Wednesday, June 26, 2013

Rheum visit: adding Enbrel (w/MTX) and maybe a steroid for my NY trip

Went to the rheumatolgist today for a follow up; so I was sitting in the doctor's office, looking at updates on the SCOTUS  DOMA and Prop 8 rulings while I waited. Mixed news, mostly very positive; it will be delayed gratification and legal gray areas for those of us in states with marriage amendments.

Sort of like the news today on the health front. That's nothing out of the ordinary, though.

My labs this month didn't show anything significant re: my liver, so I'm going to continue taking MTX.

Because I'm having new difficulties with pain in my ankles and knees (I'm now wearing braces), as well as my elbows, she thinks we should try adding Enbrel back into the mix. I was on this last fall before I needed back surgery, so we decided to try MTX, since it doesn't require a weekly injection. I already take 3-5 needles a day so it's nice to avoid additional sticks if I can.

Since MTX is not only making me sick for 1.5 days a week, but is giving limited relief, adding Enbrel is not uncommon. For some reason the findings are that together they are more effective than alone. This Friday I'll dose both and see how sick I get on Saturday.


Prednisone or not?

The other development is that next Friday we go to NYC for my birthday weekend -- and my Brooklyn Bridge walk for my 50th. I don't want to be sick in my hotel room, writhing in my bed all day Saturday, so I'm skipping the MTX and Enbrel for a week.

The rheum said I could do this, but since I'll be more active than usual, I need to be careful about fatigue and increased joint pain. To mitigate this, she's prescribed my some prednisone (steroids), to take for a week. She also said to pack Zantac and Aleve to deal with GI issues and the latter to assist in pain control.

I detest steroids -- they mess with your blood sugar control, make you gain weight and retain water, and you're hungry and thirsty all the time.

So it's my choice -- I can skip the steroids, roll the dice and risk the walking and being off schedule (and dealing with ramifications of flying and barometric pressure changes on pain) debilitating me on the trip. Or take the steroids and deal with those side effects and have the pain better managed.

I am not sure what to do yet. I'm also packing some compression socks to deal with the edema in my lower legs from flying and the extra walking. Turns out she said if I take the steroids my legs may swell even more. Argh.

It almost makes you not want to deal with travel and being off schedule. But this is my life now. Every action can have dire consequences - pay now or pay later.

And I will not be able to re-dose my MTX and Enbrel until a full week later. She wanted met to dose as soon as I returned home (Wed), but I can't -- I have to be able to go to work on Friday and can't be out sick dealing with med side effects. That's the whole reason I take it on Fridays, so as not to interfere with my ability to work.

Sigh. I get tired thinking about this. I really don't want to take the prednisone.

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