Wednesday, November 26, 2008


It's amazing how tiring continual pain is. I'm having a rheumatoid arthritis flare, which I'm convinced (despite my doctor's insistence that there's no relationship) is related to the damp, rainy weather.

It started last night - I reached out for something in the car and my hand (my right hand, of course, that being the one I use) went crazy with pain. Oddly enough, it didn't hurt when I used the hand, like to write, or drive, or even pick up heavy objects like full teapots; it hurt when I extended the fingers. This isn't something we do all that much, but once it started to hurt, of course I kept doing it to see if it was still as bad. (Don't ask. Also, people with arthritis learn pretty soon that an unworked joint is an unworkable joint.) Over time it settled into a throbbing ache in my right knuckle, which it's been doing pretty much continuously since, somewhat eased by chemicals. The knuckle is reddish and looks enlarged to me, although my rheumatologist regularly tells me I have no deformation in my hands. It isn't warm or sore to touch as the last flare was.

I didn't sleep very well last night, at least partly because I was waiting to see if my hand still hurt (even though I took Tylenol). The trouble with RA flare pain is that it does slack off from time to time; but when it does, you can't quite believe it, so you sit there wondering when it's going to start again. Today was rainy, damp, and chilly (50's), and I spent most of the day trying to get my hands warm. A cold aching hand is much harder to live with than a merely cold hand. Also, I've been having little spikes of pain in other hand joints, and even in my left hand; just my immune system going crazy, I guess. They last 30 seconds or so, so they're mostly just annoying.

Based on previous experience, I think this is beginning to ease off. I first wrote "chronic pain," but it isn't really chronic; "chronic" is constant. I had "chronic" before my first knee replacement and it was Much Worse than this. RA flares come and go, and in a few days it'll probably be fine again.
But after roughly 24 hours of it, I'm a basket case; I'm exhausted. As I think about it, the fact that I went out to lunch with some friends and walked 3 miles in the course of it may have some impact on that; but I should be able to walk 3 miles, in 2 segments, without becoming an amoeba.

I started trying to rate it in terms of the 1-10 "pain scale" Kaiser uses. Except that I can't remember Kaiser's stupid pain scale; they gave me a xerox when I had knee surgery but I threw it out. Their web site says "zero is no pain and 10 is the worst pain imaginable." A little Googling of "pain scale" brings up a number of blog posts from medical personnel who think the pain scale is garbage anyway, not to mention the fact that there are multiple pain scales. I give it a 3-4 (the initial spike was at least a 5, really nasty), whatever that is; I can work past it, but unless I'm doing something really interesting, the pain has some of my attention, and I'm always rubbing it to see if it will get better.

You do what you can, you take the pills, you keep things exercised, and it still does this. There Ain't No Justice.


  1. Tanj is right, baby. (Are you a Larry Niven fan by any chance?) My mom is going through an arthritis flare-up right now, too, on the other side of the continent from you.

    Happy Thanksgiving!

  2. Your mom has my sympathy, D.B. Actually I just iced my hand and it's helping.

    I'm not a fan of all of Larry Niven, but I love Ringworld. I sometimes wonder if it isn't a warning; what brought that civilization down was so simple and so stupid.

  3. Bummer. Annie, my girl-dog-of-a-certain-age, has plain old degenerative arthritis, and I can tell a change in the weather by how far she can walk in the morning.

    I don't have arthritis, but as a sufferer of chronic (week-long) headaches, I can sympathize with the mind-games pain can play.

    Hope you get a reprieve soon.

  4. Thanks, piglet - it's better now due to putting ice on it.

  5. The worst pain I've ever felt was in two instances:

    1) When I fractured my cartilage in my right knee while helping a plumber install a new water-heater in our old basement. That was about 120 seconds when I was uncertain if I were already on my way to heaven -- it was like partially losing sense of reality.

    2) When I passed my first kidney stone. The pain oscillated over time, but the constancy of it overwhelmed my resistance and turned me into a whimpering toddler. I vomited and quivered and felt weirdly cold and feverish at the same time. When it came out, I discovered why it had hurt. Like a piece of jagged black volcanic glass--how it ever "passed" I'll never know. I asked the physicians at Alta Bates hospital if they had any remedy: "Just drink lots of beer and jump up and down." Nothing about ultra-sound etc. What primitives!

    My wife has RA in her right wrist, the result of working with computers.

    My best advice, which has worked for me over the years: Use your hands every day. I play piano a lot, and that helps. Also, something like ping-pong, which requires that you keep your wrists limber. Shake your hands vigorously. Stretch them. Test them. Don't coddle, or it'll get worse.

    Doctor Curtis at your service.

  6. I don't play the piano, Curtis, but I've discovered the benefits of regular finger exercises - I learned several good ones from my former water aerobics teacher Marti, who also had arthritis in her hands. I found a pair of those Chinese balls at a garage sale and rolling them around helps a lot; but if you see me sitting somewhere, like on a bus, clenching and unclenching my hands, I'm just keeping the joints limber.

    "Drink lots of beer and jump up and down," eh? Sigh.

  7. Part of my assessment of patients as a nurse in hospital is to ask about their pain level. I put it this way: "1 is a mosquito bite; 10 is getting your leg cut off with a chainsaw." Does that make the scale easier to remember?

    Alternatively, think of a volume dial on your stereo. Think of what notch on that dial you'd crank the amp up to if you wanted the music to be as loud as the scream of pain you feel.

  8. Bukko, I don't have trouble with the ends of the scale; it's worse than a mosquito bite and not as bad as getting my leg cut off with a chainsaw. It's not even as bad as a total knee replacement, of which I've had two. But that's a pretty broad spectrum there, and it's the fine details in the middle of the scale that I have trouble with.