Food the friend and foe of RA

We started our research on methotrexate and the findings are scary. During this search we came across many articles that suggested that there is a direct impact of food on RA flares (Bouts of pain with inflammation) . We were skeptical as our doctor never mentioned anything related to food but a lot of research gives a whole different version of the causes of RA. And most articles are talking about elimination of foods . We came across a program called Paddison’s program for RA by Clint Paddison : http://www.paddisonprogram.com/store/paddison-program-for-ra/ . This guy was a former RA victim who was able to reverse his RA symptoms and weaned from the medicines completely so he is confident that RA can be reversed just by food naturally. We saw his videos and podcasts with testimonials from many people about how they could fight RA with food. Surprising is not right word so we were completely baffled but wanted to  give it a try anyways. (Pufff..  what else can go wrong now?? 😛 ) Never knew this will change my perspective towards food and eating in life

The below are the primary foods that were eliminated:

  1. Meat , eggs and fish.
  2. Dairy
  3. Oil and fatty foods
  4. Night shade Vegetables like – Tomato, potato, egg plant, capsicum etc.
  5. Gluten products  like wheat flour, soy etc
  6. Sugar /Sweeteners
  7. White rice

See that’s a simple list of foods to be avoided 😦 . God must really hate me 😦 . I’m a non-vegetarian addicted to anything made out of eggs with a very huge sweet tooth. So this basically leaves no other choice than plant based diet. Very difficult I say but not impossible and you know why… “Pain is the real motivator” . Once you taste the pain of RA nothing else can be more tempting to experience that sort of pain.

So, after seeing success stories of many others like Dr. Monica Aggarwal (I could relate to her as her RA also started at a similar stage  as mine i.e. post child birth ) we decided to try this approach.

Started with green juices as I just could not chew them raw without throwing up. Juice from celery, cucumber, lettuce, Broccoli, Bok Choy, leafies etc. Trust me it was horrible I felt more sick of the juice than RA. We bought a Hurrom slow juicer specifically for this  as it gives non-oxidized juice preserving the nutrients which is not the case with the traditional juicer. But slowly it sort of grew on me. Now I drink with no complaints.

Sweets, Dairy and meat are long gone now. Wheat flour is our primary ingredient in the kitchen so now that is gone too. God I miss my Puris 😦 . To substitute wheat flour and white rice we included the super foods i.e., millets (foxtail, pearl, little etc. to name a few). Started testing vegetables and fruits for any reactions. I’m sensitive to tamarind (My other favorites Sambhar and Rasam are gone!!)  and pear fruit initially.

Turns out that some foods are our friends and some are enemies as they cause inflammation and in turn pain without our knowledge. So we need to watch out for what works and what doesn’t.

 

 

 

Advertisements

Plan

Goal :

Long term : To be completely pain free for 3 months in a row, bring down ESR and reduce the dosage of Methotrexate.

Immediate: Should start walking in the morning for at least 15min after a sound sleep.

Overview : Assess the current situation and plan accordingly to achieve the above goals.

Current situation :

  1. Slight and occasional RA pain in knees, shoulders and toes. It is not consistent and moving.
  2. No morning stiffness.
  3. Feeling very tired and lethargic. Other body aches and unease.

Approach:

Even though the ultimate goal is to address RA pain other current issues are causing stress and there is a confusion between RA pain and regular pain or weakness. So we will address the other issues first so that I’m more prepared, motivated and ready to address RA.

Reason: Why this diversion? Why not go with Clint’s approach?

I’m already feeling weak and tired adding fasting and only juices may deteriorate this condition and I may land up in other problems which will make us loose confidence in Paddison program.

Plan:

Increase energy levels and stamina without irritating RA further and should start on basic walking everyday.

Things to be avoided at all costs for next months:

  1. Dairy
  2. meat/eggs
  3. sweets /sugar
  4. Atta/Maida
  5. refined /processed foods
  6. Potatoes, tomatoes, tamarind, pear
  7. white rice
  8. Less oil
  9. Senaga papu / ground nuts
  10. Raw banana (Lets hold it for sometime as it was a new inclusion)
  11. Dry figs and dates (Reduced sugar intake)
  12. Will hold on Meal maker also.
  13. Carrots

As weight loss is not a concern anymore need to eat the below foods:

  1. Millets – Dosa/Idly/Flavored rice
  2. Veggies – Beans, cabbage, bottle gourd, ridge gourd
  3. Leafy vegetables
  4. Single polished rice.
  5. Sweet potatoes
  6. Fruits – Pineapple, Watermelon, musk melon , pomegranate, apples
  7. Celery/ Bok choy/cucumber juice
  8. Sprouts
  9. Will test Rajma and chole as they are plant based and high in nutrition.
  10. Pumpkin and pumpkin seeds
  11. Almonds and walnuts.

If you are concerned or confused as in what is new here I would say not much but we will get back to a routine and have more discipline and the food intake should be increased to be a little more energetic.

Things to do :

  1. Plan meals /menu for the week in advance and keep all the required ingredients ready.
  2. Have a backup plan in place.
  3. Plan snacks for 6 PM everyday to avoid hunger and binge.

Conclusion : Why follow some body else like a sheep instead lets create our own formula  to success by analyzing our own circumstances.

Ranjith comments: We need to check the possibility of planning 2-3 weeks of strict diet with only below. I am hoping you will be fully pain free

  1. Absolutely no oil. Is this possible?  – Not 100% but we can try to some extent.
  2. Do not miss the juice of celery/cucumber/bok choy – Agreed
  3. Breakfast, lunch and dinner from below – Sweet potatoes I don’t think we will get organic ones . Even normal ones are tough in this season.
    1. Leafy veggies, sweet potatos ,millets, veggies listed above
  4. Fruits, almond, walnuts for 11 AM, 3 PM, 4:30 PM – Only organic means you will get papaya, watermelon , grapes , cheeku – Cheeku and papaya has high sugars so not allowed. I think grapes also so surviving on only watermelon is not a feasibility.
    1. only organic fruits(from whats listed above)
  5. Options to get rid of 6PM hunger
    1. Millet roti or dosa that’s made in the morning. Is this feasible considering summer.  I don’t think so I need some quick bites as i’ll be in a hurry to prepare dinner and for my evening call and these needs some time for me to sit and eat.
    2. Sweet potato. Can we make it in the morning and you come and eat it in the evening. If we get these then yes we will steam them and store them in the fridge for evening use.
    3. Chick peas are actually sanagalu and we are getting organic. Combo of sprouts and sanagalu ? Boiling them with salt/pepper/little chilli also should be good. I don’t want to eat sanagalu for now so ruled out. Sprouts will try.
    4. Muramuraalu( we should get organic) with onion and kaaram, uppu – This I need to prepare it after I go home. Again a time constraint.

 

 

 

Magical monster Methotrexate …

Change of doctor again:

As things were not getting any better we went to a new doctor at a very famous hospital. He did clinical assessment and was surprised with the amount of swellings and started on the magical and ultimate medicine for RA methotrexate. His approach was different he did not prescribe any steroid injections for quick relief and asked me to stop the pain killer Hifenac instead he gave me a 6mg of mild steroid tablet every day 😦 . So my medicines were methotrexate i.e. folitrax 10 mg once a week, Cortishot 6mg daily, Folvate twice a week and Vitamin -D supplement once a week.

Methotrexate is considered as the initial goto drug for RA but it also has so many side effects the primary being it effects the liver functionality so it is accompanied with Folvate to mitigate it and we need to test liver functionality with SGOT and SGPT tests every month as long as the test results come out normal we are good else the drug should be modified. But this combination seems to be working for me for now. As the swelling and pain came down slowly and life was near normal with adhoc bouts of pain but overall life was again in my control.

After a month doctor increased my dosage of methotrexate to 15mg as the ESR is still high at 42 other tests came out normal so everything else remained same. The only concern about this is I started gaining weight and heavy hair fall due to the drugs. And our research says soon my body will get used to the current combination and we may have to change the drugs or increase the dosage. So current situation is better but for the long term things are still ambiguous.

Gamble with alternate medicines…

As my pain is manageable with the new found pain killers I wanted to play a gamble with alternate medicine as the current medication has side effects and it is not a temporary illness which will be gone in few days and my previous Rheumatologist also hinted that there is no finite cure and the current medicines for RA are toxic.

I started with Homeopathy but unfortunately it did not help and my pain was there. Decided to quit my job and work on my health as it is deteriorating (But applied for a new job immediately as you never know whats in store in 3 months of my notice period and I don’t like uncertainty).  Stopped homeopathy and joined yoga it did help in the initial stages but there is always a nagging pain. Pain progressed from there. Our research said that RA is not going anywhere anytime and we went for Ayurveda. Met a famous doctor and he gave me a ton of medicines. My pain never came down but increased quite a lot. Stopped medicines immediately. At this point my earlier pain killers did not help.

As the days progressed my pain and inflammation reached a whole new level. My knuckles and toes were red swollen. I could not wear any rings or shoes. It was a lowest point of life. Life was miserable with near disability where basic tasks like changing clothes or feeding my daughter have become impossible tasks. I was so confused , frustrated and depressed. My kids are the sole reason for me to suck it up and move forward :(…

Diagnosis of Rheumatoid arthritis aka RA

After doing some research we went and met my first Rheumatologist. She saw me and ordered some scan to check for inflammation as it was not detectable she said it could be some muscle cramps or stiffness and gave me my first of many to come steroid injection and advised me to indulge in physical activities like swimming or yoga… ufff if only I can walk as a normal person and sent me home. Things started going down from then the injection helped me for a day then the pain is back with a bang. Till now my legs only were hurting now my fingers, hands started becoming stiff.  It was not consistent one day my left hand thumb will pain and the next day ring finger in my right hand. It is becoming more difficult to work as working on my laptop needs my fingers to co-operate. Met her again and she ran some calcium , CBP tests to check for deficiency gave me yet another steroid injection and advised to take rest and take it easy. Of course I’m taking rest as if I have any other choice other than resting :P. Same as earlier no help the pain will be gone for a day or two and is back .

These visits lasted a month and I’m limping and complaining full time now. Thank god in my next visit swelling in my fingers is visible to eye now. But my doctor is not convinced as I don’t meet the primary criteria of RA which is symmetrical pain I.e., I should have similar pain on both hands and legs at a time but I have asymmetrical pain as in both hand and leg on the same side would ache or the other side but I never had pain in two hands or two legs. But she took pity on me and ordered the magical blood tests to test her theory I.e., CBP, RH factor and Anti CCP. My RH factor turned out to be negative but CCP report will take a 3-4 days. So without wasting time we met a spine specialist thinking Rheumatology is not the one. He ran some X-rays and after clinical assessment he concluded it will be solved only by a Rheumatologist and referred me to a different doctor.

By the time we went to see the new Rheumatologist my Anti CCP results came and it is positive. (Hurrah !! something finally). My new Rheumy examined my knees, feet and arms and confirmed I have inflammation in them and confirmed I have a mild case of RA. Ordered some more tests CRP, ESR, some LUPUS related tests. Turns out I have only RA with no other side on (Lucky Me 🙂 ) . But he did not want to start RA medication right away as it is toxic and once started there is no stopping as it is a chronic illness. Gave me another steroid and prescribed Hi-fineac tablets twice a day and HCQS – 300 mg to protect my cartilage from damaging due to the disease activity.

So for lucky people who are not aware of RA it means : a chronic progressive disease causing inflammation in the joints and resulting in painful deformity and immobility, especially in the fingers, wrists, feet, and ankles. (For me it include shoulders, elbows and knees 😦 ). Basically  my immune system has gone mad and started treating my joints as enemies and started its attack there by causing irritation and inflammation initially damaging them permanently if not treated early.

Hi-fenac is a magically drug if taken continuously as my pain is gone after 3 days and doctor asked me to use it when ever my pain is back. When asked does it not have side effects he said no side effect is more dangerous than your actual problem so just go with it. So I used it as much as possible to avoid pain but I started gaining lot of weight due to steroids. But life with no pain is heaven so enjoying the bliss even if it is short lived.

 

 

 

 

 

 

Welcome to the world of Rhuematology…

After a month from my cholecystectomy started the pain. It was slow and less in severity. Started mainly in legs but we thought it is due to weakness or tiredness and did not bother much as I went through a surgery recently. On my son’s second birthday i.e., on April 17th 2015 the pain reached a new level where I could not walk I could feel the needles prickling into my feet. I could not stand or sit it was a nightmare but we had houseful of guests to cater. Everyone was able to identify that I’m in pain as I’m limping by the time the party started. Again as it reached a unbearable situation we went to seek a doctors opinion. With my previous experience with neurologist went to meet a neurologist again but a different one. By this time I had severe morning stiffness it would get better as the day progress but I would need at least an hour after I wake up to start my daily chores.

So the doctor saw me did some primary clinical assessment and decided I’m perfectly fine and it is all due to stress and the pain is in my head as my limbs and feet look absolutely normal. Gave some pain killers, supplements and sent me on my merry way. At that point even I was confused can I really imagine so much pain am I that delusional??. But the pain killers did not help my mornings started becoming worse so went to meet him gain after a week for review. By the time we get to see him it would be afternoon and I used to start feeling better so he thought it is my cry for help (Seriously 😦 ) and made fun of me. But as an after thought he said I don’t think there is any problem with you but if you wish you can meet a Rheumatologist (May God bless him..). We were like Rhumey what?? Is there a field called Rheumatology in medicine? we only knew orthopedics for issues with bones. So here comes the very significant and less famous Rheumatology in my life. Seriously why do I get such peculiar problems with unknown or less known fields of medicine….

My medical journey….

I had 2 kids both through normal delivery but i’m very sensitive to pain i’ll take anything or do anything to avoid pain. So, even though my gynic insisted on going normal I took epidural both the times even after knowing it has side effects I just cant stand the idea of pain. May be its some phobia. But looks like god planned a different approach for me to get rid of it and that is  head on collision with pain. Few months after my son’s birth there were few episodes of pain its either in my legs or hands or shoulder it would start and go by itself we thought it has something to do with postpartum  or due to the stress with 2 very young kids. It started getting worse and impacting my daily chores.But one day me and son were sleeping in a bedroom and I woke up in the middle of the night to feed and I was supposed to change his diaper  and I could not change his diaper as I could not make my fingers to fold to hold it. I cried and cried, did I tell you before I don’t like to ask anyone anything that includes my mother so I usually avoid it until there is no way i can do it myself. Finally I did change it myself that day with hell lot of pain and even more will.

That night made me realize I need medical interference as something must be really bad so we met a Neurologist in a famous hospital and he did a clinical assessment and came to conclusion that it is due to Vitamin B12 deficiency and started me on the supplements immediately. To add to it we made few changes in food to increase vitamin B12 naturally like eating more fish eggs and fish. The pain started coming down little later and all is well after that so we just felt that it is due to B12.

After an year plus few months on an awful Friday afternoon which is on Feb 13th 2015 I had abnormal pain in my abdomen, got admitted in a hospital done all the preliminary emergency tests blah blah turns out to be Cholelithiasis (Stones in the gall bladder), puffff.. pain again :(. The good doctors decided that the culprit organ should go :(.. right surgery scheduled on 16th Feb 2015. Valentines day on a hospital bed… The doctor asked me before the surgery, “Are you scared Kalyani?” I told him i’m fine as long as i don’t feel any pain. Just make my current pain go away (Oops i’m more concerned about pain than anything else at that point.). Thank god it was laparoscopic  surgery with 5 small holes on my tummy (Yeah real scary). I recovered from the surgery in 2 weeks. Took off for a week and started working from the next after criticism from everyone my parents, in-laws and my friends  but sorry people i’m wired that way my job is my sanctuary I feel that rush in solving issues and being useful and responsible. So all was well after that with me sans my gall bladder till….