The reactive arthritis—if that is what it is (see below)—continues. Some days are better than others, and it’s much easier than it was a number of weeks ago, but it really isn’t going away. Last night I was able to do some ab[dominal] crunches (something I expect to do daily now), and I also spent a short time on the exercise bike, but couldn’t use my left arm or either leg, only my right arm, because of the joint pain in my knees and shoulder. My prayer is that my legs, fingers, and shoulder will improve enough for me to exercise
the way Nichelle wants me to the way I want to. (It also means I’m not likely to be doing any real hiking or bicycling during this glorious summer, which is more than a bit disappointing.)
Of course, there’s a possibility that this isn’t poststreptococcal reactive arthritis—it might be psoriatic arthritis. On the other hand, it might have started as one thing, but be developing into any one of another inflammatory arthritic condition. (I do also have what appears to be psoriasis on my scalp—which Nichelle gets credit for noticing and making sure I discussed it with my doctors as possibly related.) Or perhaps I’m just faking this to get out of Nichelle’s “new and improved” workouts … or maybe it’s Munchausen syndrome … or maybe even Nichelle is secretly causing this, making it Munchausen syndrome by proxy.
I should add that my follow-up echocardiogram and EKG were both fine, so we have now officially ruled out rheumatic fever.
According to Dr. Eranki, I have an atypical presentation, which means that my symptoms don’t exactly match one particular flavor of arthritis, making diagnosis even more difficult than usual. In other words, I am just weird.
I start on methotrexate today. Methotrexate is officially a chemotherapy drug, but is also used to treat psoriasis and arthritis and other rheumatic conditions. For those of you who want to sound smarter than your peers, you can tell them it’s a DMARD (disease-modifying antirheumatic drug), which decreases the pain and swelling of arthritis and reduces both the damage to joints and the risk of long-term disability.
Discussion of the drug prompted a surprisingly emotional reaction. Having a new medication introduced as a chemotherapy drug … knowing the side effects of many chemotherapy drugs, I was leery of trying it. I also realized for the first time that the medication “reduces the risk of long-term disability”—dragging me into the understanding that the near-constant joint pain and swelling isn’t merely an inconvenience, it could make the rest of my life more difficult as well.
At any rate, I spent the past few days reading up on the medication, carefully observing that the arthritis isn’t going away, and a while yesterday peppering the Dr. Eranki with questions, before deciding to go ahead with this phase of treatment. Even with this, it will be at least 6 weeks before the methotrexate has any noticeable positive effect.
However, I am grateful that the fevers finally seem to be mostly gone, and that I am able to work and do many other things normally or with minor restrictions. These blessings have not always been available to me throughout this illness, and I thank the Lord daily for them.