Out of the Blue

The latest lab results are in, and the news is good. Or bad. It depends on how you look at it. There is one level in particular my doctor has been watching, hoping to see downward movement with this latest increase of Methotrexate. I'm at the highest dose possible, but the C-Reactive Protein  inflammatory marker in my blood still managed a two point increase in the last month from 19 to 21.4. Normal levels are 4 or below. Neutrophils, leukocytes, and the white blood count are still elevated. That means the Methotrexate is not working. This is bad, but it is also good. Methotrexate is the kind of medication that can do more harm than good to those who use it regularly. It was also the last of the DMARDs my doctor wanted to try before moving into the newer classes of biologic medications. Those are extremely expensive, but they also work much better to treat RA, and with fewer side effects. Health insurance will pay for these meds, but only after every other avenue of treatment h...

Last time I updated this blog, I said I was finally going to start Methotrexate, aka MTX. My doctor suggested I take the medication at night, just before bed, and she also suggested that I take it on Friday or Saturday night, so I could recuperate on a day off, because you only take MTX once a week. I decided on Saturday nights, mainly because Saturday is the day I spend catching up on housework, yard-work, and homework. I took my first dose of MTX last Saturday night. The side-effects were noticeable within thirty minutes. I got dizzy, then nauseated, but nothing worse than that. The next day, I felt tired, but not really much more tired than normal. All this week, while I've been on vacation, I've felt nauseated. It is a low-level kind of nausea, reminiscent of morning sickness. It was still as prevalent yesterday as it was the day after I took the meds for the first time. Last night, I took my second dose. This morning, I woke up feeling something I haven't felt sinc...

I saw my rheumatologist on Tuesday. She had the results of my most recent blood tests, which were two months old. The shortage of specialists means I only get to see her once every eight to twelve weeks, so the blood tests are always old by the time we review them. In this case, it was only a comparative review. She compared my numbers from July to the first tests I had done in early September of 2013, the tests I had run in January of this year, and the second set of tests I had done in April. There was good news and bad news. The good news is that there are no signs of lupus, which is what my current rheumatologist worried about. The bad news is that with the exception of a slight blip in April, my inflammatory markers and rheumatic factor have not changed since last year. This is despite nine months of treatment with Plaquenil and anti-inflammatories like Mobic and Relafen. I haven't gotten worse, but I haven't gotten better, either. The next step in treatment is Methotr...

I had the final visit with my current rheumatologist today. If you haven't been keeping up, let me recap: I started seeing this particular doctor in January. I have been unhappy with his level of involvement from almost the first visit. I decided to change doctors when my current rheumatologist took over a month to give me results of an important blood test despite my having called and left several messages. Then when I saw him again, he wanted to make important decisions about my treatment based on results that were six weeks old from a blood test that had been done only a month into the treatment plan. In March, I made an appointment with a different doctor, but because the waiting lists for specialists in this area is so long, the first appointment I could get was at the end of July. About a month ago, I injured my right knee while walking. I heard a pop and then there was bruising and swelling. It was somewhat better in a few days, but every time I am more active - for active...

Those of you who have been keeping up with this blog know about the problems I've been having with my doctor. I made another request this week to get results of my bloodwork, which was taken on March fifth. Yesterday I got a call back from the nurse who told me that the results were back (as if I didn't know that already, it had been a month!) and that my markers hadn't changed much - I showed a one-hundredth of a percent of improvement on my SED rate, but that was all. Then she asked how I responded to the steroid. I reminded her that I had called her about it several times and had left messages to say that it worked pretty well. I also reminded her that the doctor had said I could continue low-dose steroid treatment to help with the pain and inflammation. She replied that the doctor did not continue steroid treatments, despite the fact that they both told me he would. I felt completely jerked around and I told her so, though I used different words. She did not try to ex...

Yesterday, I received a call from the rheumatologist's office asking if I could come in for an early appointment the next day. The test results were back, and they had a cancellation, so the timing was right. I said I could, and asked if they could tell me about my lab results. The woman on the phone declined to discuss it because she was a member of the office staff. So I settled in to wait. Knowing that I would soon find out about my condition and prognosis made me very antsy, very unsettled. I didn't sleep well, but I woke up feeling just about par. Time and a hot shower took care of most of the stiffness and by 8 am, I was on my way across town to see my doctor. He went over the x-ray results first, assuring me that there was no discernible damage in the joints of my hands. He said there was damage to other joints - knees, hips, elbows, and shoulders, and that it was made evident by the grinding, crunching noise these joints make whenever I use them. He said my lab work w...