At the moment I feel sleepy but almost good, after a feeling very miserable all morning, and sleeping most of the rest of the day.
We discussed all sort of symptoms and possibilities. He fell for our typical joke of, “I’ve had this pain in my neck for 16 1/2 years,” almost recording that as a symptom.
The two front-runners are Poststreptococcal Reactive Arthritis (PSRA) and Rheumatic Fever. Although the diseases present slightly differently, there is still debate among some doctors as to whether they are indeed separate diseases, and not merely different manifestations of the same thing. Rheumatic Fever can lead to heart damage, which I don’t have, although I may get long-term antibiotic treatment if Rheumatic Fever is considered a probable diagnosis.
Poststreptococcal Reactive Arthritis, however, is fascinating, and perhaps a better match. I had one blood test in which my ASO was elevated, showing a past Group A beta-hemolytic streptococcal infection. One of the ways in which PSRA differentiates from Rheumatic Fever is that the joint pain in PSRA responds very poorly to normal anti-inflammatory drugs, like ibuprofen, which has, indeed, provided me nearly no relief. Another strike against Rheumatic Fever is the lack of Sydenham’s chorea symptoms—“rapid, uncoordinated jerking movements affecting primarily the face, feet and hands.” (Although I have been described as an uncoordinated jerk, that isn’t quite the same.)
Other possibilities include Human Parvovirus B19, but it seems not quite as likely. Likewise, my retest in a few more weeks for Lyme disease will be carried out, although we don’t find that as likely, either, it’s very important to diagnose as early as possible, as it can cause very serious long-term damage if untreated.
Today I am back on prednisone (a corticosteroid), for a longer-term treatment. It’s offered the first significant relief in about two weeks. I cannot express how wonderful it is to be able to stand and sit without being in serious pain while moving, nor just to be able to sit or lay down for a while without being able to get comfortable. I still limp quite a bit, but my stride has gotten longer than 6 inches, and each step isn’t accompanied by pain. The fever continues, albeit more intermittently, making this day 21 with a fever, blowing away whatever my childhood chicken pox fever record was. I have been very sleepy today, but I think it’s just my body catching up on rest after being in constant pain for nearly three weeks.
But … by the next morning (18 hours later), the prednisone has mostly worn off. The fingers in my left hand are almost impossible to move, and my stride is much shorter again. :: sigh :