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I’ll start with the most recent news first.

Yesterday I went to the oral surgeon for the first step in getting the replacement implant for the tooth I’d broken and subsequently had removed last January. The jaw has to have time to rebuild the bone where the root of the tooth was before they can start the implant procedure. The first step is putting a post into the jaw to hold the crown that will eventually be in place. alftoothacheThis is what I had done yesterday and it takes several months for the bone to heal firmly around the post before the next steps of putting an abutment (the part that extends beyond the gum line that the crown holds onto) and the crown. Since the location of my missing tooth is directly below a sinus, the oral surgeon inserted a bit of additional bone below the sinus and above the implant for extra protection. I opted for general anesthesia rather than local for several reasons and, other than the anticipated multiple pokes (5), to get the IV started, all went well. When I woke up, they had wrapped a band around my head that held an ice pack to help with any swelling. I was reminded of Alfalfa from the old “Our Gang” show. I am doing really well. I’ve had no pain and spent most of yesterday sleeping off the anesthesia. Just as a matter of practice, after any kind of surgery, I always take the pain medication “on schedule” the first day, although I didn’t really feel like I needed it. Today, I’ll definitely switch to the “as needed” approach. I go back in a week for another X-Ray and follow-up visit, then in three to four months we’ll take the second step of inserting the abutment into the post. A couple of weeks after that, I’ll get the final crown and it will be as though the tooth was never gone.

Before that, I visited my orthopedic surgeon for a follow up on my knee replacement. While on vacation, my knee started making a definite “clunking” noise. As this was new and it has been 10 months since the surgery (close enough to my one-year evaluation to count), I decided to get it checked out. Everything looks, as my doctor says, “perfect”. As the knee continues to heal, which can take 18 months to two years, the muscles continue to relax and swelling recedes. This makes the area around the new knee a bit looser and, as such, the components move more freely and can make noise, particularly when the knee is in a twisting or turning motion. He also checked my hip replacement which also looks great so I’m good to go for another two years on both of those. The only fly in the ointment (not actually as big as a fly, more like a gnat or a noseeum) is that my other hip is showing some degeneration and narrowing of the cartilage and more arthritis. Not headed for a replacement there quite yet, but it is changing.

The really good news is that I had my rheumatologist follow up and the Xeljanz seems to be working. My labs look good and most days I actually feel pretty good. I’m currently still on 7.5 mg of Mobic and 20 mg of Arava (leflunomide). I’m dropping off the Mobic starting next week. I was on 15 mg per day, but as Xeljanz can have pretty severe gastric consequences, I cut it in half and, with my rheumy’s blessing, am going to drop it off altogether. I was on it mainly to help with the transition to the new drug. In addition, I’m going to move from 20 mg of Arava to 10 mg with the goal of dropping off it altogether by next spring. My one fear is that I’ll build up a resistance to Xeljanz like I did the TNF inhibitors. But so far, so good. One step at a time.

Finally, there is the unknown. The same day I saw my rheumatologist, my PCP ordered a Doppler scan of my carotid arteries. I have cholesterol and blood pressure problems and as I generally eat the same diet as my husband who has triple-bypass and have the additional risk factor of inflammation from RA. It’s probably a good idea to check for plaque build up. The Doppler scan is very similar to a sonogram where they put a gel on your skin and move a wand/device over it. I really wasn’t expecting anything, but I have to say that now I’m a bit concerned. The technician said that I would probably hear from my doctor in a few days, but that he would tell me if everything was okay (which he shouldn’t have said). At the end of the test, he DIDN’T tell me everything was okay, just that my doctor would get back to me. I haven’t heard anything yet. I’ve been trying to be patient because of the recent Memorial Day holiday and then being out for oral surgery, but I am going to start calling next week if I don’t get some information soon.

So that’s my life lately. Lots of stuff going on but RA has generally been quiet due to (fingers crossed) the new drug routine. I hope whatever is going on in your life brings you a smile. Thanks for checking in.