What's Normal for You Now?

When you are not flaring, what's your best hoped-for normal?

In this article, "near remission" or "low disease activity" are cited as plausible treatment goals: http://www.clinexprheumatol.org/article.asp?a=2944 .

Or, put another way: I have 5 or so joints right now that are singing a tune. It's a 4 on the pain scale: I'm not happy but I can complete daily activities. Is this my new normal?

In this article, http://arthritis.webmd.com/psoriatic-arthritis/psoriatic-arthritis-12/treatments?page=2

"If you're a college professor and your treatment gets rid of all your symptoms except two swollen finger joints, you might be able to cope. But if you're a concert violinist who relies on those joints for a living, you might need to reduce those symptoms with a stronger medication."

So, your normal may involve some joint pain but not joint pain that limits severely your ability to accomplish your work and home goals.

Thoughts?

Interesting articles. I've seen the first one, but reviewed it again anyway. What's interesting is that they still can't clearly define the goals of treatment. So with your example, if you have 4 joints that are painful, you likely aren't being treated adequately. These joints can become damaged with continuing inflammation. "The ultimate aim of achieving lower levels of disease activity is to minimize the likelihood of disease progression and thereby avoid the attendant sequelae of disease-related damage,while optimising functional status and QOL."

So while your functional status and QOL are pretty good right now, will they be in a year with this treatment? Based on the level of damage that those occassionally painful fingers is causing for me, I'm thinking not.

As for me, my right knee is still the joint that is not being controlled. It is complicated for this is the same knee that was hit by a car while riding a bike when I was 18. I had some "cleaning up surgery" done after the accident but it has never been the same. The Rhumey believes that it will not get better because of the damage from the accident. Therefore, this joint is out of the equation when it comes time to evaluate my progress.

This joint needs to be replaced and I am not ready to endure the surgery and rehab.

That makes a lot of sense. That's the same way that my thumb joints don't really "count". No matter how well controlled I am at this point, they are simply damaged. I just realized that this might be why my left knee is never not swollen. I have noticed that my rheumy takes note that it is still swollen, but doesn't make treatment decisions on the basis of that. It's been swollen since diagnosis, no matter how well controlled. I just realized yesterday that not only is this the knee that I had bad patellar femoral syndrome in about 8 years ago, but it's also one that I did a real jobber on 20+years ago.

Rebel mom said:

As for me, my right knee is still the joint that is not being controlled. It is complicated for this is the same knee that was hit by a car while riding a bike when I was 18. I had some "cleaning up surgery" done after the accident but it has never been the same. The Rhumey believes that it will not get better because of the damage from the accident. Therefore, this joint is out of the equation when it comes time to evaluate my progress.

This joint needs to be replaced and I am not ready to endure the surgery and rehab.