The Flare Factor

Patient Expert

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One year after starting Enbrel, I'm doing pretty well, particularly these last six months.   The high heels have been back on, the late nights out with friends have been growing more numerous, and my yoga practice is starting to take shape again.   Even my metabolism has been showing signs of life, and some of the weight I put on has begun to fall off. All in all, you could say that my life has resumed a new sense of normalcy.

Given all of the above, I've been feeling pretty confident about this whole RA thing. Sure, it's annoying having to manage my meds and diet, but with the turn of the New Year and my resolutions in hand, things were bound to get easier and easier.

And yet, that's exactly when my RA chose to reach into its back pocket and pull out one of its dirtiest tricks: the flare. Yep. That's right.   Sassy, confident me was brought to my knees mid-January with a flare that completely blindsided me.

Looking back, it shouldn't be all that surprising given that January has been a bulldozer of a month at work.   Once I came back from the Holiday break, I was working nonstop, running around the city during a conference seeing performances and networking with colleagues and artists over drinks and dinners. My New Year's resolutions to eat better and practice yoga were put on hold.   I thought I was doing fine, and by the time the conference finished, I figured I was in the clear, right?


At an appointment the day after the conference was over, I started to feel really warm and flushed, and my breathing became a little shallow.   When it was over, I headed to the subway to go back to work, and the flash of winter cold, dry air instantly rattled my bones and joints and left me feeling even worse.   By the time I got back to my office, I was pretty sure I was running a small fever, and I felt positively awful.   It's hard to describe exactly how awful RA can make you feel. Many people think RA is a disease that just affects your joints, but along with the crippling pain and swelling that is its hallmark, RA has the power to make you feel down right sick and unwell, like you've got a bad case of the flu. That's one of the curses of autoimmune diseases- your body thinks you are constantly battling an infection, which can cause fevers and make you feel like death warmed over. All my energy vanished, and I felt truly sick, full of aches, pains and an invading weakness all over my body.

I spent the next day and a half feeling miserable, curled up in my bed with a fever and chills, completely isolated from the busy goings on of my life and the city around me. I felt zapped of all my strength, well-being, and worst of all, my confidence.   Having a flare, especially one that comes on so quickly and severely, really makes you feel utterly vulnerable.   It's a harsh reminder of how unpredictable and unforgiving this disease can be, and moreover, that it is always there, lingering in your cells and bloodstream, even when the meds make you feel like you are healthy again.

By the end of the week, I felt better.   Not 100%, but the fevers had subsided, the aches and pains had abated, and I felt well enough to head back to work and rejoin the world.   I still felt shaken, though, and unsure about what risks I should take, even about simple things like walking those few blocks vs. taking the subway to conserve my energy. Once again, accomplishing daily tasks became an exercise in risk management, calculating every move to assess what it might cost me.

I also felt incredibly angry.   Flares leave an emotional residue that can last long after the physical symptoms fade.   I hate being reminded that I am vulnerable and that I am different than I was before.   I resent having my health taken from me at such a young age, forcing me to make changes in my life that I would rather not make. I despise this disease for being able to rob me of my sense of self and render me physically unfit when I should be in the prime of my life. The post-flare depression can be pretty brutal, and the temptation to stew in it and feel defeated once again is strong.   Part of me wanted to wallow in it, shaking my swollen fists at the sky out of the unfairness of it all.   But most of all, flares leave me with the powerless feeling of just wanting it to all go away, knowing that it can't.

And yet, life has to go on. Once the flare subsides, it's crucial to confront your emotions, and then get back on your feet and get back out there and not take a day of feeling better for granted.

One week later, I'm feeling back to my 'new' normal self. I haven't slapped the heels back on quite yet, and I'm minding my diet and yoga practice, but I'll be damned if I let RA get the best of me.

Read more of Sara's writing at her blog, The Single Gal's Guide to Rheumatoid Arthritis.