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Memory Palace for those precious memories

16aI’m sure that you have heard how helpful a memory palace can be.   Generally, a memory palace is a system for remembering information.  It is a very special system and can be used in a variety of ways.

It is an excellent way to store all your favorite memories so you know where they are located.  It is a place to visit when you want to feel good.  The memory of a feeling, the  feel of a breeze on your cheek. The smell of the fresh morning air. Hugging your chubby baby. Hearing your favorite guy laugh. The good feelings of friends and family happy together. Happy carefree times with children. Valuable memories. It can be memories of favorite books, movies maybe.

A memory palace can be anything. Mine is a comfortable old white house with a wrap around porch. An old fashioned wooden screen door. Hardwood floors. Library where many of my memories are stored. A kitchen. Back porch and trees.   I can add rooms but I do think mood more than specifics. I can go instantly into the library or I can leisurely enter the house.

My purpose in building a memory palace is to have  all the favorite memories I love in special places in my mind so that when I am very sick and not able to do a lot or I just want to feel good, I can go into my mind,  locate my palace, climb the short steps to the porch, check out the flowers on a nearby table, open the screen door and walk down the hall and  into the library where I have stored my precious memories on the shelves.  I take down a favorite, sit in a cozy chair and revisit the memory. So very nice. It is mine. Yours will be yours. It can be anyway you want it to be.  Try making one.

This memory palace is for all the good memories no matter the size. There is plenty of room for adding new memories and for adding memories lost, but found again.

(The children in the photograph are my grandchildren. I made the image on one of our adventures, a memory that will always be in my memory palace.)


Exploring and moving

Do you really want to spend any time walking on a treadmill or  riding a stationary bike?  Indoors?

Sure, it’s great if you live in Watertown, NY and you get socked in with snow. It’s also good if you live in a bad neighborhood.  But if you live in Albuquerque( ABQ to us), there is more to be had.

sandhill cranes

Sandhill Cranes


 Walking with your camera in the great open spaces.

I am a professional photographer. I have all the big expensive cameras with the impressive lens. I also have a seriously progressing Rheumatoid Arthritis. I have been lying low with pain and inflammation. Finally, I am ready to move again.  Baby steps.  Out walking trying to get my legs again, I take an old Canon Sureshot 850. Fixed lens. Fast enough. Satisfying. Easy.

I would never have seen these Sandhill Cranes when walking on a treadmill. I love these guys. Makes my heart happy to see these 4 foot visitors from the North. One of the oldest surviving birds, they mate for life and care for their young for a year.

Why can I walk?  I have damaged feet!  Well, lucky me for having George Ochs as a podiatrist. He fitted me with a brace for my left foot and ankle and sent me for orthopedic shoes. My feet are much happier. Don’t know how long it will last, but I am out exploring the open space along the Rio Grande. Good for the body, the soul and the mind. Making happy memories.

Finally, a life

I sit here in the morning with coffee. Write in the faithful journal and read a bit. My fireplace is just to the left of the table.

I really thought I was going to die last year.  To prepare, I filled out the final wishes form.  Next, I made an attempt to simplify my financial records. I said thank you to all the people who have been helping me the last few years. I had a garage sale. What the heck, I thought, I would be the one to get the money if I had one before I died.

Just as I thought things were going to get worse, they were already terrible, I started coming out of the methotrexate fog.  I could think clearly again.  O happy days.  At least I had my mind.  Both cancers could return.  My RA could leave me immobilized.  Yet, I would be able to read.  My favorite thing to do.  Preston and Child’s Pendergast series. Baldacci’s adventures. All the fascinating medical books. I could be happy.

The methotrexate injections, plaquenil, leflunomide and the prednisone finally calmed the ever present inflammation in my body.  This was after 2 years.  And it may not last long but it is still a possibility.

With my fancy orthopedic shoes, great inserts. (It is a shame medical insurance doesn’t cover this.), my feet are in half  my regular pain.  Expensive, yes, very. But so worth it.

This week I have been doing my conditioning exercises. Today I went for a 20 minute walk in the open space and watched  the Canada Geese hanging out on the Rio Grade.

I did not die in 2014.  My story is good for now.  Life is better and I don’t expect to die in 2015.

Such a relief.

The challenge of Feet

RA tests

My rheumatologist sent me to a podiatrist, a foot doctor.                 Charming man. Once a client of mine.        X-rays were ordered, the podiatrist way.

Standing. Weight bearing. Three views each.  For the third view I climbed steps  and was x-rayed  at foot level.   A  much better test than the standard foot  x-rays.

Results: persistent degenerative changes with in the feet bilaterally.

I admit that this was expected. What happens next?  My doc said surgery is not the answer.  As my feet get worse he feels steroid injections would be helpful.

Now it is important that I wear shoes that fit  well and offer good support.  I should also wear special inserts (Motion Control performance insoles by Prothotics). I got the inserts first.  They are so much better than anything you will find at Target or Walmart. They have support for feet in areas that are thinning in RA.

He suggested our New Balance store or REI.  New Balance was closer. They fitted the inserts and fitted me for shoes that have lots of room for my toes, heel and arch support. I got two pairs, different models. Best to alternate shoes.

Excellent shoes plus extra special support. My feet hurt a lot less.  I do have much happier feet and I believe my RA will progress much more slowly.

Podiatrist+x-rays+shoes well fitted with support and cushioning+extra support with special inserts=MUCH HAPPIER FEET!


Rheumatoid arthritis classification criteria 2010

An international test evaluation for RA.  I scored 7 and I am RF negative.                                                        2010 Rheumatoid Arthritis Classification


Target population (Who should be tested?): Patients who

  1. have at least 1 joint with definite clinical synovitis (swelling)*
  2. with the synovitis not better explained by another disease†
Classification criteria for RA (score-based algorithm: add score of categories A – D;
a score of ≥6/10 is needed for classification of a patient as having definite RA)‡
A. Joint involvement §
1 large joint¶ 0
2-10 large joints 1
1-3 small joints (with or without involvement of large joints)# 2
4-10 small joints (with or without involvement of large joints) 3
>10 joints (at least 1 small joint)** 5
B. Serology (at least 1 test result is needed for classification)††
Negative RF and negative ACPA 0
Low-positive RF or low-positive ACPA 2
High-positive RF or high-positive ACPA 3
C. Acute-phase reactants (at least 1 test result is needed for classification)‡‡
Normal CRP and normal ESR 0
Abnormal CRP or abnormal ESR 1
D. Duration of symptoms§§
<6 weeks 0
≥6 weeks 1

The criteria are aimed at classification of newly presenting patients. In addition, patients with erosive disease typical of rheumatoid arthritis (RA) with a history compatible with prior fulfillment of the 2010 criteria should be classified as having RA. Patients with longstanding disease, including those whose disease is inactive (with or without treatment) who, based on retrospectively available data, have previously fulfilled the 2010 criteria should be classified as having RA.

† Differential diagnoses vary among patients with different presentations, but may include conditions such as systemic lupus erythematosus, psoriatic arthritis, and gout. If it is unclear about the relevant differential diagnoses to consider, an expert rheumatologist should be consulted.

‡ Although patients with a score of <6/10 are not classifiable as having RA, their status can be reassessed and the criteria might be fulfilled cumulatively over time.

§ Joint involvement refers to any swollen or tender joint on examination, which may be confirmed by imaging evidence of synovitis. Distal interphalangeal joints, first carpometacarpal joints, and first metatarsophalangeal joints are excluded from assessment. Categories of joint distribution are classified according to the location and number of involved joints, with placement into the highest category possible based on the pattern of joint involvement.

¶ “Large joints” refers to shoulders, elbows, hips, knees, and ankles.

# “Small joints” refers to the metacarpophalangeal joints, proximal interphalangeal joints, second through fifth metatarsophalangeal joints, thumb interphalangeal joints, and wrists.

** In this category, at least 1 of the involved joints must be a small joint; the other joints can include any combination of large and additional small joints, as well as other joints not specifically listed elsewhere (e.g., temporomandibular, acromioclavicular, sternoclavicular, etc.).

†† Negative refers to IU values that are less than or equal to the upper limit of normal (ULN) for the laboratory and assay; low-positive refers to IU values that are higher than the ULN but ≤3 times the ULN for the laboratory and assay; high-positive refers to IU values that are >3 times the ULN for the laboratory and assay. Where rheumatoid factor (RF) information is only available as positive or negative, a positive result should be scored as low-positive for RF. ACPA = anti-citrullinated protein antibody.

‡‡ Normal/abnormal is determined by local laboratory standards. CRP = C-reactive protein; ESR = erythrocyte sedimentation rate.

§§ Duration of symptoms refers to patient self-report of the duration of signs or symptoms of synovitis (e.g., pain, swelling, tenderness) of joints that are clinically involved at the time of assessment, regardless of treatment status.