Dr.'s Appt | Arthritis Information

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WEll, I went to the Doctor today with the idea that I would just hit this head on.  He looked at the pain chart (thanks Jasmine it has been a life saver for both GP and RD).  He said the Embrel was like taking water to your system.  Yep! 

Then the bad news came.  I can not go on to Orencia or Rituxan, because they have not been approved for Psoriatic Arthritis and the insurance would not even begin to cover them.  My only hope there is to get into a study group in Denver...studying the effects for my arthritis...not likely to happen.
He gave me Arava, but I cannot take it until my liver functions go down, so more blood tests tomorrow.  The other thing about Arava is that it can raise BP, and mine is a borderline high now.  Mind you this is a huge thing because my dad died at 61 from a massive heart attack...because the disease had stripped the valves in his heart. 
Next he hit the pain issues with oxycontin and told me to take my vicodin for breakthrough pain.  I am uncomfortable with this, but please let me know if you have had to do this one for a time. 
Then I asked him about the disability thing.  He said well, you are never going to teach if I cannot get ahead of the disease, so it is completely true that at this point you need to be at home most of the time.  So, I will finish up and submit tomorrow. 
I am not surprised with all of this...and am a little uncomfortable with the Arava and combining the narcs.  I am hoping my disability goes through lightening fast, because this month I have earned a sum total of nothing!  I guess I am overwhelmed and sad and wish I would have chosen a more prevalent arthritis, but I guess that would not be like me!  Shel, I wouldn't be too worried about the Arava and the narcs. Bottom line is you need them until they can get the pain cycle broken here and get the disease under control. I am on way more stuff at the moment than what you are describing. You not taking any narcs would be the same as a cancer patient refusing them...you are just at a place for a while where they are needed. I do know where some of your concerns are probably coming from and I understand but when you arthritis is this bad then, this is the only way, honey. Once the pain cycle is broken then you can reduce the narcs...I have done it many times, I will do it again. Don't let it frighten you and don't let other people's fears frighten you. Do what you need for your body to heal. I find the minute my pain is less, I automatically take less. There is much fear about addiction and yes, it happens but it also doesn't happen too. Believe in yourself and your strength.

I am glad about the disability...this is where it is, honey, for now but like me, hang on to your dream of teaching...you will be back, I know this. Meanwhile the last year on you has been rough and you need rest to heal.

I am absolutely disgusted for you that Orencia and Rituxan aren't approved for PA. It is worse than RA. You have the same with added extras...for goodness sake. The
beaurocracy  that makes these decisions about our health needs a swift kick.
Keep posting and venting, darling. I know exactly what it feels like to be going under. Reach out. We are here to help. [QUOTE=Shelly41]
Next he hit the pain issues with oxycontin and told me to take my vicodin for breakthrough pain.  I am uncomfortable with this, but please let me know if you have had to do this one for a time. 
[/QUOTE]
 
Hi Shelley...I've been using the fentanyl patch for pain, and my doctor told me that it was ok to also take my oxycocet for breakthrough pain.  I had no problems with it.  I don't do it often, but when things get bad I do.
 
good luck!
Thanks, we shall see tonight.  I woke up out of a sound sleep with pain in my hands and feet after taking the oxycontin.  So, I did what I was instructed to do!  I will let you know tomorrow. 
 
I just feel like I have been given an impossible senerio.  The RD did admit that I would probably never teach full time again in this lifetime unless they came up with better drugs for PA.  What a waste of time those three years were!  I could have been working and staying out of debt!  Frustrating!
Ok, so on this new pain busting trend.  I worked beautifully last night, and I slept real well.  I am hoping this is going to help keep the pain level down, and help me to get back on my bike. 
 
Have not heard back from the lab to see if my liver levels are ok to take Arava. 
Good Morning Shelly, I didn't realize that R and O hadn't been approved for PA.  I understand the place you're in now, but I think with a few nights of good sleep and proper pain control that things will look up.  Don't be afraid of the pain meds - right now they're your friends not your enemy.
 
The diseases are so unpredictable and how we react to the meds even more unpredictable  Right now Humira has put my RA in clinical remission but the PA has it's panties in a bunch.  Believe me when I tell you Vicodan became my best friend last week.   Even the psoriatic plaque on my leg has gotten worse with Humira and infected.  I started Keflex yesterday for cellulitis!  I thought Humira was the new wonder drug for PA, is it all just hype?  Like you I'm pretty disgusted right now. 
 
Do you have a disability attorney to guide you along the way? Take care and enjoy that sleep.  Lindy  
Oh, Lindy...I am sorry about the cellulitis.  Gosh, that is just frustrating, and I have been there before.  Do you have Taclonex for your outbreaks.  A dermatologist would be able to give you samples, and I have not been through my samples yet.  It is sooooo good with the outbreaks and really takes the pain and ichy feelings away!  Ask for it...it is expensive because it is new...but worth every cotton pickin' penny!
Yep, R and O are not approved for PA and since that is my primary dx the insurance will not cover it.  RD is looking for a study in Denver...should I save a place next to me for you?  I would love that!  I have just realized in the last twelve hours how many hours I have suffered in pain...pain that makes you sweat when you walk.  I am using them and probably will have to for some time.  I could be a year or a few years before I will experience any of the biologics.  PA is a very difficult disease and because it is rare it is not included in front line studies.  It usually takes about three more years after the biologic has been approved for RA to get approved for PA.  I am stuck with MTX and if my liver functions are better maybe Arava as a combo.  Still have not heard about liver function. 
 
I am thinking about highering a disability attorney, but Tonks used to work in the disability office.  She is going to be looking over my application.  I am hoping I will have it by the summer.  I would love not worrying about not subbing.  Now that I am on the big guns everyday...I cannot drive, so that puts a whole damper on the subbing. 
 
I feel another nap coming on...it is amazing how exhausted I have been, but the sleep has been good!!! 
[QUOTE=Shelly41]WEll, I went to the Doctor today with the idea that I would just hit this head on.  He looked at the pain chart (thanks Jasmine it has been a life saver for both GP and RD).  He said the Embrel was like taking water to your system.  Yep! [/QUOTE]

Glad I could help!  Sorry to hear there's been so much pain to track - hopefully you'll get some resolution and relief soon.Yeah for Tonks!  I only have one skin lesion and it's on my lower leg.  It's the only psoriatic lesion I've had and it didn't pop on the skin until after I started Remicade.  My RD explained that sometimes the biologics cause the skin lesions to appear.....go figure.  Has to do with the immune system becoming compromised.  I haven't used Taclonex because all I have is one lesion and it was getting so much better with the laser treatments until last week.  Save me a seat and we can suffer together.  I'd like to have some company on this PA journey.  LindyLindy my only fear is if you had one lesion in the winter, and psoriasis is usually worse in the summer months!  I hope it stays to one for you!  Gosh, I would hope to only have one lesion in the summer.  I know I will get hit harder, b/c MTX does not do much to prevent psoriasis.  I may actually have to use up all of my Taclonex samples. 
 
Yes, Tonks is great and I am thankful for all of the help.  The pain chart that Jasmine did was wonderful for both my GP and my RD!  They loved it.  They both said it is the first time I get to see the whole person, and not just what is happening today!Thanks, Jas!!!
Yeah for Jas
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