The Listening Project

Yesterday afternoon 'The Fella' and I travelled into Ipswich to meet up with a twitter buddy who works for BBC Radio Suffolk - a bit different to our usual Sunday routine! We were to be part of a really exciting project being run by local BBC radio stations, Radio Four and The British Library....*excited face*

I had heard of The Listening Project through listening to snippets of some of the conversations featured on Radio 4 and thought it sounded so interesting that I was very excited to be asked if I would like to 'have a conversation' which would be kept at The British Library for future generations to have access to. Who to choose to speak to? I have a couple of friends who are also 'Radio Four Bores' and one in particular would be great to talk to but she lives too far away...the conversation needs to be half an hour-ish and it's supposed to be an opportunity to talk about things you may not have had the time or chance to do so before...choosing a suitable conversation partner is harder than you would think! 

I wanted the conversation to mean something, to be of use to people and not just a soundbite of the times we are living through - I wanted people to know how it feels to have an invisible disease, the obstacles sufferers have to overcome and how a thoughtless remark or comment can be very upsetting and that we don't 'just have arthritis' like old people have....hmmmm!

'The Fella' was less enthusiastic about being recorded talking to me...for a week he put forward more suitable (in HIS opinion!) candidates but eventually I wore him down and he agreed to do it...which just goes to show what a brilliant man he is!

We talked about a LOT of different stuff (not just our creaky bones!) but it was noticeable just how much both our lives are affected by Rheumatoid Arthritis - almost everything we do has it lurking in the background and believe me *it* makes sure we know it's there! The other thing I noticed was how incredibly strong and brave a person suffering from an incurable, chronic condition has to be and how much I admire 'The Fella' for doing this without fuss for 20 years, he has a 16 year head start on me!

We also laughed, we laughed a lot!

Couldn't have done it with anyone else really...

Nic x

What happens on Humira Saturdays?

 Well the only side-effects I am aware of is a feeling akin to being smashed in the face with a shovel but as that doesn't hurt as much as having RA does so I can cope with that! Makes blowing my nose and kissing the Fella tricky but then RA makes a lot of things like that tricky too...so having passed my assessment and being able to stay on Humira injections aided by a low dose of Methotrexate which helps to stop my body rejecting the Humira. 

Every other Saturday morning I get up and when I get the milk out of the fridge for my morning cuppa I also get out a Humira 'pen' - it's refrigerated as it needs to be kept between 2 and 8 degrees C but it stings if you inject it when it's TOO cold...half an hour on the kitchen table makes it about right and I'm supposed to check that it's:

a) in date

b) has no flecks in the liquid

c) is not damaged

 Making sure everything is squeaky clean (including my pimply, pale thigh here!) I find a fleshy bit and follow the steps...I have heard that patients using Humira in the States get a talking pen which they can practise with but no such fun here in the UK unfortunately!

The needle is in that white tube and step one is to take the lid off...so far so good!

 Step two is to take the lid that covers the push button off...both recyclable BTW! I'm a bit feeble in the hand department and find it hard to grip so I use both hands to do the job and still struggle a bit but would hate anyone else to have to do it...

 (When I did my first jab on my own I had worked myself up into such a state and it was fine, in fact I barely felt it! The pain from RA is so much worse TBH...)

 Pushing down hard enough to push the white tube back - this makes sure the needle goes in and none of the drug seeps out...urgh! Always makes me feel a bit sick this bit - getting the angle right so I can see the little 'window' is a bit of a palaver but I can just about do it now! I have to count to twenty....slowly and try hard not to *jump* when I press the button!

In answer to anyone who thinks it's 'just a pen, a little prick' it isn't ya know - it's a bloody great needle and waiting for the twenty seconds to be over as you hear the liquid going in (yes, you really can!) seems to take forever!

 But....then it's over! I check the 'window...

 ...place the packaging and lids in the 'green bin'...

 ...place the needle in the sharps bin that sits next to the bleach bottle with the child (and Nic) proof lid that lives in the bathroom...

...go finish my cuppa and get on with my day!

Hope anyone waiting to start on Humira finds this reassuring and helpful, Nic x

PS. I still have a lot of pain in my feet, hands, hips and knees but can definitely see some improvement - I don't have 'sausage' fingers or toes right now and have been wearing normal boots for months now. *smiley face*

 

Feed me!

Chocolate and peanut butter crispy cakes!

One jar of crunch peanut butter, two big bars of cooking chocolate, dark and high in cocoa solids! Melted together in the microwave (choc first and then add PB) then give it a good stir, sniff (very important!) and then add enough cornflakes or rice crispies to use up all the chocolate peanut yumminess before spreading it all out on a tin or baking tray lined with a bit of greaseproof. Leave in fridge while you go and do something else and cut into squares just before you need it - the bits that drop off as you tidy are for you to test and it is kinda the law that you do this and at the same time give yourself a pat on the back! Mrs Tudor and I thought that they would be jolly nice if they also had some sultanas or flaked almonds in...or some glace cherries.....*sigh* sadly the Monday ladies are a little choosy and some don't like sultanas or orange or apple or...you get the picture? I like to try and keep everyone happy!

 This post has been inspired by a great tweeter fella who loves a good cake and always makes me smile when things are being a bit glum or tricky...he knows who he is! He liked the look of my crispy cakes which went down a storm with the crafty ladies last night...I missed another evening session of my Monday group due to being knackered and feeling a little under the weather - I have my second assessment for anti-tnf this Thursday and it's making me a little stressed. Over the last few years I have seen a pattern forming and I always get slightly 'better' around this time of year - to narrowly fail another assessment would be very hard to bear....but hey ho, there is always cake!

I've had to adapt almost every aspect of my relationship with food since becoming ill, at first I did try to isolate which villainous foodstuff was responsible in making me become so ill. Then after a while I thought 'sod it' and didn't really bother about anything, I just wanted to be able to move around and not be in pain - food became fuel and was no longer pleasurable.

I'm back round to enjoying my relationship with food again, it's different and there's always a few glitches along the way such as when I take Tramadol (takes away my appetite completely - not a good thing! I may look hefty but it isn't always food that's responsible...) but we are rubbing along nicely right now...I've developed a few different techniques which will have purists fainting all over the place but it gets me by and I have very few complaints!

These are my heavy old scales, they belong in a big farmhouse kitchen and not in a tiny modern (but perfectly formed) council house in deepest, darkest Suffolk. 

I use the butter to weigh out the self-raising flour and sugar - equal amounts of each and then pop the butter into one of my lovely old vintage mixing bowls and place it in the oven whilst it's warming up. I know that I should be creaming the sugar and butter together until it's light and whippy but if I do that I will need a lie-down for the rest of the day. It's the same with preparing vegetables, chopping up a butternut squash can finish me off for a week! As soon as there is some softening occurring I remove the bowl carefully and sit down with it at the table and using a wooden spoon start to mix everything together...I could use the Kenwood mixer but what with the pills resting on it and having to change the beater...I prefer this way. Once I've added eggs - five if they are from Zsa zsa or Button and four if they are from Hylda or Betty - I plonk it into a big silicon and glass cake tin I got from Lidl for four quid and cover the surface with chopped up fruit. Pear and raspberry work well but so do pears on their own and if you are lucky enough to live near a Bullace tree then do some foraging and get them on that cake! After a sprinkle of sugar it goes into the oven and is ready when an inserted skewer comes out clean...ta da!

It's not all about cake though and the Fella and I have had this (above) every Sunday bar one ever since seeing this on Nigella's programme - he reckons he'll never get bored of it! Parmesan dusted eggs are cooked in tomatoes that have been mushed up in a pan with garlic and chilli - we use a squeezy tube of Harissa paste from the Turkish bit in Asda instead of chopping chillies, with my track record for clumsiness it's far to risky to allow me to handle REAL chillies...

So between my wonderful ma cooking brilliant roast dinners for me and eating with the Fella I have managed to find a way to love food again. I can no longer lift my pots and I can't cook every meal everyday, I don't have the energy and my hands hurt far too much but we get there...slowly! Tonight we will have sesame prawn toasts with our Thai curry, in the old days I could rustle them up in no time but these days I need three days notice and recovery time...they are so worth it though! The only ones we have had that are better are at the China Chef in the Station Yard at Needham Market.

There's your first food blog from me then Noel...I've held back some hot cake pics for another time! Nic x

PS. Apologies for poor quality photos, I'm borrowing the Fella's laptop and only have BlackBerry photos of food to hand right now!

Harvest

It's autumn and that marks three years since I first visited the rheumatology department at Ipswich Hospital. If they ever move the pictures that adorn the corridors around I'd be wandering around in there forever! I have absolutely no sense of direction...up until May this year I have been every six months since that first appointment. Now I seem to be up there every week, recognizing the number of the hospital on my phone despite not entering in my contacts list.

Reading through my notes I see that I was presenting classic symptoms of Rheumatoid Arthritis which through most of the last three years has been raging through my body causing pain and inflammation - my feet were described as 'little trotters' once as they were so swollen...

I know it's hard for people to understand that every part of me hurts most of the time, I wear splints on my hands when my thumbs need support not because they hurt more than my feet, knees, back or hips...it is quite upsetting when people assume it's only the part of me I'm supporting at that moment whether it's with splints or a stick. This happened yesterday, last Friday, last Wednesday...a very good friend assumed that just because RA is now thought to be on the scene it's somehow, all of a sudden become so very much worse than when it was thought to be PsA. The usual suggestions of a change of diet and Chinese herbal supplements then followed....it's hard at the moment not to cry out and show people just what it's like to be permanently tired and in pain.

I know that they are merely trying to help, to try and find a quick fix, to get me back to how I was before this happened...

The programme on Channel 4 called 'Food Hospital' featured RA in it's list of conditions that can be cured with food - I'm not denying that there are some conditions that are affected by food but trust me if I could run again if I never touched another crumb of bread then do you not think that I would find the will power to resist?  Programmes like this, articles in the newspaper all citing lower ESR levels as evidence of a particular diet working give false hope to all the well meaning, thoughtful people around us.

My ESR levels have never been high, have always been unremarkable and yet there is no denying that there is always inflammation there. Celebrex has become my favourite drug - hope that they keep me on it, the swollen feet have gone down, my fingers no longer resemble sausages. The pain I have now is not from inflammation as the damage has been done, the bones are crunching against each other and I remove myself from that with Tramadol.

It's breakfast time, I'm here at the kitchen table, waiting for the pills to work and trying not to think about food, the Tramadol has taken away my appetite and as anyone who knows me in real life or via Twitter I live to eat, love to cook and feed people. The Fella and I are taking it in turns to cook nice healthy meals for each other, my parents cook for us once a week and we're struggling through...

Nic x

PS. I get the disc with Friday's MRI scan on it today! The really helpful lady in Diagnostic Imaging has posted it out to me and the nice lady at PALs is trying to find out why the Radiographer's notes were removed from my X-ray images...two painful steps forward and then one back!

MRI

Last Friday I had an MRI - I had been told on the phone that it was my hands and feet that would be done and I had to decide whether the left or right in each case was the worst affected.

This amused and confused us all and many a happy hour has been whiled away (I'm currently taking  a LOT of Tramadol!) deciding which side is worst - left hand and foot both look pretty grim but I have a lot of pain in the right at the moment...

Having been given a timescale of around 'one and a half hours per bit' during the same telephone conversation with the MRI reception I arranged for my folks to drop me off, go to do their shopping and pick me up around three hours later. 

Fella also helpfully told me that when he had his ankle done he just had to stick his foot in with the rest of him outside the machine....so I took some knitting for the feet bit and a book about knitting for the hand bit. 

Turned out it was only my wrist and hand that was of interest after all and as for 'just sticking my hand in.....' that bit was also wrong - de-bra'd (their term, not mine!) and lying face down in a 'Flying Superman' position the whole of me went in! The noise was erm....*noisy* if you have never been in one or accompanying someone having one it's like having roadworks 6" from your head. As you enter the room there's a 'thud, thud, thud' as there is already a background magnetic field - so you don't get a shock (I assume) then donning an impressive set of headphones (not unlike the Boy's Wharfedale's!) the technician warns you that the big noise will start and my goodness...it certainly does and with a minute's break at half-time for a contrast medium to be injected through an IV that is how it is for about one and quarter hours! 

Lying perfectly still and silently, hand strapped into position in a tube with a hammer drill working away...not the best of Fridays but if it gets me some better treatment then totally worth it!

I've just spoken to the MRI department and they say it's already been reported and sent to my new consultant. I'm hoping they will send a disc out to me too, they will accompany my x-rays which I have now discovered are missing their notes!

Oh, and I also had a chance this week to contribute to a book being written about arthritis and how people cope with being diagnosed with a chronic, painful, incurable and difficult to treat condition. The author is now adding another chapter about working with the condition. 

Actually diagnosis is a huge relief as it takes a long time and some of the tests can show false positives or negatives. Diagnosis can direct the treatment in a more productive and positive way preventing a person from becoming permanently disabled...it can be comforting to be able to put a name to the pains that have plagued a person, the fatigue that is invisible to others...

Nic x

Lichen

 It was my birthday at the end of August and my lovely friends are treating me to one of Rachel Dormer's porcelain workshops - I love making the little 'pinch pots' Rachel is also a very interesting person and I find it so relaxing. I won't be able to do it until (I nearly typed 'unless' there but realise that is not being very positive! Struggling with that a bit right now...) I can get this recent flare under control. 

Usually I grin and bear it but yesterday my left leg refused to bend at the knee - bit worrying as the old 'ritis had been confined to hands, feet and occasionally my hips, back and neck. I haven't had so much trouble with my knees swelling since referral to Ipswich Rheumatology in 2009...

 I even asked my mate Bob to shut up my hens last night even though I had planned to clean the poor things out before bedtime, but by the time I sat down I had completely 'locked up'...what to do? I ended up crawling up the stairs, dosed up with Tramadol and going to bed. It's a bit better this morning but after the hip pain I had on my last visit to hospital I'm starting to worry more and more about how much damage this is doing to my joints.

I finally have my x-rays! As part of the complaints procedure about my treatment at the hospital I requested my x-rays and blood test results - they sent my notes....I didn't even ask for those!

I had some x-rays done in 2009 and then again this summer and although there are no signs of bone damage there were 'changes' and I'm to have an MRI tomorrow 'to see what is going on in there' as my new consultant put it!
Why the complaint? Well my very smart dad recommended I write a timeline of all my treatment from referral to now in order to illustrate accurately what medications I had tried as I tend to get a bit worked up and upset about it all. Whilst doing this I realised that I probably hadn't had the best care and that things could and should have been done differently...I asked PALs to approach the Rheumy team and ask a few questions, one was why I hadn't had the anti-CCP test earlier as the NICE guidelines state that that test should be considered next if a negative Rheumatoid Factor result comes up. My ESR levels were raised apparently...when I pointed out that I have unremarkable blood test results and that was why the test was done the PALs adviser suggested I write a formal letter of complaint...the complaints department move fast!

Unfortunately I had none of my records in time for the meeting but they did agree to change the inaccurate notes about how often I saw my old consultant. The rest of my concerns were merely either met with a 'we are very sorry' or 'rest assured we have learnt a lot from this'...

Hmmm, the nurse who logged that she had rung me back during the time I was bleeding heavily and in terrific pain thinks that 'on reflection she may have dialed the wrong phone number...

My notes are being reviewed by my new consultant as to whether my treatment should have been different. 

It makes me cross that a test that at £30 is considered to be too expensive to do until x-rays show irreversible damage yet a face to face meeting with two healthcare professionals (one of which seemed to know very little about inflammatory arthritis....) for an hour and a half can be arranged at very short notice. It also makes me angry that I may have taken their time away from someone who is suffering as much and maybe more than myself but I can't go on like this for much longer!

Lichen for dyeing! Fab colour!

Scraped from the tree whilst damp is easy to remove but when it dries it's rock hard and nigh on impossible to get off!

Rheumatoid Arthritis caught early and treated properly can sometimes be knocked into remission - this requires a lot more than the minimal level of care that the nurses at the meeting admitted I had appeared to have received. 

Knowing that they have benefited from my being in pain for all this time and limiting my life does not make it better

I was lucky enough to have a friend take me along to the meeting last Friday which was harrowing but tomorrow I'm on my own in there...I will have to do some lye calculations for Friday evening's soap making workshop or think about knitting patterns in my head!

I still have yet to decide which foot or hand is worse as they are only doing one of each...this is a much harder decision than you may think - I'll consider it over breakfast which I can't really face yet as the tramadol has reduced my appetite - maybe I'll manage to lose a bit of weight!

I hate being so grumpy....it's taking all my willpower to not get cross when people suggest Chinese herbal crap, gloucosamine or a radical change in diet will help me - I know they mean well but reading a couple of paragraphs in the paper about it doesn't suddenly make you an expert!

I will return to being my usual jolly self soon - it won't beat me, I'm just currently recruiting a better army before the next battle!

Nic x

Half-life...

 There's something else cluttering up the big table at HH HQ, it's shiny, it's light and it's helping me get about right now!

 It folds up! Joining the 'old lady grip mat' enabling me to open jars without the aid of a butch neighbor...

 ...and the packets and packets of pills I am now on which nestle in my felted handbag.

I resorted to using a stick after waking up at 2 am on Tuesday with pain in my hip that rendered me unable to move without crying out. Like a knife being plunged into my already aching joints and then wiggled around.

 When I tell people that I'm in pain all the time I'm pretty sure that they don't really believe me. Unless you ever have been it's hard to imagine. 

I had my first meeting with the new consultant last Tuesday where he told me that the recent anti-ccp antibody test had come back as a strong positive (it's 199, anything over 59 is a strong positive) and is the first time there is actual proof of inflammation being present in me. Up to now there has been nothing, no rheumatoid factor and even I started to wonder if I was imagining it all...hearing this news was a little like little bombs going off in my brain and then landing with a thud in my heart.

So...although it's not a nice result at least it's an indication and with a referral to the pain clinic in sight, tramadol is taking the edge off right now but I've now been warned I will almost certainly never be without pain again. 

Although the x-rays of my hands show no erosion present (which is good!) and there are signs of soft tissue damage in my feet so I'm to have an MRI too. I asked Fella what having an MRI was like he replied 'boring'...he's had two!

 I've titled this post 'half-life' as that's how it feels right now - if I take enough tramadol to be comfortable I fall asleep, in the middle of the day, sitting up...I can't wear nice shoes like the gorgeous examples pictured above and as my feet become more misshapen as time goes on the choice of footwear is becoming more and more limited.

 My hands hurt all the time, I yearn to make bread - feeling the squidgy dough between my fingers...

 ...I'm fed up because I lost my grip whilst holding one of my favourite glasses. 

 The reactions I have had from people I know and who I have told about my arthritis since using my stick have opened my eyes to the fact that very few people understood. I've had reactions ranging from 'been dancing on the tables?' I wish....and 'what have you done now? 

I've done nothing, it's the cells in my body which are busy right now...

So, if you see me stick in hand and smiling, it's my brave smile, the one that stops me crying.

I hope to get the real one back soon and the other half of my life back, the one where I can get up out of bed without fear and strong painkillers. The one where I don't have to decide between having a bath and cooking a meal...both of which wear me out!

Nx

PS. After explaining the reason for the stick and arthritis I get a lot of 'head to one side' stuff!