Playing the RA treatment game.. 

Hi all, I’ve just realised it’s been over a month since I’ve posted, mostly due to the extreme fatigue caused by pneumonia. Oh the joy! Hoping the double dose of antibiotics has done the trick, though I read it can take months to recover 😮

Anyways, I wanted to talk about my RA.. I’ve been pretty lucky the past couple of months, apart from “remaining pain” it had been mostly dormant. But let me step back to February which was my last appointment with my rheumy. When she decided unilaterally to stop treatment. 

Her rationale was that she couldn’t see any active inflammation so therefore my joint pain must be from Fibromyalgia. I’d been on Humira (my fifth RA med)  for six months with no improvement in symptoms, and (I quote) ‘Humira works for 80% of people so it can’t be your RA, and there’s no point keeping you on very strong meds you don’t need’. There are actually so many flaws in this argument it’s ridiculous. 

🔵 Firstly her numbers are incorrect. A quick search of the Internet will tell you that:

In one study conducted in 544 patients who had failed previous DMARDs, rates of ACR20 response for Humira 40 mg every other week and weekly at 6 months were 46% and 53%, respectively, compared with 19% for placebo” Figures from RheumatoidArthritis.Net 

🔵 Secondly I know my math is rusty but even if the 80% was  actually correct, that still leaves 20% of patients who it does nothing for. Crazy I know but what if I was one of those!! 

🔵 Thirdly I’ve had RA and Fibromyalgia for over two and a half years. I know the difference. RA joint pain is unique, the closest I can come to describing it is to imagine you can see your joint, with the synovial fluid sitting there protecting it nicely. Then imagine someone replacing that synovial fluid with acid. Burning acid. Fibromyalgia doesn’t get anywhere near that specific or that painful. 

🔵 Fourthly (that sounds wrong) RA is a systemic chronic condition. Not everyone has visible swelling. And what about the stuff going on you can’t see? The 50% increase in the risk of heart disease, the ongoing damage to internal organs, tendons, eyes, increased risk of infection, narrowing of blood vessels…. 

If rheumatoid arthritis is left untreated in the long-term, it’s not an exaggeration to say that your life could be at risk as well. “Persistent inflammation can lead to a shorter lifespan,” Pisetsky says” in a medical article from EverydayHealth 

I digress a little, but I think the risks are kinda important. At my last count there are approximately thirteen different biological medications approved for treatment of RA in the US, though here in the UK we are behind with approving new treatments, which I suspect is down to cost. There are also different types of biologics that act on specific areas of the immune system, so if a TNF inhibitor like Humira  doesn’t work perhaps a T-cell inhibitor like Orencia might. Lots of possibilities there huh?! 

But – having already dismissed one rheumy and knowing there isn’t  an endless supply of them locally I talked it over with my GP and decided to “play the game”. Because that’s exactly what it feels like, that I (the patient) am having to humour my consultant in the short term to stay on her good side so I can get the meds I need long term. So I sat back and waited. As I said my RA had been behaving for the most part and I’m kinda used to the pain so I let it be. 

Week before last my fingers started swelling again (as I’m sure many of you know there is an RA rule that they will never do this on the day of an appointment!), and then last night my Carpals started up. These are the cluster of small bones on the back of your hand just before your wrist. Today I can hardly move my left hand. It sounds insane but this is exactly what I’ve been waiting for. 

So today I’ve put in a call to our rheumy advice line which will get me a call back from the nurse within 48 hours. I’m also going to get bloods done ASAP and I’m hoping my CRP and ESR will be raised – compiling evidence! 

So I guess it you could say that in the RA treatment game I’m currently a point behind but focusing on the next match. 

Love & blessings 💙

Simplifying Part Two – Vacations 

I’ve always loved to travel, even the word conjures up a wonderful jumble of images in my mind, from fictional journeys I’ve taken such as old fashioned steamer trunks and the ‘Grand Tour’ of Europe (Little Women*), bustling Caravasarai for travellers along the Old Silk Road through Syria, Persia and onwards (see Physician*), as well as times I’ve spent abroad over the years, the scent of the spice markets of Marrakech, the taste of fresh cherries in southern France, the beautiful work of artisans in Cuba, the timeless flavours of mezze in Cyprus, the Fairytale castles and landscapes of Bavaria, the majestic beauty of mountains in Austria, the cobbled streets and squares of Belgium with the obligatory Moules Frites! 

As you may have gathered for me travel is not about finding a good beach, but wandering local streets, finding tiny coffee houses populated by ancient men who seem part of the furniture, stumbling across cosy restaurants with food you remember years later, churches and mosques and town halls with amazing architecture, bustling souks with women in brightly dressed kaftans and djellaba haggling, always haggling. 

Nowadays all of that sounds quite exhausting! So how on earth do those of us with chronic illness and disability and fatigue even contemplate travelling? For me (yes, here’s the theme) it’s about simplifying. And to simplify you need to plan a little. Yes, this may take away a smidge of the spontaneity of previous journeys, but they were taken in days when I didn’t need to know where the nearest toilet was at all times and whether I could park within 20 feet of my destination! 

So, how to simplify travelling? By reducing both physical exertion and stress. I’m going to talk about holiday type travel here, but I’m sure some of these tips could apply to other journeys too. 

  • Simplify the airport. My number one tip is book assistance at the airport. It’s free and it’s the best thing ever, especially if like me you travel alone. Once you get yourself to the meeting point in the airport you can almost stop thinking. You get comfy in a wheelchair and often sail past queues at passport control and check in. I can already hear some of you saying hang on, a wheelchair?! Yes. Gatwick airport – 1.2 miles to North terminal from check in. JFK 0.7 miles. Zurich 1.27 miles. I can’t walk that far, and you really do not want to arrive at your destination in an exhausted and painful heap. Use the wheelchair. Of course if you have your own wheelchair or even mobility scooter the airline will carry these free of charge, just make sure you let them know in advance. 
  • Simplify your meds – yes, it’s a fact of chronic life that like me you’ll probably need a bag just for your meds. If you pack it carefully you’ll have no problem at security. Don’t decant into pill sorters, take them empty and do it when you arrive. Ensure every med has its box or bottle with pharmacy labels, and carry copies of prescriptions or a print out of your repeats list as back up. I’ve had my meds emptied out at security more than once, but I’ve never had them queried. If you’re carrying sharps let the airline know in advance, you may need a letter from your GP. NB – always carry on, never put meds in the hold, we’ve all heard tales of missing luggage…. 
  • Simplify your packing. It’s taken me a while to master this, but actually taking as little as possible is so freeing! Because of my fibro I tend to stick to soft jersey or linen, and I swear to you three pairs of trousers, five tops, a jacket or cardi and a scarf or two and I’m done. One of those tops will be one I can dress up a little if I do end up having an evening out (I’m usually on the bed watching TV by evening these days!). I spent years lugging clothes abroad that came back unworn, and I know I’m not alone. 
  • Simplify your accommodation! How? Check access to your room, and access to what makes your holiday enjoyable before you book. Once you know your booking is for a ground floor room, within 40 metres of the town square/beach and there are four good restaurants/bars nearby you can relax about your arrival & enjoy your stay. 
  • Simplify your decision! What are you really travelling for? Forget everyone else for a minute, what do YOU want out of this holiday? Whether it’s time to meditate daily, swim, lay on the beach every day or learn to paint make that the focus of your booking. If you have children book a holiday with a kids club or crèche facilities, if they spend half a day there while you swim/read in peace it means you have the downtime you need to save spoons for time with them in the afternoon, or vice versa. Remember this is your holiday too. 
  • Simplify your expectations. Probably the hardest lesson I’ve learned but the most important. Be kind to yourself. It’s OK not to see every tourist attraction in the area. It’s OK to have a siesta in the afternoon. It’s OK to have early nights. It’s OK to just sit and have a glass of wine while you watch the sunset. It’s OK to spend a whole morning drinking coffee and reading a good book. It’s even OK to spend a day in bed. (What!! But I’m on holiday, stuff to do, places to see! A day in bed when I’ve paid to be here?!!) Yes, it’s absolutely OK. Think about it. You’re on holiday, a vacation, a rest. If you can’t give yourself permission for a day in bed if you need it when can you? Doing this while I’ve been away in the past couple of years has been essential, I couldn’t have had the up days I enjoyed without listening to my body and taking a day or two to rest. 

I would love to hear any tips you have for simplifying your travel plans. 

The two books mentioned are both ones I’d recommend. A relaxing holiday read maybe?  

*Little Women by Louisa May Alcott 

*Physician by Noah Gordon 

Simplifying Part One – Living Space 

I’ve not done this before, but I’ve just come up with an idea for a few linked posts around the theme of Simplifying. It’s a term we hear a lot, especially in chronic life, of course simplifying makes things easier! Sounds obvious but is it? 

So what exactly do we mean by simplify – common synonyms include to make easy, make plainer, remove the complexity from, or make more accessible. Whilst the latter here would appear at first glance to apply to ‘us’, because accessibility is often at the forefront of our minds, the rest are certainly appealing to me too, who doesn’t want things easier or less complex?! 

So we agree simplifying stuff is good. Where do we start? The first one I’m writing about here is in the home, our living space. Whether it’s a palace, a bedsit or my own little bungalow there are definitely things we can do to make our daily lives easier.

And immediately one of the biggest challenges for a lot of people raises it’s head – where to start! When you have a houseful of things that you may have had for one year, five years or even thirty years, it’s very difficult to at least partially detach emotion from belongings so you can make sensible decluttering decisions with a clear head. But it’s really important that you do. Stuff is just that, stuff. Good memories live on in our minds and our hearts. 

Often this is where you can enlist help from a practical friend or family member, they may help you keep a clearer head. Keeping a pearl ring because it was grandma’s is a lovely momento. Keeping an odd sock she knitted in 1963, or a chair she sat in once, not so much. 

I’ll admit I find this easy, as I’ve never been very attached to things, I believe it was because my lovely mum was a…. collector 😊 so I’ve just gone the opposite way. I always remember the mild but tangible panic in our house the day before family visited, piles of stuff (from magazines to ironing) that had mysteriously grown were hidden upstairs or squeezed into cupboards before actual cleaning could commence. Don’t get me wrong, it was never dirty, it was just always cosy and cluttered.

I’ve spent a number of my adult years married, so it’s only really in the last five years I’ve truly discovered my own decorating style, and whilst not stark it is a little minimal. I’ve had friends comment how tidy I am. I’m truly not, I just don’t like clutter so I put things away. They have a place, and that generally means I can find them!

But yes, even I had a challenge downsizing from a three bed bungalow to a small one bed bungalow eighteen months ago.  And I’ve cleared out again since, because I still brought too much with me. With every room I’ve had a rule, if it’s not truly beautiful (to me) or useful it goes! Using a combination of local selling sites have netted me money for a lot of bits and pieces, and charity shops have benefitted too. I just sold a mirror today for £20 😊

So how do you simplify YOUR living space? My top tips

  • Pick a room. Never attempt more than one room at a time, you’ll get disheartened and give up. Once you’ve chosen a room split it mentally into sections. So if you’re doing the bedroom for example, break that down into the chest of drawers, the bedside cabinets,  the dressing table and the wardrobes. This way when you start running low on spoons you’re never in the middle of a big clear out, so it’s manageable to finish one task at a time. 
  • Wherever you’re cleaning grab three bags, crates, boxes, whatever is suitable. Then label these (mentally is fine!) Sell, Donate, Trash. Anything you’re keeping simply stays in the drawers/wardrobe etc – easier to sort it when you’ve got more space. One rule here – items can swap boxes but they can’t come back out, be strict with yourself! 
  • Stay organised. If you get help to stash boxes in, say the garage, until you’re finished make sure the donate/sell piles are separate, and the trash goes directly in the trash bin. 
  • Be as unemotional as possible, and as ruthless as you can stand. If you’re finding it hard, think of the money you could raise, the good you’ll be donating, and how lovely it will be to have your nicer things accessible, clean and tidy!

If you’re still feeling up to it, once you’ve cleared a room and before you start the next give a once over with a critical eye. Does the layout work easily for you? Can you move or lose a cabinet or table now you’ve cleared it to give you more space? Will that chair be nicer by the window? Trust me, this is addictive, I promise once you’ve done one room you’ll be itching to start the next!

Just remember, small manageable chunks, spread out your spoons. Keep reminding yourself you are simplifying, making things easier for YOU! 

So how am I doing? Good so far, slowly but surely, I even raised enough from selling last year to buy a new (second hand) sofa! I have just three spaces left to tackle. First is my bedroom, it’s almost finished, just the wardrobes to do now, which I keep putting off. I never said I was perfect! Next is my cloakroom cupboard. I know I have coats, shoes, boots etc I’ve not worn in over a year and they need to go. Last will be my ‘office’ cupboard in the hall which will be the easiest by far. Some of this simplication will definitely bring me a little money. Now I just need to dig up the energy!

Choosing to be happy… 

I was reading an interesting thread on twitter this morning and it emphasised something I’ve noticed online over the last few weeks. First I’ll give an example – this particular thread had asked the question of disabled people “With optimal support how different would your life be?” 

The answers fell into two distinct categories, either “I’d write/study/move house/volunteer” or “I can’t imagine this / I don’t have the energy to think about this”. Now you could say perhaps some of the responders were more physically impaired by their disability, or that they deal with more debilitating symptoms. But having been noticing this for a while now I don’t believe this to be the case.

We can all choose how we think about something. And making that conscious choice has a huge effect on how we subsequently feel. Bear with me here – if you’d have told me this a few short years ago I’d probably have become defensive or angry and felt you were criticising my thought process. It’s only due to some great therapy and a lot of reading that I’ve been able to reach a point in my life where I’m thankfully  able to make conscious decisions about what I think. 

The impact this has had on me has been so positive. Don’t get me wrong, it’s not a cure for my depression and anxiety, I’m still taking my pills and have days where it’s darker. What it has done is given me coping techniques to deal with those days without them turning into months every time. 

In simple terms only WE are responsible for what we think. Yes, that inner voice is us too. It’s our head, our thoughts, our responsibility! And we make subconscious choices about what we think, how we react to things, how we will respond. So why not make those choices concious? 

Let’s use my Saturday as an example. I woke around 11am, did the usual coffee/bathroom/clothing stuff then went to meet some friends in my local for coffee. I was there for about three hours, sitting down, chatting, crosswording and laughing. Then I went home and crawled into bed, took a double shot of painkillers and didn’t move again for six hours. This is fairly standard. Activity = pain + fatigue. 

I could quite justifiably feel angry about this. It’s not fair, other people don’t have to pay for socialising, why can’t my meds work, why did I get this stupid disease, why am I so useless, I’m no good to anyone, my life is crap. 

It’s an easy trap to fall into, I know because I’ve been there. But it leads down a very rocky path to anger, self pity, self hatred, and a feeling of total worthlessness. We convince ourselves we have no value. And that’s a self limiting belief, because we withdraw and huddle at home feeling sorry for ourselves, which means we don’t see anyone, which means they all hate us  because we’re worthless. It’s a horrible lonely and despairing place to be. 

But…! We have the power to change these thoughts. One day at a time, one belief at a time. There’s no magic trick or quick fix, it takes practice, and dedication. Which to be honest are small prices to pay for feeling better about yourself, right? 

So Saturday night, laid up in bed. Was I angry, sad, feeling sorry for myself? Nope, not even close. Was I slightly peeved about the pain? You bet, but that’s as far as it went. 

  • Rather than being angry I could only stay out for a few hours and then had to suffer I was grateful for the lovely afternoon I’d had catching up with friends 
  • Rather than thinking my life is so awful I was thanking the universe for what I had – pain relief, a warm bed, heated blanket. 
  • Rather than thinking I was worthless for not spending more time with friends I acknowledged that they love me, and enjoy spending time with me. And I’m very grateful for that gift. 

I think the most impactful thing I’ve learned has been to practice self-love and gratitude. Both are simple concepts. Accepting yourself, and loving the unique person you are will be the most important thing you ever do for yourself. And practising gratitude daily is such an easy habit. 

Start by listing three things a day. They could be time with friends, a nice lunch, a sunny day. And some days they’ll be bed, sleep, food. But you’ll find you start appreciating the small stuff, and realising it’s really the important stuff. Ever thought about why small children are so delighted by every little thing, so quick to laugh, to smile?  They have no learned pattern of negative thoughts, they literally live in the moment. 

So next time you’re about to tell the world how dreadful your life is, stop for a moment and watch what you’re thinking. There’s probably a jumble of negative thoughts whirring round all reinforcing your poor opinion of your life. So acknowledge them, and then let them go. Take a minute to think of what’s good about today. Toast, pyjamas, slippers? Great, that’s a start. Aren’t you glad you have them? ☺️

Honestly, give it a try. It is possible to choose to find the joy in your life rather than focus on the pain, and the outcome is you’ll start feeling happier. That’s what I call a win. Namaste 🕉️💙

Medical Roller-coaster!

Where to start….! 

It’s been a bit of a medical and emotional  roller coaster the last few weeks, with lots of different issues and when your medical needs aren’t simple something most people take for granted like <GP = Answers = Meds> becomes a dim and distant nostalgia. 

To be honest this is probably more of an update post than anything, but it hopefully explains why I’ve been a bit quiet with regards to blogging and my Facebook page, my focus out of necessity had to turn inward. And of course the stress has affected my RA and Fibromyalgia, as well as the ME/CFS so there’s been a lot of Fatigue which just shuts me down. 

Now the worry has lessened I’m feeling a little more alert, which is always welcome. So hopefully this will be fairly lucid. Essentially three key things have been going on, a rheumatologist appointment has led to some initially surprising decisions, there have been serious concerns about my lungs and I’ve had a plethora of ongoing joint problems that I’m just kinda fed up with. 

You may recall I started Humira, my fifth RA med and my first biologic back in September. Unfortunately it did absolutely nothing for me, and in fact my DAS score increased between November and February. My rheumy has decided to stop treating my RA for six months, so a review is planned at that point though obviously if anything horrid occurs in the meantime we can reassess. My initial response was “What?!!” but having discussed this in depth with my locum GP I’m now feeling much easier about her approach. Of course I have RA, there’s no question about that, I’m RF+ and AntiCCP+ and inflammation has shown up along with raised CRP and ESR levels. However recently although I definitely still have RA pain, particularly in my hands and feet my bloods are low and there’s very little sign of synovitis (swelling). 

So my rheumy wants to try a different approach, rather than just adding another biologic which are very strong meds she wants to focus on treating my Fibromyalgia to see if that helps narrow down what’s actually causing the majority of my pain. Whilst I am concerned about being off RA meds for this period I understand her rationale, and my GP and I will be paying close attention to my symptoms during this period. So I’ve started a Fibromyalgia med, Lyrica (Pregablin) which will take a few weeks to kick in, and we’re back to to the very familiar wait and see. 

My lungs have turned into an “interesting mystery” (quoting the doc), I’ll try and keep a very long story as short as possible, beginning of October I started a dry cough. When this hadn’t gone by December my GP blasted me with antibiotics just in case and gave me a steroid inhaler. This stopped the cough, but when I tried to stop using it twice daily in January the cough was immediately back. A lung xray taken in December showed some chronic scarring, which hadn’t been there last September. This caused me to thinking I had some very serious problems, especially as since Christmas I have been steadily getting more breathless. 

An attempt at a Spirometry Test was a bit of a failure as I couldn’t breathe well enough to register results. My Locum GP has been absolutely amazing, I had about 45 minutes with her on Thursday last week, then over an hour on Friday! She, my rheumy and my GP who is working from home (back operation) have all checked the xrays and they don’t feel there is any cause for concern which is a huge relief. However my breathlessness is ridiculous, getting up and making a cup of coffee leaves me struggling. So we’ve upped the steroid inhaler dose, and I have a ventolin inhaler to use if needed. 

Next week I have oxygen sats test booked as they looked borderline low last week, and the week after I have a repeat spirometry and an ECG – we are basically working to rule things in or out by process of elimination. It’s a slow process but I’m feeling totally reassured, heard, and supported which as anyone who deals with chronic illness knows makes a massive difference to our sense of well-being. 

So that’s where I am to date, less worried than I was and still putting one foot in front of the other, albeit very slowly! The joint issues may or may not be RA, my left shoulder is probably OA as no inflammation shows under ultrasound, my left hip likely bursitis, my knees which have been dreadful seem to be tendon problems, my feet are waiting a podiatrist appointment, I’ve had one through for orthotics. I’m getting a new referral to physio, and I’m chasing an appointment with my pain clinic consultant regarding next steps for my back. Oh and we’re booking an xray of my cervical spine as I’m in pain and losing movement. 

And what do I say if people ask? Yeah, I’m fine thanks! If I started listing this lot they’d be asleep. What have I learnt in the past few weeks? A couple of important things:

  • One is not to panic until someone really qualified tells you to
  • Two is not to assume every ache and pain that arises is RA – it’s actually important to discuss any new symptoms with your GP
  • Three is to remember that we are at higher risk of heart and lung disease as RA patients and it’s really important we look after ourselves as best we can

I’ve completely changed my diet the past few weeks, incorporating much healthier foods and ditching nearly all processed sugar, and both my Diverticulitis and my scales have appreciated the change 🙂 

Namaste my lovelies, stay as well as you can 🕉️ 💙

Simply Christmas 

I just wanted to let every one of you, my lovely readers, know that I am thinking of you this morning. I’m here in Cyprus with my brother and his family, we’ve opened presents by the tree, Christmas music is playing and I’ve had a long phone chat with Dad so all is right in my world today.. Except.. 

Of course RA is here, muscling in on the festive season – we shouldn’t expect differently I guess, though one can always hope! So yes, meds with breakfast as usual, and because I’ve had a couple of fairly active days with the kids every joint is grumbling along with my spine which is just slightly on fire. A lot. 

But today I choose to be happy. I adore spending time with family, making new memories and remembering old is so important. So my wish for you is that you can do the same today. Forget stressing about Xmas, I’ll let you into a secret – if it’s not perfect no one cares! 

Spend time with those you love, whether that’s in person or on the phone. Relax, enjoy and yes, eat too much of your favourite foods! Use that heating pad or tens machine,  have a glass of something lovely, put your feet up and please remember #selfcare, none of us want to be flaring badly tomorrow 💙

Finding Balance 

​Yesterday I cried and wept, illness taking friends is so bleak 

Today I (chair) danced and sang with friends who filled the room with life
Yesterday was for death and dying
Today was for love and joy

Balance is so important. Anyone with a chronic illness sees too much darkness. We lose time, we lose careers, and sadly sometimes we lose friends.

There are those who might say that if we’re singing and laughing then we can’t be that ill, or we exaggerate the pain. There are those who would say if we can do this today we should be able to do it again tomorrow.

They will never understand the joy of grabbing a few hours in the sun when the rest of our time is darkness. And I hope they never do. It’s absolutely necessary for our mental health as well as physical that now and again we simply say FURA!!

Spending time with people we love whose company delights us, and recharging our joy in living is probably the most important thing we can do for ourselves. No, it’s not easy. Yes, we’ll pay for it afterwards, often very painfully. But when you spend many days alone and hurting so bad you don’t actually want to even speak to anyone, dipping our toes for a time into positive, loving energy is truly restoring.

It’s very easy, especially on days like yesterday to focus on the dark, when someone passes so young and has the same condition you do you are frighteningly aware of your own mortality. It was coincidence that lead to this ‘sad day, happy day’ weekend, today being birthday drinks with lovely people, but it made me feel blessed.

So I believe that loss, as awful as it is, also acts as a reminder that we are still alive. And that’s so incredibly important. See that movie, kiss that boy, hug your children, visit your family, phone your friends, tell them you love them. Not in morbid fear, but in sheer joy that we live another day. Think of those we’ve lost, and rejoice that they were in our lives, celebrate how very fortunate we were to know them.

I’ve always loved this poem, it reminds me of those that have gone on, and how very wonderful it was that I had them in my life, however briefly.  Namaste 💙


She is gone


You can shed tears that she is gone
or you can smile because she has lived.

You can close your eyes and pray that she’ll come back
or you can open your eyes and see all she’s left.

Your heart can be empty because you can’t see her
or you can be full of the love you shared.

You can turn your back on tomorrow and live yesterday
or you can be happy for tomorrow because of yesterday.

You can remember her and only that she’s gone
or you can cherish her memory and let it live on.

You can cry and close your mind,
be empty and turn your back
or you can do what she’d want:
smile, open your eyes, love and go on.


David Harkins, © 1981

Zombies Have More Energy! 

I know I’ve often said fatigue is the hardest thing to explain. I know from speaking with others that Chronic Fatigue is incredibly misunderstood by those that have never felt its effects. The nearest most people can compare it too is feeling tired, and that’s like comparing a whisper to a shout. 

I’m deliberately trying to write this now whilst I’m in it, even though just holding my phone and touching the keypad is stupidly hard work. I feel fatigue every day, it never leaves me, but two or three days a week it overcomes all and I am capable of nothing but sleep. 

I’m just coming through a fatigue flare, I slept around twenty  hours on Sunday, eighteen yesterday and about twelve hours last night. I’ve been awake since 11.30am this morning, though I use the word awake loosely, zombies have more energy! I’ve literally fumbled my way from the bed to the sofa, and here I’ve stayed. I could list a few easy metaphors, walking through water, seeing through fog, swimming through quicksand but none quite capture the completeness of fatigue. 

It’s as if every limb of your body is filled with lead, your thinking is slow and clumsy, you fumble and drop things, and you seem to have suddenly lost the arcane magic that allowed you to coordinate limbs, judge distance and weight. Covering the ten feet from the sofa to the kitchen seems a marathon, and I drop onto my kitchen stool to rest before attempting to lift my arm and switch on the kettle. 

I suppose the nearest obvious experience to understanding fatigue is the flu, but please know I mean Influenza, not your last bad cold. Flu is actually an apt comparison, as actually very similar processes are being undertaken by the body. 

Our immune systems are fabulous and complex, and most of the time they are incredibly efficient. So with an enemy to defeat, for example the flu virus, the immune system does two things. One – attacks the virus, and two – shuts down all non essential systems so all energy is diverted to repelling the enemy. Simple and to the virus, deadly. 

However with RA our immune systems are unfortunately badly confused, and they daily try to ‘repel boarders’ that are actually our own selves. So the shutting down or fatigue, is constantly being ordered to allow us to heal – except its not needed. 

RA is of course just one potential cause of my fatigue, I also have Fibromyalgia, and my GP believes Chronic Fatigue as a separate diagnosis. I’m kind of past the point of minding at the label, I’d just like a cure please. 

Interestingly I’ve today received a letter from the Centre for Fatigue Services at the Royal National Hospital for Rheumatic Diseases in Bath. I’ve an appointment in the next few weeks. Both my GP and I are quite intrigued, she has no idea exactly what they offer or do as I’m the first patient she’s managed to get through their screening process (Nine vials of blood for tests).

I’ll certainly update you on the what and the how after I’ve been to see them, and if I need a reminder of how fatigue feels on bad days I can refer back here 😉