Love can make you crazy. I have to admit, the first time I fell in love, it wasn’t with a boy. No. It was with snow. There was something magical about it. The way it looked like the stars were falling out of the sky. The way it sparkled like diamonds when the moon hit it. The way that it muffled all the ugly sounds, and made the world look clean and innocent. When I was finally old enough to make a choice about where I would live – college – I chose Buffalo, NY. They were known to have a lot of snow.

How is it, then, that I ended up in Florida?

This was my sixth winter in the sunshine state. A year of record snowfalls – everywhere but here. One day it snowed in 48 states – Florida was among the two that missed out. I was homesick. Lovesick. So I did what any love crazed loon would do. I booked a trip to Colorado for spring break. Guess what, family? We’re going skiing!

What was I thinking? A forty-two year old woman with rheumatoid arthritis, who has never skied downhill (I’m a cross-country girl), with osteoporosis in one hip and osteopenia in the other… skiing on a mountain with an elevation of 8,000 feet? It’s official, I’ve lost it. My knees hurt when the April humidity rolls in; my wrists are already aching and we haven’t left yet.

I’m terrified. A victim of my own stupidity. A victim of love.

Yet, I can’t help but think that this might be the best time of my children’s lives. They may experience the joy of falling in love, with snow, like I did at their age. And maybe, just maybe, I will be able to rekindle that old romance, despite the years that have passed, the way my body has aged. Maybe RA hasn’t truly robbed me of my first, my one true love, after all…

Getting Back on the Workout Wagon

Somewhere around the third mile of interval training on the treadmill, I began to wonder when my legs had turned to lead, when my lung capacity diminished to that of a chain-smoker, and why, oh why, did I let myself go?

It happens to the best of us. Despite our knowledge, despite our good intentions, life gets in the way, and our exercise routines fall to the back burner. Whether it’s the kids’ busy schedules, increased stress at work, or simply fatigue (my arch nemesis), finding time for ourselves tends to be the first thing we drop when there aren’t enough hours in the day. For those of us dealing with autoimmune disorders, this is a slippery slope.

Exercise is the single most empowering tool for fighting pain, inflammation, and fatigue associated with RA (and other forms of autoimmune arthritis). There have been many times over the course of my journey that I felt helpless. Learning that I had a weapon in my arsenal to gain control was important in my overall treatment. Yet embracing exercise – whether for the first time or after a hiatus – can seem overwhelming. Here are a few tips for overcoming the “I can’t do it” blues, and getting back on track.

1. Train with a friend. It seems we are all too willing to let ourselves down at a moment’s notice, but would never even consider bailing on a friend. Working out with a friend keeps us committed – if only out of politeness! Once the routine becomes a habit, it’s easier to stay motivated on your own.

2. Hire a personal trainer. Yes, it may seem a bit extravagant. But it works. Like training with a friend, the commitment you make to your trainer provides motivation to make it to the gym even when you feel like going back to bed. What’s more, a trainer will correct your form, so you are much less likely to get injured. Make sure your trainer knows about your condition and your meds (and, of course, that your doc knows about your trainer!).

3. Set realistic goals and track your progress. Nothing is more discouraging than failure – so don’t set yourself up for it by creating impossible goals. Talk to your doctor about what is realistic for you, and keep a journal so that you can look back and see your improvement. Treat yourself when you hit milestones.

4. Be kind to yourself. Don’t get down on yourself for needing to slow down during a flare, or for not sticking to your routine for a few weeks. This is YOUR thing, and you’re in charge. Allow for setbacks, and keep a positive attitude.

We’ve all fallen off the workout wagon. But the good news is, it’s a wagon each of us DRIVE. It will be there when we’re ready to jump back on.

Resolutions

It seems impossible that we are nearly two weeks into the new year already. What health and wellness resolutions have you made, and how are you doing so far? Here’s my list, with progress notes.

1. I will eat more sustainable fish. This resolution has been an easy one to stick with. Fish is an excellent source of lean protein, and it’s low in calories and fat (when prepared correctly). Many varieties have a mild, delicate flavor, and simple vegetable and fruit preparations add a flavorful punch, while keeping nutrition the top priority. Here are a few links to some of my favorite recipes:

http://find.myrecipes.com/recipes/recipefinder.dyn?action=displayRecipe&recipe_id=10000001591120

http://find.myrecipes.com/recipes/recipefinder.dyn?action=displayRecipe&recipe_id=10000000592330

http://find.myrecipes.com/recipes/recipefinder.dyn?action=displayRecipe&recipe_id=10000000549851

Or, try this simple idea: make a pocket of baking parchment. Fill it with Chilean sea bass, chopped plum tomatoes, two sliced scallions, diced bell pepper (any color), a generous handful of cilantro, and salt to taste. Bake at 450 for 30 minutes or until done. Careful opening the parchment – it will be hot! SO YUMMY!

2. I will be more disciplined about my workout routine. My original notion was that I would devote three days each per week to cardio and strength training, with one blessed day of rest. This resolution has been more challenging. Scheduling and pre-paying sessions with a personal trainer and a workout partner has forced me to make strength training a priority. But when left to my own devices, the cardio workout has taken the back burner to home projects, work assignments, and the schedules of my husband and children. But I’m not giving up yet! I plan to use the rest of the month to organize my schedule, and find places to carve out an extra hour here and there to make this work.

3. I will give up my midday caffeine bender. Okay, I’ve utterly failed this one. Any suggestions?

Being mindful of healthy behavior, and assessing progress along the way, are the most helpful steps I’ve taken to stick with health resolutions. Wishing you all the best of luck and the best of health in 2011!

Reactionary!

I’m nursing a hangover of sorts. Not the kind preceded by an evening of tequila shots and dancing. This is a different kind of hangover – the kind where the fun comes after the headache and nausea – not before. It’s what I fondly refer to as the Methotrexate Hangover.

I know plenty of people who take Methotrexate. Many suffer no side effects. I am not one of them.

Today’s side effects are unusually severe – blinding headache, nausea rivaled only by pregnancy, exhaustion, the inability to do anything productive. I take my MTX on Thursday evenings after dinner, and on a typical Friday, I’m more fatigued than usual, with a mild headache and a little queasiness. But on occasion, the meds affect me more or less than the average. Today is a more day.

On the whole, these days don’t bother me anymore. I have learned to accommodate them; to be flexible with my own routine. I am aware that anything scheduled on a Friday may have to be postponed or cancelled. I am also aware that some Fridays, I feel almost fine. The question is: do we gripe, complain, and hate life because our meds have side effects? Or do we slow down on those days, thankful to have fairly normal movement and minimal pain the remaining six? I choose the latter. I’m enthusiastically willing to sacrifice one day each week, so that I can feel well and productive the rest of the time – especially knowing that I am preventing long term damage and deformity to my joints with this one day.

I don’t know why some weeks are worse than others, or why some people suffer while others don’t. After five years of questioning, I still haven’t found a pattern or a trigger. For me, the benefits of MTX outweigh the risk of side effects. I am content in knowing that I can proactively impact my RA – that I am empowered – by my meds. Even if they make me feel hung-over sometimes.

Happy Thanksgiving

The sun is up, and it’s almost time to put the turkey in the oven. In a few hours, the house will be filled with the savory smells that bring the memories of Thanksgivings past to life. It took a lot of work to get to this point.

We have so much to be thankful for – so naturally, Thanksgiving is a big deal to us. It takes a minimum two days to pull off the perfect meal. Yesterday was a sort of culinary prep marathon. I ironed the table linens and set the table, placed the centerpieces. I peeled five pounds of sweet potatoes, then chopped them into one inch cubes. I rolled pie crust. I diced two pounds of onions, and an equal amount of celery. I mixed cornbread, and cut it into cubes for stuffing. I minced cups of rosemary, sage, and thyme. And I washed endless pots, pans, knives and cutting boards.

At the end of the day, my hands and wrists had had enough. Swollen, red, and achy, I submerged them in warm water, and wrapped them in warm compresses. It was the kind of overuse treatment reserved for a vigorous workout. I ignored my swollen feet and knees – they weren’t happy about standing on a tile floor for the twelve-hour cooking extravaganza. But they didn’t take the abuse that my hands did, so they had to wait in line.

Today is less a chopping-mincing day, and more a heavy lifting day. Moving the turkey in and out of the oven, stirring a roux, pouring drippings over it from the roasting pan to make gravy. Removing casseroles filled with sweet potatoes, stuffing, and green beans from the oven for placement on the warming tray to await the star of the show. Hand whipping mashed potatoes.

I’m thankful for another year that I am capable of putting on this affair, and hopeful for many more. I’m well aware that my condition can decline at any time without notice, and that epicurean events like my kind of Thanksgiving may not always be a possibility in my future.

I'm thankful for my family and my home, for the United States, for a job and food on the table. I’m thankful for my faith in God. And this year, like the five before it, I am thankful for my rheumatologist, and for the advances in medicine that have made today possible for me. I’m especially thankful for the chemists at Amgen who created Enbrel.

To all of you, and especially to those who had to overcome a physical challenge to make this day joyful for the ones you love, Happy Thanksgiving!

Will You Do Blue?

This summer, the MLB All-Star Game was held at Angels Stadium in Anaheim. Though every team was represented, the stadium was, nevertheless, a sea of red. Red t-shirts, red jerseys, red hats. There was such a sense of solidarity there – a common bond among strangers. It evoked memories of camp color wars, high school pep rallies, sororities and fraternities. Pink ribbons remind us of breast cancer; yellow, of our soldiers overseas. The simple act of donning a color can inform the world that you stand for something; that you are a part of something greater than yourself.

Tuesday, OCTOBER 12 is World Arthritis Day. I invite each of you to join me in DO BLUE by wearing BLUE for someone you love who has arthritis (even, and especially, if that someone is you!). Show your support for and solidarity with millions of people affected by this disease, and call attention to the most common cause of disability in America.

Landmarks across the country will be turning blue on October 12, including the New York Stock Exchange, Niagara Falls, and Miami Tower (for a complete list, check out www.fightarthritispain.org/worldarthritisday ).

Help the Arthritis Foundation reach the goal of walking 24,900 miles - the circumference of the world! – by October 12. Let your steps be counted! Log your miles at www.fightarthritispain.org/worldarthritisday. I personally pledge to add at least 25 miles – how far will you walk?

I’ll be looking for my friends in blue on the 12th. I hope to see all of you!

Halleluja Chorus

Today I sing the praises of the emotionally-charged two-word phrase: normal biopsy.

A biopsy invokes fear in even the strongest among us. No one faces such a test without considering what if; without reflecting on one’s own mortality, and the impact his/her absence would have on loved ones (particularly children). I don’t think I’m unique in that.

It was my reaction to learning that something on a test looked suspicious – that a biopsy was indeed recommended – that surprised me. My knee-jerk response was, “Oh God, what will this mean for my RA – can I still take Enbrel?” Imagine that. Facing the possibility of a terminal illness, my instinctive response was fear surrounding arthritis – not cancer.

That, in a nutshell, is how serious arthritis can be.

I remember years ago, going through a stack of mail filled with requests from various charities. My general rule back then was to toss everything except requests from the American Cancer Society and the American Heart Association – the charities I unquestioningly supported, because those were the illnesses that were killing Americans. Arthritis may be painful, but it wasn’t deadly, and my funds were limited.

Now I know better. Arthritis can destroy quality of life. It is the leading cause of disability in the U.S. And despite the inaccurate characterization as a disease of age, arthritis affects people of all ages – including small children. For auto-immune forms of arthritis like mine, onset usually occurs between the ages of 25 – 50. I was 37.

Luckily for me, and millions of others like me, there is help, and there is hope. So for today, I give thanks that my biopsy was normal, and that I won’t need to learn what affect treating cancer would have on my arthritis treatment. Here’s hoping I never find out.