Icing

I’m sitting on the futon next to a sleeping golden retriever.  I’ve got an ice pack that I reposition on my back, then my hip, then my shoulder, then my neck.  It’s a little ironic that I’m applying ice to my body in the middle of a winter storm.

I can hear the snowish-rain and rainish-snow pelting our concrete roof.  I’m happy that I made the decision to cancel this afternoon’s tutoring sessions in a neighboring town.  I really wasn’t up to the drive, or the sitting at a table for three and a half hours, or the critical thinking that would’ve had to happen during those hours.

The weather was my excuse, but it would’ve been just as legitimate to call off on account of my physical state.

And here I am again, writing about this invisible illness that tries and tries to steal my joy.

It’s not going to win, ultimately, but my body and I are in a wrestling match right now.

Just over three years ago I got my first diagnosis — psoriatic arthritis — and I did what I thought I was supposed to do: I took the medication.  I can’t even tell you all the different things that I have tried — whatever is the standard regimen for these types of things — some kind of pills, then another kind, some injections, and finally, the latest strategy prescription NSAIDs.  I’ve been on diclofenac (Voltarin) for a couple of years now.  It was managing my pain pretty well, actually. I would say that while on this drug, an average day meant consistent pain levels of 2-3 on a scale of 1 to 10.  Bad days might surge up to a 5, but not usually higher than that.  A five is manageable.  It slows you down, but you can still function.  It drains the battery, but you still get some limited functioning.

Well, as part of my quest for health, I read a book called Total Recovery, by Dr. Gary Kaplan, a doctor at the Kaplan Center for Integrative Medicine, and an associate professor at Georgetown University.   I’ve mentioned this book before in this blog.  It has really challenged my ideas about medical practice and the use of pharmaceuticals.  Dr. Kaplan cites research that shows that although NSAIDs are useful in the short-term, their long-term use can actually lead to an increased experience of pain. My doctor, who, as I’ve mentioned, takes a holistic approach to health, which includes, but is not limited to,  medicine, homeopathy, nutrition, exercise, and physical therapy, also voiced concern regarding my use of NSAIDs and their long term impact on my digestive tract.  The whole team — my doctor, my physical therapist, and my chiropractor — all shared this concern.  So, under my doctor’s guidance, and with the encouragement of the team, I first cut my dosage of diclofenac from 150 mg/day to 100 mg/day and then to 50 mg/day.

After several months on that dose, I accidentally forgot to take my meds last Sunday night.  The team and I had been planning for me to discontinue diclofenac completely at about this time anyway, so I took that as my cue and haven’t had any type of anti-inflammatory or pain medication since Saturday.   Hence, the ice.

Kaplan’s theory, based on his clinical experience, is that after a long, pain-filled couple of months without NSAIDs, my body’s endorphin system will kick back in and the pain will go away (Kaplan 43).  Hence, the wrestling match.

It’s Wednesday.  I have only been without this medication for three days. My pain for the past two has been well above 5.  Let’s say it’s a 7.  Seven drains the battery much more quickly than 5 does.  It’s like having all your apps open, the wifi roaming to find a signal, bluetooth on, and the screen light on high.  I don’t last long.  Exhausted,  I try to sleep, but I can’t get comfortable.  The majority of my pain is in my right shoulder/upper arm and  my right hip,  but that pain likes to travel to my low back, my neck, my left elbow, my feet, my eyes, and anywhere else it can find a place to reside.  No sleeping position is comfortable.

Kaplan says that if your body doesn’t get enough rest, your experience of pain is greater. Yeah, I know.

So, I’m trying to look on the bright side.  I make my own work schedule.  I can lie down in the middle of the day if I feel like it.  I’m getting to see a lot more Jimmy Fallon than usual. And maybe, just maybe, this decision will eventually lead to less pain and a better quality of life.

That, my friends, is my prayer.

Psalm 103: 2-5

Praise the Lord, my soul,
    and forget not all his benefits—
³ who forgives all your sins
    and heals all your diseases,
⁴ who redeems your life from the pit
    and crowns you with love and compassion,
⁵ who satisfies your desires with good things
    so that your youth is renewed like the eagle’s.