The Knee Issue...Part 3

A couple weeks ago, I wrote about my knee - yet again. And, I have an update now that I'd like to post, as it helps me keep it all clear in my head as well as helps me not have to repeat this over and over again. I've had four weeks of physical therapy 3 times a week since August 6th. I'm getting really frustrated because I am not seeing or feeling a lot of improvement. Sometimes I feel like the PT is actually making things worse. Since my rheumatologist suspected arthritis of some kind, I talked it over with my physical therapist about two weeks ago, and he said to take it easy and rest the knee for a while. It got better during that time, but when we slowly started trying to exercise it again, sure enough it got worse. I was really annoyed at the timing of the worsening, too, because Kira's wedding was only a week away at that time, and I really wanted to be able to enjoy the night of dancing, walking, standing for a long time, and otherwise just being comfortable. I wanted to be able to squat down and help fluff her dress or lay the veil for her. But, no such luck! About two weeks after taking the anti-inflammatory that the rheumatologist put me on, I started itching like crazy. My elbows, especially, were constantly itching and developing small raised areas that looked like chigger bites or even bed bug bites! I freaked out and immediately washed my sheets and mattress cover like a mad woman! Luckily, that wasn't the issue. When the itching didn't stop, I called my internist, and she said to stop taking the meds that the rheumatologist had prescribed. I called his office to let him know I was having this reaction, and his nurse told me that the itching would not be due to the anti-inflammatory. I was confused, but I still listened to the internist. I began taking another prescription to help with the itching. This was only days before Kira's wedding, and my internist had me taking several meds that she told me would make me sleepy: Atarax, Zyrtec, and Benedryl. Just what I needed... to feel sleepy before and during Kira's big weekend!

The itching never stopped, but I felt less annoyed by it, and it may have subsided from time to time, but I still itch throughout the day and the bumps come and go. Anyway, I made it through the wedding (LOTS more on that later!!) fairly well, but my knee continued to be an issue. It got more and more stiff without the anti-inflammatory meds. And, I was hating PT that whole time!

I saw my rheumatologist yesterday, and we finally got an answer. After some blood work came back, and after I explained new symptoms that have popped up since I last saw him (about 3 weeks ago), he had a general diagnosis. I'm a bit of a puzzle at this point with my complaints and with conflicting blood work... I have a positive ANA (as I wrote about before) which could be nothing. He's certain I don't have lupus. My rheumatoid factor came back negative (which can also mean nothing... he explained that lots of people with rheumatoid arthritis have a negative factor). My ESR (which basically measures inflammation) was high, and at this point, the doctor looked at Sam and said, "You know what that tells me? That she's not making this up." He smiled and described more about that, and basically said that he's diagnosing me with pauciarticular arthritis - "pauci" meaning "few" and "articular" meaning "joints." The big problem, of course, is the right knee, but the other areas that have started hurting, swelling, or stiffening are: my left elbow, my right wrist, and my right second toe. Which kind of arthritis he's not sure, but it's either rheumatoid or psoriatic; either way, the treatment remains the same - anti-inflmamatory medications. He's switching me to a different med since he agreed I was probably allergic to the first one he tried (Lodine). (I found this interesting since I called his nurse, and she told me it wouldn't cause itching! UGH, so frustrating that not everyone gives a clear, straight, correct, agreeable answer!!) So, the plan is to try this med for 3-4 weeks and hope to feel no stiffness, no pain, and no swelling. If that works, then we're golden! If not, we try another med for 3-4 weeks and see what happens. If that fails, we try another for 3-4 weeks, so basically, we're on this path for about 3 months to figure out which drug will be most helpful. If all else fails, we have to discuss more intense drug therapy, which I cannot take if we want to have more children. I appreciated that the doctor was so cautious with this issue because Sam and I are young, and we do want Banner to have siblings one day. So, we're really hopeful that one of the less intense drugs will work!

After seeing the rheumatologist, Sam and I went to the orthopedist for a post-op check-up. I saw the PA, and he told me that everything looks great, even if I'm still really swollen and stiff. He said to wait another 6-8 weeks to see better results. He also agreed that perhaps the PT is upsetting my body, and that we should hold off for a week and see what happens. Given the inflammation and the arthritis, we may need to tweak the plan for a bit. I was relieved to hear that because going to those appointments really sucks, and I wasn't seeing a benefit to them yet. I'm not against them if they help - but they weren't helping!!

I'm really hopeful that the anti-inflammatory pills will help. My left elbow is achy and running a close second to my knee pain. Drying my hair is difficult, lifting Banner is difficult, carrying in groceries is difficult. You just don't realize how much you need your body on all these little mundane tasks. And the itching has driven me nearly insane. Try writing a wedding toast or a rehearsal dinner speech while you are wanting to scratch ALL over (and I mean ALL over - in the most embarrassing places!). So ready to feel like me again - so ready to wish that I had a few more moments to sleep in the morning ONLY because I'm tired and not because I can't imagine trying to lift my baby out of his crib or chase him all day when my body is betraying me. Literally, that's what's happening, and a diagnosis of arthritis confirms that. I know this will be a long road, but I'm hopeful it can be a smooth one from here on out.