Saturday, June 1, 2013

Will my RA meds and travel by air kick my @ss?

My rheumatologist called yesterday evening. She's a gem; always responsive. We discussed the labs, which did indicate that I'm doing fine on the Methotrexatate (aside from the onerous side effects), and can go up to six pills (@2.5 mg, all in one dose) weekly. We talked about possibly going to the injectable route to avoid the stomach pain and nausea, but I only have that for a day or so.

My primary issues are the flu-like symptoms -- all-over body and joint aches, unnatural fatigue. Those last about 3 days. Then I have relief -- very little joint pain. The issue is whether over time I will have less days of side effects and more days of relief. I think this is week 7, so it's still a bit early to tell. I don't think I'll go the needle route for now. It's old school -- in a vial -- which makes it more annoying to deal with. I take my insulin and other injectables (Victoza, Lantus) via pen, which is much easier to deal with. At 4-5 shots a day, I'm already a human pin cushion. I'd like to avoid more if possible.

Anyway, the doctor also said that if MTX doesn't give me more relief after another month (I have to do labs again to monitor its effects on the liver for the first few months), I can try adding Enbrel back. That's another biologic sledgehammer drug. It gave me about 5 days of relief. Apparently together these drugs have been proven to be more effective than alone. But it means a real whammy those first two days on the combo.

Joint pain has been so bad this week that I've had to wear my wrist wraps even at night. My knees have been on fire. Only on Friday did I have anything resembling pain below a 4. It's been a steady 6 all week.

Ah, life with RA. Never simple, never pain-free. It's where things are.

I'm looking forward to going to NYC for my birthday (July); I hope that these med adjustments allow me to do a relatively pain-free walk across the Brooklyn Bridge. I may need to alter when I take them (I usually dose on Saturday evenings), so that I am not sick as a dog for the Sunday walk.

I think this was taken in 2007; on that day Kate, my brother Tim and I walked across to Manhattan and all the way up to Union Square. All that was possible before the fibromyalgia and the rheumatoid arthritis.
I also don't know how the air travel will affect me. Since the RA really started escalating in 2011, flying and the barometric pressure changes really hurt my joints and cause edema in my legs as well. I almost always experience a flare of bad fatigue and increased joint pain. This trip will be the first time flying since, hmmm, a long while, so I don't know what to expect. At least the herniated disc has been taken care of. Kate will have to handle the baggage, and I'll have to travel light; thankfully it's a direct and relatively short flight.

But I will do it. I have to.

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