Monday, December 31, 2012

Unexpected development on the health front.... 

Saw the rheumatologist on December 10 for my routine checkup. Didn't even bother to mention it here because the nothing had really changed in terms of treatment for the past year. The doctor was only agreeing to see me every four months because I wanted to keep my records updated for Social Security disability, not because she thought such frequent visits were mandatory.

My pain level was quite high, particularly since I had not recovered from a 48-hour visit to see my sister in a neighboring state on Thanksgiving. But it has been that high before with nothing new noted by the doctor. This time, though, she thought it was significant that I yelped every time she tried to flex my toes and that swelling was present in my feet which was not caused by hot weather; at the time of the appointment, the temperature outside was minus 4 degrees.

The rheumatologist ordered x-rays of both feet and an MRI of the left one, which for the past nine years has consistently been more swollen than the right. The results of the MRI that was done in 2003 indicated edema, and the x-rays done in 2004 showed mild degeneration. These were not considered significant by this doctor when I became her patient.

Honestly, my hips and neck have been bothering me much more than my feet the past couple of years. But I went ahead with the x-rays, figuring the feet would look the same as they did in 2004. The MRI was done three days later. 
Surprising news from the rheumatologist's office on Thursday: the MRI of my left foot revealed degenerative changes. Synovitis and bursitis in addition to the non-specific edema I already knew was there. I now have an appointment with the rheumatologist January 28 to discuss treatment, which may include prednisone or methotrexate. 

Interesting that my rheumatologist was so sure that my Sjogren's, which can cause autoimmune arthritis, was dormant that in 2010 she took me off the Imuran that the Mayo Clinic had prescribed in 2008 (she probably would have dismissed the Sjogren's diagnosis altogether had it not been confirmed by three rheumatologists in the past). She was blaming my worsening symptoms the past year on the fibromyalgia. While I know the fibromyalgia has been a significant player, it does NOT cause joint degeneration or the elevated c-reactive protein levels I've had for the past 15 years. 

So NOW she's going to take me seriously. I think some rheumatologists just don't believe the findings of previous experts until they find something wrong themselves. It's disgusting that the chronically ill often have to prove over and over that they are sick. It gets to the point where we actually get a little excited when they find something wrong with us, which is awful because it can mean treatment with very toxic medications. Nevertheless, part of me is a bit relieved that there is a reason (in addition to the fibromyalgia) for the intensity of the foot pain.

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