Arthritis, The Ultimate Bully….

Police officers, even those of us in remission, are trained to despise bully’s. We are what often stands between bully’s of all stripes and those that are bullied which presents a real problem for the bully as we are also trained to not lose in confrontations. That being said, I am writing this at 2 AM because my personal bully, arthritis, is on the job. My readers who suffer from any one of the hundred or so types of arthritis know what I am talking about, however; a review of this disease’s impact on our lives might prove interesting to everyone.

I have fought arthritis with every imaginable resource to include a terrific set of rheumatologists, one at the Cleveland Clinic and one in Springfield, two pain management specialists, again one at the Cleveland Clinic and one here, an orthopedic surgeon here in Springfield and my PCP. These efforts are directed to the management of the disease with no chance of curing it. As all sufferers know, there are bad days and days, well, that aren’t quite as bad. I have experienced two thumb surgeries to relieve pain, trading this relief for the strength normally found in a thumb. I have also experienced a series of x-ray guided injections in my lower back. The point here is that I am trying to keep old “Arthur” at bay.

Post surgical X-ray of my left hand.

Dr. Mathew Bunyard, of Cleveland Clinic fame, began our association by suggesting there is much that doctors know about arthritis and much more they do not. After an exhaustive head to toe examination, x-rays and extensive blood work, he concluded that my arthritis might be a type associated with European descendents afflicted with an anomaly in the way our bodies manage iron. My affliction is associated with the more common osteoarthritis as opposed to the more dangerous rheumatoid arthritis. After all of these medical interventions, we are left with two strategies to combat “Arthur”; symptom reduction and slowing the progression. The emphasis here is on symptom reduction, a strategy that presents a new set of problems as the medicines all have sometimes dramatic side effects.

I rely heavily on prescription strength NSAIDs. These medicines combat inflammation and provide pain relief. They are a two edged sword with the benefits being offset by gastrointestinal bleeding and a negative impact on cardiac function accompanied by an increase in stroke probability. The second approach involves powerful pain relievers, such as Tramadol, a synthetic opioid believed to be a safer option in terms of dependence and abuse. Tramadol works very well, however; you cannot set foot in the cockpit of an airplane while taking it, even though I seem to function normally. There are a few drugs that are thought to slow the progression of Arthur, but their efficacy is questionable.

Next comes the diet approach. There are a number of theories here, often contradicting each other. Generally you should adopt the Ewell Gibbons (of Grape Nuts fame) approach, eating rocks and sticks and other stuff that is disgusting. One should avoid baked goods, sugar in any form, red meat, fried foods, salt, refined grains, cheese and corn oil. Even some vegetables, such as tomatoes, are not in your best interest. Apparently boiled eggs and kale are your go to treats! I am not handling this approach very well.

Although counter-intuitive, exercise in moderation is thought to be very good for those of us in relationships with Arthur. I am fine with this premise, although some gym functions are not pleasant, especially ones that involve the hands to any extent. Exercise also falls under the heading of “two edged sword”, just as the meds do. Grin and bear it….

Now, how does Arthur impact my daily life. I have given up most forms of fishing as I do not have the dexterity to tie a Palomar knot or decent blood knot. Handling a 2# tippet is out of the question. In addition to the dexterity necessary to handling terminal tackle, I cannot handle a trolling motor pedestal for much more than a few minutes. With weakened hands, I imagine I would look like a harpooned walrus trying to get back in the boat after tumbling out, an event that has happened on occasion. The simple manipulation of a rod and reel is accompanied by pain, especially aggravating if the conditions are cold. I am incapable of putting more than 4 rounds of ammunition into a pistol magazine without relying on one of the many excellent load assist devices on the market. It is a race when I mow the lawn, with the pain in my feet and toes competing with the hand pain that begins building immediately after the mower is started. I love yard work, however, there is a price to be paid when outside. I am determined to ride the Harley as long as I can, but even short trips challenge Arthur to a duel. My clumsy footwork does not lend itself to the smooth flying of an airplane on those days when I am not taking a med for pain control. I am adapting but refuse to concede in this conflict.

One in four Americans will suffer from some form of arthritis. I absolutely do not feel sorry for myself as there are many who are in far worse shape. I can remember a time when I had little respect for this malady, thinking it to simply be an inconvenience. I can assure you that Arthur is a monumental pain in the butt, a world class bully. In a final attack on the dignity of people suffering from Arthur, many specialists now believe that coffee aggravates this malady.

Oh hell no……I am having none of that!

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