Walking funny again

[cjsmith]

I got my second set of Killer Death Injections of Doooom this morning.

As before, I pinched myself awfully hard during each one to distract myself from the pain-and-wrongness sensation. (Last time, the welts I made by pinching took four days to fade. Aren't you glad you now know this detail?) Also as before, I have the anaesthetic effect over much of my foot without benefit of actual anaesthesia. Last time, this effect took about a day to fade.

There are dark purplish dots at the entry points where the needle went in. Those haven't faded from last time, so now I look like I have measles or something. If they all stay for seven weeks I won't be able to resist taking a photo of the resultant mess. :-)

If I concentrate really hard I can walk almost-normally with my partially numb feet.

Comments

[mactavish.livejournal.com]

They don't anaesthesize the foot with cold spray first? :(

(I get cold spray for cortisone injections, it's amazing stuff.)

[cjsmith.livejournal.com]

Yes, they do. I don't feel the pinprick at the surface at all. But they're injecting deep into the interstice (ideally directly into the nerve itself) so I definitely feel that!

[mactavish.livejournal.com]

Oooh yeah. I guess a major difference was that I was getting something soothing between bones, and you're getting something harsh on nerves.

That'd do it.

[cjsmith.livejournal.com]

Apparently anything in that area hurts a bit 'cause there's no room. Frankly, the cortisone-analogs I got there hurt worse! Do you get cortisone in places like the foot-knuckles or hand-knuckles? How owie is it?

[mactavish.livejournal.com]

From where I've gotten it so far:

The shoulders don't so much hurt as feel endless because it's the lonnnnng needle, and he comes in from behind, feels like the joint's about 5' below the surface.

The wrists are probably more like your feet are. He goes into the small bones in the hand just above the arm, and the pressure of the drug feels like the small bones are being shoved radially outward. But it's not really pain; I imagine he tries hard to avoid the nerves. There's very little room for extra in there. The big bulges I was getting on the backs of my hands, in fact, were joint fluid that built up in my hands and had nowhere to go, so worked its way to a subcutaneous storage spot.

(I also had cortisone in my back 20 years ago, but that's different.)

[mactavish.livejournal.com]

(I haven't yet had knuckle injections, and I'm not hoping for them.)

[cjsmith.livejournal.com]

I hope you're never at a point where they'd be beneficial. :-/

[cjsmith.livejournal.com]

There's very little room for extra in there.

Yeah, definite similarity there.

joint fluid ... worked its way to a subcutaneous storage spot.

Wow. Is that something that would have been safe to simply drain off by drawing it through a needle?

I was told that the cortisone (or cortisone-like) shots I got were limited: I could have only two (some doctors go to three) in my foot-knuckles before doctors would refuse to give me any more. Too many, apparently, and the fat pad on the bottom of the foot would start to deteriorate. Do you have limits like that on your injections, too?

[mactavish.livejournal.com]

With RA, as it's anticipated that folks will have to have injections off and on indefinitely, we're pretty much limited to three injections anywhere on the body per year, with no more than two in any one joint. It's not good for bones.

And yes, they remove excess joint fluid by aspiration. In my case, he (for free, I love my doctor) used cold spray on it, then just slid a needle in -- it wasn't deep, as it was on the back of my hand, not in my wrist -- and withdrew as much as he could, examined it (thicker = more inflammation, mine was thick but not so much he thought cortisone was required), then massaged a bit more out through the hole. It was fairly non-dramatic, but I've got no needle-phobia at all.

[cjsmith.livejournal.com]

Three per year total, two of which can be in one place? That's... not much. I hope they last a while.

A good doctor is worth his weight in gold fresh homemade chocolate chip cookies.

[mactavish.livejournal.com]

When I got my hands done (both at once) it went systemic, it was as if the RA in my hands went away, but all over, the symptoms were reduced. A week after the shots, I was able to go hiking at Pinnacles -- three miles up and down steep hills and stairs, and through a cave! -- and saw the condor. After a month, I was starting to get more symptoms everywhere, after three months, it was back to "normal". But that's three months in which I was doing considerably better. If I could have that even once or twice a year, I'd feel very lucky.

Also, my doctor's 6'5", slender, and geeky-looking (me? perv?) and trusts my intuition and body sense. When I say, "Well, I read on alt.support.arthritis that taking grapeseed extract helps with methotrexate side effects, and those folks tend to know the difference between snake oil and good medicine," he accepted that I wasn't being misled my crazy internet talk. He doesn't say, "That can't be RA, the symptoms aren't typical," he says, "You're a puzzle, let's find out how to make you better."

Anyone want a rheumatologist? I'm happy to refer.

[cjsmith.livejournal.com]

all over, the symptoms were reduced.

Ah, I didn't realize that. I remember you talking about the hike at Pinnacles but I didn't make the connection as to why that was possible.

Anyone want a rheumatologist? I'm happy to refer.

I have a friend who needs a good rheumatologist, but sadly she is in Ohio. I reeeeeeeally hope she finds a good doc soon.

[just-cyd.livejournal.com]

you talkin' 'bout me? i'd KILL for a rheumatologist who did more than say "sorry, we've tried everything. i don't know what to do with you"

and from what little research i've done, i don't think we've really tried all that much. i think they just don't want to bother being creative. :P

[cjsmith.livejournal.com]

you talkin' 'bout me?

Yes, I was. Even a mediocre rheumatologist would be a step up for you.

[just-cyd.livejournal.com]

oh yeah. oddly enough, my family doc put me on an older generic anti-inflammatory, and while i'm not 100% pain free, i feel better than i did on any of the newer drugs. i'm not even going to ask why my genius specialists never thought of that...

[cjsmith.livejournal.com]

Heh. Sometimes geniuses are too busy being geniuses to ask if the basics have been tried already.