Tag Archives: Rheumatologist

First Joint Aspiration: I did not die.

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Today I am typing with one hand because yesterday I had my first joint aspiration and cortisone injection into my left pointer finger. And yes, it was just as much fun as it sounds like, maybe even more.

At my rheumatologist appointment last month, he mentioned that he may be doing this at this month’s appointment if my finger didn’t look better.  Actually, he mentioned he might be doing this on two fingers so I guess I lucked out? 

Sure. 

So, as he was examining my hands I wasn’t surprised when he said he needed to do one.  I figured that it would be one of those things like “sure, let’s do one.  Talk to the scheduler and we’ll set you up to come back for it.”  That way, I’d have at least a few days to either wrap my brain around it or find a way to get out of it.  So when I said that  I would be out of town the rest of the week but could do it next week I was a bit surprised when he responded ‘that’s great that you’ll be out of town- because we’re doing this right now.”  He stood up, fetched some supplies out of the cabinet and started prepping the needles.

“Put your hand on the table and sit on the stool.”

GULP. 

He pushed and pushed on my finger with his hands, I assume trying to assess where he was going to go in from, which really really hurt. 

Then he finished up his prep work- one large syringe with a large needle that he would use for the aspiration and one smaller syringe and needle that he filled with a whitish liquid (cortisone).

“Ok, I’m ready.  You ready?”

NO!  I’m NOT ready.  I don’t let ANYONE touch my left hand so WHY ON EARTH would you EVER think that I’m ready for you to stick a needle in it? Being “ready” for this to happen is a day that will never come.  The better question would’ve  been “have you come to terms with the fact that I am the expert here and this really is the best thing for you” or “are you sure you won’t haul off and pop me when the needle goes in?”

I quietly shook my head yes and told myself to look away.

He sprayed my finger with the numbing agent and I didn’t feel the needle go in.

Gosh, those are some great mini blinds.  Are they plastic or are they wooden?  I prefer wooden but plastic is more affordable and in some cases easier to keep clean.  And a lot of the plastic blinds can be made to look like wood.  I wonder if I could afford plantation shutters right now.  I like plantation shutters. Wow, I’m doing it.  This isn’t so baa……  WHY THE HELL ARE YOU DIGGING AROUND IN THERE? Mini blinds, mini blinds, MINI BLINDS.  IT FEELS LIKE THE NEEDLE IS COMING OUT THE OTHER SIDE,.  Great, then I can put an earring through it- maybe a bull ring- as if my finger doesn’t look freakish enough- LET’S PIERCE THE DAMN THING.

“Ok, I’m done aspirating.  Now the cortisone.”

Ok, aspiration kinda sucked but I hear cortisone feels great once it’s done.

HOLY HELL.  I THINK MY FINGER IS GOING TO EXPLODE.  No really, actual explosion.  Joint, finger meat, and blood- coming at you in just a minute.  OH MY GOD. 

“Please stop.”

“It’s ok, I’m done.”

“I can’t bend my finger at all.  Is it supposed to do that?”

“Yes, I couldn’t aspirate as much as I wanted so you can’t bend your finger because it’s full of cortisone.  It’ll go down quickly.  Let me get you another bandaid.”

As I stood up, I realized that there was visible sweat on the table from where I had my other hand resting. 

“So, this will go down- it’ll probably be a little tender for 48 hours and you probably won’t be able to bend it for the rest of the day.  I couldn’t aspirate as much as I wanted which probably means that the joint lining is now really thick.  The cortisone should make it go down though so we’ll look at it again next time.  We may have to do it again, on this finger and possibly on the other one.  But I won’t make you do the other one today.”

Damn right you won’t.

And, drama queen tendencies aside, I don’t think it’ll be as scary next time.

Advocates for Arthritis

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Wow. Wow. WOW.

I don’t even know how to catch you all up on everything that’s going on.   I’m exhausted but in a good way. So bear with me if this seems a bit scattered…I have so much to talk about that there is no way I can do it justice.

I really truly feel that the only control I have over my RA is my reaction to it.  I can be negative about it and let it hold me back (and exascerbate my  symptoms) or I can try my hardest to keep my life as close as possible to how it was pre RA.  The second choice is clearly the one that works for me although sometimes I do still have a really hard time with it.  Every once in awhile, I’ll have these identity crises- I know who I was before RA and who I was on track to being without it….so what does this mean to who I am now? 

The easy answer is the same person.  The hard answer is the same person.

I continually search for outlets to mesh the “pre” and the “post” me and I just got back from one of the best RA specific experiences I’ve had to date.

This past Monday and Tuesday, I had the privilege of being a part of the American College of Rheumatology’s Advocates for Arthritis Capitol Hill Fly In.  For those of you who are not familiar with this, it is a non-partisan (ie the only way I was comfortable participating) yearly event where a group of rheumatologists and patient advocates from all over the country jet in to discuss legislative issues that affect rheumatology with their local members of Congress. 

The trip had been on the books for quite some time and it was an absolute circus to be doing this in the midst of “current legislative events.”  Literally, the phones in the offices didn’t stop ringing, people were running in the halls at times, media was everywhere, and it seems like every major health organization was represented up there that day.

Issues that we discussed:  (I’ve linked these to the issue briefs for those interested)

Prior to our meetings to prepare us for our Capitol Hill meetings, they had a patient advocate reception.  I wasn’t sure what to expect and was a little nervous at walking into a room full of other patients I didn’t know.  I’ve never been accused of being shy but still, it’s a little intimidating. Also, when I’m nervous I either a. turn in to Rain Man b. chatter and giggle incessantly or c. curse like a sailor.  Please God, do not let me do any of the above.

I did not.

What a diverse group of wonderful people all the patients advocates were!  It was amazing- all ages and many varying levels of disability were represented.  (Not that levels of disability matter at all but coming into this, I was worried that I’d have fatigue issues/feet issues but decided the proper response was to NOT verbalize this fear when I saw that several of the people who were so excited to walk all around the Capitol had walkers…THAT is impressive.)  I love that so many people affected by this are so involved!

By luck, I wound up sitting at a table with Melinda Winner, another RA patient whose website I love to stalk.  She is hysterical and truly inspiring- while dealing with multiple types of arthritis, she still manages to write and promote her cookbook, Cooking With Arthritis, and travel the world doing all sorts of fun things like appearing on the Food Network! 

The rest of the day was spent brainstorming with our teams (generally a patient and several rheumatologists), discussing the issues, and dinner.  I was 100% exhausted but excited for the day to come when I hit the sack at the ripe old hour of 9PM. I’m so young and fun.

Our meetings on Tuesday with members of Congress were eye-opening. There were so many things I hadn’t realized about how our country works.  First, we were prepared ahead of time that most of the staff in these offices would be young, REALLY young.  Knowing that, I still wondered if the gentleman who greeted us in the first office was old enough to drive. (No, I didn’t ask.)  In spite of being so young, they are remarkably well informed and well spoken.  Everyone listened attentively, asked a few questions, and agreed to review the issues we spoke of. 

We were also prepared ahead of time to realize that we weren’t going to change the world in a day.  Meaning that getting them to review the issues or, on a more basic level, understand what rheumatology is, is still a success.  Given that criteria, I feel like our team did a very good job.

Highlights of the day?  Hmmmmmm…..three highlights. 

  • First, the made to order pasta bar in the dining room.  FANTASTIC although I did have to tell them to take it easy on the garlic. That could potentially be bad for business!  
  • Second, one of our meetings was with the legislative aide for one of our NC Representatives…who just happens to be a childhood friend of mine.  Who I also was on dance team with for years- so someone who knows what I used to be capable of and may understand just a little bit more of what this diagnosis means to me and to other people diagnosed.  I hope I didn’t scare her….
  • And third, meeting yet another Representative who has Rheumatoid Arthritis.  I feel good that RA (and other types of arthritis) are beginning to have a “face” where it matters.

So.  What now?

I realize now more than ever how important it is for us to have an accurate image out there- in the media, in magazines, in society, and in government- regardless of what side of the fence that you sit.  I’m still floored and greatly inspired by the number of patients I met who are doing just this.

I plan on keeping in touch with the people I met up there as well as attending next year (if they’ll have me!)  I plan on continuing to volunteer and finding other ways to get involved.

I’m enjoying feeling like the same old me.  Albeit me who is still exhausted and whose feet still really hurt.

Amanda-1: PPO-0

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For now at least.

After submitting all my paperwork (mainly 6 years proof of continuous credible coverage) to the insurance douchelord company,  I finally got the word today that I really can see the rheumatologist next week.

You see, this same company who I am now covered by (again) and I have a checkered past.  This is the carrier I was with when I was diagnosed.  So, I learned the hard way that I CANNOT go to the rheumatologist until I have all my ducks in a row because it will be a nightmare to sort out on the flip side.

I really do feel bad for their customer service reps.  I mean, it has to be a horrible job.  I would imagine that everyone who calls in is like me- ticked off.  And they can’t really do anything to help you.  And (and this is going to sound horrible) the only way to get any attention from someone who CAN help you is to not be the nicest person in the world.  And that makes me feel pretty crappy.  For the record, I do tell them that I’m not mad at them personally and I realize that they are just the messenger.  But still…

So today, the poor rep excitedly announces to me that they have all my paperwork and that I’m good to go.  Underwhelmed.

Really?  I’m not falling over with gratitude that you DID YOUR JOB and will be fulfilling your BASIC policy requirements?  After I only had to fax it 3 times?  And call multiple times after that?  And what does that really mean?  Does that mean that you’re going to pay the bills in accordance to the policy or are you going to put me through the same ordeal you have in the past?

I so wanted to shout: DO YOU NOT KNOW WHO YOU’RE DEALING WITH?  Yes, it’s me- the girl you had to reimburse 3K several years ago after you drug your feet on paying bills in a timely fashion which forced me to make the painful decision of put it on the credit card vs. let it go to collections.  And then I (gasp) continued to follow-up with you because I’m pretty sure you assumed I would just pay off the balance and forget it. But let me tell you something you probably already know: I can beat the heck out of a dead horse.

And let’s talk about lab work.  A big chunk of that bill in the past was just that.  You have this nifty little loophole where you won’t pay for labwork that’s drawn more than 5 business days OUTSIDE of the appointment.  OUTSIDE, not AFTER.  So say your doctor likes to have your current labwork in front of her AT your appointment.  Would it not make sense that she gives you orders to have it drawn 3 days before?  Which falls less than 5 business days OUTSIDE of your appointment.  But someone in your corporate office interprets it to be (and from a calendar standpoint this is correct) more than 5 business days AFTER your last appointment.  

Seriously, we fought about just that for months.  OUTSIDE vs AFTER.  And the policy says OUTSIDE.  And I WON. I call that my Elle Woods moment.

Did you like the letters I wrote to the insurance board?

I realize I sound kinda psycho about this.  But put 3K that you don’t have on a credit card with the realization that the person who’s supposed to pay for it is trying with all their might not to and see how you feel.

Very defensive.  

I am feeling better.  True to form, the finger isn’t looking so nasty but I am taking the picture with me.  I still think it may be time to switch up medications.

Oh God.  I’m going to have to start the process all over with that.  

Those poor CSR’s.

Hitting the proverbial wall

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This past week marked my 4th diagnosiversary.  January 11, 2006.  Woo hoo.  Did I plan any sort of celebratory event?  Um, no.  I do not celebrate things I’m not excited about.   I noted the date, rolled my eyes, and as best as I could tried to not think about it.  Unfortunately, my RA had different plans…

I’ve been fighting a low grade cold since before Thanksgiving.  I get almost better and then come in contact with someone who reinfects me.  It’s awesome.

I typically have “flares” when I’m either really stressed out or have any other sort of event that my immune system has to battle.  I swear, this RA thing is an absolute DIVA- if my immune system has to divert some of its forces to battle a cold, RA gets its panties in a wad and stages a mutiny.  This happens to me about twice a year.

I don’t have typical flares where all of a sudden my affected joints are completely swollen and locked.  Like I said, my flares are almost exclusively accompanied by a cold or flu. It’s more of a gradual thing and it’s more of a combination of different symptoms- I start to notice more swelling over a period of a few weeks that I can always find excuses for (overuse, increased exercise etc.), I usually start to experience minimal joint pain in joints that typically aren’t affected and then WHAM, my iron and potassium levels bite the big one.  The fallout from the drops in my iron and potassium are actually more incapacitating than the joint pain (now- this was not the case when I was newly diagnosed.)  This is usually followed by a dramatic increase in joint pain. Hence, hitting the proverbial wall.

Monday am, I awoke to increased swelling in my fingers despite having taken methotrexate on Sunday night.   That’s funny….but I’m on cold medicine so maybe it’s not working right.  I still figured nothing was amiss when Monday night I was in bed by 8:30pm.  I must’ve been tired- I don’t even remember falling asleep and I seriously feel like I was drugged.

It took me 45 minutes to get warm again after a client site visit on Tuesday.  I thought I bundled up enough.  Oh well, lunch will warm me up.  I seriously want the biggest rarest hamburger Cracker Barrel can give me.  And lots and lots of those salty steak fries! Those who are familiar with my eating habits would know that this is unusual.  

While driving on the highway back from my visit, I have to suddenly stop and take back roads because I’m so shaky.  I have this weird feeling that I am going to lose control of my car and slide sideways underneath a tractor trailer.  I’m never taking Mucinex again- makes me too jittery.

At a Tuesday evening dinner with my boss, I basically do not participate in any of the conversation because even though she’s talking to me about work, I can’t process any of the things she’s saying. I’m so tired.  All I want to do is go to bed.  This Mucinex and this cold have really knocked me out of whack.  And my feet are starting to hurt.  And my shoulder is sore right now too.  WTF!

On Wednesday morning, my coworker tells me that I look like I could be in Twilight.  Yay- I knew pale would finally come back in.  I know I’m sparkly like Edward.  When I finally looked in the mirror, I realize that I most certainly am NOT sparkly like Edward.  I have bags under my eyes and I’m gray.  I try to adjust my make up to hide this and end up looking like I’m wearing warpaint.  I decide to call it a day and go home and rest.  Afterall, this cold is kicking my ass.  My fingers really hurt, for some reason my left knee is bothering me, I’m bruised, I’m shaky, and I just can’t concentrate worth a damn.  I finally get my first thought that maybe it’s not just the cold at work here…

Wednesday evening, I leave my cave of a bedroom for a much needed haircut.  Hey, I am female- no cold gets in the way of beautification! LIGHTBULB!  EPIPHANY!  BREAKTHROUGH! When my hairdresser asks me what my favorite TV show is and even though I am concentrating intently on every word she’s saying, I DON’T UNDERSTAND THE QUESTION NOR DO I HAVE AN ANSWER.  I nod in agreement that I just love watching The Bachelor (oh, the horror).  To set the record straight, I do not love watching The Bachelor.  I the opposite of love watching The Bachelor. I would rather watch paint dry. Upside down.  Naked.  In Times Square.

All of a sudden, this whole experience is hauntingly familiar.  Extreme fatigue- check.  Bruising- check. Acting like a space cadet on crack. Extreme mental fogginess- check. Strange muscle pain- check.  Increased joint pain- check.  Joint pain in places that usually don’t bother me- check.  

Ohmygod- I’m having a flare.  And I’m anemic.  And I’m hypokalemic.  

When paying at the salon, they ask me if I want to schedule another visit.  I don’t understand a word that they’re saying but tell them ‘no, I have to go to the doctor.’  They stare at me and half-smile when they take my money and watch me walk out the door.  They think I’m crazy.

I locate my iron and potassium supplements I have stashed in my car. (I know, shouldn’t be kept in the car!)  I am able to get into the doctor the next day to verify that I am indeed super low on iron and potassium.  I am told to keep taking the supplements and come back next week for a recheck. Thursday night, I sleep soundly and awake Friday morning well rested yet not feeling drugged.  My joints still hurt though.

Over the weekend, I concentrated on resting.  The joints are still more swollen than normal but the knee has backed off.  The bruises are already fading, I can actually hold coherent conversations.  I still have a cold.

I need to restrategize to figure out a way to pinpoint this earlier.  I also need to figure out how to more consistently take my supplements.  That’s another post though.  Titled: You’re an adult dammit, remember to do this crap!

I’m feeling better.  More than a little bit.  And feeling extremely dumb!

Happy Diagnosiversary, RA.  You are one heck of a skank.

I needed to see someone who looked like me.

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Wednesday, January 11, 2006

“Your x-rays still show no new bone growth on either foot so we can rule out a stress fracture.  Your bloodwork, however, was much more revealing.  Your rheumatoid factor is a 68; it should be less than 20. Your CRP and ESR are also elevated.  These results, in conjunction with symmetrical joint swelling in your feet and hands all point strongly to rheumatoid arthritis.”

Blink.

“I’m going to start you on several medications today.  Celebrex for pain. Prednisone is a steroid that we’re going to start you on a high level and taper you down.  This will reduce the inflammation while the other medications start to work.  Methotrexate is a chemotherapy drug.  It can have some pretty nasty side effects so we’re going to start you low and build you up to 8 a week.  I’m also giving you a combination folic acid and vitamin B to help combat the side effects.”

Blink.  Chemo???

“We’re going to do this for two months and then re-evaluate to see if you need a biologic.  How do you feel about giving yourself shots?”

Blink.  Giving myself shots?  For what?  I don’t even know what it is that I have. Please just let me get out of here.   

I’d never even heard of rheumatoid arthritis.  When I thought about any sort of arthritis, all I could picture were the elderly folks my church youth group would visit with at the holidays and my great grandmother.  I mean, think about it: that’s generally what’s shown in advertising. At the time, I had no clue that there were many types and that they could affect people my age.  

To make matters worse, after getting home from the doctor that day, I decided to “educate” myself on rheumatoid arthritis.  How, you ask?  By using the END ALL BE ALL most reliable and authentic source of all information in the entire universe: ye merry olde interwebs.  Needless to say, I was much better off “uneducated.” I had no idea at the time that there was such a general misconception of what RA is.  To this day, I see pharmaceutical ads on TV and in magazines that are just wrong.  Hello Enbrel ad from 2009- I shall never forget you. But at the time, I took them as fact.

So I cried for hours and then took my raccoon eyed self to the mall where I dropped $200 on the cutest pair of incredibly fugly orthopedic dress shoes.  I remember thinking ‘so, I guess this is life now. So long running.’ Then I decided my best course of action was to hide this from everyone and would continue to do this for over 2 years.

Let’s just say this was the worst decision I could’ve ever made a decision that made everything harder and based on my own uninformed ideas and leave it at that, ok?  

So, what does Rheumatoid Arthritis look like?

Specifically, Rheumatoid Arthritis was 26 on that day.  A friend, a daughter, a sister, a coworker.  Loves running, kickboxing, reading, dancing. Very reluctant to let go of any of these things. Very sensitive and self conscious when she received  a diagnosis that she didn’t think she was representative of thanks to horrible misconceptions.

Except that she was.  Right on the money actually.

Demographically, RA is 20 – 40 at onset and two to three times more likely female than male.  Rheumatoid Arthritis is an autoimmune disorder in which the immune system attacks joints.  It is chronic yet also very treatable through combinations of very strong medications with many patients (yours truly included) able to eventually return to almost normal.

Yet the arthritis the public generally attributes to ALL autoimmune arthritis conditions is osteoarthritis- the condition caused by wear and tear  from aging or overuse and the ONLY one where “just go take a Tylenol” may yield positive results. 

That’s frightening.

“Buckle Me Up!” International Autoimmune Arthritis Movement is an up and coming non-profit dedicated to helping those suffering from autoimmune arthritis conditions by increasing understanding and awareness through education, partnerships, and support.  We are trying to raise money to finance legal fees and startup costs associated with filing 501(c)(3) paperwork.  

I can’t imagine how much this would’ve helped me when I was newly diagnosed.  Having information and support and people to talk to would’ve made everything so much easier and less scary.  And believe you me, it was a very scary and lonely time.  

It would mean the world to me if you would visit www.bucklemeupmovement.com/donate to read more about this and to donate $1.

An Open Letter to my Future Rheumatologist

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Dear Dr. (insert your name here),

First and foremost, let me tell you that I’d so much rather be shoe shopping than rheumatologist shopping.  To put things in perspective, I’ve never gone shoe shopping and left with 5 vials less blood than I came with.  Rheumatologist shopping…different story.

I’m really frustrated.

I think I’m a pretty good patient.  I like to understand and learn as much as I can about my disease state, what exactly is going on in each joint affected, why certain bloodwork is ordered, how my medications work, different options for treatment etc so I can have informed discussions with you.  I do not believe in blind faith as far as medical care is concerned, especially MY medical care.  

In return, I do ask a few things of you.  I expect you to listen to my medical history, understand my goals, respect my concerns, and work with me to find a mutually agreed upon plan.  Specifically, I am open to resuming methotrexate if you are open to me not resuming it.  I’m not trying to tell you how to do your job or play games.  But I am telling you that I’ve had minimal success on it and I would like for you to look at my medical history, think about it, and see if you can come up with a better idea.  That’s all.  If you think it through and still think you’d like me to try it, sure, I’m game. I do realize that practicing medicine is exactly that: practicing.  

But I do ask that you practice- don’t just give me what you give all your other patients.

I don’t think I’m asking the world here and this is not just about methotrexate, although that is a sticking point with me.  I would just like your time and thoughtfulness before you stick me on any strong medication or other uncomfortable course of treatment that (let’s be honest here) you’ve probably never taken yourself and don’t have firsthand experience of trying to function with the side effects of in your daily life.

Here’s to hoping that the next one of you is better!

Three, Tres, Trois!!!

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Something curious has happened to me lately and I’ve been a little nervous to mention it for fear of jinxing myself.  Several months ago, when my health insurance was cancelled by my douchy ex-employer and I had to put myself on a craptastic emergency policy that covered only $100 per month in prescription medication, I made a decision to cut some dosages in half or more so that I could make it until my new insurance with my new job picked up.  You may have noticed in my meds tab that as of April 09 I was taking:

-1 Humira injection/week

-6 methotrexate/ week

-6 sulfazine/day

-4 Aleve/day

-Prednisone prn

Well, to make a long story short, I have been taking the following for the past month and a half:

-3 sulfazine/day

-1 Humira injection/ bi-weeekly

AND I HAVEN’T HAD ANY PROBLEMS.  In fact, my joints just may feel a tiny bit better right now.  Now, this was a decision made out of necessity rather than a consultation with my dr, although I did tell my dr I wouldn’t take the mtx anymore because it tore up my stomach so bad.  The Aleve was cut because I ran out and didn’t have time to go buy more.  When I did finally get more, I realized that I hadn’t taken it in a week.

I CAN’T REMEMBER THE LAST TIME I ONLY TOOK 3 PILLS A DAY!!!!  

I do realize that this could change on RA’s whim but for right now, I’m really excited.

New Way RA

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Go on over here and check out New Way RA, a great new resource for those of us who won the auto-immune lottery and for our loved ones.  This is an online talk show hosted by Deborah Norville, whose mother had RA, and features several chats with experts on nutrition, activity, the emotional side of it, and even career coaching.  I’ve seen the DVD and think it does a great job of breaking these things down in layman’s terms…..YAY for good RA PR. :)

To bring things somewhat current

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So, I had every intention of getting all this background story posted in like 2 days. But, thanks to our economy and some serious work drama, I got a tad bit sidetracked.  Sigh…

I guess I stayed on the same treatment plan for a year with some reduction in symptoms but not much.  I ended up having a pretty serious falling out with my rheumatologist, mainly due to the fact that his social skills never improved and the last appt when he walked in, didn’t even look at me, and asked me how my elbows were doing.  “Elbows?  ELBOWS? I wasn’t aware there was a problem with my elbows.”  That was the one time he actually made eye contact with me.  Perhaps I should’ve let him examine my middle finger, it started itching at that moment.

I found a new rheumatologist who is wonderful.  At my first appointment, she spent an hour with me.  She agreed that our end goal was to get me running again (which I am!) and to get me back into the pretty shoes I lust over (which I can wear in moderation if they’re not too high.)  She was pretty upset with my old doctor- he never ran certain blood tests that give indicators on how aggressive RA is and basically let me lose a year in treatment time by continuing a course of medication that wasn’t working.

I’m currently on a low dose of mtx (which I’m not thrilled with but I’ll do for now), sulfazine (basically aspirin and a low dose antibiotic), and Humira.  It’s going okay thus far so let’s all knock on wood!

Have some blood, why don’t you?

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When I was first diagnosed with RA, it seemed like everybody and their brother wanted a good gallon of blood from me.  They . test. for. everything. For the record, in case you’re curious, I can tell you that I’m not pregnant, do not have AIDS, do not have syphillis, do not have chlamydia, do not have herpes, do not have cancer, do not have lyme disease etc.  Want to know something funny….even knowing in 100% confidence that you don’t have syphilis BEFORE you take the blood test, you’re still like “awesome, I dodged that bullet” when you get the results.

Needless to say, when I first met the rheumatologist, they had a pretty comprehensive work-up already done on me. He flew in, looked at me, wrote some notes down, and left.  The nurse came  back in, gave me some prescriptions, and sent me on my way.  FYI: if your doctor doesn’t take the time to explain things, especially new medications, find a new one.  

I was put on methotrexate (mtx), more prednisone, folic acid, and vitamin b supplements.  (see bottom of post for what these are as well as what I wasn’t told about these that I should’ve been told.)  I spent the first month feeling like ass on a platter.  My feet actually got worse, I was covered in bruises, was totally lethargic, and I could actually FEEL when the mtx hit my stomach.  Weirdest, creepiest feeling ever.  I went back the next month for a checkup and they increased my mtx. This continued for several months and I continued to feel like ass although around month 3, the inflammation started to improve.

Methotrexate: actually an old chemotherapy drug.  It screws around in your bone marrow making you very anemic ergo bruising and lethargy.  Iron pills fix this.  The folic acid helps protect your stomach– you can also take calcium to do this.  You SHOULD be taking calcium anyway- see notes on prednisone.  BIG NOTE:  I am very vain so this is ultimately why I took myself off of it- it makes your hair fall out in higher doses.  

Prednisone: anti-inflammatory drug.  Makes you retain water and an appetite stimulate so get ready to pack on some poundage.  I got super fat at first on this.  (I am almost back down to my fighting weight- yay!)  I know, I know- I already told you though- very vain. Make sure you take calcium AND vitamin D with this- Prednisone makes it hard for you to absorb calcium while vitamin D helps with it.