The Controlled Burn Strategy of Disease Control for RA

How Rheumatoid Arthritis Medicines Work Like a Controlled Burn

Here in Central Florida, wildfires are a regular problem. Sometimes, it rains down cinders when the fires are miles away. Creepy until you get used to it.

However, I have seen several fires in my own neighborhood that were out of control. One season, we got used to going to sleep with the helicopters a mile behind our house “keeping an eye” on the fire for us. And last year, the fire came right up to my friend’s yard. Green on her side of the fence - black on the other. The firemen flooded the property line to protect her property.

The fires cannot be prevented. There is fuel. And there is heat. And there is a long dry season. So, there will be fires.

Instead, there is the strategy called “controlled burn.” The forestry service comes in and sets fires on purpose. But they do it for a good reason: they burn up some of the would-be fuel, hoping to prevent an “uncontrolled” flair later. Once, they burned right behind my house. It seemed like the swing set would catch fire.

Yesterday, when I did my shots, I thought how much they are like a controlled burn. My leg undoubtedly feels like it’s on fire. But that’s actually not my point.

It’s just that I’m doing something that appears to be harmful –but for a good reason. It is destructive. At least to the immune cells that die, it is. But, it’s for a good reason. The hope is to prevent an inferno of the Rheumatoid Arthritis through my entire body.

I have to put the methotrexate needle deep into the quad muscle. And sometimes, it rebels. There are spasms and pain for days. This week, I got new spasms on the left leg and the right leg is still injured from last week. (This is all on top of the site reactions from the Enbrel.)

But this is not the real danger. The shots and the side effects are merely a nuisance compared to the dangers of Rheumatoid Arthritis. That is like the wildfire: a menace which is difficult to get under control. And which produces irreparable damage.

Disease modifying medications (DMARDs) are the best thing there is today to put water between you and the RA. They are creepy until you get used to it, but the goal is to keep the green on your side of the fence. It beats the helicopters. They can be really loud.

Two Kinds of Site Reactions about RA

It’s been a week of site reactions. There were lots of positive reactions to the new blog site. After a few days, I realized that I was receiving two distinct flavors of responses.There have been those who were en- couraging: "Nice article”; Good writing”; and “Well done!” I am so grateful.

Then there were the reactions that came from those suffering with RA or another chronic illness. In some way, I think they heard my voice differently - like we are speaking the same language. They said things like: “This is so hopeful!” and “Wow, can we pray for each other?” and “Thank you, Kelly. It’s ok to say I hurt.”

Everyone was positive (Yeah!!) and everyone was sincere (I think!)

What I detected may be a symptom of the detachment which exists between the world of Rheumatoid Arthritis and the non-RA world. I have read hundreds of pages of RA blogs and forums and message boards over the last three years and at least as many times as I read, “It hurts,” I also read “No one gets it!”

I want to build a bridge. This blog is my first baby step. Please join me in working to disassemble the partition. That brings me to my second “site reaction” that I observed this week.

Normally, I would never share this with anyone (except RA-ers). But, here goes. I have been really suffering with an injection site reaction (ISR) to the Enbrel. It’s like a huge 4” bee sting on my leg. It’s hot and hard and itchy - it hurts. When I lie down, it feels like there’s a rock under me. This is the third ISR in a row, and each one is worse, and appears sooner after the injection.

It is amazing how much this ISR is like a bee sting. I wanted to post a picture of my leg, but it’s pretty bad. So, I decided to look for a pretty picture of a bee…

Maybe he can also inspire us to be like carriers of understanding the way he goes about spreading around the pollen. We can touch others lives like the bee, letting something also rub off on us like the bee. I am thankful for the way that others rub off on me and I hope that I can write things that will be penetrating – hopefully without all the itching, though.