Wednesday, May 29, 2013

Looks like I'm good to go with Methotrexate...for now.

10:30 AM: Off to the rheumatologist for joint exam and to check up on the tests from last week re: methotrexate and any harm to my liver. From what I can read, the labs look good. The large bruise on left arm from the bad phlebotomist incident is still hideous; it's just starting to fade, lol. Fingers crossed.

Noon: Back from rheumatologist. Sore from joint manipulation (geez, everything hurts when she tested). Liver tests OK, though. Will let me know whether to up the MTX dose to 6 tabs/once a week from 4. Will consider injectable if side effects are worse in the first couple of days than normal. If this doesn't improve my joint pain after a few weeks, then it's on to the next trial and error drug. I suggested a MTX/Enbrel combo since that seems to bring relief for more people. Of course I don't know if that means double the side effects for 3 days. Who knows. They are all sledgehammer drugs.

Anyway, it's back to work; not a great day to have to give a presentation to a large group of staff (in about an hour). I really feel like lying down right now.


Today is my cousin Julie's birthday. She hits 50 six weeks before I do, lol. Happy birthday, cuz!

Friday, May 24, 2013

Getting by after a month on Methotrexate for my RA

Happy-ish Friday! Have been offline, working hard, getting by, never enough sleep. Now I want to crawl into the memory foam and go unconscious to rest the bones. And it's only 7:15 PM. Sad. But that's life when all energy has to go into just being able to be effective at work for those few hours -- and then you're spent.

Dose #5 of methotrexate for my RA this weekend; seems it makes me sick for 2.5 days, and the rest of the week is better, joint-pain wise, but it's definitely no magic bullet yet. At least there is some improvement even after a month; doc said 6-8 weeks to get a good view of its effectiveness. Nausea and GI issues are getting a bit better as well. Will see the rheumatologist next week to find out if my liver is doing well enough to continue this therapy, or I have to chuck it and try another biologic.

At least I don't have to deal with that damn herniated disc now! Back is doing well. Walking is fine, though I'm slow and still limp at times because of the RA f'ing up my left hip and knees faster than I'd hoped. Still looking forward to the Brooklyn Bridge walk in July. It will be slow going, but I know I can do it.

Still avoiding lifting more than 10 lbs through the 9 month recovery from the L5-S1 bilateral discectomy in January. Otherwise no problems bending or twisting. The surgery was sanity-saving/life-altering, Laurel. I had no idea how much the back pain was affecting my ability to cope (from any perspective). I could easily see how people might be afraid of spinal surgery, but for me, there was no alternative. I couldn't cope with sciatica pain plus the RA. I was starting to lose it re: pain tolerance. Mine's pretty high, but I hit the wall on this one.

Back surgery gone wrong is a nightmare -- my particular surgery has a high "success" rate (~95%), but the definition of success is quite specific -- relief of the acute pain. There's no guarantee that nerve damage that causes numbness will go away, but that's livable. Some people have full recovery from that as well, but that's months down the road before you can know. I already had unrelated permanent nerve damage/neuropathy in my feet, so my expectations in that area were realistic -- as in no chance that was going away. So from my POV the surgery did what was accomplished with no serious complications.

As I mentioned, the remaining issues affecting walking (speed, mostly), for instance, are related to RA, and that's progressive/degenerative. Just have to do my best to slow it down.

Methotrexate is used to treat severe psoriasis (a skin disease in which red, scaly patches form on some areas of the body) that cannot be controlled by other treatments. Methotrexate is also used along with rest, physical therapy and sometimes other medications to treat severe active rheumatoid arthritis (RA; a condition in which the body attacks its own joints, causing pain, swelling, and loss of function) that cannot be controlled by certain other medications. Methotrexate is also used to treat certain types of cancer including cancers that begin in the tissues that form around a fertilized egg in the uterus, breast cancer, lung cancer, certain cancers of the head and neck, certain types of lymphoma, and leukemia (cancer that begins in the white blood cells). Methotrexate is in a class of medications called antimetabolites. Methotrexate treats cancer by slowing the growth of cancer cells. Methotrexate treats psoriasis by slowing the growth of skin cells to stop scales from forming. Methotrexate may treat rheumatoid arthritis by decreasing the activity of the immune system.

Monday, May 20, 2013

There's nothing like bad phlebotomy...

How about this fun -- went very early this AM to get blood drawn for labs re: methotrexate effects on my liver. They take 3 tubes of blood (took 2 tries in my left arm, bruising it a lot), then the doc office calls this afternoon to say I have to come in again in the AM tmw to do it b/c something was wrong with the tubes they drew. Geezus. My arm still hurts from the bad phlebotemy.


An update on the nausea-inducing phlebotomy experience -- something was wrong with the tubes of blood from the draw so I had to come back to do it again this AM!).

Anyway, as you can see from the photo, the bruising and swelling from the vampire-level work on Monday was unpleasant and left my arm hurting quite a bit. However, since I wasn't about to let them draw from my dominant right arm (which sux anyway, it has rolling veins) today, it was back to the left arm. This nurse was successful in getting the blood out of a vein in my hand; I left with it wrapped up to hopefully avoid what happened on my forearm.

(The wrap on my wrist is unrelated; I need those on both wrists for joint support while typing because of inflammation/damage already caused by RA.)