Month: November 2024

Happy Thanksgiving

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I made my favorite cake this week. It is a cranberry spice bundt cake. Fresh cranberries. Cardamon. Ginger. Sour cream. It is a moist, flavor filled cake. I found it in the New York Times last year. It had previously been in a book on cakes. A dependable bake. Baking involves a series of specific procedures performed in a specific way. When is the cake done? Most of the time you can tell by looking at it. It looks done.  Now just to confirm my choice of doneness, I use a food thermometer. Cakes are usually done about 195⁰F to 200⁰F. Today is our Thanksgiving holiday in America. It is a family day. People fly and drive long distances to be with family. It is a day of too much food for many. Favorite family recipes. Storebought sides.  An aunt’s pumpkin pie recipe. The food is generally the same but people do rebel against the standard fare. Turkey, stuffing and mashed potatoes continue to be the standard fare. I have an excellent recipe for an …

RA and Heart Disease

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The number one cause of death for those with rheumatoid arthritis is cardiovascular in origin.The mortality rate for those with RA is 2.5 times what is normal for everyone else. The increased rate of cardiovascular disease (CVD) in those with RA is caused in part by accelerated atherosclerosis (hardening of the arteries) due to the chronic inflammation of RA. Atherosclerosis is the most common cardiovascular manifestation in RA. Inflammation is bad for the body. It causes damage. Early aggressive treatment for RA may reduce the inflammatory process and reduce the number of deaths due to atherosclerosis. Paradoxically in RA, a low BMI (less than 18.5) has been associated with a high CVD risk. RA doubles the risks of most heart related disorders including Those with RA have twice the risk of heart failure. The risk is higher in those with seropositive RA than  it is with those who are seronegative RA. RA patients do not have the typical signs of heart failure so they might be treated less aggressively than they need to be. Rheumatoid …

Cannabis at Eleven

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For about half of us the biologic medication of the last twenty-five years has been helpful in reducing symptoms and lessening disability. Methotrexate has been a big help. It is especially helpful when given in combination with the biologics. The JAK inhibitors can cause cancer. Since I have had five cancers, they are not advisable. It has been eleven years since my diagnosis. I have learned to live with my symptoms. I do know that it is important to keep moving. Sitting in your favorite chair reading a good romance novel or instead catching up with your broadcasts, or podcasts, is inviting. But it is still important to alternate physical motion with sitting in the easy chair. We all know how stiff we feel after sitting for a while. It is called gelling. I still have a bad flare that lasts a week once a month. There is not much I can do when my pain level is between a five and a seven. The inflammation level is high and makes me feel sick. I …

RA, a Progressive Disease

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I have seronegative rheumatoid arthritis. That means I have more issues with inflammation and less joint damage that a person with seropositive rheumatoid arthritis. My rheumatologist sometimes thinks they must be two different diseases. Once diagnosed both are given the same treatment. I was on methotrexate for seven years. It helped about fifty percent. Biologics helped anywhere from twenty to fifty percent. The combination made life bearable. Methotrexate had been a difficult drug with the side effects of nausea and diarrhea. They passed. With the injectable version of methotrexate, the side effects disappeared. I have a history of breast cancer that required surgery and radiation. It left my breast tissue with poor circulation. I developed methotrexate black box complication number thirteen, soft tissue necrosis. It took ten months to heal and included surgery. Absolutely no more methotrexate, or it would happen again. So I lost my fifty percent relief. I was lucky to get twenty percent relief with the biologics. I have been through most of them. The TNF inhibitors can cause cancer and the …