Throughout this illness, which appears to be Poststreptococcal Reactive Arthritis (although it could be something else), my health has been quite varied. (Also, I have filled in some medical detail after the symptoms descriptions; mostly to clarify what PSRA is, and how and why my treatment is progressing the way it is.)
No, these aren’t my shoes, but … dang … [Enunciate the last bit the way Will Smith recommends Beatrice (Edgar’s wife) hire an internal decorator in Men in Black.]
For example, here’s how the past few days have gone:
Thursday: Ibuprofen taken at night allowed me to move fairly well in the morning. As soon as I woke up, I took my prednisone, and within a couple of hours, was able to hobble about without much pain. I had a doctor’s appointment mid-day, but worked at the office and from home around the appointment, and felt very good. By late afternoon, I had a fever, and needed to take a short nap. Still, I managed to get to and lead our small group Bible study, with Nichelle driving. I felt good, and didn’t take any extra medication at bedtime, when the prednisone was definitely beginning to wear off.
Friday: Not taking the ibuprofen seems to have been a big mistake. I awoke at about 5:00 a.m. with serious pain and movement issues. I could barely move my legs, and couldn’t use either hand. I waited until 6:00 to take the increased dose of prednisone Dr. Eranki prescribed, but it took hours to have a noticeable effect. I did go to work, but didn’t make it into the office until 11:30 a.m. Due to the pain and swelling in my left middle finger, typing on my left hand was reduced to 1-finger. Still, in the evening I felt very good. Nichelle and I were able to attend “Run for Your Wife,” a TCAN Players [hilarious] comedy play featuring co-worker Laura Crook.
Saturday: I felt good for a few hours in the morning, but spent most of the day fighting the low fever, playing some games with the kids and hanging out in Azeroth, spending an inordinate amount of time trying to beat a seasonal instance.
Sunday: Good in the morning. I was able to drive to church early for my Geek work (A/V), and even ran a couple of quick errands in Nashua after the service (pharmacy; gas for the mower). By mid afternoon, the fever was back, and I spent a couple of hours starting at supper time just sleeping. Afterward, I felt pretty good.
Today: Today I was able to move my legs well enough to put on shoes and socks for the first time in several weeks! (After taking prednisone a few hours earlier.) The biggest problem today is my left hand. I do have a low fever, but it’s only about 1/2 a degree above normal, which to me is starting to feel normal.
By this evening, my movement ability had dropped a bit, but not much, but I became febrile again enough to notice. Oh, well, today was better than usual.
PSRA Details / Symptoms / Concepts
Tomorrow will mark my fourth week since the onset of obvious symptoms, and I had noticed some minor symptoms before that. Wow!
Poststreptococcal Reactive Arthritis is only a probable diagnosis. I will have an echocardiogram in a few weeks, as well as another Lyme disease titer, to rule out Rheumatic Fever and Lyme disease, respectively.
However, PSRA does seem to fit the symptoms. Neither PSRA nor rheumatic fever are testable conditions; they are syndromes—collections of symptoms—and the symptoms must be weighed carefully to figure out what the overall diagnosis should be.
The biggest meaningful symptoms or test results have been a positive blood test for a recent strep infection, the swelling and joint pain in my legs, hands, and shoulders, the fever, and vast number of negative tests for heart problems, liver function problems, active infections, etc.
Note that arthritis essentially means joint pain, so the reactive arthritis (assuming that it what I have), is not the type of arthritis that we all tend to develop as we age. (There is some x-ray evidence of that happening in my back, which is completely normal for this point in my life, and has not affected me in any way.)
I have a few days to go on my antibiotic treatment, and have already started tapering down the prednisone. Today has been my best freedom-of-movement day so far, and I hope that trend will continue. The guys in my at-work Bible study laid hands on me and prayed for my recovery today, which was very moving.