Thursday, May 31, 2012

Two Steps Forward, Six Steps Back

By sunshinegal43oh Thursday, August 12, 2010

I've had a rough past couple of days! I do my Methotrexate pills and Enbrel injection on Sunday evenings. So by Saturday, I was feeling stiff and swollen, so I could tell it was time for the meds! Normally, on Sunday evening, my symptoms wind down and the meds allow me to have a good week at work.

This week, unfortunately, the meds seem to have lost their luster! I woke up in a cold sweat in the middle of the night Sunday night. I was SO stiff and swollen that I had dreamed I was paralyzed! I literally couldn't move. And this trend has continued through today!

I've read several posts where people say that the biologics stopped working for them after a certain point. I was doing so well on Enbrel- within the first two weeks I felt symptom relief! I'm hoping this is just a flare that will eventually die down...that my Enbrel will again kick in and all will be well!

I can't see my Rheumatologist until 9/1- I can't go to an appointment during working hours, so I have to hold out for two and a half weeks to get an appointment after work, which kind of stinks! By that time this flare will be over and done with, and once again my Rheumy will not see my symptoms at their worst!

Yesterday, I couldn't get out of bed! I've burned through all my vacation and personal days fighting flares. I can qualify any further work absences with FMLA, but I lose my pay doing that! Kind of defeats the purpose LOL I guess I could get my Rheumy to approve me for medical leave. If I'm out over a week the insurance kicks in and pays my salary, so I'm not out any money.

Back in the winter time, when I was having a lot pain caused by my RA- I couldn't get any sympathy from my co-workers, bosses or human resources. In fact I got quite the opposite- I was put on a "performance review". I was told that for that 90 day period I couldn't miss any work. So I did what I was told, even though some days I felt horrible and couldn't function very well. So I made it through that, and so far I've missed two days of work. One day in July and then this past Monday.

Monday was the worst for me, though. I can say, hands down, that on Monday my symptoms were the worst they've ever been. I could barely get out of bed. I made it to my dining room table (using the couch for support) to grab my cell so I could call in to work. I was going to take a half day, but when 11 a.m. rolled around I still felt awful, so I took the whole day.

I'm still not up to par, and was a nervous wreck coming into work today. I was sure my company was going to fire me when I asked for FMLA for Monday's absence.  I have had a lot of trouble with my company's HR manager picking on me about my attendance. 

Instead the HR manager was quite kind to me and just asked that the next time I see my Rheumy that I get her to fill out new FMLA paperwork so she can keep my account up to date. I was floored! I have no idea what brought about this change of heart in the HR manager! She even commented that she understands "how painful your condition can be". She said, "Help us help you" by making sure your paperwork is up to date.  It made me wonder if she'd done some research on RA? Or if someone in her family was suddenly diagnosed and struggling with the disease? I have no clue. But I do know this- I don't trust her as far as I could throw her (which wouldn't be very far!)! I just feel like something is lurking, waiting to rear its ugly head! It's terrible when you can't trust the people you work with!

8/12/10 4:32pm

Hey Shine

Are you beginning to notice a recurring pattern in your life? First it was Pain in the Doctor and now it's Pain in the HR Manager. Seems to me like you are attracting the wrong kind of people. Maybe you are going through life alphabetically and once you get past the P's you will be okay. I don't really have anything useful to add, just sorry to hear that you are having so much trouble but glad to hear you have good friends.

One word of caution, don't eat PITA bread sandwiches they would definitely be detrimental to your health.

Hope to hear the "shine" has come back in your life real soon.

All the best

Chuck 

8/17/10 12:40pm

Chuck,

 I am noticing a pattern! Your comments are awesome! You always make me smile and laugh!

I applied for FMLA leave due to this RA flare, and pain in the HR manager ended up being really nice to me. I don't trust her at all, but I think she's being nice because of some new ADA changes. She's afraid of getting sued! HA!

8/12/10 4:32pm

Hey Shine

Are you beginning to notice a recurring pattern in your life? First it was Pain in the Doctor and now it's Pain in the HR Manager. Seems to me like you are attracting the wrong kind of people. Maybe you are going through life alphabetically and once you get past the P's you will be okay. I don't really have anything useful to add, just sorry to hear that you are having so much trouble but glad to hear you have good friends.

One word of caution, don't eat PITA bread sandwiches they would definitely be detrimental to your health.

Hope to hear the "shine" has come back in your life real soon.

All the best

Chuck 

V, Health Guide
8/12/10 7:56pm

Hi, Shine. I am so sorry to hear you are in that much pain.  I know what you mean about coworkers.  So many people in our society are self-absorbed.  I always say they wouldn't notice someone in the middle of the floor bleeding to death, so why should we expect them to notice someone struggling with pain?  I don't know all the ins and outs about the ADA laws, but Lene does. I think you should send her an email. Maybe the HR person finally figured out she better treat you a little better because of the ADA. Then again, maybe not.  I wouldn't trust her either.  I certainly hope you feel better soon. Try to relax and get some rest this evening. Sending you some warming, healing, virtual "rays", so you can build up your reserve and truly let your sun shine again.  Hang in there! Cool

Lene Andersen, Health Guide
8/13/10 12:29pm

Would it be possible for you to take a day off to go see your rheumatologist? It sounds as if you think it's important that they see you during a flare when your symptoms are really bad.

 

There are people for whom the Biologics stop working - it can happen with any medication, not just Biologics. You don't mention how long you've been on Enbrel - if it's a relatively short time, it could be that you haven't built up enough in your body to handle the flare. However, if you have been on Enbrela member for a while, you may need to increase the dose. The fact that your symptoms usually come back before your next shot and pretty much like clockwork seams to indicate that either you haven't been on the medication for more than a month or so - Enbrel usually takes a couple months to hit maximum capacity - or that you need a bigger dose. Ideally, as long as you're taking your medication on a regular basis, you should not experience a recurrence of symptoms unless you're having a flare.

 

In terms of your job, I recommend you check out my post on working and RA. As someone who lives with a chronic illness, you are legally entitled to accommodation under the Americans with have disabilities Act. My post has links to government resources at the Job Accommodation Network that can help you identify which you can be accommodated at work and put together a strategy for approaching your boss about it. Or rather, the human resources staff. It sounds as if she has realized that exposing you to a performance review and penalizing you for being sick is in fact discrimination. Make sure you put everything in writing and get everything in writing from her, as well. The people at the Job Accommodation Network will be able to help you with this issue, as well.

 

8/17/10 12:44pm

Lene,

 Thanks for your advice and insight! My Rheumy can never fit me in when I'm having a flare. When I first called the earliest appt I could get was 9/1. When I called a second time they could get me in tomorrow at 4:00p.m. Unfortunately for me, my symptoms will have probably settled down by then! Dang it! I did see her once a while back when I was having a flare, and she said she couldn't feel any inflammation in my hands, and felt a little in my toes. I'm not sure about this whole "feel inflammation" thing. What if there is no swelling but inflammation on the inside? Who knows. But I'm hoping tomorrow will be a good appointment! Trying to think positively!

Lene Andersen, Health Guide
8/17/10 9:11pm

usually,inflammation is quite obvious to the touch - it makes the joint feel sort of squishy. However, there is such a thing as no swelling active RA, although it doesn't happen often.

 

If you're having trouble connecting with your rheumatologist, have you considered getting a second opinion? It can be difficult to get into see your rheumatologist - they're often very busy doctors, but if you're having an emergency, you should be able to at least be able to speak to her on the phone. On the other hand, if she is responding appropriately to your concerns - e.g., giving you a boost with a temporary dose of prednisone, increasing the dose of your current meds, etc. - that's really what you're looking for. But if you feel that she doesn't believe you or doesn't react to you having a flare, then perhaps interviewing another doctor might be a good idea.

8/16/10 10:50am

Sorry to hear you're having a hard time. What about having someone take pictures (or a video on your phone) of the places that are swollen and sore then you can show them to your Doc if you can't see him.

8/25/10 8:48pm

Becky,

 I would never have thought of this on my own! Thanks so much for this fantastic idea! I'm going to do just what you suggested. Take pics and video to show to my doc the next time I see her.

 Thanks again for such an awesome suggestion!

Amy

By sunshinegal43oh— Last Modified: 09/20/10, First Published: 08/12/10