Living with Chronic Illness Changes To Your Life

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Living with chronic illness is overwhelming and it brings with it a whole range of emotions from shock to anger to sadness to grief. Chronic illness can feel like a life sentence because it impacts our lives forever.  The good news, however, is that, while most chronic illnesses do not have cures, they usually can be managed with medication, diet, exercise and lifestyle changes.  Moreover, being sick doesn’t mean your life is over or that your plans have to change.  It just means that the timing and path likely will.

 I often think about at how my life has changed since chronic illness came into it.  For a long time, that unwanted and forced change created unhappiness in my life.  Over time, however, I have learned that if I allow myself to be flexible and open to change, I can adapt, accept, and even use the change to my benefit.

 Chronic Illness Has Changed Me

Like many others living with chronic illness, unwelcome change from chronic disease has been a daily reality for me.  Having two children, a career and dealing with the trials and demands of a work-life balance, I understand that illness can drastically affect a person’s lifestyle, relationships and future goals.

 Not only has chronic illness brought change to my life but it has also changed me.  Some of the change has been positive and some of it hasn’t.  Most notably, it has made me a stronger person – both in conviction and in the ability to see past my limitations.  At the same token, I have struggled with forced change from chronic illness, including failed personal relationships, a different career path, and a changing financial situation.

Making the Best of Life with Chronic Illness

Every day, chronic illness finds new ways to challenge me and I am reminded daily how being sick has forever changed me.  Prior to being diagnosed, I was a busy working mother who had plans to attend law school in addition to my already busy law office job and family life.  One very sad day, I realized I could not take care of two children, attend law school, work fulltime, and be chronically ill.  However, I still could decide what I wanted out of life.  I could either choose to dwell over my changed plans or I could make the best of my life even with chronic illness as a dominating factor.

How did I make the best of my life despite chronic Illness?

I chose acceptance.  I have often applied the Serenity Prayer to various aspects of my daily life and I have also learned to add it to my long term goals.  “God grant me the serenity to accept the things I cannot change; courage to change the things I can; and wisdom to know the difference.”   I may not have much control when it comes to being chronically ill but I still have a choice when it comes to managing my health and being happy.

I offered and sought support.  I found that in doing so, I not only helped myself but I also helped others. I also found out that I wasn’t alone in the change that chronic illness brought to my life.  By sharing experiences with others, I learned that there are better ways to cope with change and that I can make the best of what life has to offer with and despite chronic illness.

I looked for the silver lining instead of asking “why?” I realized that while I didn’t have a choice in being sick, I had a choice in how I responded.  I could spend my time asking “why?” or I could ask “what now?”  My dreams may have changed but being sick has challenged me to find out what I am truly capable of and how I can use my abilities to my advantage.

Using Change to My Benefit

I understand all too well that chronic illness has changed my life and has forced me to change.  And sometimes, I mourn the person I used to be but in the grand scheme of things, I am happy with the person I have become.  Further, accepting the change that chronic illness brought into my life has allowed me to better focus on management of my health while continuing to find better ways to accomplish my goals and to challenge myself.

Dealing with chronic illness is no walk in the park. It can be demanding and it can be hard.  However, the ability to overcome and accept is a personal preference.  You can either choose to dwell on your weaknesses or you can dare to find your strengths and to look for a silver lining even when life forces your hand.  Forced change can either be to your determent or your benefit.

Anemia of Chronic Disease

Photo Credit: http://anemiaofchronicdisease.com/
Photo Credit: http://anemiaofchronicdisease.com/

 

Certain disease diseases, such as autoimmune forms of arthritis, chronic infections, or fibromyalgia, can interfere with the production of red blood cells.  The result is a condition called Anemia of Chronic Disease or ACD.

What is Anemia?

Anemia is a disorder where the blood has a lower than normal range of red blood cells. Anemia can also happen when the red blood cells do not have enough hemoglobin in them.  Hemoglobin is an iron rich protein that makes blood red. This protein also helps our red blood cells to carry oxygen from the lungs to the rest of the body.

In people with anemia, their bodies are not getting enough oxygen-rich blood. Symptoms of anemia include fatigue, shortness of breath, dizziness or headaches. Further, severe or chronic anemia can damage body organs including the heart and brain and even result in death.

The good news is that you can even prevent anemia with a healthy diet and treatment can be as simple as a dietary supplement.  Conversely, some forms of anemia, such as ACD, can be severe, chronic and even life threatening if not diagnosed early enough and treated.

Anemia of Chronic Disease  

People who develop Anemia of Chronic Disease do not develop a severe form of anemia.  Further, ACD is second most common form of anemia, after iron deficiency anemia.   While it most often found in patients with chronic diseases, with the elderly being at the greatest risk, it can also be found in young children suffering from a simple ear infection.  Most often, this type of anemia goes undetected and untreated because attention is focused on treating the chronic condition or infection.

According to the National Institutes of Health, ACD occurs when a chronic illness affects the body’s ability to make healthy red blood cells.[1]  In most cases, this happens because the chronic condition prevents the body from using iron efficiently to produce new red blood cells regardless of whether the body has normal or high levels of iron.

Anemia of Chronic Disease is slow progressing so symptoms are generally mild and may be similar to symptoms of the underlying chronic condition.  Symptoms will include paleness, weakness, dizziness and a fast heartbeat.

What Conditions Cause ACD?

It is believed that up to 60% of patients with rheumatoid arthritis (RA) are anemic, this according to a research study reported by the National Journal of Medicine.[2]  RA is not the only inflammatory disease that can cause ACD. Other conditions include lupus, ulcerative colitis, Crohn’s’ disease, degenerative joint disease and diabetes.   Inflammatory diseases provide a response in the body that can produce cytokines, proteins that protect the body against infection and interfere with iron processing and the manufacture of red blood cells.

While fibromyalgia is not considered an inflammatory condition, it is still a rheumatic condition that impairs the joints and/or soft tissues causing chronic pain. Further many fibromyalgia patients have anemia and many often go undiagnosed because of the similarity of symptoms between both conditions.  Without proper treatment, anemia will worsen fibromyalgia symptoms and make life for patients even more difficult.

People with chronic infections or infectious diseases can also develop ACD.  This is because their immune systems will respond to the infection resulting in an impediment of red blood cell production.

Treating ACD is Fairly Easy

Anemia of Chronic Disease is fairly easy to treat.  Treatment may depend on the reason for the anemia and how severe it has gotten.  ACD can generally be managed through medication or dietary supplements, including folic acid.  Most anemic patients take vitamin injections or iron supplements to correct iron levels. Further, most treatment can be administered at home with little monitoring. In rare cases, a blood transfusion may be necessary.

Successful treatment of ACD also involves treating the underlying disease.  As the symptoms of the chronic condition diminish, so will the anemia. If you think you have anemia of any form, talk to your doctor. A simple blood test is all it takes for an accurate diagnosis.


[1]               “Anemia of Inflammation and Chronic Disease.” (2012, April 6.) National Hematologic Diseases

Information Service. Retrieved from http://hematologic.niddk.nih.gov/anemiachronic.aspx.

[2] Wilson, et al. (2004, April 5). “Prevalence and outcomes of anemia in rheumatoid arthritis.” US National Library of Medicine National Institutes of Health. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/15050886.

Getting Quality Sleep despite Arthritis Pain

InsomniaPatients living with arthritis pain often find themselves struggling with insomnia and other sleep difficulties. In fact, 23% of Americans with arthritis have reported a link between sleep loss and arthritis pain, this according to a study out of the National Institutes for Health.[1] Interestingly, there are very few studies about the link between the sleep and arthritis pain because many arthritis patients are not reporting their sleep issues.  In fact, many do not see their sleep problems as unusual and/or feel that nothing can be done to resolve them.

For most of us living with arthritis pain, sleep is the only time we get a break from our pain.  Unfortunately, good quality sleep can be hard to acquire when pain keeps us up at night. It becomes a vicious cycle because being overtired results in making pain worse.  Even when you able to fall asleep at night, arthritis pain can also wake you up during the night or even cause you to wake up tired.  The good news is that there are ways that you can still get good quality sleep despite arthritis pain.  This involves medical treatment for both your arthritis and sleep issues and also specific strategies you can try to help with both issues.

Here are some tips to help you if you are tossing and turning at bedtime and throughout the night.

Practice good sleep habits. Having good sleep habits can help to minimize sleep issues. Going to bed at the same time each night and getting up at the same time each morning makes a big difference. It is also helpful to keep your sleep area free from distractions.  Avoid over-arousal at least three hours before bedtime. This includes things like exercise, a heavy meal, an argument or an action packed movie. Last, create a bedtime ritual that helps to induce sleep such as taking a warm bath, listening to calming music or reading for a short time.

Cut the caffeine and alcohol: It is especially important to avoid caffeine and alcohol from late afternoon on. Caffeine and alcohol are stimulants and if consumed too close to bedtime can keep you from falling asleep and getting sleep that is restful.

Get your pain under control and check your medications. When pain is controlled, you have a better chance of getting better quality sleep. Talk to your doctor if your pain isn’t well managed to find alternative options treat and manage arthritis pain. Different medications and unconventional therapies including massage, acupuncture and relaxation techniques can provide relief for pain and stress.  Further, it is possible that the side effect of one or more of your medications is sleeplessness.  If you suspect this to be the case, talk to your doctor about different treatment options that can assist with pain management without keeping you up at night.  

Exercise daily.  If you exercise at least four to eight hours before bedtime, you will find that your sleep improves at night. This is because physical activity helps to relieve stress which is another thing that can keep you up at night.  Further, arthritis pain can be lessened through exercise. Just remember that you should not exercise two to three hours before bedtime because exercising too late can actually keep you up.

Try a sleep aid or a natural supplement: If falling asleep or getting good quality sleep has become a constant struggle for you, talk to your doctor about prescribing a sleep medication.  Sleep medications work by slowing activity in the brain so that you can fall asleep much more easily.  Sometimes, doctors will prescribe anti-depressants to help with sleep issues.  Please remember that prescription sleep aids can only be used in the short-term and for no more than a few weeks at a time.  If you are unable to take a prescription sleep aid or prefer not to use one, a dietary supplement, such as Melatonin or Valerian Root, maybe a better option.  Melatonin is a synthetic version of the natural sleep hormone that is produced in the pineal gland (a small endocrine gland in the vertebrate brain). Valerian Root is an herbal product made from the roots of the valerian plant.  Found as a tea or supplement, it can be used to treat sleep problems, including insomnia.

It is vital for arthritis patients to get plenty of sleep and rest because arthritis pain and sleep are intrinsically connected.  Getting better quality sleep can help arthritis patients to restore their energy levels, improve mood, lessen fatigue and minimize pain.


[1] Louie, G., et al. (2011, Jan. 28). Sleep disturbances in adults with arthritis: Prevalence, mediators, and subgroups at greatest risk.” Arthritis & Research. Retrieved from http://onlinelibrary.wiley.com/doi/10.1002/acr.20362/abstract;jsessionid=2ACD34D9BC0CE9A746B7A9527166F4CB.d04t02.

Coping with Chronic Illness in Marriage

How Managing a Disease Affects Both Partners

Coping with Chronic Illness in Marriage

What no one is ever told about chronic illness is that it will have an effect on marriage. It can take a toll on even the best of relationships. Chronic illness rewrites a relationship and significantly influences issues such as money, work, chores and sex. Managing the way illness affects marriage is as important as managing the disease itself and couples who take responsibility for working through both find that they can built a stronger and closer relationship.

The Effect on Marriage

Studies have shown that marriages in which one spouse is sick are more likely to end compared to those in which chronic illness is not an obstacle. And spouses who become caregivers are six times more likely to be depressed, this according to the Caregiver Action Network.

Most of us do not think about chronic illness when we are young, healthy and making a long-term commitment to someone else. We tell ourselves that we will be there for each other in “sickness and health” but despite our best intentions, chronic illness can get in the way of the vows we made. This is because chronic illness is physically and emotionally exhausting. Additionally, the partner who becomes the caregiver may struggle with patience and regret while the partner suffering from chronic illness may be racked with guilt.

Chronic Illness Affects Both Partners

It can be difficult to adapt to the illness of a partner, especially when illness requires changes to both the future and everyday life. The sick spouse may no longer be able to work outside the home or help out with household chores. Other adjustments will have to be made that affect both spouses, including, but not limited to, modifications to schedules, diets and sleeping patterns and making time for doctor appointments.

Abrupt and constant change affects both partners equally, so it’s natural that both will feel fear and anxiety over what is happening. While unhealthy, most spouses try to shield themselves and each other from the reality of chronic illness by not speaking about their fears and the affects that chronic illness have on their lives.

A New Plan for Moving Forward

Effectively coping with chronic illness in a relationship requires communicating to form a new plan for going forward. That plan should include discussing specific matters such as: how to handle the illness; dealing with finances; caring for children and elderly parents; intimacy; the handling of new changes imposed by chronic illness; and letting go of a past that involved good health. Once both partners know where they stand on these concerns, they can come together to find amicable solutions. Both partners should actively participate in working toward a future that can still be happy and exciting.

What I Have Learned

I wish that someone had told me that chronic illness would have an effect on my marriage. No one ever did and I had to learn that lesson the hard away. Experience also taught me that marriage requires two people willing to be there for one another “in sickness and in health.” Not everyone can pass that test. In my case, I learned that chronic illness had little to do with my marriage issues. If anything, it had to with a lack of communication about the issues that affect both chronic illness and marriage — individually and in sum.

I have learned that couples who find themselves faced with chronic illness have to decide whether it will make them or break them. Coping with chronic illness is a difficult process and most people do not anticipate having to deal with its influence on their lives until it happens. Surviving the strain of chronic illness requires a great deal of empathy and open communication, and without it, relationships cannot survive.

Couples who survive chronic illness’s effects end up with happy and fulfilling relationships where illness doesn’t define their marriage but becomes something they manage as a team. When a marriage doesn’t survive chronic illness, allow yourself to take comfort, as I have, and recognize that chronic illness isn’t the only culprit for the breakdown of a relationship. Acknowledging and understanding this can better prepare you for chronic illness’s effect on future relationships.

Originally posted at Arthritis Connect.

Ways that Physical and Occupational Therapy Help with Rheumatoid Arthritis – Guest Post

 

Photo Credit: http://www.mblyp.com/
Photo Credit: http://www.mblyp.com/

Living a life in pain is a difficult thing to do. If you are living with the pain caused by Rheumatoid Arthritis, then this is something that you know all too well. The swelling of joints can be so debilitating and painful that life can seem, at times, unbearable.

To help with this, therapy is a great plan of action. In regards to Rheumatoid Arthritis there are two types of therapy that can be beneficial: physical therapy and occupational therapy.

What is the difference between the two? Let’s take a look at these two different therapies, how they can play a supportive role in increasing your ease of movement and your ability to go out and enjoy life.

Occupational Therapy

The use of occupational therapy in your treatment plan helps in various ways. An occupational therapist is a highly trained specialist that will help you return to normal activities by helping you create an easier life for yourself. For example, an occupational therapist will go beyond the office and visit you, assisting you in modifying your home and place of work so that your places of dwelling don’t increase discomfort or aggravate the arthritis. An occupational therapist will also will create supportive braces that will help the joints feel more stabilized. They can, in addition, assist in finding different ways to make common tasks like driving, bathing, cleaning the home and other normal activities easier through the use of helpful tools such as a larger steering wheel to grab on to, or a large handled scrub brush to assist with washing oneself.

Physical Therapy

When it comes to physical therapy, the main goal of the therapist is to assist you in regaining mobility, strength and the ability to do everyday activities with ease.

How does a physical therapist assist with mobility, strength and the ability to do things? The therapist is a guiding friend in showing you various exercises, stretches and movements that will help the body to reduce swelling, increase muscle capacity and decrease pain. One of the main focuses of a physical therapist is to increase a person’s range of motion. A key element in making this happen is increasing a person’s strength. Through the physical therapist developing ways that the patient can increase strength, the therapist is offering a way for the muscles to assist in stabilizing a joint that is compromised. In addition to showing the most beneficial exercises for gaining strength and increasing mobility, a physical therapist will also be a good source of education if learning how to walk with a brace or cane is needed.

Bio

Kishana Sainte writes on health & lifestyle topics, including rheumatoid arthritis on behalf of MyDocHub.com, a trusted online patient recommendation and medical information website developing condition-specific apps such as its RA Health Flare Tracker iPhone/iPad app.

Getting More Vitamin D Can Help With Managing Pain

sunshineIf you are not getting enough Vitamin D in your diet, chances are you will have worsening pain from arthritis and other related pain conditions, including fibromyalgia.  Recent research studies have found a connection between low levels of vitamin D and chronic pain that does not respond to medication.

What Research Has Found

A 2009 study out of the Mayo Clinic found a relationship between low levels of vitamin D and the amount of pain that arthritis patients are in.  According to the researchers of this study, patients who were taking a high dose of narcotic pain medication also had insufficient Vitamin D levels.   In fact, these patients were taking nearly twice as much narcotic pain medication compared to those who had sufficient Vitamin D.  Further, the patients with low levels of Vitamin D reported worsening pain, an inability to function, and an overall failing health picture.

A 2007 study from the American College of Rheumatology found that as much as 13.3% of fibromyalgia patients are vitamin D deficient while 56% had insufficient levels of Vitamin D.  Further, various studies have found that vitamin D deficiency is quite common in patients with autoimmune diseases, including rheumatoid arthritis.

Role of Vitamin D

Vitamin D helps bones to stay healthy and grow.  It is also plays an important role in bone repair and prevention of osteoporosis.  When individuals do not get enough Vitamin D in their diets, they are at risk for bone softening and pain, osteomalacia (the softening of the bones caused by defective bone mineralization), osteoporosis (a disease of bones that leads to an increased risk of fracture), rickets in children, hypertension, chronic pain, cognitive impairment, and other serious health risks.

Causes of Deficiency

Vitamin D deficiency can happen for a variety of different reasons.  The most common causes are inadequate intake of Vitamin D from food sources, limited exposure to sunlight, disorders that limit absorption, and the body’s inability to convert Vitamin D in the body.

Individuals who do not consume the recommended levels of Vitamin D can become deficient.  Most natural sources of vitamin D are animal based foods and include fish, beef liver, eggs, milk and cheese.  For individuals who eat a primarily vegetarian diet, Vitamin D supplements can help. Most doctors recommend taking in no more than 2000 IU (International Units) a day to increase Vitamin D levels and keep them at normal levels.

Inadequate exposure to sunlight can lead to vitamin D deficiency.  Our bodies make vitamin D when skin is exposed to sunlight. However, if you are housebound, live in the northern part of the country, have an occupation that limits your exposure to sun, have dark skin, or if you were wear head coverings and robes for religious reasons; you have a higher risk of becoming vitamin D deficient.  If your exposure to sunlight is limited, you should discuss with your health care provider about getting your levels tested and whether taking a supplement is necessary.

Certain medical problems including autoimmune diseases, such as rheumatoid arthritis, can affect the body’s ability to absorb vitamin D from the foods we take in.  Taking in more vitamin D, though supplements, can help to promote heart health, strengthen bone cartilage, and may even help to reduce pain and disability. Supplements can also help to alleviate other symptoms of arthritis conditions.

In some cases, the kidneys cannot convert Vitamin D properly.  As we age, our kidneys become less able to absorb and convert Vitamin D thus increasing the risk for deficiency.

How can you get more Vitamin D?

You can get more Vitamin D through diet, sunlight and supplements.

Diet: Most people can acquire adequate Vitamin D from the foods they eat. Foods high in Vitamin D include fatty fish, such as salmon and catfish, fish liver oils, mushrooms, vitamin D-fortified milk and whole eggs.  The Office of Dietary Supplement has a fact sheet that offers additional information about food sources that are high in vitamin D.

Sunlight: Exposure to sunlight is the most natural way to get more Vitamin D. Our bodies create the sunshine vitamin when exposed to adequate sunlight.  Sunlight also helps those suffering with depression and many patients living with arthritis, fibromyalgia and other pain conditions, are already dealing with or are prone to depression.

Vitamin D Supplements: For most adults, the highest safe limit for vitamin D is set at 2,000 IUs per day.  Taking more than 50,000 IU puts a person at risk for Vitamin D poisoning. Doctors will prescribe a dose no more than 50,000 IUs for patients suffering from severe deficiency or who have very low levels of Vitamin D.  Supplements can help with pain reduction as well as long term bone protection.

The Bottom Line

It would be nice of Vitamin D worked to treat chronic pain on its own since it is a cheap and simple treatment with little or no side effects.  While treating with Vitamin D will not stop pain, stable Vitamin D levels can still help to keep pain levels down.  If you have chronic pain from arthritis, fibromyalgia or other pain condition, it doesn’t hurt to ask your doctor to check your vitamin D levels. If you are vitamin D deficient, a simple supplement can help you to reduce pain and other symptoms associated with arthritis and other pain conditions and can also help to improve your quality of life as live with and deal with chronic pain.