Rheumo visit results (or lack of, lol)

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Aldo
Regular Member


Date Joined Jan 2006
Total Posts : 289
   Posted 7/4/2006 11:55 AM (GMT -7)   
Boy, I got a very thorough exam from this doc. He checked everything I had and more. Yesterday I was into my 11th day of corticosteroids dosing packet. Some pain and swelling in my hands/joints had disappeared. He checked my forearm nodules, moved all of my joints.
 
Diagnosis:  Arthritis of unknown origin, and arthralgia......Took more blood for further testing. I tried to remember the specific test types he ordered but...I do remember 1) Thyroid 2) CPK 3) CRP 4) ANA.....xyz, etc :)
 
I have not slept for more than 2 hours at a time for 11 days. Life is surreal. Bout finished the steroids....Things will be great! I will see the Rheumoman in 2 weeks. I think that I will need more chest x-rays. I have had so many due to the ticker and exposure to all the rodioactive contrast dye during caths and ct scans.
 
Thanks again to all, and have a great 4th,
 
Rj

Ducky
Veteran Member


Date Joined Mar 2005
Total Posts : 3199
   Posted 7/4/2006 3:55 PM (GMT -7)   
Hey Aldo... wow, sounds like you have been run through the mill... What meds is your rheumy going to put you on for your arthritis? Or is he waiting to see what the bloodwork says in a couple of weeks? Hope you are well... Happy 4th to you as well!

Duck
Confirmed Diagnosis of - Psoriatic Arthritis/Spondylitis/Graves Disease/GERD/Scoliosis/Hiatal Hernia/Graves Disease of the Eyes/Chronic UTIs
Current Meds -  Enbrel/Prevacid/Synthroid/Nitrofurantoin
Past Meds - Inderal/PTU/Prednisone/Voltaren/Feldene/Mobic/Cortisone and Steroid Shots
Additional Supplements - Multi-Vitamin/Bromelian/Acidophilus/Green Tea


Aldo
Regular Member


Date Joined Jan 2006
Total Posts : 289
   Posted 7/4/2006 6:51 PM (GMT -7)   
I saw pamphlets on the Enbrel and Humira (sp) in the waiting room. He only said that we can make you feel better or more like excercising, after he had told me that I was going to lose muscle mass if I did not start excercising. I told him that that had been impossible.

Just fininshed 2 sleepy hours. The body ache/joint aches that had left appear to be coming back. Waiting to take pain meds to see what this goes to. My head is still wrecked. I have never been so disoriented and paranoid. Sorry to be so gloomy. I was looking forward to getting off the dexamethasone. I realize now that the pain can come back. I can deal with the pain better than the steroid.

I don't want to have to start any other medicines because I take so many ticker medicines. I hope than Enbrel or the other is not contraindicated with my current meds. Have folks had good luck with any of these, w/o side affects?

Thank you

Ducky
Veteran Member


Date Joined Mar 2005
Total Posts : 3199
   Posted 7/4/2006 7:03 PM (GMT -7)   
Hey Aldo - I have been very fortunate with the Enbrel. I didn't think I would find anything that would take away my pain... the Enbrel has made my arthritis much more livable. I can actually function like a normal person now. I still ahve some bad days, but for the most part, I am good to go. I take a slew of different meds too, and so far, I haven't had any bad interactions with them. I haven't had to have any steriods since the Enbrel either. Hang in there Aldo, there is a light.. I promise... Duck
Confirmed Diagnosis of - Psoriatic Arthritis/Spondylitis/Graves Disease/GERD/Scoliosis/Hiatal Hernia/Graves Disease of the Eyes/Chronic UTIs
Current Meds -  Enbrel/Prevacid/Synthroid/Nitrofurantoin
Past Meds - Inderal/PTU/Prednisone/Voltaren/Feldene/Mobic/Cortisone and Steroid Shots
Additional Supplements - Multi-Vitamin/Bromelian/Acidophilus/Green Tea


erin.K
Veteran Member


Date Joined Mar 2005
Total Posts : 3148
   Posted 7/5/2006 10:00 AM (GMT -7)   
Rj,
Ah sorry man! I know how terrible this is. And the stinkin' steroids although they help with inflammation, they sure make life difficult.
Hey, you're radioactive?....So that means you must have a great glow to you! LOL
I live in NJ so I was born radioactive....don't even need radioisotopes for scans/MRIs/CTs... ;)
I don't believe Enbrel will interfere with anything. But most likely you'll need more bloodwork than others & be extra careful for infection and such.
I have some heart problems so I can't really have any dental work done while on these immunosuppresants...and I go for bloodwork almost every 2 weeks.
Hang in there tiger.
erin
Active, Severe Rheumatory Arthritis. Crohns. AS. Chiari Malformation & Right Brain venous anomoly. Partial complex seizures. Emphysema. Rheumatic Lung & Heart. MVP and Tricuspid prolapse. Had Lymes disease for 10 years.
Meds: Humira 40mg Q 4 days; Pred 20mg prn; Pentasa 4G daily; Imuran 50mg; Dilaudid 4mg; Diazepam 5mg; Avinza 30mg; Reglan; Meclizine; LidoDerm; MiraLax & too many others.


Aldo
Regular Member


Date Joined Jan 2006
Total Posts : 289
   Posted 7/5/2006 2:08 PM (GMT -7)   
Thanks so much guys :) Your encouragement means a lot to me. Maybe I can repay some of your kindness, some day. I was waiting around to croak from heart disease and wham, sumpin new to deal with. I am a big whiner right now. I am in a new world now, and am not that brave at all.

I had no idea what a toxic dose of dextramethasone I was taking. The max recommended does of 9mg/day for 5 or 6 days I took. This max dose CAN BE adjusted up, much to my surprise. I have read that my adrenal cortex could become deficient in the natural production of cortisone. Whow, I don't know if this one time deal is enough to do it or not. I will never take this medicine again. Never ever. The pharm company that makes the Dexpak is EPS Pharmaceuticals. On their website, it says the dexamethasone (Dexpac) is for treatment of poison ivy. What a joke-eh? I have also had a prior stroke and I read where nutty folks shouldn't take steroids due to psychotic reactions. My BP has went beyond control.

I have an appointment tomorrow a zillion miles away at a pain management clinic. I wonder how that will go. I think I will be short and to the point. I am not begging for pain medicines. If needed I can buy them off the street, probably. I have heard of this all of my life. We have docs and pharms that have been doing this for years, or it comes out in the papers. I am planning for all possible options. Don't want a doc looking down their nose at me. Heck, I can start the whiskey, if I ever again am well enough to drink it.

Pain meds: Do they combine opiates with tylenol or ibupropen in order to stop an accompanying headache? I really need a tad of "euphoria" right now. I come close when the pain med I have now, hydrocodone plus, stops my physical pain. It relieves my mental pain also. I would really like to get a bottle of PGA and sit in the corner for a few days. I can't though, I am too sick.

Please advise on the best pain med if possible. I know the oxy. is a no no, because of drug addicts abusing them. I surely do not consider ANY OF YOU as a drug addict. I don't want to be high, just without pain, both physical and mental. Years ago, I was injected with demorol during a kidney stone and I immediately could have cared less about the stone. I am bad to get a headache from hydrocodone. Morphine is good for a sick heart. I forget why, but they will max you out on it. I have been in and out of hospitals for 3 years. I always get a headache and become kinda mean from the injections.

I hope that all of you are as well and happy as possible. Thanks again for listening to my outrage :)

Rj
 
P.S. I saw these steroid equivalences on a pharm info site. If you take 9mgs of the dex, is that considered very strong?
 

DEXAMETHASONE 0.75 mg is equivalent to:

Methylprednisolone & Triamcinolone 4 mg

Prednisolone & Prednisone 5 mg

Hydrocortisone 20 mg

        Cortisone 25 mg

 
 

Post Edited (Aldo) : 7/5/2006 3:37:53 PM (GMT-6)


cbrossman
Regular Member


Date Joined Apr 2005
Total Posts : 191
   Posted 7/5/2006 7:22 PM (GMT -7)   
To the best of my knowledge, 5mg of Prednisone is not very much. I was eating 20-30 daily at my worst, though that was only for a few weeks.
Erin will probably know better anyway ... Craig

Aldo
Regular Member


Date Joined Jan 2006
Total Posts : 289
   Posted 7/6/2006 6:46 AM (GMT -7)   
Thanks Craig a bunch. If my math is right, I was taking an equivilant dosase of 60mg/day of Prednisone. (9mg/.45=12) * (5)=60mg prednisone.
Also the same as 300mg of cortisone/day.

I am just trying to understand what hit me, and if I am extremely sensitive to corticosteroids. Well, I have no doubt about the medicine helping my A or RA. It is just what it did to my head!

Thanks again and be well

Rj

erin.K
Veteran Member


Date Joined Mar 2005
Total Posts : 3148
   Posted 7/9/2006 7:42 AM (GMT -7)   

hey there Rj,

with inflammatory diseases, a whopper of a dosing schedule of steroids are used for "short term" stages.  so 40, 50, and 60 mg of prednisone for example is routine for flares and acute phases.  i am "supposed" to be on 5mg of predisone daily and that was over 3 months ago! tongue but i never took them unless necessary, because well you know....we've had the roid rage conversation already.

when i get steroid injections, they are 60mg or 80mg of DepoMedrol at a time.  so with the dexamethasone...you'l most likely taper down to less and less of a dose as the weeks go by right?

the adrenal insufficiency is correct.  that's why the steroids are "saved" for acute flares.

so much fun eh?

ciao

erin


Active, Severe Rheumatory Arthritis. Crohns. AS. Chiari Malformation & Right Brain venous anomoly. Partial complex seizures. Emphysema. Rheumatic Lung & Heart. MVP and Tricuspid prolapse. Had Lymes disease for 10 years.
Meds: Humira 40mg Q 4 days; Pred 20mg prn; Pentasa 4G daily; Imuran 50mg; Dilaudid 4mg; Diazepam 5mg; Avinza 30mg; Reglan; Meclizine; LidoDerm; MiraLax & too many others.


Aldo
Regular Member


Date Joined Jan 2006
Total Posts : 289
   Posted 7/9/2006 3:50 PM (GMT -7)   
Hey Erin :)

Life is a blast, yeah for sure, lol. My joint pain is good today. The muscle pain is ok. The steroids did their thing I guess. I can never do that again though. I will crawl around before I take those doses! I finished the meds about 5 days ago. My knuckle joints are swollen and tender on both hands, but not like they were 2 weeks ago.

My biggest problem now is gastroooooh. I am eating like, baby food, lol. All things bland. Zantac is my best friend :)

I cancelled my pain management clinic appointment for last Thursday and rescheduled it for this coming Friday. I wanted to see how my pain went....or don't went :) I am taking Tramadol now, and it is helping. Have you ever been to one of these clinics? I am going to feel like a hypochondriac when asked to explain what is hurting. What ain't hurting, lol?

I see many hellacious, nightmarish conditions in your signature. Life must be, well heck, life is what you make it, right? We all do the best that we can with what we have. I asked for many of my problems, I think. Not A or RA though. I burned the candle at both ends (OUCH). I traded in my tomorrows for yesterday, a long time ago (stole that from a song writer) If I knew that I was going to live so long, I would have taken better care of myself. I am 53, going on 93, lol.

I just hope all of your conditions are kind to you at least sometimes....I wish all times. At least we can share our misery.

Be well and as happy as possible :)

Rj
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