Arx Hereticus

Welcome to the ramblings of a merry heretic, an ex-pat (Tex-pat?) American living in Maryland after having spent six years in Germany. Arx Hereticus is part travelogue, part cooking, part budo, part socio-political commentary and mostly just me BSing.

Thursday, October 18, 2007

Resolution

(Another post that's all about ME-ME-ME!)

Me and Kev on the dock in Am-dam.Last couple of posts were pretty grim, I know, and, honestly, things looked pretty grim from in here, too. Hedgewitch was worried out of her hide and I wasn't feeling too damn chipper meownself.

However, it seems we've got a 95-99 percent sure diagnosis to the vast load of suck that I've been carting around this past month or so.

Here's what's happening ...

July 18 - THR. All went well, 10 days in hospital, two weeks in rehab, then home.

Me, beergarden, Bad Abbach, post-op, late July.Two weeks home - I was doing very well, moving well, exercising, crutching around like mad.

And, I was even getting on the mat in the dojo, albeit cautiously. I sat in and observed a class or two, and actually taught a bit, and threw Miguel around whilst sitting on a physio-ball.

Me, dojo, on physio-ball with sword.About four weeks home - I was in my first week back at work full-time. Somehow, two things happened almost simultaneously; I contracted a stomach flu and -- somehow -- strained my right (op side) ankle.

That's when the fecal rotary oscillatory melee began.

Shortly after suffering from a 24-hour gastric flu that lasted about 10 days, my right eye blew up (uveitis/iritis).

Iritis is a nasty condition of inflammation and spasm of the eyeball. I'd had an episode about four years ago, and recognized the symptoms. I started self-treatment and got an appointment with the ophthalmologist. He started me on a regimen of dilators and steroid drops. Immediate improvement and steady recovery.

About the same time as the iritis was flaring up, my right ankle swelled to Biblical proportions and my left great toe (the ball joint) turned into a nasty chunk of rotten sausage that was painful even to have the bedsheet touch.

I was back on crutches due to the intense pain and was slipping into sleep dep from the pain and discomfort.

Hedgewitch, looking lovely, boat tour, Am-dam.Oh yeah, about the same time, I had an intercostal muscle spasm that felt alternately like someone was sticking a dull needle in between two of the ribs in my back (and wiggling it around) and some small, hungry burrowing creature was chewing its way through the meat there.

Sleep was out of the question, as was taking very much time off. I was tapped out of sick leave and diving into my reserve of annual leave.

We consulted a rheumatologist friend of HW's who said it sounded a bit like pesudo-gout. She called in a prescription for oral steroids, 5 mg, 4x a day for 3 days, tapering to 3x3, 2x3 and 1x3.

Me, Peter, Pauliina, Kevin, Utrecht.The relief was immediate, but not quite complete. I felt good enough to go traipsing around Utrecht and Amsterdam, Holland -- though it was more a slow stumping in my case, and my days included two-hour naps while our friends escorted HW around. We did have some of the BEST.Indonesian.food.EVAR.

And a very restful boat tour of the Amsterdam canals (otherwise Am-dam was full of drunks, stoners and clueless tourists; terribly crowded and expensive. Field-expedient surgery on Kevin's wasp sting, tour boat, Am-dam.If you go to Holland for reasons other than chemical recreation, go to Utrecht, it's prettier and cheaper). That was the boat trip where poor Kevin found the one curious wasp in all of Am-dam.

Then about the time I hit the 1x3 phase of the oral steroids, things had devolved almost back to pre-steroidal levels.

When we got back from Holland, I went to our German hausarzt who started ruling out conditions, and who gave me a fairly massive injection of IM steroids and methatrexate.

Again, immediate relief, but as soon as the injection worked its way through my system, I crashed hard.

A second dose a week later yielded the same result.

And, by the way, I was anemic and my inflamatory factors (CRP) in my bloodwork were about twice the high norms (15).

SO, being anemic, the docs decided to draw more blood. Three times, each time at least 2 vials and once six. Okaaaaay. You're anemic, so let's suck you a little drier!

Yay! And I didn't even get orange juice and a cookie.

Anyhow, most of the bloodwork was solidly normal. However, as soon as the injections wore off, the pain returned, though by last week, it did seem to be abating a bit.

Went Wednesday for a full-blown consult with HW's rheuma doc friend and spent a couple hours with her. When she had the above timeline and info, and had done x-ray and exam, she decided I'd developed not pseudo-gout, not rheumatoid arthritis (as I'd feared), but non-sero-reactive arthritis.

It acts like RA, but can actually self-resolve after about six months.

She started me on another regimen of low-level steroids and Indocin, a pretty powerful arthritis med. This regimen should resolve the situation in four-six weeks, if all goes well.

Yesterday, I was pessimistically hopeful, and today am positively optimistic.

I'm feeling good. Still in some pain, but WAY less than a few days ago, and have more mobility than I've enjoyed for weeks.

I taught beginners class last night, moving gently and carefully -- it'll be a long time before I trust the new hip to full-on ukemi, but I can still teach and move bodies around.

Today, I'm walking more normally, standing, sitting and turning quite easily.

I'm hopeful about the upcoming mini-seminar we're arranging for the last weekend of October. Dunno how MUCH I can do, but I know I'll enjoy it way more than I'd been hoping I would.

On the job/move front: Nothing new, but we've firmed up the timeline for Plan A (Austin). If the Great Job Fairy does come along, we'll work out details on Plan B (something else).

3 Comments:

Blogger Janet said...

My own suspicion is that SOMETHING your hip surgery/implant triggered a massive systemic inflammatory response (everything but the ankle sprain has been of an inflammatory nature).
Glad it is responding to meds. Keep on the back burner, just in case the steroids end up needing to be kind of middle to long term, that some folks whose bodies need to be on oral steroids, for reasons not understood, are able to reduce the dosage A LOT by simultaneously taking ULTRA LOW DOSE methotrexate. My sister was on oral steroids for years for respiratory inflammation and that made a huge difference in letting her lower the dose (hence harmful side effects) w/o changing the therapeutic response.
Hopefully your system will settle down on its own over the months as it fully recovers from everything.
hugs to ya big guy.

4:29 PM  
Blogger Carolus Hereticus said...

Heya Sweetie,

Dunno if it was the implant per se, but the lowered immunity and generally weakened condition (and the damn gastritis) certainly didn't help.

Em's leaning toward some sequelae of the implant, herownself, BTW.

Had yet another battery of tests done last week (HBL something or other? And some checking for parasites ...) and awaiting results.

The rheuma doc seems very sharp.

My family doc was using IM steroids combined w/Methotrexate, and I got immediate, but very short-term relief. Rheuma's holding methotrexate as a backup.

Right now, tapering the oral steroids down (15mg today, 10 tomorrow and thence), and 25 mg Indocin TiD.

All in all, the hip ain't bad. Just got to get a handle on the rest of it.

Hugs back at ya and warm wishes for your coming adventures!

cg

1:07 AM  
Blogger Janet said...

Its good when the wifes agree :-)

5:44 PM  

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