RA-iversary

This month, I recognized 10 years since my Rheumatoid Arthritis (RA) diagnosis. It's obviously not a cause for celebration and is more of a marking of what all my body had been through and all I've learned over the last 10 years. For those newer to my blog, I found out I had RA in August 2013 when I was living in Charlotte (I was relocated for my job). I had been diagnosed with stress fractures that spring shortly after I relocated to Charlotte and then the pain kept extending to different areas of my body and it became more intense. I was in a walking boot for a stress fracture on one leg and then 3 months later, had pain in the other leg and the podiatrist thought I had a stress fracture in the other leg. I knew something wasn't right and had been to the doctor multiple times that summer. I sort of wrote the pain off as "getting older." But my parents were kind of alarmed when I stayed at their lake home in early August and needed my dad to carry my (small) carry-on suitcase upstairs. I wasn't physically able to do that which is odd for a healthy 32 year old woman. 

A blood panel and physical examination showed that I had RA. I happened to be in NYC visiting a friend when my primary care doctor called to tell me that my blood work showed that I likely had rheumatoid arthritis. I can still envision myself walking around Washington Square Park, crying, and trying to make sense of it all. It was probably best that I was visiting a friend that weekend because she was so kind and supportive. Otherwise I would have been alone in my apartment in Charlotte which was so not my happy place (long time readers will recall that my time in Charlotte was a very challenging time in my life). 

The last 10 years have been quite the journey. There have been times when my disease was well managed. In fact, when I moved to Minneapolis and established care with a new Rheumatologist, he commented that he wasn't sure that I actually had RA! Eventually I got a flare so it was evident I had it but I wanted to say - have you not looked at my medical records that were sent from Charlotte? I eventually changed doctors and found an amazing female rheumatologist. This spring I told her about my doubtful previous doctor and his doubt about my diagnosis and she was FLOORED by that encounter. 

There have been times when my disease was not well-managed. Like during my pregnancies. I got so many steroid injections during my pregnancy with Paul that the PA drew a picture of my hands and would mark off where we had done an injection so I could keep track of when I might be able to get another injection (you need to wait at least 6 weeks before injecting a joint again). My pregnancy with Taco was so different as it all occurred during the pandemic when only essential staff was in clinic. So I was only able to get 2 steroid injections and had to get by with high doses of oral steroids otherwise. I had flares so many places - my hands, elbows, hips, knees, and even my jaw! 

My disease went back to not so well managed last fall but I think/hope we are getting back to a well managed point. It's required maxing out my dose to methotrexate (MTX), which is a chemotherapy drug, but I've tolerated it well overall. I switched over to an injectable form of the drug this week which means I have an injection weekly and every other week I have 2 injections - MTX and my super expensive Humira. I'm hopeful we can drop some of the other medications I'm on right now once we're sure the MTX is working so we can decrease my pill burden. I currently take 9 pills/day, split between morning and night, for my RA. It's a lot and every time I fill my days-of-the-week pillbox (with am and pm slots) I feel like such a senior citizen! No shade on senior citizens - it's just that it's not ideal to have so dang many pills to manage. 

When I was at my parents' lake home at the end of July, I had coffee with my cousin who is like a sister. She asked about my RA and shared a story about a time I shared a hotel room with her when I was home in the summer of 2013. It must have been the same trip that I stayed with my parents at their lake home. She said she vividly remembered that I could not open the door of the hotel room - the reason I couldn't open it is because I could not grasp anything since I had flares in my fingers and I didn't have the strength to pull the door open because of flares in my elbows. She said she was so terrified that something terrible was wrong with me. So I guess I am glad that my health issue was figureoutable and treatable and hasn't had long lasting effects. The amazing array of drug options have prevented permanent joint disfigurement.  

So I recognize this diagnosis anniversary with mixed emotions. On one hand, I am lucky to be as healthy and active as I am. But on the other hand, I'll always have to take my RA into consideration. That means prioritizing sleep and listening to my body when I am tired. That is something we all should do but if I don't, I will pay for it. I'm not operating on a level playing field for my peer group and I have to frequently remind myself of that when I'm overtired or getting a flare. I just hope and pray neither of my kids end up with this, or a different autoimmune disease, but time will tell. 

Rheumatoid Awareness Day

For most of the world, when they think of February 2nd, they think of Ground Hog's Day. But for me, today is Rheumatoid Awareness Day. When I was diagnosed with this disease, I knew next to nothing about it and I did not know anyone in my age group that had been diagnosed with the disease, so it is my hope that by sharing my experience with RA, I will raise some awareness and help others achieve an early diagnosis, which is the key to effective treatment of this chronic disease.

Since I've only had this disease for 2.5 years, I'm still learning how to talk about the disease with authority, but one area I can speak with confidence about is the diagnosis process. When I started to deal with the symptoms of RA in May of 2013, I consulted Dr. Google (like many of us do) and early on I saw that I had some of the symptoms of RA. However, the information I found online indicated that it typically affects women after age 40. I was 32 at the time and thought, "this couldn't be happening to me - I'm too young."  So I pushed aside the chance of an RA diagnosis. 

Then when I was home in August of 2013, I was in so much pain that my dad had to carry my suitcase upstairs for me because I could not grasp the handle. And my mom saw me cringing as I walked down the stairs in the morning due to the pain in my feet.  And my sister-in-law's ears pricked up when I commented about how the swelling in my hand had mysteriously moved from one hand to the other. My mom and sister-in-law both expressed concerns that I was exhibiting RA symptoms and strongly encouraged me to go back to the doctor again and demand that they get to the bottom of what was causing my pain and swelling. 

So when I got back to Charlotte, I made yet another appointment with my primary care physician and told her that something did not seem right. I had seen her several times over the course of the summer but she had diagnosed my pain and swelling as tendinitis. Ultimately, I was diagnosed with RA after my blood work was reviewed and I was physically evaluated by a Rheumatologist.

It's not a coincidence that Rheuamtoid Awareness Day falls on Groundhog's day. As the founder of the Rheumatoid Patient Foundation says: "(You can) compare disease onset to the moment the groundhog comes out of his hole to look for his shadow. It's impossible to predict how aggressive the disease will be or whether treatments will be effective. The six weeks that the groundhog forecasts correspond to the short window of opportunity for people with rheumatoid disease to get early diagnosis and treatment, which has been shown to be a crucial component of positive outcome."

While I hope that none of my readers are impacted by this disease, my hope is that by sharing my symptoms and experience with this disease, it will raise the awareness and help someone else get diagnosed during that short window of opportunity so that they, too, can effectively manage their disease as I have been able to.

To learn more about RA and read others Rheumatoid Awareness Day (RAD) post, check out the carnival of RAD carnival on RA Warrior's site.

Living with RA: My First Flare

Those of you who have been reading my blog for quite awhile know that I was diagnosed with Rheumatoid Arthritis in August of 2013. If you are unfamiliar with it and are curious about it, you can read more about it here. Here's an extremely abbreviate version of what it is:

"Rheumatoid Arthritis (RA) is a systemic autoimmune disease which attacks primarily, but not solely, the joints. It is an incurable disease affecting the synovial tissues which surround joints and similar lining tissues of certain organs. Through a very complex process, various kinds of immune cells attack and eventually destroy otherwise healthy tissues."

When I got diagnosed with it in 2013, I started a pretty aggressive treatment plan that put my disease into remission and for the most part, I've been asymptomatic for the last 2 years. Most days I forget that I even have RA. Well, besides when I take my bevy of drugs each week.

Well last Thursday, I was reminded that I do, in fact, have a shitty chronic illness, when I experienced my first RA flare since my diagnosis. When I went to bed on Wednesday night I had some pain in my middle finger but was thinking/hoping it would go away overnight.  Boy was I wrong.  I woke up on Thursday to a very swollen hand.

Due to the swelling in the joints of my right hand, I could not fully extend my fingers or made a fist and the pain was so bad that I ended up crying quite a bit that morning. I could not do the simplest tasks, like grasping the handle of the fridge to open it, holding a spoon, fork or glass to eat and drink, or open my make-up compact. My left hand was fine but doing everything one-handed is challenging - especially eating and applying make-up as I am FAR from being ambidextrous.

My Rheumatologist was not in the clinic that day but luckily I was able to get an appointment with his partner and he did an ultrasound which confirmed that it was definitely an RA flare as he could see the fluid around my joints, indicating that they were under attack by my immune system. He also determined that my cold had turned into a sinus infection so in addition to putting me on a steroid to reduce the swelling, he prescribed a strong antibiotic to take care of the sinus infection.

I know there are a lot 'at least' statements that can be made, like "at least this was your first flare in 2 years!" or "at least this didn't happen when you were in Mexico" or "at least the steroids will help" and I certainly said some of these statements in an effort to make it seem like I was handling it ok. But the reality of the situation is that it royally sucked and I once again felt betrayed by my body. I was reminded that you can do ALL the right things (eat healthy, exercise, etc) but sometimes it does not matter. So I let myself mope and cry and feel all the "why me?" feelings. Because in my opinion, you have to let yourself feel all those things so you can release those emotions and move on from the experience.

The steroids have kicked in and the swelling has subsided but what I am left with is a feeling of fear.  Fear that this was not a fluke and that I will have more flare-ups in the future. Fear that this might happen again when I am traveling for work or while on vacation or at some other time when I don't have access to my physician.  I know that I have to make the choice to not give into those feelings of fear and to trust that my physician will figure something out if more flares continues, but it's hard to choose to walk away from that feeling of fear.

I realize that this is a Debbie Down post and not at all uplifting but I believe in "keeping it real" and showing what real life looks like (when it's your story to share, as it is in this case). Because life is not all sunshine and roses.  I know that I am very blessed to have a supportive boyfriend, kind and caring family members, and compassionate friends. But you can be thankful for all of those big things and still be sad over the circumstances of your life. And right now I'm feeling a little sad.

So right now I'm trying to focus on self-care. I'm giving my body lots of rest and am taking more rest days than I've taken since the marathon. And I'm trying to squelch those feelings of guilt over my lack of activity as I know that rest and extra sleep are what my bodies needs right now. And luckily this flare coincided with a mostly plan-free weekend and today's "shouldless" day. I know that with time this bout of sadness about my RA diagnosis will dissipate as I continue to get better but right now I just have to be OK with not always being OK With my diagnosis.

RA-nniversary #2

This Sunday marks the 2 year anniversary of my RA (Rheumatoid Arthritis) diagnosis.  In some ways, my diagnosis still feels fresh; in other ways, it feels like a distant memory.  I've certainly come far in the last 2 years and am so thankful that my disease is managed.  I had a surreal moment of reflection after my triathlon last Sunday. I thought back on my first appointment with a rheumatologist.  The waiting room had all sorts of depressing magazines about disease management and such, but in the pile of magazines, I found one that featured an elite triathlete with RA.  At the time, I was in a boot and in so much pain so it was hard to believe that maybe I'd consider myself an athlete again.  But I remember feeling a sense of hope when I read the story about her.

Now, 2 years later I've completed my first triathlon and I can confidently say that I am an athlete again.  I'm training for a marathon which is something I thought I'd never have the opportunity to do again.  I'm pain free, for the most part, and thriving.

But of course, it isn't all sunshine and rainbows.  I hate how many bottles of pills reside on my counter.  I hate that I get so many prescription refill reminders from Target that I can't keep track of which request is for which medication.  And I really hate Monday nights when I have to give myself my weekly injection.  On those nights I try to remind myself that a minute of discomfort is worth being pain free but I still mope quite a bit and usually have to find some sort of reward - usually a sweet of some sort.  I hate that aches and pains that wouldn't get much of a second thought plant the seed of worry over whether that pain is the first sign of a flare up.

And yet - in the grand scheme of things - life is good.  Life is really, really good. I try to remind myself that while I was unlucky to get diagnosed with this chronic disease, I am lucky that it was caught so early and is being managed so well.  Some days it's hard to think of myself as "lucky," but I know I am.

The past year was an uneventful one for me health-wise and I just hope and pray that I have many more years like this to come!

Strength Training: One Year Later

Last spring when the symptoms of my Rheumatoid Arthritis started to subside, my Charlotte Rheumatologist really pushed me to add strength training into my fitness routine.  Truth be told, I have never been great at strength training on a regular basis.  I'm great at doing cardio, but strength training sort of overwhelmed and intimidated me in the past. 

But I came across article after article, like this one, touting the benefits of strength training for people with RA and my doctor continued to emphasize that strength training would strengthen my joints which would protect them from further damage from this disease.  When your decision about whether or not to strength train becomes a question of your long term health, it became pretty obvious that I needed to find a way to incorporate it on a regular basis.

In early April of 2014, the nagging joint pain in my elbow, wrists and fingers began to subside so I started off by going to classes at the YMCA, such as Body Pump, which is one of my all-time favorite strength training classes.  After moving to Minneapolis in May, I decided I couldn't justify the cost of a gym membership since my condo building has a great gym so I decided to try Bobbi McCormick's summer shred program.  I loved her program so much that I ended up doing 3 different shred programs.  I now have a lot of different workouts to choose from each week.  One of my organizational projects for the year involved printing off all of the workouts and arranging them by the area of the body that they work out (full body, lower body, upper body) and I have a special section for Tabata workouts. I've also wrote down or printed out a lot of workouts from Peanut Butter Runner's blog and included them in this binder.  She has a page full of great workouts.

In the last year, I've learned that I need to go into the gym with a plan.  I need to know exactly what I am going to do and the sequence of the moves I will do.  I've also learned that I prefer workouts that combine strength training with short bursts of cardio.  I like workouts that are broken up by 30-60 second high intensity cardio, like mountain climbers, burpees, or high knees, for example.  Lastly, I've learned that I need an accountability partner.  My accountability partner, Amber, lives over 1,500 miles away but we keep each other motivated by texting/instant messaging about what we are planning to do and if I am planning to get up before work to workout, I usually tell her as then I am less apt to change my mind when the alarm goes off.

A year later, the results in my muscle tone are probably subtle to others...

April 6, 2014

April 6, 2015

but they're noticeable to me.  I feel more fit, my clothes fit better, I run faster, and most importantly, I can say that I'm managing my RA - it's not managing me.

Do you consistently strength train?  If you do, where do you get most of your workouts?  

R.A-nniversary

It's kind of surreal to say this, but tomorrow will mark one year since I found out that I have RA. In some ways it feels like I got my diagnosis ages ago; in other ways, it still feels fresh and new.  I don't think I'll ever forget the days and weeks leading up to my diagnosis, or the experience of learning that I had a chronic illness.  I'll never forget the fear and anxiety I felt in those initial months or how much I doubted that I'd ever feel like my normal self and live an active life again. 

I've come incredibly far in the past year and am happy to say that most weeks, the only time I think about the fact that I have RA is when I take my weekly injection and oral medication on Monday nights.  Besides that, I feel fortunate that I can say that I really do feel like my normal, pre-RA self.

But there are times when I am reminded that I have RA.  Things like having to explain why I am not running a marathon this year (or possibly ever) or having to explain why I don't drink at work happy hours or most social events (I'm limited to 2 drinks/month so really have to ration my alcohol intake) and not being able to wear heels (they hurt my joints too much) remind me that I have RA.  Seeing my hazardous material receptacle in my closet and the syringes in my fridge remind me that I have RA.  I do wonder when/if the next flare-up is going to occur and I worry that I won't find a Rheumatologist in the area that I will like as much as the one I saw in Charlotte. 

But all in all, having RA has not been the life-crippling experience that I thought it was going to be when I was first diagnosed.  I know I am fortunate that it was caught early before permanent damage was done and for that I am very grateful.  I owe a big thanks to my mom and sister-in-law for mentioning RA as a possible explanation for the pain and swelling I was struggling with last August.  If they hadn't pushed me to go back to the doctor and ask to have further tests ran, who knows when I would have gotten my diagnosis.

A year ago, if you had told me I'd be running, doing burpees, lifting weights, and getting out of bed with no pain, I wouldn't have believed you.  I will never take for granted the ability to be active ever again.

So my message to you is this:  if you can walk, run, jump, swim, and bike with no pain, be grateful.  If you have unexplainable pain or feel something just isn't right, listen to your intuition and see a doctor.  Advocate for yourself until you have an answer. 

*Ahem, now excuse me while I step down from my soap box*

Workout Wednesday: A Milestone Achievement

Happy Wednesday!  I don't know about you, but this week is feeling especially long on the tails of what was a short week last week due to the holiday.  But hey - we're almost half ways through the week.  Woo hip.

So I wanted to post about this last Wednesday but I wanted to do my recap of the Summer Shred before the July session started in case my post inspired anyone to sign up...  but if it wasn't for that post, last week's Workout Wednesday post would have certainly been about this:

Yes, I realize I look like a hot mess in this photo as it was super humid and warm, but this moment had to be documented!

Those pictures were taken a week ago Saturday. If you look at the lower right hand corner of my Garmin you'll see that I ran 10.50 miles!  This is a big deal because it was my first double digit long run since my RA diagnosis!!

~11 months ago when I was diagnosed with RA, I honestly questioned whether I'd be able to walk pain free so the fact that I'm able to run 10+ miles and feel good afterwards is a major accomplishment!  Having RA is hard and I don't always talk about it because I don't want to be that person who is talking about her health all the time, but one way RA has changed me for the better is that it makes me appreciate feeling good and having an active lifestyle more than ever.

So take that RA.  Lisa - 1, RA - 0.

Have you ever been through something that has made you appreciate your health? Do you feel like you appreciate your health and ability to be active?  I do now, more than ever.  I'll never take my healthy, active lifestyle for granted again.

My First 6 Months with RA

It's hard to believe it's been 6 months since I found out about my RA diagnosis.  I'll probably never forget the day I got the phone call as I was standing in a super loud Jewish deli in New York with Alli when my GP called to tell my blood tests and symptoms indicated that I had RA and would need to meet with a Rheumatologist to discuss a treatment plan.  In the first days after the diagnosis, I was pretty much in a state of shock and was pretty scared about how it would impact my life, but over the past 6 months I've gotten to the point where, for the most part, I've accepted it. 

I quickly learned that it was best for me to not read about the disease online because there is a lot of scary stuff out there - things like articles on how RA shortens your life expectancy or can impact your heart and lungs or results in being in disabled status/unable to work.  There is some truly scary stuff out there, and while some of it may apply to me, I guess I am in the 'ignorance is bliss' category.  I have a doctor I trust who will tell me what I need to worry about, so I leave the worrying up to her and avoid reading all the scary things out there.

While I have moved towards acceptance of this chronic disease, I still have my bad days.  Days where I get frustrated over my limitations, especially my inability to do any weight bearing activity as my upper body joints are still not doing great.  Besides that, I still can't really wear heels as it puts too much pressure on the joints by my toes.  Not being able to wear heels might not seem like a big deal to others but it bothers me as I feel best and most confident in a pair of heels.  Lastly, I get frustrated over the limitation on the amount of alcohol I can drink each month (I am limited to about 2 drinks/month due to medication I am on that increases the chance of liver damage).  My frustration mostly stems from having to explain why I am not drinking - it's amazing how many people will ask why I am not drinking or jokingly ask if I am pregnant. 

I also get frustrated by the number of drugs I am on.  It feels weird to pull out my bag of pills when staying at others' homes or when I am eating breakfast in a public place.  I have cut out one medication, but am still on 4.  Granted 2 of those are only taken once a week, but it's still a lot.  It seems like every week I am getting a notification from Target that I have a prescription to refill so it's a constant reminder that while I am doing better, my "new normal" is so different than my old one.  Now I have pill bottles on my counter, sharps containers in my dining room as that is where I give my injections and syringes of medication in my fridge. 

This guy is both a miracle and my enemy at the same time.  It's improved my joint paint but causes skin reactions. But the good outweighs the bad.

All in all, I am doing pretty well and I have seen improvement, but I feel like it's sort of an internal silent struggle at times.  I hesitate to talk about it with family and friends or on the blog because I don't want to be that person who is always talking about her health.  The disease is manageable and I am coping with it as well as I can, but it still sucks that it's something that I will have to deal with for the rest of my life.  And it's been tough to deal with it on top of all the other struggles the past year has contained. 

All that said, I'm in a better place, health-wise, than I was 6 months ago, and I expect to be in an even better place 6 months from now.  I expect the skin reactions to go away and my upper body joints to heal a bit more.  But in the mean time, I am thankful that my foot joints have healed enough to allow me to return to running.  My fingers are crossed that my doctor will clear me to start training for a half marathon when I see her in early April!

My Diagnosis: Rheumatoid Arthritis

Warning - long post to follow...

I don't think I have ever been so happy to see a long weekend arrive as I am today.  It's been a long week.  Actually, it's been a long month.  As I mentioned in my NYC post, I received a phone call from my doctor, and the news was not great.  She gave me a preliminary diagnosis of Rheumatoid Arthritis (RA) and referred me to a Rheumatologist for further testing and a treatment plan.  The news left me reeling, to say the least, and I was very happy to have the constant company of Alli throughout the weekend.

I don't expect anyone to know what RA is - I knew very little about it until I started to research it after finding out that it was a potential explanation/diagnosis for why I have felt the way I have felt this spring/summer. To explain what it is, I am going to cite the words of Kelly, author of the site RA Warrior:  Rheumatoid Arthritis (RA) is "a systemic autoimmune disease which attacks primarily, but not solely, the joints. It is an incurable disease affecting the synovial tissues which surround joints and similar lining tissues of certain organs.  Through a very complex process, various kinds of immune cells attack and eventually destroy otherwise healthy tissues."

How I knew something was wrong... 

As anyone who has read this blog since April knows, I have been plagued by foot injuries, one which was diagnosed as a stress fracture, another which was diagnosed as a hairline fracture.  I accepted the first diagnosis, but the 2nd injury in my left foot just seem "off."  I had been doing very little and it just did not make sense that I would have another fracture so close to the first.

But that was only part of it.  As early as April, I had been feeling pain in some of my joints.  I dismissed it as first as my body's reaction to the amount of stress it was under due to CFA preparations, or I thought it was my body's way of adjusting to the boot.  But then the pain in my arms and hands got so bad, it was difficult to do things like put on clothes, pick up my suitcase, open jars, or take the cap off of my chap stick. I kept thinking - what is wrong with me or what have I done to cause all of this strange pain.  When I would get out of bed every morning, everything would hurt and I honestly felt like I was 80, not 32.

I saw a GP in late June as the pain in my arms was getting so bad, it was really getting hard to do day to day tasks, and she diagnosed it as a case of tendinitis and increased the dosage of the anit-inflammatory that I was on for my foot injury.  But the arm pain would not go away and eventually I had to discontinue the pilates sessions because the pain in my arms was too bad for me to do anything.  At this point I started to wonder what, if any, physical exercises I'd ever be able to do again.  While pilates is challenging, it's gentle, so if I couldn't do that, what would I ever be able to do to stay active/fit?

I think the real tell-tale sign was the swelling in various joints - the worst of which was the 3rd finger of my left hand.

This is what my hand looked like

This is what it should look like

This swelling, coupled with the 2nd fracture diagnosis, is what led me to see my doctor last week - that and the prodding of my mom who felt something was really wrong.

My diagnosis/prognosis...

I saw my rheumatologist yesterday and he confirmed the diagnosis by doing a physical examination of my joints, asking me a lot of questions, and reviewing my blood work (which showed abnormal levels for a couple of different labs).  He is very optimistic and feels we caught this early and that there is very little chance of any permanent disfigurement or deformity.  He sent me home with a bunch of literature to read so we can make a decision about how to treat this.  He recommended a drug that is actually used to treat some forms of cancer - I would just take it in a much, much lower dose so my side effect should be more tolerable than someone who is using it as a chemo-treatment for cancer.  There are a long list of side effects/risks that I know I need to take with a grain of salt, but it's still a scary decision for me.  I have talked to one person on this drug and she said it has been a miracle drug for her, so it was at least nice hearing one person's testimony in favor of this drug.

I won't bore you with the details of the appointment, but I will say that while I was happy with his thoroughness/amount of time he spent with me, I was very disappointed with his demeanor.  Maybe I expect too much when I expect a specialist to show some compassion.  I just felt like he was very dismissive of certain things and unwilling to talk at length about other things (like my multiple fractures - he did eventually acknowledge that RA may have caused some osteopenia, making me more susceptible to stress fractures.  Hopefully the bone density scan I am having next week sheds some light on this).  I have decided to get a 2nd opinion, not because I don't trust the treatment plan he is recommending, but because I need to establish care with a doctor that I feel comfortable talking to.  I am sure he sees many who have more advanced forms of this disease, so seeing someone young with an optimistic prognosis impacted the way he treated me.  But while he deals with it everything day and is probably a little bit "numb" to the brevity of the diagnosis, it's all new and overwhelming and scary for me, so an "I'm sorry you are dealing with this" or an acknowledgement that this is overwhelming would have helped.

How I am feeling...

Honestly, I feel cheated.  I feel like I have done all the right things - I exercised (prior to the fractures), I eat healthy, I don't smoke, I rarely drink.  But none of that seems to matter.

I feel scared.  I don't know how my body is going to react to the drug I ultimately choose to take.  I don't know when/if I will return to running, or how far I will be able to run  when I do return to running.

I feel like it's all too much when coupled with the other challenges I have faced this year.  I just wonder - when is the string of crappy things going to end?  I keep thinking it won't get worse, but then it does.  This year has just worn me out.  

But, I feel a little bit of a sense of relief because now I have an explanation for why I have felt so crappy all summer.  I have not told many people about the pain I have been feeling or the exhaustion I have experienced because I felt I had exhausted the patience of others when talking about all my foot issues.  I told a couple of people but mostly I would lie awake at night and wonder, "What is wrong with me?"  So having an explanation of it - and hope that the pain will go away eventually - is somewhat of a relief.  I just wish the explanation wasn't a chronic disease that I will have to manage for the rest of my life.

What I need...

People keep asking me what they can do, but since all but 2 of my close friends live far away, there isn't much I can ask for at this point besides your thoughts and prayers as I process this.  I do need friends/family to acknowledge that this is a big deal and accept that right now I can't be all "rah rah, they caught it early, everything is going to be fine."  I know eventually I will feel that way but right now, I am sort of grieving the fact that my life will be forever changed.  I am not going to give into these feelings of grief forever, but I will for awhile.

The last thing is that I need people to accept and respect decisions I make about how I go about treating this disease.  I am relying on the expert advice of specialist who live, eat, and breath RA every day.  I appreciate the research family and friends will do on my behalf and will look at things they are suggesting I do, but ultimately, I am going to rely on the advice of my Rheumatologist.  Right now, I am not open to holistic approaches to treating this disease.  I would prefer to start off with an aggressive treatment so I can get back to living a more normal, active lifestyle ASAP.  Once the disease is under control, I would be more open to seeing what the alternative treatments, but right now, I'm not there yet. 

With that, I will bring this novel of a recap to a close.  I want to emphasize that while I am pretty down/overwhelmed/frustrated, I do know I will be ok.  I have been encouraged by stories of others who are living with this disease and leading normal, active lives.  I hope that will be me soon. 

I'll close with a quote that my Aunt Betty embodied with the way she lived her life while battling cancer.  I am going to try to take a page from her book and try to adopt this approach to life as well.  Lord knows, 2013 and Charlotte have provided sufficient rain for me to dance in.