Like Gasoline on a Fire
Over the past decade, I’ve become keenly aware of the impact stress has on the activity level of rheumatoid arthritis in my body. I was diagnosed during my senior year of college, and in the 16 years since I have gone through graduate school, a series of job changes, various family crises, and the creation of a family of my own. This journey has included peaks and valleys, joys and sorrows, and times of intense stress and periods when life feels more manageable. I’ve now had enough life experience to recognize that the times with the most frequent, severe, and/or long-lasting flare ups of disease activity are the times when I was dealing with the most stress.
What does RA flare-up mean?
The term “flare up of symptoms” is apt. RA burns like a slow flame through the body, and a variety of factors can influence the height of the fire. When symptoms increase, sometimes completely unexpectedly and with severe intensity, it does seem like the fire of RA “flares.” There are all kinds of factors that can act as oxygen feeding an open flame, such as barometric pressure and weather changes, infections, overexertion, repetitive motion, and lack of sleep. Some people have also found that eating certain foods leads to an increase in their RA symptoms. When a person with rheumatoid arthritis experiences a trigger, the bonfire of their disease activity can burn brighter and hotter.
How stress can impact chronic conditions like RA
When it comes to stress, I feel like it impacts this fire more strongly than a breeze of oxygen, more closely resembling gasoline in the severity of symptoms it can ignite. Oftentimes stress is cumulative. We may not be experiencing a crisis, but may be dealing with financial worries, toxic work environments, marital discord, and family concerns that all contribute to our stress level. I work as a behavior specialist in public high schools, and in speaking with students I frequently describe our capacity for stress as a glass, and the stress as water. Sometimes a crisis happens, which can pour a huge amount of liquid into our “stress glass” all at once. Other times, multiple events add smaller measures of stress to the glass. Either way, the stress can accumulate and rise to levels that cause us to “spill,” resulting in emotional outbursts, mood swings, or, for those of us with chronic conditions such as RA, increased health problems.
Here’s where my metaphors collide: when my stress glass spills over, it isn’t like water pouring, but rather like gasoline splashing on the bonfire of RA. Stress sends me into a flare like nothing else. When my stress glass is being filled slowly with minor events and underlying stressors, it can be difficult for me to connect the fullness of the glass with the increase in my symptoms. However, when a crisis hits and my pain and inflammation immediately burn bright, the connection is obvious.
Stress, RA, and work
In my job, I frequently work with students who use violence as a means of resolving conflict. My office is located in the “Security” area of the high school (it saddens me that schools require security personnel nowadays, but that is our current reality), next to the on-site juvenile justice probation officer, the School Resource Officers, and the In School Suspension classroom. Therefore, when a student is in crisis and becomes violent s/he often ends up in my area of the school. Last week, a fight broke out just outside the Security area’s doors. The crowd of spectating students was making it difficult for the School Resource Officer to separate the boys, so she opened the doors to push the fighting students into Security to separate them there. Hearing the commotion, I went out to lend my assistance just as she was opening the doors. While she was able to get the fighting teenagers through the doors, she wasn’t able to keep out the wave of students that spilled into the Security area wanting to watch the fight. I tried my best to hold students back in order to give the security officers room to separate and restrain the boys who were fighting. The air was thick with the excitement of the onlookers, and it made me feel sick to my stomach.
Protecting my mental health
More security personnel and teachers made their way into the room, and we were able to clear it of all students who were not directly involved in the fight within a couple of minutes. The experience left me feeling shaken, as it troubles me to my core how violent today’s youth can be, and how they seem to feed off of brutality like sharks smelling blood. As I felt my adrenaline levels decrease back to normal, my pain level skyrocketed. That fight was like a huge pour of gasoline into my stress glass, quickly overflowing and dousing my RA bonfire in rain of flammable liquid. First my wrists started hurting, then pain shot into my elbows, and moved up into my shoulders. Next my hips felt burning surges of discomfort, followed by my knees. I felt like a connect-the-dots picture with a stream of pain coloring between the points. This flare continued for the rest of the afternoon, evening, and following day. Fortunately, I made it to the weekend, and the flames of the bonfire quieted back down to warm embers of manageable discomfort.
There are some winds that I cannot control, and these will feed the flames of RA from time to time with little I can do about it. However, the gasoline-like effect of stress on my disease activity is something that I do have some level of control over. While the students at the high schools are in dire need of the services I have to offer, it is wreaking too much havoc on my health to be in a setting where such extreme stress can ignite at any moment. Therefore, I have recently accepted a job for next school year at a private school, where several friends of mine are employed and say the work/life balance is far healthier than in the public school system. While there is a part of me that feels like I am deserting the children with highest needs, I’m making an effort to prioritize my own needs so that I can keep the flames of RA as low as possible.
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