It’s Friday and as I was going to get coffee, I realized that a little humor was in order. The trip to get coffee may not be an easy one for someone with RA. I teach at a university where the campus lies on a series of hills. Come to think of it, all of Seattle is a “little” hilly. I set off out from my office and headed up a series of many steps to visit the barista for a grande, non-fat, caramel macchiato. For you non-coffee snobs, that’s where the espresso shots are poured over the steamed milk and yummy caramel is drizzled on top. Along the way, I noticed that this trek is becoming more difficult especially on days like today when my feet, knees, and ankles are loudly reminding me that I have RA.
When people think of arthritis, they usually think of eroding bone. In RA, this is certainly one of the more common symptoms. (As a side note, in RA the cause of the erosion is biochemical. In the more common osteoarthritis, the erosion is mechanical. This and the confusion around it is a topic for a future post.). Besides bone erosion, the biochemical processes can also attack soft connective tissue such as ligaments, tendons, and cartilage. Ligaments connect bones to other bones. This is especially important in a joint where bones meet. Ligaments provide stability. Tendons provide connections between muscle and bone. In addition to other purposes (think nose and ears), cartilage provides a cushion between bones. Tendons, ligaments, and cartilage make it possible for the skeletal system to move.
The inflammation caused by RA can attack these soft tissues causing them to be damaged even to the point of tearing. For me, this was the first skeletal system symptom of RA. My Achilles tendons (the largest tendon in the body) starting getting tender and then tears eventually developed leading to surgery on both ankles. And the battle with these tendons is ongoing. Recently, some of the cartilage between the leg bones in my right knee started to tear apart (confirmed via MRI). With all this damage to the soft connective tissues in my lower extremities, walking can sometimes make me feel like I’m a rubber chicken. I’ve learned to move slower (well, the stiffness caused by RA does that also) and more cautiously in an attempt to avoid a taking a major trip.
Oh well, I got my coffee and the return trip was all downhill!