Monday, February 26, 2007

arthritis and bicycles

I have a diagnosis. Last week I had my rheumatologist appointment, at the Victoria Arthritis Centre, a small but rambling shingle-walled structure near the Jubilee Hospital, with a cute dove? graphic on the sign. The significance of a small scribbly bird to arthritis is not immediately clear to me, though I remember that a pigeon sliced in half and applied to the soles of the feet was a folk remedy for the plague. Probably not what they had in mind.
The rheumatologist suggests, largely because of the rapid onset and departure of symptoms, sometimes only a day and a half, never more than a week, that I don't have rheumatoid arthritis. What I likely have is a type of arthritis so unusual it has no official medical website, even. It does have a fairly good amateur website by a young man in the UK, and passing mentions on various arthritis sites.
Palindromic rheumatism. Which is a terrific name, but unfortunately doesn't mean 'arthritis that reads the same forwards and backwards, which would be more entertaining. No, in medical terminology it reportedly means 'coming and going' (as in 'will get you coming and going', perhaps). It may be a type of rheumatoid arthritis, it may be something different. It is an autoimmune ailment, and about 1/3 to 1/2 of cases develop into RA, which is the bad news. The good news is that unless it does develop into RA, there's no permanent joint damage, just pain, inconvenience and annoyance.
This is rather good news, aside from the pain part.
I have a renewed prescription for Naproxen, and a new prescription for Panaquil, the latter being an immunosuppressant and antirheumatic, originally developed as an antimalarial. So I probably won't get malaria, even if global warming sends infected mosquitoes up this way. More good news all the time.

My recent experience with biking in Victoria without using handbrakes (conclusion: it would work much better in Regina) made it clear that it's time for a new bike. One that doesn't put pressure on my wrists and shoulders, and where shifting and braking are very easy indeed, or don't use the hands.
Mind you, the info on palindromic suggests that the knees may become a problem, in which case biking is probably right out until the flare-up is past. So far it's been hands, wrists, and shoulders, with problems only in one knee after the no-brakes ride.
Over the weekend we went and looked at bikes. My current bike is a Norco that was my son's until he outgrew it, and I think the only adjustments made for me have been raising the seat and handlebars as high as they'll go (which was pretty much where he left them). I started riding his after my old Raleigh was stolen--given its habit of slipping the chain off when I was going uphill, I didn't search all that thoroughly, nor mourn all that inconsolably. The Raleigh cost about $30, and I don't remember what the Norco cost, but probably more than that. Fortunately I'd braced myself for the order of magnitude of new bike prices.
Shopping, the silver lining to the arthritic cloud.

This is what it's come down to:
Specialized Crossroads Sport, women's model: upright position, twist shifter, three-finger braking, cheapest.
Miele Umbria City: coaster brake, Nexus 8 internal drive train, longer-lasting.
I tried out the Electra (no link because of annoying Flash-y site) Townie, and it was okay, but nothing I didn't get with the Crossroads, and more expensive.
The upright position puts no weight on my wrists, but the guy at Performance Bikes, who also has arthritis (and carpal tunnel) says the regular setup works as well or better if the bike frame is the right size and is properly adjusted to the person (this was explained with much reference to geometry and ratio, and I didn't follow very well). Since I've never had a bike adjusted to me as far as I know, this could well be true. I'll be trying out an Umbria that's the right size for me tonight, so perhaps I'll find out.
The internal hub thing is very cool, my husband assures me, and the coaster brake feels safer, but the upright position may be easier to adapt to than trying to keep my wrists straight and elbows bent all the time.
The key thing is going to be how they each handle steep hills, because that's what I have on my route to work.

No comments: