images of a brick wall, a semi-truck, and a train coming from starbursts.

The Brick Wall, the Big-Rig, and the Train

Some days, I run into the brick wall. The fatigue sets in, the pain begins, and I must rest a little. Typically, if I rest, the brick wall recedes some and I can function. Our culture is big on “pushing through the pain”, “don’t give up, give out”, and “no pain no gain”. Following this advice can be a nightmare with rheumatoid disease.

A progression of pain and fatigue symptoms

If I fail to rest when the brick wall hits, I am quickly run over by the big-rig. You know, the eighteen-wheeler on the interstate going 75 miles an hour. Wham!! Everything hurts, the brain fog is present, and the fatigue is close to overwhelming. My body cries out for rest and pain relief. Arthritis-strength acetaminophen, Voltaren gel, and a major nap are required. It may take several days of rest to be fully functional again.

Believe it or not, this is a mid-pain day for me. It is not the worst. If I push through on a big-rig day, the result is predictable and horrible.

When ultimate pain makes is hard to function

Ultimate pain can be the result of pushing through the big-rig day, or it can happen out of nowhere. On June 24, 2020, I had a great day. I was able to walk a little, cook a little, and my brain was in gear.

So, I was taken by surprise on June 25, 2020, when I woke up after being hit by the one-hundred car train!! Barely able to make it to the bathroom, I took my meds and stumbled back to bed. A quick text to work and went back to sleep. Having been awakened 4 hours later by a son needing a ride, I decided I could work.

Two hours later, I was miserable. Back to bed with more meds. I needed to take my opioid med but couldn’t due to mom-driving needs. Finally, I was able to go to bed and sleep. June 26, 2020: Better today, but still need meds. I was able to work a few hours. It seems like this train will not need a steroid shot.

What's normal in managing RA?

What is normal for rheumatoid disease? Those of you who are new to this diagnosis need to understand that there is no normal. We are all unique. We react differently to medications, exercise, nutrition, treatments, and supplements. There is no one way to do it.

Find methods that work for you

Pain management. This is also unique for each individual person. It takes time to determine what works for you. Heat or cold therapy? Heat works best for me and my disease is much more manageable in warmer months. For some, cold is the treatment of choice. Medication treatment takes time to work out.

Be honest with your healthcare team

One of the best ways to manage your pain is to be brutally honest with your rheumatologist. Tell them what you can no longer do because of pain. The more specific and concise you are, the better results you will receive.

Seek support through a community

Reading stories here at about others who understand has helped many of us. I have learned all sorts of options and tried new things. We welcome suggestions and questions.

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This article represents the opinions, thoughts, and experiences of the author; none of this content has been paid for by any advertiser. The team does not recommend or endorse any products or treatments discussed herein. Learn more about how we maintain editorial integrity here.

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