typically involve many more participants studied over several years, he said.

“The findings are encouraging, but [TwHF] is not likely to be recommended by rheumatologists based on the findings of this one study alone,” Klippel said.

And, though sulfasalazine used to be very popular as an arthritis treatment, the drug is not used that often today in the United States, according to Dr. Stephen Lindsey, head of rheumatology at Ochsner Health Systems in Baton Rouge, La.

I started this blog over a year ago — July 2008 — right after I had my RA diagnosis. This blog has lasted longer than some of my husbands (seriously!).  It started as a way to keep family and friends informed of my progress as I went through my hip replacement, then my shoulder replacement, then my husband’s bypass surgery — all in the last year or so.

Besides keeping family and friends up to date, it has served as sort of a personal diary to keep up with my health. If you’re like me, sometimes it’s hard to remember exactly what we felt when, or when symptoms started getting worse, or something changed.

A year ago, after my hip surgery, I felt well enough that I insisted on stopping treatment. Today, I’m counting the days [hours, minutes] until my next Simponi shot. I can tell myself that the disease hasn’t changed/increased that much over the past year, but when I go back and read my notes on how I was feeling, what choices I made, I can tell with certainty that my RA is progressing. I can’t imagine writing todayI decided that my symptoms were not bad enough to be taking “serious” drugs.

Above and beyond all that, this blog has served to introduce me to a whole community of people facing the same issues I am on a daily basis. Some have gone ahead, some are learning from my experience. Regardless, there is an underlying sense of sharing and support. I am amazed, every day, when I see the number of people who read this blog (and no, I don’t have THAT many cousins!). Thank you for caring enough to check in.

I’ve decided that money is just like air: it’s not important unless you don’t have any.

I’m very fortunate in that I have a job that I like and it pays well. The benefits are good — they support my $1800/mo. Simponi habit. My husband owns his own architectural firm and while he’s not Frank Lloyd Wright, it has had consistent business over the years. We’re a long way from being rich (particularly based on Dallas standards), but our income supports our relatively modest lifestyle and allows us to indulge our passion for travel on a fairly regular basis.

I grew up [really] poor, and I’ve worked hard starting at a very young age to get to where I am today. The last 15 years or so I had my own consulting business, which takes an enormous amount of hard work and long hours if you don’t want to starve. I closed my consulting firm and ran for cover under the corporate umbrella about a year ago when I saw the economic handwriting on the wall.

What I would really like to do, what I’ve never had the opportunity to do, is to either stop working or cut way back — perhaps do some project work at home. I love keeping house and cooking. I’d like to be able to seriously work on my second novel — which has been gathering dust for over a year. I’d like to be able take exercise classes in the middle of the day — instead of missing them because I’m working late (again). I’d like to indulge those days when I don’t feel well without worrying if I have enough time off accrued.

And while our lifestyle would become even more modest, and travel become less frequent, we could manage on my husband’s income alone. The other night when I got home after a particularly grueling day, he even told me that if that’s what I really wanted to do, that he’s right there behind me all the way.

It sounds good until I look back just a few months ago when my husband had his triple-bypass surgery. What if he had not survived or had not been able to return to work? What if that had happened and I had already quit my job? It made me realized that as comfortable as our lifestyle is today, we, like many people, are one major health event from potential financial disaster.

We just applied (and were finally approved) for long-term health care insurance. This was right after my husband’s heart surgery. It seemed to take a while for things to move through and yesterday I spoke with our agent. It seems the hold up was not my husband’s health, but my RA. In fact, my RA disqualified me for one of the benefits we applied for (a waiver for the waiting period for home health care), and put me in a sub-prime group, which increased the premium on my policy. My policy has less benefits and costs more than my husband’s who has had open-heart surgery.

I tell people that I don’t necessarily believe the phrase, “If you have your health, you have everything,” but I’m a firm believer that if you don’t have your health, it impacts everything.

I’ve also decided that health, like money, is a lot like air. When you’re young, healthy, and invincible, you don’t pay attention to it because whatever you’re doing is working, right? But when you’re health becomes an issue, it’s like getting that after-Christmas credit card bill in the mail.

So take care of your health budget. Put some nutrition, exercise, and rest in the savings bank, and they’ll pay dividends well into the future.

Thanks for checking in.

I have to apologize for the pity party about the high heels yesterday. I’ve always said it’s not the big things that get you, it’s the little things. 

Better posts coming in the future. Thanks for checking in.

This weekend was tough. After three weeks, the Simponi shot has apparently completely worn off. I woke up Saturday morning almost unable to even get out of bed and didn’t even consider going to my water aerobics class. My husband had to leave town early Sunday, so he was somewhat insistent that we do dinner and a movie on Saturday night. I hinted that he really needed the time to get packed and organized for this trip and that we could just stay home and watch old scary Halloween movies instead.

I haven’t yet gotten to the point where I tell him, or anyone else, that my RA makes me feel bad enough that I can’t do things. I hate saying no when my husband is trying to do something nice or fun for me. I guess that’s the next step in my multi-step program of accepting/dealing with this disease.

I keep telling myself that RA hasn’t changed who I am, that I’m still the vivacious, independent person I was.

It’s a lie. All I have to do is look in my closet for the truth.

For most of my adult life, I’ve worn 3″ high heels. My shoe racks were filled with all different colors and styles. High heels make your legs look longer and enhances your butt. It also makes you carry yourself in a posture that is both confident and compelling. (Don’t even get me started on toe cleavage!) I have a total of two pairs of 3″ high heels in my closet today — both holdovers from a previous time. I wear them only on various special occasions (much to the chagrin of my orthopedic surgeon and my rheumatologist) when I need to be dressed for the best and I know that I won’t be on my feet for very long.

I’ve written a couple of posts about the disease being visible or invisible. Well, my high heels were my signature. They were the “S” on my SuperWoman cape. I’ve been in more board rooms, airports, meeting rooms and nightclubs than I can count, all exuding the confidence that looking your best in 3″ high heels can bring.

I’m definitely still me, but swollen ankles and high heels don’t match. And I miss the person who used to be able to wear them.

Thanks for checking in.

Small supplies of the H1N1 flu vaccine have finally arrived in Dallas and last night at water aerobics our instructor asked who in the class was planning on getting vaccinated. It was a small class, but I was a bit surprised when I was the only one who raised a hand.

After class, in the locker room, one of the other ladies in the class asked me if I worked in the health care industry. For the life of me, I couldn’t imagine where she had come to that conclusion, so I asked her. She said that because I indicated I would be getting the swine flu shot, that she thought I might be in the medical field.

“No,” I told her, “I have rheumatoid arthritis and one of the drugs I take suppresses my immune system and so I’m at risk.”

Just like that. Right out loud I told a relative stranger some of my most private medical facts.

Earlier this month, I wrote about our invisible disease and what it means when it becomes visible to others through our use of assistive devices. I’m finding out that, like a lot of things, the real stuffing is in the middle.

I’m in that place where no one would guess that I have RA. I’m still “invisible”. But while I’m aways yet (I hope) from becoming “visible”, I am at least becoming vocal. Giving voice to this new part of my life is helping me start getting part way out of the closet of denial. Most days it’s easy for me to ignore the fact that I have RA. Sure, I have aches and pains and fatigue, but when you’re over 40, nearly everyone does.

But because it’s easy for me to deny the disease, it’s also easy for me to deny the things I should be doing to take better care of myself. By including RA in my everyday life, including it in conversation, I find I have given myself permission to do the things I need to do — take a rest, take some Tylenol, exercise and stretch, ask for help.

So here I am in the middle — between denial and being visible — where the good stuff is.

I hope your life brings you good stuff, too.

Thanks for checking in.

The DFW Metroplex has an intricate system of highways, streets, and side roads that somehow manages to move  millions of us from one place to another. These transportation arteries are connected through an amazing array of engineering marvels constructed of connectors, cloverleafs, and fly overs. One interchange that I drive through twice each work day has been featured on the History Channel and is aptly named the High-Five because it soars about 60 feet in the air and has five levels of roadway that connect I-75 and I-635.

I was recently driving from downtown to my home in North Dallas and needed to take the Dallas North Tollway (DNT). This particular intersection is a single-lane raised ramp that connects one of the main downtown surface streets to the higher level of the DNT. Since it’s a single lane, it is often backed up. It’s also narrow, curved, and rises off the ground about 20 feet. (What’s not to love?)

It seemed particularly backed up on this occasion and I noted that while there were no cars actually on the ramp, there was a single car that was apparently stalled right at the entrance of the ramp. There was no way to get around the car on to the ramp and traffic was quickly backing up.

Sure enough, the emergency flashers came on the car, but it [thankfully] began to ease up the ramp at about 10-15 mph. It came to a complete stop at the crest of the ramp, then continued inching carefully forward.

When we reached the DNT, and were once again on solid ground with four straight lanes of traffic, the flashers went off and the car drove away at highway speed.

It was not a problem with the car, it was a problem with the driver. The driver was apparently terrified of driving on the overpass, and thus slowed down.

The fact of the matter is, you can get anywhere in DFW on side streets, without getting on a highway. It’s not as fast or possibly convenient, but its possible. While there are trade offs, if you’re afraid of driving on overpasses, perhaps side streets are a better option.

Having RA is similar. Just like there is an intricate network of transportation arteries in DFW, there is a wide range of treatment options for our disease. Some of them are really scary. They have side effects that affect vision, increase the risk of cancer, and who knows what else. Perhaps a safer route is an anti-inflammatory diet, natural supplements, exercise, and massage. Every day we have to face our fears and choose the route that is best for us.

My one irrational fear is the fear of falling. Not of heights — of falling. I’ll leap at the chance to fly in a helicopter, but I simply will not climb a ladder to change a light bulb. I don’t think I’ll fall out of the helicopter, but I’m convinced that I’ll fall of the ladder.

So I contemplate RA and wonder if one of the emotions I feel is fear. Perhaps. Probably. But what of?

Looking closer, I realize that it’s that deep, dark, secret fear that each of carries within. [No, not public speaking or that underwear thing.] It’s the fear of the unknown.

I’m a micro-managing, type-A, control freak and not knowing what this disease holds for my future is scary. Will I be able to continue to work? walk? drive?

What I’ve come to understand is that like all other things in life, as the future becomes the present and things are revealed, I can deal with it. And like other things in life — relationships, career — it truly is a one day at a time situation. And I can do that. I can make decisions based on what I know today, how I feel today, that will hopefully make my tomorrows the best they can be.

Thanks for checking in.

I had a boss once whose decisions depended on to whom he spoke last. One person could present a case for doing something by a certain date and he’d decide that was the way to go. Fifteen minutes later, a different person could talk to him about doing the same task in a different manner, with different resources and budget, on a different schedule, and that’s what his decision would be.  It was like the first conversation never happened. So you always wanted to be last in line when you talked to him.

I’ve figured out my life is like that.

I had a terrific weekend — one of the best and most relaxing weekends I’ve had in a long time. I was in a terrific mood.

Monday (yesterday) was a totally different day. In the morning I found out some not-happy work related things.Then in the afternoon, I had a rather arduous 2.5 hours in the dentist’s chair having a root canal done, and today I still feel like someone socked me in the jaw. You would think that some of the euphoria from the weekend would have carried forward, but it’s more like a new slate every day. It’s whatever life throws at me that day is how I feel. Forget about what happened the day before, it all exists in the here and now. What has life done for me/to me lately?

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On another note, the Simponi is definitely wearing off. I don’t feel like I need another shot yet, but I can tell the aches and pains are no longer under control. I’ve updated my Simponi Synopsis page if you want more information.

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On yet another unrelated subject, I got asked how I come up with the titles for my blog posts.

That’s one of the hardest things for me to do. I wrote a trashy [award-winning] paper-back novel about a guy who wins the lottery, but was robbing the convenience store when he bought the ticket. I got the entire book written, rewritten, edited and nearly published before I came up with a title (Wake Up With Fleas). I’ve never been 100% happy with the title, but the book’s been published for a couple of years now and I’ve yet to come up with anything I like better.

Naming blog posts is a bit easier since they are shorter and generally deal with a single topic. It’s weird, but I usually have the title in my head before I write the post instead of the other way around.

Other than the root canal, life is generally good, but about to get very busy, so I may not get to post every day. However, I do appreciate the interest and the support.

Thanks for checking in.

I guess it’s appropriate that it’s a Monday and overnight a cold front moved through Dallas bringing cool, damp, rainy weather with it. It’s the perfect morning to get some things off my desk then to spend the afternoon in the dentist’s chair. The rainy weather is tough on my joints, so afterward I’m taking the rest of the day off, curl up in bed and watch “Twilight”. (I really don’t have a desire to see the movie, but I’m curious to see what all the fuss is about.)

I like my dentist. I’ve been going to him for about 25 years now, if that tells you anything. He’s what I call a “real” dentist. Some dentists in Dallas are more beauty parlors than medical offices.

I have a real problem getting numb. Novocaine doesn’t even start to work — we have to go straight to the “good” stuff. It normally numbs people for 6-8 hours. Last time, I timed it and I was completely unnumb in 1 hour, 45 minutes. Since we’re doing a molar and therefore have three “roots” to canal, I’m going to need an extra dose.

The medication has epinephrine in it which makes your heart race and your blood pressure rise. Not a good situation with someone like me who has hypertension.

Oh, well, it is what it is and I’ll get through this day. I’m just looking forward to a rainy afternoon off.

Thanks for checking in.

When we’re growing up, we look forward to those fabulous “firsts” — the first grade, the first date, the first kiss — all kinds of new adventures.

As we move forward as adults, we start noticing the “lasts”. Some of these are intentional. A few years ago after spending a soggy week in Orlando with two 12-year-old girls, I looked my [now ex-] husband squarely in the eye and stated quite clearly that I had visited my last amusement park.

Some of these lasts are good things, like when you finally figure out it’s the last time you ever want to drink too much and pray to the porcelain god all night.

There are also some “nevers”. You know, those things on your bucket list that you’ll probably never do. I’ll never take up sky diving. I haven’t given up on learning to fly a helicopter or how to speak Spanish, but with each year that passes, those things inch closer to that “never” column.

But what I’ve come to realize lately, is that there are “lasts” that sneak by you and don’t realize it until it’s too late.  There ought to be signs or trumpets or announcements that, “Hey, this is the last time you’re going to get to do this, so pay attention and enjoy it.” Like having dinner at a restaurant only to have it close shortly thereafter. Heck, if you’d known it was going to close, you might have foregone the diet and enjoyed the world-famous dessert one last time.

I’ve had a pretty significant “last” come to my attention. And it’s something that I thought I’d do again, but I’ve come to the realization that I was wrong. It’s sad when that happens, when a chapter closes in your life.

With RA, some of those chapters close sooner than they should, and you get to enjoy firsts that you’d rather not: first dose of Methotrexate, first time to use a cane, first time you really can’t get out of bed.

The good thing about it is, there are still unread chapters in my book (and hopefully yours), adventures to be had, firsts (and repeats) that I really enjoy.

Thanks for checking in.