RA (Rheumatoid Arthritis) Sucks

Wound up to Unwind

Eric and I are two weeks away from our Disney vacation -- and after spending 6 weeks on sticks, I'll need it. I am pretty close to physically and psychologically "done."

But even if I weren't nearing the end of my metaphorical rope, having spent a butt-load of energy and effort planning my time off, I'd probably still need to vacate. I mean, consider what actually goes into the making of a "vacation:" tickets, reservations, tee times, car rentals, itineraries, plans to meet up with others, packing lists, 3-1-1 (pfffft).... Is it any wonder that we actually need a vacation by the time it's time to take vacation?

Of course, there's no small irony in the fact that we get ourselves all wound up in order to unwind.

"Unwind" can be an odd sort of word, if you think about it. And lately (due to some books I've been reading), I've been thinking about it in an odd way. More specifically,I've been thinking about the way in which clocks and watches can be "unwound" or reset, and about the way in which truly "unwinding" time would allow us to have do-overs. Mulligans, if you will.

The following list represents some Mulligans I wish I'd been granted:

1. I would have tried to be more patient and less stubborn (just in general).
2. I would have been more demonstrative and less hide-bound emotionally in my youth.
3. I would have been more gracious -- in victory and in defeat.
4. I would have followed the spirit of the law more than the letter of the law.
5. I would have tried to be an optimist (even though it's a total waste of time).
6. I wouldn't have broken my sister's tooth by throwing the Atari game controller at her while we were playing Frogger (see #3 above: gracious in defeat). Instead, I would have just punched her in the arm.
7. I would have beaten the crap out of Jeff Davis in 7th grade for putting Tabasco sauce in my punch. What a douche.
8. I wouldn't have given myself highlights two times in two days. (!)
9. I would have worn a helmet. (This has nothing to do with #7.)
10. I wouldn't have lied to my parents about where I was going, what I was doing, and with whom I was doing it on Friday nights. Nah -- that's not true. Lying to them was one of my wisest decisions.
11. I would have insisted on meeting my mother-in-law BEFORE the engagement.

Of course, there are some things that I'd never change. And those things are probably more important than the desired Mulligans:

1. I still would marry my husband (despite # 11, above).
2. I still would drive our riding lawnmower into the deep end of our inground pool (primarily because it makes for a good story).
3. I still would get bitten by a dolphin (ditto). And a donkey (again). And a monkey (yep).
4. I still would speak my mind with conviction, often stepping in shit along the way.
5. I still would go to the University of Virginia. (FIRE AL GROH!)
6. I still would teach safe-sex classes and do condom demonstrations for prostitutes.
7. I still would be ordained an Episcopal priest.

Nothing in there about RA: Interesting....

On Zombies...

(This is entirely non-RA related. Just so you know.)

I am a VORACIOUS reader. My mother once said that the rate at which I read makes it seem as if someone is following me with a knife.

I'm afraid my reading "non-addiction" (heh) has become even worse since we moved to Chicago. Whyzzat?

Because of that evil device known as Kindle.

My Kindle allows me to buy books from the comfort of my own home (which is clearly a win right now, given that I'm crutch-bound for three more weeks). It also allows me to store said books electronically, without having to worry about finding room for them in our cramped urban quarters.

So what do I read? Anything and everything. Except romance. I read history, fiction, historical fiction, biographies, horror, humor, science, spirituality, mysteries, economics, and Jane Austen. (Okay, I know that Jane Austen *is* romance, but it's also biting social commentary. I also watch "Pride and Prejudice" at least once a year. I mean, Colin Firth in tights... oh my!)

Anyway, lately, I've been on a horror jag -- more specifically, a zombie jag. A post-apocalyptic zombie jag. (Yes, I've read "Pride and Prejudice and Zombies." I thought it was okay, but I got bored with it about half way through.) Who knows why? Sometimes I just go through phases.

I finished one such piece of pulp the night before last and promptly started a new mystery. But last night, I dreamt about zombies attacking Eric and me. Having read so many zombie novels, of course, I was prepared and knew exactly what to do: shoot the suckers in the head. But eric was wary of shooting the things. (Don't ask me why. Ask him.) One of the reanimated dead was close at hand and I was out of ammunition, so I picked up a stick of furniture with my left hand and brained the damned thing.

At that point, Eric woke me up. Apparently, I'd been thrashing about and kicking in my sleep, and had just succeeded in whacking the crap out of my bedside table, thereby scattering my glass of water and the various and sundry books and medications I keep there. It was a mess. And I had to clean it all up then, at 3 AM. As I cleaned up, I told Eric about the dream.

When Eric and I finally settled down in the dark to reachieve sleep status, I turned over and punched him in the arm. "Ouch. What was that for?"

"For not listening to me: Shoot first; ask questions later."

Jeez.

Pain Meds: Addiction vs. Dependency

So I'm aware I haven't posted in a while.

My posting scarcity basically is the result of two factors. First, I haven't felt like it (which is reason enough unto itself). Second, I don't want my life to be defined either by RA or by a blog about RA. I realize that blogging about RA may be therapeutic for some people (indeed, sometimes I find it to be so). But I'm trying to fit RA into my life (as opposed to trying to fit my life into RA). So, what works for me is occasional posting rather than daily posting. And that's pretty much it. I hope that despite my daily inattention, some may still find this blog to be funny, informative, and useful.

I guess we'll see.

Anyway, as you know, teh interwebs are a great thing: they put so much information at our fingertips and frankly, can seem to make geniuses of us all. So, there's a lot of information out there. But my concern is for the quality of the information available to us.

Fairly frequently, the subject of pain medications rears its head on RA/arthritis forums. I have to say that I often am astounded by the lack of good information that is presented by posters on these forums. I'm just not sure whether it's because there's a dearth of information about the medications (which I kinda doubt: look at rxlist.com, for example) or whether there's a dearth of understanding about how the medications work. I think it's the latter, however.

For example, my jaw literally drops when people say things like "oxycodone is a slow-acting narcotic." Well, actually, it depends on the form in which the medication is received. Percocet, for example, is a fast-acting form of oxycodone (which also contains acetaminophen). Oxycontin, on the other hand, is a controlled-release (i.e., long-acting) form of oxycodone (which can be stripped of its long-acting powers by crushing and snorting it.).

My point is, there are significant differences between the two medications, both of which contain oxycodone.

But if people cannot be made aware of the differences, then they cannot make educated decisions about their treatment.

Speaking of educated decisions....

It seems as if many RAers, when talking about pain medications, refuse to use them because they say that they are "afraid that I'll become addicted." 

Look, I am a former addictions counselor, and I can tell you that there are significant differences between dependency and addiction. It's critical that RAers learn these differences, or we'll risk being in more pain than we need to be during our lifetimes.

So what's the difference between dependence and addiction?

In a nutshell: Dependence occurs when your body becomes physically dependent upon the presence of any sort of medication in your system and that medication improves your quality and function of life. For example, I am on Lyrica, which technically is an antiseizure medication (for neuropathy), and Cymbalta, which is an antidepressant (for migraine prophylaxis and neuropathy). My body has become physically dependent upon these very powerful medications -- enough so that if I were to stop them cold turkey, I would experience withdrawal symptoms that could get really, really ugly. But am I addicted to these medications? Nope. What's more, because they decrease my pain, they improve the quality and function of my life.

Of course, the same type of physical dependence can happen with narcotics. But, as demonstrated above, physical dependence, by itself, is not the same as addiction.

Admittedly, physical dependence can be, and often is, a part of addiction. But so much more is involved in addiction. For example, anyone who has watched Intervention on A and E knows that addiction also involves powerful biological and psychological forces that compel the addict to satisfy -- again and again -- his or her needs for a specific substance or high, regardless of the (usually negative) outcome. In addition, addiction is characterized by extreme decreases in the quality and function of addicts' lives.

Yet another significant difference (that is implied, though not directly stated above) between dependence and addiction is that addicts typically use medications to feel some sort of high. Patients who are drug-dependent feel no such high when they take their medications.

Anyway, there we have it: my rant for the week.