Hopefully, you will recall some 5 months ago I was suffering from painful swelling on the top of my left foot just behind the toes. I finally had the 1st appt with a specialist and he arranged for xrays of my feet and hands and blood work......following are the results received today.
Nothing major to worry about with my RA. He, Dr. Fairfax, said that the medications I now take for it (Methotrexate, Plaquinel and low-dose Prednisone) are keeping it under control.....especially since it is 8 years since official diagnoses. Also, the Rheumatoid Factor in the blood test once again proved that YES I do have RA. Here's the kicker (literally, hahaha).......the massive swelling on top of left foot just behind the toes was, indeed, 2 fractures, which were caused by the RA having a flare. By the time I got in to see the rheumatologist and had my feet xrayed, the fractures were well into the healing process. In fact it was referred to as "healing fractures...." by the radiologist. Now this was already into the 4th month of pain and swelling and then just pain which got milder and milder. I wonder if had my primary care physician ordered an xray at the onset of this pain/swelling, would there have been any meds available that would have eased the swelling and pain a lot quicker than 4 months??? If any of you have a comment on this question, please let me know. I guess since I don't feel all that bad most of the time, that I should consider myself lucky that my RA is under control and that I do not have the major problems that I hear some of you comment on. I have never been unable to get out of bed, walk, and have never been unusually fatigued which I hear commented a lot. Oh, don't get me wrong, I have discomfort when bending over or holding a position too long, humidity and barometer changes etc. but if it wouldn't get any worse (is there a guarantee, haha) I can live with how it is right now. The xrays of my hands showed nothing major going on there other than phrases from the radiologist that I don't understand, but the rheumy did say "minor". I don't have any trouble with my hands other than a little discomfort now and then......and potatoes are harder to peel now than 20 years ago, hahaha! Other areas of my blood work came back ok, but he did order another draw today to compare during the last 8 weeks time. I'll call for those results. He said to call for an appt if anything flares again and otherwise see him in 2 month's time. I'm not too thrilled with my PCP right now and there is a chance that we will change to a different one in the near future, now that I know what's going on with my foot. There ya go with what went on with my follow-up visit to the rheumatologist! Please comment for me. Thank you! Have a great Friday! Charlotte in Arizona
Healing, immunity and inflammation are inextricably related. Ironically, if the inflammation is lowered TOO much, it can take longer for everything to heal (yes, you heard me right! Too much Enbrel and my paper cuts on my fingers can sit there for 2 weeks ... until I back off and wait!) So, ironically, it might be just as well that you didn't do too much too soon. Celebrex even has been shown to slow down healing of bones and tissues, especially at higher doses rather than lower. That's one reason why RA meds make us more vulnerable to infection - because the same system that causes the inflammation, kills the bugs. So SOME inflammation is necessary for life. (I went to a seminar where I work and heard a researcher talk about what happened when they "knocked out" the genes that cause inflammation in mice. Their babies didn't survive - any of them!
That's why, when I hear people asking for drugs that "stop the Ra but not the immune system" - well, I'm not sure if that's really possible. (But I'll take what I can get, within reason!) I personally have been able to back off somewhat on the typical dose of Enbrel in order to reduce my risk of infection. My rheumy did not agree with this at first - but he does at this point, because I have these occasional side effects that I watch very closely, and if I think it's due to Enbrel, I back off and see if it goes away. Then I try and find the happy medium. I had to quit Celebrex due to stomach trouble and then Tylenol because it was making my liver act up. The good news is, that in some ways I actually feel better. Since my RA was caught so early (though not before wrist damage), I think hammering it with Enbrel early on allows me some flexibility... thank goodness, because I've had foot surgery, and carpal tunnel surgery, and had to stop the Enbrel during those periods. Whew, was I glad to get back on it!
Glad to hear you're doing OK. Before you leave your doc, make sure you have copies of all your tests, etc (you don't need to tell him why, except that you want to have your own copy - you are entitled to a copy of your own records!)
I got copies of my hand/feet xrays and the blood work results too.
Thank you for your comments. Very interesting!
char
Great!
Looking back at what I wrote, I don't know if I was very clear .... healing involved the body fighting off germs just so things don't get infected - that's where the germs, healing and inflammation all happen together.
I for one almost never get a real fever. My body temp is rather low (94 - 97). So 98-99 is 'high' for me. I sometimes get what I could call 'fever flashes', almost like hot flashes, and i'm not really sure sometimes what is going on, unless I don't feel well.
Anyway, that's great that you seem to be moving forward - go for it!