An update on my medications, or why I’m breaking up with my primary care doc

I haven’t done my Enbrel shot for like a month and I hate that.

Oh come on now, it’s not like this was my plan.

Earlier in the year, I developed a mucocele just to the right of the middle of my palate. I was nervous and thought I should see the dentist but clearly did not. At the beginning of May, the mucocele was still there and I developed a cyst above my upper right canine along the gum line but also so big it was up next to my nose. When it didn’t go away after a week-ish and actually was beginning to swell to the point that it was impeding my work, talking, and drinking alcohol at trivia, I decided to make an appointment with my primary care doctor. I had held enbrel already hoping for this to go away and I probably should’ve gone to the dentist in the first place, but I never thought I’d experience what I have in the last month.

He feels my face for differences between the right and left side and apparently feels nothing. He sits back and WHILE LAUGHING says “I think it’s just a pimple.” I then go into explaining that I’m 25 and I’ve had my share of pimples but this isn’t a pimple. I explain that it is affecting my job, how moving those facial muscles at all is incredibly painful. I invite him to mash my face again. He goes to town, mashing incredibly hard and even my left side is in pain and by the time he’s done he says, “Well, it clearly doesn’t hurt that bad because you’re not reacting.”

Okay, by this point I’m pretty pissed and I figure he’s already laughed at me so all bets are off the table really but I’ll still be civil. My laughing along with the comment, “Well, you’re talking to a chronic pain patient who pretty regularly sees 8s and 9s on the pain scale so that doesn’t hold as much weight as you think it does,” is met with no response. I would’ve offered to have him look in my mouth but it’s pretty obvious he thinks I am an idiot. He moves on, reassures me that it is a pimple and I’ll feel better when it comes to a head, tells me to take my enbrel, and gives me a week-long script for an antibiotic – which he is only giving because I protested because he warns me AGAINST taking since I had C-diff last year.

I walk out pissed beyond belief that I can’t even fathom what has just happened. He’s always been a bit off and seemed to dismiss a lot of what I have gone through or am going through when he sees me. While I had C-diff, he gave me ten oxycodone pills because I basically broke down in his office since I had to hold enbrel and my normal meds were not going well because of the infection – and that’s after he prescribed me something I was allergic to at first, necessitating me driving all the way back over town to pick up the script.

I make it to the car and it takes all my resolve to open the door and get in the car instead of going back in and going off on him. I sit, unable to bring myself to start the car, and just sob uncontrollably. I don’t even know what to do. I drive home, continuing to sob, and manage to stop enough to get into the apartment before going off again.

One of the worst things that happens with these diseases is when you aren’t believed – that goes double for family members and doctors. My primary care doctor thinks I’m a hypochondriac, a young girl who knows nothing about her own body or medicine. I would’ve expected something like that out of someone much older than the 30- or 40-something man that barely sees me.

I hold my enbrel, despite the incredible amounts of pain I stumble upon in the almost two weeks until I see a medical professional again – but this time it is my scheduled visit with my rheumy’s NP who is the sweetest, most caring person I’ve ever met. I know that, whatever I have going on with me, she’ll know what to do.

My appointments with her are always pleasant, no matter how much I hurt, and I always look forward to them. We sit there, like a couple of River Song clones with our big fabulous hair, and discuss my wedding plans, seeing Wicked, and how I think I’m doing right now compared to last year when I started enbrel. I talk about running and about my fitness regimen that I keep up myself now without PT. She’s so happy. I fully intend on mentioning what has gone on, but I wanted so much to have an appointment with her that wasn’t full of problems.

“So, no more infections?”

Sigh.

I go into the whole thing – what makes this worse and how nothing seems to make it better, and that I’ve been off antibiotics for almost a week. She finally looks inside my mouth to find my lovely sac o’ pus. We discuss my financial state and how without the enbrel I feel terrible – my right shoulder has just started going off, a great sign of a flare for me that only gets worse. I am to update her in a week and if this thing isn’t gone go to a dentist asap. She goes into some more detail on how bad abscesses can be and what they will do to my ability to take DMARDs for, oh, a few months if left alone to fester – or worse. Did you know abscesses can kill??? She leaves me with a hug and reassurance that I did the right thing, along with the name of the primary care doc who she and her husband both see so I can make the switch.

“Hold the enbrel until all signs of infection are gone” are not words a girl in a flare – Kathy noticed the puffy joints – want to hear.

All week I am in agony and freaking out. The right side of my face is killing me with itching, and my arms are trying to finish the job. I have essentially had my arms more or less frozen at my sides, in typing mode. I have to wear my regular bra because even thinking about the sports bras hurts to high heaven. I have a terrible time getting dressed and doing my job. When it isn’t busy, I cry while reading pretending that book is the reason. This pain won’t stop and I can’t take it anymore.

June 6th arrives with only minimal lessening in this sac that I can’t seem to stop playing with. I’m scared to death I’m going to pop it and melt or something. I make a call in the morning to the dentist office I love but haven’t been to in almost two years due to low funds. I set up an appointment for the 7th.

Judgment day arrived today. I’ve known from the beginning that this was an abscess and that I would either be missing a tooth or get a root canal. I knew it and I’ve known that was what I should do all along, but of course I didn’t. I’m there 5 minutes and the x-ray confirms what I’ve thought for a month, but didn’t follow up on because my GP made me feel like shit about myself.

Turns out, my dentists had a cancellation right after my appointment and could do the root canal right away and since I now have dental insurance I owe less than $500. In an hour and a half, my root canal was done and the most painful part was numbing up my gums. I feel fine, mouth wise now. The rest of the infection should be cleared up within a week – if it’s not I get to call for more antibiotics. So best case scenario I’ll be away from enbrel 6 weeks total – worst 7 or 8.

I plan on writing a note to my current GP about the situation and my distaste for his wanton disregard for my safety, knowledge, and experience. I just don’t know what to say exactly – “Thanks fucker, you were wrong and go fuck yourself!” seems a bit much.

This all just goes to show that we know our bodies much more than others do. When we know something is wrong, we’re generally right. Don’t silence that little voice in the back of your head, because it could end up saving your life.

STAY THE EFF HOME SICK PEOPLE

Dear everyone in the work force or going to school:

Some people in the world unfortunately have to be on medications that destroy their immune system in order to keep them a functioning member of society. They can’t take these when they get a normal illness or infection like the cold or the flu. A cold for you can turn into amazingly wonderful things like pneumonia, bronchitis, and all kinds of fun infections for us. So the next time you are sick, please stay home from your job or from school. Seriously.

I just, I can’t handle the ignorance of people with regards to being sick. Maybe jobs need to have more sick days allowed when there is someone with an autoimmune condition requiring these types of treatments. Sure, the sick person usually gets a little slack or FMLA. But I mean for the others, so they can actually not get me sick.

I seriously feel like a whining 4 year old. This whatever-infection-it-will-turn-out-to-be-by-the-time-I-get-it-looked-at is like decimating me. I’m used to pain a hundred times more worse than this. I’m used to feeling a lot worse than this all over with a much higher pain problem. But add a tickle and swelling in the throat to itching in the throat and ears and I’m out for the count.

UGH.

I want to seriously punch the next person who gets close to me with the goddamn sniffles or a hacking cough or a fever.

Long story short: I don’t want to be immobile for weeks or in the hospital deathly ill because you didn’t want to use a goddamn sick day or you felt like you needed to man the fuck up and tough it out at work. Everyone wants you to go home including you, but especially me.

Sincerely,
EVERY FUCKING PERSON WITH AN AUTOIMMUNE DISEASE

2012: A Year in Review

2012 was an… interesting year for me. It’s not like it was horrible – and yet there were definitely times it was. It has been a tough year.

In January, I officiated a wedding between two good friends. It was wonderful to be a part of their special day. I always knew they would end up together. I also had a good ophthalmology appointment, thankfully, after dealing with some more uveitis off and on in the end of 2011. I also started MTX injections to see if I could handle them better than the pills to help boost Humira. It seemed like it was okay, until the back spasms that still plague me today started and the MTX had too much of an affect on my energy levels and my body function. I was coming to terms with the fact that this semester would be my last in graduate school, as my illness was worsening enough to cause too many problems.

In February, I learned that I was on the verge of getting fired because of misunderstanding poorly explained attendance policy information at work. I brought a note from my rheumatologist about the flare up nature of my disease and stated that I shouldn’t be in as much trouble as I was because I wasn’t missing days to go dick around or go to concerts – I was missing days with illness. I got to play the waiting game. I also saw a PT a number of times for my left knee and back.

With March came the JAM walk in Minneapolis at the Mall of America. We took a long weekend and drove up there, enjoying experiencing the shopping and food nearby. I also had been taking Arava instead of the MTX – but even with that, Humira was definitely not working.

By April, I had run out of my free shipments of Humira from Abbott anyway and it was as good a time as any to make an appt with my rheumy about switching to Enbrel. Even though we decided on switching in April, it would be May before I could start it. I set up a new GP since having one at the university I was no longer attending wasn’t helping anything. I also got to see one of our favorite musicians, Eric Hutchinson, right before my birthday.

May brought with it another arthritis walk, where my sweet boyfriend got an ‘arthritis hero’ sign for me. Doing the whole walk was really tough, as my hips were definitely not excited about a 5k. I had a bone density test, which came back perfectly normal. I participated in the first ever World Autoimmune Arthritis Day (WAAD) by preparing a number of documents and a presentation on living life to the fullest with autoimmune arthritis. The same weekend that was going on, the fiance and I got to go try out for Jeopardy. I have literally been training for that since I was very little and it was great great fun to be a part of it. I had to stop Enbrel after my first injection for about a month due to a sinus infection that got so bad as to swell my entire face. At the end of the month, my rheumy’s NP cleared me for Enbrel again and I got to spend some time with a few friends in town running a marathon… which turned into a half instead because of the horrible hot spell we were having.

By June, dealing with the mental issues of having an illness caught up with me. Though I wasn’t suicidal by any means, I was having thoughts that scared me and I had my first appt with my therapist. The Enbrel was working well enough that we decided I should try it without the Arava as it was upsetting my stomach. The boyfriend and I also went on a wonderful vacation, seeing some sights associated with the Civil War and Abe Lincoln, taking in a Cincinnati Reds game, and meeting one of the best spoonie friends I have ever had. I was able to do so much more physically than I thought I would because of the Enbrel. I also had some dental work done.

As a result of that dental work and taking antibiotics as a precaution, July saw me dealing with C-diff – an infection that is one of the leading killers in hospitals every single year. I dealt with it for 11 days before seeking treatment, thinking it was just salmonella or food poisoning. I am very lucky I got better and didn’t have to face hospitalization. I did drag the boyfriend to Urgent Care on his birthday though, and scared the crap out of him when the nurses came to get him to bring him back to the exam room where I was getting my first IV of fluids due to terrible dehydration. This meant another month with no Enbrel. I got to see Dave Matthews Band, one of my favorites since I was little. I could’ve done without the copious amounts of drugs being done around us but it was neat nonetheless. I went with my sister to her last prenatal visit, and tried to talk to my GP about pain meds. He sent me home with ten pills total. UGH. But I also got  a nice haircut and color, and saw the new Batman movie all by myself.

August started off with a bang. On the 1st, I was lucky enough to get to be around for the birth of my niece Marissa Mae. I got to spend time with my best friend when she came along with the boyfriend and I to the Irish Fest Arthritis Walk in Milwaukee. I wasn’t able to walk all of it and almost had to break out the cane to retrace my steps. It was a tough tough day. The next day though, I got to see my idol Hugh Laurie in concert playing the blues. It was one of the most amazing things I have been able to do. I cried out of happiness and being moved by his music. We finished the month off with a Milwaukee Brewers game and spending some time with the boyfriend’s dad.

And then came September. We started the month off with a friend’s wedding and then having to miss Marissa’s blessing because of horrible fibro and rheum pain. It was a horrible day pain wise, but even worse knowing that my family maybe didn’t understand and thought I was an atheist freaking out about going inside a Mormon church again. We went to a Juvenile Arthritis Family Network meeting, along with Megan and Mia and Megan’s sister who deals with AS. It was wonderful to get to meet them after talking so much with them since June when Megan found this lovely blog. I had an appt with my rheumy’s NP, only to get diagnosed with fibromyalgia on top of my Still’s. On the 20th, the boyfriend and I had our 5 year anniversary and headed out to Dubuque to celebrate for the weekend, where he proposed 🙂

In October, I got to spend some time with my best friend and now maid of honor. I was also finally granted FMLA at my job which has made things a lot easier. I babysat Marissa for a while so my sister and her hubby could go out on a date for their one year anniversary, and we found out Marissa likes ukulele music.

November was a hellish month though. I had four appts between the 8th and 9th, one of which was a sleep study. I had to stop Enbrel AGAIN (seriously??) because of an issue with my throat and all doctors involved not wanting to see that end up as an infection. I gave a speech at an Arthritis Foundation fundraiser and got a hug from a Heisman Trophy winner. I also celebrated the 19 year birthday of my Still’s on the 14th and we made a cake. In two years, I am having a 21st birthday party all over again I swear. I also started seeing 2 PTs for my neck/spine, one being pool based therapy.

December has been an incredibly tough month. Cold weather always makes Arthur an ass, and it is definitely doing so now. I’m mid flare as I type this even. And what’s worse for sure is losing someone that I was so close to, that always had ideas and advice and help even if she was going through worse. Losing Laura has made the rheum community come together in a way I have never seen before. She was truly an angel and I am grateful that she isn’t hurting anymore, but I am so sad not only for myself and our other friends but for her fiance and families. As so many others have put it, her death makes me feel numb and I know that I am having a hard time dealing with it. There is a void left by her absence that will never be filled.

While I was lucky enough to go through some amazing once-in-a-lifetime kinds of things this year, I am ready for it to be over and to start anew. Dear 2013, bring a bunch of kick ass things like 2012 had but can you leave the crappy parts behind? I could really really use a break.

MIA

I might be MIA for a little bit. Why?

Well…

I have an infection. Don’t know what it is, don’t really care. It has turned my adorable face into a poofy, poofy mess. I’m on antibiotics now, thankfully, but I’ll also be without Enbrel and Arava for the next little while so the anti-b’s can get to working and not be impeded further.

I feel like I look like I need a Phantom of the Opera mask… but that would add pressure so I don’t really want that. My gums are swollen too, which means all my teeth are squishing together. Yeah, not fun.

I need to sleep some more. It’s been really hard because this is super painful and laying down is… well, probably the least comfortable thing I can do right now.

I guess for right now I’m just grateful that I felt bad enough that I knew I needed to go into Urgent Care since my rheumy was in appts all day. Seriously, I called them at 8am about this right when their offices opened… and it took the Urgent Care doc getting in touch with them about the seriousness of what I’m going through to get through to her directly.

I didn’t get any additional pain meds. I didn’t ask for any, but they certainly also were not offered… which seems like a dick move, right?

*sigh*

Tomorrow will almost certainly be a day to stay home from work again, with Wednesday already a designated day off.

I just hope this clears up before Jeopardy next weekend.