FLARES

July 12, 1999

> jani wrote:

>

> This may seem a stupid question coming from me. But what is the

> correct definition of a FLARE?

FLARE .. generic term meaning an increase in subjective symptoms, i.e.,

increased inflammation, pain, stiffness, etc. Can last from a few hours

to months and even years.

Flares can be caused by any number of stimuli, alone or in combination.

Certain drug-induced flares, e.g., tetracyclines, are termed Herx's,

short for Dr. Herxheimer, the gentleman who codified the reaction as an

immune response to increased dead or dying bacterium in free

circulation.

HTH

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geoff@...

" Behold now, Behemoth, which I made as well as you; He eats grass like

an ox. Behold now, his strength in his loins, and his power in the

muscles of his belly. He bends his tail like a cedar; The sinews of his

thighs are knit together. His bones are tubes of bronze; His limbs are

like bars of iron. He is the first of the ways of God. "

God speaking to Job...

July 12, 1999

> jani wrote:

>

> Group

> This may seem a stupid question coming from me. But what is the

> correct definition of a FLARE?

> I've had RA for a year and a half now and have belonged to this group

> for a year and been on AP since 10/98, but now I seem confused by what

> constitutes a FLARE.

> Mark and I have had discussions about this, and each of us have a

> different thought of what a FLARE is, and we have both had RA, group

> and AP about the same time.

> So please all of you with far more time and experience into these

> horrible immune system diseases, share " WHAT IS A FLARE " ?

> How do we know when we have one and how do we know when it is over?

> Thanks so much.

> Hugs, Jai

A flare is an exacerbation of the disease. It can be drug-induced and

then it's called a Herxheimer reaction.

Flares can be caused by stress, a change in barometric pressure, etc. -

and sometimes they seem to occur for no reason at all.

You will experience flares on this therapy, but if your disease is being

properly managed by the AP, those flares should lessen in intensity and

occur farther apart until remission is finally reached.

Ethel

July 12, 1999

Hi Jai:

Well this is my description of a flare - it hurts like hlllllllllllllll. You

get up in the morning and the joints are so stiff, hot and swollen and soooooooo

painful you want to cry. For me it takes a long time before I can move those

joints. What I mean is when I first get up there is no way I can move those

joints, so I take a bath, put so arthritis pain cream - I used A535 ice rub,

take my medication and some extra if I have some on hand and then I put bandage

on the joints. Usually by about 4 pm I can stand the pain. Also I am like a

bear - so stay away from me - leave alone so I can take pity on myself and

usually I get around of snapping out of it.

How long does it take to go away - I don't know. For the past year, I have had

very sore wrists and even with prednisone at 30mg a day, it still not cleared

up. So I try to ignore it and go on and sometimes a good cry helps. God these

diseases are so awful, they rub us of our freedom.

Probably this did not help but it felt good just to get it off my chest.

Mado RA 7yrs AP 3 months next week. By the way gang, what does the " P " stand

for?

rheumatic FLARES

Group

This may seem a stupid question coming from me. But what is the correct

definition of a FLARE?

I've had RA for a year and a half now and have belonged to this group for a

year and been on AP since 10/98, but now I seem confused by what constitutes a

FLARE.

Mark and I have had discussions about this, and each of us have a different

thought of what a FLARE is, and we have both had RA, group and AP about the same

time.

So please all of you with far more time and experience into these horrible

immune system diseases, share " WHAT IS A FLARE " ?

How do we know when we have one and how do we know when it is over? Thanks

so much.

Hugs, Jai

February 25, 2000

Hi Debbie,

Just a quick note to say that I hope you recover real soon from the

shoulder replacement surgery. I hope it all went well, and that you'll

heal quickly. I hope there were no unexpected problems. How are you

feeling?

Aloha,

Georgina

PS ... Wow! That is a really long flare!!! None of the meds they like to

use were able to control it?

The Schuh Family wrote:

> I hate to be the barer of bad news, but I have had full flares that lasted 6

> years.

> Hugs,

> Debbie <first attempt at typing since shoulder replacement on Monday>

> Message: 1

> Date: Mon, 21 Feb 2000 13:37:09 -0800

> From: " WILLIAM PRICE " <william.e.price@...>

> Subject: length of flares

>

> For anyone out there with experience with systemic flares, I have a

> question. We are in our first flare since diagnosis. How long can it last?

> n was really bad this week, but has really improved over the weekend.

> It was so bad that she couldn't walk for a few days. She has headaches,

> stomachaches, and the fever at night. Even with those 3 things, she is

> pretty good compared to last week. She might even be able to go to school

> tomorrow. She has a rash, but she has that since the beginning--that has

> never left us. Her original fever lasted a bit over a month. Do we have

> that to look forward to again?

February 9, 2002

Debby,

A flare for me how you explained it hurts intensely. I have to take strong

pain pills to just get out of bed. When my Fibro and degenerative bone

disease flare it seems both at the same time I can hardly move. Stiffness its

awful.

February 9, 2002

I think by " flare " she just means that the hepatitis is active...that

your liver is inflammed and enzymes probably up. I think this may or

may not coincide with increased symptoms, everyone is a bit different

in this respect. Enzymes may be elevated (inflammation high) and no

symptoms. Also, inflammation may be low, but symptoms persist. My

guess is she is referring to the inflammation flare-up, not

necessarily the symptoms. Just a thought...I'm speculating, really.

> This might sound rather silly, but the doctor last time I saw her,

mentioned that she hoped that I was not in a 'flare' and I sort of

looked at her and wondered exactly WHAT IS a flare like? Anyone

know? I had been so sick for the last few years, stiff, sore,

hurting...etc...so that I thought that was normal. There were times,

however, when I would wake up and would barely be able to get out of

bed. My finger joints would swell and I could hardly make a fist.

Then, there would be times when I would just be so sick that I would

only be able to crawl to the bathroom to throw up. I am wondering

now if those were " flares " ...any ideas on this?

> debby

February 9, 2002

Debby,

I think that flares don't necessarily mean your labs go up or down. When my Fibro flares. I can't stand the pain. I had to go to the doctors several times trying to get something for the pain. They are giving me arthritis meds. but it is not enough. Finally one day I went in in a flare and demanded they give me pain medication, told the doc that I should not have to be in this much pain. Even touching me hurt. I get so sick of feeling like I have the flu. So I did get oxycodone that seems to help, not totally because I am still in pain but I can live with this. And not happily because I can't find a way out. I have flares most of the time takes forever before it lets up.

gayle/trans.6-99

galye@... bmb

February 9, 2002

THank you ...Maybe that was why the doctor was very surprised when I showed Active AIH when I had the biopsy done. She said that usually AIH is chornic and was very surprised that it read this way. Now, I think I understand that I just happened to have the biopsy done during an active mode! THanks for helping me undersatnd...debby

[ ] Re: Flares

I think by "flare" she just means that the hepatitis is active...that your liver is inflammed and enzymes probably up. I think this may or may not coincide with increased symptoms, everyone is a bit different in this respect. Enzymes may be elevated (inflammation high) and no symptoms. Also, inflammation may be low, but symptoms persist. My guess is she is referring to the inflammation flare-up, not necessarily the symptoms. Just a thought...I'm speculating, really.> This might sound rather silly, but the doctor last time I saw her, mentioned that she hoped that I was not in a 'flare' and I sort of looked at her and wondered exactly WHAT IS a flare like? Anyone know? I had been so sick for the last few years, stiff, sore, hurting...etc...so that I thought that was normal. There were times, however, when I would wake up and would barely be able to get out of bed. My finger joints would swell and I could hardly make a fist. Then, there would be times when I would just be so sick that I would only be able to crawl to the bathroom to throw up. I am wondering now if those were "flares"...any ideas on this?> debby

February 9, 2002

Gayle, that is how I feel.....maybe it is a flare, but my labs were normal two weeks ago. I don't like feeling like this. Then, last night, that heart thing started up again! Darn...made me so angry that I felt like that. Will talk to the doctor when I see her next month. Hope you don't have too many flares. Also, thank you for the article you sent. It was very helpful indeed...sounds like how I feel and am so much of the time. I am just grateful that I have a job that can keep me busy and I don't think much about the pain and problems.

debby

Re: [ ] Flares

Debby,A flare for me how you explained it hurts intensely. I have to take strong pain pills to just get out of bed. When my Fibro and degenerative bone disease flare it seems both at the same time I can hardly move. Stiffness its awful.

February 9, 2002

oK...that makes more sense. But I just thought that if you were in a flare, that your labs just naturally would go up. That might make sense why the doctors could not figure out why I was always hurting. They just told me it was arthritis. I know that the spinal stenosis has been acting up and I just keep on working with the physical therapy exercises that I was given and taking the Neurontin. It helps. I even increased the Neurontin to help with the pain. It has seemed to help.

Now, today, I just still feel like I have been hit by a truck. My head hurts just to move it. I think that is what upsets me the most...the headache. I can function with the pain, but NOT with the headache. I have had to drive hubby to get our car and just feel like I am detached from my body! I HATE that feeling...but my head just does NOT want to connect to the body. Hopefully this will go away before Tuesday! I am out of sick leave...

debby

Re: [ ] Flares

Debby,I think that flares don't necessarily mean your labs go up or down. When my Fibro flares. I can't stand the pain. I had to go to the doctors several times trying to get something for the pain. They are giving me arthritis meds. but it is not enough. Finally one day I went in in a flare and demanded they give me pain medication, told the doc that I should not have to be in this much pain. Even touching me hurt. I get so sick of feeling like I have the flu. So I did get oxycodone that seems to help, not totally because I am still in pain but I can live with this. And not happily because I can't find a way out. I have flares most of the time takes forever before it lets up. gayle/trans.6-99galye@... bmb

February 9, 2002

The headache may be caused by a migraine. I take imitrex shots for mine. They work in about 20 minutes. I usually sleep for a while afterwards, but when I get up the headache is gone and the feeling is great. I hate migraines. I thought they were from monthlys but don't have that anymore since the hysterectomy. Don't get them quite as much, but when I do. Look out, I'm one miserable person. Hope you are able to get rid of yours. Ann CT Now, today, I just still feel like I have been hit by a truck. My head hurts just to move it. I think that is what upsets me the most...the headache. I can function with the pain, but NOT with the headache. I have had to drive hubby to get our car and just feel like I am detached from my body! I HATE that feeling...but my head just does NOT want to connect to the body. Hopefully this will go away before Tuesday! I am out of sick leave... debby Re: [ ] Flares Debby,I think that flares don't necessarily mean your labs go up or down. When my Fibro flares. I can't stand the pain. I had to go to the doctors several times trying to get something for the pain. They are giving me arthritis meds. but it is not enough. Finally one day I went in in a flare and demanded they give me pain medication, told the doc that I should not have to be in this much pain. Even touching me hurt. I get so sick of feeling like I have the flu. So I did get oxycodone that seems to help, not totally because I am still in pain but I can live with this. And not happily because I can't find a way out. I have flares most of the time takes forever before it lets up. gayle/trans.6-99galye@... bmb

February 9, 2002

Ann CT..I don't have migranes...or at least have never been dx with them. This just happens when I get this 'hit by a truck' feeling. All of my muscles ache, my joints hurt, then after that has been going on for a couple of days, the head begins in and will ache for several days. From what I have heard about migranes, it doesn't seem to fit...

debby

Re: [ ] Flares

Debby,I think that flares don't necessarily mean your labs go up or down. When my Fibro flares. I can't stand the pain. I had to go to the doctors several times trying to get something for the pain. They are giving me arthritis meds. but it is not enough. Finally one day I went in in a flare and demanded they give me pain medication, told the doc that I should not have to be in this much pain. Even touching me hurt. I get so sick of feeling like I have the flu. So I did get oxycodone that seems to help, not totally because I am still in pain but I can live with this. And not happily because I can't find a way out. I have flares most of the time takes forever before it lets up. gayle/trans.6-99galye@... bmb

February 9, 2002

Debby. I'm not an expert by no means, but I don't think it would hurt to try something. It's better than having a headache for a couple of days. Hope you feel better soon. Ann CT Re: [ ] Flares Debby,I think that flares don't necessarily mean your labs go up or down. When my Fibro flares. I can't stand the pain. I had to go to the doctors several times trying to get something for the pain. They are giving me arthritis meds. but it is not enough. Finally one day I went in in a flare and demanded they give me pain medication, told the doc that I should not have to be in this much pain. Even touching me hurt. I get so sick of feeling like I have the flu. So I did get oxycodone that seems to help, not totally because I am still in pain but I can live with this. And not happily because I can't find a way out. I have flares most of the time takes forever before it lets up. gayle/trans.6-99galye@... bmb

February 9, 2002

Ann, I agree....anything is better than this! I am going to bring it up to my GP...am going to try to get an appointment next week

Thanks for the input! I really appreciate it!

debby

Re: [ ] Flares

Debby,I think that flares don't necessarily mean your labs go up or down. When my Fibro flares. I can't stand the pain. I had to go to the doctors several times trying to get something for the pain. They are giving me arthritis meds. but it is not enough. Finally one day I went in in a flare and demanded they give me pain medication, told the doc that I should not have to be in this much pain. Even touching me hurt. I get so sick of feeling like I have the flu. So I did get oxycodone that seems to help, not totally because I am still in pain but I can live with this. And not happily because I can't find a way out. I have flares most of the time takes forever before it lets up. gayle/trans.6-99galye@... bmb

February 10, 2002

Gayle and Debby,

I had to demand pain meds for my fibro also. I don't take them

unless I really need them. And, I proved this to my dr. when she saw

that 1- 30 da prescription lasted me for 4 mos. My pain is mostly in

my middle back and neck, is with me constantly and some days/nights

almost unbearable. Some days, it is like you said, even being touched

by someone is terrible. Now, with the AIH, I take pain meds even less

because I don't want more harm to my liver. It is that vicious

circle- what do I do- relieve the pain or harm the liver more?

I hope your pain goes into remission soon.

Hugs,

Joanna

> Debby,

> I think that flares don't necessarily mean your labs go up or down.

When my

> Fibro flares. I can't stand the pain. I had to go to the doctors

several

> times trying to get something for the pain. They are giving me

arthritis

> meds. but it is not enough. Finally one day I went in in a flare

and demanded

> they give me pain medication, told the doc that I should not have

to be in

> this much pain. Even touching me hurt. I get so sick of feeling

like I have

> the flu. So I did get oxycodone that seems to help, not totally

because I am

> still in pain but I can live with this. And not happily because I

can't find

> a way out. I have flares most of the time takes forever before it

lets up.

>

> gayle/trans.6-99

> galye@a... bmb

February 10, 2002

Debby,

Are you on a high dose of Pred? Maybe that is the cause of your headaches. It is just getting use to the side effects and the drugs is the challenge.

gayle/trans.6-99

galye@... bmb

February 10, 2002

In a message dated 2/10/02 9:11:44 AM Pacific Standard Time, scott_p@... writes:

Joanna,

I am under the impression that the damage to your liver is dependent on the

drug. My understanding is that the more pure drugs- like percoset- are

earier on the liver than ones that are more complex like darvocet etc.

Anyone react??? Harper do you know? You are a good pharmacist?

Patty

Remember, I don't have any medical training. However, on a gut level, it doesn't make any sense to me that "the more pure drugs -- like percoset -- are easier on the liver than ones that are more complex like darvocet etc." One could make an argument in the other direction, that it is perfectly possible that a "pure" and non-complex drug could be much harder on the liver than one that was engineered to be less hepatotoxic. Pure sounds nice, but I don't think our bodies recognize that aspect. Belladona is pure and natural, and it looks pretty blooming in our garden, too!

Harper

February 10, 2002

In a message dated 2/10/02 12:03:25 PM Pacific Standard Time, tdcc2000@... writes:

Weed looks nice too, but somehow, it is not allowed!

debby

That probably depends a bit on where you live!

Harper

February 10, 2002

Joanna,

What pain meds do you take? I had to battle my docs to get pain meds as one doctor tells me I am too young to be taking pain meds. every day. I take pain pills every morning I have to to get out of bed. This one doctor told me that they are worried I will become addicted. At that point why do I care. I only take my pain pills like you when the pain gets worse. Finally I have a pain contract with my Primary and they will do refills when I need them instead of having to go to the doctor to prove my pain. I also know from University they have signs everywhere that we should not have to suffer pain that there are many pains medications out there to help. They also tell me that someone with chronic pain cannot get addicted. I feel no high and all I want is for the damn pain to go away.

gayle/trans.6-99

galye@... bmb

February 10, 2002

In a message dated 2/10/02 12:46:38 PM Pacific Standard Time, galye@... writes:

Joanna,

What pain meds do you take? I had to battle my docs to get pain meds as one doctor tells me I am too young to be taking pain meds. every day. I take pain pills every morning I have to to get out of bed. This one doctor told me that they are worried I will become addicted. At that point why do I care. I only take my pain pills like you when the pain gets worse. Finally I have a pain contract with my Primary and they will do refills when I need them instead of having to go to the doctor to prove my pain. I also know from University they have signs everywhere that we should not have to suffer pain that there are many pains medications out there to help. They also tell me that someone with chronic pain cannot get addicted. I feel no high and all I want is for the damn pain to go away.

gayle/trans.6-99

Gayle, did you see the article from the NYT that I sent a couple of weeks ago on pain management? It mentions that opiates work differently on people who are in chronic pain and therefore addiction is less of a problem. Let me know if you want me to dig it up and re-send.

Harper

February 10, 2002