The post that i was writing just got eaten by the computer gods but here I go again. Anxiety management for me, in life and with respect to my health is critical. I make myself so much worse when I am stressed. Two nights ago I convinced my self that my 6 months of knee pain were the result of taking VIt D and I was horrified. I woke up on and off all night and though I do not advocate this, I think I sent Dr. B 4-5 posts at two hour intervals. I WAS PRETTY ANXIOUS. I could not sleep, I was twitching, my stmach was in knots and I could not shut it down. I did try but I got sick of meditation tapes and finally just read the excellent book that Sarah C suggested.

Things always look better to me once the sun rises but I was pretty trashed and as the morning went on and I did not hear from Dr. B, I began to get nervous.

Thus I wrote her the following email: (furtively while in class)

 Dear Dr. B:

Feel so guilty about bombarding you. Thank you for keeping me as your patient.

As we all know, Dr. B is way more generous than most people...

Allowing me to preserve my dignity, she merely wroe back "Don't worry about that."

But in the morning before she wrote back, I was worrying because what would I do without her in all of this?

Yesterday i could see how bad my knees were- worse than usual-because I hadn't slept much. I think that has got to be true for our bladders, too. Sleep is so important and I am so frustrated when I can't effectuate it but I wonder if I trash myself because once I am that sleep deprived I cannpt sustain the anxiety (or much of anything else.)

I would not have done it in the past- concern about looking bad to my staff- but without giving a specific reason, I told them that "we" (believe me, when I sleep badly, my husband does, too) had gotten very little sleep and I was going home early.

So I ducked out at 3, got my son at school and came home and hit the cocoon. And that awakening was like rebirth.

So today, I feel better- had my appt with Dr. B (face2face is amazing!) and we have a new plan and my knees seem to be tolerating a bit more. And that is enough for me. it changes everything to feel optimistic.

A recent article in Arthritis found a correlation between knee pain and depression, specifically, that many people with only mild degeneration report their knee paiin as severe and that this is because their perception of their pain is being aggravated by depression.

Pain is a complex phenomenon which is influenced by many factors, including several physical and psychological factors,” Dr. Kim explains. “Concurrent pain and depression have a much greater impact than either disorder alone on multiple domains of functional status.

“Painful sensations are relayed through the brain in a very complex way, and can be modulated up or down,” he says. With stress, poor sleep, anxiety and depression, which are known to influence pain levels, “stimuli feel more painful than they would in someone without the adverse psychosocial factors. This probably explains in part why the largest effect of depression in the study was seen in those without much OA to see on X-rays.”
 

Of course, the article goes on to talk about referring patients to psychiatrists to get prescriptions for antidepressants. Not applicable to us but we do need to keep talking on here about what techniques help us manage our rather understandable anxiety. Dr. B says that she would like to start a special web page to capture these ideas (some of which would be contributed by prior patients) for current patients. What do you think? Is anxiety worse for you than the symptoms of IC? if you are managing your anxiety well, what do you suggest for the rest of us?

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