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jmooney
15-Jan-2010, 15:13
Hi All,

I'm looking to see what those of you that suffer from arthritis of the hands and wrists use and find that works well for you from an equipment standpoint.

Yes I'm young (33) but I have what's known as Rheumatoid Arthritis or RA, it's an auto-immune arthritis, not your run of the mill old folks arthritis.

It affects several fingers on each of my hands and also both thumbs and my left wrist.

What gear works well for you? What type of accessories have made it easier for you to photograph? What hasn't worked?

I shoot 35, MF, and LF, and some digi so any and all advice or opinions are welcome.

Take care,

Jim

Gem Singer
15-Jan-2010, 15:29
I also have arthritis in my hands and hip joints.

So far, it hasn't been severe enough to hamper the use my of photo equipment, although I can no longer walk great distances without pain.

The only thing I found so far is that I can no longer comfortably tighten and loosen the twist locks on tripods. Therefore, I have been using Manfrotto tripods with flip locks. instead.

Kirk Gittings
15-Jan-2010, 16:16
I have a moderate to advanced case of osteo in all my joints. In terms of photography my big issue has been loss of grip strength in my hands. So I have moved away from anything that requires twist tightening like on tripod legs or heads-no more knurled sleeves like on the legs of Gitzo tripods or the knobs on Bogen 3047 heads.

Drew Wiley
15-Jan-2010, 16:18
I don't have arthritis, but have had horrible rheumatism in my hands my entire life, and am prone to bursitis in my arms and shoulders. Fortunately, my back and knees are in good shape, so I can carry heavy loads fine. But the aforementioned miseries caused me to reexamine my large format cameras. For some reason lifting up the monorail onto
a tripod block was particularly prone to straining something the wrong way, whereas
fold-up cameras don't seem to do this. So for most of my work, I switched from a Sinar to a Phillips 8x10 and Ebony 4x5. It wasn't weight per se which bothered me,
but simply the manner in which something is routinely lifted. Another thing which has
been really helpful going through middle age is a set of spring-loaded walking sticks,
which take the shock out of my knees on long downhill descents. Otherwise, I try to
carry a heavy pack at least once a week to stay in condition. I also pay attention to
minor detail, and have improved the knobs of some of my equipment to make things
easier to tighten etc. My feet, unfortunately, are badly deformed, so I have to wear
expensive custom-made boots. But now entering my 60's I'm still backpacking with
large-format gear, and hope to do it for some time to come!

brian d
15-Jan-2010, 16:50
I dont have much trouble with my hands and wrists but I have arthritic knees, bone spurs and three different tears in my right rotator cuff and surgeries each time among other things. The advice to stay active is very good,other than that celebrex and lortab or vicodin. Just dont take too much!

Nathan Potter
15-Jan-2010, 17:22
Jim, rheumatoid arthritis can be nasty stuff. Usually develops at an older age, but at 33 is a real bummer. I have rheumatoid but am much older. It comes, typically in flareups, due to a heavy temporary load on your immune system - say alergies, colds, flu. For the flareups I would use Prednisone, from 20 to 40 mg. - then gradually taper off to none. Now, for me, the rheumatoid is more invasive causing inflamation of the tendons where they wrap around the joint bones. To pretty much control it now I take Methotrexate once a week and Rhemicade infusions once every other month. But this treatment shoves my immune system into hibernation so I'm very susceptable to various bugs. These therapies have worked well for me so I can still perform LF functions almost like normal, albiet painfully at flareup times. Over time I think one just develops a psychological immunity to some of the pain so you just get used to the problem.

See a doctor about the use of Prednisone for flare ups.

Nate Potter, Austin TX.

Toyon
15-Jan-2010, 17:43
Prednisone is really bad for you long-term. So be sure it's just for periodic use.

Scott Knowles
16-Jan-2010, 06:32
I've had Raynaud's Syndrome since 1990 which triggered working in the Olympic Mountains during a winter storm. I'm fine during warm months but once the temperature drops below 50 and especially 40, the hands stiffen and become cold in 5-10 minutes and won't move after 15-20 minutes and even with warmth they barely move the rest of the day. And the gloves in the world don't help, but it's all I got and keep the fingers in pockets and moving as much as they will.

The sad reality is that the susceptibility to it is genetic and this last winter it found the toes when I had a mild case of stage-2 frostbite which took 2+ months to heal. And like AR and similar conditions, it worsens with age where now I should use gloves to take stuff out of the freezer and can't hold cold things very long even in warm weather. Kinda' put a damper on some LF work, to see the shot and then think about the time outside to get it.

jmooney
16-Jan-2010, 13:08
Thanks for all the wonderful advice so far folks. I do have a bit of a plan but I wanted to see what others have done first.

As far as the arthritis itself goes, I have good and bad days. Good days are not so bad, bad days can involved a cane and trouble tying my shoes. Biggest limitations are gripping and turning (two things that there are a lot of in photography and life for that matter) but again, somedays are much better than others and thankfully so far I've had a lot more good days. In this vain I'm sorta trying to plan for the future with this stuff because I refuse to stop photographing and because this is not the sort of thing that gets better with time. With regards to medications I'm currently using Humira twice a month and Celebrex. I was on Enbrel which worked much better than the Humira but I had bad reactions at the injection site. It makes it tolerable but not great. I also do short runs of Prednisone for flare ups.


Back to photography....A suggestion I've gotten here and a few other sites I posed this same question is to use a tripod. This is something that I think will make a big difference and I'll have to get used to it. I'm newish to LF where a tripod is pretty much a requirement previously with MF, 35, and digi I think I can count on one hand the times I've used a tripod. It's going to be a big change for me but it should help improve the sharpness of my photos either way.

I have found that bigger cameras do help. I love my Leica but it's become difficult to use to it's on it way out. I have it's big brother, the Mamiya 6 but I think that's going out too. The manual focusing and thumb wind can be a bit of a problem too.

I have a battery grip for my D80 digi cam and I'm switching to zooms so I don't have to change lenses as much, I honestly never print those above 8X10 or 11X14 so better consumer zooms will work fine for my needs.

I think I'm done with 35mm for the most part. A 35mm cam big enough to be comfortable will be the same size and weight of an MF camera so I might as well have the bigger negative. Plus the MF film is bigger and a little easier to handle. I'm looking at a Hassy and a Pentax 645N in this department. The Pentax is AF and some zooms are available and the Hassy has focusing handles available most lenses so focusing won't require a gripping twisting action and cable release could be used.

I'm also thinking of doing a lot more LF. I currently have a B&J 5X7 with a 4X5 back and a Bender 8X10. I might also pick up a smaller 4X5. Kind of in the same vain as above, if I going to put it on a tripod I might as well use a bigger negative. Handling sheet film shouldn't be a problem. I do have an enlarger but realistically contact prints are probably easier to do as I don't have a dedicated darkroom right now and would have to set up in a bathroom.

Thanks again for all the thoughts and keep the ideas and experiences coming!

jmooney
16-Jan-2010, 13:13
Prednisone is really bad for you long-term. So be sure it's just for periodic use.

I'm well aware of that. My grandfather had RA and at the time Prednisone was pretty much all they had to treat it and his long term, high dose Prednisone use sent him to an early grave. I hate being on it for more than 2 weeks.

ki6mf
16-Jan-2010, 17:35
I think the Shen Hao field camera has the largest diameter knobs which can help with getting a grip to tighten the camera controls. I am speaking anecdotaly and have never measured them against the other wooden field cameras!

IanMazursky
17-Jan-2010, 18:51
Last year i was diagnosed with the beginning stages of inflammatory arthritis working its ways to RA according to my doc.
The Xrays showed it in my hands, shoulders, elbows, knees and spine.
I also have a number of bone spurs on a number of my cervical discs in my neck. I also have a bad bursitis in my left elbow.
I call it my genetic crap shoot, heavy on the crap. Im only 26, this all started over 10+ year ago.

Like others with arthritis i have good days and bad. Anti-Inflammatories (Celebrex and Volatren) help a bit and so does rest.
Its much worse in the winter and changes of the seasons but all in all it could be much worse. My knees can also tell the weather!

I like shooting my Korona 12x20, it has big knobs. Its not that hard to handle considering its size.
I sometimes find it hard to push the small buttons on my sekonic L758DR meter but you can switch the buttons from back to front which makes it easier.
My Crown Graphic 4x5 has small focusing knobs but i just grin and bear it.

I know a few guys who will wrap rubber bands around the knobs to increase traction and make it easier to turn.
Or you can go to a sports store and buy some grip tape which also works.
If i do venture out in the winter, i take a bunch of the heat packs you buy in ski stores and put them in my gloves.
They help a lot with the finger joints. You just have to be careful not to burn yourself. Been their not fun! Same with heating pads.

Frank Petronio
17-Jan-2010, 19:29
I have RA too but I'm lucky that it isn't too bad and I've found the right combo of meds after experimenting with my doctors for a couple of years. In combination with my new middle-aged nearsightedness I have been getting frustrated with my cameras and keep experimenting with different set-ups to see which is the best for hands and eyes....

For small format 35mm and dslr, I finally realized that AF and larger cameras are the way to go. My Nikon D300 is heavy but the buttons and controls feel right; I have an AFS prime and zoom and I like them much better than the screw drive primes. I also have a D60 but it's a backup and family camera, I find it too small for serious shooting but it is best for casual outings.

Nikon 35mm N80s and F100s are the film equivalents but I don't feel like shooting 35mm unless I can use a real Leica to be honest, even if that sounds snobby. But Leicas are hard to see without glasses and because I tend to compose and shoot a lot of frames doing portraits, I find the Leica (Hexar AF, etc.) not as good for portraiture so I gave up on them. Right now I just have a couple of AF P&S Olympus Styluses and 35mm is gone....

Now 120 film - Blads - are not going to be as easy as you're thinking. Loading 120 is not fun, more intricate than any 35mm. I can't say that other brands are any easier but maybe the Fuji rangefinder 6x9s are the easiest -- big wide open backs and large controls.

The Crown you have is going to be pretty nice, I swapped a heavier Linhof for one and found the weight savings great for handholding.

But ultimately for large format, 4x5, 8x10, whatever, I think a full studio monorail, like a Sinar, will have the easiest controls and easiest set up to use. You're not backpacking and the weight of it on a tripod isn't going to be that bad. Heck a heavier, more solid tripod might be good to have if things get worse, you can lean on it!

The most important thing is to stay active, shoot a lot and live large because who knows what will happen next?

dave wagstaff
18-Jan-2010, 00:35
I have severe RA (actually psoriatic arthritis) and was diagnosed to be in a wheelchair by now. When it was bad I could only walk from the chair to the fridge, and with great pain. One leg was twice as big as the other, they call it sausage leg.

I do methotrexate, injectable kenalog (not good long term, but I do it when I travel), and also on Humira. Enbrel did nothing for me. Now I "phase in phase out" my dosages, have just finished ramping up now I can coast for awhile on low doses (1/4 of my mtx and humira maybe once every 6-8 weeks for 4-8 months). I am now symptom free (in remission) and photography is one of the activities I pursue that keeps me active and interested in keeping getting about.

Obviously I'm no Doc so don't do what I do, it's not advice. I got a lot worse before I got better.

My Doc says I healed (temporarily at least) myself. I'll tell you what changed my life around. I used to think, "I will beat this and live a healthy life". I changed my thinking to just visualizing myself perfectly healthy, by removing the negative thought of having it, ....for me anyways.....it worked. I also drink lots and lots of spring water, use sea salt with trace minerals, and eat no processed food and organic only.

I have changed my life as my priorities changed. Seeing my family crippled, I have given up the desk job. No sense for me to work hard to retire enjoy life. I am poor now and do what I want to do every day and I enjoy it!

Best of luck to all others with this condition.

Nathan Potter
18-Jan-2010, 16:08
Self injectable Enbrel is quite effective for some individuals with RA. For those not familiar though, it's expensive, on the order of $3000.00 per month. Insurance pays some of that depending on what kind you have. But either way the cost to society, per individual, is so staggering as to be unsustainable. Of course the cost to manufacture is expensive since, I believe, it is a form of recombinant DNA and produced in volume in the ovaries of Chinese hampsters. I suppose American hampsters would be even more expensive. But does anyone seriously want this stuff injected into them? :(

Nate Potter, Austin TX.

dave wagstaff
19-Jan-2010, 04:00
You are correct Nathan, it can be effective for some.

Let me point out though none of us do it recreationally LOL. Enbrel is $1000 a month, Humira is $2100 a month (in US). Everyone on it faces a tough choice, one that requires us to choose between a lifetime of the crippling disease or in a very worst case scenario a few years of pain free living good. The risks are high, recent warnings went out that increased lymphoma is something like 10x or more more likely with Biologics users. With MTX we also have to worry about lowered immune system and bone marrow decrease. NSAIDs also destroy the immune system long term.

It's something that only those of us that face this can make the call, and we all weigh the benefits and cons and none go blindly into it. We make a choice and we live with the consequences. That is why I ramp up ramp down, I def don't want these in me all the time.

I know people that have been on these meds (the ones that have been around long enough) for 17 years. They go skiing and have a normal life. Dangerous? Hell yes! But until you are in that situation, it is a pretty hard call. I would not post about it, but for those afflicted.........it changes our lives. We all try diet and herbal therapies first... push comes to shove you have to make a choice. Used wisely those of us on it will live a decent standard of healthy life and achieve old age. Sounds good to me :-) LOL.

Respectfully,
Dave

jmooney
19-Jan-2010, 06:12
. But does anyone seriously want this stuff injected into them? :(

Nate Potter, Austin TX.




It's a lot better than the previous treatment which was high dose prednisone. Prednisone thins tissue over time and not just your skin, all tissue. We buried my grandfather at 62 because of a ruptured bowel and abscess due to long term prednisone usage.

Also the biologics have the capability to slow or stop the progression of the disease. This was never possible before.

So to answer your questions: No, not a blessed one of us WANTS to inject this stuff into ourselves, however it's either inject or use a cane to walk, not be able to tie my own shoes, turn a key in a lock, or use a camera.

Jim

Nathan Potter
19-Jan-2010, 10:14
Dave and Jim, I understand what you're saying and agree wholeheartedly. You've gotta do what you've gotta do to lead a near normal life and minimize the inflammatory pain. BTW the cost of Enbrel in Austin, without insurance reimbursement, is in fact just about $3000.00 per month. Either the insurance Co. or the individual has to pay the cost. I use a Remicade infusion every other month at the local hospital and it has been very effective for me - I'm about normal with ,usually, no difficulty working LF gear, or packing my 40 lb. backpack.

Nate Potter, Austin TX.

J_Tardiff
19-Jan-2010, 15:44
I have Raynaud's like Scott that gets worse year by year, at this point I can no longer shoot in the cold so this is the time of year when I fiddle around with restoration projects and one of my favorites is replacing knobs on my field cameras! Always fiddling with these.

I found that I really had to make sure to get my hands on the cameras I was considering, came within inches of buying a Canham sight unseen (until Ted Harris, who knew about my lousy hands warned me to try one first...).

My favorites are the larger knobs with a strip of rubber, I think some of the Shen Haos have them. I do find my Crown very easy to work with.

Good luck with the RA, my sister-in-law struggles with it and the endless on-off steroid game. But she has finally found an approach that works with her tapers and that helps. She was diagnosed over 25 years ago after multiple misdiagnoses :( .

JT

ASRafferty
21-Jan-2010, 10:51
Jill, as you say, Ted knew firsthand (no pun intended) whereof he spoke when it came to dexterity issues and cold...I seem to remember at one point that he actually settled on a Toyo IIA because of its big rubber knobs (not the only reason, of course, but I recall his saying that's what swung his decision at the time)...he probably posted about it here somewhere.