Compromise

Ever since I moved to 1 mg of Prednisone per day, I've been struggling with various joints. It's now getting onto 7 weeks, I just haven't been moving well - creaky knees, sandpaper hips, curled up fingers. In late March, I talked to my rheumy and we agreed to change my Diclofinac to Naproxen and see how things would go as I didn't think the Diclofinac was doing very much. Well, they didn't go much better with the Naproxen and throw in some stomach issues, to boot. So after a call to my rheumy, he suggested I take my Diclofinac twice daily. And I move my prednisone up to 2 mg. I said no to the Prednisone but yes to the increase of Diclofinac.

The Diclofinac is not doing much better at two times per day . . . and it got me to thinking about my relationship with Prednisone. I have the perception that Prednisone is the root of all evil and the giver of life at the same time. I do not like all the side effects I have experienced and some I continue to experience, however I love the way it helps me move significantly better.

I talked to my hubby - his thoughts were that it is just a number (2 mgs instead of 1 mg) and my quality of life would improve. In the end, he is right. It's just a number and I shouldn't get too attached to it. I will get off Prednisone soon enough, but not this week or this month. I think I am holding on to this so much because it is the one thing that I can control, and while it doesn't make sense to live in pain because I want to take 1 mg of Prednisone, it seems that is what I am doing.

So, I compromised (caved?). I'm alternating days of 1 mg and 2 mg. I took my first 2 mgs last night before bed and woke up a new woman - well at least there was no obvious pain and I didn't creak as much as I used to. Damn you, Prednisone, for making me feel better . . .

Oh, med students . . .

I saw my rheumatologist yesterday. Good visit. We checked-out my mini-flare, my joints, and a quick physical exam. To help my through the final stages of my Prednisone reduction I will be enlisting the help of an old friend - Naproxen. The appointment went well - except for that pesky med student. To be fair - he is a doctor of Internal Medicine going for extra training in Immunology. So not a super green 3rd year med student - but still seemed just as green and clinical.

Now don't get me wrong - I always agree to have med students watch procedures, perform procedures, take my blood, interview me, perform joint injections - the whole nine yards. This time, however, it was beyond awkward - he just didn't get RA. Here are a few excerpts from our conversation.

Med Student: Are you sure you're flaring? Because I can't find any inflammation...
Me: Um, yes - I am flaring and there is inflammation in the following joints...

Nice. I've had RA for 19 years, but - according to him - perchance I can't recognize a flare when I see one. Perchance he can't recognize a joint if he sees one.

MS: I see you are on Enbrel. Well, Enbrel is a biologic that -
Me: (smoothly cutting him off) I'm a fairly well education patient and I've been on Enbrel for 10 months. I know what it does.

Seriously? Did he honestly think that I would take a medication, any medication, that I didn't know what it did? For 10 months?

MS: I don't see why we don't raise your Prednisone back up to 2 mg
Me: I just explained that I've worked for the past 10 months to get off of it - I'd rather look at NSAIDs as an alternative. I don't want to be on Prednisone anymore.
MS: It's not that much Prednisone.
Me: For whom?

The Med Student seemed like a nice guy, he just treated me like a number and was quite clinical about the whole thing. A + B = Flare. Not matter what the patient actually says.

He hadn't reviewed my file (I know, because I asked in one exasperated moment) - not even the last letter to my GP updated on my current status. Sigh. I usually have a good amount of patience for this kind of thing, but I couldn't help feel that he was wasting my time. I knew a 5 minute conversation with Dr. T (my rheumatologist) would solve everything - and quickly. And in the end it did. Whew, that was as exhausting to write about as it was to experience it.