YOUR RHEUMATOID ARTHRITIS WHEN THE SEASON CHANGES - If your rheumatoid arthritis acts up when it's cold and rainy, there's a lot you can do ease stiffness and pain. Your instinct may be to hunker down at home when it's rainy or cold outside, but try to resist. If you want to feel better, get active. Exercise wards off stiffness and keeps you from gaining weight, which puts added stress on your joints. Moving around also gives you a rush of feel-good chemicals called endorphins, which can help block pain. Regular stretching can help you ward off pain and stiffness. What you put on your plate can affect stiffness and swelling. Try to limit sugar - avoid high-fructose corn syrup. A healthy diet makes a difference in how you feel when the seasons change -a diet that's low in cholesterol and high in omega-3 fatty acids, which can fight inflammation. Being aware that seasonal changes often trigger pain also helps. You can't change the weather, but if your rheumatoid arthritis acts up when it's cold and rainy, there's a lot you can do ease stiffness and pain. It's especially hard when autumn turns into winter and when winter makes way for spring. Experts aren't quite sure why weather has an impact. Autumn may be the sweet spot for RA, while winter and spring are the most challenging. No matter the cause, take some easy steps to keep your RA in check when the weather isn't on your side. Try to keep yourself nice and toasty, especially when it's cold and damp outside.

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Your Rheumatoid  Arthritis When the Season Changes

There's not much you can do about the weather, but knowing what to expect helps manage flares

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If your rheumatoid arthritis acts up when it's cold and rainy, there's a lot you can do ease stiffness and pain. Your instinct may be to hunker down at home when it's rainy or cold outside, but try to resist. If you want to feel better, get active. Exercise wards off stiffness and keeps you from gaining weight, which puts added stress on your joints. Moving around also gives you a rush of feel-good chemicals called endorphins, which can help block pain. Regular stretching can help you ward off pain and stiffness. What you put on your plate can affect stiffness and swelling. Try to limit sugar - avoid high-fructose corn syrup. A healthy diet makes a difference in how you feel when the seasons change -a diet that's low in cholesterol and high in omega-3 fatty acids, which can fight inflammation. Being aware that seasonal changes often trigger pain also helps. 

By Kara Mayer Robinson

WebMD Feature Reviewed by Michael W. Smith, MD

 

You can't change the weather, but if your rheumatoid arthritis acts up when it's cold and rainy, there's a lot you can do ease stiffness and pain.

Pittsburgh resident Ashley Boynes-Shuck knows the issue firsthand. The 32-year-old author has RA, and when the weather shifts gears, it tends to flare up.

"The seasons changing often presents a problem for me," says Boynes-Shuck, who has written two memoirs about living with long-term illness.

It's especially hard when autumn turns into winter and when winter makes way for spring. 

Experts aren't quite sure why weather has an impact.

Research suggests autumn may be the sweet spot for RA, while winter and spring are the most challenging.

"Small studies have been done, but there's no real conclusive evidence supporting the reason for it," says Magdalena Cadet, MD, attending rheumatologist and assistant professor at New York University School of Medicine.

No matter the cause, take some easy steps to keep your RA in check when the weather isn't on your side.

Stay Warm

Try to keep yourself nice and toasty, especially when it's cold and damp outside.

Wear extra layers. Stash a blanket in every room of your home. Power up a space heater.

If your place is drafty or cool, Cadet says, look for home improvements that seal up drafts.

Let warm water work its magic. "Take a warm shower or a 20-minute soak in the tub," Cadet says.

It's good for your blood flow and massages your joints.

Lotions or essential oils also do the trick. Warm them up in your hands first. Then use them to massage your joints.

Get Moving

Your instinct may be to hunker down at home when it's rainy or cold outside, but try to resist. If you want to feel better, get active.

Exercise wards off stiffness and keeps you from gaining weight, which puts added stress on your joints.

Moving around also gives you a rush of feel-good chemicals called endorphins, which can help block pain.

Try an activity that doesn't put pressure on your joints, like yoga, tai chi, and swimming.

"If the weather's really cold and you know it's a trigger, you may want to limit your outside activity," Cadet says.

But you've got alternatives. Instead of a walk, head to the gym.

Do an easy workout on a stationary bike or treadmill. Use light weights, resistance bands, or a balance ball. Just be sure to clear these exercises with your doctor first. 

Stretch It Out

Regular stretching can help you ward off pain and stiffness.

Try to do a series of stretches and gentle exercises every day. You can do them in the morning or before you go to bed.

Start with small, easy exercises. While you're in bed, do a few gentle stretches for your wrists or ankles. Then get up and try gentle knee bends. Use a chair or counter for support.

Eat Well

What you put on your plate can affect stiffness and swelling, Cadet says. A healthy diet makes a difference in how you feel when the seasons change.

Try to limit sugar. Avoid high-fructose corn syrup.

Cadet suggests a diet that's low in cholesterol and high in omega-3 fatty acids, which can fight inflammation.

Of course, eating well is good for you no matter the season.

Do What Works for You

"Every person with RA is different," says Ziv Paz, MD, a faculty member at Beth Israel Deaconess Medical Center, Harvard Medical School's teaching hospital.

"You have to find what makes you, specifically, comfortable."

For Boynes-Shuck, being active and getting out in the sunshine goes a long way to bring relief.

Being aware that seasonal changes often trigger pain also helps.

There's not much she can do about the weather, of course, but knowing what to expect helps her manage flares.

"I try to manage them with medications, massage, essential oils, chiropractic, acupuncture, yoga, and an overall healthy lifestyle of wellness," she says.

The right frame of mind also makes a difference. "I think that a good support system and a positive outlook are crucial," she says.

"Pain is certainly not fun and it can make life challenging, but we can take charge of our own health as best as possible."

Michael  W. Smith, MD, MBA, CPT

As Chief Medical Director at WebMD, Michael W. Smith, MD, MBA, CPT, is in charge of the medical team, which is responsible for upholding the accuracy and credibility of all WebMD health information.

He joined WebMD in 1999 and now oversees a team of staff physicians and medical reviewers across the U.S. responsible for creating content and assuring its continued medical accuracy and relevance to the WebMD audience.

Dr. Smith is a regular expert on national and local broadcast media, including regular appearances on Fox 5 News in New York to discuss the latest health headlines. Other appearances include Fox News, The Weather Channel, MSNBC, CBS’ The Early Show, and Katie Couric's web-based show @KatieCouric, among others. In addition, he has appeared in multiple publications, including Men's Health, Newsweek, Forbes, and Reader's Digest and was featured as the Internet's Top Doc in USA Weekend. He has also been interviewed by local and nationally syndicated radio stations, magazines, and newspapers across the country, speaking on everything from hangover remedies to navigating the internet for accurate, credible health information.

Dr. Smith serves as a member of the Nutrition Wellness Educator Certification Panel, established by the American Association of Family and Consumer Services. The panel is responsible for determining the competency scope of the Nutrition and Wellness Educator certification.

In 2013, Dr. Smith provided the keynote speech at the Institute of Food Technologists Wellness 2013 conference and was a featured presenter at the Digital Health Communication Extravaganza.

Dr. Smith also volunteers at the Good Samaritan Health Center in Atlanta, where he sees patients who do not have health insurance or are unable to pay for health care.

As a board-certified general internist, Dr. Smith's interest and knowledge span a wide array of medical topics. Autoimmune conditions are an area of personal interest to him, having developed ankylosing spondylitis in his college years. In 2014, he authored a book on his journey with this condition, Ankylosing Spondylitis Pyramid: The Lifestyle That Lets You Take Back Control. He is particularly interested in prevention and helping people live a healthy, active lifestyle. Dr. Smith is an American Council on Exercise certified personal trainer, with specialty certification in weight management, and is a certified health coach with Villanova University's MacDonald Center for Obesity Prevention and Education

Dr. Smith graduated from Mercer University School of Medicine in Macon, Ga., in 1994, then did his internship in internal medicine at the Medical Center of Central Georgia in Macon. He finished his internal medicine residency -- his final year as chief resident -- at Georgia Baptist Medical Center in Atlanta. He became board-certified by the American Board of Internal Medicine and then entered private practice as a primary care physician. In 2013, he earned a Master of Business Administration degree.

Dr. Smith is a member of the American College of Physicians and the HealthLeaders Media Council.

https://www.webmd.com/rheumatoid-arthritis/features/ra-pain-changing-seasons

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STEROIDS - Steroids save lives but we have to face-up to their side-effects - Steroids truly are wonder drugs — life-savers in some cases — that for decades have been relied on for their ability to reduce inflammation. Drugs with so much power have side-effects when taken long-term — prednisolone, the most ­commonly taken long-term steroid, can cause osteoporosis after just a few months.

Steroids

Steroids save lives but we have to face-up to their side-effects

By Dorothy Byrne

A woman I barely know leans across the dinner table and strokes my cheek. ‘No wrinkles at all!’ she says enviously. ‘How do you do it?’

It’s a compliment I have grown used to in recent months. Despite being in my 50s, my skin is as smooth as a toddler’s bottom.

It’s a compliment I have grown used to in recent months. Despite being in my 50s, my skin is as smooth as a toddler’s bottom.

 But my secret is not Botox. ‘Steroids,’ I reply. ‘15 mg a day. 

Wrinkle-free: Dorothy Byrne,
Head of Channel 4 news, hates that being
on steroids has given her a 'hamster face'

I am one of the quarter of a million ­Britons who take steroids long-term. They are corticosteroids, which are not the same as the anabolic steroids taken by bodybuilders. 

In my case, steroids control the painful symptoms of a temporary auto-immune condition called polymyalgia rheumatica (PMR).

Others take steroids for ­inflammatory conditions such as Crohn’s disease, chronic asthma, chronic ­obstructive pulmonary disease, ulcerative colitis and rheumatoid arthritis.

Steroids truly are wonder drugs — life-savers in some cases — that for decades have been relied on for their ability to reduce inflammation.

But they have some unpleasant effects on physical appearance that patients are often embarrassed to talk about. It is time for us to come out.

As head of news and current affairs at Channel 4, I am meant to talk about ­subjects others find difficult to discuss. How strange that one of those subjects should be my own body.

As you can imagine, drugs with so much power have side-effects when taken long-term — prednisolone, the most ­commonly taken long-term steroid, can cause osteoporosis after just a few months.

But the potential medical ­consequences hardly bother me on a day-to-day basis. What makes me miserable is the way steroids make me look. That smooth skin comes at a price — we steroid-takers call it the hamster face.

‘You could buy yourself a little wheel to spin round on, Mum,’ said my teenage daughter Hettie.

She did tell me I was still her beautiful mother ‘underneath’. At least she was honest. Many ­people have told me I look just the same — does this mean I’ve always looked like a hamster?

Doctors call our chubby chops ‘moon face’. It’s caused partly by water retention, but also by the peculiar way in which steroids redistribute fat round the body.

We also have little humps on our backs just below the

Dorothy before: Steroids make takers look puffier
because they cause water retention and
redistribute fat to the face, back and midriff

neck, known as ‘buffalo hump’.

There is another weird fat deposit round our midriff.

Meanwhile, our arms and legs lose ­muscle and fat. 

Some medics refer to us as ‘lemons on matchsticks’. Others call us ‘potatoes on sticks’. Obviously, they don’t say these names to our puffy faces. 

Doctors are, of course, mainly concerned with the long-term medical benefits of taking steroids and so often don’t mention ­temporary changes in appearance to patients.

I’ve interviewed ­several people who didn’t know until I told them that the weird fat deposit round their torso was caused by steroids.

Similarly a lot of doctors don’t, or hardly ever, mention the ­possibility that you’ll put on weight. In fact, someone on long-term steroids for PMR might expect to put on half a stone.

The higher the dose and the longer you are on steroids, the more weight you are likely to put on. This is because steroids make you feel hungry, affecting the areas in the brain that control feelings of hunger and satiety.

A study of PMR patients found more than two-fifths put on ­significant weight. Several people I know on steroids complain of weight gain of a stone or a stone and a half. I’ve heard of one woman who put on five stone.

My consultant did warn me about weight gain and advised me to surround myself with oranges (rather than crisps or chocolate).

Thank God she did. I quite often sit down and eat five, one after another. I can polish off two supermarket string bags of satsumas in a night. But despite eating healthily, I have still put on half a stone.

I don’t like the new me. I was invited to a party at which one of the key draws was the presence of the Leader of the Opposition.

I looked at my puffiness in the ­mirror and just couldn’t face going out that night. I asked myself if it was rational for a woman to feel too unattractive to meet Ed ­Miliband. Still, I stayed at home.

Feeling isolated, I went on the internet and was hit by a cry of pain from across the world.

Someone with eosonophilia pneumonia — a lung condition — describes the love/hate relationship patients have with steroids: ‘I began to look like someone I didn’t even know. But the ­alternative to prednisolone was to stop breathing.’

Someone who’s had two organ transplants agrees. ‘It’s a lifesaver, but is hell for its side-effects.’

‘I would rather have the pain than a moon face and weight gain,’ another wrote.

Some ­people feel steroids have had a serious effect on their social lives. ‘I miss being pretty. I used to love having so many friends, but now all I think of is how they talk behind my back about how I look,’ said one woman.

I asked myself if it was rational for a woman to feel too unattractive to meet Ed ­Miliband. Still, I stayed at home

A teenager with Crohn’s disease writes: ‘I absolutely hate this moon face! It is probably the worst thing I have to deal with in my life. I really can’t bear the thought of having to go back to school looking like this. Please can someone help me?’

That poor child didn’t think Crohn’s disease, a serious illness, was the worst thing that has ever happened to her — what bothered her was her face.

People who go on to websites are more likely to be complainers. So I asked some sensible, middle-aged women on long-term ­steroids what they felt. I expected them to scoff at such distress; I was wrong.

Val Emblen, who was 64 when she went on steroids, put on 1½st.

‘When I looked in the mirror, it was a different person looking back. I found it very difficult to go to the hairdressers,’ she says.

‘I didn’t want to buy clothes for someone with this new shape. I felt I was presenting myself to the world as someone who was not me. I didn’t realise how important body image was.’

Her doctor was ­sympathetic and Val agrees the change in appearance was the price she had to pay for improved health. But she believes patients should be warned.

‘Doctors should tell you because knowing it happens to other people is important,’ she says.

Gilly Gilmore was 54 when he was prescribed the drugs.

‘At first, I felt hugely relieved. Then I put on a stone and felt depressed. My face puffed up and it made me feel dreadful. The shock made it much worse.’

Should doctors think more about how miserable sick people are about the way they look?

Years ago, I was so seriously injured in a motorbike accident that I later discovered doctors had considered amputating my leg. I feel grateful and lucky that most people don’t even notice I limp.

But for decades my wardrobe has been designed to hide the huge scar on my leg, which has defined my vision of myself.

Millions of people feel a lower sense of self-worth because of changes to their bodies through illness or accident and they could be happier if they talked about it.

I have a friend who disagrees strongly. She has lupus and has also had a kidney transplant.

She’s been on steroids for ­decades and thinks doctors shouldn’t warn patients about puffy faces, as it could put them off potentially life-saving drugs.

But the hospital she attends provides counselling about weight gain and facial and body changes to patients who want it.

In these difficult financial times, it’s hard to see scarce resources being diverted to such services. But couldn’t doctors and family and friends help by recognising and discussing the problems?

When people stop taking ­steroids, their hamster faces ­disappear and most lose the extra weight.

Perhaps I will shrivel up like Ursula Andress in the film She.

Mostly, I look ­forward to ­worrying about wrinkles again.

http://www.dailymail.co.uk/health/article-1354628/Steroids-save-lives-face-effects.html 

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