I need to find printed, proveable, research to site .....

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_Christina
Veteran Member


Date Joined Feb 2007
Total Posts : 553
   Posted 4/27/2009 7:21 PM (GMT -7)   
I would like to provide my caseworker with a link between stress and RA flairs.
 
I am also looking for a link between pain (chronic or acute) and Bipolar swings.
 
How long does it typically take to find a medication mix to stablize pain from initial dx?
 
Once medication mix is chosen, how much discomfort can the person expect regularly?  How often does a flair happen anyway?
 
I am getting ready to get onto national disability insurance, but I must proove that I am unable to hold a job for an extended period of time.  BP and RA are such unpradictable conditions, there is often no way to tell for sure how it will react in the coming months.  All I acn really do is state how I am now and collect information on what could happen in the future.  I don't want to go through the flair/swing to proove that stress will make me worse.
 
If you have any links, please post below, otherwise I would need the arthor's name and when/where published.  Thanks.
 
 
Christina
 
Current medications:
Bipolar treatment-Lamictal, 200mg, Mood stabelizer, daily(main side effect: brain fog) Bipolar treatment-Cymbalta, 40mg, Antidepressant, daily(main side effect: GI upset, decreased clotting, insominia) Anemia, Fatigue treatment- Iron supplement, 65mg, daily(main side effect: constipation) Insominia treatment- Ambien, 10mg, daily(main side effect: amnesia eppisodes between taking pill and falling asleep) Mania treatment- Alprazolam, .25mg, Very rarely(main side effect: fatigue, slowing of thoughts, depression of CNS, can't take ambien or vicodin when on it) RA treatment- Plaquenil, 400mg, daily(main side effect: GI upset, decreased clotting) RA treatment- Methotrexate, 25mg, 1X weekly(main side effects: hair loss, stomach upset, mouth sores, sore muscles, fatigue, brain fog, compromised immune system, decreased Folic Acid absorption) GI upset treatment- Leucovorin Calcium, 10mg 1x weekly(main side effects: ?) Folic Acid defintioncy- Folic Acid, 1mg, daily(main side effects: ?) RA treatment- Prednisone, 8mg(and decreasing...)daily(main side effects: increased manic eppisodes, constipation, brain fog, bone density degeneration, compromised immune system) Multi-mineral Supplement (main side effects: constipation, GI upset) Constipation treatment- Docusate Sodium, 200mg, daily(main side effects:?) pain control- Motrin, 800mg, PRN Q6hours daily(main side effects: GI upset, decreased clotting) Pain Control- Vicodin, 5-500mg, PRN Q12hours regularly (main side effects: brain fog, fatigue)
 
 
 
 


momto3
Veteran Member


Date Joined Nov 2006
Total Posts : 1331
   Posted 4/27/2009 8:39 PM (GMT -7)   
can't you get something from your rheumy? that is probably more reliable than something off of the web.

_Christina
Veteran Member


Date Joined Feb 2007
Total Posts : 553
   Posted 4/28/2009 7:22 AM (GMT -7)   
My rheumy does nothing more than come in the room, check to see if I have any tenderness or swelling in my hands, list off my medications to make sure nothing has changed. The last several has been all about getting off prednisone. All of the information I have about RA I have gotten off of published material or from a stand in Doc that answered questions for me.

I am looking for reliable sources, but I am more likely to print it off the web than get my rheumy to look it up for me.
 
 
Christina
 
Current medications:
Bipolar treatment-Lamictal, 200mg, Mood stabelizer, daily(main side effect: brain fog) Bipolar treatment-Cymbalta, 40mg, Antidepressant, daily(main side effect: GI upset, decreased clotting, insominia) Anemia, Fatigue treatment- Iron supplement, 65mg, daily(main side effect: constipation) Insominia treatment- Ambien, 10mg, daily(main side effect: amnesia eppisodes between taking pill and falling asleep) Mania treatment- Alprazolam, .25mg, Very rarely(main side effect: fatigue, slowing of thoughts, depression of CNS, can't take ambien or vicodin when on it) RA treatment- Plaquenil, 400mg, daily(main side effect: GI upset, decreased clotting) RA treatment- Methotrexate, 25mg, 1X weekly(main side effects: hair loss, stomach upset, mouth sores, sore muscles, fatigue, brain fog, compromised immune system, decreased Folic Acid absorption) GI upset treatment- Leucovorin Calcium, 10mg 1x weekly(main side effects: ?) Folic Acid defintioncy- Folic Acid, 1mg, daily(main side effects: ?) RA treatment- Prednisone, 8mg(and decreasing...)daily(main side effects: increased manic eppisodes, constipation, brain fog, bone density degeneration, compromised immune system) Multi-mineral Supplement (main side effects: constipation, GI upset) Constipation treatment- Docusate Sodium, 200mg, daily(main side effects:?) pain control- Motrin, 800mg, PRN Q6hours daily(main side effects: GI upset, decreased clotting) Pain Control- Vicodin, 5-500mg, PRN Q12hours regularly (main side effects: brain fog, fatigue)
 
 
 
 


momto3
Veteran Member


Date Joined Nov 2006
Total Posts : 1331
   Posted 4/28/2009 8:30 AM (GMT -7)   
Have you told him you are applying for SSDI? I'm sorry I don't know much about it, and there are others here who do, but I think they need verification from your doctors since they are the ones who are working with you, and if your RA is debilitating and will be in the future.

_Christina
Veteran Member


Date Joined Feb 2007
Total Posts : 553
   Posted 4/28/2009 10:37 AM (GMT -7)   
It was my Psychologist that suggested that I should get onto SSDI. She does not think that I would be able to maintain employment the way I am with my Bipolar. The thing is, the pain that I have with RA affects my Bipolar swings, and a flair can send me into a spiral. The Bipolar swings make it difficult to treat the RA, because so much of the clinical aspect of it is subjective. Then there is the effect of the combined medications. I spend many of my days in a FOG, unable to concentrate, unable to complete complicated tasks (such as driving) unable to hold conversations without drifting off.
Truly, it is the Bipolar/RA combination that puts me over the edge. I think I would be fine if I only had RA. I just have to prove that it is likely that I will have regular or constant pain for 12 months or more. It would not be debilitating on it's own, but will aggravate my bipolar to the point where the additional stress of working would send me over the edge.

Right now I haven't held a job in 2 years. In that time I was diagnosed with RA and have gone from annoying discomfort to daily pain+ side effects. I loose 2 whole days a week to fatigue after taking a weekly treatment of MTX. I then spend the rest of the week trying to catch up on housecleaning. I have to take regular breaks and do only bite-sized tasks or I have to take more pain meds that knock me out. If I am in a manic I don't bother with the chores, so I am constantly trying to backtrack over what I did while in a manic, and if I am in a depression simply can't deal with it. Loosing that time to a bipolar swing is hard enough when you are "well" when not swinging. Right now I can barely keep the house healthy for my 3 children without the time lost and additional stress given to employment.
 
 
Christina
 
Current medications:
Bipolar treatment-Lamictal, 200mg, Mood stabelizer, daily(main side effect: brain fog) Bipolar treatment-Cymbalta, 40mg, Antidepressant, daily(main side effect: GI upset, decreased clotting, insominia) Anemia, Fatigue treatment- Iron supplement, 65mg, daily(main side effect: constipation) Insominia treatment- Ambien, 10mg, daily(main side effect: amnesia eppisodes between taking pill and falling asleep) Mania treatment- Alprazolam, .25mg, Very rarely(main side effect: fatigue, slowing of thoughts, depression of CNS, can't take ambien or vicodin when on it) RA treatment- Plaquenil, 400mg, daily(main side effect: GI upset, decreased clotting) RA treatment- Methotrexate, 25mg, 1X weekly(main side effects: hair loss, stomach upset, mouth sores, sore muscles, fatigue, brain fog, compromised immune system, decreased Folic Acid absorption) GI upset treatment- Leucovorin Calcium, 10mg 1x weekly(main side effects: ?) Folic Acid defintioncy- Folic Acid, 1mg, daily(main side effects: ?) RA treatment- Prednisone, 8mg(and decreasing...)daily(main side effects: increased manic eppisodes, constipation, brain fog, bone density degeneration, compromised immune system) Multi-mineral Supplement (main side effects: constipation, GI upset) Constipation treatment- Docusate Sodium, 200mg, daily(main side effects:?) pain control- Motrin, 800mg, PRN Q6hours daily(main side effects: GI upset, decreased clotting) Pain Control- Vicodin, 5-500mg, PRN Q12hours regularly (main side effects: brain fog, fatigue)
 
 
 
 


momto3
Veteran Member


Date Joined Nov 2006
Total Posts : 1331
   Posted 4/28/2009 3:29 PM (GMT -7)   
I'm sorry since it is your psychologist that is asking you to do this and not a rheumatologist, maybe try the depression board? (I know it is not the same as bi-bolar) or look for online medical journals/case studies etc from your local university.

psAinCanada
Regular Member


Date Joined Feb 2009
Total Posts : 34
   Posted 4/29/2009 11:48 AM (GMT -7)   
The best way that I know to search for peer-reviewed medical research is with "Google Scholar."  Go to the google page, then choose "scholar" under MORE... and you will get only journal articles and academic books. A search for "RA flares stress" for example, yielded these studies and many others. These are just abstracts. To get the full text, your best bet is to get help from a librarian.
 
HERE's a couple of abstracts. Hope this helps a little. Good luck!
 
Field Research on the Relationship between Stress and Disease Activity in Rheumatoid Arthritisa
ALEX J. ZAUTRA 1 , NANCY A. HAMILTON 1 , PHILLIP POTTER 1 , BRUCE SMITH 1
  1 Department of Psychology, P.O. Box 871104, Arizona State University, Tempe, Arizona 85287–1104, USA

a This work is supported by grants from the National Institute of Arthritis and Muscular-Skeletal and Skin Diseases (5 R01 AR41687-05; A.J.Z., Principal Investigator) and The Arthritis Foundation (A.J.Z., PI). The authors wish to acknowledge Kathleen Matt, Ph.D., and David Yocum, M.D., for their many contributions to this research.

Copyright 1999 New York Academy of Sciences

ABSTRACT

ABSTRACT: We review empirical evidence from two field studies for the role of stressful life events in disease flare-ups among patients with rheumatoid arthritis (RA). RA patients were expected to be more vulnerable psychologically, and physiologically, to stressful events in their everyday lives than other arthritis patients without an autoimmune disease. Findings from two studies are reviewed both for their substantive contribution, but also to provide guidance on measurement issues in future field research of this kind. One study included 41 patients with RA, who were interviewed weekly and called to a clinic for blood work and joint examinations when their levels of interpersonal stress increased significantly. A second study used a similar design but included comparison samples of patients with osteoarthritis (OA) and healthy controls of similar age and the same gender as the RA sample. The findings provided support for the proposition that interpersonal stressors are predictive of increases in disease activity. Not all RA patients, however, showed these relationships, and there was evidence that some participants with OA who were depressed also showed higher disease activity following interpersonal stressors. Significant individual differences in the stress-disease relationship were uncovered that deserve greater attention in future studies. Important improvements in the assessment of stressful events and refinements in panel study design are also presented as guides to research on the role of stress in disease processes.


DIGITAL OBJECT IDENTIFIER (DOI)
10.1111/j.1749-6632.1999.tb07664.x about DOI
 
 
HERE's ANOTHER
 

Bradley T. Thomason1, Phillip J. Brantley1, 2   VIEW IMAGE, Glenn N. Jones2, Herbert R. Dyer2 and Jed L. Morris2

(1)  Louisiana State University, 70825 Baton Rouge, Louisiana
(2)  Earl K. Long Memorial Hospital, LSU Medical Center, 5825 Airline Highway, 70805-2498 Baton Rouge, Louisiana

Accepted: 12 May 1991  

Abstract  This study investigated the relation between stress and current disease activity in rheumatoid arthritis (RA). During a routine clinic appointment, subjects were given ratings of global disease status by their physicians and completed self-report measures of major stress and minor stress. In addition, each subject''s erythrocyte sedimentation rate was taken. After controlling for disease severity and major stress, minor stress accounted for a significant amount of the variance in inflammation level. These results suggest that minor stress is associated with current disease activity in RA.

Key words  stress - rheumatoid arthritis - inflammation

 


Healing well with psoriasis, PsA, and hypogonadism, and happy to share my experiences.
 


_Christina
Veteran Member


Date Joined Feb 2007
Total Posts : 553
   Posted 4/30/2009 8:19 AM (GMT -7)   
Thank you. I didn't know that Google had that option.
It seems to be accepted in the RA community that stress can bring on a flair, or make a flair more severe. I am looking for a study to back that up. I'm going to check out Google. Thanks.
 
 
Christina
 
Current medications:
Bipolar treatment-Lamictal, 200mg, Mood stabelizer, daily(main side effect: brain fog) Bipolar treatment-Cymbalta, 40mg, Antidepressant, daily(main side effect: GI upset, decreased clotting, insominia) Anemia, Fatigue treatment- Iron supplement, 65mg, daily(main side effect: constipation) Insominia treatment- Ambien, 10mg, daily(main side effect: amnesia eppisodes between taking pill and falling asleep) Mania treatment- Alprazolam, .25mg, Very rarely(main side effect: fatigue, slowing of thoughts, depression of CNS, can't take ambien or vicodin when on it) RA treatment- Plaquenil, 400mg, daily(main side effect: GI upset, decreased clotting) RA treatment- Methotrexate, 25mg, 1X weekly(main side effects: hair loss, stomach upset, mouth sores, sore muscles, fatigue, brain fog, compromised immune system, decreased Folic Acid absorption) GI upset treatment- Leucovorin Calcium, 10mg 1x weekly(main side effects: ?) Folic Acid defintioncy- Folic Acid, 1mg, daily(main side effects: ?) RA treatment- Prednisone, 8mg(and decreasing...)daily(main side effects: increased manic eppisodes, constipation, brain fog, bone density degeneration, compromised immune system) Multi-mineral Supplement (main side effects: constipation, GI upset) Constipation treatment- Docusate Sodium, 200mg, daily(main side effects:?) pain control- Motrin, 800mg, PRN Q6hours daily(main side effects: GI upset, decreased clotting) Pain Control- Vicodin, 5-500mg, PRN Q12hours regularly (main side effects: brain fog, fatigue)
 
 
 
 

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