Saturday, March 26, 2016


I'm coming to grips with an impending diagnosis of early stage rheumatoid arthritis as soon as my doctor gets around to coordinating and evaluating the avalanche of test results that have come in this week.

It's hard to state coherently how much pain I've been in for the last several months, but it has periodically been severe and debilitating. Joint pain. It began with two episodes of general joint pain -- involving practically every joint -- last summer, pain which did not respond to pain relievers -- aspirin and naproxen -- that I had been taking. My doctor recommended that I try ibuprofen, which I did, and sure enough, it seemed to help. On recommendation by a relative, I tried turmeric curcumin which also seemed to help.

After the second episode of general joint pain, the problem became one of a pattern of periodic joint pain that would center in one set of joints after another. Ibuprofen continued to control the pain until mid January of this year when the inflammation and pain seemed to concentrate in my hands and wrists and the pain was nearly constant no matter how much ibuprofen I took. I was up to as much as 2400 mg per day, and still would wake up in the middle of the night needing more.

I'd stiffen up during the night so much it would take hours for me to unstiffen enough in the mornings to even brush my teeth.

Finally the pain became so bad and so constant that I tried an old left-over prescription of Tylenol and codeine that I'd gotten years ago for back spasms. I hated taking it then, and I didn't want to now, but something had to be done. It controlled the pain long enough for me to get some sleep, so that was good. The side effects were still unpleasant, though, and I didn't want to rely on it for pain control.

So it was time to see the doctor again. After hearing what I had to say about what had been going on, the doctor ordered a raft of blood tests, x-rays, and suggested this was probably an auto-immune issue, not osteoarthritis that is caused by degeneration of joints.

She also prescribed an anti-inflammatory drug diclofenac -- which I'd never heard of -- which she said I must not take with ibuprofen. In fact she said over 800 mg a day was ineffective anyway. Oh, well. I beg to differ, but that's another issue for another day.

The anti-inflammatory helped right away. I'd s say the pain in my hands and wrists was 60% controlled almost immediately, and by the second day of taking it, the pain was almost gone for most of the day, though there was still a good deal of stiffness and swelling.

Then the test  results started coming in. At first they were ambiguous, suggestive of an auto-immune issue, but not clearly pinpointing it.

Then results came in that confirmed a  diagnosis of rheumatoid arthritis with an possible other autoimmune component on top of mild osteoarthritis.

Understanding what it is is taking me a while. My sister had lupus for the last 20 years of her life, and I really never knew what it was. She was periodically in intense pain, but she seemed to be getting along reasonably well at other times. Medication helped, and after the first few episodes, the pain seemed to diminish though it kept coming back.

My doctor tested for lupus, and that's the other autoimmune component that appears to be confirmed.

I'm noticing that the anti-inflammatory's effectiveness appears to be diminishing. From 60% control, it's down to about 40% and overnight stiffness and pain seems to be returning in force.

I'm not the world's best patient, so this is going to be an interesting time.

I'll try not to be too self-pitying!

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