I had a doctor's appointment today - with a podiatrist. I wanted to talk about sharp electrical shock pains when any pressure is put on the tops of my feet, and about heel pain on my right foot. I also wanted an assessment on the bunion that's progressing rapidly from a bump on my foot and into deformed foot land.
I recently had to change all my doctors because of change in health insurance (please do NOT get me started on this. It angers me to no end that the last 2 years of building a relationship with a medical staff has been flushed down the toilet because I changed jobs.). One of the things that is incredibly important to me was that I was being seen in a "one chart" clinic. I'm already coordinating care across several specialists to deal with a variety of issues, I at least need to make sure chart notes and lab tests are shared with no effort on my part.
Currently, I'm under the care of a primary care for general health and medication monitoring for depression and anxiety, a rheumatologist (Psoriatic arthritis), hematologist (pernicious anemia, iron-based anemia and assorted other malsorption issues - vitamin d, selenium and folic acid to name a few.), gastroenterologist (gastric polyps) and now a podiatrist. I get IV infusions of a TNF blocker (immuno-suppressent therapy) for psoriatic arthritis via a portacath in my chest every 8 weeks. I self inject methotrexate (a chemo drug, which also suppresses the immune system and reduces swelling) weekly. I get IV infusions of elemental iron twice a year, (which is an improvement over just ferritin infusions every 8 weeks) to keep from being dangerously anemic, coupled with a corticosteroid and benadryl so I don't have a reaction and go into cardiac arrest during the administratoin. I self inject complex B vitamins every month to keep the pernicious anemia at bay. I have comprehensive blood work drawn, again through the portacath in my chest, to make sure the arthritis treatment is not causing liver damage. I require endoscopies twice a year to make sure polyps aren't changing in size and that no malignancies have developed. I take 1200 mg of folic acid daily to make sure the methotrexate doesn't cause the inside of my mouth and tongue to be covered in ulcerated blisters. I take 50,000 IU of vitamin D3 weekly just to maintain status quo inside my body. I am not an easy case, and I am not a single sentence diagnosis. When I went to the podiatrist in this one-chart world, I expected him to be able to make an assessment with total care in mind, and to be able to recommend treatment.
He asked some questions, examined my feet, and said "The source of your pain is inflammation."
I grew up with brothers and a sister that are substantially older than me, so I learned lots of colorful swear phrases much earlier than the average kid. I can remember being in 2nd grade and when a teacher said something that seemed obvious to me, I replied "No shit, Sherlock", one of those charming phrases that my 13 year old brother taught me. (I also spent a week in detention and caught one hell of a whipping from my Mom for sassing a teacher.)
"No shit, Sherlock" was the first thing that came to mind when he announced "The source of your pain is inflammation." When the arthritis flares up, my fingers and toes swell up like sausages. There are days where I cannot put the screw on tops and bottoms of BabyBoy's bottles together because the pain in my hands and wrists won't let me do these simple tasks. I wear compression socks like an old diabetic man to try and keep the ankle swelling down at least two weeks out of every month. I ice, I keep gluten to a minimum in my diet, I keep sodium to a minimum in my diet. I let the doctor stick needles into my joints and give me cortisone shots WITHOUT ANESTHETIC when the pain gets high enough that I can't easily function. I know a thing or two about inflammation and it's effects.
"The source of your pain is inflammation."
At least he had the good sense after reviewing my chart to NOT recommend I take NSAIDs (a big no-no with methotrexate - too taxing on the liver). He gave me a prescription for a topical anti-inflammatory gel that has a low uptake into the blood stream and recommended I ice for swelling and come back in a month. While I'll give the gel a shot, and I'll hope for some relief, I'm really not confident a month will make some magical difference.
This is one of those days where if I thought just putting my head down and crying until I can't cry any more would help, I'd be typing this post from a lake of tears and snot on my desk. Crying doesn't help. Getting mad doesn't help. Hell, nothing really helps. About the only thing I can do is to choose to not give in to the pain, to not give up on the day-to-day tasks, and to keep loving my husband and son as best I can from the core of who I am. I wear a necklace that says "Live Life" - that's my motto. Live it, don't give in to the stuff that can only be a crippling factor, emotionally and physically.
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