A few weeks back I visited my rheumatologist.
Although the infusion I’d received almost four months before had started to work, now it seemed to have stopped cold. My hands and feet were hurting again, and unfortunately, worse than before. I’d enjoyed a noticeable increase in energy and stamina, as well, but that, too, was gone. I won’t lie: I was disappointed and a bit blue.
But I was also hopeful. Because this biologic, unlike the two I’d tried before it, had actually worked. So, after updating my rheumy, I asked if I might be able to schedule new infusions soon. Maybe, I reasoned, the next round would start working faster and last longer.
“No,” she said, explaining that doses of this medication were restricted to every six months. Under dire circumstances, I could get more at four months. Well, the circumstances seemed fairly dire to me. After all, I was the one who’d have to wait at least two more months for relief from my increasingly tender, aching hands and feet. I was afraid, frankly, that the flare would get much worse—and I feared it. I make my modest living with my hands.
She looked at my blood tests. Naturally, they looked good (this happens often for those of us with rheumatoid disease. We can feel awful while sporting perfect or near-perfect clinical results. It’s maddening). She checked my hands, palpating my wrists and knuckles gently. When she gave them back to me she told me she thought my pain was probably the result of osteoarthritis, not RD.
I started to protest. She stopped me, explaining that it’s common for someone of my age to have OA in the joints of her hands, feet, and other places, such as the shoulders, hips, and knees.
I admitted that my previous rheumatologist had told me I had some OA in my fingertips (called the distal interphalangeal, or DIP, joints). RD usually doesn’t affect them. But the pain I was experiencing wasn’t at the ends of my fingers. It was in my PIP (proximal interphalangeal) joints—the ones in the middle of the fingers, my metacarpal phalangeal joints (the largest knuckles at the base of the fingers) and my carpal joints (the group of wrist joints).
She asked if I’d ever tried using a paraffin bath for my hand and foot pain. Yes, I said. I have one at home.
“Does it work?”
“It’s soothing,” I said, “but there’s no lasting relief from it.”
She said that it might not be very helpful for me with my RD, but I should try it for my osteoarthritis anyway. It should help.
“Use it two or three times a day. You can also use a lotion with capsaicin or menthol in it. Those are often very good for OA.”
I sighed and said I’d try them, and she told me she wanted to see me again in six weeks. If there’d been no improvement by then, we’d talk about what to do next, and if my pain got a lot worse, I should come back and see her again sooner.
I left the appointment feeling frustrated and dispirited.
But I did try the paraffin bath. It had been a long time since I’d used it, so I was heartened a bit by how much my thick, soft paraffin gloves heated my joints. It felt heavenly and I enjoyed the incredibly deep, spreading warmth on my aching hands and wrists.
Of course, the paraffin cooled off within ten minutes, usually faster. But for about 15 minutes after I peeled it off, my hands felt about 50 percent better, and I was able to bend my fingers and wrists with a minimum of stiffness or pain.
Then it came back.
Since then, I’ve used my paraffin bath at least three times a day. Sometimes I dip my hands six times. I’m fortunate—I work from home, so I can take the time to do this, even though it’s far from convenient. I try to make good use of my hands-encased-in-wax time, since I can use them that way. I do my so-hum meditation, clearing my mind so I’ll be calmer and less stressed afterward. Sometimes I close my eyes and take a cat-nap.
Today, my hands are still giving me fits. I'm obviously no doctor, but I honestly don’t think this is OA pain. It feels like RD, and I’ve had many years of experience with that. My feet—thankfully—are more bearable, though they’re not any better than they were. I’m grateful that I have the option of taking pain medications, but I save them until I’ve exhausted all my other pain-relieving options—my so-hums, my distraction techniques, and my good ol’ Tiger Balm. Now I’m just waiting out the six weeks until my next appointment and betting my cards on another set of infusions. Early, with luck.
Do you have osteoarthritis along with your rheumatoid disease? Do you have some special techniques for treating it? Please share—I’m all ears.
Has having RA put a hold on your ambitions?