Saturday, May 24, 2014

Rheumatoid arthritis update

So back in March I received the “official” diagnosis of Rheumatoid Arthritis. After some rather extensive dental work I got done during the second week of January I experienced what in retrospect must have been a severe flare of rheumatoid arthritis. My hands were the worst: swollen, extremely sore and stiff and more or less useless—getting dressed took a long time. (buttons! pulling on pants!). I needed those grippy things for everything-doors, bottle opening etc. My knees were also not good and at first I also got bad headaches and just generally felt miserable.
A picture of my puffy right hand during the worst of the flare
The day after a follow-up visit with my dentist, where a newly made crown was found to not fit quite right, my left knee became so sore and stiff I had a hard time walking. This of course really scared me.
This was all happening against the back-drop of the “polar vortex” and I'm sure the weather played a factor in the flare.
The slightly odd thing is that even at the time of my first appointment with the rheumatologist in February I was already slowly getting better, i.e.experiencing less pain. And since the lowest of the low which was probably the three weeks back in January (after the initial dentist’s visit) I have been on a gradual trajectory of less pain-a slow upward slope towards relative painlessness.
This is probably why at the visit in March I balked at the idea of going on Methotrexate- a strong medication often used for RA but also for treating certain cancers. It can have strong side effects including vomiting, diarrhea and nausea. I was busy with teaching and the idea of being laid low on the weekends due to this med made me very sad. I therefore decided to not go on it and just continue with taking prescription strength ibuprofen when the pain warranted it.
Now after a follow-up visit I decided to give the methotrexate a try. My doc kind of talked me into it—she poked around a bit and kept saying – this joint is swollen and that joint is swollen. She made me move my shoulder around a bit in a way that hurt. (My most stubborn pain areas have been my left arm and shoulder).

At least now I’m not as busy and can take it easy on the days I take it –which are going to be Tuesdays. I took my first dose last Tuesday and felt quite dizzy and woozy but also mentally quite good. My stomach was a bit upset but I did not really feel nauseous and I did not lose my appetite which was good.  Apparently it can take a while before one notices an improvement which makes sense if one is only taking it once a week. My next appointment with the doctor is in July and I assume she will run some tests to make sure the methotrexate is not adversely affecting the liver. Until then I hope the side-effects will remain tolerable, and that I’ll perhaps notice an improvement in my (already pretty tolerable) pain situation.  Only time will tell…..

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