Friday, April 25, 2014

What a difference a new pair of glasses makes!

I CAN SEE! I picked up my new glasses today. No big style change for me, as you see. These glasses are plain, black geek frames, a little larger than my last pair, to give my eyes a bit more coverage for sun protection with Transitions lenses. My current insurance allows me one new pair a year, I think.

My horrid nearsightedness improved, as did my reading script. But it's still bad; I needed hi-index 1.67. This is the script for the progressives:

OD Sph: -7.75 Cyl:-0.50 Axis: 180
OS Sph: -7.50 Cyl: -.75 Axis: 165
OD ADD 2.25
OS ADD 2.25

I used to be > -8.00 in both eyes prior to requiring bifocals when I turned 42 (I'm 50 now). I also need a separate single-vision lens for computer work (I just had them replace the lenses in my old glasses to save $). I'm still blind as a bat by most folks' standard:

OD Sph: -6.50 Cyl:-0.50 Axis: 180
OS Sph: -6.25 Cyl: -.75 Axis: 165

***

Blind as a bat without them.
Q: Has anyone ever ordered a pair of prescription glasses online? I didn't know how satisfied people were, particularly if they have a difficult script. I was thinking of getting a pair that is tinted for indoor use, since I have light sensitivity from developing cataracts.

***

On a related front, I can report that my prescription insurance, ExpressScripts, actually covered Restasis (drops for extreme eye dryness caused by RA/Sjogrens and other similar conditions). It's insane how much these meds cost. I paid $100 for 3 months' supply, the insurance covered > $700! Why does this med cost so much? Never mind. I'm sure it's cheaper across either border.

Tuesday, April 22, 2014

Managing a RA flare sick day

Sick day today; my first full-blown RA flare up in months since I switched to Orencia as my biologic vs. Enbrel. I haven't taken an actual sick day like this from work in months, as in: no work email, texts, calls, IMs. I was only online in the AM to "call in" via email and to rearrange all the meetings I had to miss. And even that was a horrible effort since light is really hurting my eyes this time. Flat out on my azz sick. Not working through it to prove that I'm impervious to chronic, life-altering pain. No way to fake it through a flare.

I then slept almost all day. It's annoying to be so wiped and in pain that you have to sit there in a stupor thinking about a plan to get up to make it across the room, but that's the reality of a big time RA flare. It just has to pass.

It was about 80F today, but I was cold when I briefly stepped outside, so my body therm is screwy. Doc gave me a script for prednisone a while back, but I won't take it unless this goes on for days since steroids F up my BGs.

The light sensitivity has abated somewhat this evening (why I can type this), but my muscles and joints are so tight that I'm already showered and coated in my rotating cast of liniments (tonight starring Biofreeze + Sombra + Capsaicin!).

Getting under the fleece and going to fall asleep to mothership L&O (1992 season is on We).

Monday, April 14, 2014

Life changes -- RA drives me onto the professional off-ramp

Last week I officially acknowledged what I can no longer do -- my current job. It was announced in my org that I was stepping down from my position as an IT manager. I'll vacate as soon as they hire a successor.

I did this job for ~15 years. But I am no longer the person I once was because of pretty aggressive rheumatoid arthritis (RA), and I've been telling my boss for a couple of years now that a person is needed in this position that can handle the long hours that come with the job. So the succession plan is being rolled out ASAP.

Actually, my rheumatologist and endocrinologist have said for the last 4 years to "get out of that job," because the stress that comes with the ever-demanding and changing world of IT is wholly incompatible with an autoimmune condition that is profoundly affected by stress, the weather, and random foolishness I never can quite figure out. I'm deteriorating faster than I could have imagined. I guess the docs were right. I was in denial.

But those who know me know that I thrived for a long time on stress and long hours (or so I thought I did).

It's part of my own acceptance process to admit that I am not the person that I once was, chugging away on ungodly over-work up to about 3 years ago (doing this job plus running a full-time, nationally recognized blog, traveling during my vacation time to go to press conferences, the White House, covering all sorts of things as a citizen journalist in digital media). It was tiring, wonderful fun.

Fast forward to now -- rheumatoid arthritis has so destroyed me from the inside out that I:

1) can no longer down a 40 hour job;
2) had to shut down my blog;
3) can no longer travel alone because I can't lift my bags and I suffer from extreme fatigue and threats of flare ups from the barometric pressure changes because of flying;
4) live by the clock for meds, sleep breaks and the like; and
5) give up my weekends, taking my RA biologic med, and methotrexate that make me sick as a dog, and doles out unreal fatigue, all sacrificed so I can work the next week.

My spine is also now affected and one of my disks not only re-herniated (L5-S1), but it is collapsing on the other side, affecting feeling in my left leg and foot.

All in just three years. 

My life now revolves around preserving myself for work -- and nothing else of me is left for life. I am one of only a couple of patients of my rheumatologist that is still able to work. It's estimated that as many as one-third of people with RA are forced to stop working within 10 years of being diagnosed. You can read about others' experiences with RA and the workplace here.

Unlike some RA patients on the professional off-ramp, the organization is crafting an accommodation that may allow me to slide over to a different, hopefully more manageable 30 hr/week job. What's definite is that I will no longer be a senior manager. Does this bother me? Actually, I'm in such a constant state of pain and exhaustion that losing that status isn't something I'm mourning. It remains to seen how much of a demotion this new position represents.

In terms of reactions to the change, it's pretty clear that thinking about disability and my need to step down scares many people into silence (after all, it's natural to think "glad it's not me/that could be me" -- it's a very human reaction). Are you supposed to congratulate the person, have a sense of sorrow that they are stepping down for obvious health reasons? There is no good way to react. It was kind of like the interesting reactions I encountered during the couple of days I lost my voice due to a med change ("People -- I can't speak, but that doesn't mean I can't hear or think..."):
"[T]his temporary situation shows just how ill-prepared the average person is to deal with a disability of this nature. Our ability to speak allows us to convey a lot of information in very few words. Body language (thumbs up, down, OK gesture), is pretty limited when you need to communicate detailed thoughts or nuances.
Those who can communicate vocally assert their privilege/ability to try to force the mute to communicate on their level even when logically they know the other person cannot speak. You can see the frustration on their faces; they'd rather avoid me rather than try to compensate for the communication delay. Well, of course -- a pad and pen is a poor substitute.  I've also had to whisper from time to time because of my frustration in moving conversations along so I can get back to work. They don't want me to break my vocal rest, mind you, they just don't know what to do, so they avoid."
What I cannot avoid

Emotionally, I'm not really able to celebrate anything, since some things are still up in the air. But honestly, I'm still having those feelings of "Dead woman walking" or that I represent "the old dog taken out back and shot in the head." Pick your poison of negativity. It's all normal feelings I've had over the last week, and I just have to work through it. I do take solace in that I know that I'm not alone; this is a story that has played out (with even worse circumstances and resolutions) for most patients with severe RA. It's the netherworld prior to full disability -- too sick to work full time, not sick enough to qualify for disability. It's a high bar to clear. Besides, in my case I, want to work. And just be able to exit with dignity when the time comes. That option usually doesn't happen for most. Many simply have to resign.

It's horrible to know that I have a professional expiration date that isn't long in the future. Even something as simple as writing longhand is excruciating. I have to wrap my hands (and now my thumbs too) each AM, to tolerate typing all day. If I lose that ability, I don't know how I'll adjust. I detested using Dragon Naturally Speaking when I tested it. I think so much faster through my hands; when the day comes and I cannot type, it will be a real crossroads.

Part of me wants to flee and leave it all for someone else to deal with rather than exist being less than whole and involuntarily on a professional off-ramp at 50.

But I live in the real world. I just have to stay healthy enough to make it through the fire of a long list of to-dos to pass the torch to the next IT manager.

And figure out how I'll be able to make it to the next Journey concert when they hit Raleigh (on a weeknight, no less. I'm usually in bed by 7PM these days). I'll really pay dearly in terms of fatigue, but I need something to feel positive about right about now. I'm still holding out on buying tix because of the health circumstances, so I guess I won't get good-for-photos seats now. Sigh. Ah, just think Anything is Possible.


Thursday, April 10, 2014

My eyes, my eyes! Travails of progressive bifocals, the eye doc...and cataracts?!

Saw eye doc yesterday. Terribly necessary because I cannot see anything in focus in any field of my progressive bifocals at this point; things are fuzzy, and for close up (like reading a pill bottle), I just take my glasses off or lift them up. It's incredibly annoying.

Good news/bad news. Good news first - no damage from taking Plaquenil (rheumatoid arthritis drug), or any sign of diabetic retinopathy. She was shocked since I've had insulin-dependent diabetes for ~30 years at this point -- I keep my BGs in line, that's why! [Eyes fine; legs/feet and neuropathy not so much.]

My prescription at this point has changed (no shock there), but the other element at work is that because of RA and some of my meds, my eyes are extremely dry, so much so that the doc said I need to come back next week. I have to use eye drops every 4 hours and eye ointment at night. Then I'll come back retest and see if the script matches my tests yesterday. Some info:

Dry eyes is a common problem for patients living with rheumatoid arthritis. Patients may notice irritation, a gritty feeling, painful burning, sensitivity to light, and a sensation that something is in the eye. It is caused by a lack of tear production. Patients with dry eyes are at increased risk for infections around the eye and damage to the cornea. 
Eye dryness is also a symptom of Sjögren's syndrome which is an inflammatory disease that can affect many different parts of the body, but most often affects the tear and saliva glands. Approximately 10 to 25 percent of rheumatoid arthritis patients will develop Sjögren's syndrome. Treatment for dry eyes include artificial tears or prescription eye drops (ie. Restasis).
We'll see how things go in a week. On the matter of the actual glasses, I don't know if I just need to pick my battles and trash the whole progressive bifocals thing.

Oh yeah, the bad news -- she was shocked to see that I'm developing cataracts in BOTH eyes. She was like -- "wait, you're too young for cataracts at this stage!" (I'm 50) Last year there was no sign of this, but yet again, inflammation from very active RA can play a role. So I have to stay out of the sun, keep blood glucose numbers (BG) in line and stay away from prednisone (a steroid many RA patients rely on for some relief; I don't use it because it screws up my BGs). Thankfully I don't smoke, another factor in developing cataracts.

It also explains why night driving has become more difficult, and why bright light has been hurting my eyes more than in the past.

Friday, March 28, 2014

A nod to the late PHB - a Vicki Award from Woodhull Sexual Freedom Alliance

What a wonderful surprise! Nine years of online activism and one award that I never expected to receive is a sexual freedom award. Does the content my former labor of love, Pam's House Blend's rate that honor?

The good people at the Woodhull Sexual Freedom Alliance (Facebook, Twitter) thought so, and contacted me recently to announce that I will receive its Vicki Award (and I'll deliver a keynote address) at the Sexual Freedom Summit  (@WoodhullSFA) on August 14-17, 2014, in Alexandria, VA. Hashtag: #SFS14.

About the award:
Established in 2010, the Vicki is named after Victoria Woodhull, the namesake of the Woodhull Sexual Freedom Alliance. Ms. Woodhull was an American suffragist born on September 23, 1838, who was described by Gilded Age newspapers as a leader of the American women's suffrage movement in the 19th century. She became a colorful and notorious symbol for women's rights, free love, and spiritualism as she fought against corruption and for labor reforms. A strong advocate for collaboration and for full equality rather than "just" individual rights, Woodhull was generations ahead of her time.
I am in terrific company. From the press release:

The 2014 Honorees

Carol Queen is an American author, editor, sociologist and sexologist with a doctorate in sexology who is very active in the sex-positive feminism movement.  The founding director of the Center for Sex & Culture in San Francisco, Queen serves as Staff Sexologist at Good Vibrations, where she’s worked since 1990.  Read more here.  

Cory Silverberg has developed and facilitated workshops for hundreds of agencies and organizations serving both youth and adults across North America on a range of topics including sexuality and disability, sexual pleasure, sexual communication, sex toys, and sex and technology. Cory has also delivered keynotes, lectures, and interactive public talks for professional conferences and student groups. Read more here.

Pam Spaulding considers herself an accidental activist.  The founder, editor and publisher of Pam’s House Blend, a startling honest and astute blog focused on the LGBT community, Pam has guest posted/contributed to Americablog, Pandagon, Firedoglake, The Rude Pundit, The Bilerico Project, Glenn Greenwald’s Unclaimed Territory on Salon, and written for The Independent Weekly.   Read more here.

The event will be a rare occasion for me these days - traveling, due to impact on my RA. Woodhull and its Executive Director Ricci Joy Levy have been very accommodating re: my need for rest and recovery. It's sad I have to live by the clock for meds and such these days. But I'll go down fighting.

Tuesday, March 18, 2014

Losing the RA battle and it's only Tuesday!

Made it through the usual fire of biologic med side effects that kill my weekends (Fri PM to Sun afternoon) so I can continue to work, but between the impact of a terrible weather front and an insane workload, I came home in searing joint pain everywhere today.

Bed time? 6:15 PM. That's a new record for me.

Anyway, the reason I'm up now is to take some more Aleve to tide me over till I have to get back up at 3:30 AM for the next cocktail of meds so that I'm functional at work tomorrow. Otherwise I'd rather be unconscious to recharge my limited body battery supply before I have to get back on the hamster wheel again.

Even the popular biologic RA drugs (like Enbrel, Humira, or Orencia) can't perform those miracles that Big Pharma portrays in those commercials you see on TV. They seem to air with greater frequency these days. These ads really downplay the serious side effects - the narrators speed through a partial laundry list while showing the sunny, compelling visuals of people opening jars, digging in gardens, tossing a ball with kids, etc.

I guess visuals showing patients writhing with chills, experiencing crippling fatigue, and communing with the potty for 2 days a week after dosing their meds probably wouldn't go over well with focus groups...

The drugs don't stop progressive joint damage for everyone either, or stop the chronic pain entirely. They temporarily relieve some inflammation and, to their credit, for me have reduced sick days to nearly zero, a huge relief. Hell, I worked (though I probably should have been out, but duty called) even while suffering from shingles agony for a couple of weeks. Before biologics, I was probably down and out on average a day a week; that was at first diagnosis in 2011.

BUT, my effective high-functioning ("gee, you don’t look sick") hours per day are continuing to shrink, in the slow, steady decline folks with RA (and similiar autoimmune disorders) are all too familiar with. I look in the mirror and can now easily see the toll of the battle of trying to hold on to "normal" as it fritters away.

Sunday, March 2, 2014

Another lost weekend...

This weekend has been quite pitiful. Between the shingles (in parts where you'd never want them), my weekly RA biologics making me feverish, sick & sore,  and the side effects from the 3x a day anti-virals for those shingles, I spent most of the weekend in searing pain, nodding out, or unconscious.

Thus no FB activity. I didn't have the attention span or energy to even pick up a tablet. Now that's bad for me.

Today's major "activities" -- since I'm sick of being sick from my declining autoimmune state and I'm stubborn -- involved limping, slow, short trips -- one to the grocery store, and briefly to Costco. That was so exhausting that as Kate drove the 15 min home, I nodded out, then needed a 4 hour nap. Saturday I was even more useless, if that can be believed.

I don't know if I'll be in any shape to work tomorrow since the anti-virals knock me out and I have to take one dose midday. (4 more days to go).
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