I had my follow-up with my rheumy today and i came out of the consultation room very pleased.
I did not expect much from this consultation actually. And for once in a few years, i had actually decided to let the issue of biologics rest. I’ve been coping rather well with the disease activity since the previous follow-up, even though the pain comes and goes. It is something i can live with. I reckon that the switch from diclofenac to Arcoxia, as well as the full compliance of it, helped a lot with the inflammation. But if the disease activity is anything more than that, then it’s a different story.
My bloods haven’t been really good however, though it is probably skewed due to the low Hb level. My Hb level is still hovering around 9, with a haematocrit of about 31%. My CRP went as high as 21.6, and the ESR up to about 45. And all of these despite having rather good days. But it’s ok anyhow, because i am no longer going to push for biologics (well at least for now while things are still manageable).
So we’re playing around with the doses again, but nothing significant. MTX and HCQ remains the same. SSZ has been increased from 1g to 2g/day. Arcoxia will now be taken ON instead of OM. And i am still refusing prednisolone and ferrous fumarate.
We chatted a little, as usual, and my heart was all warm and fuzzy at the end of it. She tried to get some updates from me about everything else other than RA even though she had personally made calls to my other doctors to find out more about my condition. She told me that although my other doctors have updated her, she wanted to hear it from me (that was so heartening). I told her about how RA is less of a problem for me right now. And how all my other issues are more pressing than RA right now. I shared with her the difficulties i am facing with the school, the difficulties with treatment and recovery, how i missed nursing so much, and my reasons for my reluctance to take prednisolone and ferrous fumarate (finally some explanation there). I also shared with her about my issues with my psychiatrist, the mirtazapine i was taking then, and how it stimulated my appetite so much that i gained a lot of weight (which led to heightened paranoia of such side effects and the subsequent worsening of my eating disorder). And finally i told her that for once, my family dynamics have changed for the better, which is quite contrary to what she has been hearing from me for the past few years. She was glad, the rheumy nurse was glad, and so am i.
She listened, as she always does, and it is always such a blessing to have a doctor like her, who doesn’t condemn or judge me for the choices (however flawed) i make. And before i left, she grasped my hand firmly (twice actually), looked me in the eyes, and told me to keep trudging on and to never give up.
I walked out of the room smiling, like how i always do everytime i see her. Nevermind the RA. Such simple gestures were enough, and are all that i need to keep me going. Silly i know, but doctors (or people for that matter), are hard to come by.
Things can only get better, i hope.