An Integrative Approach
Acupuncture. Supplements. Restrictive diets. Do any of these things really work to improve RA inflammation? There's a lot of confusing information out there, mostly on the Internet, that claims they work--and that they don't. What can a person trust and believe?
I've tried some alternative treatments for my RA in the past, although a bit lazily and half-heartedly. Maybe at the time I wasn't fed up yet with having to choke down more and more pills, or exhausted from nearly constant, relentless flares in my feet and ankles. I don't know. What I do know is that I'm pretty fed up right now. My RA does whatever the heck it feels like doing, and I need to regain control. I desperately want to be in less pain, get off prednisone, lose weight, and be healthy--or as healthy as possible.
A couple of weeks ago I had an appointment at an integrative medicine clinic in South Minneapolis--one of the rare few that exist in the Twin Cities. Months earlier a friend recommended this clinic, after we had several long chats about alternative treatments for health problems. She was encouraging about the clinic, having heard good things about it from her doctor and doing research herself. Trusting her opinion, and looking for something new to tackle my disease, I began making phone calls and got sucked into the lengthy process of getting a consultation appointment.
I needed to try a different approach to managing my disease and my health. Simply put, I was sick of being sick all the time. I also didn't want to add more drugs to my already long list of powerful prescription medications that could even be making my health worse. Trying alternative therapies again seemed like a good idea, but this time I would make sure to diligently follow the doctor's advice. I knew that nothing would work if I couldn't find the discipline to do what I was supposed to do.
Plus, eating healthier, exercising, getting enough good sleep, practicing meditation and mindfulness, and replenishing depleted vitamins and minerals certainly couldn't hurt me. Those were all things I should've been doing anyway, yet my coffee, carbs, and night-owl habits kept getting in the way. Scheduling time and mustering up energy to go exercise was also a difficult habit to form and sustain. But, as a firm believer in a person's ability to start over and become successful at making changes, I was willing to try again. I had to.
My appointment at the clinic went well, and the provider spent over 1.5 hours with me, which seems incredible in today's world of 10-15 minute meetings with curt, harried physicians. We went over my medical history, as well as discussing things about my personal life and lifestyle. She asked why I wanted to be treated at the clinic and I answered, "I want help getting my RA under better control. I want to be a lot healthier and I don't want more prescription drugs thrown at me in order to achieve that."
She agreed with my answer and then went on to describe two changes I should make right away that involved diet and supplements. I had already changed my diet drastically earlier in April: no gluten, no caffeine, no refined sugar, no processed or fake foods, more fruits and vegetables. These restrictions weren't easy to stick with, especially since I was a self-diagnosed coffee/carbs/sugar addict. I felt pretty good about the willpower I had managed to hold onto until she threw me for a loop.
"You should be a vegetarian," she said. "You need to cut out all dairy, red meat, and all meat preferably except for fish."
What? No dairy? In place of gluten and the sugary carbs I loved so much, I had been chowing down on cheese every day. Lots of cheese. I love cheese! No meat? I wasn't a big beef eater, but I did often enjoy turkey or chicken. And eggs! She also warned against eggs. Hard-boiled eggs, scrambled eggs, omelets--I thought the protein and the omega-3s were helping me, not contributing to more inflammation.
I sighed. "Why vegetarian?" I asked. "What's wrong with meat?"
She explained that most people have an excess of omega-6 fatty acids compared to omega-3 fatty acids (found in fish and fish oil), and that food with too much omega-6s can make inflammation worse in people with RA. This is also the reason she wanted me to start taking fish oil capsules of around 1,000 mg three times daily--to help balance the omega-6/omega 3 ratio and to fight against inflammation. Foods to stay away from that are high in omega-6 fatty acids include: food oils (palm, soybean, corn, sunflower, vegetable), poultry, pork, beef (all meat, basically), eggs, and nuts, to name a few.
I sighed again. And started fantasizing about cheeseburgers.
Probably noticing the disappointed look on my face, the doctor relented and said, "Well, to start, if you have to eat eggs, make sure they're rich in omega-3 acids." She also told me that until I get used to eating fish (does sushi every once in a while count?), I could have a little bit of chicken. But really it was best to totally cut out meat, and certainly red meat.
"What about gluten?" I asked. The doctor replied that going gluten-free wasn't necessary unless I had an allergy or a sensitivity to it. But if I wanted to keep cutting it out from my diet, I was welcome to continue doing it. Ok, sure, why not?
Hmm. All of this was so confusing. I thought gluten makes inflammation and RA worse, doesn't it? I've read many articles preaching against the evils of gluten for people with inflammatory conditions. Are those wrong? Is my new doctor wrong? I don't know who to believe anymore.
I figured that since she's the integrative medicine specialist at a reputable clinic that takes ages to get into, I better follow her advice and see what happens. My new diet of no dairy, no meat, no eggs, and the other "no-nos" I was already trying to eliminate was going to be hard. Really hard. I was going to starve trying to live off of twigs and berries and celery sticks! However I also really need to lose weight, so I guess there's that.
One last diet change the doctor suggested was to try fasting, such as 12-hour fasts for at least a week. At least a week?! This also sounded unrealistically difficult to do and stick with, however I was intrigued at the idea. I've heard stories from other people with RA who tried fasting and their pain and swelling got a lot better. It's worth a try. Or, um, maybe worth a thought for now.
At the end of my appointment I left the exam room and headed over to the lab where six vials of my blood were drawn to see if any of my levels were off, or if I was deficient in vitamins or minerals. I was curious to see what the results would be; I wouldn't be surprised if at least something was out of whack.
After I finished getting lab work done, I pushed open the front doors of the clinic and stepped out into the bright sunlight and walked through the parking lot to my car. The appointment was long and tiring and a bit overwhelming. I felt positive though, and excited at the thought that maybe this would be the thing to finally give me significant and long-term relief, and in a healthy way.
I slowly climbed into the car, with stiff knees and throbbing ankles, and I fantasized about throwing my bottles of prednisone out the window and then running over them repeatedly. I knew that would be foolish though, because completely overhauling my diet and my life was going to require time and patience--and a lot of sacrifice.
Oh, the sacrifices. There will be many sacrifices sticking to this treatment plan. But if never having another juicy, delicious cheeseburger again could mean being pain-free--that's a sacrifice I'm willing to make.
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