Psoriatic Arthritis

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There are different types of arthrits: OsteoArthritis vs Inflammatory Arthritis

Psoriatic (Sor-ee-at-tic) Arthritis is an autoimmune inflammatory arthritis, similar to Rheumatoid Arthritis, but with a negative RA factor.  When we talk about ARTHRITIS, most people think of the good old fashioned wear and tear arthritis where the joint has lost it’s cartilage or lubricating factor, so that it’s bone on bone grinding.  This kind of arthritis is known as OSTEO Arthritis.

There is another kind of arthritis, at the other end of the spectrum, called INFLAMMATORY ARTHRITIS.  These are the AUTO-IMMUNE types of arthritis where your body attacks it’s own tissue, thinking your own tissue is a foreign invader.  The immune system goes in to over-drive as it attempts to fight what it thinks is a bacteria or virus.  White blood cells flood the area, in this case the joint, and this creates inflammation, which causes swelling, redness, heat and pain.  In this realm of inflammatory arthritis, there is a further separation into two categories.  On the one side is the Rheumatoid Factor, RF or RA positive, which includes Rheumatoid Arthritis, Systemic Lupus, Scleroderma, etc.  On the other side is the “Negative RA Factor” side, meaning there is no RF antibodies present and is called SPONDYLO-ARTHRITIS (spon-de-low).  The blood test that indicates this side of inflammatory arthritis is called HLA-B27 (Human Leukocyte Antibody) and includes the inflammatory arthritis categories as Psoriatic Arthritis, Ankylosing Spondylitis, Enteropathic Arthritis, and Reactive Arthritis.

I was first diagnosed with Psoriatic Arthritis in 2003.  I was fortunate enough that my Primary Care Physician listened to psoriatic-arthritis/fusion-chiro.com/DrCynthiaSeebachermy complaints and referred me to a Rheumatologist – a doctor who specializes in musculo-skeletal disease and systemic (whole body) auto-immune conditions.  Having psoriasis (red patches with silver scales) does not necessarily mean you will have Psoriatic Arthritis.  Psoriasis itself is an auto-immune condition caused by inflammation, and usually indicative of liver congestion according to the nutrition specialists and functional medicine specialists.  When I was diagnosed, I had psoriasis on my elbows and there was a 5-10% chance of developing into Psoriatic Arthritis (PsA).  Today, that number has increased to 30%.  This is a clinical diagnosis, which means its a careful collection of symptoms, including a positive HLA-B27 genetic marker, joint pain – usually in the hands, feet and along the spine, particularly the Sacro-Iliac joints (SI joints) and the neck. The GOLD STANDARD for diagnosis is the SAUSAGE DIGIT, where one of your fingers or toes along the entire length of the digit becomes hot, swollen, purple or red and very painful – looking like a sausage.

PsA is a long term condition that waxes and wanes, but essentially becomes progressively worse by damaging the joints.  My Rheumatologist (affectionately written as *Rheumy from time to time) explained to me at the time that any time there is pain and inflammation present in the joint, there is damage being done.  Of course, I had to have this conversation because I am, or at least I was, the kind of patient who did not like to take medication no matter what… until he explained it to me as damage.  The pharmaceutical options include anti-inflammatory medication (NSAIDs or steroids), a DMARD – disease modifying anti-rheumatic drug, and finally a Biologic – injections or infusion of medicine that targets a specific cell called TNF alpha – Tumor Necrosing Factor alpha.

The non-pharmaceutical prevention and care plan is where the magic happens, which I share about on my website, blogs and Facebook Live.  You can follow an anti-inflammatory diet, get adequate sleep, exercise on a regular basis, and my all time favorites: chiropractic and massage.  For me, my maintenance care plan is to get adjusted once per week and get a therapeutic massage every two weeks.  I had to change my sleeping habits, which is challenging enough as it is, and I was in chiropractic school when I had to make my change.  Basically, the more hours of sleep you can get before the midnight hour, the better your sleep hygiene.  I had to learn how to pace myself, balancing high energy days with days of recuperation and rest.  I had to become aware of the ebb and flow of the disease, also known as FLARE UPs and take extra self-care measures when I would have a flare up.  Most people with these types of chronic pain illnesses (this includes Fibromyalgia) will notice a rather big flare up around January when the weather changes to cold and damp, and the stress of the holidays is over.  A flare up always seems to rear it’s ugly head AFTER the stress has subsided.  It’s just the nature of the beast.

With PsA, when it affects the fingers and toes, it’s usually the most distal joint, closest to the finger/toenail.  PsA attackes the ENTHESIS (en-the-sis), which is where the tendon meets the bone.  When this becomes inflamed, it’s called ENTHESOPATHY (En-thes-o-path-ee).  This, to me, is such an intense, sharp, stabbing, electric-like pain in the edge of the finger when it is barely brushed against something.  PsA also attacks the SI joints on either one side or both sides.  It also loves to attack the neck.

The disease progresses either rapidly or slowly, depending on your environment, stress levels, self-care and how well you can manage inflammation.  The first 10 years of my diagnosis, I rode horses, taught yoga and Pilates and worked as a massage therapist.  I am often asked how can I do all of that without my hands hurting or my body hurting.  For me, staying physically active, especially with giving massages, always made me feel better.  When I give massage, it’s not just my hands, but my entire body goes in to my work.  The other major contributor to managing this disease is to get regular chiropractic care and regular massages myself.

There are several more symptoms that go along with an inflammatory arthritis, which is why these are called systemic auto-immune diseases. There can be inflammation of the iris of the eye, called UVEITIS (you-vee-eye-tis) or IRITIS (eye-ry-tis), which is quite painful causing your eye to turn red and vision is blurry.  There is definitely the factor of sleep disturbance where some people may not be able to get fully in to REM sleep, tossing and turning all night, or having pain that wakes you up at night.  Fatigue is also a problem, mostly during a flare up, but also associated with chronic pain.  There are also a lot of gastro-intestinal problems such as diarrhea, bloating, constipation, or all of the above.

If you have a family history of an inflammatory arthritis, or psoriasis, and you are experiencing joint pain, please don’t hesitate to contact me to discuss how chiropractic care and therapeutic massage can help you.  At Fusion Chiropractic, we discover together what positive coping skills will keep you managing a functional lifestyle with pain relief.

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Pacing and Self Care

Most people who live with chronic pain tend to mentally block that pain so that they can function day to day.  I have to admit, I am one of those people.

While I was in chiropractic school, I developed pancreatitis.  I have a long history of a very rare metabolic disorder, which I’ll share about in another post.  I ended up having pancreatitis three times while in chiropractic school, each incident creating more pain and embarrassing ambulance transport.  Since I’ve graduated, I continue to have episodes and hospitalizations, however, I am much better at listening to my body before I get in to trouble.

The key is knowing when you truly need medical intervention versus alternative care.

Pancreatitis is not one of those things you want to play around with.  It requires hospitalization for IV fluids and pain medicine, as well as nothing to eat or drink.  I will say that once the medical emergency was over and I was able to return home, the first thing I would do was visit my chiropractor.  I needed to re-set my nervous system after laying in bed for 7-10 days and having lovely pain meds.  There were times I’d see her on a daily basis for a week, then maybe 3 times the next week.  I just innately knew that my body needed to be reset.

I’ve made the mistake of returning to work or school too soon after being hospitalized.  I had to learn the fine art of pacing myself, pacing my activities and allowing self-care.  Do you know how very difficult that is?  We tend to want to keep pushing forward, but sometimes pushing forward means relapse.

I live with chronic pain from my pancreatitis.  Some days the pain is barely noticeable, but some days my body is so fatigued from the pain, I have to pace myself to slow down.  This past spring, I attended two conferences back to back and a few marketing events scheduled every weekend.  I’d always take one day off after an event to recuperate, but this last time, one day was not enough.  Living with chronic pain is exhausting and your body becomes fatigued as you push through your pain.  I’ve had to learn to pace myself to slow down and take extra care of myself after exciting events.

For some people, that fatigue happens on a daily basis.  You quickly learn the fine art of prioritizing your activities.  See the page about the Spoon Theory here. Even people who don’t live with chronic pain have felt the effects of their body protesting recent adventures.  Think of that time you drove 8 hours to get to the beach, but more importantly, the 8 hours it took to drive home from the beach.  While the vacation was relaxing, sleeping in a different bed with different pillows and the long stretches of driving without moving can be taxing on your body.  There is a reason for the comment “I need a vacation after having a vacation.”

Take the time NOW to take care of yourself.

See your chiropractor to have your nervous system re-set: Release any subluxations in your spine and muscle tension in your body that prevents you from being YOU.

Give yourself the gift of therapeutic massage.

Take that extra day off to release not just the physical tension, but the mental and emotional tension you’ve been holding on to.

Find your passion and PLAY.

Make sure you have a support team of people with whom you can talk about your pain or the many emotions involved in chronic pain.  Make sure they are compassionate and have earned the right to listen to such privileged information.  Have someone special who can look after you and remind you to take a break.  My husband is often reminding me to take a break when I get involved in yard work.  I even have my travel buddy look after me to remind me to stop and take a break when I go to conferences.  Your support team is extremely important.

I have been caring for chronic pain survivors for 25+ years.  I truly understand what my patients are going through: the fatigue, the pain, the relationship strains, the anxiety with depression, the insominia, and especially the drive to keep going despite all the pain and those frightening moments when you feel you just can’t take one more moment of torment.  I have earned the compassion to assist you.

Please reach out if you would like a consultation on how to manage your chronic pain isssues.

With Love & Abundance,

Dr. Cynthia

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Human Barometer

Are you a human barometer?  Have you ever wondered why you have a unique talent for knowing when a storm is coming?   Do your joints ache when it’s cold and rainy outside?  You may be a human barometer.

Barometric pressure is the effect of air on the environment.  Think of this as a heavy blanket exerting downward pressure on everything when the barometric pressure is low, or dropping.  We like to say that a cold, rainy day is “good sleeping weather”, to just stay in bed and hibernate.  It is true that lower barometric pressure causes us to seek sleep mode.  Strangely enough, as the barometric pressure drops, the air we breathe drops the level of Oxygen, so less O2 in our blood and going to the brain makes us feel sleepy.  The pressure on our bodies causes fluid in the joints and blood vessels to expand.  Remember back to elementary school that hot air rises, cold air is denser and pressure gradients always shift from high to low in order to create balance.  This is why we have so many aches and pains when the barometric pressure is dropping.  Any old injury you have may express itself with a vengeance, particularly if you have arthritis or have had surgery to a joint.  Everything inside expands.

On the other end of the spectrum from achy joints is the awful storm approaching migraine.  If you’ve ever noticed when weather patterns collide and create massive thunder storms or possible tornado activity, the human barometer can sense that rapid drop in pressure.  There is some speculation that the electrical charge in the air is what effects the body’s chemistry.  Other weather related activity that can spark a migraine or pressure headache include: changes in temperature, high humidity, high winds, extremely dry conditions (causing dehydration), sun glare.

What can be done about this?  The primary goal of the nervous system is to adapt to the environment, both inside the body and outside pressures on the body.  It is perfectly okay to crawl back in to bed on those cold and rainy days when you are able to do so.  For the migraine sufferer, you may need some extra assistance to help you adapt.  Getting a regular chiropractic adjustment helps the nervous system function at it’s optimal level so that these swings in pressure don’t effect us as dramatically.  The sooner you can come in at the onset of a migraine, the better chance of stopping or at least significantly reducing your symptoms.

Here are some of my “go to” relief remedies I have in my tool box:

Migra-Eeze – This came highly recommended from my neurologist to take as a preventive measure.  I can attest that this works very well when taken on a daily basis and it significantly reduced the severity of my migraines.

Intensity 10 TENS unit – using a TENS unit on those muscles that are in spasm is an excellent way to relieve pain associated with migraines and barometric pressure changes.  Dr. Seebacher can help you find the right fit for you, as well as ordering the TENS unit with insurance approval.

Migracap – I will admit that I have not used this yet.  In the midst of a migraine, cold temperature works best due to the rapid expansion of blood vessels.  This cap covers the eyes and provides that extra comforting pressure when you feel like your head is about to explode.

Hydrate – A good rule of thumb is to drink 1 oz of water for every 2 pounds of body weight.  As an example, if you weigh 180 pounds, you need 90 oz of water daily.  You’ll need more if you’re physically active.  When the environment is dry and drought conditions persist, the human body needs more water. You can add a pinch of salt to the water to provide extra minerals and to retain some of the water needed by your body.  I prefer Pink Himalayan Salt as it has more mineral content to help balance the electrolytes in your body.

Epsom Salt Bath – You can find epsom salts at any grocery store.  I recommend to my Fibromyalgia patients the Fibro Detox Bath: 1 package (2-3pounds) of epsom salt in the hottest water you can safely handle; add 1 box of Baking Soda (8oz), 1 tbs of ground ginger. Warning, ginger makes this a stimulating bath, but it reduces pain significantly.  Soak as long as you possibly can.  For relaxation, try adding lavender essential oil or any soothing blend to replace the ginger.

Chiropractic + Therapeutic Massage: Chiropractic adjustments are designed to help the nervous system restore balance in the body.  Therapeutic Massage helps to release trigger points so that your body does not hold patterns of spasm.  Combining the two together gives you the best of both worlds.  Keep in mind, neither one is intended to be a one time cure-all.  It took a long time for your body to build up the stress and toxic environment that is created by barometric sensitivities.  Dr. Seebacher provides the chiropractic adjustment and the therapeutic massage all in one visit.  Click here to schedule your chiro+massage appointment.

 

 

Customizable Pain Relief

I believe in chiropractic care as a relationship between doctor and patient, providing customizable pain relief and teaching you how to care for yourself. My goal is basically to teach you how not to need me.  The important thing to remember though, chiropractic is not a product you use once or twice for quick pain relief, chiropractic is a process from relieving pain to creating optimal health for the rest of your life.

Depending on the severity of your symptoms and condition, your initial treatment may be three, two or one time per week. My goal is to see you progress to once per week and then every 2 weeks until you are stable with your care and optimally once per month just for a check-up. I will provide you with not only chiropractic care, but also the soft tissue work that goes along with your adjustment.

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