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Dear friends:

First of all thanks for your interest. I’m not sure if this blog is to keep all of you up with what’s going on as much as it is for me to document the journey I’m about to undertake, hopefully to better health.

As you probably know, after some time of dealing with weird symptoms and worsening joint problems I consulted with Dr. Don Cheatum, a really top-notch rheumatologist. After scores of tests and enough nuclear medicine and regular X-Ray scans to make me glow in the dark, he has diagnosed me with Undifferentiated Spondylarthropathy. It is a type of sero-negative Rheumatoid Arthritis.

The good news and the bad news is that I now have a diagnosis. If you know anything about Rheumatoid Arthritis (otherwise known as RA), you know there is no cure. The best they can do is slow it down.

The bone scan showed severe arthritis in my right hip, which is no surprise since I’ve been seeing an orthpedic guy and physical therapists for some time trying to get some relief. It also showed inflammation scattered all throughout my joints, but not yet severe enough that I’ve noticed them. So it’s good that we’re catching this when we are, because there’s no reversing the damage. (More about the hip in a minute.)

I’ve been taking the anti-inflammatory Mobic for months now. To this, Dr. Cheatum has added methotrexate, which is apparently an effective disease-modifying antirheumatic drugs (DMARDs). In higher doses it also is used to treat cancer. That should give you an indication of the potential side effects which include a suppressed immune system, stomach/intestinal distress, sun sensitivity, liver damage, lung damage, etc. etc. etc. In addition, I am taking folic acid to counter the side effects of the methotrexate, a prescription to help protect my stomach and hydrocodone to control the pain so I can sleep. Dr. Cheatum is extremely cautious about the diminished immune response. He wouldn’t let me out of the office until I had a pneumonia vaccination and has made me promise to get a flu shot this fall. I also can’t drink. All that luscious wine and wonderful single malt Scotches that I love are now a thing of the past. (Actually, my research indicates that I can have two drinks a month — but not on the days that I take the methotrexate.)

I take the methotrexate once a week, and I’ve picked out Friday evenings to give me the entire weekend to recover if it wipes me out. So tonight is the first dose. I’m going to use this blog to track my reactions and benefits to it. I looked briefly for some blogs of people like me so I’d have some first-hand reports, but no luck yet. A lot of people who have RA are no doubt old farts like me, but who aren’t technically inclined to do blogs.

Dr. Cheatum also recommended that I get the right hip replaced since it causes me so much pain. He “suggested” that I use my cane when I walk to help take pressure off the hip. Not sure that is going to happen. However, Jack has threatened/promised to get me a fancy walking stick with a silver wolf’s head handle. (Wow!) It does feel better walking with the cane, I just can’t get over the image thing.

I was really, really upset when I got the diagnosis. I was expecting it, or something similar, but something about hearing someone tell you that you have an incurable, disabling disease hits you like a sucker punch, no matter how prepared you think you are. That lasted for a couple of hours. Then it became a relief to finally figure out what was going on and have a plan to make it better. Also, Jack took me out to our favorite watering hole for one last martini and some decent red wine over dinner before I climbed up on the wagon.

That was yesterday. Today, Friday, I saw my orthopedic surgeon, Dr. Tucker. I brought him up to speed and told him that Dr. Cheatum had recommended replacing the hip. He’s a very conservative guy and looking at my last X-Rays, wasn’t convinced that we were quite there yet. So we took a new X-Ray. And he says, “Oh yeah, it’s getting worse, isn’t it.” So we’re at the point that the hip joint/cartilidge is definitely degenerating, but the bone is still in really good shape, which is the best of all worlds for hip replacement. Probably in a month or so (3rd or 4th week of August) we’ll get that taken care of. (Sometime after Jack’s birthday trip to Las Vegas, but in time for me to heal up for our Thanksgiving London trip.)

We discussed the pros and cons of resurfacing instead of replacement, and based on my age, activity level, etc. he’s recommending the replacement, but with high-impact implants. (Never thought I’d have implants ….. hmmm.)

The twist to all of this is that I have to be off the methotrexate for two weeks prior to the surgery (since it interferes with my immunity), which means that if I want, I can have a drink to celebrate Jack’s birthday when we’re out in Las Vegas for his birthday.

I’ll be in the hospital 2-4 days for the surgery, but not sure exactly how long I will be “out”. I have a friend that just had both hips done (one right after the other) and she was back to work/full activity in six weeks. The good news is that I can work from home. My fingers will still be able to type.

Dr. Tucker’s asked that I take a week to think about it so next Thursday I’m scheduled to go back to see him and, I’m sure, get everything scheduled.

That’s all I know for now. I’m still a bit manic-depressive about the whole thing. I am really glad to be able to do something to feel better, but if I had asked for something for Christmas, you can bet that Undifferentiated Spondylarthropathy wouldn’t have been it.

I’ll update this over the weekend after I take my first dose of MTX.