I have this disease but dont totally understand it because it's so complicated. I cant understand how stress or what stress has to do with RA. Wow, what a good question, we all know it makes us feel worse, but what is the 'trigger' is it in our nervous system? A reaction to stress is pain, stiffness and swelling. Why? I'll ask my doctor when I see him next week! SarahI have been told that cortisol in the body which usually deals with stress is directed to deal with the pain in our bodies hence the problems with stress. Am going to get my cortisol levels checked next time I have a blood test.
I think the MDs saying stress causing our symptoms is hogwash. They don't have any answers, so their only way to get their lack of knowledge and empathy off their shoulders because they are ill-trained on how to first of all spot, diagnosis then handle a sick person is to blame "stress". Define "stress" doc, please. Stress causes inflammation, deformities, seizures, strokes, high RA blood factors, seropositive readings, etc., etc.? Isn't that why this well-known disease is defined as a "disease process of chronic, debilitating, lifelong symptoms?" I don't see the word stress in the definition.
The day I can bring down my "scientific blood test results" and "stop the destruction confirmed by xrays" by reducing stress is the day I will stop criticizing MDs, the FDA, the AMA, and the whole health care establishment for just plain lying to us, instead of being caring humans and at least give us the diginity of drugs to relieve our pain and stress levels, without denigrating us for being "stressed" because our bodies are eating themselves up from the inside from an autoimmune disease process they cannot agree on the definition of, what causes it, and how to treat it. Doctors are morons.
I feel stress plays a huge factor for me. I started out Friday feeling ok. I'm flaring so it wasn't the most wonderful day in the world. Had argument with teenager (well she had it with me I remained calm) before she walked out the door at 715am for school. Went back to bed after other child left at 8. Got up and was ok. Did meds..housework...etc. Children come home from school. OMG stress hits the fan. Now, I can't move. Spend the rest of the evening laying on couch. Swell like someone added helium to my body.
Body chemistry is extremely complicated. I have a rheumy that it is top notch in his field. Spent years doing research. Has a PhD. We have asked him about stress and how it affects RA. He said it can have some affect because of the cortisol and the corticosteroids that we do not produce enough of on our own. Both control inflammation and how we react to stress in a physiological manner. I am on a low dose of pred (5mg) and that is obviously not enough if I am super stressed out. Stress is not good for ANYONE...not just us with RA. Type A personalities...more at risk for heart attacks, strokes, and other not so fun stuff.
Cathy...not all docs are morons. I have a couple of pretty darn good ones. In fact, I have written a letter to the board of the hospital my family doc is associated with because he is so awesome. If he doesn't have the answer for me right away in the office...he calls me with it. When he told us about Danielle having JRA...the guy cried with my daughter and told her he would be with her every step of the way and so will our rheumy. He offered to come to my HOME when I thought I couldn't get in to the office for cortisone injections for Danielle. That of course is rare...but not all these docs are morons. RA just happens. Because there is nothing firm on what causes this...research just isn't that advanced yet into genes and DNA and that sort of confusing stuff, they have to work with what they've got (us that have it already) to try and find a cause and a cure. Believe me, I have 2 kids with RA and a cure would be most excellent in my book. A prevention for the last chickie in my family would be stupendous. Everyday when I turn on my CNN in the morning, I want to see the big news as a being a cure or prevention. Everyday nope. I still hold out hope that there will be one of these mornings I turn on the TV. It keeps me going.
For me, I have found there is no black and white with RA since it does affect everyone differently. Because we are all different in our DNA make up and gene make up. There are really only shades of gray for us to work with and deal with. Why does one med work for someone else so well when others fail it? Why did my baby get JRA when the pattern in our family is getting it in adulthood? Why am I flaring and on the verge of being out of control again when my meds were working so well? How come I can not recover fully from when I was so seriously out of control over the fall/winter months? Too much gray area. There are moron docs out there not worth the paper their degree was written on. But not all of them. And we are pretty good at picking out which of them are morons and moving on to find one that is not.
Gramma - if stress is such a big factor, and supposedly it can be tested for (cortisol), why aren't we treated for it instead of being told to "reduce our stress levels"?
http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=15 21664
It's all part of the moronic doublespeak of RA and autoimmune that doctors use to hide their ignorance and lack of respect for sick patients, telling them to just cope and "reduce their stress" when there are tests and pharmaceuticals available for treatment.
And I am glad you have such awesome doctors. I have built a small team of non-morons which took years, but the vast majority are still morons, as proven every day in this forum from the posts of the members.
I agree that stress plays a huge factor in this disease, as well as many others.
I also think that despite RA being around for years and years, that no one really knows, I mean REALLY knows about RA. I think it is important to build an excellent team of physicians, nurses, PT/OT, pharmacists, etc. However, it is imperative that the patient be proactive and take some responsibility for their own health.
Phats
Think about Finals time in school. Two weeks or so of study with pressure of passing tests. More than 50% of students get sick during this time. Stress is directly linked to your immune system - rather stress impairs your immune system. We already have impaired immune systems - stress is a monster - causes all kinds of havoc with your body.
PS Liz - got in argument with Brett. Started feeling many symptoms I had with stroke - ringing in head, dizziness then my RA pain (joints) started flaring and stomach pain (I think I have an ulcer) I was fine before his phone call. For me - controlling stress IS disease control.
Thinkthinn,
If there was something to take for stress, this would be a stress free world =) Whoever comes up with that magic pill will be set for life.
Phats
OK...I finally have everyone busy doing something and I can sit and do research about this. I had a great day even tho I am flaring. Spent most of it outside in my moon chair watching the kids and hubby have fun. Hit the beach for a bit and got great video of my moron dog running in and out of the waves. Labs!! Water is like 45 degrees!! I was able to reduce my stress level quite a bit today lol.
On to the research. Cortisol is produced by the adrenal glands located right above the kidneys. It is our "fight or flight" chemical. It helps maintain proper blood glucose metabolism...regulation of blood pressure...insulin release for blood sugar maintenance...immune function...and last but not least...inflammatory response. Cortisol is an important part of the body's response to stress but it is also important that the bodys relaxation response also be activated to return the body's functions back to normal. Higher and prolonged levels of cortisol in the body lower immunity and affect how the body responds to inflammation. Basically...the body can not slow down the inflammation process with too much cortisol floating around in us. Basically at this point, the only way to get the stress level down is to get that relaxation response active with our own personal stress management techniques. I did find kind of an old article (2001) that stated researchers are looking at medications to help lower cortisol levels in chronic stress situations. As we all know, if they did find a med to do this, it will be several years before it is available to patients since it has all those trials to go thru and the FDA to get past.
I wish there was a simple answer to all of this. Unfortunately there isn't. Stress is one of those things that just can not be avoided in life. Unless you want to live like a hermit. Behavior changes, lifestyle changes, and stress management techniques can HELP with stress. But so far...there is nothing out there medication wise available to help with the cortisol issue. Hopefully soon there will be so that we can manage our disease better when we encounter stressful situations.
I can tell you that I was fine Friday evening until something very stressful happened. Then no amount of my pain killers was touching the pain I was in. Nothing helped my swelling. Now I know why. I couldn't activate my relaxation response to get that cortisol to calm down.
Oh yes...there are a grip of moron docs out there. More so than there are good ones I think. It takes time and sometimes a lot of searching to find the right docs for you. I would encourage everyone not to give up and build a good team of docs etc. It is imperative to your health that you do not settle for the mediocre. I agree with Phats that you have advocate yourself for your health. It is a MUST! Docs are people too. Just because they have MD after their names and are buried in student loans doesn't mean they are uber smart or even smarter than you. They put their pants on same way as anyone else...one leg at a time. Some of them are just plain stupid and trip over their own two feet while doing it.
Thinkthin: from the site I posted above, so the answer is "yes", we can receive treatment for "stress":
Recent experimental evidence suggests that hydrocortisone (Kendall's Compound F) is probably the principal glycogenic steroid secreted by the adrenal cortex and that under conditions of stress it may participate more than cortisone in physiologic reactions. Laboratory studies indicate that hydrocortisone has greater physiologic activity, milligram for milligram, than cortisone and with certain assays its potency is twice as great.
Two forms of hydrocortisone, the free alcohol preparation and the acetate, were given systemically to patients with rheumatoid arthritis and were observed to possess significant differences in ability to suppress the disease manifestations.
[QUOTE=grammaskittles]
On to the research. Cortisol is produced by the adrenal glands located right above the kidneys. It is our "fight or flight" chemical. It helps maintain proper blood glucose metabolism...regulation of blood pressure...
[/QUOTE]I have seen those commercials too. However, as with anything else...if it sounds too good to be true it probably is. See if you can find the ingredients online (I can not for the life of me remember the name of those diet pills..sound the brain fog horn please) and really look and see what is in those pills. Remember also that too little cortisol is bad for us too. I would have blood work etc done before even thinking about taking those.
Michelle...I read all about DHEA and cortisol and wanted you to handle that part of it since you are going thru that right now and would be more informed on it than I am. Personal experience vs. reading data speaks volumes. I hope like heck your treatments work for you and you can get those adrenal glands working again. I can certainly see how they became shut down. Now we just need to get them woken up!! Yell at them too lol.
Thanks grammaskittles. You are correct is saying you should have blood work done before taking either cortisol or dhea supplements, too little or too much of either is extremely bad!!! I have also seen those diet pills but with our wacky systems, I wouldn't go near them even though I need to lose a good 50 pounds or so!I bet it is the combined effect of everything that you are doing that lowered your pain level to a yell. I can imagine you are still at an 8 at night since you do work and do not have the time to lie around and rest like you need to do.
I am hoping beyond hope this works for you. It just totally makes sense tho about your adrenal glands and stress and feeling the way you do.
Can you do little stuff to start scrap booking? Are you going to scrapbook your journey back to health? I'm just believning in all my heart you are gonna get better with this treatment you are doing now.
I am given both valium and Cymbalta for stress. Stress management is very important for RA and all auto-immune diseases. I have just a ton of scrapbook stuff, my mom buys me stuff on sale all the time, its just a matter of having the energy to do it. When I was a young woman my doctor put me on Valium during my divorce. I became addicted. Not easy to get off of. I did eventually however, I dont really remember alot of events during the time I was taking it. This is bad when your raising children. You need these memories.