rheumatoidia

Nobody likes a needle

David — Tue, 09 Mar 2010 07:00:00 +0000

Just returned from this month's blood test at the hospital.

When I started having blood tests I was full of bravado; a needle, right? Hardly feel anything. That was until the day a phlebotomist did something odd - I'm guessing she hit a nerve - and I felt a terrible pain, agreed she should continue, then passed out. I came to still sitting in the chair where a moment before I had been expecting a routine blood sample to last just a minute or so before I jumped up and said goodbye for another month.

The staff were very solicitous and I was wheeled to another room where a nurse stayed with me until I felt better but since that day I've been a little concerned whenever that one phlebotomist has been on duty. The fact that she's taken my blood since, several times, without anything like the same thing happening again hasn't quite calmed my nerves.

I have my favourite phlebs; favourite not for their chat and easy manner, or their interesting stories (one has a pet iguana, talk of which is guaranteed to take your mind off the proceedings), but for the small degree of pain they have inflicted in the past. Seriously, the fainting episode aside, it's hardly any pain at all of course but in the phlebotomist's parlour where there's nothing else to focus on apart from the pain, the slightest discomfort can take on epic proportions.

Today, perhaps because a student was present and a little more care was being taken, perhaps because this one phlemotomist was particularly good, I felt nothing at all. That's not a way of saying I didn't feel much or that it hardly hurt. Literally, no feeling of pain at all. I asked if she was using specially sharpened needles.

Now the bar's been raised for everyone. Now I know that it is possible to take a blood sample without inflicting any discomfort whatsoever I shall be expecting such treatment every month

Ignoring RA, for the moment

David — Mon, 08 Mar 2010 07:00:00 +0000

A few years ago I stabbed myself in the hand with a small knife while attempting to de-stone an avocado. It made for a more than usually exciting evening and a trip the next day to a hospital for a general anaesthetic and nerve reattachment surgery. That was about the extent of my involvement with doctors and hospitals until my Rheumatoid Arthritis diagnosis two years ago. Since then I've had to become familiar with GPs, consultants, registrars, nurses, nurse practitioners, practice nurses, doctors' receptionists, practice managers and the phlebotomists with amusing vampire-themed tourniquet straps.

Immediately after my diagnosis I read everything I could find about RA - but I soon became bored by it all. Just because I had RA didn't mean I had to spend my time obsessively learning about it and thinking about it. My spreadsheet of blood test results, with colourful charts, lies somewhere on my hard disk, untouched for months. The RA-related podcasts are no longer in my iTunes playlists. Browser bookmarks have been deleted long ago. The cheap electric plug attachments broke and haven't been replaced. The finger exercise regime recommended by my physiotherapist has lapsed as quickly as a gym subscription. The moulded wrist braces are discarded in a wardrobe corner. Now, I take my methotrexate, my folic acid and painkillers, and I trot along to the hospital every month for my blood test, and that's all.

I expect that in a few years' time, as the cumulative effects of this chronic condition begin to kick in, I will be obliged spend more time getting to know my RA again. I'm not refusing to face the facts but just now, while I can, I'm going to continue having fun. White water rafting? Done. Cycling holiday? Maybe, if I can work out how to brace my wrists against hours of leaning over handlebars. Continue working? Definitely

Methotrexate to the Max

David — Sat, 14 Jun 2008 22:10:06 +0000

So now I'm on 15mg of Meth per week and still not having to take the anti-emetic although it is wiping me out a little each weekend.

I was looking at the sort of doses of Methotrexate cancer patients are given - about 30mg it seems, and felt quite chuffed with myself for handling it so well until I realised they take 30mg per day. Hats off to them.

Three blood tests worth of data so far isn't really enough for me to spot and significant trends. Nothing's too way off expect perhaps my liver and my kidneys are creeping up - the creatine levels well within normal bounds but has risen each week. ESR halved over two weeks but I'm still in quite a bit of pain.

Ramping up the Meth

David — Fri, 30 May 2008 10:03:20 +0000

So after two weeks of 2 x 2.5mg of Methotrexate I've just taken 4 x 2.5 mg.

I know these are trivial doses for some cancer patients; and although I was quite ill the first week I took Meth, I was fine the second week on the same dosage. But now I've doubled it. I'm expecting a duff weekend.

Blacked out

David — Fri, 30 May 2008 09:51:12 +0000

I blacked out this morning. Luckily I was in hospital at the time.

I'd popped along for my fortnightly blood test but this time the phlebotomist couldn't get the vein in my arm to show itself properly; it was just a faint bluish trace under the soft skin of the crook of my elbow. After about five minutes tapping me and strapping my right arm she gave up and tried the left, with no better luck. So she went ahead anyway.

I felt a sharp pain shoot right the way down to my fingers. 'Something not quite right here', I thought, as I struggled not to cry out. The phlebotomist saw me wincing. 'Should I stop?', she asked. 'No, no, carry on', I said and then yelped as she wiggled the needle and the same pain shot down my arm again. 'I think I'll stop', she said, and in a slight panic knocked a box of the tubes that would have held my blood for the various different tests all over the floor and almost knelt on my groin as she stretched for some cotton swabs.

I felt sweaty and sick and my vision started to go. The other medic in the room glanced at me. 'Leave him alone for a moment, he looks very pale', she said. Then I passed out.

I came round with five or six nurses hovering about. Once I could sit up they helped me to an examining couch, where I lay down and chatted to the nurse who'd been detailed to make sure I'd suffered from nothing more serious than a faint. After a while I felt better and another very solicitous phlebotomist came into the room to try taking the blood sample again. This time all I felt was a small sharp sting and the job was over in seconds.

'I can't understand it', I said, 'I've had blood tests before, I've donated blood, this has never happened'. I got to my feet. The senior nurse said, 'Oh, don't worry, it happens all the time. Besides, some people are more careful when they take samples'.

So I think what probably happened is that the needle went straight through my vein and probably hit a nerve - that might account for the sharp pain down my arm.

Back again in a fortnight.

Methotrexate day

David — Sat, 17 May 2008 20:56:59 +0000

Took the first dose yesterday - 2 x 2.5 mg tablets. For the first go, my doctor had suggested to me that I might like to skip the anti-nausea pills, just to see if I needed them.

So 24hours later I haven't been sick, have felt only mildly nauseous, although I have been very tired today, something that could be a coincidence, an effect of the drug, or an effect of the rheumatoid arthritis. Impossible to tell.

I'm taking the folic acid on Monday to help with the anemia side-effect. Then blood tests every two weeks, results of which I'll post here, I think.

Thoroughly Tested

David — Thu, 08 May 2008 19:55:07 +0000

At the hospital, I had my blood tests, blood pressure taken, was weighed, measured, injected with a steroid in my arse, investigated by the registrar who, worryingly, had Wikipedia open to the Rheumatoid Arthritis entry, had both hands, both feet and my chest X-rayed, met the consultant who confirmed the diagnosis and told my I couldn't have methotexrate and an anti-TNF unless I had an extra £10,000 hanging about but that I could have methotexrate.

The prescription's at my GP, to be picked up next week, pills to be taken each Friday in steadily increasing doses, with a before-and-after anti-emetic, and folic acid on a Monday. Fortnightly blood tests to be taken.

Sounds great fun.

First rheumatology consultation

David — Wed, 07 May 2008 10:50:44 +0000

So tomorrow's my first hospital consultancy appointment. I'm half-hoping the pills I'm taking keep working as ineffectively as they have been so far, so my consultant recognises the true rampaging awfulness of my disease and puts me to the top of all lists for the best, most urgent treatment.

Actually, my right arm doesn't fully straighten now - it just stops with a pain at the elbow at about 170%.

I would prescribe methotextrate plus an anti-TNF but we're not allowed that in the UK, according to NICE, even though it looks the best course for early intervention. You can, of course, have that combo if you're wealthy enough.

Sausage Fingers

David — Tue, 06 May 2008 20:57:10 +0000

Two days out from my first consultant's appointment:

The Colour Turquoise

David — Sun, 04 May 2008 10:21:53 +0000

I had a vague memory of a connection between some form of arthritis and a certain ex-goalkeeper turned tv sports pundit turned world campaigner against the Reptilian Menace.

I checked and it's true. David Icke has rheumatoid arthritis:

At the heart of Icke's theories is the view that the world is ruled by a secret group called the "Global Elite" or "Illuminati," which he has linked to The Protocols of the Elders of Zion, an antisemitic hoax. In 1999, he published The Biggest Secret, in which he wrote that the Illuminati are a race of reptilian humanoids known as the Babylonian Brotherhood, and that many prominent figures are reptilian, including George W. Bush, Queen Elizabeth II, Kris Kristofferson, and Boxcar Willie.