while my blog may have been quiet for the past couple months, our lives certainly haven't been.  from moving to a new apartment, to finishing Fall semester in school, to a trip home to Michigan, John and I have been anything but void of a constant To Do list.  but here we are, moved into our new place (still trying to get settled and make it feel like home, however), finals taken and research papers written, and back from snowy Michigan.  we both thrive with routine, so when you throw a bunch of out-of-the-ordinary stuff at as, we kinda flip.  these next few weeks will be spent trying to get our mo-jo back.

my RA certainly hasn't been silent either.  actually, I have had more changes in treatment the past month or so than in any other stage of this disease process.  and the changes have been big.  and painful.  and involve needles.

about six weeks ago Dr. J.'s nurse called to inform me that Dr. J. wasn't happy with what he saw in my most recent blood work, meaning the antibody levels were still way too high.  I wasn't exactly surprised because my fingers were looking sausage-like and the morning stiffness was still making it difficult to comb my hair.  then the bomb was dropped.  we're moving on to a little drug called Humira.  [that was an RA joke. everyone with the disease knows about Humira and gives a little shudder when it's mentioned.]  

Humira is a self-injected medication given every other week.  it comes in a "pen" where the needle hides until you push a button and it comes screaming out of its holster and into your thigh or stomach.  then you hold the pen still for 5-10 seconds while something that manages to have both a cold and a burning sensation oozes into your body.  both the high speed needle and the actual medication hurt like hell.  just going to give it to you straight, because I'm not in the mood to sugar coat anything.  

for my first injection, John and I had to go into Dr. J.'s office for training.  the nurse talked a lot about the drug, the side effects, the administration, and the like, but I was too busy shaking like a leaf to listen.  I'm not usually such a wimp, but the whole situation was just so surreal and I was waiting for the candid camera crew to jump out and tell me this whole RA thing was just a farce.  an elaborate joke, I know, but I feel like that show could totally pull it off.

anyways, after the nurse calmly told me how to stab myself with a needle, the spotlight was on me.  first I pulled up my shirt and grabbed some muffin top, but after 10 minutes of crying and wimping out in that position, I opted to pull down my pants and sit in my unders with the pen poised above my thigh.  the leg seemed a little less vulnerable.  more tears, more calm words from the nurse, amazing support from my husband, more wimpy Julie.  I didn't have a stopwatch going, but I'm pretty sure we sat like that for another 20 minutes while I worked up the nerve to push the button of doom.  I finally did, I kept crying, I kept my pants down and focused my attention on snot control instead, then I had to wait in the lobby for 30 minutes to make sure my leg didn't fall off or something.  the leg, I'm happy to report, is still attached.  

John has continued his role as amazing husband and now gives me the injections.  they still hurt and I still cry, but at least I don't have to be responsible for keeping my hand steady for 5-10 seconds.  

yes, the injections hurt and the medication feels a little like a volcano has erupted in my veins, but the reason I cry is mostly emotional.  these injections are such a harsh reminder of what my life is now because of RA.  this is my future, this is my new routine, this is Julie getting stuck with a needle.  how did this happen?  one year ago RA wasn't even something I had looked up on Wikipedia, and now it's my everyday.  it really sucks and it makes me cry.

Dr. J. and I had another visit this week that involved x-rays and more blood work, both showing that the RA is still having a heyday in my body.  x-rays showed that my feet do not have any permanent deformities, but my hands do have cartilage loss.  Dr. J., not one to let RA get the best of me, prescribed another oral medication and we will reassess in 3 months.  if Humira is being a bitch and hasn't started doing its thing yet, we have to move on to IV medications.  all I can say is you better get it together, Humira.

welp, this post is probably way too long and Debbie downer for anyone to actually read, but it sure has been cathartic to write again and continue to document this journey.  

The Lord is my strength and my song, and He has become my salvation; this is my God, and I will praise Him, my father's God, and I will exalt Him.  //Exodus 15:2   

babies

I have never been one to dream about having kids or even feel particularly drawn to being around them.  many of you know, I'm an old person kind of person.  I have always felt drawn to being around the elderly and have geared my life and my career in that direction - the opposite end of the spectrum, some may say.  being pregnant has never been something I've looked forward to or even given much thought to.  raising a family has always been a vague thing that I know may happen in the future, but by no means has ever been a priority.  pretty much the only thing that John and I disagreed on while dating was the fact that he wanted five kids and I wanted zero.  in the spirit of compromise, I remember saying something like I'd be ok with two or three.  maybe.

but a funny thing happens when someone tells you that you probably "can't" do something.  most people get a fire in their belly and a resolve to prove that someone wrong.  I can't say that's exactly what happened with me, but having Dr. J tell me about the difficulties, even the impossibilities, surrounding pregnancy and child rearing when you have rheumatoid arthritis made me reflect, search, think, and pray. a lot.

pregnancy with RA is something you have to plan for, calculate, discuss extensively with your doctor, and is essentially void of all mushy love excitement and romance.  instead of just John  and me deciding we'd like to have children, it'll be John, me, and Dr. J.  how romantic.  I'll probably recite some poetry and light some candles.  maybe even bring some chocolates in a box shaped like a heart.

you see, the medications I'm taking are nothing to be messed with.  they're potent and they are toxic.  those are good things when you're trying to battle an autoimmune disease, but not so good when you're trying to grow a tiny human being inside of you.  these meds will either deform or abort any little guy or gal that tries to take up residence in my uterus.  these meds also take a year to completely leave my system.  that means we need to tell Dr. J a year or more before we try conceiving and then wait another year for my system to be hospitable to a baby.  or, if I get pregnant before having this well-calculated conversation, I rush to the hospital to be pumped full of another medication that will flush my system of the toxic medications.  I'm thinking of including that cute little story in the baby book.  maybe even include some snap shots of my panicked face or the IV stuck in my arm.  ah, memories.

and then there's the inflammation.  even on my current medication regime, I still have flare ups.  take away those meds and I may go back to square one.  if I can't even comb my own hair, how am I supposed to lug around a belly with a baby in it?  my knees are pissed at me already.  and then, how am I supposed to get up in the middle of the night to care for a crying baby?  will I be able to hold my little darling while I feed him or her?  will my fingers be able to manage securing a diaper?

so, while I may never have dreamed about having kids and I don't even volunteer in the church nursery or know how to talk to my friends' toddlers, I do want to have a family with John and I do want to experience the miracle of pregnancy and giving birth.  the female body is badass, and I want to be a part of that.

just another reason to praise and thank our sovereign and gracious God.  He knows what the future holds, how many children are in it, and exactly how this whole process is going to go.  hallelujah! because I'm sick of worrying about it.

ps: and yes, we are open to adoption.  we'll let God make the call on that as well.

medication dependence

I have become even more painfully (literally) aware this past week of how dependent I am on prescription medication to control my rheumatoid arthritis.  this past week brought two changes in my medication schedule - one purposeful, one accidental.

on Tuesday I cut my Celebrex intake in half, per Dr. J's instructions.  I have been on Leflunomide for over a month now, and it should be doing its part to stop the disease progression by now.  if it is, I shouldn't need to take so much Celebrex to control the pain.  Tuesday also marked the first time I didn't take my Methotrexate on schedule.  I get my medications through my insurance's mail order system, and it failed me this time.  my refill wasn't here on Tuesday, so I missed my weekly meth pill popping.  my local pharmacy was able to help me out with a "bridge," or a one time, one dose refill that would tide me over.  the meth returned to my system Thursday evening.

so here we are on Sunday.  the morning stiffness has been out of this world the past few days, reminding me of those mornings seven months ago when I couldn't even throw back the covers to get out of bed or walk down the hall to get some coffee.

now I'm no doctor - I leave the doctoring to the good Dr. J - but I have to believe there's a connection here.  my medication regimen changes and boom, I'm back to square one.  well, it's a little better than before treatment started, so maybe square three or four.

what I do know for sure is that these pills are what's keeping me going.  as annoying and sometimes disheartening it is to choke down dozens of pills and shell out the cash for them, they have given me back a quality of life that was lost completely when RA started kicking my butt.  and by butt, I mean joints.

I wrote some weeks ago about wanting to be medication-free.  there are many RA sufferers out there who are able to control symptoms with dietary changes and different vitamin and supplement cocktails.  sure sounds good to me, but it just might not be my reality.  definitely not now, and maybe not ever.  so, dreams and courses of treatment and visions for the future change, and that's ok.  the naive RA patient I was months ago did not know what the only slightly less naive RA patient I am today knows -- that doctors are smart, Dr. J is the man, medications can be life changing, and sometimes it's worth a more intrusive course of treatment so that I can throw back the covers to get out of bed and walk down the hall in the morning to get a cup of coffee.

hats off to all you med-free RAers.  and my heart goes out to those who can't seem to find a medication regimen or other course of treatment to their symptoms under control.  this is a cruel, cruel disease and also a very unique one.  keep on keeping on, my RA friends.

Sjogren's syndrome

Praise the Lord, my emotional well-being is back on track and I've regained my positive outlook.  I really fell into a slump after experiencing so much pain, swelling, and overall scary symptoms in New York.  But God has been oh so gracious, blessing me with support, encouragement, and reminders of His faithfulness and sovereignty all over the place.  I am one thankful gal!  He is with me through all things and gives me amazing folks to lean on, confide in, and just laugh with because it hurts (here's looking at you, Jennie).

Moving on.

One of my latest concerns is a little autoimmune disease called Sjogren's syndrome.  It's actually not little at all, but instead extremely annoying.  At least it's annoying and not crippling like the RA.  Anyways, Sjogren's syndrome is an autoimmune disorder that impacts moisture-producing glands, such as the eyes, nose, and mouth.  Many people with RA also experiencing Sjogren's.  As if we didn't have enough to worry about.

A few weeks ago I was walking through the halls of the local senior independent living community where I work, and it felt like I was walking through a wind tunnel.  To my face, at least.  My eyes were extremely dry and sensitive, the Sahara desert relocated to the inside of my nose, and my mouth felt like I hadn't had a sip of water in a year.  Allergies, I thought?  Seriously, denial and an everything-but attitude when it comes to autoimmune disorders is the way to go.  Wink, wink.  Then I remembered the pamphlet Dr. J gave me on this silly sounding disorder.  I flipped through it, did some online research, and then called Dr. J's nurse.  She gave me the deets, told me they'd add some Sjogren's panels to the blood work I have scheduled for later this month, and then sent me another pamphlet.  Education, people.

The fact of the matter is that Sjogren's can't be cured, like RA, and the only thing to do is manage symptoms.  You can go the prescription route and get fancy (and expensive) lubricants (that word is gross), or you can just go to the CVS down the street and grab some dry mouth tooothpaste and mouth wash and all the saline spray and eye drops you can find and start a continual flow into your face.  I chose the latter.

In addition to the uncomfortable nature of Sjogren's, it kind of makes me look like a crazy person.  I have to squint when I walk because of the wind tunnel feeling, and the redness from the dryness makes it look like I've either been crying or am allergic to everything.  I also blink a lot.

Now you're all caught up on the health soap opera that is my life.
Thanks, once again, for the support and encouragement and thoughtful questions!

PS: Venus Williams also has Sjogren's syndrome, so we're as good as best friends now.  I'm sure I'll start getting invitations to play tennis with her any day now.

going public

the response to "going public" with my rheumatoid arthritis and this blog has been outstanding.  the encouragement, kind words, thoughtful questions, and prayers are just priceless.  what a gracious reminder of the gift of church community and relational support.  in the midst of an isolating disease, I don't feel quite so alone anymore.

with that being said, I also want to apologize for my awkwardness when discussing this part of my life in person.  I really need to work on fine tuning those communication skills, as I feel myself getting really uncomfortable and flustered by this vulnerability.  

so thank you! (and I'm sorry.)

I do not cease to give thanks for you, remembering you in my prayers.
Ephesians 1:16

my story

it's about time to get this in writing...

it all started with my right middle finger.  without any warning, I woke up one morning about seven months ago and it was swollen, stiff, painful, and the knuckle was a disturbing red/purple color.  a mystery, indeed.  had I jammed it at the gym?  did I hit it on the door frame?  did I sleep on my hand funny?  I could not remember doing any damage to my hand, but I figured I must have injured it somehow.  it would clear up in a few days, for sure.  well, the days went by and instead of getting better, the stinkin' middle finger just got worse.  it made it difficult and painful to comb my hair, turn on the faucet, open a ziplock bag, put on my shoes - it was quite the annoyance!  and at this point, just an annoyance.  I don't think the concern really set in until other fingers started following suit.  until then, I just continued to explain it away and assume all would be back to normal soon.  why would I think anything else?

but then the rapid spreading of symptoms began.  first to different fingers, then my toes (although anyone who knows me well knows I've had foot issues for forever.  bunions in your teens.  sexy.), onto my ankles, some swelling in the knees.  that's when the a-word first entered my thoughts.  could this be... arthritis?  I had been maintaining a pretty rigorous workout routine for some time - maybe I had done some damage to my joints?  I've never been one to shy away from the doctor like some, so I didn't hesitate to make an appointment to get in to see the expert.  by the time the appointment came around, I was pretty convinced it was arthritis, but even at that point I was thinking osteoarthritis, which is damage done to joints by physical activity.

my primary care physician, Dr. B., a lovely woman who had spent some time living on the East side of Michigan in her younger years and thus we were bonded, took one look at my inflamed hands and immediately ordered blood work.  that's when the big boy first entered the picture.

rheumatoid arthritis.  an autoimmune disorder that causes your body to attack itself, mainly the joints, but also the organs, skin, and other areas and functions of the body.  it's not caused by wear and tear or extreme running routines; it is a disease.  an illness.  blood work would measure my antibody levels and x-rays would show what, if any, permanent damage the disease had already done to my joints.

it took three long days for me to hear back about the results of my blood work.  I remember it like it was yesterday.  I had the day off from school, work, and internship and was sitting on the couch eating lunch and watching some mindless tv.  the phone rang, and it was Dr. B. on the other end.  she wasted no time and told me that one of the three blood work panels had come back and my antibody levels were through the roof.  it was rheumatoid arthritis, she said.  but there are still two other panels to be read, I countered.  is it possible that I don't have RA?  those results could be different.

no, the antibody levels could not be ignored.  all signs pointed to RA.  extreme, aggressive RA that was wreaking havoc on my body.  she made the referral to her favorite rheumatologist ("because he is thorough and his charting is very detailed").  I was able to get in to see Dr. J. within a couple weeks.

let's pause here.  the initial diagnosis was like a sock in the gut.  the tears flowed freely and violently, the phone call to share the news with husband John was sob- and snot-filled, and my immediate emotional response was hopelessness and fear.  I felt totally caught off guard, unprepared, ignorant, in the dark, and scared shitless (sorry, mom).  I had no idea what this diagnosis meant or what the future would hold.  I didn't know the first thing about treatment options or disease progression or how to live life with RA.  I was looking straight into a black hole and it was frightening.

word to the wise: when faced with a situation like this, do not google the disease you've been diagnosed with.  all I found was some disturbing pictures that would give small children nightmares.  yes, those fingers bent at 90 degree angles are accurate pictures of what my hands may look like someday, but I didn't need to know that on day one.  as you may expect, it didn't do anything to help my feelings of hopelessness.

by the time I went to meet Dr. J., I had calmed a bit.  like I said, I trust doctors and am not opposed to medical treatment.  I couldn't wait for Dr. J. to prescribe me some pills and be on the road to recovery.  oh, how much I have learned in the last six months.  there is no magic pill, evidently, and the road to recovery really isn't recovery-bound, but more geared towards symptom-management with a here-let's-try-this approach.  let me tell ya, it's an exhausting road to be on.  the destination is unknown, and you just have to hope and pray for the best.  and the scenery is not pretty along the way - purple joints and medication side effects make sure of that.  there is no map to follow, but just a guide who you have to trust because he's your only hope for finding a smoother way to travel.  ok, this analogy has gone too far...

what I'm trying to say is that RA is confusing, scary, and forever.  I will have this disease forever.  when I write that all the emotions of day one diagnosis come flooding back.  it's hard not to feel hopeless, isolated, alone, exhausted, and scared.  this is not how I envisioned my next __ years, and it's still taking some getting used to.

I do trust my doctor and his straight-to-the-point way of doing things, and we are working together to find the perfect medication cocktail to not only deal with the painful symptoms, but also to stop the disease progression.  I already have some permanent deformities, but Dr. J. is hopeful that we will be able to stop any further damage, and I feel blessed to have a confident and capable doctor.

so that is my RA diagnosis story in a nutshell.  it's been about six months since the fateful call from Dr. B., and those six months have seen lots of ups and downs - physically and emotionally.  I have to be very aware of my emotional state as I can find myself in a depressed slump and stay that way for far too long.  I'm actually trying to break free from such a slump right now, and with the support of my wonderful husband, family, and friends, and the faithful presence of my loving God, I know I'll be able to see brighter days soon.

In this broken world the disappointments add up quickly. Disability feels relentless. But it will end someday, swallowed up in the ultimate promises of God to make all things new for his glory and 
for our eternal joy. // 
John Knight for Desiring God

a more positive nyc post

Broadway and the US Open and Times Square, oh my!  we certainly packed in a lot of goodness in our four day whirlwind trip.  not only was it fun to see the sights, but it was also amazing to see two of our best friends from Michigan and share those times with them.  despite my RA-induced shortcomings (which I talked enough about already - my apologies), the trip was truly a success.

it was Aaron's first time in the Big Apple, so we made sure to hit the must-sees and actually went to Times Square our first night there, even though we didn't get in till after midnight.  there is energy in the City!  I haven't been out that late in a long, long time, but it didn't even phase me to take a sweaty subway ride and walk miles in the hustle and bustle of Manhattan.

we stayed in Brooklyn at my cousin's home instead of in a hotel in the city like we have before.  I fell in love with Brooklyn - so charming - and having the comforts of home was priceless.  our own bedrooms, a patio to sit on each morning with our coffee, two bathrooms (a luxury when travelling with three men!).  we are forever grateful for that arrangement.

and now, some more pictures.

I have said these things to you, that in Me you may have peace.  In the world you will have tribulation.  But take heart; I have overcome the world.

John 16:33

new york

one of my favorite things about my husband is his love of travel.  two years ago, right after we got married, he proposed a trip to New York City with our friend, Micah, to see the US Open.  of course I said yes and I was hooked from my first glimpse of Grand Central Station.  two years later we made a repeat visit and we're still trying to recover from our "New York hangover."  a wonderful, fast-paced, whirlwind time was had by all!

this trip was extremely emotional for me.  I was not suffering from rheumatoid arthritis on our last visit, and the miles and miles of walking didn't phase me in the least.  this time was different.  by the second day, my knees, ankles, and feet had swollen up larger than I have ever experienced.  I struggled to get my shoes on and could make a sizable indent in my knee when I poked it (yuck).  also, cankles.  it was so shocking and disheartening to have this visible reminder of my failing body.  I felt betrayed, angry, and deeply saddened.  I wanted to enjoy the trip and New York City in all its glory, so I put on a happy face, popped Tylenol regularly, and slept with my feet elevated.  but in the moments by myself, I broke down.  tears while waiting in the subway, in the shower, drinking coffee alone in the mornings.  negative thoughts plaguing me and only being reinforced by my jumbo joints.

is this my future?  am I forever to be limited and broken down by this blasted disease?  am I always going to be the weak link in the posse, asking to sit down for a minute and bee-lining it for the elevator instead of walking up the stairs?  

a pity party is very tempting, but not the healthiest option, I know.  this body-breaking trip convinced me that I need to find an RA support group.  I would love to get together with some RA comrades and talk about the ups, the downs, the meds, the tears.  but alas, small town Billings, Montana has no such thing.  can I get a "what the heck?"  still fuming a bit after finding this out.  just because you're teeny tiny doesn't mean you can get away with denying resources to your citizens.  come on, Billings!  maybe when I cool down a bit I can focus my energy on starting one myself.  until then, I'm just going to be angry.

that's all for now.  next post will be much more positive, I promise.

exhaustion

one of the most crippling things about rheumatoid arthritis is actually not the pain and stiffness; it's the extreme fatigue.  it hits me throughout the day, but most consistently in the evening.  I have napped more since diagnosis than in my entire life prior to.  I can't sit down on the couch at the end of the day without nodding off, sometimes for more than an hour.  now I like a nap as much as the next guy, but it's starting to get annoying.  my muscles ache to lie down, my eye lids are constantly heavy, and I feel utterly useless.  and the nap does not clear these symptoms, but makes them worse.  I wake up feeling groggy and even more useless.  I'm exhausted.  this is a side effect of the medication, namely the Methotrexate, but it is also simply a symptom of rheumatoid arthritis.  it comes with the territory and it's going to be lifelong, just like my disease.

the more I think about this exhaustion, the more my mind is brought away from my arthritis and to other areas of my life.  the truth is, there are far more exhausting things weighing on my mind from day to day.  this fallen world provides many opportunities for pain, grief, sadness, hardships, brokenness... it's just plain exhausting.

back to the arthritis for a second.  yes, my body is physically exhausted, but the mental and emotional exhaustion trumps that.  the what-ifs, the frustration with the changes in my abilities and appearance, the different treatments and medication trials, the grief of things lost.  I'm exhausted.

but there's more, of course.  my family is hurting so deeply, my friends struggle with various trials, dreams go unrealized, plans and promises are broken, and I'm haunted by sin that seems more pervasive by the day.  I'm exhausted.  we're all exhausted.

but there is rest for the weary.  there are promises to cling to!

Even youths shall faint and be weary, and young men shall fall exhausted; but they who wait for the Lord shall renew their strength; they shall mount up with wings like eagles; they shall run and not be weary; they shall walk and not faint. 

Isaiah 40:30-31

For I will satisfy the weary soul, and every languishing soul I will replenish.

Jeremiah 31:25

O God, you are my God; earnestly I see you; my soul thirsts for you; my flesh faints for you, as in a dry and weary land where there is no water.  So I have looked upon you in the sanctuary, beholding your power and glory.  Because your steadfast love is better than life, my lips will praise you.  So I will bless you as long as I live; in your name I will lift up my hands.

Psalm 63:1-4

in times of weariness, I will turn my eyes to the Lord and receive His promised strength, replenishment, and love. 

serious disease progression

went to see my rheumotologist, Dr. J., this week for a regular check up.  I was feeling pretty confident, even cocky, as I walked into the office.  I have been feeling really great the past month or so, experiencing only mild morning stiffness that loosens up within minutes and then a little hand pain during the day if I've been doing a lot of writing or carrying heavy objects (grocery shopping, lifting weights, etc.) and foot pain if I push too hard at the gym.  it's all taken care of with a single Tylenol or my regular daily dose of Celebrex.  I was ready to hear Dr. J. say "we've done it.  we've stopped the progression and you're set with this medication regime for the rest of your life."  then we would high-five.

this dream appointment that I had played out in my head was actually quite naive.  I may be relatively pain free, but every single day I'm aware of the purple/red color of my larger than life knuckles, especially if I eat some processed food, which we all know I do (see the post on my paleo fail) or, like I've already mentioned before, pushed my hands or feet to their limits.  so, there was no high-fiving with Dr. J.  he made it clear that I still have "serious disease progression" and deformities in my hands and feet.  in his very to-the-point way, Dr. J. encouraged me to look at the big picture, not just the small picture - which is me getting along very well, but only because of good pain management.  just because my pain is managed does not mean that my RA is managed.  welcome back to reality, Julie.

so, there's going to be some medication changes.  I've been put on Leflunomide in addition to the Methrotrexate, both medications are meant to stunt and stop the progression of rheumatoid arthritis.  beginning October 1st I will cut my Celebrex (pain medication) in half, because it's masking the RA symptoms and we need to see if I can get along without it.  regular blood tests and x-rays will continue in order to measure the antibody levels in my blood and inflammation/deformities/etc. in my joints.  hopefully by my next date with Dr. J. there will be plenty to high-five about.

---  the very thought of that is just hilarious to me.  John can attest, Dr. J. is a straight-faced, get down to business, no time for tomfoolery kind of guy.  I have cracked some of my best nervous jokes in his presence and barely got half a chuckle.  so a high-five is probably not in our future, but a girl can dream.

I love my Dr. J. and am so grateful for his knowledge and his desire to see me live my best life in the midst of this disease.  ...even if he doesn't laugh at my jokes.

paleo fail

the paleo journey lasted one whole day.  and I even cheated by having my regular oatmeal breakfast.  maybe I'm not strong enough or dedicated enough, but whatever it is, I just couldn't hack it.  I'm not the paleo diet type.  so on to the next thing.  or maybe just back to trying to eat healthy and manage the best I can.  hats off to all you radical diet types!  respect.

in other news, I started by internship with a local hospice agency.  one week in and I am already loving it.  I admire my supervisor and her offbeat ways.  she's pretty quirky and definitely disorganized, but her care for her clients and her respect for each of them in their particular situation is something to respect.  and that's what it's all about, right?  reaching people.  she reaches people.

I know this internship is going to stretch me in ways I'm not prepared for.  I know I'm going to learn some really important things about being a social worker.  my prayer is that God will start equipping me even now for the responsibilities I will be given and the things I will be asked to do.  I want to reach people too.

I'll leave with the verse of the day from by Bible app.  such sweet, astounding, life-shaping truth for the day, for always:
He himself bore our sins in his body on the tree, that we might die to sin and live to righteousness.  By his wounds you have been healed. || I Peter 2:24

grumbling

read a devotional this morning on the Desiring God blog about sins that are common temptations to humans.  the devotional reflected on 1 Corinthians 10:13 which reads, "No temptation has overtaken you that is not common to man. God is faithful, and he will not let you be tempted beyond your ability, but with the temptation he will also provide the way of escape, that you may be able to endure it."  the particular tempting sins that are being referred to in this passage are grumbling and sexual immorality.  God knows I love to grumble.  I grumble about being tired, my health, homework, money, to-do lists, living so far from my family, the hot weather... the list goes on and on.  

it is certainly tempting to me to grumble and complain!  this particular sin shows my false assumption that this world is my little kingdom and everything should go my way.  it's all about me and mine.  what I want, what I think should happen, what I deserve.  but the reality is that this world belongs to my God.  and thank Him for that.  He is in control and He is sovereign and He is faithful.  how quickly I forget

with each temptation is a promise.  if you turn to God's Holy Word, you will read loads of amazing and jaw-dropping promises.  for example, when I am tempted to grumble and complain, I must remember these promises: "Trust in the Lord with all your heart, and do not lean on your own understanding. In all your ways acknowledge him, and he will make straight your paths." (Proverbs 3:5-6).  "And my God will supply every need of yours according to his riches in glory in Christ Jesus." (Philippians 4:19).

when all I want to do is grumble, my focus and attention is on me, not on the almighty God who cares for me and promises to direct my paths and supply my every need.  He is truly an amazing Father.

blueberries

my favorite thing on the list of top 10 anti-inflammatory foods

storm clouds

a majestic display of God's power and might last night

sometimes I just don't feel like it

my latest battle has been with exercise.  well, it's been going on for a while, if I'm going to be honest.  I used to be quite the gym rat and run 15+ miles a week.  then my feet started hurting, which was blamed on bunions, and then the dreaded diagnosis, and then all the meds, and then the fatigue, and then the crankiness and general displeasure with having joints that are purple and double their normal size... oh the excuses and blows to my ego and sense of well being are too many to list.  it goes without saying, I can throw myself quite the pity party.  I'd send invitations, but I'm too tired and cranky.

anyways, I've gained the weight and the bad attitude that everyone warns can come with an RA diagnosis.  there are days where I'm motivated to beat the 'tude and days when I just stare at my gym clothes from my comfy perch on the couch.  I have an internal dialogue about 'to work out or not to work out' about a thousand times a day.  it's anybody's guess who will win the argument.

it's easy to say "I have RA, I can't work out," but it's harder to admit that "I have RA and it pisses me off and I'm going to use it as an excuse to be lazy."  but that's the honest truth sometimes and here I am, owning it.

I need a new outlook, a new mantra, a new motivation.  health.  it's my health, not my jean size, that matters.  I may be hurting, but I'm also given hours and sometimes entire days where I'm feeling pretty normal.  I need to seize those pain-free opportunities and choose happiness and health over pity and potato chips.

but sometimes I just don't feel like it.  working on it, though.

arthritis meds aren't just for people with grey hair

some of my family is here from Michigan!  I love visitors.  after a few days in Yellowstone National Park, we are back in Billings just doing life together.  I just love it.  I've mentioned before that my sister has been experiencing joint pain and inflammation (she's awaiting her doctor's appointment where we hope and pray there's an answer other than RA).  the altitude and physical strain of the park's activities didn't exactly help our situation, but we were bound and determined to have a good time despite the pain and weakness.  mission accomplished, but we're definitely paying the price now.  completely exhausted.  

we joke that this is our advertisement for Celebrex.  we won't let rheumatoid arthritis slow us down!

your words have blessed me

RA is a difficult thing for anyone.  not only the person with the disease, but also those in the RA patient's life.  I've heard a fair share of offensive and hurtful things regarding my diagnosis, mostly people just not being educated and knowing appropriate ways to address the subject with me.  but I have also been asked some of the most thoughtful questions and have been supported in really beautiful ways.  so here's a little list I made.  maybe someone will read this and be better able to support the person with RA in their life.

how's your health? - this is great because it acknowledges the fact that RA is a health issue, not just a weakness issue or something that will clear up.  a person with RA has a lot going on health-wise (medications, struggles, victories, treatment options, frustrations), so you may get a really detailed answer, or a short and simple one.  but rest assured, it feels great to have someone care enough to ask.
you look great. - well this may sound shallow, but it's such a wonderful compliment for someone with RA (or anyone, for that matter!).  RA makes you feel really ugly sometimes.  red/purple, giant, painful joints for one.  I can no longer wear any rings other than my engagement ring and wedding band because of the size of my knuckles, but I wouldn't want to draw attention to my hands anyways.  my fingers are kinda nasty, even with well treated RA.  then there's the weight gain from the meds and a lessened ability to work out, poofy face from the steroids, bad skin from the meds and increased sensitivity to meds, random hair growth - yeah, RA and the pills we pop because of it are pretty messed up.  being told that I'm looking better than I feel is a huge morale booster.  keep it coming, I don't care how shallow it sounds.
this must be very difficult. - yes!  it is!  thank you for acknowledging it.  I understand that RA is extremely hard to understand unless you have it, but let me tell you - it's really, really difficult.  life with RA is hard, emotional, frustrating, confusing.  
how are you holding up? - thanks for being so thoughtful.  sorry if I cry when you ask me.
anything I can do to help? - on second thought, maybe you should ask my husband this, because he's the one listening to me whine and worry, going to doctor's appointments with me, paying for my meds, buying me expensive shoes because I need lots of support and cushion when I walk, opening ziplock bags and jars for me, and much MUCH more.  

go and support the ones you love!  healthy or ill, we all need love, encouragement, and a helping hand.

let the games begin.

after being told that even my skin is being effected by my RA, I've been thinking a lot about the medications I'm on, their pros, their cons, and what my future holds as far as treatment goes.  at the same time, my sister started experiencing inflammation, stiffness, and pain in her joints.  she hasn't been diagnosed with anything, but when your body starts betraying you, the first thing on your mind is how to make it stop.  and so, my sister and I have started thinking about the paleo diet.  yikes!  it's definitely not the most extreme diet out there, but it does involve cutting out things that I really enjoy (bread!).

I've never been very good at limiting myself or putting restrictions on myself.  except for the dedication I put into training for a 25k race a year ago, I've really just let myself go with the flow as far as diet and exercise goes.  everything in moderation; some days better than others.  but then RA happened and I started gaining weight, looking poofy, struggling to get in and out of a car, not lasting more than 20 minutes on the elliptical..... and I've come to the realization that this body of mine is going to start taking some work.  no more going with the flow, but instead I need to be proactive, thinking about what I put in my body, and getting committed to managing this disease without medication.

oh yeah, did I mention I'd like to go med free?  a big goal, but one that is obtainable with a lot of hard work.  can I do it?  let the games begin.

the product of surprise

you can only be surprised so many times by rheumatoid arthritis before you start saying "I need to start a blog. people need to know about this stuff."

earlier this week I was told by my dermatologist that I had acquired a skin condition as yet another side effect of my RA meds.  my rheumotologist and the internet never told me anything about skin conditions.  weight gain, check.  stomach pain, check.  lethargy, check.  skin conditions, what the heck.

so that's where this blog is coming from.  a place to share information, be brutally honest, and hopefully raise some awareness.  I know I'm not the only one experiencing these growing pains.

above all, I want to bring glory to my God.  RA isn't the only thing stretching me, teaching me, causing me to run into the arms of my Father.  above all, I want to bring glory to my faithful, sovereign God.