Monday, April 13, 2015

The Self, the State, and the State of Self

DS1 brilliantly defended his senior thesis this afternoon. I was a bit late - driving over to his school always takes longer than I think it will, and then there's the need to park-- but I only missed the first few minutes.  By the time I arrived, he was settling in to the groove of addressing the very tough but fair questions his panel of professors addressed to him.  I asked him over the weekend if he wanted to practice, but he assured me he didn't need to; he loves to talk about this stuff.  It was evident in his responses, which consistently referred back to his source material even if they did get a big circular at times (glimpses of the old expressive fluency issues, coming to the surface.)   Still, he made his professors think in a new way about personal "truth," not as something that just happens inside your head, but as something that you act upon and build your life around.  It was obvious that it was a new idea to them all, and there was some push back, but that's not a bad thing.  I am extraordinarily proud of him for making them re-evaluate their approaches to the question of truth.  It was fascinating.

This year has been marked by huge accomplishments by all the offspring (as I often call them.)  DS1 with his thesis, DD with her brilliant musical composition, and DS2 in becoming a more active participant in his own life by auditioning for, and winning a spot to perform at, the Titan Triad and going out for the track team.  After 18 years I'm seeing the first indications of the adults they will become, and it is literally amazing.  I am so often overwhelmed these days, but I will never mind this feeling of my heart being too full when I see what my children can do.

Saturday, April 11, 2015

meloxicam, day 3

So far my impression is "meh."

It has done a good job of reducing swelling, so I'll give it that.  But pain in hands, collar bone, hips, etc is all still there, just slightly less -- say a 4 on the pain scale instead of 6.  So that's better. 

However, neck pain is nearly as bad as if I were taking nothing.  The ibuprofen did a much better job controlling that.  This is not muscle pain but pain at the vertebrae themselves.  It feels "crunchy" (which makes me think bone-on-bone, but I don't think it's that bad) and it hurts.

Headaches range from ignorable (1-2) to killer (7-8), which is pretty consistent with the ibruprofen.  I intensely dislike it when my front teeth hurt...

Worst of all, though, is the reflux.  I had a smidge of heartburn yesterday (Thursday, day 2), but today I feel the way I did years ago when I had gastroparesis and my gerd was out of control.  Sick.  Popping some calcium antacids helped; omeprazole would've been better but we're out. I'm not willing to get back on a drug I worked hard to wean myself from (omeprazole).  Even one day of reflux left me struggling with my voice today.

On the upside, trying to keep the reflux down encouraged me to drink tons of water today.

I don't think this is the drug for me, but I'm not sure how much longer to give it before I say "enough". I have been taking it before bed (about midnight) to help mitigate that side effect, but that hasn't been entirely (or even moderately) successful.

I'm not taking any more tonight -- I'll investigate more tomorrow and figure out if I should try to tough it out another couple of weeks, but I don't think that makes any sense.

Thursday, April 09, 2015

pain management

After an inordinate delay caused by the insurance company's long telephone wait times, I was finally able to get in to see my new rheumatologist on Tuesday.  I have mixed impressions but I'm trying to remain open about the experience.

First off, his manner is a complete 180 from my previous rheumatologist, was a nurturer and very much into building a relationship.  New doc is all business and brusque, and that's OK, except he seemed to be discounting everything I said: when I told him I had RA, he challenged the diagnosis, going so far as to examine - without explaining what he was doing and why - every joint in my body (literally). 

I want to say that it was his tone that made his questions ruffle my feathers, but that's not quite true: When Dr. P diagnosed you, do you happen to know if your lab test were positive?  (I said I didn't know, but I have a feeling they were not...)  Then: How is your anxiety?  (I told him I was feeling stressed because I was concerned about getting to my class on time.)

He pretty much completely dismissed the problem with my neck, saying that arthritis rarely strikes the spine -- to which I replied, it could be osteo, but the MRI showed arthritic changes -- and his response was, "You probably have a disc problem." 

No, I don't have a disc problem, and I know that because I finally got the MRI report from my doctor's office today and it specifically says that the problem is not a disc problem.  So there.

He ordered a billion tests (I had the blood drawn yesterday) and put me on a once-a-day NSAID called meloxicam, 15mg/day, which is interestingly double the normal starting dose.  I started it Tuesday night so I have had 2 doses and I have noticed that it is helping tremendously with the swellng, but not the pain, as my hands are still killing me and my neck is now giving me more issues than it did when I was on the ibuprofen, plus the return of the ever-so-delightful headaches. 

OTOH, I have lost a few pounds of the fluid I was retaining and I'm happy about that, and my fingers don't look like little fat sausages every morning -- yesterday I could put my rings on almost right away, but today, again, I had to wait about 2 hours before I could wear them on their proper finger.

I'm seeing him again on the 28th, and I'm praying that my bloodwork shows something "real" because he seems like he might be one of those doctors who needs labs to back up a diagnosis, even though 25-30% of RA patients don't have RA factor.  All I know is, I'm miserable, and if it's not RA, what is it? 

Monday, March 23, 2015

spring

That month was a blur.  I expected to be less busy after science fair, but the two classes I am taking are keeping me hopping, mostly because I keep implementing stuff I am learning.

Also, I'm falling apart (again).  My RA is still flaring unbelievably, to the point where round-the-clock ibuprofen is having next to no effect, at least on my hands. (I've given up - I'm trying to get in to the rheumatologist for pain management.)  But the real kicker is my neck, which has been bothering me since the beginning of the year so I finally went to the doctor, who ordered an x-ray (first).  You know it's bad when you can see the problem on the x-ray.  I had the neck MRI on Friday and I'm waiting to hear what my next steps will be: most likely physical therapy, maybe a brace, but I need something to manage the pain.  600 mg of ibuprofen 3x/day as a therapeutic dose like I did last time is helping a bit but not completely. 

Then there are the headaches, which are not back-of-the-head headaches that I would get from my neck, but middle-of-the-head, behind my eyes headaches, sometimes my front teeth hurt.  This makes me nervous that it has to do with the pituitary adenoma, because I've also noticed light sensitivity and a couple of brief moments of double vision.  When I saw my eye doctor for my annual eye exam, she was concerned about the size; 11 mm is about the size that starts squishing the optic nerve, so I'm going for a vision field test to see if my peripheral vision is affected on Friday.  I'm glad I'm seeing her soon because I'm not happy about this.  I shouldn't be having headaches when I'm on 600 mg of ibuprofen...

Of course my weight is up because of all the inflammation (RA), the bad sleep, the ibuprofen which messes up my insulin metabolism. Sleep is OK with the ibuprofen but still not that good, which isn't helping either.

Meanwhile, my unit plan is due Thursday and there's gobs I still have to write up for it; plus I have to grade last week's 8th grade quiz in advance of tomorrow's test (and 7th grade quiz), and we're launching my new physics unit on Wednesday and I'm simultaneously excited and terrified.  If I felt physically better I think I would be mostly excited and only a little terrified, but since I feel so beat it's about 50-50.

So I have summer plans already, going to Mom's early in June, solo; the kids and DH will come out later.  DH will have his two weeks, and the kids will stay until the end of July.  DD is taking a summer oceanography course at WBNERR, and I've applied for the teacher course the week before (fingers crossed).  Plus I'll be working on revamping the science fair as a portfolio project, and I'm thinking that might be for credit -- so that would be two different independent studies over the summer...

... but I am NOT taking two courses during the school year ever again. 

Wednesday, February 18, 2015

OK, part 2

The MRI went well on Monday, once the insurance company found me in their system, and after only 3 failed attempts at putting in the IV for the contrast.

I hate MRIs because the noise is so startling, but when you're having a head MRI, they put foam around your head that helps a lot.  If I ever have to have an MRI that's not for my head, I'm going to ask for the head gear anyway, because otherwise I feel like I'm under attack (literally) from all of the loud banging sounds surrounding me, getting louder and louder until they suddenly stop.  And then start up again with little clicks that progress to a different cadence of loud banging.

I keep my eyes closed the entire time because I'm pretty sure I would freak out if I saw how confined the space is.  And I pray; that helps a lot.

The very cool thing about going through Banner/MDA is that all of my records are uploaded on to their myBanner website, so I logged on Tuesday to get the report.  I don't have it in front of me and I'm too lazy to download it again, but: results consistent with adenoma (which means benign); no unusual vascular activity (so, no sign of cancer building up a blood supply) and no sinus cavity invasion (it's not so big it's growing into my sinuses).  It is bigger than normal, there is definitely a mass there, and there is "leftward deviation of the infundibulum," which means the mass is pushing the pituitary stalk to the left.

I still haven't heard from the doctor, but I'm not sure about how or when that will happen (it may be up to me) , but it seems to me that none of this is particularly worrisome.  I'm asymptomatic and the mass is non-functioning and my pituitary function is fine, so there's no reason to do anything.

I suppose we'll just keep an eye on it.  An annual CT may be just the thing, less trouble and expense than going through the Thyrogen protocol, and I can check in on the mediastinal nodule and the pituitary adenoma in the same test.

Sunday, February 15, 2015

Yay!

Did I say I'm slightly less grumpy about science fair since two of my students took first and second place at the district science fair?  Only slightly, but still - they made me look good.

I finished grading, entering, sorting, and stacking all the science-fair related materials at about 2:30 this afternoon.  I'm trying to tote up the number of hours it took: 3 hours Friday at school and then 5 hours at home and then 2 hours Saturday morning and a marathon 8 and a half hours Saturday night and then another 3 and a half today... that makes 22 hours, right? 

Thank God we have a 3-day weekend.

I am so very appreciative of how quickly I can read, how consistent my snap judgments are, and how good my addition and subtraction skills up to 100 are.  I can't imagine getting through that amount grading if I were any slower. Plus, my organizational skills came to play: I put together a one-sheet listing of all my students so I wouldn't have to be rifling through stacks of paper while I was grading their display boards.  Brilliant, and a great snapshot of who-did-what.

I haven't taken any ibuprofen today and I don't feel too bad.  I'm hopeful that my flare is subsiding now that huge stress is in the past.

Head MRI tomorrow morning, and then basically nothing, so I can get caught up on my homework and my sleep.  Glorious!

Monday, February 09, 2015

OK, part 1

Saw my endocrinologist today, and happily, all my pituitary-related labs are fine. 

She (mildly) harangued me to see my rheumatologist about this flare that is killing me, although it does seem to be letting up.

I'm getting the MRI done anyway.  Endo doesn't think it's worth it, since she says, "There's no baseline, so you don't know how big your pituitary was before anyway."  However, I have had quite a few looks at the inside of my head over the past decade or so and no one has ever remarked on my pituitary before, either from CT or MRI scans.   Even if it's benign and not pumping out hormones, it can still mess me up if it gets too big. 

Still haven't graded a bit for the science fair, but am feeling fairly well caught up on everything else, so I hope to start grading all that ... tomorrow.  Maybe.