The "Get Out of Flare Free" Card

Living with rheumatoid arthritis is frustrating to say the least. This disease causes pain, inflammation, and fatigue, all of which can place limitations on one's activity level. While that's bad enough, rheumatoid arthritis is extremely unpredictable, making it challenging to plan ahead. I may go to bed feeling pretty good, yet wake up in the morning (or the middle of the night) with intense discomfort and/or swelling. I may be having a good day with minimal symptoms, but be struck by a shooting jolt of pain that stops me mid-sentence or mid-stride. The unpredictable nature of RA often leads to cancelling plans with others and rescheduling appointments or projects.

The RA activity hangover

While RA's erratic activity can be infuriating, there are certain patterns I can expect. Often when I'm able to be physically active, I later experience what I call an "activity hangover," which is a relatively brief (24-48 hours) flare of pain, swelling, and fatigue that follows strenuous activity. These activity hangovers are common enough that I will plan for them. For instance, I don't host dinners or get-togethers on Sundays, as I'll have to work the next morning and will need time to recuperate after the shopping, cooking, and cleaning involved in hosting an event. Similarly, I always pad trips with a day of rest upon my return home before I have to go back to work. Just as one can expect a headache the morning following a night of drinking, I expect an uptick in my RA disease activity when I engage in anything at all strenuous.

A day free of RA pain?

However, RA is anything but consistent, and every now and again its unpredictable nature works in my favor. While activity hangovers are common, every once in a while I'm thrilled to discover I've instead been granted a "Get Out of Flare Free" card. This occurs when I’ve engaged in a strenuous (by RA standards) activity, yet I don’t end up having to pay for it. For example, a month or two ago I spent a couple of hours weeding the yard and thought my knees and hips would be screaming at me later, but was delighted to discover that I escaped a flare. A few weeks ago I went on a trip with friends that involved a lot of sightseeing on foot. I thought I’d be paying for it that night or the next morning, yet I was no worse for the wear, other than being a little tired.

The unpredictable nature of RA can feel like I’m perpetually rolling the dice, never knowing whether I’ll get winning numbers or end up feeling like I lost big. All too often, it seems I’m paying fines for any advancement I’m able to make, having to move back a space for every two I move forward. Therefore, when the flipside happens and I score a “Get Out of Flare Free” card, I’m overjoyed with my good fortune. While the unpredictable nature of rheumatoid arthritis can make it hard to navigate through life, it also keeps me feeling grateful for the “good days” when my body is able to move, when I am able to fully participate, without having to pay a price.