Ummm... that's a "little" snow. And my car under the snow-laden laurels.

The weather forecast as I went to bed last night (OK, this morning) was for light rain, and snow another 1,000 feet up the mountain from us.

So you can imagine my surprise when I woke up at 7 and saw 51/2 inches of snow

Umbrella drinks, anyone?

out the windows and a temperature of 29 degrees. Wow.

Of course, it’s absolutely beautiful. And we did prepare for the possibly snowy week by bringing in a load of firewood for the stove. We’re nice and warm inside and glad for it. Mr. Wren had plans to go to a MG class this morning (he’s a county Master Gardener, and is mentoring a new student), but since he hasn’t bought chains for his new truck, he had to stay home.

Oh, well. He’s going to help me cut up veggies for a nice, hot, savory stew. Spring may have sproinged, but Old ManWinter looks like he’s not quite ready to exit stage left.

Finny the Valley Dog discovers snow and decides he likes it.

Finny McCool, who had never seen or bounced through snow before (he’s a Valley Dog) was absolutely delighted. After he came inside from his wee walk in snow up to his belly and I got him dried off, he raced around the house like a mad thing, rolicking and completely energized. What a hoot this little dog is!

Snowed in on the last day of March. Go figure.

I have a Google search set up on my iGoogle page that hunts down the latest news regarding rheumatoid arthritis.

Today, the headline for one of the articles reads “Pilot Study for Rheumatoid Arthritis, Fibromyalgia to Begin.” Naturally, I clicked on the article, curious about the study. Turns out it’s about a substance called CMO, and the article starts out with a testimonial from a woman who suffers from fibromyalgia.

“Now, after hearing from her neighbor about a treatment called Liquid CMO, she says things have changed. ‘Being able to go play ball with my kids and go back to college. I would recommend it to anyone that’s going through the pain and suffering that I have gone through,’ said Vicki.”

Note that Vicky doesn’t say that she’s actually taken Liquid CMO, though the quote certainly inplies that she has. It also implies that the product has relieved her fibromyalgia symptoms.

The link takes you to a website which sells the product Liquid CMO. One bottle (the size of the bottle isn’t specified) costs $92 for a 16-day supply.

Once I caught my breath, I did a little more research on this wondrous stuff.

“CMO” is short for cetyl myristoleate, which, according to a Wikipedia article (clearly written by someone who wants to make it appear legitimately effective) is the cetyl ester of myristoleic acid, a naturally occurring, animal-based fatty acid.

Further searching revealed that CMO is supposed to work by “lubricating” the joints, and can be taken orally or rubbed into the skin over the affected joint as a cream.

A quick Google search for cetyl myristoleate brings up hundreds of websites pitching supplements containing CMO for relief of osteoarthritis, lupus, multiple sclerosis, gout, psoriasis, leukemia, emphysema and fibromyalgia. Rheumatoid arthritis hasn’t quite made the list, I guess, except for the Liquid CMO company’s list. And, while its use in osteoarthritis been shown to be moderately effective, the studies have been quite small. Results of studies regarding CMO’s effectiveness in relieving the rest of the list of ailments are inconclusive.

I don’t have anything against taking natural or herbal supplements for RA or any other disease. Shoot, on my PCP’s advice, I took grape seed extract for a couple of years to relieve the hot flashes I experienced as a result of menopause. Did it work? I don’t know, because at the same time, I also cut back, drastically, the amount of caffeine I was drinking each day. She felt that caffeine could have been making them worse. My hot flashes did become less in number and intensity after a few weeks of taking the grape seed extract and drinking a lot less coffee and tea, and they remain that way today, even though I no longer take the grape seed extract. I’ve kept my consumption of caffeine to a minimum, though.

For the record, I took glucosamine and chondroitin for nearly a year, hoping to relieve RA pain and inflammation. They had no effect. Same for copper bracelets. I’ve also tried various creams and rubs with capsaicin in them. They caused my skin to feel as if it was burning, which (ow, ow, ow!) certainly distracted me from my joint pain, but they did not relieve it. I hated the burning sensation and decided they’re not for me.

My feeling is that if you want to take a natural supplement for your RA, do it, as long as you’re careful and do a little research first. Not all supplements are without side effects, some of which can be serious. Only one of the websites I found had any warning about CMO side effects: those wishing to take it should discuss it with their doctors; pregnant and nursing women should avoid it; and that people with liver problems should also avoid it.

Interesting.

But most of the websites I found said CMO had no side effects and that it’s completely safe. I’d like to point out, however, that in the pilot study article, the naturopathic doctor who will conduct the RA/fibromalgia and CMO Liquid study, and who, in the article, encourages readers to take the product now, before he’s even done the study, mentions flu-like side effects:

“Dr. Arneson says CMO alleviates symptoms of rheumatoid arthritis and fibromyalgia. [He says this prior to doing his study and in spite of studies that say it’s inconclusive in its effect on RA and fibro.] He says studies [not referenced] show side effects are mild and include nausea and occasionally flu like symptoms for several days. ‘You can feel a little bit worse before you get better, but it’s a very short duration,’ said Dr. Arneson.”

(Bolded comments are mine — Wren)

Hmmm. I was able to find only a couple of CMO websites that weren’t obviously run by companies or individuals mainly interested in selling it and other natural supplements; you can see one of them here, and another, here.

My conclusion is that the “news” article that came up in my Google search is actually a press release from the Liquid CMO company, tarted up to look like hard news about a rheumatoid arthritis and fibromyalgia cure, and released in order to sell the product to people who are desperate for relief from pain and disability.

That irritates me. Sorry.

The other thing that stands out is the fact that the article encourages people to buy and take Liquid CMO, even though the “study” is intended to discover which dosages of the substance are effective — and it hasn’t been done yet.

My BS radar is pinging like mad.

I don’t know if this is a scam. Maybe it’s not. Maybe some people – with osteoarthritis – do experience some relief when they take CMO, in any of its numerous forms under many different brands and prices (other brands and forms are sold on Amazon for far less than $92.). But it’s also obviously not a cure for rheuma or fibromyalgia. If it is, why aren’t we all taking it, courtesy of our rheumatologists? The product website claims that Big Pharma wouldn’t buy the stuff and develop it because it’s an unpatentable natural substance – they wouldn’t be able to make any money off it.

But these other, private natural supplement companies sure can – and do — make money off it. I guess we just have to be careful before we open our wallets.

(P.S.: Thanks to everyone for your kind get-well wishes about my sick stomach yesterday, your suggestions for ways to soothe it, and well wishes regarding my achy right hand. The good news is my tummy is just fine today. Must have been a little bug. Or maybe it was those kettle chips I indulged in Saturday night … My right hand is back to a dull roar, which matches my left hand, and that’s pretty much normal these days. Anyway, I appreciate all of you for your kindness and empathy. That is all.  ;o) )

Blarg. My grungy tum continues. I’ve tried ginger tea, soda crackers, and plain toast. A long Sunday nap (so decadent – naps always make me feel guilty) with Finny and elder cat PIB (they’ve reached a sort of truce; PIB gets the pillows at my head, McCool burrows down beneath the quilts and uses my legs as a chin rest). But so far, no relief from the nausea.

Next on the list of possible remedies: spiced chai herbal tea with cinnamon, cardamom, ginger and anise. Sigh. I hope this grumbly stomach goes away soon.

At the same time, my right hand and wrist are being particularly ugly. I figured it was the barometer causing the pain. It had to be either rising or falling, since we’re heading into a rather drastic weather change — a weak storm is headed in off the Pacific tonight and then at least two more, much bigger, stronger, colder storms are predicted for tomorrow evening through Wednesday. The weatherheads are saying there will be lots of snow in the high mountains above us, and there’s a very good chance we’ll get some as well before they all blow through. The dogwood buds on our trees are still tightly furled, though, so these storms won’t be the legendary  “snow on the dogwoods” ones that herald winter’s end in the Sierras.

To my surprise, though, it’s not the barometer causing my hand to ache. A check of the weather on my Yahoo page says the barometer is holding steady at 30.18 inches. Hmmm. Who knows why my right hand is being so gnarly today, then. It’s just my old nemesis rheuma, doing what it does so well for no good reason.

Brighter news: while walking Finny McCool today in the thin sunshine I noted plenty of springy things happening. The crepe myrtles and forsythia are blooming wildly, as are all the fruit trees – apples, nectarines, pears – out in the back garden. I also noticed we have some nice looking leeks and a few lone stalks of asparagus out there. Probably should pick and use the leeks, at least. I love leek and potato soup. The roses are putting out new leaves by the bunches, some of the daffodils are blooming, and the wisteria is full of long, spear-like buds.

We usually lose the first wisteria bloom each year to random hailstorms, which never fail to occur the day after the flowers open up in all their blue, lavender and white glory on leafless whips. It always makes me a little sad to see those battered blooms afterwards, but wisteria is tough and takes such setbacks in stride. It simply blooms again two or three times through late spring and summer.

Last night, I heard a great horned owl hooting from somewhere in the fir trees. That’s one of my most favorite sounds in the world. I’m pleased to hear it, too, because it means the owl pair is back, preparing to nest and raise a few owlets.

There were chores today: Matt helped me fill the wood ring next to the wood stove with almond-wood stove-lengths this afternoon in anticipation of the colder temperatures to come, and I cleaned the stove out and emptied the ashcan. We’ll be cozy, but it felt a little odd, really. It’s been so warmish here – most days alternating between sun and clouds, temperatures in the mid-60s – that we’ve hardly used the stove during the last two weeks. Instead of building a fire in the stove, we’ve simply worn an extra layer of clothes in the mornings and evenings, because by mid-day, it’s far too warm to have the stove radiating heat. We’ve even had most of the windows open to the fresh air, which I absolutely love. The breeze moves the windchimes and makes music for us. But with these new storms on the way, the nights will back down into the low 30s. Well, we’re ready.

Like this post, it’s been a slow, meandering sort of Sunday here at the Wren’s Nest. I wish you all a lovely Easter week.

“In the spring I have counted one hundred and thirty-six different kinds of weather inside of four and twenty hours.”

~Mark Twain

I rarely have trouble with my stomach — thankfully, up to this point in my rheuma experience I haven’t had the “flu-like” symptoms so many people suffer with along with RA — so when my tummy does act up, I’m sort of at a loss. Usually, a sick tum goes with a stomach bug. But this one … I don’t think so. I’m just mildly nauseous.

So I’m drinking ginger tea and trying to ignore it. Anyone out there have any suggestions?

UPDATE: I just ran across this article from Reuters. Seems that studies are finding that moderate drinking may slow the progression of RA and, in those who haven’t got it yet, may actually prevent it. On the other hand, the same studies indicated that heavier drinking makes RA worse (the article didn’t quantify what constitutes “moderate” or “heavy” drinking).

Most of us with RA take meds that are rather dicey, liver-wise, so we’re advised not to drink while taking them. And of course, drinking can have its own fairly serious consequences. I’m not much of a drinker anyway; I like an occasional glass of wine with dinner, and I love sipping scotch, but I don’t indulge in either anymore. My liver has enough to handle, thankyewverymuch!

The authors of the study stress that they don’t recommend those of us with RA should start drinking. They haven’t figured out why alcohol seems to have this possibly beneficial effect. But it’s interesting, isn’t it? I wonder what substance it is in alcohol that inhibits inflammation? Maybe they’ll find out …

I saw Dorrie, my physical therapist, again yesterday. She’s been teaching me exercises I can use to maintain strength and flexibility in my hands, my feet, and today, my shoulders and hips. Keeping our joints flexible and the surrounding muscles strong is so important. It may not stop rheuma from attacking, but it surely can help us endure the flares more successfully, and, hopefully, reduce their pain, duration and damage over time.

(Take a look at WarmSocks’ post today – she’s got a good shoulder exercise I’m going to add to my daily routine, and she’s promising more as her own shoulder improves.)

After PT, I saw the ophthalmologist. Yes, I will soon be getting a new, slightly stronger pair of glasses – I knew that was coming, actually – but more importantly, I’m now cleared to start plaquenil. I’m hoping that a call to my rheumatologist will be all I need to do to get the slow VA pharmacy gears cranking to fill and mail the stuff soon; I don’t have another appointment with my rheumatologist until mid-May, and I’d rather not wait until then to start.

Like everyone who’s reading this, I’m hopeful that the new medication will have a positive effect. Also, like all of us, I’ve had almost countless experiences where new drugs have not seemed to have any effect at all, at least on my pain levels and frequency of flares. Methotrexate might have helped at some point, but it made me so sick I begged to get off it. I’m on sulfasalazine, Arava and diclofenac now, and while they seem to be having an effect on my sed rate, my hands are still sore nearly constantly.

So while I’m good with starting another drug, I’m also somewhat ambivalent.

You see, I did try plaquenil for about six months in the late 80s, when my rheuma was extremely severe and frequently disabling.  (Oh, the stories I have of canes and crutches, casts and slings and splints …) It’s my understanding that today the dosage has been greatly reduced to avoid the frightening side effect of retinal “holes,” and I don’t recall, now, what the dosage was back then.

What I do know is that upon having my eyes checked six months after I started taking it in the late 80s, the U.S. Army ophthalmologist discovered a small hole in my retina that hadn’t been noted during my baseline eye exam. He was dismissive about it, saying, “I don’t think the plaquenil caused that. It would take much longer to develop that side effect. You’ve probably always had that tear.” The rheumatologist I saw that day was even more dismissive. It was as if I was wasting his time by being there.

True, my vision was not affected by the hole, but I couldn’t understand why, if I’d always had it, it hadn’t been noted upon that pre-plaquenil exam, which of course I’d had specifically because I’d be taking the drug. The idea that they’d ignore such a potentially fearful side effect sent my trust for that rheumatologist – who I’d traveled six hours by Autobahn to see at the giant U.S. Army medical center at Wiesbaden – into the toilet. When I got back to Bremerhaven, I told my internist that I would not take that drug anymore. I was terrified.

To his credit (boy, I liked this guy) he sighed but didn’t argue with me. I told him I’d like to see a local German rheumatologist, someone who might be better equipped to deal with me, and bless him, my doc gave me the nod (another reason to like him). I found one, was given a thorough examination, and put on oral gold. The U.S. Army ordered the medication for me and my care was transferred back to my internist.

I took it for a full year. While I was on it, I had to have my liver function checked with a blood test every two weeks. By the end, the veins in my elbows had collapsed and they were taking blood from the veins on the backs of my hands. And still, no effect. My RA remained just as severe, just as agonizing, just as disabling. Eventually, I stopped taking gold, too. What was the point?

My poor doc was out of options. We’d tried everything they had available. He had me take yet another type of NSAID and, when my pain was severe, filled limited prescriptions of Percocet to help me deal with it. Once, when my hip flared so badly I couldn’t walk and oral narcotics weren’t touching it, he hospitalized me for two days and put me on intravenous morphine. The flare finally eased (six days, total) and he sent me home.

During those early years, narcotic analgesics were the only medications that ever had any effect at all on my pain. I knew – he explained it clearly – that these could do nothing at all about the disease itself; they were only relieving symptoms. I didn’t care. It was the symptoms of the disease that disabled me, and I didn’t know enough about RA at the time to understand its potential for more permanent disability. I had to work. I needed relief. And I hated the NSAIDs – they all tore up my stomach – and I was not very good about taking them regularly. I was a nightmare patient, I’m afraid.

Upon our return to the U.S., I started seeing another Army rheumatologist. This one pooh-poohed my previous doc’s diagnosis of rheumatoid arthritis because, wouldn’t you know, when they tested my blood they didn’t find the rH factor. This in spite of my Bremerhaven doc having found it in my blood, earlier, and the German rheumatologist’s concurrence of his diagnosis. This new doc said I had polyarthritis and prescribed naprosyn.

Frustrated and furious, I’d had it. I stopped going to the doc for my RA. I simply endured it, taking ibuprofen and, once it went OTC, Aleve now and then. Other circumstances in my life changed as time passed, too – I was divorced and moved from Washington back to California, where my family lived. And during the five years that followed, my rheuma slowly, slowly went into remission.

I didn’t see a doctor for anything but a new seasonal allergy to grasses until 2005, when a large pannus formed on my right wrist, requiring surgical removal. Even then, my rheuma wasn’t bothering me. The pannus had formed quickly and was only mildly and rarely painful. But I was surprised to discover that even though it was in “remission,” my rheuma was still there, doing its slow, relentless damage. I only started seeing a rheumatologist again in 2008, which brings my story current.

Since then, thanks to the Internet – and all of you – I’ve learned a great deal more about RA. And so I’m going to try plaquenil again, reassured by my rheumatologist and the ophthalmologist I saw yesterday, that the chance of it damaging my vision is infinitesimal. I’ll be seeing the eye doc again in six months, when they’ll do further testing to make sure all is well. I’m better informed and much less fearful this time.

And in spite of myself, I’m hopeful. Perhaps in combination with sulfasalazine and Arava, diclofenac and the positive work I’m doing with physical therapy, more exercise and a much better diet, plaquenil will work this time.

My achy fingers are crossed.

What a nice weekend it was! The weather was wonderful, though I’m hoping(perversely, I know) that we’ll get a couple more good, wet storms before it’s over. There’s a wise saying in these parts: “Winter isn’t over until it snows on the dogwoods.” When I first came to live here, I smiled at it, thinking that it was one of those old-timers’ tall tales, leftover from the Gold Rush days. But I soon found out that there’s truth in those words. For every year I’ve lived here in the Sierras, the old saying has been right. Snow has fallen on the newly bloomed dogwoods.

We have three young dogwood trees in front of our house; the bracts are swelling fast and I expect they’ll be opening up, pink and white, within the next couple of weeks. And that means, yes, we’ll have at least one more storm with snow, even if it’s just a light dusting.

And then summer will sweep in.

We usually buy our firewood in early summer, when it’s less expensive. But this year, I’m hoping to get a gas or oil heater to supplement the woodstove when the weather gets cold. For the last 12 winters I’ve carted firewood into the house; the last two, it was much more difficult for me because my rheuma has gotten so much worse. The almondwood stove-lengths are heavy, painful to lift and move for my sore hands, and while Cary and Matt have been a great help this winter and last, they’re hoping to be able to move to their own home before too much more time passes.

Can’t blame them. Cary just turned in her final college class assignment for her Bachelor of Arts degree – graduation is officially in two weeks (!) and she’s got her resume out there, hoping to land a much better job. She hopes to be hired in Portland, Oregon, the place they want to live. I’ve got my fingers crossed for them even as I acknowledge my own sadness that they’ll be moving on. Such are the transitions of life.

In the meantime, changing the way we heat our house will be a good thing. I love the special, cozy warmth the woodstove gives – and we’ll continue to use it – but it won’t be the only source of heat anymore. It will be nice to be able to simply turn a heater on, set a thermostat and let it keep us comfortable.

I’m also glad that the Health Care Reform bill has finally been passed. It’s not perfect – far from it – but it is full of positive change for all of us. Personally, it means that when I find another job – whatever it happens to be – I’ll be able to get health insurance regardless of my income and regardless of the fact that I have rheumatoid arthritis, a “pre-existing condition.” I’ve worried about this a great deal since losing my job and my employer-based insurance.

I’ve been very lucky, as a veteran, to have the Veteran’s Administration health care system available to me, but I’ve never wanted it to be permanent. I’d much rather that the VA take care of soldiers who’ve served in wars and who need that care far more urgently than I do. By transferring my health care, one day soon, to a civilian system, my spot in the VA will go to some other vet. That’s good.

So hurray for HCR. There’s still a long way to go, but at least we’ve got a good start on making sure that all Americans, regardless of income and circumstances, can get medical care without facing possible bankruptcy.

For now, the VA is taking good care of me. I have two appointments coming up on Wednesday. One is for PT, and the second is with the ophthalmologist. It’s time; I’ve noticed quite a lot of change in my vision since my last visit, two years back. I think I have new lenses for my glasses in my immediate future, and I can’t wait. No more blurry vision! But more importantly, once the appointment is out of the way and I’m given a green light, I’ll start taking plaquinil, in addition to sulfasalazine and Arava. I’m hoping that it will have a positive overall effect on my rheuma. I’d sure like my hands to feel better.

And they do, today, by the way. They’re still sore – they always are, anymore – but not nearly like they were even yesterday. Today the pain is down to annoyance-level. I’d like to keep them that way, or (I can hope, right?) perhaps even pain-free.

And now, I’m off to run some errands. Finny is going with me – he’s such a kick, that little dog. We’ll go for a walk when we’re done with the dull stuff. Sun’s out, there’s a light breeze, and temps are in the 60s. Life is good.

Because it’s so easy to get grouchy and focus on all the things we can’t do because of rheumatoid arthritis, I would like to take a moment now to mention all the things we can do.

Spring bluebells

Personally, I can (wooHOO!) walk the dog. I can clean the old ashes out of the woodstove. I can dress without help. I can make oatmeal, and eat it. I can vacuum the carpets and sweep the floor. I can make beds. I can drive. I can go outside and enjoy this gorgeous run of spring weather. I can put all my many pills into individual day-packs, ready to take for the next 31 days without having to open any of those niggly small bottles. I can put away clean dishes and wipe down counters. I can type, which means I can write, letting my imagination take me away to another place and time, or even another dimension.

Of course, I can only do all these things mindfully, since my hands and wrists are going through a nasty flare (72 hours and counting). But I can do them. Sure, most of them are just chores, the daily small jobs that we all have to do if we don’t want to live in a pigsty. But it gives me pleasure to get them done. My mind is easier when my home is neat and clean, and when I know I can remember my meds and take each dose without a hassle.

What really pleases me is that, for now at least, the most of me is pain-free. When I take Finny for his first long walk later today along the El Dorado Trail, my hips, knees and feet won’t hurt.

I’m grateful for this; in the longago, I used to walk Maxwell (my old wire-haired dachshund, the one Finny reminds me so much of) while I hurt like a mo-fo. We lived in a fourth floor flat with no elevator, so every one of his four or five walks a

Not Max, but close enough.

day meant climbing up and down those stairs, one at a time, often while leaning on a cane or using crutches. Around the long city block we’d go, Max pulling as hard as he could (I never could teach him to heal) while I brought up the rear, cussing beneath my breath with each and every painful step. He’d range along in front of me, his tail sticking straight up, round bottom bouncing, his goofy short legs reminding me of those of a cartoon character, full of joy and utterly oblivious of my grouching.

Those were painful years. Agonizing years. And yet Max, bless him, taught me something very important on those countless walks. He enjoyed each of them without reservation. Even though he had to (literally) drag me along, he took total delight in his world. Because of Max, I learned to set aside my pain and notice things.

What things? How about the fairy-ring of mushrooms in the grass behind our building, each ‘shroom tiny and perfect, the ring three feet across and perfectly formed. I’d read about these in stories, but I didn’t believe they existed. Because of Max, now I know they do. There was the grand, old linden tree a block over that buzzed like a live-wire each spring, its spreading branches covered with tiny white flowers that drew tens of thousands of honeybees. We gave that tree a wide berth because I’m allergic to bees and didn’t want to risk getting stung. Nevertheless I loved it. I could hear it buzzing a block away. It filled me with awe.

In the summer, sometimes we’d walk to the vast city park a quarter-mile away. It had a beautiful rose garden I loved to visit, and a huge pond upon which floated white swans and troops of ducks. There was an old café by the pond called Das

Das Boothaus, Speckenbuettel Stadtpark, Bremerhaven, Germany

Boothaus; I’d stop at the outdoor tables for a cup of strong German coffee, and sometimes a slice of berry torte. It was a good place to rest. I’d put my throbbing foot up onto another chair and will myself to ignore it. I’d sit there and steel myself for the return walk while I enjoyed the cool sunshine and marveled that I was there at all, living and working in Northern Germany. And wee Max panted happily beneath the table, waiting for me.

Without Max, I’d never have seen real, live hedgehogs after dark. I’d never have seen one roll up tight into a ball the size of a big honeydew melon, prickles out as Max

This is a little one.

tried to figure out what to do with the pointy thing. If Max hadn’t needed his walks, I’d never have noticed the sudden, sweet scent of gardenias at night. I’d never have walked while the icy wind blew the rain sideways and the cars shoooooshed by, their tires clacking rhythmically on the cobblestones. I’d have missed the foghorns lowing across the dark city from the harbor, a mournful sound that went with cold, foggy nights like bread goes with butter.

Max taught me what I can do in spite of pain that seems to fill the mind to its corners. That I could find space in myself to notice other, much more pleasant things, even when I hurt so badly it was all I could do not to cry. I learned to count cadence to myself when we walked – the simple “HUP, two, three, four, HUP two three four” allowed me to block out pain. Sometimes I’d sing to myself beneath my breath. Simple childhood songs like “Row, row, row your boat, gentle down the stream…” And all the while, no matter the weather, no matter how hard he had to work to drag me along, Max was filled with delight.

So today, I’m thinking what I can do, rather than what I can’t. There’s a tired part of me that wants go dark and moody; wants to just wallow in misery because dammit, my bloody hands hurt! But all wallowing does is make me feel old and crabby and hopeless. I’ll admit that there are times when I indulge myself in a little self-pity party. We all do, now and then, and perhaps we even need a short break from being relentlessly upbeat. Max taught me to keep the breaks short, though. There was too much to do!

What things can you do in spite of RA? When you’re in the depths of a bad flare, where do you find your joy? What is it that makes you get out of bed each morning, even though it hurts?

We are all very brave. We live our lives with joy in spite of RA. Let’s celebrate.