Please help me!

I have been struck recently by some people of my age who seem to give up on life.  They seem to think is is somehow normal that getting older means getting ill.  No-one wants to be ill.  Being ill is a horrible thing.  And yes, in today's modern society being ill is associated with being old.  Not only that the older you get the more ill people seem to expect to be.  These people want to avoid being ill and so their solution is to hope to die quickly when it happens.  They are hoping the die (dice) spins that way.

But they do not need to rely on the spin of a die.  From my experience over the last two years I am totally convinced that a most common illnesses (many life-threatening) of the older population can be  completely avoided with close attention to just two things: what you eat and what exercise you get.  Critically to be healthy is not just about exercise.  Exercise, however hard and regular, on its own will not stop stroke or cancer or a heart attack.  The answer begins with a very serious close look at personal dietary choices, and that's where I need help.

If people very seriously look at what they consume it is possible I will not be the only last men standing amongst my friends and family!  Do I really want them to have strokes (small or large), cancers, heart attacks and yes chronic illnesses such as rheumatoid arthritis?  No, I do not.  That's where I need help.

Where am I?

Over the last few months I have had two main challenges.  That of reducing my methotrexate and also adding back foods that previously caused me arthritis problems.  Along with this I have been continuing my yoga and in fact doing more.  But let me start with my medication.

Medication: Like many people I wanted to avoid the DMARD medication such as methotrexate.  Emotionally I simply could not handle it.  In fact after starting I found no noticeable side-effects and settled down to it.  That said I refused point blank to have the dosage increased, as advised by my doctor.  Had I done that I am sure my doctor would have doubled the medication level, possibly moved on to injected methotrexate and/or other drugs.  But I held out at 10g in four tablets at first and then reluctantly allowed an extra tablet to raise it to 12.5g.

Not sure I dare post this

I am feeling very good.

Not perfect but my three good days earlier in the month at Cropredy are now being followed by a further four days, and counting...  To me a good day is when I feel I can just walk like a normal human being, no aches, no pains.  I may walk at a slow speed, but if these improvements continue then with more walking and swimming now doubt the speed issue should resolve itself.

Also I ate something on my dangerous list last night, and magically no side effects.  Does this indicate my gut is healing to the point where the gut has decided that an arthritic reaction is not the default?

This is not to say I am in the all-clear, not by a long way.  I have to come off methotrexate and that will be a slow process that may take me into next year.  I have a poorly right elbow which has not come out of the last year or so of Rheumatoid Arthritis smiling. Finally my wrists have just the smallest amount of inflammation and pain.

But altogether, anyone who says a wise change of diet cannot improve arthritis is talking hogwash.  I see stories of people who have had much more complex medications than mine, and for them the road to recovery is infinitely more challenging.  For those who have started down the road to recovery, I salute you!   I hope that my blog here gives some hope that recovery is possible.

Annoyed with myself

Not sure quite what is going on, but I have tried to stay clear of any non-MTX drugs over the last days and nights.  Inflammation and pain have followed.  This shows to me the ineffectiveness of MTX, so that's one good outcome.

I suspect that I have had some free-from foods that have dairy in them.  For instance I double checked Mrs Crimbles bakewell tart.  Yummy, but contains eggs.

It's annoying because there are not a lot of treats for someone on my diet.  Now there are even less, and it shows I need to check and double check ingredients on the label.

At this time of year my wife, a teacher comes home with several boxes of chocolates given as presents by students to say thank you.  Previously I would have helped her devour them, but no more...

Digestion, part 3: It's all about the enzymes

And so to my third blog post on digestion.  Hardly a week ago and I would have not had any substantial material to write here, rather what I had in my mind was a mystery.  Thankfully both for me and for you, dear reader, I am beginning to get an understanding.

When you read on a packet of something from the supermarket and its says so much Vitamin C or B or whatever what it will never tell you is about the enzymes.  That may be because in part packed food from supermarkets is notably low on enzymes.  Sadly fresh food, unless it is organic is also low on enzymes.  Sadly also any cooking destroys enzymes, especially that at higher temperatures and longer cooking times.  This blog post my be seen as a sales pitch for buying organic produce!  Actually it is more than that.  But let's start at the beginning, and what are enzymes and where are they found?

Day four on far less medication

I am not saying I am med free, after all I am still eliminating foods and that process caries a likelihood of reactions.  So yesterday I wanted something, or rather needed something to eat after my endoscopy.  The M&S cafe inside the John Radcliffe Hospital has a very poor selection of gluten free and dairy free products.  Considering this was a service inside a hospital, I am frankly appalled at Marks & Spencer!

The only item they had was a tomato (and red pepper?) soup with (optional) gluten free rolls.  I asked for the GF rolls, only to be served with normal wheat rolls!!!!  I complained, naturally, and the waitress went to the M&S shop next door and brought a GF loaf, from which I had two slices.

Bread notwithstanding I am safe with neither tomato nor red pepper.  So overnight my wrists both hurt and became swollen.  Not totally intolerably, but I new I would need something to get me through the night.  So on with a generous dollop of 10% diclofenac gel around the wrists and my right elbow, and thence a couple of paracetemol.

Morning is here and certainly I am not recovered fully from that flare, but I will get there.  My feet feel a bit tender so I guess that's another bit of reaction.  A bit more gel and a certain amount of patience...  Whatever my inflammation is not coming back in earnest.

Let me say clearly, the road to recovery continues unabated.  At the next meeting with my doctor I hope to place the termination of my MTX medication clearly on the agenda!  The end of MTX may be a month or two, or more away, but the end is nigh.

Oh, and by the way, my endoscopy came out with normal results.  So any anaemia problems I have are not manifesting themselves in a poor digestive system that this endoscopy shows.

PS: I have just been onto M&S website and used their live chat service for complaints and had an apology and a promise of a gift voucher.

On a downer

I did not post yesterday.  The morning started well with no inflammation and little pain and so I was feeling so pleased with myself.  But then, from nowhere, inflammation built up and thence followed by pain.  The increase did not stop through the day and into the night.  This was despite building up the meds.

What did I do wrong?  My Methotrexate day is Tuesday so perhaps I had been well with that boost and now I am on a downer as a quid-pro-quo.  I think I have had this kind of roller-coaster effect in previous weeks.  Must ask my doctor, though I suspect he will have no opinion.

My Meds

Here's the drugs I have taken/am taking...

1. Methotrexate.  Is the main drug of choice by doctors for people with bad arthritis.  It has been around for a long time (since the 1940s).  Initially used for cancer (100 times the strength used for arthritis), somehow they found it help arthritis patients.  No-one (as far as I can see) knows why it helps, or exactly how it helps - but it does.  I'll write more about this later.  For now I am on the lowest dose, which I take once a week - Tuesdays at 4pm.
2. Folic acid.  Goes with MTX to counteract MTX main goal which is depleting the immune system, by design.  Arthritis is an immune system disease.  Stop the immune system working and you stop arthritis.  The dosage of folic acid must match the dosage of MTX.
3. Codeine.  An NSAID, it is my main anti-inflammatory, and today the dosage was doubled.
4. Arcoxia. Is an emergency NSAID drug because codeine just has not been sufficient.  It is not a nice drug.  My doctor is happy that I take it because I am on regular blood tests.
5. Paracetemol.  Whilst a "normal" person is advised to take this drug for no more than a day or so without seeing a doctor, in my condition it is welcomed as one of the safest drugs for pain relief.  So, bring it on.
6. 10% maximum strength Ibruprofen gel: is used to reduce inflammation in specific areas, eg my wrists and ankles.  The active ingredient is diclofenac, which I am banned from using these days, except in this form.  On some occasions I have had generous dollops applied all around my feet.
7. Ferrous Fumarate: High-strength iron tablets to combat anemia.  Started taking it May 2016.
8. Diclofenac Sodium: An NSAID which I have possibly taken for 30 years or more, but usually not more than a blister pack per year.  Stopped taking it around June 2015.

A History of My Arthritis

Forty years ago, around the age of 23 one Sunday in spring I went cycling. By the time I got home I felt stiff in my knees.  So I rested up.  By the next morning my legs were like balloons and soon to hospital I went.

Six months of physiotherapy and a diagnosis of Psoriatic Arthropathy was the result. Not just my knees were affected, rather almost every joint in body seemed to have aged another 30 years.

This was followed by 40 years of stability leaving me to work,  play badminton, swim and walk at the weekends.  All I needed was a blister pack of Diclofenac Sodium per year of so.