Tuesday, July 31, 2012

If you ever wanted me to shut up, you're getting your wish...

I've been having voice problems off and on  for the last few weeks - first it began breaking up (cracking, dropping out words mid-sentence), then a loss of range and clarity, and now it has become painful to talk for extended periods (like in meetings, or even sing to my beloved Journey in the car). I'm hoarse almost all the time.

I dug around and on RA Warrior I discovered that it could be vocal cord (cricoarytenoid) arthritis, a result of rheumatoid arthritis attacking the  cricoarytenoid joints near your larynx.

So, how common is cricoarytenoid Rheumatoid Arthritis?
Very. Arthritis materials estimate the rate of cricoarytenoid involvement to be anywhere between 17 and 75%. No wonder people are confused. At least 35% of RA’ers complain of hoarseness, a common symptom of cricoarytenoid RA.
But wait! Post mortem studies range from 45 – 88%. I have read a couple of journal articles which find autopsy evidence of laryngeal Rheumatoid Arthritis in 87% of patients. An American College of Rheumatology report found that 7 out of 8 RA patients showed histopathologic changes postmortem. They stated, “Arthritis of the cricoarytenoid joint occurs much more frequently in patients with rheumatoid disease than has generally been suspected.”

In the last week it has felt like there is always something in my throat and surrounding neck muscles are hurting. I mostly only speak if spoken to at this point. I stay off of the phone. It's getting scary. I asked my rheumatologist about it and so she's slotting me in this week. Cricoarytenoid arthritis can impede breathing, so ignoring these symptoms isn't a good idea. But it would have been good to know that this complication existed since I just thought it was a minor annoyance until the symptoms started escalating.

The other possibility of course, is that Enbrel, the drug I take for RA, may be causing some trouble in this area. Sore throat is a listed side effect, though I didn't see anything about the feeling of something in the throat or constriction and neck pain (save a severe allergic reaction, which I haven't had; I started Enbrel in May). I won't get to see an ENT doctor until mid-August.

Between this sh*te and RA my wrists making typing painful, it looks like Mother Nature wants me to shut up, lol.  That should please some folks.

I'll hobble my @ss over to Duke South today to get my neck X-rayed.

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