When it comes to living with both Type 1 diabetes and arthritis, I don’t experience the amount of pain and disability that burdens some of my favorite people in the DOC. Rick Phillips who deals with rheumatoid arthritis and ankylosing spondylitis shared his story on my blog a couple of years ago. Rick tirelessly advocates for people with diabetes, but he often admits that arthritis negatively impacts his life much more than diabetes. Molly Schreiber has had Type 1 diabetes for 28 years. Her rheumatoid arthritis is a formidable opponent and she deals with the worst that RA can dish out. In general I am doing okay when it comes to living with arthritis. Except when I’m not….
I am good at diabetes.
I am bad at arthritis.
I have had a tough summer. Although I was diagnosed diagnosed with inflammatory spondyloarthropathy over 10 years ago, my problems are peripheral. My hands hurt and my thumb joints are shot. In May I woke up with horrible heel and foot pain which continues to get worse despite following doctor’s orders.
I don’t write about arthritis very often because I am a diabetes blogger. Type 1 diabetes is a constant in my life and I do little without taking diabetes into account. After 40+ years of T1, I have no major D-complications. At the same time diabetes is a “needy condition” that requires constant affirmation and is entrenched in my psyche. More than once I have mentioned that I deal with other inflammatory and autoimmune conditions in addition to diabetes. I once wrote about a skin problem called annulare granuloma and mentioned that I felt helpless in dealing with it because “When you have Type 1 diabetes, you get used to the idea that WHAT I DO MAKES A DIFFERENCE in my health.” I’ve never bothered writing about hypothyroidism because it goes hand-in-hand with T1 diabetes. Mine was discovered through a routine blood test 21 years ago. I’ve never struggled with symptoms and my Synthroid-generic dose is the same as prescribed in 1996.
Arthritis. This is the thing that I’ve not written about and it is the health problem that most threatens my Pollyanna “Life is great!” philosophy.
I think that some of the personality traits that make me “good” at diabetes make me bad at arthritis. Diabetes loves people who overdo things and power through when you don’t feel great. Diabetes thrives on doing the same thing over and over again. Arthritis does not reward overuse of my body and I know that I would feel better if I didn’t sync as many steps on my Fitbit. (Actually I put my Fitbit in the drawer a few weeks ago because I need to rest.) I know that I would feel better if I gave up playing golf. I quit tennis a dozen years ago and still feel sad about that. I don’t know about hiking, but I suspect that I would do better with fewer mountains and more walks around the block.
It all comes down to pain.
Unfortunately sitting at home doing nothing is worse than pain and diabetes is a bear when your body is glued to a chair. I have always been active and I attribute my relatively good health to exercise. Blood sugars are better with movement and I believe that exercise helps ward off D-complications such as heart disease and neuropathy. Transitioning to a couch potato life because of sore feet and swollen fingers doesn’t seem like an optimal life strategy to me.
But exercise currently brings me pain.
I am strong but pain makes me sad.
My primary arthritis diagnosis is inflammatory spondyloarthropathy and it is a type of arthritis where many people feel better moving rather than resting. It is a type of arthritis that fits my “can’t stand to sit down” personality. But my hands and feet are diagnosed as osteoarthritis. I’m struggling with achilles tendonosis, heel pain, and elbow tendonitis. Overuse “old people” conditions.
Back to diabetes. What happens to my blood sugars when I am not active? Mostly they get worse. But I can take more insulin and then they are OK. But I gain weight and my insulin sensitivity goes to h*ll.
I am a self-manager of my diabetes and my endocrinologist is
totally mostly on board with that. Diabetes usually does best when you manage it in the moment (AKA Sugar Surfing) and my Dexcom G5 protects me from most of the submarine lows that drive my endo crazy. My rheumatologist has never gone ballistic at my decision-making, but he occasionally looks askance when I arrive at an appointment and say that I reduced the dosage of one medication and refused to take another. At the same time he is older than I am and still plays tennis. He goads me to get back to the courts and suggests that I wear an arm strap to help with elbow tendonitis and use more of the topical Diclofenac gel to ease pain. More than any of my other doctors he understands how my medical issues are woven together in a spiderweb of autoimmune and inflammatory conditions.
I am an uber-educated diabetes patient. I understand my disease and voraciously read diabetes research articles, websites, blogs, and message boards. I am an active participant in the DOC and credit my fellow PWD’s for most of my knowledge and activism. I arrive at my endocrinology appointments with printouts of BG statistics and always have a list of pertinent questions.
I am less capable when it comes to my arthritis. To tell you the truth, I am not completely sure of my diagnosis. I do not have rheumatoid arthritis (RA) and once you don’t have that, it can be hard to find a niche for your condition. My medical records reflect terms such as inflammatory spodyloarthropathy, inflammatory polyarthritis, and osteoarthritis.
When I look at the future, I am much more afraid of physical limitations due to arthritis than I am of diabetes. I don’t worry about diabetes complications and have never experienced diabetes burnout for more than five minutes. But what will I do if walking is unbearably painful, elbow pain blocks me from playing golf and carrying my grandchildren, and hand pain rules out opening a jar?
I am good at diabetes.
Unfortunately arthritis scares the bejesus out of me.
Pain is a formidable opponent.
* The image for the pain measurement scale was purchased from shutterstock.com.
Thanks for the shout out, but I am sorry you did. Arthritis is such a tough condition. I have had diabetes for 43 years and RA / AS for 17. I have always said RA is the more important of the two and that is saying a lot.
Hi, Laddie. Susan Lane here. it’s been a long time since we’ve communicated and I was sad to read this blog. It’s terrible to be in pain all of the time and I unfortunately understand that. But, even though I can no longer do what I used to, I do what I can. This makes me tear up and even want to cry when I write it, but it’s the truth. You can’t give up. You can alter. I can’t ride outside with my friends and achieve great distances, but I can ride my bike in the house. I can’t hike into nature any more, but I can walk around the neighborhood. It hurts, but I can do it. To me, having to sit still would be human torture (although at times I excel at it!).
I’m so sorry to hear that you are having these problems, but maybe when you get back into town, we can go for a walk together. Around the block.
Hi Laddie … great post and I’m so sorry you are dealing with this too. Me too and oh, what a challenge! A thought … my rheumatologist put me on Otezla 2 years ago when it first came out … for hand pain. It really has helped. I think it is cleared for psoriatic arthritis and possibly ankylosing spondylitis … you might want to ask. sending hugs … joanne
Thanks, Joanne. It is probably time to be talking with my rheumatologist about a medication change.
The good thing about Otezla is that it doesn’t compromise your immune system … and lucky for me, no side effects (and I’m always the first to get every single side effect!). I wonder what the incidence is of T1s having inflammatory arthropathies … I’m sure it’s more than anyone is talking about.
Have you looked at any changes in diet? I’m not a nut and am not recommending cinnamon or anything stupid. But I’ve always heard about inflammatory/non-inflammatory foods. My husband and I just watched the documentary What the Health … and we are giving it a try to live vegan for a month. So far, no change in pain or inflammation but we’re sticking to it (which is a huge leap of faith for my husband who is a very passionate meat eater).
Modern biologic medications work better, last longer and preserve join function more than any other medication available for a wide range of arthritis conditions. I am blessed with T1, RA and AS. I say blessed not because i want any of those , rather because they make me who i am today.
I have used 7 biologic medications and some work, others not so much, but the great thing is it is vey likely your first will work amazingly well. I hope you find that medication. The reason I am writing is to assure you that these medications can be rough, but they beat the alternative by a far range.
If any.one has been told you may have RA, AS, Lupus or Osteo arthritis, I urge you to get to a rheumatologist. Yes other doctors can prescribe these medications, but your best treatment for a very complicated disease is to see a Rheummy. They are the only ones capable of dx’ing these conditions and finding those amazing firs treatment that will work.
Best of luck Laddie, if you wish to communicate please each out. I am always available to help or help you find someone knowledgeable to talk with. There is no need to suffer over the fear of these extraordinary medications. THe fear is if you epicenter to not do it.