Tag Archives: rheumatologist

And You Thought Nothing Good Came From Ankylosing Spondylitis

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Image courtesy of webmd.com.

For five years, I have been battling chronic pain. My issues began with a botched vasectomy and I seem to have picked up new aches along the way. I don’t know if all of these issues are connected or not, but does it really matter?

My damaged ilio-inguinal nerve has generally calmed down, but over time I have been enduring increasing pain in my joints. My lower back has been weak for years, but I never paid it any mind. As a matter of fact, I was diagnosed with mild osteoarthritis which led me to ignore my back pain. What can you do about osteoarthritis anyway? Take NSAIDs? I can’t because I’ve already had one ulcer. I don’t intend to get another.

Then came the gout diagnosis. My uric acid level was over 9. My understanding is you want it below 4.5. My ankles felt like crushed glass. It had to be the gout. Maybe my knees were gouty. I chalked all of my lower joint pain to gout. Allopurinol should solve that.

As I became more aware of the different pain sensations and from my internet self diagnoses (believe me, there were many), I learned that gout typically doesn’t affect the same joints on either side of the body. I had white hot stabbing pains in my flat feet, but my knees and ankles had more of a crushing, radiating pain. There was no relief from the allopurinol, either.

By now I was so flummoxed I finally decided to see a rheumatologist.

Probable diagnosis: ankylosing spondylitis. It has a nice ring to it. Plus, my first Humira self-injection a week and a half ago feels promising. At 38, I still feel like I have the body of a 70 year old, but the pain is much more bearable. It always gets worse at night, but I actually had zero pain in my knees this morning. I have also been able to get around with relative ease in the morning the last few days.

It’s normally a chore to get out of bed. Oftentimes, I wake up and watch television at least a half hour before I dare to put my feet on the floor. It’s as if I’m beset with rigor mortis. Then, I get up to brush my teeth and sit on the couch awhile. The rest of my day consists of a trip to the grocery store along with another errand or two, picking up my oldest daughter up after school, and if I’m feeling especially spry, cooking dinner. Leftovers have been common as I haven’t felt like cooking lately. If there aren’t leftovers, the kids can have a can of ravioli or a fried egg. Or even better–we can have yet another supper consisting of boiled eggs. Four or five are quite filling. And I love eggs. A lot.

It’ll be 2 1/2 more months before I see the rheumatologist for a follow up. I’m sure he will make the diagnosis official. I hope there is an ankylosing spondylitis ticker tape parade.

Why a parade? I finally have a diagnosis! I’m especially blessed because my autoimmune disease is treatable. It’s not some stage 7 chemical burn on my brain where there is no hope at all. (As a general rule, if your brain is chemically liquified and drains out of your ears, that is an unfavorable diagnosis).

I’m thrilled. My wife is relieved. My kids hope the treatment will keep the pain at bay so I won’t be so cranky. Ankylosing spondylitis is no chicken dinner, but I feel like a winner. I have a diagnosis and a treatment.

Ankylosing What?

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I saw the rheumatologist for the first time last week.  It was refreshing to see someone who seemed to know what was going on.  My general practitioner is great but I’m glad she referred me instead of just treating the symptoms.

I don’t have a diagnosis, yet, but the new guy ruled out lupus and rheumatoid arthritis. I told him I can’t afford an MRI, so he is taking a “Dave Ramsey approved” course of action.

The doctor asked me a bunch of family history questions. I told him about my dad. He’s 70 and he claims he can still run like a deer. The doctor laughed and said I’m better off than running around like an effeminate deer. I had never considered it, but deer are kind of effeminate.

I had a few x-rays taken and a few vials of blood drained from me. He sent the blood to the lab and I’m going to start some super-expensive medicine that should be deeply discounted with one of those prescription cards issued by the drug company.

As long as my end is under a hundred bucks I’ll manage. The doctor said this medicine costs about $3000 a month. Before he told me my out of pocket cost would be reasonable, I considered leaving. Who needs a diagnosis if you can’t afford the treatment?

Using medicine as a diagnostic tool reminds me of House M.D., but my physician isn’t giving me hepatitis to treat me. I’m glad.

The doctor says it is possible my issue is mechanical, but if the medicine works, the two ailments that fit my symptoms are psoriatic arthritis or ankylosing spondylitis. The symptoms fit the latter disease better.

I can’t even pronounce it. I just know I’m in pain. I may be near an actual diagnosis, and at this point, I hope it is one of these disorders. It means there is a treatment.

(CC image courtesy of Anagoria on Wikimedia Commons).

Not-So Affordable Care

The medical industry is a racket. Tomorrow will be my first appointment with a rheumatologist. I have various joint symptoms, and after seeing my regular doctor and an orthopedist, this is the next step.

We have private insurance because my wife works for a small company and I have been unable to work full time for three years because of my ailments. Our best guess is that I have an autoimmune disorder that was triggered by trauma stemming from a vasectomy. (In simple terms, the doctor forgot to inject the lidocaine). I have had numerous procedures and have been dealing with nerve damage in this delicate area only to have increasing pain in my knees and ankles.

I’m displeased because I just received a phone call from the doctor’s office informing me to bring $500. I read was a requirement for those without insurance. The day I filled out the forms, I told my wife, “Yay us! We have insurance!”

Private insurance. $6600 deductible. All so we could have insurance for under $700 a month. Insurance that is pretty much useless unless one of us gets into a car accident and loses a face while growing a tumor farm on their back. And athlete’s foot. It’s the athlete’s foot combined with everything else that helps meet the deductible.

This insurance nightmare is still pre-Obamacare. By January, we should be feeling the rainbows and unicorns from the Affordable Care Act bearing down on us. I’ll be surprised if we don’t end up paying $1000 a month for less coverage.

I’m sorry. Did I say coverage? Paying for everything out of pocket doesn’t sound like an equitable proposition. On top of that, let’s pay the equivalent of a small house note each month so we can carry around a worthless insurance card.

I can see why some people might be driven to rob banks. Maybe I should bring a cap gun to my appointment and demand a free consultation.

 

(Above CC image courtesy of 401(K) 2012 on Flickr).