How Do You Deal With The Fatigue?

I’ve always been a huge fan of incorporating lifestyle measures, stress reduction, mindfulness-everything, gentle exercise (which I’ll admit, is the one item on this list where I can use the most improvement) and a healthy diet into my rheumatoid arthritis treatment plan. What is your experience with these issues and their relationship to fatigue? When my RA is most active, nothing seems to help but frequent naps…but on more mild days, I’ve found that all of the items mentioned above really help. Dr. Irwin Lim–a rheumatologist from Australia–asks the same, in the following post.

By Dr Irwin Lim, Rheumatologist

Rheumatoid arthritis, as well as the other inflammatory arthritides, are very much better treated in this day and age. And yet, it’s common to hear patients speak of tiredness or fatigue. Sometimes, this is profound and crippling.

When the disease is active, and I can detect objective signs of inflammation, the disease activity is an easy scapegoat. The more active the disease, the more systemic the symptoms. Fatigue will likely occur.

However, it’s much harder to explain when the disease seems well controlled. This is especially true if the disease is felt to be in remission.

If I cannot detect swelling of joints, and the patient denies joint symptoms, and the monitoring blood tests are all normal, how do we explain continuing fatigue?

I don’t have that answer.

Sometimes, it’s attributed to a side effect of the medications used. Sometimes, fibromyalgia is diagnosed as a coexisting problem and this is blamed.

I don’t think the answer lies in more medication.

Instead, I think lifestyle issues need to be addressed. Patients who have lived with a chronic disease, become deconditioned. Pain and stiffness reduces normal activity. Over time, muscles, tendons and ligaments become weak. In some, weight gain is an issue. Tolerance of effort reduces.

I believe it’s important to act early in the disease to encourage mindful eating and regular, targeted exercise to address these issues.

Randomised control data? I’m not sure that exists but it does seem to make common sense.

Medications can only improve one aspect of rheumatoid disease. Lifestyle measures remain an important, but unfortunately, often forgotten goal.

If you’re a patient, please share your experience with fatigue. If you’re a doctor, please share how you deal with this difficult symptom.

Dr. Irwin Lim obtained his fellowship with the Royal Australasian College of Physicians in 2003 in the specialty of Rheumatology. As director of BJC Health, Irwin developed the initial clinic in Parramatta to a multisite and multidisciplinary group. He strives to develop innovative, effective treatment solutions for patients suffering from chronic disease.

For more information, please visit


Show Us Your Hands! Join Our Board Of Directors!

Show Us Your Hands! is moving to the next level. We are beginning the process of becoming an official nonprofit charity organization in order to continue organizing creative community projects and awareness campaigns aimed at increasing public understanding of inflammatory arthritis. This means we need to grow our Board of Directors.

This is where you come in!

As a member of the Show Us Your Hands! Board of Directors, your responsibilities would include:

  • defining our Mission and ensuring we stay on course,
  • developing an annual plan and managing programs to accomplish our Mission,
  • implementing and maintaining transparent financial systems, budgets and accounting controls,
  • supporting and engaging in fundraising efforts,
  • internal board management, such as electing officers and replacing outgoing Directors,
  • establishing and overseeing special-issues committees (e.g., community outreach, volunteers, awareness programs, special events), and
  • helping promote Show Us Your Hands! and its activities to the public.

Our organizational culture is one that emphasizes proactive teamwork, respect and a sense of humor. We believe in the inflammatory arthritis community and in this organization and work hard for the love of the cause. (This is another way of saying that this is a volunteer unpaid position!)

If you are committed to working at the global grassroots level to unite and inspire people who live with inflammatory arthritis, please let us know by responding to a few questions before November 1, 2012. We will carefully review all submissions and then contact selected individuals in order to schedule brief online interviews.

Experience with finance and accounting is a plus.

Apply now to join the Show Us Your Hands! Board of Directors.

The mission of Show Us Your Hands! is to unite and inspire people who live with inflammatory arthritis. We carry out this mission through creative community projects and awareness campaigns aimed at increasing public understanding of inflammatory arthritis. Our community members, program participants, volunteers, donors, directors and staff work together to build hope for the inflammatory arthritis community, one hand at a time. For more information, please visit


HealthCentral: Back To School Guide For Parents With Rheumatoid Arthritis

With Labor Day weekend behind us, all of the kids have slowly made it back to school.  In my family’s case it is “to school for us.”  After having my kids home with me as homeschoolers all their lives, they are giving high school a try this year.  Their first day was August 14th. My son is going part-time taking two electives and still considered a homeschooler while my daughter will be a full-time public school student who is also running cross country.

As they were preparing for their first days of school, I started thinking about how life might have been different for me living without my kids at home with me.  “It’s a good thing we homeschool momma and can be here during the day to help you when you need it.”  This was something my children used to often say as they helped me dress or undress.  Honestly, as a homeschooling momma, I did feel lucky to have my kids home with me where they could help me when I needed a hand getting my shirt off or my buttons buttoned.  As early as six and eight years old my children were learning that as much as they needed me, I also needed them.  I needed their physical help around the house moving light objects, picking things up from the floor, and more.  I also needed the constant hugs they gave me throughout the day reminding me that no matter what rheumatoid arthritis had in store for me, I was still a momma that was loved.

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