Residue of Tidying

Recently, I took a few days off. The car needed an oil change and I had an eye doctor appointment. I like my eye doctor very much. She's nice, friendly, and extremely thorough. RA can affect your eyes so I have to see a specialist. Yet, getting in to see her can be an ordeal necessitating hours of my time so I took the day off. Then, realizing I had days to use up, I just took extra days off. We all need time to rest and recharge.

Part of that involved tackling a small spot in the home office. I have saved all the receipts from medications dating back to when I was diagnosed with RA. Insurance covers my prescriptions, but I felt it was important to keep tabs on my medications. But I realized, when I sorted the filing cabinet over Christmas, I get a running report with every doctor visit. I don't need to save the receipt. Some of the medications come with a patient information sheet. This adds up to a lot of paper, sitting in a stack, in the home office.

I shredded it; all of it; excepting the information sheets. They had no identifying numbers or my name on them. All of it went in the recycling can. Before I could send a receipt through the shredder, I had to remove staples; lots and lots of staples.

I get my prescriptions at CVS. There were, sometimes, 3-4 staples in a receipt. That's a lot of metal. I recycled these too.

The area where 5 years of prescription receipts was is now clear. I can use it for more important storage or just leave it empty.

Beverage:  Assam tea

Deb

A Wee Touch o' Sadness

I was going through my photos on Flickr today, as I ate my lunch, trying to put a bit more organization to them. I still have a ways to go to get through some 6,000 photos taken since 2009, but I made a bit of progress. I stumbled across this photo.

Oh man. I remember this event. I went to the store and bought these beers, and a few others not shown, all of them of Scottish origin. Belhaven was, at the time, my favorite, but I'm thinking I wound up liking the Old Engine Oil best. I found the blog post which used this photo but it doesn't say how I liked Dark Island. I don't remember. Perhaps worst of all, I don't remember how any of these tasted.

Now, mind you, life changes on you and what you once took for granted can be gone quickly. With rheumatoid arthritis drugs in my body, my liver cannot handle extra things like alcohol. I will, on extremely rare occasions, drink a teaspoon of something, but when the choice is RA drugs or a damaged liver, I'm going to choose the drugs.

Still, I'm feeling nostalgic for the time I could look in the fridge and find a wide variety of Scottish beer. In 2012, there were times I'd be out for dinner and feel so awful about not being able to share a drink with friends. In 2016, I don't think twice about it. I've given away almost all the alcohol that was in my house. I have some unopened bottles of things in the basement. They are going this year. It's all about your perspective. Making this choice was easy for me, if the implementation was a bit hard. The photo represents a time in my life that was different. I'm happy with where things are now.

Beverage:  Raspberry Seltzer

Deb

Helping the Memory

It's hard, sometimes, not to feel my age. This is particularly true when the morning comes and I'm running late and I get half-way to the office and realize I don't have my meds with me. "I'll just take them when I get home," I think. More often than not, that doesn't happen. My inability to remember something so basic and so important can open the door to that little mocking voice we all have. "Boy are you OLD," it can say. "You can't remember something that important." And that's a spiral those of us who have existed with depression know all too well. That voice can be very, very hard to silence. When your health depends upon a regimen of pills and you forget them, the creaks and aches give that voice ammunition.

With a vacation away from the familiarity of my kitchen, where bottles are neatly stacked in the order in which I usually take them, I felt a slight fear. I really did not want to pack all the bottles of things I take. While it's not a pharmacy, it's more than two. The more I thought about this, the more anxious I became about forgetting to take something in the excitement of the vacation. In a flash of enlightenment, I thought about a pill box.

I put morning pills in the blue side and evening pills in the purple side. It worked like a charm. What day is it? Friday. Open that container. No bottles and the compartments snapped tight. I took everything when I had to take it and didn't forget anything. When I came home, I stuck this in the cupboard in the bathroom. It served its purpose and, it will travel with me whenever I go out of town, even if it's an overnight. No more lugging bottles.

Lately, I've been struggling with the winter blahs. It's manifested itself in forgetting to take my meds. I get up late and the dash out the door to get to work on time causes me to skip doses. Then I get down on myself. At the end of last month, I remembered this.

There were conversations with myself. I'm getting old if I admit that I can't remember to take my meds. That nagging voice started to overrule the gentle voice that reminded me why I take this stuff. But I went 4 days without taking my meds and I started to feel it. I need help to remind me. Out came the pill box.

So, for the last 2 weeks, I've carefully dropped the morning's pills into the blue side. I don't have much trouble with evening pills. They are taken on an "as needed" basis and I keep the bottles by the computer, where I tend to wind up at some point at the end of a day. I have the computer set up to send me an alert, too, when it's time to take the evening pills. The big issue is the morning doses. I pop open the top, put the pills in an empty bottle and bring the bottle with me to the office. I've been cutting time close lately so Dunkin' has been breakfast of late, something I need to cut back on. Chocolate donuts, while fun to eat, shouldn't be eaten daily. I don't close the top on the compartment until it's filled again.

I'm finding this method is helping me remember. I don't think there is anything wrong with my memory. I just let the negative voice drown out the positive voice. It's also winter and the cold and dark can be oppressive, sapping what little self-caring energy you have. I felt my internal 'ship', if you will, had tilted and was taking on water. This small step will right that ship and get me back on track. It's like the cleaning I've been doing after reading the tidying up book. Things have to be done in small steps. I can do this in small steps.

Beverage:  Raspberry Seltzer

Deb

Occasionally, It Pays Off

I'm really on the fence about loyalty cards. I have them. I use them. But the benefits don't seem to be hugely apparent. I joined Best Buy's loyalty program with I bought my TV and Blu-Ray player last year. I got $5 back. Woo...hoo. I used that, in January, to buy the external storage device. I'll probably not accrue any more loyalty stuff from Best Buy unless I have to buy a major appliance.

Hallmark is another place I have a loyalty card. That does sometimes pay benefits, if I remember to bring the coupon with me when I go into the store. My Panera loyalty program gets me a dollar off on a pastry or a free beverage, on occasion. My Dunkin Donuts "Perks" card is probably the one loyalty card that nets me the most freebies.

I find, at this stage of life, I'm at CVS Pharmacy quite a bit. I haven't managed to get all my prescriptions to be filled at the same time so I can make one run. I have this one at this time and these two at that time, so I find myself in the place quite frequently. I have their loyalty card and it will give me a lot of discounts, most of which I don't need. I've talked about it before, how loyalty cards don't really inconvenience a company. You can give me $15 in coupons, but if I don't NEED batteries, even giving me a buy any size get one free coupon isn't going to entice me into the store. Sometimes, however, I can hit it just right.

Shampoo and two bottles of conditioner. I was out of conditioner and had to pick up a prescription. I also happened to have a $3.00 off on my next purchase, thanks to all the times I'm in the store to pick up medication. VO5 is 99 cents. My final bill was pocket change. The receipt has a coupon for greeting cards; buy 2 and get 1 free. I might use that. I might not. I need to look to see what's upcoming that might need a card to send.

I don't go somewhere because there is a loyalty program. In fact, I could probably weed the key fobs I don't use off the key fob on which I have them. Still, it does pay to check. Every so often, I can score a great deal.

Beverage:  English Breakfast tea

Deb

Like I Needed More M&M's

The count on top of the fridge stands at 8 separate bags of M&Ms. I also got a bag of what I thought was M&Ms from Kevin and Megan in Canada, only to find out they are Smarties.

I've taken them to work for boosting my morale during the day. After I have my lunch with it's fruit and sandwich or leftovers or soup, I have some chocolate. These have helped as I slog through more reports and process more data.

I had to go to CVS to get my monthly supply of RA meds and passed through the Valentine chocolate aisle. Now, with the sheer amount of M&Ms I have on the fridge, there is no need to contemplate the pink and red bags of pink, red and white candies. But then, a different colored bag caught my eye. Oh dear.

This is the only time these are available. CVS only had 2 bags and both came home with me.

No, I don't need more M&Ms, but it's the cherry ones. They are my all-time favorite. I will put them at the absolute bottom of the stack. That means, I should have them through October, just in time for the Halloween colored ones. If I'm really careful, I can stretch what I have into December of this year, just in time for Christmas presents. Maybe I should get another bag...

Beverage:  Hot Cider

Deb

A Case of the Thaws

It's been lovely the last two days.

There's been a whole lotta melting going on. Almost all the ice in the birdbath is gone. There's usually a January thaw and we've had it.

Given that last year, at this time, we had received close to 2 feet of snow, I enjoyed the nice weather. Mija and I went out on the deck for a few minutes, rather, she followed me out while I took out the garbage and the recycling. Our deck visitor hasn't been seen in over a week. There is no sign that she's been anywhere near the house. I'm trusting that she's got a family who loves her. The house will stay on the deck until mid-spring, just in case.

I've started new RA meds. The Enbrel, started before Thanksgiving, just didn't seem to work. I've been given samples of Humira to try. This is an every other week shot. I can't say that there was an immediate change to my life. When the weather is bright and sunny and cheerful and mild, I don't notice that I have aches and pains. My biggest complaint is the chronic fatigue, not swelling of or pain in my joints. I'm supposed to get some relief, some energy back.

Sitting on the top deck stair in the warmth of a mid-January sun made my RA seem a million miles away. I'll take it. I still don't get as much done as I'd like, I wear out too quickly, but mild January days make that aspect much easier to bear.

Beverage:  Water

Deb

A Change of Meds

There was a doctor visit in November. At that time, Dr. Francis and I discussed the state of my RA. I don't necessarily feel worse. I have little aches, but, come on, we all have those from day to day. It wasn't pain. It was an ache in a joint; a thumb, a wrist, a toe, a shoulder. On a few days, at the end of the day, I'd take an aspirin or, if I knew I would be on my feet for awhile, I'd take an aspirin at the beginning of the day. I can't take more than two aspirin in a 24 hour period and, if the need for an aspirin continues over more than 3 days, I need to call Dr. Francis. I felt I was doing well, all things considered. That Vectra test changed the perception of what I'm dealing with.

One simple number, 42, changed everything. Joking aside that it's the "universal answer to life, the universe and everything', it says I have moved into severe levels with RA. Left untreated, joint damage will occur. I'll get the bent fingers I remember a number of my great aunts having. It was time, Dr. Francis said, to add one of the newer biologic drugs to my arsenal.

At first, we tried to get Xeljanz. You might have seen their elegant black and white commercials on TV. It's attractive because it's a pill taken twice a day. It's relatively new to the biologic market. But, my insurer would not approve it. I was going to need to take one of the older established biologics and see if I have an intolerance issue with them before Xeljanz can be considered. They said I needed to start with Enbrel.

You might recognize this name if you watch sports or a lot of TV. Golfer Phil Mickelson is the celebrity spokesperson for this. He has Psoriatic Arthritis and Enbrel was developed to treat that. But it's also useful for RA and for Plaque Psoriasis. Dr. Francis has a number of patients on Enbrel and she likes it. She has fewer on Xeljanz, but they are doing well. It is newer to her than Enbrel is, so she has less experience with it. Still she went to bat for me to get what I thought would be much easier for me to take.

This comes as a pen-type injector which I need to do myself. This scared me to no end. I know of people who have to give themselves shots and I admire their fortitude. But, if I'm going to progress on, I needed to get over my fear and learn to do this. Just telling me "it's easy" is not helpful or mind settling.

For drugs like these, the data sheet rivals a small novel.

I spent last night on the phone with nurses from the pharmacy that sends me the Enbrel and with my insurance company going over the side effects. Unfortunately, there is no magic "by" date to tell me if I tolerate this without side effects. I can say that I haven't grown a third eye or have been covered in hives. One side effect to consider with the holidays approaching is that my immune system is suppressed and I will be less able to fight off colds. That means there probably aren't going to be a lot of "Aunt Debbie" hugs at Christmas, particularly if someone has the sniffles. I got the flu shot this year but am slightly worried about my health since reports are that the flu shot may not help one's immune system fight the flu. I've been informed that what is usually a 7 day battle with a cold, could be a 2 week battle for me. That's a long time to be sick. It means hand washing is huge for me and, although I like you, you might have to stand over there to talk to me. Nothing personal. Just know I don't want to be near you if you're sick.

An interesting thing about this medication is that it comes chilled.

It needs to be kept refrigerated. I had it sent to the office where we have a mini-fridge and I could keep it cold. Technically, deliveries in the winter shouldn't be affected, but the last thing I wanted was for someone to swipe the box off the front porch, too. Since the delivery is next day, I can call for a delivery on a day when I know I will be in the office to sign for it and put it in the fridge.

My first box came with all this stuff.

There are small circular band-aids, alcohol pads for cleaning the injection area and a sharps container. I'm not a bleeder and often, after having blood drawn at my RA appointments, I will forego a band-aid. But I've noticed that there is just a pin prick spot at the injection site and a band-aid is helpful for a couple hours. I don't know, yet, when I will send the sharps container back, but I like that it's small enough to sit on the shelf in the bathroom yet it appears it will hold a couple months worth of pens.

The drug itself arrives in a styrofoam cooler.

It was a perfect fit for the box and getting it out at the office involved removing the top, grabbing both sides and shaking the box so it would drop off. It fits nicely in the office fridge.

It's not very big.

A 6-pack of soda is probably all that would fit in here. The box of pens, 4 to a package, was under and on top of gel packs; 2 on top and 2 on the bottom. Since this is a month's worth of drugs and I have to do this now forever, or until something changes, the thought of all these coolers and gel packs in my house makes me weak. I was informed that, once I've been on this for 3 months and if I'm tolerating it well, I will get my 4th shipment as 3 month's worth. Well, that's still a cooler and gel packs. I don't know if I can recycle those, although the styrofoam cooler I can. The last thing I need are stacks of gel packs in my freezer, although they last a long time and keep frozen dinners frozen.

I went to the doctor's office and learned how to give myself the shot. It went okay under my doctor's nurses' watchful eye. The next week, it stung a bit when I did it on a Saturday in the bathroom. Last week, however, it didn't hurt beyond the initial pin prick. I have to take the meds out of the fridge and let them come to room temperature for at least 30 minutes. This past week, I waited 40 minutes. When I use the alcohol pads to wipe off the injection site, I need to make sure all the alcohol has evaporated or that will sting. Once I see the indicator on the pen go to solid purple, I count to 5 before removing the pen from my leg. This way I make sure all the medication has been delivered.

Do I have an immediate feeling for change? No. Yeah, I was hopeful there would be some dramatic feeling better, that this almost crushing fatigue I fight would be lifted. But, with a drug like this, my body has to get used to it being in my system and that takes time. It could take as long as 3 months. I need to be better by March so I can go back to Virginia and not be completely wiped out by the travel.

And, speaking of Virginia, they provided me with a travel pouch.

It has gel inserts. The whole thing goes into the fridge before I travel and then a month's worth of pens can be put inside the case. The pouch will keep them chilled for up to 14 hours. When I go to Virginia, I'll have this and a cooler for travel. Things you have to plan for that you didn't before.

One of the questions the nurses ask when going over the drug is if you are depressed. I've been thinking a lot about that question on my own. Am I fatigued because of something else? It comes back to no and I expressed that to the nurses. I'm tired. Both the reading I've done and Dr. Francis agree that my fatigue is due to the RA. She doesn't guarantee I will feel better, 66% of patients report an easing of symptoms, but Dr. Francis feels this is the best route to go. Once there is enough drug assisting my body in fighting this disease, then I won't feel so tired anymore.

Here I go, walking down a different road. Right now, if feels as if the road is going up and up and it's hard to climb. It's not filled with pot holes or boulders, it's just steep and I'm struggling to progress. I'm hopeful this will do the trick and give me back my energy. I miss feeling refreshed all day.

Beverage:  Water

Deb

The Cost of Tired

I have been missing here for almost a month. The girls know where I've been and have spent a lot of time with me there. Bed. Struggling to sleep and get rested.

Since coming back from a quick trip to Virginia at the end of October, I've felt myself slide. It's not that I'm in pain. There isn't "pain" associated with my RA. It's more a case of a dull ache here and there, but a dull ache every day. Maybe it's the left thumb or the right wrist or my right shoulder or my left pinkie finger. It's never enough to say, "Oh wow. Does that hurt." I can work through it, but it's there. And please understand that I'm not trying to pull pity out of you. I'm merely recounting what's going on so you know where I've been for the last nearly a month.

One of the markers for RA is fatigue. It figures. Your body is fighting yourself, attacking your joints and your joints are trying to fight back. That internal war just wears out your body, making sleep attractive. RA sufferers are a tired lot and when it gets into the severe area, where mine is, fatigue is as common as sunshine.

Also, we have been extraordinarily busy at work. Since Labor Day weekend, we have received two projects requiring weeks of work in the city. Now, I love the city. I enjoy driving in. You've seen my photos of sunrise over Lake Michigan and over Chicago. I've had a lot of overtime and more is needed as I do the reports for the field time. But, when you suffer from RA, getting up early, working late, being on your feet as much as I have been, comes with a price. That price is added fatigue on top of what you already experience just in fighting the disease. I come home after 12 hours on the job, get the mail, sit in the recliner, add a cat and boom, it's 2 hours later and nothing's been accomplished. I pick one thing to do, say a load of laundry, do that and then I have to sit, which leads to dozing, which leads to, "I should just go to bed". It becomes a sorry cycle.

This can also lead to depression because you just don't have the energy to do anything other than what absolutely has to be done. I'm out of pants. I have to do laundry. Dishes pile up in the sink until something smells. Then, it takes 3 days to do them because I only have the energy for a couple loads. At least they are stacked on the stove. That's good, right? Not really. I come in the back door and have to walk right by the pile which reminds me that I need to do another couple of loads which I don't have the energy to do.

So, I make a conscious choice NOT to eat at night or eat something which doesn't need much in the way of prep time or dishes. Peanut butter  or turkey and cheese sandwiches have been my meal of choice. Frankly, I don't want to fix anything and I've gone to bed without supper many, many times in the last month because I'm too tired to even unscrew the lid off a jar of peanut butter, let alone cook the hamburger I took out of the freezer so I could make meatball vegetable soup. It's a great cold weather soup and it's reasonably easy to make, but not as easy as peanut butter on bread which is harder than just having a cup of tea and calling it a night. Yes, my doctor is not pleased.

I find that I spend much more money eating out. As you know, Dunkin' Donuts is a favorite place and it's been frequently a lot in the last month. Just this week, I've gone there 3 times. A couple of donuts and a large hot tea and I'm set for hours. I also frequent Panera but breakfast there is more expensive as their pastries are more expensive. Still, going to both frequently means I've earned free drinks both places, which does cushion the cost. I also have another person almost "trained" at Dunkin' as to what I get when I walk in. Let's not talk about the healthiness of this breakfast choice.

Lunch is also a conundrum. If I'm out in the field, I can justify having lunch expensed to the client. It's built into the cost of the work. But if I'm sitting at my desk working on reports or processing data, I have to foot the bill for lunch. Recognizing my tendency to take an "easy" way out of procuring food, I bought a bunch of frozen dinners and yogurt which could be grabbing in the morning and eaten for lunch. The operative word in that sentence is "could". When I get up with less than an hour to be at the office, even grabbing a frozen dinner and yogurt doesn't happen. So, when it gets to be 12:45 and I realize I need to eat lunch, it's off to Panera or Subway. There are a lot of choices near the office, but those are my go-to places and are far more healthy than a lot of the other places. With a hearty lunch, I can go the rest of the day without feeling the need to eat, not that that's a good thing, mind you.

All of this leads to feelings of inadequacy. I can't care for myself adequately. I look at the girls. Am I doing right by them? I have Christmas gifts I want to sew yet looking at the patterns stacked neatly on the table in the living room leaves me feeling exhausted and I haven't done anything with them. My house is dirty. I need to clean. The best I can do is sweep a room with a glance and try not to write my name in the dust. All these things I want to do get tossed aside because I have no energy. And let's not consider the cost of breakfasts and lunches out. Uh oh. That's a very real effect of not feeling that I can adequately care for myself.

There was a doctor's visit on November 14th. We went over all of this. You know how, sometimes, you don't feel you can tell your doctor everything you're going through. You're afraid that you'll be labeled a scaredy-cat or obstinate or who knows what else. I don't want to be thought of as a hypochondriac. I know people who fit this description and that's not what I want to be. But I've come to see that telling Dr. Francis everything, all the aches, pains, bumps, non-eating, bad sleeping, falling asleep at my desk at 10 a.m. leads to frank discussions of what's going on and what can be done to help me. She put her hand on my arm and said, "You have to stop trying to tough it out. That's not working well, is it?" No, it's not. I think I'm more tired when I try to simply push on than when I admit that it's not working. I find it so hard to ask for help, so hard to say, "I can't do this".

There was, at the end of November, an article in an online RA newsletter I receive which talks about the tired. That appears to be the number one issue people with RA report. Exercise can give you more energy, but you need a certain pool of energy to begin with to even attempt the thought of walking or running or swimming or, man, that makes me tired just thinking about it. The author of the article said we know we are tired so we, wisely, scale back our expectations. So instead of, "I'm going to clean the house", we decide, "I'm going to clean the bathroom". But, when we are fatigued, cleaning the entire bathroom becomes an exercise in futility which leads to a cycle of mental shaming and sadness. She said that you need to pare a project down even further. Instead of "I'll clean the bathroom", it needs to be, "I'll clean off the mirror", "I'll clean off the sink", "I'll wash the floor". Yes, this may mean the project goes from what you could do in 2 hours to what I need a week to accomplish, but this is what I have to do.

I also need to give myself permission to nap. I can't do it at work, unless no one is here and both the post office and UPS have made their deliveries. Then I can turn off the lights and snooze. But on weekends, I need to give myself permission to say, "I'm tired. I'm taking a nap" and to sleep however long my body tells me I need to.

I also need to give myself permission to admit that this is a struggle and that some days I will win and some days I will "lose". I need to stop seeing those days as losses and see them as adjustments in the road I have to travel. Not blogging has weighed heavily on my mind. I have hundreds of photos to share and have written thousands of posts in my mind as I drift off to sleep. I sometimes think that, perhaps, an iPad would be a good investment because I could write a blog post while I am in the recliner, with my feet up. But I don't want the cost of an additional item on my Internet service.

There has been a change in medications in response to this. I'll detail that in another blog post as this one is getting long. I don't know if the medication has made any sort of difference in my quality of life. Dr. Francis said it could take 2-3 months to see a change. She says this heavy fatigue will lift. You know, the recent end of November cold was rather energizing. I didn't mind it at all.

I also added back into my medications a nightly sleeping pill Dr. Francis prescribed. I thought I was tired enough that I could fall asleep without it, but that's not the kind of fatigue which promotes sound sleep. I found myself waking up two or three times at night. Fractured sleep is not good sleep. Since adding that back into my regimen, I notice that I'm not falling asleep during the day, nor do I need a nap when I come home after work. The brain fog one gets when one is overtired is lifting.

So, if you've stuck with this post this far, this is what's been going on in my life. I can't promise I will be better. I need to carve out time to actively post and my days and nights have been akin to mashed potatoes. Bear with me. Life is a journey and I seem to have hit a slightly bumpy stretch of road.

Beverage:  Dunkin' Donuts tea

Deb

Colors of Sunshine

So I'm sitting at the table having my Cheerios (see post below) and totally enjoying the sunshine of the first day of fall. It splashes over the table and everything on it. I have to take a bunch of pills every morning. Most of them are vitamins, but it's still a lot. I have the sewing machine set up to finish the curtains and to progress to Christmas presents. I'm already thinking that far ahead. I have all this fabric. Oh! I know what I can make. Inspiration comes from everywhere.

I put my pills on the sewing machine and the sunshine caught them.

The various colors of cream and white are quite interesting to me. There's the cream-clear gel of the vitamin D in the back and the cream of the round folic acid in the front. And the white of the diuretic and the zinc and magnesium. Contrast that with the stark white of the sewing machine and the lightly gold tinged sunlight. There's beauty in everything if you just look. You could say it makes taking all of these an exercise in art consumption.

The sunlight also illuminated the curtains on the table.

Look at how the fabric glows. This is exactly what, in my mind's eye, I wanted for Carole's side door. I wanted sunshine and happiness and color. The side seams are stitched and tonight I will pin and sew the top for the rods. The fabric is quite stiff and will hang beautifully. Now I'm thinking I should make curtains for my house. I have rooms that would benefit from a sprucing up of new curtains.

Beverage:  Scottish Breakfast tea

Deb

Monday Morning

What a beautifully gorgeous Monday yesterday was. Clear blue skies and the perfect temperature to be out and about.

Well, that's not the office. I had to go to the lab and have more blood drawn. So many things have to be monitored when you have an auto-immune disease. I don't know what all the things are when I get the results back, but I have developed an understanding of what the values mean. It's a rare doctor visit that doesn't result in some sort of blood test. I have to ask Dr. Francis, "Are you sure I don't need blood work this time?" I'm just not used to not going to the lab.

Hence, my Monday started with a visit to the Outpatient Clinic at the hospital to have more blood drawn. The new RA medication we're going to try has specific requirements before you can take it. I've been approved but they needed to know I did not have TB, for starters. These kinds of drugs lower your body's ability to fight off infections. You can't start them if you have TB. My test came back negative.

The next thing I need to be monitored for is cholesterol. These drugs increase your cholesterol. I have to have a test before starting and then a month after starting to see how much they raise my levels. Low cholesterol runs in the family (Thank you genes.) so I'm not real worried about that side effect.

I am getting a flu shot this year for the first time in about 6-7 years. I don't go anywhere there are large groups of people with the potential to have someone be sick. And we are encouraged not to come into the office if we are sick. I tend to stay in my corner and not venture out if I hear someone with the sniffles. Even if I didn't have RA, I don't want your cold. A compromised immune system and the flu is a recipe for disaster and with my RA taking another step forward, I finally felt my introvertedness and tendency to be alone wasn't going to be wholly successful in fighting off anything. It's good that I don't mind needles.

Needing to find gratitude in all of this, I decided I was grateful for having an understanding employer. I was grateful that I could sit and read, when I walked up to the lab and found 15 people in the waiting area. Three more pages ticked off in my current book. I debated on whether to bring the book or the magazine. I decided that I don't have much left in the magazine and it could be a wait on a Monday morning so the book was a better choice. I didn't wait that long. I was surprised.

I am also grateful for walking into the lab room and seeing a technician I've had before. She looked at me and said, "You!" I looked at her and then looked away and said, "Who? No, it's not me." She laughed. "Can I have your name?" I said, "No" and then went silent. She burst out laughing while the student who had called me back, looked at us in bewilderment. I don't know this gal's name, yet. She turned to the student and said, "We know each other." I'm silently resigned to all these sticks so having someone to make it silly and fun is a blessing.

After giving blood, I went to my Dunkin Donuts to get breakfast. I have the clerks so trained that the only thing they ask me now is which other donut I want. I get a large hot tea and a double chocolate donut for sure, every time. Then I get some other donut. It costs $3.97 and I'm a member of the DD Perks club. I recharge my card every month and then sprinkle out the use over the course of the month. Dunkin' isn't the best breakfast, but I find that I feel better when I go there because they know me now and that starts the day off right.

This time, the clerk noticed my bandage and asked if I'd given blood. "I had to do the fasting blood test today so I haven't eaten since 10 p.m. last night. GIVE ME ALL THE DONUTS AND NO ONE GETS HURT!!" He just laughed. Armed with a hot tea and two donuts, I headed off to the office.

Now I wait. The tests came back positive for all values. Nothing was askew. I have been approved, as I said. I'm not sure if I will get a call from CVS that my meds are ready or if I get it in the mail. Dr. Francis wasn't clear on that. Once I start this, we'll see how I do. My hands have not hurt since last week, but, thanks to all the walking last week, it's my hip joints that hurt this week.

I'm not looking for a miracle here, although Dr. Francis said RA can go into remission. There was a recent study which claims to have found the trigger that switches on these kinds of diseases. They were looking for triggers for Multiple Sclerosis but finding the switch brings hope for breakthroughs in the treatment of all auto-immune diseases.

For the moment, I'll be content to head to the lab on a Monday morning and then hit up Dunkin' on the way to the office. It's not really that bad to have a hot tea and two donuts waiting for me.

Beverage:  Irish Breakfast Tea

Deb

Missing

You think you have it under control. Everything's moving along just fine. But, when you're dealing with a chronic disease, you're really at the mercy of your body.

I've been reminded by several friends that I have not posted anything in over a month. I have started a half dozen posts but something would come up, I'd get side tracked, and the post would languish, only to be deleted because I didn't like how it sounded.

I was busy at work at the end of July and the first part of August. It's only recently that things have slowed down. I've taken exactly 2 phone calls today. We kind of don't mind because things ratchet up here in a couple of weeks. Once I got caught up, I realized it was the first time since February that I didn't have a pile of things to my left. My daily work gets done and we have even been dismissed early because we were all sitting around surfing the web. Again, this is temporary, but it's a lull we'll take because we know what's coming.

I had a doctor's visit in mid-August. It was the required visit to see how my RA is doing. It's been a summer of aches. I realized, as I sat talking to Dr. Francis, that there probably hadn't been more than a couple of handfuls of days since I fell May 1st, where I wasn't in some kind of pain. Now, I use the word "pain" because that's the clinical definition. For me, it's been more of an ache here or there. My left wrist hurts. The next day, it's my right shoulder. The next day it's the middle finger of my right hand. (When fingers hurt, it's always THAT finger. "So, tell me where it hurts." Really? You really want me to tell you?) It's sometimes the same place two days in a row, but not usually. And it's not a stabbing pain. It's an ache. Most of the time, it's easy to ignore. Oh I know it's there, but it doesn't impact my ability to get my work done. It does, however, affect my quality of life.

I found, when reliving the summer of 2014, that I had slowed down. I no longer walk. I don't always have pain in my feet or hips, but I lack any sort of energy to put on the shoes when I come home and go for my 6 block walk. I sit which turns into a nap which means I can't fall asleep until 1 and then I'm wide awake between 2-3. Dr. Francis listened to all of this and asked, "Have I ordered a Vectra scan for you? Hmmmm, I have not. We need that."

You can see on the box that it's a test for disease activity. It's used to find out how much of an auto-immune disease is in a patient's blood. It rates markers on a 1-100 scale. The test takes a week. I was told I'd get a call, but I never did, which is fine. Dr. Francis got the results in less than a week.

My RA marker is 52. That puts me at the low end of "moderate". While I don't feel horrible, the daily ache and the fatigue are also marks of moving up, as it were, into the moderate category, from "mild" RA.

I won't lie and say I have dealt with this wonderfully. I was, and to a degree, still am, depressed by this finding. I tried to tell myself, when the blood was drawn, that it would be a low number and I was doing fine. But my heart was telling me something else. I was not surprised at the higher number, sad, but not surprised.

So, what is the next step? My vitamin D level was low, too, so I have added 5,000 unit pills daily. I could also spend 15 minutes every day that it's sunny, sitting in the sunshine to up my levels. I don't go home and sit on the deck after work. I usually have energy at that point so I use it to try to get things done before I feel drained.

Prednisone was added back in to help control the inflammation of and ease the aches in my joints. I had prednisone left over from March so I'm using that up. I had started with a whole pill and then moved to a half pill before going off. I'm back to a whole pill which is 2 halves.

The big thing is the introduction of what's called a "biologic" into my medications. Over a year ago, I was approved for a drug called Orencia, one of a new breed of biologics which were developed only for RA. You may have seen Humira advertised for RA. It can be but it was developed for Crohn's Disease and helping RA is a side benefit. I wasn't interested in that. I wanted an RA specific drug.

Orencia is also available only as an injected medication. Either I would have to give myself weekly shots or I'd need to go to the lab once a month and have them do it. Personally, the idea of giving myself a shot scares me so Dr. Francis is going to try to get me approved for Xeljanz, which is the only RA biologic available in pill form. It will be another week before I know the status of that request.

What isn't shown above is the sleeping pill I now take. The above batch is the Saturday pills. I take the same amount, minus the green pill, on Sunday. Then green and salmon color pills are removed for the rest of the week. I used to look at these and think, "It's not so bad. I just take the methotrexate. Everything else is a vitamin." But I'm also taking a small white pill, a diuretic, to help heal my leg from falling in May. RA slows the healing process. And the sleeping pill was added because I kept waking up at 2-3 a.m. and taking an hour to fall back asleep. It keeps me asleep all night. My hope is that I'm retraining my body to expect to sleep through the night instead of expecting to be awakened at 2-3 a.m. I don't remember why I was waking up at that hour in the first place which would have caused my body to think it was acceptable to be up.

While this helps, RA leaves many sufferers with chronic fatigue that no amount of sleep can dispel. I think that's what depresses me the most. I just can't seem to feel energized by sleep. I sit down to read and am asleep in 10 minutes. Heaven help me if I have to be on my feet working. I come home exhausted and can easily take a 2 hour nap. This influences what I do, when I do it, what I want to do, what I eat, everything. It magnifies the little things that don't need to be magnified. I can't sweep the house because I'm too tired so everything is dirty now. I can't get the kitchen cleaned because I'm too tired, so I see every little thing that needs to be cleaned. I want to sort stuff. I'm too tired to do it so the piles remain for weeks, for months. I make promises to myself I can't keep, which depresses me. I'm scared for the cost of yet another medication, something rather brand new. Will there be enough or will there not? What about Christmas this year? Carole's birthday? I don't feel like eating so I don't. I eat lunch out way more than I should, which compounds my feeling of financial insecurity. I'm too tired to cook anything that could have leftovers which I could take to work. So I get up late and think, "I'll just get Subway for lunch". I shouldn't be doing that, but, to my only credit, I do make very good food choices when I eat out at lunch. I buy food I like so that I will take lunch but assembling it in the morning can be an exercise in futility when I'm stiff and I got up late.

I'm not posting to ask for pity. Oh heavens, that's the last thing I want. I have no use for that emotion. I'm explaining where I'm at in my life right now. I'm trying to remember gratitude. I do get up easier now than I have in years. I'm not as stiff as I used to be. But the gradual fatigue, over the course of the day, wears me out. The minor daily ache of one body part wears me out. I tell myself to keep moving but the reality is that I don't. I'm not sure, right now, what makes me happy, other than the girls.

So, I apologize for not being here, for not posting. I tried, but it has felt as if the world has closed in this summer. We are approaching my favorite season and with Iowa football and hot cider and pumpkins and apples and crisp fall days can come a resurgence of energy. I will continue to keep on keeping on.

Beverage:  Water

Deb

Stiffness

At my last rheumatology appointment on January 31st, Dr. Francis mentioned that, of all her patients, only 2 had NOT complained about joint pain or stiffness this winter. She said it's been a very hard winter for those of us with arthritis or other joint problems. She said there's no literature about this theory she has but she thinks the cold shrinks the capillaries that deliver blood to the joint. Without this blood flow, it's worn muscle on bone and that causes inflammation which causes pain. I'm not sure how one would go about proving this either but it's as good of a theory as any other to explain how much I hurt.

And actually, in going through this assessment I do before every appointment, I wasn't quite as bad as I thought I was. I'm not really in a lot of pain. It's more stiffness. It is taking me about 5-10 minutes longer in the morning to get going than it did, even back in December. I try to build that into my morning, by getting up earlier, but I find myself still running behind simply because I'm slow. She put me back on Prednisone for the month of February and, if necessary, into the first 2 weeks of March, just to get through winter's last gasp here, help with the moving about and ease some of the aches that crop up from time to time.

But, in the last 10 days, that hasn't helped. The pain has been in the middle of my butt-cheek, radiating over to the hip and, particularly with my right leg, down the leg to the knee or, sometimes, the top of the calf. As the prednisone kicked in, the left side pain went away. The right side has lingered.

I realized it reminded me of the sciatica I had when I was pregnant. The medications you are given to alleviate sciatica cannot be given to pregnant women so I wound up spending a lot of time off my feet with my legs elevated. I find that now, it's a good way to ease the pain, too. But my friend, Becky, who is a doctor of physical therapy said elevation of the legs needs to be combined with movement. So, once an hour or 3 times a day, if I'm busy, I get up and walk around the office. It helps, but it just isn't making the pain go away.

This is so frustrating. I have a lot of things I want and need to get done. Floors need to be dusted, dishes washed, laundry done. But I can't be on my feet for long periods of time because it eventually hurts, very much, to move or stand or bend. I've moderated my abilities as I've learned what I can and can't do with this disease, but this pain is something else entirely.

Dr. Francis decided I needed to be on a Medpred pack. A what now? I've never heard of this.

I started yesterday with the top row. Each day, the pill count is reduced. It was kind of depressing to see my oatmeal bowl surrounded by all these pills since Saturday and Sunday are my days to take my weekly RA meds and there are a lot of those. But if it helps get through this, then it's necessary.

So, I'm on day two. I've been able to do a bit more than yesterday, but I'm still achy and sore. I'm going to do some reading this afternoon because I can elevate my legs which helps, plus, I've been up and down the stairs to do laundry and move things from upstairs downstairs.

What would also help is if we didn't get snow for a week. Although I take it slow and I bend my knees and not twist to toss the shovels full and I have a shovel that is designed to take some of the stress off shoveling, the sheer amount of snow we've had to shovel this year has contributed to my achiness. Hurry up spring. I'd rather be out raking the lawn than moving white stuff from one place to another.

Beverage:  Darjeeling tea

Deb

This Vexes Me - #18

I had to search my own blog for the last time I posted about something that vexes me. I'm thinking the change in attitude leaves me much less likely to be vexed about something. But, this has cropped up and it's worthy of a vexation.

I'm a week past an RA visit. At the time of the visit, I was coming off a minor flare up of the RA. Normally, I have a pretty good idea of what caused the flare. This time, I had no clue. It could have been the amount of field time I've had to do lately. It could be fall allergies. I was feeling rather smug back in April when everyone around me was sniffling and snorting and snuffling with spring allergies and I wasn't affected, not one iota. Normally, I suffer along with them, but this year, nothing. So fall comes and, well, karma's gonna get you.

I walked into Dr. Francis' office with one bright red eye which was itchy and watery, sneezing and the biggest case of post-nasal drip I could remember. I felt like I'd been hit by a truck. All of this is normal for allergy season when I don't take my meds. The plain old generic allergy stuff works, but it's only good for 4 hours. I have to remember to take it. Ah yes. My downfall.

Instead of the generic, Dr. Francis told me to get Zyrtec, Claritin or Allegra, "Whatever is on sale. Make sure it's the 24 hour stuff which you take at night because it can make you sleepy." As I had to go to CVS to pick up the month's medications, I figured I'd buy whatever was on sale. It turned out to be Claritin.

Now, I can accumulate a lot of pill bottles. CVS will take the empties and recycle them so I make a stack on the microwave and when it's time to get the next month's batch, bring those along. I take another medication at night so I had the bright idea to put the Claritin in an empty bottle and keep it next to the other medication. Then I wouldn't forget to take the Claritin.

Talk about frustration.

I know that if you can get the paper name backing off the pills, they are reasonably easy to push through the blister pack. I couldn't get it off the back of the pills. The amount of force needed to push a pill through the whole mess exploded a pill because these are gels. I tried slicing through the top plastic with a knife, but felt that was just a slip away from slicing open my hand. So, I wound up using a scissors to cut open the packages. I have a month's worth of Claritin and I see Dr. Francis again in a month. If she wants me to continue with an allergy medication until the first frost, I'm going to look at Zyrtec because I know it comes in a bottle. I cut up one blister pack worth of pills. That's all I could handle doing at one time, it frustrated me so.

On a side note, the rumor about CVS trimming back sales receipts isn't a rumor. They have.

The top receipt is for my medications. I've got some good coupons there that may entice me to come into the store when I don't need to pick up pills. The bottom receipt is for a few other things I bought. The bottom receipt is the whole thing, not cut apart. Now, the printer on their register wasn't printing the left half inch but it did get the whole bar code they need to accept the coupon. I think people still believe their receipts are way too long and I agree, but this is a step in the right direction.

Beverage:  Huckleberry tea

Deb

Cut It By Half

Generally, once a month, I head over to CVS Pharmacy for prescription refills. Everything's on automatic refill so I don't even have to call the doctor when I'm due for her authorization. It's all handled automatically.

Lately, you might have heard about CVS agreeing to reduce the length of their receipts. If you don't have a CVS near you or you  never go there, you might not have any idea of the length of these strips of paper. Because I bought additional items when I picked up one prescription and one of the scripts fell at an odd time and could not be filled on the same day as the others, I had 3 receipts over a week's period.

Here's what typical CVS receipts look like.

That's a yard stick in there. The top and bottom receipts are 38 inches long. The middle one is 33 inches. A yard long, a whole yard. The first foot is the actual receipt. That's the part I save for medical files. The rest is coupons. The top and bottom receipts are for my medications. The middle receipt is for 2 bottles of conditioner I purchased because they were a great deal.

I understand the reason for printing the coupon on the receipt. It's immediate. The clerk looked over the just printed receipt for a coupon for hair products. No luck, but it's happened to me in the past that there is a coupon for something I'm buying printed on the medication receipt. Other than the cost of the paper and toner, it doesn't cost CVS much. I'm sure the ratio of received to redeemed coupons is very low. Indeed, I rarely use the coupons on the receipt. Sometimes, it's a simple cost factor. I know, for instance, what VO5 shampoo and conditioner cost at Dominicks. Even with a coupon at CVS, it's usually more. The purchase here was a chance encounter. Sometimes, it's because the product on the coupon is not something I'll use. Most of the time, it's because I'm getting a coupon on the 6th of September with an expiration date of the 8th. I know they are trying to get people back into the store, but that's not the way to do it. Yet, it doesn't cost them much to hand you 3 feet of receipt.

So, I went in on the 6th. I got 25% off your purchase which expired on the 8th. I had to come back for another medication which was not ready. It had to be authorized by insurance so it wouldn't be ready until the 10th. Expiring today are coupons for:  body wash, deodorant, milk, antacid, pain reliever or sleep aid, vitamins, hand and body lotion, self-tanning product, batteries, and snacks. I could also buy 3 greeting cards and get 1 free. Expiring on the 19th are coupons for nasal spray, 2 bottles of hand and body lotion, school or office supplies, and two coupons for snacks. I don't need any of this.

To me and to a lot of people, this is a hugely wasteful use of paper. I don't know of any other retail establishment with a receipt this long unless you actually buy that many items. Even when I spend $150+ at the grocery, the itemized list is not anywhere this long. Last month, CVS responded to this hew and cry by saying they will reduce their receipt length by 25%. That's still too long, in my opinion. I can recycle my receipts but not everyone can. This is a lot of bleached, waxed paper being chucked into the garbage.

Even employees, who have to stand and wait while the print spits out a yard of paper don't look happy about it. Those extra seconds add up and could be used to, oh, I don't know, actually help someone in line.

Beverage:  Dr Pepper

Deb

Four Months

There was a doctor's appointment this past week. It had been delayed from April while I finished up physical therapy. Then, it was rescheduled twice due to work. I demanded to take it when this last reschedule came up. Some things, particularly when you're dealing with a chronic disease, must be taken seriously.

I was worried about my timing as the office phone rang just as I was shutting off my computer for the day. To answer or not to answer, that is the question. Hamlet could wax three times as long if he mused on the question of answering the phone because you wish to provide excellent customer service versus getting, on time, to a doctor's appointment that you have rescheduled twice already. Would I cause someone else after me to be delayed? I certainly didn't want that, but I answered the phone and discovered it was an easy call to handle. I actually said, out loud, to the phone, "I'm leaving now. Don't you dare ring."

So, off I went, arriving in a driving rain. And the umbrella I considered tossing in the car hung quietly in the front closet. It was a warm spring rain, however, and the distance to traverse to the hospital, not far. I can get damp. I'll be just fine and I'll enjoy the walk, actually.

I am through with travel, for the time being. A potential trip downstate has not materialized. There is the rumor of travel into the city, to the south side, specifically, but we await confirmation. Through all of this and the troubles with the Jeep, I waited, with baited breath, the arrival of an RA flare. I know these. They start with itchy, dry eyes. Then, my joints ache, not just the knees that need to be strengthened, but my wrists and fingers. I feel more than a little tired and I don't sleep soundly at night. Flares ups are different for everyone but this is what I endure. In the throes of a full-on flare, every joint aches in some possible way and I must go back on prednisone to control the swelling and pain.

I waited, certain of this inevitability. I experienced merely a couple days of either the left or the right eye being drier and itchier than usual. That's it. I am tired but that can be traced solely back to spending hours upon hours in the car going from point A to point B and back again, of worry about the costs associated with a Jeep that wasn't working or of the prospect of getting back in the Jeep and driving some more and having a 12 hour day to get home and into my own bed.

As I sat with Dr. Francis, going over everything, we remembered a year ago, when I first came to see her and where I was in May of last year. Movement was painful. Getting up from a seated position meant I put my feet where they needed to be to stand and then stood up. That completed, I took a step forward with the right foot and followed with the left. Walking was a conscious decision. I had to figure out the optimum distance between feet when I stood up. I had to think about moving one foot forward and following that with the other. Think about how you stand up and go. Push your chair back, stand up and walk. I had to think about every single step in that action because of the pain. And I often didn't stand up until vitally necessary simply because it hurt; my hips, my knees, my ankles and my feet. God help me if ever there was an emergency requiring swift movement. Wasn't going to happen.

Now, however, I don't even think about standing up and walking. My hands and wrists don't hurt, haven't hurt in months. If I got back into crocheting, as I will when I finish this cross-stitch piece, I'm sure I'll have some twinges in my thumbs, maybe a pop in the wrist with movement of the yarn and the needle, but this is nothing. The combination of physical therapy for my knees and the drugs for the RA have improved my quality of life ten thousand percent. That seems hyperbole, but, to me, it's the truth. We're going through a trough in spring weather where the warmth of late spring has been usurped by the chill and damp of early spring with the accompanying rains that brings. My knees hurt, a lot, but I know this will pass with time and exercise.

Therefore, I am not required to see Dr. Francis for four months; that's 4; count 'em; 1, 2, 3, 4; months. That's the entire summer. She's there if I need her but I am a success story. The injectable drug I was strongly considering back in December, is off the table of RA measures.

When I started walking this road, I figured there would be highs and lows, as there are with any illness. I would savor the highs, because they would be brief, but I would learn to manage the lows, since I felt that's where I would generally spend my time. It would be about seeing the lows as normal for life and embracing what I could do within them. I never dreamed I would feel that I am almost back to a point as if nothing had happened. Do I like taking 9 pills on the weekend? No. I'd rather I didn't have to take any, but I will happily take them now because I see they keep me healthy.

Beverage:  Irish Breakfast tea

Deb

Understanding

My mom's husband, at age 81, has some health issues that come with slowing down and getting older. He's got one of those weekly pill strips and sits down to sort out the myriad pills that get taken at different times of the day. He really needs a full check up, probably with a doctor specializing in geriatric medicine but he has resisted, very strongly, the suggestion that he see one.

"I don't want to see another doctor," he argues. "I don't want to take any more pills." Now, never mind that a geriatric doctor could look over everything he's taking and make some decisions to reduce the number of pills. In his mind, it's a doctor and all doctors want to do is add to your pill intake.

The attitude never resonated with me until this month when the blood tests to gauge my rheumatoid arthritis were done. Although they only took 2 vials of blood, a whole host of things are looked at. I gave blood on Friday and on Monday afternoon, had the results. Everything was normal except my vitamin D levels. They were too low for my doctor's liking. I remember reading a study from the Mayo Clinic which said that vitamin D seemed to be necessary to the absorption of RA drugs as well as the easing the symptoms. The pharmacist where I fill my brown bottles feels that vitamin D is the newest "wonder drug" and will, like other vitamins, be downplayed once more studies are done. "Now, folic acid, well, you better be taking that," he said. At the time, I shook my just picked up bottle of folic acid.

I take a vitamin D supplement once a week, but that is not enough. I was to add 1000 iu to my daily intake. Suddenly, I understood the "I don't want to take any more pills" feeling. Above is Sunday morning's set. I take zinc. I take magnesium because it helps with calcium absorption from all sources. I take 4 methotrexate. I'm to take 8 over the course of a weekend, but taking all 8 at once upsets my stomach so I take 4 on Saturday and 4 on Sunday. That yellow pill is folic acid. On Saturday, I take a dark green gel capsule of concentrated vitamin D. Enter the horse pill, the glossy white long pill in the photo.

That's my calcium with 1000 iu vitamin D supplement that I have now added to my mix. If I were male, that pill would be smaller and would just be vitamin D. But, being female, I needed to get additional calcium to prevent osteoporosis, which is a problem in people with RA. Calcium is not absorbed very well when there are other things going on.

Another pill. I sat at the table looking at the line up. "I don't want to take any more pills." Even if I go to an injectable RA drug, I'm still going to have to take supplements and methotrexate. Nothing really gets eliminated, cut down to be sure, but not eliminated. For the first time in awhile, I felt rather depressed at this disease.

I remember, years ago, a spurt of press was given to the over medication of ourselves. We take a pill for this and a pill for this side effect and then another pill for that side effect. We were, at the time, the most over prescribed nation on earth. Are we still? I don't know. What's not shown is the pill I take for the tingling in my toes at night. It can be like you've spent hours sitting on your legs, cutting off the circulation and then it comes roaring back and lasts most of the night. I couldn't sleep. It's just in my toes and no other place. I have to have a reminder note because I have to take that an hour before bed. It has, however, allowed me to get a solid night's sleep.

Given all this, I certainly could be justified in saying I feel over prescribed. I know what everything is for and why I need to take it. The zinc helps keep my immune system, as compromised as it is, as strong as possible. I swear by it and recommend anyone take it unless you have a medical reason why you can't. I believe it's one reason I don't get sick as much as someone else nor does any cold I get last as long. Still, this is a lot of medication. I would really love to consolidate everything into one pill, but that's not possible right now. I keep telling myself that it's for my good, that it keeps me as healthy as possible. I try not to think about it as I line them all up on the weekend and knock them back, 3 by 3, with a nice glass of orange juice. At least, with vitamin C, I can drink it.

Beverage:  Lady Grey Tea

Deb

Breakfast Buddy

I usually have cold cereal for breakfast. It's easy to prepare and reasonably healthy. Plus, because I have to take pills every morning now, the milk in the bowl makes sure that I get that done. On those days when I have Dunkin', I have to grab the pills before I leave the house and then remember to take them once I get to the office. You probably would not be amazed at the number of zinc or calcium supplements that fall out of pants pockets when I  prepare them for the wash.

The girls aren't that much for human food. Mija is more than Pilchard. Right now, her list of "likes" is deli turkey and cooked turkey in small pieces, Cheetos, sharp cheddar cheese, and milk. She wants to sniff everything and, with the Cheetos, all she does is lick the cheese off the piece. She only eats a couple bites of cheese. They are hit or miss on tuna juice. I think they have to be in the mood for it.

The milk in my cereal is a Mija-magnet. I set my bowl down and sit to have my cereal and you see where she sits. I wish I had a way to tape record her motor. It is incredibly loud, especially when she's trying to worm her way into my heart for a treat.

That's a bowl of Chex. It was on sale when I needed cereal. She loves it when I have plain cereal, no chocolate, or sprinkles or flavoring. Then the milk isn't tainted. I don't give her milk in her dish. Technically, cats cannot digest cow's milk and it gives them the runs. Shakespeare was really bad for that in the waning years of his life. He loved milk but the resulting cat gas could clear a county. I leave about a tablespoon at the bottom of the bowl and she may, or may not, drink all of that. Pilchard isn't really that interested although once, in a blue moon, she will have a taste.

Even when I have Special K with chocolate pieces which I know she won't want the milk after I finish the cereal, I like having her sitting there with me in the morning. She's obviously happy and what a better way to start the day than with a purring cat. I just wish she wouldn't camp on top of the magazine I'm trying to read.

Beverage:  Orange Pekoe tea

Deb

Less to Waste

It was time for a new bottle of zinc. I have taken zinc for a long time. It seems to help with regards to warding off colds, flu and other such things. I take 50 mg a day, which is one capsule. It, a calcium and vitamin D supplement, and Folic Acid are taken every morning with breakfast.

So I open the bottle. Inside is the cotton plug. I remember reading some place a long time ago that, in the spring, putting these out for birds to take is a great idea. They will pick them apart for nesting materials. Well, it's October and, other than lining the nest to keep out the cold, I can't see them taking this.

I was thinking about all that as I started removing the wad, and removing, and removing and removing. Sheesh. There's half a field of cotton in here. After I pulled the wad out, there is half a bottle of zinc. I am not making this up. The line in the photo more or less shows where the zinc started and the cotton wad stopped. I wondered why the bottle I emptied was smaller. There was less cotton and less plastic bottle. The brand I had emptied was not available at CVS.

I understand the need for the cotton. It prevents the pills from shifting in the shipping process, smashing together and breaking apart. Zinc isn't that expensive and I can recycle the bottle easily. I used to have a cat who loved to play with the cotton. You'd ball it up and throw it around and she'd chase it. These two, when offered the ball, sniffed it and the looked at me as if to say, "Now what?" Still, it just seems to be such a waste of resources to have half the bottle stuffed with cotton.

Beverage:  Water

Deb

Originals

I've been away from blogging. First of all, it's work related. We've had a huge project that required a lot of my time; overtime and driving thither and yon. (Hmmmm. I should do a post on old words I still use.) I come home from a drive or an overnight or a day at the office and collapse into the recliner. Up go the feet, recline the back (Whoops. Move it away from the wall first.) and settle in for an hour or hour and a half nap. Usually, that would delay the onset of the sandman, but I'm quite worn out at the end of a day so slipping into sleep hasn't been a problem.

And, I'm unsettled with my RA meds. I'm supposed to be cutting back on the Prednisone but I'm scared that the driving I've had to do will take more than a little toll on the joints so I have not gone from one whole pill to a half pill. I have one more trip, I hope only one more, and then I can start cutting those pills in twain. I don't feel like cooking when I'm tired like this so cereal and oatmeal are staples. What did our prairie ancestors do when they worked 10 hours in the fields in August? There wasn't a Subway to make them a sandwich. They couldn't pop open a can of tomato soup. I often feel guilt in chugging down a mug of soup because I'm too tired to do any "real" cooking. My great-grandmother didn't do this. I'll bet she ate better than I.

So, blogging has been something of a second or third after-thought. There are so many photos uploaded to my Flickr account with the idea of a post behind them. This past week, I haven't considered writing anything other than the reports I needed to get done. Those are sitting to my left, finished and ready to be delivered with tomorrow's jaunt. I have time to consider blogging again. My goal is, always, a post a day. I am quite behind. Let's get somewhat caught up, shall we?

One of the trips of the past week was to Iowa for a meeting with clients. My boss was on vacation and this was a "What can we do for you?" kind of meeting. Instead of my boss having to pay overtime and mileage, I decided to stay overnight with my mom. I haven't been back to see her since March. When I called, I said, "I'm going to bring that box back." You should have heard her cackle.

"Oh good," she laughed. "I have a box you can take back with you. More fabric I found."

Pilchard's box was put in the back seat of the Jeep and dropped in the living room where mom could find it to fill for the next time I come back. In return, she handed me a smaller box with fabric scraps. When I got home, I took the scraps out to see what she'd found. It was like looking backwards in time. Witness these two squares found in the bottom of the box.

The fabric on the right is from the very first item I ever made. It was a skirt and it was required in Home Economics class in 7th grade. When I pulled it from the box, I actually had to sit down. I turned the piece over and over in my hand. It's a cotton, but it has a shiny finish to it. I remember, back when I started sewing, that fabric, while on bolts, was not always made evenly. Edges would often be angled and pinning pattern pieces onto non-square fabric resulted in awkwardly hanging clothing. You'd take a thread and pull it through the edges to form a line. Then, you'd cut off the extra fabric of this line, thereby squaring the edges. I remember how the thread of this broke, constantly, because of the sizing applied to the fabric. I remember that it took an hour or more to get the fabric square in order to pin the skirt pattern onto it.

It was a very simple skirt; two pieces; a front and a back. The waistband was elastic and there were no pockets. I remember being so pleased with this and desiring to make more clothing. We couldn't afford much at that time so "current" fashion was not something I was a party to. But, by being able to sew, I could have the latest trends in clothing for a fraction of the cost. My mother sewed. It was kind of expected that you learned, at some point during high school. I don't remember her sewing as much as I did but she probably didn't have the time.

The blue on the left is from something she had made. I cannot, for the life of me, remember what that was. I'm thinking a dress or a jumper, perhaps. I look at that swatch now and think, "Wow, I'd like that fabric now. It would make a great camp shirt." I love the sort of watercolor pattern in the vibrant blues with green accents. I"m pretty sure she bought the fabric and the material and I made whatever it was she wanted. We often did that as she just didn't have the time to sew.

Looking at these pieces brings back the hours spent looking through the fabric and the pattern books at the dry goods store in town. You had to order patterns back then, as they didn't have a way to store everything in every size. It took about a week to get them. You'd mark the fabric you wanted and they would hold it under the counter until the pattern came in. Fabric was laid out on long tables with everything from upholstery to special occasion to cottons to knits all mixed together.

Later, when an actual fabric store opened two doors down, you got to sit at tables and look through all sorts of pattern books. Fabric was organized by type and color. It was, and still is, to some extent, a magical time to be able to look through the pattern books and run my hands over the myriad of fabrics in their textures, prints and sizes.

I don't know what happened to the two items made from these swatches. I'm sure we gave them away. They really would be vintage now, if we still had them. I have been sewing a long, long time.

Beverage:  Huckleberry tea

Deb

Hmmmm. Maybe I Should Save This

There comes a time in one's life when purging is necessary. The accumulation of stuff just adds up and up and up and you're eventually looking for "I know it's here somewhere" instead of reaching right for it. You know I've been slowly, at a glacial pace, going through the accumulation of years of life in this house. I have a brown paper bag in the hallway into which I toss still usable but unnecessary to my life items. When the bag gets full, the first veteran's group that calls for donations gets it. I'm trying to be utterly ruthless in my purging but sentimentality often gets in the way. That and, well, this does have a use. Maybe I should save it.

Into this latter category is where this item falls.

Any clue? It's a pill splitter. When Penney was alive, I had to split the pills she took for her thyroid condition. Before I bought this, I would take a sharp knife and try to split them. That was awful. I think I went through a half a bottle before deciding there had to be a better way. The pharmacist looked at me as I explained my dilemma and said, "You need a pill splitter." What a marvelous invention! When Penney went over the Rainbow Bridge, I tossed this into a drawer and forgot about it.

Remember the drawer in the bathroom where the mice were visiting? Over the winter, I finally cleaned that out, sterilized the drawer and put it back in service. The pill splitter was in the bottom of that drawer. I looked at it not sure if I should keep it. I didn't have a need for splitting pills. I walked it over to the give away bag but something said, "No. Don't toss it, yet." Back into the drawer it went.

Yesterday's doctor's check up for my RA was the best one yet. I still have the occasional twinge in my wrists and right knee, but the pain I had when I hobbled into Dr. Francis' office back in March is gone. I am officially entering the maintenance phase.

What that means is it has come time to wean me off the Prednisone. This is done slowly and in half pill increments. Half a pill? I can do that and not use a knife with the crushing and the breaking and the uneven splitting.

There's the old joke that when you're looking at something and wondering if you'll need it, you will need it AFTER you toss it out. I guess I figured, in this case, that someone I knew would probably have a use for this and I couldn't really toss it. It didn't take up much room at all in the back of the drawer.

So, I am down to a half a pill at night for 2 weeks and then no pill at night for two weeks. Then, we see how I'm doing and reduce the dosage further. I'm ready. I like the faint crunch sound when you split a pill in half.

Beverage:  English Breakfast tea

Deb