Surprising Triggers

Surprising Triggers

Periodically, I encounter surprising triggers—senses that give me a jolt of anxiety and remind me of negative experiences related to my rheumatoid arthritis. When you live with RA, you live with moments that are painful and uncomfortable, that must be endured in the quest for treatment and relief. I have found that as these experiences have been accumulated over nearly four decades, that certain ones become triggers of memory and anxiety.

The RA-related smells, images, and feelings causing anxiety

Certain smells, images, and feelings bring up these memories. Sometimes they make me feel anxious, sometimes sad. But I breathe through the moment and move forward. I know the present is different than the past, but I acknowledge and respect the challenges I lived through.

  • The scent of alcohol swabs. I can’t pinpoint when it started happening, but the scent of alcohol swabs gives me the jitters. Since a young age, I went frequently for blood draws to measure my inflammation. I remember sitting in the high chair with the fold down table arm, waiting patiently for my turn with the needle. The room was always filled with that scent and I always remember anxiety about whether they would be able to get the vein (and even better: do it in one stick). Blood draws have never been easy for me and have only gotten more difficult. But every time I get a whiff of that alcohol I can feel the anxiety bubble in my tummy.
  • The sight of needles. I am not afraid of needles. I know what they can do and don’t fear them, even though I am familiar with the pain. But the sight of needles always makes me think of blood draws and the difficulty even the best technicians have in tapping my veins. I may not be afraid of needles, but I definitely do not like the look of them!
  • Entering a medical facility. There must be some universal cleaning solution used by medical facilities because every time I enter one it is the same scent that gives me the jitters. They are always overly cold as well, such that I want to leave my coat on (or wish that I brought one!). To me, the experience of sensations in these places cause discomfort and are rarely about soothing or making patients feel more relaxed. For good reasons, they are sterile and hard (easy to clean) places. After all the examinations and procedures I’ve endured, I just always feel ill-at-ease when entering a medical facility.
  • Meeting a new physical therapist. Physical therapy has done so much for me over the years to help maintain my health and keep as many abilities as possible despite an aggressive case of RA. But don’t get me wrong, they can scare the bejeezus out of me! My experience with PT has often been a pain. It is a part of the process, whether I’m just working hard at my exercises or the therapist is doing a range of motion or massage that hits just the right painful spot. The pain leads to gain, but I definitely do not enjoy the process! So when I meet a new therapist I get anxious about how it will go. Thankfully, I’ve had really good therapists who have helped me along the way.

As a child, I used to really hate Wednesdays. This was because I had weekly blood tests and that was the day designated to go. For a long time, the hatred of midweek lingered even after the weekly tests stopped. I couldn’t figure out why I felt such anxiety on Wednesdays, but then it dawned on me that the actual day had become a trigger. After I realized it, I could face my fear and it eventually faded.

I imagine that others with RA have collected their own triggers. While it’s uncomfortable, I think it’s important to recognize and reflect on them, to treat yourself kindly during these moments.

What triggers have you developed with your RA and how do you manage them?

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.


View Comments (9)
  • starscream
    1 week ago

    I have begun to fear a hug or a squeeze on the hand. And I have become afraid of sexual advances from my husband as well. He’s not rough at all, but even when I’m on top I might jar my knees. So now, even when not flaring, I have begun to fear sex: to flinch away from a touch. I really would welcome the comfort of a hug but I duck away from raised arms. I would enjoy some passion but I freeze up. We always had a loving sexual relationship before. At this point I wonder if the only way I could safely have sex is if I sit on a table, but how will I climb up there? My husband cannot lift my 200lbs. But really, when I’m not flaring a bed ought to be fine if only I could stop fearing the pain.

  • Indigo2
    2 weeks ago

    The weather becoming cold & rainy…I know I will have severe pain in my joints.

  • DeborahK
    2 weeks ago

    I completely relate this this! Just last week I noticed a trigger for feelings of anxiety around RA going back to childhood. I sing in a chorus that rehearses weekly in the building that the SF Girls’ Chorus uses, on the third floor. I always take the elevator up and down. There is a sign next to the elevator on each floor that says: “Girls Choristers may not use the elevator, you must take the stairs.” I realized last week that this sign induces anxiety and unease for me, because I remember being a kid with RA who didn’t look outwardly disabled most of the time but actually was. I feel like a child again when I see that sign – I would’ve been convinced I wasn’t allowed to use the elevator either, even if I needed to, and I would’ve been scared that if I did try to use it, an adult who didn’t know me would tell me I wasn’t allowed because I looked able-bodied – or that other kids would call me out and give me a hard time. So many times like this during childhood, I suffered in silence and didn’t think I had the right to ask for help or accommodation. It would be so easy for them to add a caveat to that sign: “unless you are injured or disabled.” It might not prevent kids who are invisibly disabled from having to advocate for their right to use the elevator, but at least it would let them know they had that right!

  • Lawrence 'rick' Phillips
    2 weeks ago

    I have almost all of the same triggers, However I have found ways to overcome some of these.

    My additional trigger is explaining to someone what Ankylosing Spondylitis is. I hate doing that.

  • Dalia
    2 weeks ago

    Definitely blood draws and needles are a trigger for me! My rheumy switched me to injectable Methotrexate and the shots stressed me so much that I felt it negated any good the shot did. So I asked to go back to oral and the stress levels dropped a ton. Still hate the blood draws every 2 months but at least I’m blessed with great veins. Gentle hugs in dealing with your triggers!

  • Monica Y. Sengupta moderator
    2 weeks ago

    Hey Dalia @zaismas! Thanks for sharing! I am the same way with my MTX injection. The alcohol prep always triggers nausea and some level of anxiety. Interestingly, I don’t have the same problem with my infusions. I guess they are two different situations?

    All the best, Monica

  • DeborahK
    2 weeks ago

    Oh, yes, for me too, the alcohol prep smell before I do my MTX injection triggers nausea and anxiety; sometimes I even gag when I smell it – my body anticipating how the MTX will make me feel.

  • Jo J
    2 weeks ago

    I went through a very traumatic year prior to diagnosis. Tons of pain, fatigue and a Rheum who didn’t believe or care about diagnosing and treating me. It left me with PTSD that affected me daily for the next 18 mos. It took me that long to feel the support and help the right Rheum with a great office staff could offer me. I don’t know my triggers yet, but every once in a while I get an overwhelming sense memory from that time. I will get angry and scared. I deal with it by practicing writing her letters in my head. Sometimes I actually print them, then shred them.

  • Monica Y. Sengupta moderator
    2 weeks ago

    Hey Jo!

    I am so sorry you’re dealing with this. I can only imagine how difficult that year was but I am so glad you found a doctor (and office) that supports you.

    Please know you can always come here if you ever need to talk or vent. We are here for you!! ~Monica

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