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Suiting Up . . . For a Day at the Office

Most people familiar with rheumatoid arthritis understand that mornings are tough. Those of us with RA tend to experience morning stiffness, so we need more than a cup of coffee to get moving in the morning. Sometimes before I get out of bed I have to make fists and extend my fingers several times, roll my wrists and ankles in circles, and bend and straighten my knees before I feel ready to stand on my own two feet. Once I get out of bed, some additional stretches and yoga moves are sometimes necessary, as my arthritis pain can also lead to muscle tension and soreness. Then, finally, it is coffee time.

However, if my disease activity is at a higher level, my arthritis morning routine doesn’t stop once my morning stiffness ebbs away. I have to take additional steps in order to get through a workday. First I’ll take the maximum doctor-recommended dose of either acetaminophen or ibuprofen (I alternate them). Then after my shower I’ll apply either over-the-counter topical analgesic patches or prescription lidocaine patches. The latter are expensive, costing me just under a dollar a pop after my insurance plan’s portion. So as I apply them I say to myself, “Is the numbness worth a dollar? Yep. Is it worth two dollars? Uh-huh. Is it worth three dollars to take the edge off this pain? It sure is.” Three is the maximum that can be applied at one time, so I don’t have to take that line of questioning any further. However, if multiple joints are flaring, I do have to decide which three offenders get the patches, bearing in mind that large joints like my hips and sacroiliac joints can require two patches for adequate coverage.

Then I go about the rest of my morning preparations. On bad mornings such as these, I am truly blessed to have a husband who steps in and does the bulk of the work to get our kids ready for preschool. The rushing around to get myself out the door is hard enough, but chasing after a two year old with socks and shoes in hand just isn’t feasible when I feel really bad. The last thing I do before leaving is a mental inventory of any aides I might need, such as wrist splints or replacement patches. Finally, I get into my car.

On mornings like this, I can feel totally exhausted before my workday even starts. Of course the pain and fatigue symptoms contribute to that, but when my joints are inflamed so much extra thought goes into my preparations and my movements that I feel worn out before my day has even really begun. Sometimes as I smell the menthol scent of the over-the-counter pain patches, I’m sent back to my soccer-playing days, when players would rub ointments on their sore muscles. In a way I feel much like an athlete before a big game, going through a routine of preparations and psyching myself up for what lies ahead. However, in my case it isn’t a winning touchdown or the perfect free throw that I’m aiming for, it’s just making it through a day at the office. On bad days, someone else’s mile is my marathon. And on these achy, painful days I have to calculate my movements and put in a lot of prep work if I’m going to make it across the finish line.

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

Comments

  • winnben1945
    3 months ago

    My comment is concerning the person changing Drs several times. I completely understand where they’re coming from. I was diagnosed three yrs ago with RA and Lupus and have tolerated waiting up to two hrs to see Dr. Lately she spends about two to three minutes in the room with me. She has never told me anything about my blood work, condition, if she feels I’m improving, etc. There simply aren’t that many Rheumatologists around so it’s just easier to stay.

  • Tamara Haag moderator author
    3 months ago

    Hi winnben1945,

    I hate that you are going through that! This disease is challenging enough with a good doctor, and contending with it while feeling like you’re not getting the attention you need makes it so much harder. You may find you can relate to this article about the difficulty in finding a good rheumatologist: https://rheumatoidarthritis.net/living/trials-and-travails/.

    The American College of Rheumatology has a search tool that you can use: https://my.rheumatology.org/find-a-rheumatologist. However, I think a search engine probably provides more results, but just in case anyone pops that you haven’t been able to find via a search engine, I wanted to share it.

    Thank you for sharing your experience, as I know others in our community can relate. I wish you all the best in your search for a better doctor (I’m even wishing that a new rheumatologist will decide to open an office near enough to you that you can have another option).

    Gentle hugs,
    Tamara

  • Coffeecraz
    3 months ago

    No coffee??? I had no idea. I’m having horrible flare right right now should I quit coffee? Not sure I can.

  • Tamara Haag moderator author
    3 months ago

    Hi Coffeecraz,

    If there’s one thing I’ve learned about rheumatoid arthritis over the nearly two decades I’ve had it and from moderating on this website and our Facebook page for the past few years is that there is nothing that works for everyone. There are people who swear by certain diets and others who say the exact same diet did nothing for them. There are people who go into medical remission on a biologic and other people who experience no benefit whatsoever from the same drug. My sister also has RA/RD, and we’ve discovered that even sharing DNA, we still react very differently to different treatments and triggers.

    I recommend you talk to your doctor about your current treatment plan and, if you haven’t already, the flare you’re currently experiencing. Then once you get past this flare you can consider experimenting with a dietary change such as eliminating coffee. While you may find that eliminating coffee makes a big difference, you may also find that it makes no difference for you, as everyone is so different. Therefore, I recommend that you not make a major change while having a bad flare and that you consult your doctor.

    I hope you find some relief from this flare soon,
    Tamara

  • Floydrr
    4 months ago

    Hello! Thanks for sharing. I was diagnosed over 4 years ago with RA and am 53. So far Methotrexate has worked well to control my pain and inflammation most of the time. I have averaged about 3 times per year having a month with a random painful joint swelling and feeling more exhausted. Having chills and a general not well feeling. The rest of the time other than feeling more tired than normal I am good. After the holidays end of December I had a rough few weeks and that required Prednisone. Then Jan 1 I started a diet challenge with several at work. Doing this I cut out almost all sugar and am doing low carbs and very little dairy. It’s too early to know for sure but I’ve been feeling so much better. My fingers that I didn’t know were so swelled look so different and I’ve been able to wear rings that I haven’t worn in ages!! I’ve lost 8 lbs but have 22 to go. My diet has been an eye opener for how food makes a negative impact on my RA. I recently started doing the Classical Stretch (http://classicalstretch.com/) that takes about 20 minutes each morning. I feel so good afterwards! It really scares me to think some day there may not be anything I can do to prevent my RA from making me disabled and in constant pain but I want to do all I can to prevent that. I do drink coffee and haven’t heard that I shouldn’t until previous comment. Now I’m wondering if that’s something I should eliminate. I’m thankful for forums like this that we can see what others are experiencing and possibly help each other.

  • Monica Y. Sengupta moderator
    4 months ago

    Hey @floydrr! Thanks for sharing your story! I am so glad the changes have worked in maintaining your RA!

    You mentioned changing your diet. May I ask, are there any foods you have noticed makes a difference in your symptoms? For me, personally, potatoes and butter are major triggers for inflammation!

    All the best, Monica

  • Floydrr
    4 months ago

    I was really going crazy eating sweets through the holidays and I have almost cut all of them out. Sugar is probably one for sure. I did give in to some free Ben and Jerry’s ice cream at work one day and had a little flare 2 days later. I have not had a potato since I started this diet and am cooking with a little olive oil or spray now. I have had butter on a sweet potato but didn’t notice any change.

    One thing that happened a few days ago. I have been chewing a lot of gum to help myself not eat. I caught myself chomping on it pretty good and that night I had a pain hit my jaw that lasted a few hours. I put ice on it and took some ibuprofen and the next morning it was just a little sore. So no more gum! I have started doing the carb cycling this week so I will try a potato Friday and see what happens. I’ll let you know.

    I know for sure that when I can’t eat due to a virus or fasting for a colonoscopy, my pain is gone along with the tired foggy feeling. This realization made me try to only drink water and broth a for a day or 2 when I was having a bad pain and it is like magic.

  • magienoire
    4 months ago

    Thanks for sharing. Before I left my full-time job, I had reached the point that I was getting up 2 hours before I needed to leave the house, just so I could sit/stretch/drink coffee long enough for the physical stiffness and mental fog to ease up. Then, even while getting ready for work, I’d pause to lie down flat on the floor for 5 minutes a couple of times, and summon the energy to carry on.
    The disease so insidious; these changes had occurred so gradually that I didn’t realize how abnormal it all was!

  • Tamara Haag moderator author
    4 months ago

    Hi magienoire,

    Thanks so much for sharing your experience – it is so familiar! There is emotional healing in knowing we are not alone in struggling to cope with this awful disease. Thank you for sharing a bit about what you’ve gone through.

    Wishing you all the best,
    Tamara

  • starscream
    4 months ago

    Thank you for posting about how you prepare for work. I’m also working but have flexible hours so I don’t have to go in on a bad day unless I’m giving a presentation. I schedule those for the evening which helps a lot. I do not have as much pain as you describe having and don’t use patches. I mostly try to avoid flares by watching what I eat.

    My doctor forbid me to drink coffee or smoke. So I stopped coffee and am cautious to avoid even second hand smoke. I do eat dark chocolate. I also avoid other foods specific to me and have friends who avoid different foods than I do for RA. When I do mess up and eat something by accident I have a flare that lasts two weeks. Then I need a cortisone shot or prednisolone before I can function at all.

  • Monica Y. Sengupta moderator
    4 months ago

    Hey! I just wanted to jump into the conversation because I am addicted (ADDICTED) to coffee. I echo Tamara in that I drink it even more when my RA fatigue flares.

    I hadn’t heard drinking coffee was a potential trigger but now I’m interested. I am sure I drink too much of it but I’m curious how long it takes to see a difference and what kind of difference cutting the coffee out makes?

    Thanks! ~Monica

  • Tamara Haag moderator author
    4 months ago

    Hi starscream,

    Thanks so much for sharing what works for you. How long did it take after stopping coffee to see an improvement? Can you have caffeinated tea or no caffeine at all? I’ve come to rely on coffee, but if my RA symptoms (which include fatigue) weren’t as big a factor then perhaps I wouldn’t need it. So now you have me curious. I’ve tried eliminating other foods and didn’t find it made a big difference, but I haven’t tried eliminating coffee.

    Thanks for sharing, as we can all learn from one another.

    All the best,
    Tamara

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