Keep On, Keepin’ On

I had a rheumy appointment yesterday, a simple follow-up appointment.  I guess I’ll be having lots of those from here on out.

Anyway, things looked okay.  No weight gain from the prednisone (yay!), blood pressure holding steady.  The “squeeze” test showed a lot less pain in my hands, which was great.  Still some pain in my feet and my arms during the test, but overall much improved. So the basic message from Dr. K was to keep doing what we’re doing.

A couple of things stood out for me during out visit.  First, I have to start weaning off the prednisone.  Which is good.  But also bad.  It’s going to suck, and I know it’s going to suck, so I don’t want to do it.  At the same time, I would love to be off of it.  So after my next MTX dose, I am going to go down to a lower dose.  Fun!

I find Dr. K’s approach to things  really interesting.  She phrases things like this “you can lower your dose.”  Not “you should” but “you can”.  My partner says it’s because she wants the patient to be part of the treatment, and I think he’s right.  Ultimately when I lower my prednisone is up to me, in Dr. K’s mind.  I like that, knowing that I have some choices.  At the same time, I would love there to be one right way to do things, one perfect path that will make me feel better.  I guess that’s the difference between treating curable illnesses and chronic (incurable) ones.

The other big stand out with Dr. K was a conversation we had about managing multiple diseases.  Our big challenge, she said, would to be to make sure that we are treating each disease correctly, to make sure that we can identify what is causing each kind of pain.  So when I go down on the prednisone, an increase in back pain is not reason to put the dosage back up, nor will my back pain improve with the MTX.  It’s a separate entity.  I knew already that this was a challenge, and that it was important for me to pay attention to my body so I can decipher what is really flaring up or improving, but it was nice to know that she’s paying attention to this.  It’s almost as if she is treating me as three separate, but entwined patients, in order to find the right level of treatment for each problem.

So for now, I am going to keep on, keepin’ on.  And maybe we’ll get somewhere on this path!

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