Flares- Please help me understand this mess?!?!

Hello Everyone,

      Although this is my first post, I've been hanging out and reading the posts and replies while crying with pain from swollen, throbbing wrists as well as shedding tears of empathy for the struggles and agonies each of you has gone through.  And..  I have learned so much.    I've had arthritis for years and joint pain and damage-  spine fusion in 2002, infamed elbows, shoulders, ankles, you name it since about 2001, had to have most all of the meniscus in my R knee removed in October, and just last week my orthopedic doc gives me the RA Dx.   Ironically, this flare, if that is what I am experiencing, came on within 48 hours of that Dr visit.  I have several questions/ comments that I would really appreciate your input on:

   After the Dx on Wednesday, my 16 yo dog fell down the steps (again) and we knew it was time to put her down.  I've been an emotional wreck for months but Britt's death sent me into a real tailspin.  I cried day and night and was (still am,  actually) grieving her death terribly.  The day I pit her down was worse and in truth it was a long time since I fell apart to that degree.  Less than 24 hours later my both wrists were hot, painful as heck, throbbing, stiff and weak.  That was 4 days ago and each day has gotten WORSE.   I am on vicoden and I even altrernate it with vicoprofen and neither drug even touches the pain.  Ice helps a little and I feel like an ice gel-pack junkie.  I plan my day around the number of cold gel packs I have-  honest!  ANyway...  is this a FLARE??  Do flares come on without warning and escalate?  Is there anything like a typical duration time??  I can't even grip a coffee mug and getting dressed actually reduces me to tears.  Oddly, I can type so-so as my hands aren't that painful unless I try to support or lift something using my wrists.  Forget any motion like opening even an easy jar lid or putting my hair in a scrunchie! 

     The main reason for my terror over this new ailment is that I am an artist.  A muralist, actually, and I do faux finishes in plaster and paints.  I am also just about to begin a REALLY big mural for a two story foyer even though I can't even grip a paintbrush or open a tube of paint.  My jobs are comissioned/ contracted.  I *have* to deliver on this mural even if I have to paint it holding a brush in my teeth.  

    I do understand that each person has different types of flare ups, I guess I am just trying to compare the 'norm' to what I am experiencing...  you know?    I just was blindsided by this sudden flare up-  I don't see a rheumatologist for another 2 weeks and my PCP is on vacation.  THat leaves my ortho doc and basically pain pills and injections.  Cortisone injections helped a lot in my knee, elbow and shoulder....  would they help the swollen throbbing wrists? 

     Thanks in advance for your replies-  your openess and experience are priceless!

 

God Bless,

Holly in PA

www.art-dujour.com

 

 

Thanks, Curley, for your reply!!

I was just got the RA diagnosis last week so I have not started with RA meds.  The ortho doc had mentioned RA before but I guess I wanted NOT to believe him....  I just kept going in every 2-3 weeks and begging for cortisone shots in the affected joint(s).   Right now I am waiting on more lab tests for all the standard stuff for RF, and the other RA indicative ones, as well as the ones to rule out lupus and a host of other connective disease/ disorders.

PREVIOUS Meds:

1. oxycodone- I was so high my hubby tells me I was talking about raccoons driving white cars!  Never again!  (I think)
2. cymbalta-  made my depressions WORSE if possible
3. mobic-  might as well have taken sugar pills!
4. celebrex-  had an allergic reaction due to the sulfa component.  I have allergies to most antibiotics.
5. naproxen-  I had a bleeding ulcer in 2001 so I can't take any NSAID that might cause that to return....  well except for my begging for an occaional Rx for vicoprofen which helps a LITTLE more with pain than vicoden.

CURRENT MEDS:

1. Prozac 20 mg qd
2. Wellbutrin 75mg bd
3. vicoden 10/325 up tp 2 tabs qid
4. vicoprofen 7.5/325 one every 8 hours prn
5. hydrochlorothiazide 50 mg qd
6. glucosomine chondroitin with MSM 2000mg/1000mg combo,  2 tabs qd

All of the above taken with saltines to prevent nausea!  LOL

Now to my drug ALLERGIES:  (*sigh*)

1. penecillin, amoxicillin-  all 'cillins'
2. sulfa
3. tetracyclines
4. cephalosporins
5. celebrex
6. feathers and poultry related by products are  used to produce Supartz and after my insurance actually APPROVED those costly injections, my allergy to the feather/ poultry stuff prevented starting that treatment!  My ortho even called the company the day I was to receive my first treatment and it was a big NO GO.  I was so hoping, as was the ortho that Supartz would buy me time in place of a knee replacement.  LUcky me, eh?
7. aspirin based/ ibuprofen based NSAIDs due to the bleeding ulcers

So..  that's a brief drug profile, past, present and 'never again' or allergic.

I woke up at 4 AM with pain, took the dogs- Dharma and Zeke, our NEW puppy of 2 days- outside, ate my saltines and I am heading back to TRY to sleep with my vicoprofen and ice gel packs.  Curley, I may JUST go to the ER today if things remain the same.  Maybe it's wishful thinking but my left hand seems to be a little tiny bit better-  or not...?  *shrug*

It's so nice to be able to come down to my office, log in the this forum and feel like I've done something positive by sharing (and complaining!LOL).  Thanks for being there!

God Bless,

Holly in PA

I second that!
welcome to HW hunnybunny!
Holly...a Medrol-dose pack or a course of prednisone JUST MIGHT help you more right now than the injections!
prednisone works a little more systemically than an injection into a joint or area of the body.
IV steroids are the cream of the crop however, LOL.
so yeah...perhaps some oral prednisone will help kick this in the butt!
the ortho doc could (and i don't see why he wouldn't...but as you described em'? hmmm?) RX some prednisone. i mean, it's a very potent antiinflammatory, it's an orthopeadic med for the most part...and if it WORKS it means that ya got somethin' inflammatory going on! {thus would aid in his definitive diagnoses}
oh i LOVE that you're an artist! can't wait to check out your site. i was a fine arts major at Marymount Manhattan College before i switched to nursing. i did archival framing & French Matting for 10 years as well. it's wonderful isn't it?
i actually got swooped up in medicine because of art!
i started taking Anatomy & Physiology classes to learn how to draw the human body better, LOL...then i caught the bio-bug! and it was all medicine & science then on in! it was a nice course of actions & i think the 2 worlds collide beautifully.

you take good care.
erin

I vote with the other posted who suggested Prednisone. I was on that for over a year before the other meds kicked in enough so I could function. Yeah, I gained a few pounds, whatever, it beats not working. Oddly enough I always managed to keyboard, even if it was just two fingers working, LOL! Hang in there and report back on how you are doing.

Hi Holly,

I am an 18 year veteran of RA. Everything as you know depends on the individual. So therefore for me predisone can work for flairs if taken in substantial quantities for short period of times and then taper back to zero.. Injections are great for the knees which I have had during the past 2 weeks primarily because I change my diet while traveling. All the other drugs I've tried and have little success. 

Also very importantly, a 24 hr to 48 hr food fast has totally elliminated the pain. Elliminate sugar, meat, dairy and bread from your diet immediately increasing your water take and you may start feeling better within the next few days, as I have found works for me. Keep the system flushing regularly especially during the first 48  hours, very important. I have a  diet that I developed and when I hold true to the plan I can stay pain free for 4-6 months, coupled with moderate exercise.  

Hang in there.

Hi Everyone,

 

Today was my best day in a week and I am feeling more positive.  The wrist splints have helped me so much that I don't even like to be without them.  I had x-rays today and physical therapy and more lab work tomorrow.  Even though I am still in pain, the vicodin does relieve it for the most part.  I'm even going to begin the mural this week-  possibly even tomorrow evening after Dave comes home from work.  (He has to help me get it all ready)

 

We are active in a Life Fellowship Group at our church and tonight I shared what has been going on for the past week and the Dx.  The people in our LFG are like family and they were all so supportive.  Something happened though that emabarassed me so much I broke down and cried.  We all  meet at each other's homes once a month and Dave & I are very close to the couple who hosted it.  Since today was a good day and my wrists felt better, I had better strength in my hands, right?  WELL... I tried to carry a glass of lemonade about 8 feet from the counter to the table and in front of everyone I dropped it!  My hands just went weak on me and it crashed to the floor soaking the carpet.  I was so upset and humiliated that I cried.  The hosts assured me it was fine but I was mortified.  I really thought I could handle that stupid glass and well...  I hate having to always ask Dave or someone else to pour my drinks, carry my plate, and so on.  I was also surprised at how much it affected me and how easily I cried!   In the passt I would have joked and apologised for being a clumsy oaf but somehow tonight this little episode was like a preview of what is to come and the faces of my friends looked so sympathetic-  like they pitied me!  I don't want to be pitied or be treated as an invalid.  I am NOT going to let this get the best of me.   Good Lord, I feel like my emotions are always right there ready to spill out and things that I used to brush off now seem to bother me.

 

It's been an emotional roller coaster, to say the least.  I am just SO luck to have my Dave-  he's such a goodguy that after HIS real job, he comes home and does all of the laundry, shopping and cooking.  (And help me when I can't manage something)

 

I thank God for the wonder of computers, internet and this forum.   Life seems so much more manageable after I read the posts.  God Bless you all!

 

~Holly in PA~

Hey Holly.. how are things?

Weather changes of any kind cause my joints to hurt,cold weather really bothers me.Glad i'm in Texas,lol.Before a rain I hurt & it gets better after the weatherfront has passed by.I only take Tylenol extra strength as I refuse traditional pain meds.They make me feel even worse.Besides I have a very high tolerance for pain.............

Hiya Erin and everyone :)

 

Erin-  your posts ALWAYS cheer me up!!       Most of the time I can ignore my mom's nasty comments but the email to Peggy was just a little hard to take, yanno?   I mean, if she trashes me like that with relatives that know me, how does she talk about me with her cronies???   I am sure that all of her red hat sisters think her oldest daughter is a head case!!  Now, don't get me wrong...  I do claim a certain degree of insanity and quirkiness as an artist and I really don't give a rat's bum what a couple of hundred older women dressed in flambouyant red and purple really think about me!  I have to remember to keep my sense of humour although these days I find myself crying easier than smiling!  I gotta change that!!

 

Iontophoresis is the way they are administering the dexamethasone.  Basically, they use injectable dexamethasone and shoot it into a pad on an electrode.  They attach the electrode and another contact to each wrist and then zap the med into me for 45 minutes or so.  It's not painful-  sort of feels like getting a tatoo or a bee sting.  And the best part-  I really do think it IS Working.  My wrists are improving daily even though I am still wearing my splints day and night.

 

I'm going to post this part on the fibromyalgia forum too.   I have so many goofy and seemingly unrelated little symptoms and problems and I want to know if it's the way FM is.  Or maybe some RA people have it too.  Almost every week for several years now I have at least one or two nights when I am awakened by incredibly painful leg cramps-  we used to call them 'charlie horses" :)  I usually wake up screaming for Dave to rub the affected part.  It can be my feet, ankles, calves, thighs, even my gluteus maximus!   The crampy spasms last about a minute or so but even the following day my legs ache and feel sore like I was running a marathon in my sleep.  Is this a symptom anyone else has?  BTW, my potassium levels have been good, so it's not that.

 

I see my Rhematologist again on June 28th.  The meds so far have not changed-  I still take vicodin 10/660, 2 every 4-6 hours, mobic, vicoprofen when I really need them at night, and I use the lidoderm patches qd for 12 hrs.  I am waiting on the appointment for my sleep study and the results of all the tests the rheumy requested.  SO presently, there have been no meds for my RA as the docs want to have all my test results back.  *shrug*  I only want to get on with it, yanno??  I accept my Dx so let's be proactive now!   My life is waiting!

 

I always appreciate any input and advice from the forum community and I thank God that I have the 'net and this venue to use while trying to cope with daily living.  Thanks from the bottom of my heart!

 

~Holly in PA~

Hello everyone,
I get those leg crams from time to time during the night time and I havae been able to reduce these problems by insuring I have more than enough fluid-water before I go to bed.
I gotta a flair that has been moving every week, left knee, rt knee, rt. foot and now rt hand. I had injections for the knees and the rt foot I just toughed it out with lots of ice. Now the rt hand. I know it will pass in time. Only those that have experienced RA will truly understand.
Hang in there.
Jimmy

Erin, girlfriend-  you are a genuine HOOT!  LOL   IV Tequila!!!   I love it!!  But it has to be that really good stuff you can only get in Mexico-  the stuff that is so smooth you don't even know you've just swallowed Tequila! 

 

Yeah, the thingie is like a TENS unit, or so I think.  The PT guy tells me the modality is slightly different though. 

 

My hubby just told me he's heading to bed so I'm outta here, too!  Thanks, Erin, for the visual of you and your honey hooked up to tequila and a TENS unit.....    LOL

 

~Holly~