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? 

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