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Skiing with Rheumatoid Arthritis

post #1 of 19
Thread Starter 

Been off of these forums for a long time.

 

Background:

50 year old male; skied 30 - 35 days a year; advanced/expert; woods; moguls; steeps; Most skiing in the East (MRG, Jay, Stowe) one to two trips out West each year.

 

This year after skiing my first day my knees where stiff the next day (nothing too unusual).  The day after that they were very stiff (I don't usually take drugs but considered buying some NSAIDS).  Third day was better.  The evening of the third day I awoke in pain and the left knee was swollen (up until then there was no swelling).

 

Get it MRI'd and orthopedic says minor tears nothing big enough for operation, recommends rest and PT.  Walking around with a cane and both shoulders are stiff, then both wrists.  Mention to primary care DR (5 weeks after the day of skiing) and she recommends blood test for Rheumatoid Arthritis.  I blow it off and attribute stiffness to stress.  A week later I can not get out of bed.  Get the blood works and visit Rheumatologist (6 weeks after the day of skiing).

 

He gives me an inter muscular cortisone injection, a prescription for prednesone, a chest x-ray and orders blood work.  The cortisone has me up and about the next day.  Blood work shows high RF (over 14 is high I'm at 301) and high Anti-citrulline (high is over 5 I'm over 100).  All of which indicates RA.  The fact that my joint problems are symmetrical (both wrists, both shoulders, both elbows and now both ankles) seals the deal that its RA.

 

Three weeks of prednesone and now I'm adding methrotrexate and folic acid to the mix.

 

Anyways to my question.  Is anyone on the list skiing with RA?

 

 

 

post #2 of 19

I'm sorry to hear you have RA. I can't comment on the skiing, but have a bit of knowledge about RA as my mom has suffered with it since her late 20's (she turns 70 this year.) The only thing that provides her considerable relief is Humera. She took methotrexate for years, also. Unfortunately, the drugs are hell on the immune system. She's battled two life-threatening infections in recent years. She was septic last year and damn near died.

 

She definitely does better if she stays active, but not TOO active. She still rides horses when she can, walks almost daily (after a knee replacement about two months ago) and goes camping, etc. The knee replacement has afforded her a lot less pain and a lot more mobility. If you have any particular joint that is causing excessive pain, don't wait to have surgery! Just do it.

 

My one thought/piece of advice to you is to space your ski days out. You seem to have already discovered that back-to-back high-activity days are brutal. But one day of it followed by a day of rest and therapy can be manageable. NSAIDS are going to become very good friends of yours, so make sure you take care of your stomach, too.

 

Are there other autoimmune disorders in your family (even diabetes?) Did your rheumatologist peg any specific illness or event that might have triggered the RA to kick in? The autoimmune disorders (it seems) have been found to often have a trigger. They lie "dormant" in your system for years. I believe that my birth was the major event that caused my mom's to surface. Lucky me! :D

 

Good luck with it. It sucks. I won't lie. I hope you find a course of treatment that works, and even better, a cure is found soon. I hope someone who skis with it can pipe in here, too.

post #3 of 19
Thread Starter 
Quote:
Originally Posted by contesstant View Post


Are there other autoimmune disorders in your family (even diabetes?) Did your rheumatologist peg any specific illness or event that might have triggered the RA to kick in? The autoimmune disorders (it seems) have been found to often have a trigger. They lie "dormant" in your system for years. I believe that my birth was the major event that caused my mom's to surface. Lucky me! :D

 

Good luck with it. It sucks. I won't lie. I hope you find a course of treatment that works, and even better, a cure is found soon. I hope someone who skis with it can pipe in here, too.

 

No family history of any autoimmune diseases.  I have 7 siblings all of who are healthy, parents didn't have any nor did their siblings.

 

I'm hoping I get mobile enough to start biking so I can regain the 20 lbs of muscle I've lost since this thing started.
 

And yes from what I've been reading it does suck.  One pet peeve of mine is how most people think its the same as osteoarthritis.  Really needs a different name to better indicate how nasty it is.

post #4 of 19

Def NOT the same as osteo arthritis. Not even close.

 

Biking should be excellent for it as it's non weight bearing, except your wrists. A recumbent maybe? You'll find your "balance point" as far as what's too much. Your life will never be the same, but keep attacking this thing and you'll adapt. My mom is much worse if she is idle for any stretch of time. While it really sucks how much it's going to affect someone as active as you, count your blessings that you are ahead of most who get it who never WERE active.

 

Will you have any more opps to ski this spring to see how the methotrexate works in that kind of environment/activity? I hope you have found a good rheumatologist. They will become an integral part of your life.

post #5 of 19
Thread Starter 


 

Quote:
Originally Posted by contesstant View Post

Def NOT the same as osteo arthritis. Not even close.

 

Biking should be excellent for it as it's non weight bearing, except your wrists.

 

 

Will you have any more opps to ski this spring to see how the methotrexate works in that kind of environment/activity? I hope you have found a good rheumatologist. They will become an integral part of your life.


I mountain bike in the NE, rock gardens, single track, and carriage roads.  Not sure how that will work out.  Its been an awesome winter here so the snow should last until late April. If enough people continue to buy lift tickets to keep the lifts spinning is another thing.

 

My rheumatologist is an old practitioner (graduate Medical school in 1962).  I am very happy with him.  The best web site I've found is Johns Hopkins.  So far he has been following there recommended practices almost to the letter.  Only real difference is he is slightly (and just slightly) more aggressive with the drugs.  He started me with the two cortisone injections (on consecutive days) and a daily dose of 20mg of prednisone (since ramped down to 15 mg), the Methtrexate was started at 15mg/ week.  But my onset and severity of my case seem more aggressive than most of their disease descriptions on the JH site.  He expects me to call if there are any flare-ups and has provided more cortisone injections to bring those under control.

 

He has kept me informed of what to expect and says we have an excellent chance of controlling the disease.  He says even 15 years ago we would have needed a lot of luck to get it under control but the improvements he's seen in treatments developed in the last 10 or so years (including the biological drugs like your mom's Humera) have really improved the chances of finding the right drug mix to keep me living a semi normal life.

 

I just hope he stays in practice long enough to see me through the start (first 3 - 5 years) of my treatments.

 

 

post #6 of 19

I really wish you the best. I hope you at least have a bike with full suspension! You'll soon learn your body's new limitations and probably adapt well. Hopefully catching it immediately as you did will help keep the damage at bay. My mom's joints have tons of damage since she was diagnosed in the early 70's when aspirin was the treatment. Keep me posted on how you are doing with your activities. Your rheumatologist sounds fantastic. You are fortunate there!

post #7 of 19

I have been skiing with RA for the past 14 years. It can be done but you have to prepare. I start getting in shape 3 months before my first ski trip of the season. I start taking Motrin for one week before and during the ski trip (take with liquid antacid to protect your stomach). I try to ski groomed runs which are easier on the joints. I always wear knee supports with metal strips on both sides. I have custom orthotics in my ski boots. Try to get a massage half-way through the ski week, or take a day off to rest. I look for a warm fire at night.

 

Good luck. I hope this helps.

post #8 of 19

PRAGMATICSKIER, did you get your blood tested for HLA B27? I just got diagnosed positive for that. I am meeting my doc tomorrow and discussing what route  if any we will take. Seeing a Rheumatologist will probably be my first step. I would be very interested in hearing back from you.    Dave

post #9 of 19
Thread Starter 
Quote:
Originally Posted by Daveski7 View Post

PRAGMATICSKIER, did you get your blood tested for HLA B27?


Not that I know of, I'll have to check the blood results (been getting tested monthly for liver and kidney function).

 

Currently on methotrexate (20 mg weekly), prednisone (done to 15 mg daily trying to taper lower), Simponi (50 mg injection monthly), folic acid, calcium supplements.  Most joints are under control.  Still have major swelling of both knees (difficulty walking and using stairs), occasional foot problems (cramping of toes and stiffness). 

 

Have not been able to ride my bike.  Currently thinking that the coming ski season is a no go for me.

 

post #10 of 19


You have to request this test, it is not normally tested for unless a doctor suspects something has occurred because of it's presence. It is a little complicated to explain exactly what it is, google it, called HLA B27.  Even  if it was present, this may not be the cause of your condition, I just saw your thread and was very curious.  Good luck and I hope they help you out so you can get back into action.     Dave
 

Quote:
Originally Posted by PRAGMATICSKIER View Post




Not that I know of, I'll have to check the blood results (been getting tested monthly for liver and kidney function).

 

Currently on methotrexate (20 mg weekly), prednisone (done to 15 mg daily trying to taper lower), Simponi (50 mg injection monthly), folic acid, calcium supplements.  Most joints are under control.  Still have major swelling of both knees (difficulty walking and using stairs), occasional foot problems (cramping of toes and stiffness). 

 

Have not been able to ride my bike.  Currently thinking that the coming ski season is a no go for me.

 



 

post #11 of 19
Thread Starter 

After Googling it, my problems do not fit the discription given of AS

 

From LABTESTSONLINE.COM on HLA-B27:

 

"AS and reactive arthritis are both chronic, progressive conditions that occur more frequently in men than women. The first symptoms typically occur when a person is in their early 30's. Often, the initial symptoms of these autoimmune disorders are subtle and may take several years before characteristic degenerative changes to bones and joints are visible on X-rays.

  • Ankylosing spondylitis is characterized by pain, inflammation, and a gradual stiffening of the spine, neck and chest.
  • Reactive arthritis is a group of symptoms that includes inflammation of the joints, urethra, eyes, and skin lesions.
  • Juvenile rheumatoid arthritis is a form of arthritis that occurs in children.
  • Anterior uveitis is associated with recurring inflammation of the structures of one or both eyes."

 

My symptoms are classic RA, both wrists, both elbows, both knees, both feet, never had back of spine problems.

 

My blood work shows high RF 301 IU/ml; high Anti Citrulline >100 U/ml.

post #12 of 19

I am not a doctor and I wasn't assuming anything. Like I said, saw your post and was intrigued. I hope they figure everything out and get you back up and running again.  Life is too short. good luck and keep me posted on progress.  Dave

post #13 of 19
Thread Starter 

Just an update.  Tried several meds over the last year.  Currently on weekly Methtrexate and monthly IVs of Actemra.  I currently have a hard time walking or doing stairs but I have been able to ski.  Have been out 8 times so far this season.  As long as I limit myself to 2 hours per day and do the hardest stuff first I'm OK.  I've lost alot of foot speed and leg strength. 

 

I was able to do Fall Line at MRG in an OK manner (not what I would like but much better than not doing it at all).  Also did several woods runs at Jay.  Again not as I use to do them but at least I'm out.  After 3-4 runs legs and bump runs become very sloppy.  Hopefully off-season conditioning (I only gave up the cane at Thanksgiving) and continued drug therapy will allow some improvement next year.

 

 

 

 

post #14 of 19

Having been treated for RA for a 3 year stretch, I got tested for Lyme and treated for Lyme. Joint pain almost gone, some damage still there. 

 

Get tested through www.igenx.com, read up at www.canlyme.com

 

If thats the cause, it greatly reduces a lot of the symptoms of RA.  Little expense, lots of gain.

 

BTW a lot of the RA drugs are imuno-supressants, and have nasty side effects.

post #15 of 19
Thread Starter 

Was tested multiple times for Lyme before beginning RA treatments.

 

All of the drugs for RA inhibit the immune system.  They also have large impact on liver function (no alcohol) and kidneys.  Being as the disease itself ruins the joints, destroys the blood vessels, and fills the lining of the lungs with fluid.  I'll take the side effects over not walking (which is where I was before starting treatment).

post #16 of 19

Glad to hear (about the lyme tests, my doctor hadn't considered it, I had to fight for it and was correct, BTW I never started RA drug therapy luckily).

 

An educated choice on the lesser of the evils is always good.  If it helps great! There are other very serious impacts, however, it looks like you have probably considered them in your approach even though you have not mentioned them.

 

Wish you the best, sorry I don't have any advice on what would be a good solution other than possible lower DIN settings to excess stress, in the event of a fall (which I'm sure you have already considered) and knee braces to help support the joint (maybe Opedix, sorry haven't tried it, others may have).

 

Finally, Hope it gets better, as it comes in cycles.

 

 

 

post #17 of 19

There's more to it than drugs.  Take a look at Robb Wolf and gang.  Their research in diet and auto-immune disease is worth understanding.  Leaky gut!

 

Annoy the immune system - get inflamed!


Edited by Paul Jones - 3/12/12 at 6:00am
post #18 of 19
post #19 of 19

Sorry to hear ... I have a friend whose husband has RA, and he started taking Wobenzym  N after I had good results with it. Might as well try anything, right? Anyway, he felt better within the week, and much better after only 2 weeks on it. Anyway, it's worth a shot if you haven't tried it yet.

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