Re: Am I contributing to joint damage?

[Guest guest]

,

You mentioned going to nursing school. How are your hands? Do you have good strength? I ask because I am an RN and regular floor nursing was a huge pain to me. I am now in Public Health, still doing OB, but now mostly teaching. The 12 hour shifts were one thing, but pulling and moving patients was more than I could handle--not to mention all the writing for documentation. Most my pain and swelling is in my hands though, so hopefully you will fare better than I did. I am currently going back to school to obtain a different bachelor's degree, so I can continue to work long term.

Everyone is different, but I thought I would relate my experience to you, and good luck!

Ru )0(

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[Guest guest]

How well RA needs to be controlled is a highly subjective thing. I've only had RA for about 20 months so I can't tell about the long-term effects of pain and/or swelling. Some people say that swelling is required for damage to be happening but others say that pain by itself shows that some damage is occurring. Also it probably varies from person to person. You seem to be quite young (I'm 75 so lots of people are young to me) and want to have an active life. My guess is that you would benefit from either an increase in your Methotrexate or addition of another mild DMARD such as Plaquenil or Sulfasalazine. Since you seem to be almost controlled with your current medicines I doubt that you are a good candidate for the biologics (largely because of the expense).

Your doctor may not you straight answers just because he is trying to be honest with you. RA has enough different faces that there are probably more exceptions than rules. In fact if you get answers that are too definitive you might want to change doctors. RA requires patience and trial and error before you get to trial and success. I don't know of any other way. Good luck and God bless.

Harold Van Tuyl (Grandpavan)

----- Original Message -----

From: Matthies

Rheumatoid Arthritis

Sent: Sunday, August 24, 2003 11:27 PM

Subject: Am I contributing to joint damage?

OK... need advice from you knowledgeable RA veterans. I am one of the lucky ones who methotrexate is seemingly working pretty well for. I managed to ween myself off the prednisone and now am taking 15 mg methotrexate weekly and 150 mg of an anti-inflammatory daily. I choreograph beam and floor routines for gymnasts as well as occasionally coach and I am starting nursing school this fall. Obviously what I am most concerned about is the what ifs and what nexts. I flare up after choreographing all day or if I'm on my feet all day (not to the level of many of you out there) but because joint pain (as a former gymnast) is something in the past I've been used to... I just kind of shake it off and keep going. (Even limping) Choreography is my moneymaker. Am I contributing to joint damage or is it an okay thing to continue if the pain tolerance is within reason and I am on a DMARD? I know it is something to run by my doc. but occasionally I get not so straight answers from him. I admire you all so much and your experience and wisdom. Thanks... Oh... by the way... no tumbles down the stairs lately. Must be that I'm back in the gym.

[Guest guest]

Hi ,

This is in VA. I understand where you are coming from. I used to teach dance. It never made me any money, I did it as a barter thing (teach a class, take a class). When I was in high school I was teaching/dancing or practicing every day. In college I taught dance on an informal basis. In fact, I was teaching aerobics, ballet, & tap when I was diagnosed.

Looking back on my dance life, I realize my injuries and frequent stress on my joints probably contributed to my arthritis -- although if I knew then what I know now, I still would have danced!

While you may be able to deal with the pain now, what will happen long-term if you get to the point when you can't handle it? Do you have a back up plan (until you get your nursing degree)? For me, dance was fun, but not a moneymaker (I wasn't that good). I did try to take a summer dance class a few years ago but I couldn't keep up with the class. Now I dance for me in the privacy of my home, when my joints are up to it.

So, that's not really an answer to your question but I wanted you to know I sort of understand how you feel. Like other things, it is one of the many choices you will make in order to live with your arthritis.

Take care,

in VA~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

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[Guest guest]

Hi , I,am an RN. I initially went through an old-fashioned diploma program (hospital based), but I'm very glad I carried on to get my BS in Health Science. My physical limitations severely shortened my direct patient care career - even while I was still in my 20s. (I completely nursing school when I was 20.) However, with my degree, and having had about 5 yrs of direct patient care, I was able to move into administrative type functions. Hospital nursing seems to be where most of us start off. No question that nursing is one of the most rewarding professions, however, I can't lie, in saying that it is very physically taxing in most every specialty of direct patient care. I'm not sure how much help this was, but I wish you the best of luck in your decisions. God bless you! Sandy

From: " Matthies"

Reply-Rheumatoid Arthritis Rheumatoid Arthritis Subject: Am I contributing to joint damage? Date: Mon, 25 Aug 2003 06:27:59 -0000

OK... need advice from you knowledgeable RA veterans. I am one of the lucky ones who methotrexate is seemingly working pretty well for. I managed to ween myself off the prednisone and now am taking 15 mg methotrexate weekly and 150 mg of an anti-inflammatory daily. I choreograph beam and floor routines for gymnasts as well as occasionally coach and I am starting nursing school this fall. Obviously what I am most concerned about is the what ifs and what nexts. I flare up after choreographing all day or if I'm on my feet all day (not to the level of many of you out there) but because joint pain (as a former gymnast) is something in the past I've been used to... I just kind of shake it off and keep going. (Even limping) Choreography is my moneymaker. Am I contributing to joint damage or is it an okay thing to continue if the pain tolerance is within reason and I am on a DMARD? I know it is something to run by my doc. but occasionally I get not so straight answers from him. I admire you all so much and your experience and wisdom. Thanks...

Oh... by the way... no tumbles down the stairs lately. Must be that I'm back in the gym.

[Guest guest]

From all the literature I read, the biologicals are indicated if the other DMARDs are not working. The insurance company I work for only will authorize them under those circumstances. However, I did go to a lecture given by the Chief of Rheumatology at Univ. of Calif. at San Fran. who indicates that he likes to put newly diagnosed patients on biologics with methotrexate stating that more recent studies indicate that they prevent the deterioration of joints over a longer course of time. There are still many scientific studies being performed. I do believe that medicine is very much a combination of art and science.

From: "Harold Van Tuyl"

Reply-Rheumatoid Arthritis

Subject: Re: Am I contributing to joint damage? Date: Mon, 25 Aug 2003 09:13:23 -0700

How well RA needs to be controlled is a highly subjective thing. I've only had RA for about 20 months so I can't tell about the long-term effects of pain and/or swelling. Some people say that swelling is required for damage to be happening but others say that pain by itself shows that some damage is occurring. Also it probably varies from person to person. You seem to be quite young (I'm 75 so lots of people are young to me) and want to have an active life. My guess is that you would benefit from either an increase in your Methotrexate or addition of another mild DMARD such as Plaquenil or Sulfasalazine. Since you seem to be almost controlled with your current medicines I doubt that you are a good candidate for the biologics (largely because of the expense).

Your doctor may not you straight answers just because he is trying to be honest with you. RA has enough different faces that there are probably more exceptions than rules. In fact if you get answers that are too definitive you might want to change doctors. RA requires patience and trial and error before you get to trial and success. I don't know of any other way. Good luck and God bless.

Harold Van Tuyl (Grandpavan)

----- Original Message ----- From: Matthies Rheumatoid Arthritis Sent: Sunday, August 24, 2003 11:27 PM Subject: Am I contributing to joint damage?

OK... need advice from you knowledgeable RA veterans. I am one of the lucky ones who methotrexate is seemingly working pretty well for. I managed to ween myself off the prednisone and now am taking 15 mg methotrexate weekly and 150 mg of an anti-inflammatory daily. I choreograph beam and floor routines for gymnasts as well as occasionally coach and I am starting nursing school this fall. Obviously what I am most concerned about is the what ifs and what nexts. I flare up after choreographing all day or if I'm on my feet all day (not to the level of many of you out there) but because joint pain (as a former gymnast) is something in the past I've been used to... I just kind of shake it off and keep going. (Even limping) Choreography is my moneymaker. Am I contributing to joint damage or is it an okay thing to continue if the pain tolerance is within reason and I am on a DMARD? I know it is something to run by my doc. but occasionally I get not so straight answers from him. I admire you all so much and your experience and wisdom. Thanks...

Oh... by the way... no tumbles down the stairs lately. Must be that I'm back in the gym.