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I think we should just rename “August” to “Doctor” to commemorate all the doctors’ appointments I seem to have accumulated this month. I have appointments with five doctors (plus another the first week of September), lab work, at least one X-Ray, seven physical therapy appointments, and a “drop-by” to drop off a form to get some medical records transferred. And that’s if none of the doctors schedule any additional tests (which I am expecting). As a good friend quipped recently, it’s hard to throw a dart at a calendar without running into one medical appointment or another.

But I’ve made it through three important check ups with generally good results.

I saw my back surgeon for my second follow-up and things are looking good. My spine is showing new bone growth where it’s been fused (which is a good thing). I am now officially cleared to lift 25 pounds (up from 15) and in October that increases to 50 pounds. I don’t think I can lift anything more than 50 pounds anyway, so I don’t know that I really care about what comes “next.” I am supposed to continue using my bone growth stimulator – mainly as I was so bad about using it the last month I was supposed to. With being in Washington, DC for two weeks for work followed immediately by knee surgery, using the device was pretty much on the bottom of my list.

As reported in my previous post, I saw my knee surgeon for a follow-up and now have my physical therapy sessions scheduled — the first session starting the day after tomorrow. I have them about three times a week which, if nothing else, will get me up and out of the house on a regular basis. That has to help with the stamina issue. I have alternating therapy in the pool and in the gym, which I think is a good schedule that gets some “hands-on” therapy in the gym but also provides some therapy in the pool which will help protect my healing back and all my RA-affected joints. I don’t feel like I am progressing as quickly as I should and am hopeful that being back with a therapist will help me get back on track.

Finally, I saw my rheumatologist yesterday. Like Andrew and Pollyanna Penguin, my cholesterol levels have been escalating. Even though my HDL/LDL ratio is still holding, my total cholesterol and my “bad” cholesterol are way out of control. I haven’t changed my eating habits and my weight has been stable. My cholesterol jumped 60 points in three months — fairly consistent with when I increased to 20 mg of Arava from 10 mg. (You would expect to see a parallel jump in my weight with that kind of increase, but that hasn’t happened.) So I charted all this out and took it with me to the appointment. My rheumatologist discounted my Orencia or Arava causing the increase in cholesterol and instead cited several reasons why this “blip” might be an anomaly — many of them related to my recent surgeries and resulting decrease in physical activities. She didn’t really comment on the potential link between RA and metabolic syndrome — which could lead to these results. However, I am also scheduled to see my PCP and my cardiologist in the near future (more on this in a future post), so I will continue the discussion with them. My cholesterol is hovering close to 300 (100 points above where it should be) and with a history of heart disease on both sides of my family, I need to figure out what is going on. I have taken a hard look at my diet and made some immediate changes and the scheduled PT will help make me more active. However, I can’t help but feel that something else is contributing to the issue.

I fully subscribe to being an active participant in my health care and think it is incumbent upon me to help manage the content of my doctors appointments — making sure that we discuss things are important and getting answers to issues that concern me. Doctor’s memories are just as good as their notes and sometimes those aren’t very good even if they take time to review previous appointment discussions. Sometimes the patient needs to remind the doctor that, “Last time we spoke about X and if it didn’t improve, we would discuss Y.”

But I will tell you that with this many doctors’ appointments in a row, I sometimes feel like I’m herding cats!

I will continue to update you with progress with the doctors, although sometimes you have to wonder about spending so much time and money just to have someone tell you that you’re doing fine. :-) I appreciate you checking in.