So far 2018 has been a physical challenge for me.<\/p>\n
The year got off to an inauspicious start.\u00a0 On January 10, while I was riding my bicycle, I felt a sudden pain in my left knee.\u00a0 It subsided for the rest of the ride, but over the next day it became apparent that something wasn’t right when I bent my leg.<\/p>\n
You may wonder–how could someone injure a knee peddling a bicycle?\u00a0 It’s a non-impact motion.\u00a0 But in 2016 I fractured upper tibia, near the knee.\u00a0 Moreover, due to long-term glucocorticoid use, my bone density is below average (osteopenia<\/a>).\u00a0 I’m more prone to get bone fractures.\u00a0 The discomfort I felt was reminiscent of that previous injury.<\/p>\n So, to be prudent, I decided to keep weight off my left leg.\u00a0 I used crutches and a knee brace.\u00a0 My knee started feeling better.\u00a0 After a couple weeks of “rest,” it felt solid enough that I shed the crutches for a couple days.<\/p>\n Bad call.\u00a0 I re-aggravated it either through overuse or by carrying extra weight.\u00a0 It felt worse than before.\u00a0 I resumed using crutches\/knee brace and finally made an appointment to see the orthopedic doctor.\u00a0 The knee felt so fragile I was worried there was a crack and I’d need surgery to fix it.<\/p>\n Surprisingly, at two exams (first using X-ray, then an MRI) the doctor didn’t find any fractures.\u00a0 My knee was basically intact (the MRI did reveal a tear in my meniscus, but this alone could not have been the cause of my discomfort).<\/p>\n I was relieved to learn that my knee was “okay.”\u00a0 But the good fortunate I felt from my positive diagnosis soon evaporated in the face of my greater nemesis: rheumatoid arthritis<\/a> (RA).<\/p>\n Although my knee movement continued to improve, the swelling did not go away.\u00a0 To the contrary, system-wide, my joint inflammation was getting worse.\u00a0 Why?\u00a0 Because the Enbrel<\/a> I was taking to combat RA was losing its effectiveness.<\/p>\n At my rheumatologist appointment on February 22, we decided to stop the Enbrel treatments and try a different bioloic drug, ACTEMRA<\/a>.\u00a0 It’s now been almost six weeks since I started taking Actemra and I have yet to see much of a reduction in inflammation.\u00a0 Typically, in patients where the drug does work, symptoms improve in 2 – 12 weeks.\u00a0 So the jury is still out on whether it will help me.<\/p>\n In the meantime, I’ve been relying on ~20-25 m.g. of prednisone<\/a> (per day) to maintain my joint flexibility.\u00a0 It’s not a great option–the drug carries a host of side effects.\u00a0 I’ve gained weight, become moodier, more easily frustrated, and can’t sleep for more than a few hours at a time.\u00a0 It’s disconcerting to be wide awake after only two or three hours of rest.\u00a0 I’m operating on about half the sleep I was getting in the fall.<\/p>\n But by far the biggest problem I’ve had in the last month is the emergence of painful hip flair ups.\u00a0 I’ve had roughly ten episodes, mostly at night.\u00a0 My rheumatologist said they may be palindromic rheumatism<\/a>. They have a distinctly different character from my normal RA joint inflammation.<\/p>\n A full-bore attack is rapid and debilitating.\u00a0 In the span of six hours, I’ve gone from normal walking to barely being able to move with crutches.\u00a0 The pain is brutal and I lose my ability to move the affected leg.\u00a0 It takes all the willpower I’ve got just to get in and out of bed.\u00a0 When it hits, all I’m able to do is find the least painful position possible and wait for the drugs to start providing relief (two hours+).\u00a0 I recommend avoiding this experience, if at all possible.<\/p>\n