Coaltrain I couldn't agree with you more. In fact I would say I could reach remission if I was able to sleep more and drop town to part time work at home. I'm stubborn as a mule and don't want my body dictating how I'm to live the rest of my life. As for stress - well not only did this flare begin with a stressful day dealing with insurance over my meds, but the shear fact that I'm stressed out of my mind about working next year and even making it through this year has generated more pain in my body than I've ever had before. Plus if I do go out now Ii feel like I've ended my career on a sour note. I'm not embarrassed or anything but retirement should bring happiness, bot misery that I couldn't complete a life long goal of teaching between 30 and 35 years!

Plus I feel like I constantly have to sell my wife on how awful I feel in terns of pain and fatigue. I feel she wants me to grind it out as long as possible even if it puts my health and well-being at risk. This is probably not entirely true but she never wants to talk about me taking a disability so I've decided that if I get offered some severance from my employer to apply sooner than later for the benefit of both parties that I'm gonna jump at the chance and start my own business from home which is completely acceptable under my retirement board's disability plan. Thank you so much for your invaluable advice.
Put away my rakes! Never! Reducing the amount I use such tools I will do but they aren't going into retirement yet! That's asking too much! lol

One final question: I'm on Enbrel, Celebrex, Voltaren Gel and Norco as needed. When I'm home I'm cured. When I work I'm not.
Will adding another DMARD make it so I can work on less rest and live a more stressful life? I would think rest and lower stress levels will always be part of the healing equation.
Thanks!

my private LTD was exacting to apply for the standard was that I could not return to ANY job. they told me, I did not tell them. my medical record had to support it to the exacting standards that they wanted (not implying that your's does not). the point was it was not my review to make, it was their's. I had a mega pound file from working with RA about 6 years, (with a two hour commute round trip plus) not the longest working with RA period on here by any stretch of the imagination. or the shortest.

each one of us is different. I support each and every one of us each and every step of the journey wherever you are whatever you need.

knowing your plan and what the application standards are (can you work part time and receive part time benefits? are you precluded from any income 1099 included? do you have to do vocational training?) and speaking to your doctor will get you much further than us all here. We are here for you 100 percent and support you but I do not know the specifics of your application process. I do not know how medically supportive and documenting wise your rheumatologist is. My neck surgery tipped me over the edge of holding on.

you will know and so will your doctor and your disability company will tell you. If you want to review the application ahead of time, maybe you can get some help inquiry wise from HR? Not sure if you think that wise.

in the interim, I am happy and proud for you that you are juggling the act. I am sorry it is taking such a toll on you. Can you give some of the education supporting docs that we talk on here about all the time (like the spoons article) to your wife by printing it out for her?

can you slow down on the lawn work and sub contract that out? (kidding) :)

holler anytime

Depot

Regarding your one final question -

The medication is kind of like Russian Roulette in a way - I've heard of so many people who've tried many different combinations of meds to find the sweet spot. For me my doc seems to be happy with how my combo of Methotrexate (4 per week) and Humira are doing for me. I'm actually afraid to ask him if he thought I could do better on something else. I find that I am ~50% of my old self.

Hypothetically let's say you are now home all the time. I know your main hobby is your lawn and working outside. Same here also - not so much my lawn but just general maintenance on my 6 acres of lawn/field/woods and 3 old buidlings. As I said earlier I have now found a schedule of sorts that I can deal with. The short version is I can work on a project for 2-3 hours in the late morning to early afternoon then have to stop. After 2pm I am pretty much done and porch bound. I will tinker with some other stuff in the shop sitting on a chair after that - I have to be doing something.

And as much as I hate it the Norco it has become a part of my daily routine. My wife has been a chronic pain sufferer for over 10 years (much worse than our RA) and she has taught me to take the Norco on a regular basis throughout the day. This alone allows me to get out there and do stuff. I take one every 4 hours starting just before breakfast and this allows an extra 1 or 2 in the evening when I get bad when I get tired.

So yes - you'll be able to get out there and do stuff but it will take some practice to find your limits. The first week the weather broke I spent the first 2 days going all day like a bull - finally got outside! But then I paid for it with having to stay in my recliner for 3 days after that. So I found that the 2-3 hours a day is a must and have to stop after that as hard as that is.

I know I get to rambling and get off on tangents - product of the good 'ol brain fog.....but I wanted to give you some more concrete examples of how I have learned to deal with all this and still try to get some enjoyment from working outside on my property.

First thing that really got to me was using my string trimmer. I guess the fact of the constant vibration along with holding your hands in the same position was it - after running the trimmer I would have a super flare in my wrists and fingers. So the solution for that was I now use a herbicide. I know the lawn guy will say "GAHH!" My trimming is now done with a sprayer.

Using a rake - another thing that would really get me. I also have Bursitis in my shoulders so any repetitive action like using a rake would put me in my chair for 2-3 days. Now I will use one occasionally but very lightly. What used to take 1 stroke now will take 3 or 4.

Every little project or action takes some pre-planning. I will think ahead of what I want to accomplish the next day the evening before. Thinking about this when I go to bed actually helps me get to sleep. I know my time limit is 2-3 hours. Then I think about what tools I will need to use and see if there are any substitutes that I could use to make it easier. One thing that is usually the first "tool" I get out is a chair. I can't squat, kneel, or bend over at all so I set up anything I am doing to be able to do it from a chair.

Wheelbarrow is out now also - I use my tractor bucket for everything. If you have a garden tractor a pull along dump cart can replace that wheelbarrow. As I mentioned before - a light cordless drill/screw gun in lieu of a screwdriver. A reciprocating saw in liue of a hacksaw. I was brought up using all hand tools and have a heck of a collection from my father. It pains me to not be able to use most of them now - some I can use for short periods of time and others I just can't.

One more example and I'll let this rest - I am OCD about keeping my pick-up in top shape and clean. Every spring I do a detail job on it which includes a full wash, clay bar, wax, treating the plastic pieces, interior clean and wipe down. This used to take me 3-4 hours. Now it takes me 3-4 days. I will look for a week (like next week) where the weather will be nice all week. Day 1 will be the wash and clay bar - day 2 the wax - day 3 the exterior trim - day 4 the interior. This is how I now get things done. I always have to remind myself that I don't have any time restraints now. I have actually found I can get more enjoyment out of things like my truck detail when I really take my time like that.

Hi Depot,
I wouldn't be required to get vocational training. I have to give them 20% of any income I make during the first 2 years but my disability isn't reduced, there are no exacting standard - my doctors claim that I am disabled is gospel and she would have to provide my records which indicate my disease and severity of it. There are few applicants so a review board usually rubber stamps its approval if your doc is on board. Also I can work a light duty job but couldn't teach which is my current profession. This isn't insurance in my case but cones directly from my retirement board which I've paid into for years.

Coaltrain,
I like herbicides and you gave me a great idea when it cones to the string trimmer which I likely won't be able to use either. You can apply a plant growth regulator like Embark or Primo Maxx which will keep grasses around fences and poles from growing for months. PM me if you want more info.

As far as the Norco, I am prescribed 4 a day as well but it makes me tired so I have to wait to get to work to take it. I don't use it the way I should either. I take 2 when I'm in acute pain and forget I have it the rest of the time. Maybe taking 1 every 4 hours will take the edge of my pain which in turn will lower my stress. Sadly I built some tolerance to these meds and they don't work like they used to. Have you experienced any tolerance issues by taking the Norco daily?

I'll be sending you a PM about the growth regulators.

Again from the advise from my wife and also my PCP whom I've had extensive talks about controlling the pain, the main thing is to get in front of it. I only started the daily regimen about 6 months ago - before that I took them when I felt the pain already. What I found is once the pain is there I couldn't control it with the Norco. It seems to work so much better for me to do the daily regimen as it seems I am staying ahead of the pain instead of chasing it.

When I was working (driving) I couldn't take it at all except for when I was home. A lot of very hard days those last 6 months being I was in the truck for 24 hours at a time. With your commute I know it's tough but I applaud you for paying attention to the fact that you are driving and limit taking it - I've seen so many very bad things on the road.

Yes, I know I have built some tolerance to it but it seems to have leveled off for me and still works for the most part. This also might be partially since I now always have some in my system more or less.

According to my doc and everything else I've read about these pain meds, the object is to take the edge off and not to take all the pain away. I use this as my guide and the 4 per day (every 4 hours) does just that. When I do get those super flares once a month or so I do need to take some extra to get through it along with some Ibuprofen.

My situation is of course different that I am home all the time. We only leave the homestead 2-3 times a month for grocery runs so daily driving isn't an issue.

Staying ahead of pain makes perfect sense. I suppose I do that by taking Celebrex daily but never considered doing it with the Norco. At some point I'll ask the doc to move me from 7.5 to 10 mg doses. I will try and stay ahead of the pain in the future when I can.

I'm looking for ways to maintain an elite lawn with mild to moderate strength and effort. I'm a member of a lawn care forum where folks help each other out, plan renovations together, etc, I made my first post of the year earlier today. I told my friends there about my condition and asked for suggestions. Write me anytime if you want to know about plant growth regulators so you can give that string trimmer a rest. I have some here but I may be trying another brand soon, loading up a sprayer and outlining my property. Also, if your hands hurt but your upper back can handle some weight you can purchase a backpack sprayer which is on my list this year as well. It's great for a variety of lawn and garden applications and costs less than 100 at Home Depot.

Along with the great help I've received from the members on this forum I've also revived a lot of support from other forums that I frequent.

I replied to your PM about the sprayers and such.

Greg, I'm a desert rat, where having a lawn (using the water to maintain one anyway) is a no-no, so no suggestions there! You probably don't want information on xeriscaping . . .

Your ability to get disability must give you some peace of mind. Even if you don't want to use it, knowing it's there must be like having an ace up your sleeve.

Does your district allow for part-time work, and if so, would you still have insurance? It sounds like you are close to being able to get through a week. Could you do four days? Finish at lunchtime a couple days a week? If it wouldn't affect benefits, pension, etc., cutting down rather than quitting might be a good compromise move.

Summer break is coming: six more weeks? That will give you a chance to step back from the daily grind and clear your head to make some decisions. Summer's also the height of the lawn season, I'd imagine, so you'll be able to give the grass some of the energy the kids are using up now. A break will also give you time to try to optimize your medication. By early August you may have a better sense of which way to go.

Hi Alto,
No chance of part time or reduced schedule. Part of my problem is the hour commute. I find myself coming close to falling asleep on the road daily. I would love to do one more year but I'd have to be considerably better than I am now. I have lots of computer skills so I may as well put those to use and start a part time repair and consulting business at home.
Greg

I got RA about 4 years ago. could barely walk in the morning. It took a very long time to get the right mix of meds. I am fortunate to still work. I walk to work everyday. Yoga and walking help. For me the key is to keep moving. The fatigue does not come on like it did in the beginning I would be in bed most weekends. Now only once in a while I will have to stay in and rest. The meds are improving all the time. Hang in there- it most likely will get better ounce it is under control, you are still in the early stages.
Ps nonightshade, I am going to try a elimination diet. I don't eat nightshades much, but will start limiting the carbs, and processed foods. Thanks for the info.

if you have options then execute away!!!!!

private and commercial long term disability and social security disability of course have different standards about what your activities of daily life you are able to pull off 24/7. if you plan has no exacting standards how wonderful!

my commute was an hour each way and I did it for over 7 years with the disease but I would have been both at the YMCA as a single parent and neither grammar school kid would have gone to college so the goal then was to say upright and sleep where able (offices, cars, side of road, friends houses) that kind of thing.. kids are a wonderful option makers! during this time i stated often I do not take pain meds at work or driving to work because I can not drive with them. i also had strict rules about when I took them at home (during the night) if I had some left over from a surgery as they affected my driving and my intellectual abilities at work (just me can't speak for others)

during this time I became addicted to 800 mg motrins (which I chewed) and naprosyn (aleve) and the over use raised my liver numbers. i also had massive fatigue, of course, from methotrexate brain fog and the fatigue of the disease. i would say that the cervical surgery and other issues 7 years later led to the demise of my career more than anything. I think living alone presents unique challenges but then every living situation does.

I admire your lawn work as a hobby. I feel that way about music. but mine is mostly sitting from a chair listening live from lincoln center on saturday night :) - your's is prettier. :)

I will have to post pictures of my acre of weeds - i pay no attention. But I am still in the house and one kid graduates from college this month in NYC another to go. small miracles. we ALL make and take small miracles.

keep on chugging and I am so glad you have options. fortunate life.

depot