Dare I Hope?

September 14, 2011

DH took me to my appointment with a specialist today. I think it was so meant to be that I delayed in calling for the appointment and that he couldn’t see me for three weeks. In that time my knees took the brunt of the mystery pain. I was able to go in to this appointment with full-blown swelling and a great deal of pain–proof that it wasn’t all in my head!

And as he drew out 5 cc’s of white blood cells it definitely wasn’t all in my head.

It may actually be in my genes. Everything from the chest tightness, the hand, the back & neck (not sold that the foot was ever part of is) and now the knees may be caused by a disease known as psoriatic arthritis. Psoriasis. Yes, it runs in my family–grandmother, mother, me apparently, and my sister. It turns out that my mother and my sister have both been diagnosed with one of the 5 forms of the disease.

It is a chronic condition but it does not have to be progressive if I respond well to treatment. My sister has not had a recurrence in 10+ years.

There are certain triggers. Interestingly, ibuprofen which I take liberally for inflammation and pain from work outs, can cause an outbreak. It could be why I am feeling a great deal of pain through the prescription strength NSAID I am currently on.

Stress. Just like stress can make the psoriasis flair, it can cause the arthritis inflammation to form. I would say last November I was stressed enough to trigger this. So part of it may be “in my head.”

Asymmetrical psoriatic arthritis can cause inflammation of the lungs and aorta (the chest tightness and difficulty breathing), it can attack small and large joints on either side of the body but rarely both sides. If I hadn’t had the hand already with both knees (though the pain and location in each knee is different) I would say I had the symmetrical form.

Both my mother and sister had the form that goes after the spinal column. Earlier in the summer I was having it in my spinal column as well and this would fit with the asymmetrical form.

I had more chest x-rays and more blood work. We’re going to 100% rule out Lyme. They will analyze the fluid for gout crystals. (This too can run in the family but usually not before 60–I did point out to him my mother was in her 50s–okay, I’m far from my 50s but at this point I say anything is possible. After all our family, including me, has gall bladder problems in our 20s, well before the accepted 40s.) He is ruling out a few other auto-immune inflammatory disorders too between the fluid analysis and blood work.

And he had great bedside manner. I did not handle my one experience with a cortisone shot for bursitis very well and I was not happy to be getting fluid drawn or the shot. He explained everything and even joked, “I’m wiping the area with an alcohol swab. Last time I checked, no needles are used for this part.” He had a gentle hand and I survived.

I will feel great for a few days because I’m back on steroids. I can still do E.o.t.T. as long as no cardio for a while (just 20% of what I’m used to–a brisk walk) and as long as I follow the rule “if it hurts, stop.” I’ll step down the steroid to get to the lowest possible dose that keeps the pain manageable and the inflammation away. I don’t want to be on the steroids for a long time due to the side effects of weight gain and messing with blood sugar levels. But we reevaluate in three weeks after all the results are in.

Dare I hope? At least I can be comforted that we took another step forward and I’m blessed to have doctors who believe me. I know God, the Great Physician, has had a hand in this and is working this for His will. I am comforted by this too.

I am just so grateful that even though I had to wait for this appointment, DH was still home to take me. The drive is easy but it was almost an hour away. And, well, I didn’t need any more stress…


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