Happy New Year!

CalvinAndHobbes

If only my name was Calvin.  Alas, there are days I feel more like Pigpen.

Resolved… I just can’t make a million resolutions that I’ll never keep.  How about just one:  I resolve to try to take better care of myself.  This body is the only one I get, so I need to take better care of it before it completely gives out.

Diet:  It matters what I put in my car’s gas tank, and it matters what type of fuel I put in my own body.  I resolve to pay more attention to using the best fuel.  This includes a good look at what goes into my garden so I can grow most of our produce.

Activity:  I hate “exercise” because it makes me think of running (which I hate), or gyms full of little kids doing jumping jacks (let’s not go there).  I’ll be teaching swimming lessons, and will try to do some laps between classes, but that’s not going to provide as much activity as I really need.  My home gym is great, but it’s in the garage, which is freezing cold this time of year (really, the refrigerator is warmer than the garage).  I’m considering developing a routine that can be done in the nicely heated house on an exercise ball. Dr. Synonymous’ mentions of his Get on the Ball exercise classes sound low-impact and warm, so I’ll look into doing something similar.

Weight:  Not going to worry about it.  Since my rheumy and PT both have said my weight is okay (I think they’re lying), I’m going to concentrate on eating well and getting at least 30 minutes of activity daily.  With any luck, gravity will lessen its hold on me, but I’ll quit worrying about it.

Meds:  After my horrid ordeal with pancreatitis and being off meds for three months for surgery & recovery, it was difficult getting back into the habit of taking all those pills & shots.  Add in a schedule change and additional prescriptions, and things have been less than ideal.  I resolve to resume taking all prescriptions exactly as prescribed.

The resolution is to try.  If I have an off-day, then I resolve to not give up but try again.  This should finally be a resolution I can keep.

Good luck with any resolutions you make!

RA & Dental Work

When my son was four years old, he hated the word “dentist.”  I started saying “tooth doctor” and his whole attitude changed.  Well, my spine hates going to the dentist and it doesn’t really matter what terminology is used.  Sitting in the dental chair as long as it takes to get work done on my teeth isn’t so bad, it’s the change in position afterwards that’s a problem.

Stiff spines need to change position gradually.  That means raise the chair a little bit, then wait a second for the back to adjust.  Once the spine is okay, raise a little more, wait, raise a little more, and so on.  It probably takes an extra 30 seconds.  After repeated requests that we take it slowly when returning me to vertical were ignored, a few years ago I started looking for a new dentist.

The dental offices closest to home got a chance at my business.  One place required a five-month wait for new patients, which might mean they’re really good. Turns out it just means they have scheduling issues.  The other place had better scheduling, but I didn’t like the office or the dentist. Finally I skipped two cleanings because I couldn’t stand the thought of enduring another appointment.  I am not a rocket ship. Do not launch me out of that chair!

DentalChair

I am happy to report that I finally found a fantastic dentist!  Unfortunately, I have to drive a distance to see him.  What a contrast, though.  The guy in town put me in a closet-sized windowless room.  He never introduced himself.  It seemed I was just another boring mouth to look at and then launch out of the chair so he could see another mouth.  The new dentist (I’ve been twice) introduced himself.  He actually read all my paperwork.  The staff was friendly and helpful.  He addressed my concern about going vertical slowly — then confessed that he’d probably forget and asked me to remind him.  When I did remind him, he apologized, paused, and waited for me to give the go-ahead.  It was really nice to be treated like a person, not a mouth.

Another thing I liked about the new dentist is that he’s using current technology.  No more molds and waiting weeks for the lab to create the needed cap/crown.  There’s a CAD program for dentists (that would be Computer Aided Design, not Coronary Artery Disease).  Special pictures of my teeth and their alignment were taken and loaded directly into a computer.  The computer created a 3D image and designed the needed cap to fit exactly into the tooth in need of repair. The design was then sent to a little machine and created on the spot.  Instead of waiting weeks and needing a second appointment, I waited 20 minutes and was done the same day.  That’s an amazing machine!

I am happy to have finally found a good dentist, and no longer need to dread the back pain associated with time spent in a dental chair.

New Oral RA Med

Yesterday, the FDA approved Pfizer’s XELJANZ (tofacitinib) for treatment of RA when methotrexate has failed to work adequately.  This oral medicine is in a new class of drugs:  Janus kinase (JAK) inhibitor.

Another JAK, ruxolitinib, was approved last year for the treatment of myelofibrosis.  Other JAK inhibitors are being tested as treatments for psoriasis, RA, and some cancers.  I have to admit that reading about JAKs made my eyes glaze over; all I retained was “just another kinase” having to do with cytokine receptors and “named after the two-faced Roman god Janus.”   Perhaps Andrew will write something comprehensible for us laymen (hint).  Until then, I know which reading material I’ll select next time insomnia strikes.

Tofacitinab comes with the black-box warning that RA patients are all too familiar with:  elevated liver enzymes, lower blood counts, high cholesterol, and increased risk of infection, tuberculosis, lymphoma, and cancers.  Post-marketing studies were ordered, so time will tell how effective this medication is, and whether there are other side effects to watch for.  Those who have run the gauntlet of every available medicine but found no relief now have a new treatment option.

See Medscape’s article here, and the FDA’s approval letter here.