Author: Mary Mann

Spondylolistheses

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Spondylolisthesis  frequently occurs in the lower spine. A vertebrae is gradually pushed out of position. I had a spinal fusion years ago. The vertebrae above it was gradually pushed out of position. The classic symptom is not being able to stand without pain for more than ten minutes at a time. It can block nerves coming from the spine and cause paralysis and severe pain. I have pain in my lower back radiating to my left hip. Sometimes when getting up from a chair or getting out of a car my feet are numb and take a moment to have feeling  return. Additionally, I believe the murder suspect mentioned that he had trouble with sexual performance. Severe pain can be a problem. The slippage can also cause bowel or urinary problems. Physical therapy, over the counter NSAIDs are recommended (not for the elderly), rest, oral  steroids  and steroids injected into the back might help. Surgery is last resort. I take pain meds, steroids, and cannabis for my RA so these measures might help my back. …

Adapt or Perish

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“It isn’t the strongest of the species which survives, neither the most intelligent, but rather that which adapts best to change.”  Charles Darwin He must have been talking about rheumatoid arthritis. The most difficult aspect of RA is its unpredictable nature. RA may be simmering.  Suddenly, without warning, a severe fatigue, an exhaustion so bad its immobilizing,  arrives to totally disrupt your day. New severe pain in your right foot makes walking impossible. The simmering pain becomes more than simmering and the constant hurting becomes discouraging. A drug that has worked so well stops working. A very short list of RA’s unpredictable nature. What to do? Adapt and survive. The number  one consideration is your attitude. You will need to come to the understanding that you have a chronic, progressive  illness. It is not going away. And YOU are in charge. You have the balancing act between controlling symptoms of RA and the side effects of medication. You know the importance of RA medication is to avoid crippling disability, which is guaranteed without proper medication. Consider …

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 …

New Book and cannabis report

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I finally finished my book. I published it as a Kindle book. An adventure. A romance. Science fiction.  Matilda Finnegan meets up with an old acquaintance . A handsome six foot white hair, sexy  blue-green eyes charming man. Romance blooms. Adventure beckons. The story is about outcasts from a nearby planet finding refuge on Earth. Their obstacles and their romances.  Book website, Matilda and her Alien and place to buy,  Amazon Book site I have known about my rheumatoid arthritis for about eleven and a half years. A little more. Despite Kevzara, steroids and cannabis, I still have a week long severe flare at least once a month. The flares are bad. Most of the moveable joints in my body are affected. All but my knees. Strange ads that seems. However, flares  are still better than what they were. The inflammation  is reduced. My RA seems to simmer the rest of the time. Not good but better than it was. I am on the last biologic left to me. I either have tried them or …

Diagnosing rheumatoid arthritis

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Once a person has at least one joint that is painful and inflamed, a rheumatologist can use a ten point check to help diagnose rheumatoid arthritis (RA). The assessment covers four areas: joint involvement, serology, acute phase reactants plus duration of symptoms. There is a total of ten points. A score of six confirms a diagnosis of rheumatoid arthritis. Here is how it breaks down. Choose one from each group and total.. A. Joint involvementOne large joint 0 points2-10 large joints 1 point1-3 small joints 2 points4-10 small joints 3 pointsGreater than 10 joints including at least one small joint 5 points B. Serology (blood tests)Negative RF and negative ACPA 0Low positive RF or low positive ACPA 2High positive RF or high positive ACPA 3 C. Acute phase reactants(inflammation blood tests)Normal CRP and normal ESR 0Abnormal CRP or abnormal ERS 1 D. Duration of symptoms< 6 weeks 0 6 weeks 1 My choices are a total of 7. Note I am seronegative, and it took a lot of joint involvement to get a positive diagnosis. …