Tags: aches, arthritis, blood test, cats, doctor, flare, flare-up, GP, hospital, joint pain, knee, medicine, methotrexate, MTX, NHS, nurse, pain, R.A., RA, rhematoid arthritis, rheumatoid, Rheumatoid arthritis, rheumatoid arthritis (RA), rheumatology, stiffness
Thanks to the state of the NHS today (which, if you read this blog often you will know I harp on about endlessly) it is simply not possible to have a relationship with your GP these days (unless you’re incredibly lucky or live on some tiny island that actually has its own GP or something!) My GP practice has around 10 GPs plus locums. It’s pot luck who you get to speak to when you call and they phone you back, and then if they decide you should be seen you won’t see the person you spoke to that morning.
It also seems that they don’t have much of a relationship with the hospital and seem to have some sort of mythic belief in the power of the rheumatology helpline, as I’ve also mentioned before.
The patient calls the GP because they have an RA flare. This is a shocking waste of the GP’s time because these lucky, .lucky patients have an RA helpline that they can call and that will solve all their problems. They can speak to a lovely nurse* straight away and the nurse will wave her magic wand, waggle her magic pixie ears and solve the patient’s problem.
* Actually that’s the only true bit – the one we have at the moment IS a lovely nurse!
The lovely nurse, or even a secretary or receptionist, never EVER answers the helpline. It is an answerphone. That’s the way it’s set up. It’s not an answerphone on odd occasions when they’re exceptionally busy, it’s ALWAYS an answerphone. The message on the helpline says something like: ‘If you’re calling about a non-RA related problem, please call your GP. If you’re calling to change an appointment, please call reception. If you’re calling about an urgent need, please call your GP. If you’re calling to buy fish, please contact your fish monger. If you’re calling to moan about Brexit, please contact your MP. If you’re calling because you’re a moron, voted ‘Leave’ and can’t work out what a helpline is for, please call someone else and bother them. Now, if you really, really want to leave a message, we suppose you can. Give us your hospital number and name and telephone number and we’ll try to call you back in 24 hours – but no promises mind.’
I don’t know about you (actually I probably do, if you have RA) but I consider a flare pretty urgent.
While in an ideal world I would sit back on a couch, watch the telly and let my servants feed me grapes while I rested my knee and waited to see if it would clear up on its own, I do actually have a life (and no servants, and hubby is great but also has a life, and the cat just ain’t interested in helping), so I can’t just sit about and rest it. On that basis I can’t wait potentially 48 hours or more for the helpline to phone, and the nurse say, ‘Call your GP and get some prednisolone’ because then I can’t call the GP until Monday as 48 hours is Friday morning and by the time I’ve heard back from the helpline the GP has run out of appointments. By that time I will have been flaring for over a week!
What Polly did Next
So … I went to the appointment grudgingly granted me by the grumpy GP. (Ooh, nice alteration that penguin!) Fortunately it’s with a much more pleasant locum GP than the one I spoke to on the phone. Unfortunately of course she doesn’t know me from Adam (or strictly speaking, as a doctor, she can probably spot I’m not Adam from the wobbly bits, so I should say she doesn’t know me from Eve). This means that she doesn’t know if I’m a moron or not, and therefore has to assume I am, as we always have to cater for the lowest common denominator.
‘How can I help you?’
‘I’m having an RA flare in my knees, as usually particularly in my left knee. It’s stiff, not very flexible and painful at times.’
‘Have you called the helpline, because really -‘
‘Oh, and what did they say?’
‘I said I’d called them, not that I’d spoken to them!’ I then explained, gently, ’cause she was a locum and therefore wouldn’t necessarily know any better, the realities of the helpline. (I didn’t mention Brexit or fish mongers.)
‘Hmm, you had a blood test only yesterday and your bloods were hardly elevated at all.’
‘They never are.’ The mere fact that my bloods are even a smidge elevated is a pretty strong indication of a flare with me. Sometimes I flare and there’es no indication whatsoever in the bloods. Now this is where a doctor relationship would come in handy. If she’d actually known me, known that I’ve had RA for nearly ten years, known that I’ve had umpteen flares in my left knee, known that blood tests are not a helpful indicator with me, known that I have a brain, we could have skipped the pointless bits, more of which are coming up.
‘Ah, well let’s have a look.’ Prod, poke.
‘Did that hurt when I pressed there?’
‘No, I just thought I’d make screamy gurgling noises for fun.’ (Nope, I didn’t really say that either, I just said yes.)
‘Can you bend it?’
‘This much.’ Demonstrated a very slight bend.
‘Ah. Have you tried pain killers… like paracetamol?’
I’m afraid I just looked at her and laughed, finally managing to choke out a ‘yes’, followed by ‘interspersed with ibuprofen.’ She looked amazed that I’d been able to think of painkillers all by myself.
‘Well I’ll prescribe a course of steroids. Now if they don’t work, we’ll have to consider other possibilities like osteoarthritis, as they should work for RA.’
‘Well, they’ve worked every other time I’ve had them, so touch wood that they will this time too.’
‘Oh … right.’ Look of mild astonishment, either that I’d had them before (it’s in the notes dear) or that I actually knew that I’d had them before, who knows.
So I thanked her very nicely, ’cause I’m a well brung-up penguin … and I might run into her again, and off I went to the chemist to get my steroids.
Again, after nearly ten years of RA, I think I recognise an RA flare when I see one … I really hope I’m not proved wrong and that the steroids do work again this time and it doesn’t turn out to be OA. That would be sooooo embarrassing after this post!
Tags: aches, arthritis, canadian smocking, cats, cholesterol, coffee, crochet, decafinated, doctor, embroidery, GP, methotrexate, pains, Rheumatoid arthritis, Spanish
Well, I’ve been very remiss posting lately, I must say … so prepare for a very long and rambling post – perhaps I’ll put headings on so you can skip to the bits that you might find interesting! A combination of being very busy and yo-yo health – but fortunately, mostly busyness.
Anyone remember the game ‘fortunately, unfortunately’ where you’d take it turns to make sentences beginning with either fortunately or unfortunately, to make up a story? Well I was wondering whether to write an entire blog post like that, as my life seems to fit that pattern quite well right now – but thought it might get tedious, for you and me! Here’s an example though in case you have no idea what I mean:
Fortunately I have been doing a lot of fun things lately.
Unfortunately doing a lot of fun things is rather exhausting.
Fortunately I am, on the whole, sleeping quite well.
Unfortunately my Spanish teacher forgot I only drink decaf coffee and made me two fully ‘cafinated’ coffees last week, and I had a terrible night’s sleep (or lack of it) trying to climb down off the ceiling.
So – here we go with the update on the health front: About three weeks after my methotrexate increase in May I started to feel much better – go methotrexate! All those ‘regular’ niggly aches in my hands and feet were spirited away – I was still getting twinges and some knee pain (my knees probably being the worst affected bits of me) but no stiffness and none of that constant, nagging, draining pain. Hurrah! Unfortunately … sorry, just slipped into it there … it’s now about twelve weeks later and I’m feeling really pretty rotten. If you’re reading this then the chances are that I don’t need to describe that rotten feeling – you either know it only too well or you probably know me and I’ve moaned at you enough already – so suffice it to say I’m just not feeling good!
I’m hoping, and thinking it most likely, that it’s a temporary blip rather than that the methotrexate is ALREADY not doing the job.
On top of that I had my annual cholesterol test recently … hmm … suffice it to say I am now SERIOUSLY on a diet!😦 It’s very boring – actually that’s not really true – there’s a lot of GREAT and tasty food out there that’s fine for dieting, including much delicious fruit – but remember being a kid and having plenty of toys and games and friends, but you’re BORED and you DON’T WANT ANY OF THOSE? Well that’s how I feel right now about peipono melon and strawberries and lovely home-grown courgettes (zucchini) and all the other apparently delicious things in the fridge! I want caaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaake! But fortunately (sorry!) the weight is coming off so that’s encouraging me to avoid the cake and stick to the melon! Also I do NOT want to be on Statins at 46!!
And so to cats – it’s been absolutely ages since I mentioned my cats (or indeed my poor hubby, but he might have to wait for another post!) They are still, of course, a central part of my life (as are you hubby-dear, before you read this and complain) and in fact we may have to rename Enormous Cat as Mr. Handsome, as he has dieted (or perhaps I should say we have dieted him?) way more successfully than his penguin, so far. I should get encouragement from him – he’s ten years younger in sprightliness and joi de vivre, although (like me) he does complain loudly that he’s hungry sometimes! And Tiny Cat 2 has really come on – she’s gone from being a practically feral scardeycat to a real member of the family – she’s even been known to sit on my lap for twenty minute at a time and stay quite happily curled up next to hubby when he’s sat down beside her. (Not often – but increasingly.)
Having fun (and occasionally working)
So … the rest of life: I had a lovely visit a few weeks ago to Bro and SIL’s new(ish) house in the Midlands – and we’ve visited some other friends and had some friends visit us; Hubby and I have been doing quite a bit of wildlife surveying which is fun; I’ve been doing a lot of crochet, trying to get something ready for a competition but I fear it’s NOT going to be close to ready – but on the bright side I did get third prize in our local show for my crocheted St. Edwards Crown last month, so that was nice. I have also been trying out ‘Canadian smocking’ which is fun. Just small samples so far, practising on an old gingham curtain, because that way I don’t have to mark out squares on the fabric! I have a cunning plan for a clutch bag based on this technique – but no hurry … and the Spanish is coming on nicely – although to be honest I can understand my Spanish teacher fairly well but plonk me down in Barcelona and ask me to translate and I’m sure I still couldn’t understand a word! Still – getting better! And in amongst all this fun, fun, fun – work has, thank goodness, picked up lately, so we’re busy there too. No wonder I’m tired!
Phew – sorry that was so rambly – I’m off for a lie down now … although Mr Handsome is trying to persuade me to feed him instead.
Tags: cats, children, day out, folic acid, gardens, methotrexate, MTX, peacock, RA, Rheumatoid arthritis
Saturday was an absolutely glorious spring day – sunshine by the ton! My Saturday started by being woken by an unexpected visitor in the garden. I thought it was a cat and couldn’t understand why our cats weren’t responding to these incredibly loud meeows. The cats, of course, knew better! Here’s a picture of our visitor.
The sight of him was a grand start to the day, but it just got better and better. Thanks to the f-f-folic acid on F-F-Friday I was f-f-feeling f-f-fine and I braved my first trip out in Hubby’s open topped MG. As bravery went, I wasn’t very! I had a long-sleeved t-shirt, two jumpers, a jacket, a ‘slanket’, a blanket, a hat and gloves!! It felt fab though, being driven along with the wind in my hair … there were times when I felt as though the wind was in my very bones, but mostly it was heavenly.
We visited East Ruston Old Vicarage Garden first of all – an extraordinary place which must surely have pioneered the idea of garden rooms. It’s very close to the coast (as you can see from the picture, where Happisburgh (pronounced hays-borough of course!)) Lighthouse is visible through a cleverly placed hole in a hedge, but due to incredibly skillful planting and deep, deep double hedges, they can grow the tenderest of plants, including stunning camellias.
It has to be one of the easiest places in the world to get lost in because there are so many paths and so many nooks, but although it feels really spacious it’s actually quite small so not even I can really get lost for long!
We made a couple of friends while we were there. The first can be seen below on Hubby’s lap. Note the gazes of mutual adoration. Not sure who’s cuter!
The second was equally cute but slightly more worrying. We’d found a nice secluded bench to sit on and soak up the sun for a few minutes, and were enjoying the peace and quiet when suddenly a very small child came barelling in from nowhere and jumped up on the bench next to hubby, pulling his legs in and crouching as small as possible. I whispered ‘Are you hiding’ and he nodded. After a few seconds, when no one had come to find him, he got bored and said ‘Did you know there’s a dinosaur head over there?’ We said we didn’t. (In fact we knew there wasn’t, because we’d already noticed the cow’s skull complete with horns in the part of the garden designed to mimic the Arizona desert, complete with a range of cacti etc.) I asked him if he was sure it was a dinosaur head and he assured me that he was – it was, he said, in fact a Tyrannosaurus Rex head. When we asked him how he knew he looked at us pityingly and said ‘Because it’s got horns!’ Then, grabbing a rather surprised Hubby’s hand, he said ‘Come and see!’ and dragged Hubby over toward the cow’s skull. ‘You’d better come with me!’ said Hubby hurriedly, as images of angry parents, police, child abuse accusations and court cases flashed through his mind! So off the three of us trouped, like a line of ducks, small child pulling Hubby along by the hand and Hubby pulling me along.
Fortunately at this point small child’s father caught up with us. More fortunately he obviously knew his son well! ‘Ah, I see little Jonny has adopted you. Sorry about that. He has a habit of doing that.’ I explained that we were off to see the Tyrannosaurus head (and added ‘cow skull’ sotto voce when he looked confused). Laughing and apologizing he came with us, and when we’d admired the most impressive dinosaur and Little Jonny was satisfied, we went our separate ways. As we wandered of Father said to Jonny, ‘Which way shall we go now then?’ and Jonny replied loudly, ‘Well I’m going with them!’ Fortunately Father persuaded him otherwise, probably with a bribe of ice cream as we saw them later in the cafe!
The rest of the visit was less eventful but still very enjoyable, and after a tea break we headed off around the coast and stopped at Cromer. (Penguins like to see the sea!) We finally rolled home just as it was getting dark, tired by very content. Hubby commented that I was looking and sounding and moving better than I had for quite a while – I felt it too. Amazing what a spring Spring can put in my step!
Feeling a tad creaky today (Monday) but it’s m-m-m-Methotrexate day so hopefully by tomorrow afternoon I’ll be full of the joys of spring again (although perhaps a little queasy as I’ve not managed to see the doc about changing the folic acid dosage and timings yet!)
Tags: arthritis, cats, knee
Poor Middle-Sized Cat had an emergency vet appointment yesterday after having spent most of the day throwing up … on various floors, various mats, our bedding … By three o’clock hubby was wondering if the end was nigh, so we got him a vet appointment. If you know cats you’ll no doubt guess that by 5:30 when we saw the vet he was quite perky and made us feel a bit silly for panicking.
Temperature: normal, colour (how they tell under the fur I’m not sure): normal, growling at vet: normal, showing interest in the bit of food she waved at him: normal. She actually said he was in excellent condition for his age, which was good to hear. The only problem … he’s got bad arthritis in one knee!
Poor lad, I do sympathise with that. I presume his is osteoarthritis, but dashed unpleasant nonetheless.
The vet has recommended cod liver oil, of all things! I thought that was on old wives tale, that it actually helped. People still talk about it ‘oiling the joints’ which is obviously nonsense, but presumably it does actually do some good. Anybody know how? I’ll be trying to track some down for him today, and hopefully he’ll actually like the taste! (If not there’s no chance of getting it down him!)
And while I’m talking cats, for anyone who remembers my old posts about Tiny Cat 2, you’ll be glad to know she’s settling down well, although ‘run away’ is still her favourite phrase. She does grudgingly accept cuddles most days now and is even sometimes happy to curl up on my lap (or sometimes hubby’s) for a good fuss and purr!
Tags: arthritis, broke, cats, fatigue, joint pain, methotrexate, Middle-sized cat, money, MTX, NASTY, National Institute for Clinical Excellence, NHS, NICE, occupational therapist, OT, R.A., RA, rhematoid arthritis, Rheumatoid arthritis, rheumatoid arthritis (RA), rheumatology, sleep, stress
Firstly a ‘big shout out’ to Warm Socks for reading comment replies. Well done to you, m’dear! I also read them when I remember to tick the little box, but I usually don’t remember.
Secondly, for them as don’t keep up with comment replies, like me, tinglywinglypingly is a thing of the past – hurrah.
Thirdly, I had my methotrexate last night and, unlike last week, not only kept it down but slept like a log afterwards and feel great today. Middle-sized cat is also delighted, as he tends to sleep next to/on top of me, so he also got a good night. After a trip to the V-E-T yesterday he’s now costing me about SIXTY POUNDS A MONTH in medication … but of course he’s worth every penny, and more.
Hey ho – it’s only money … not as important as health.
I obviously value him more than NICE values me, or rather values other R.A. patients who are not so lucky as I am currently! This article in The Guardian tells an all too familiar story.
Tocilizumab (another biologic), which costs £9,000 per patient per year (so about the same per month as middle-sized cat costs me per year … but then consider the difference in resources between lil’ ol’ me and the British government … on second thoughts, maybe not; I’m not quite broke yet), is being given to patients in Scotland (and indeed most of the rest of Europe), but NASTY has decided once again that it’s too expensive for patients in England. And once again the fact that it could keep people in work and reduce the costs of unemployment benefit, keep them walking and reduce the cost of wheelchairs, keep them out of hospital and reduce the costs of round-the-clock healthcare … etc. etc. etc. has escaped them. It’s an argument I’ve had with them a few times before on this blog, here and here and
Tags: aches, cats, enormous cat, fatigue, RA, rhematoid arthritis, Rheumatoid arthritis, rheumatoid arthritis (RA), sleep, tiredness
Picture the scene: it’s three in the morning and I’m in pain and wide awake. Tim Piggot-Smith has failed me – for once even his dulcet tones reading David Starkey’s Monarchy: The Beginnings haven’t lulled me to sleep. Neither has a podcast of a lecture from the wonderful Dr. Stuart Lee on Anglo-Saxon History – my other failsafe. I’m at my wit’s end.
Suddenly there’s a crash, a bound, and a superhero comes flying through the bedroom window and lands on the bed with an enormous thump. Yes, it’s The Grey Shadow, feline super-hero extraordinaire, to the rescue. A lick, a purr and I’m already feeling better.
Soon the gentle sound of purring has done the trick and I’m fast asleep.
I wake up at around 5:30 and The Grey Shadow has mysteriously disappeared. My ankle’s in agony. Why? Ah yes – Enormous Cat is fast asleep on top of it. I wonder where The Grey Shadow went? He would have been far too considerate to sleep on my ankle.
Thanks to Wren at The Rheuma Blog for reminding me about this incident with her post on wee beasties! What would we do without them? I’d far rather put up with the discomfort of the occasional sore ankle than not have these nocturnal visits from my superhero at all!This is enormous cat. You can tell it’s not The Grey Shadow, in spite of the general similarity in colour and size. The Grey Shadow wouldn’t be seen dead on a pile of washing!
Tags: arthritis, blood test, cats, GP, methotrexate, MTX, nurse, RA, rheumatoid, Rheumatoid arthritis, rheumatoid arthritis (RA), stress
I have had a bad day … but a good R.A. day!
Here’s how the day’s gone:
1. I had completely forgotten I had a blood test this morning, went sailing off to work, got there, realised that I should be going to the GP, turned around, and the red petrol light came on. Mad dash to fill up with petrol from my spare can before the appointment, because I KNEW that otherwise I’d forget.
Positive R.A. stuff:
- All results from the previous test were fine – in spite of a recent increase in MTX.
- The nurse only had to have one go at getting my blood instead of the usual Penguin is a pincushion routine.
- I got the top of the petrol can and it didn’t hurt!
2. For some reason the red light wouldn’t go out, so I decided to go and buy some petrol. Just as I’d driven PAST work on my way to the petrol station, the petrol needle readjusted and the light went off!! Aargh. Decided to get some petrol anyway and fill up the can. Filled up the can, put some more in the car, went in and joined the queue. There was a man in front of me but I didn’t take much notice of him, as you don’t. When I got to the front the conversation went something like this:
Penguin: Pump 2 please
Penguin: Number 2 … please.
Penguin: Pump … number … 2 … please?
Assistant: Ohmegawd, ohmegawd, ohshite, ohmegawd, stop Mr Pratt … Mr Pratt, Mr Pratt!* oh no he’s gone. Lydia, Lydia, shite, heeeeeelp.
As you may or may not have guessed, the aforementioned Mr Pratt had told her that he was on pump 2 and she hadn’t checked. It was obviously not deliberate as he had an account with them so it can be changed on that, but it caused havoc as far as me paying went, and added about ten minutes to my already delayed start at work.
Positive R.A. stuff:
- I worked the petrol pump and it didn’t hurt at all! (This is not usual at all for me.)
- Standing about patiently (and then mildly irritably, and then impatiently) while the assistant sorted herself out didn’t hurt either. My feet were fine.
3. I get to work, tell ‘the boss’ what kind of morning I’ve had and firmly announce that from now on the day is GOING TO GET BETTER! I am determined that this will be so. I am thinking positively. NOTHING ELSE is going to go wrong.
Then, at about 10:33 I realise I’m supposed to be in the cafe down the road meeting a friend for coffee …at 10:30. Aaaaaaaaaaaargh. I tell the lass that works for me (a.k.a. the boss) that if my friend phones, say I’m on my way (she’s a good lass, she could have worked this out for herself, but I’m panicking at this stage), throw my coat on and run (well, jog … well OK, walk fairly fast) down the road.
I’ve only gone a couple of hundred yards when a horrible realisation dawns. I phone the boss and ask her to check my calendar. Sure enough it’s NEXT Monday I’m meeting my friend for coffee. Another few minutes wasted out of a busy day!
Positive R.A. stuff:
- Racing down the road and my knee didn’t even twinge!
4. Had to take middle-sized cat to the v-e-t this evening. Hubby rang at about 4:30 to say there’s no way he’d be home in time. ‘That’s fine,’ says I, ‘I thought you wouldn’t be.’ I wondered why he was sounding so bothered about it. Then I got home, put MS cat in the box, picked it up and thought, ‘AH! That’s why hubby’s worried.’ I’d forgotten that MSC weights a tonne (approx.)
Positive R.A. stuff:
- OK … it hurt, I can’t deny it … but it didn’t hurt anything LIKE as much as it has done in the past!
So hurrah – what a great day – what a lot of signs that the MTX might be doing its job properly at last!
* Names have been changed to protect the idiot.
There’s one small thing I hadn’t really seriously considered, although it did cross my mind. Tiny cat disappeared on Thursday with quite a pronounced rounding to her middle regions. She appeared today back to her usual svelte self … yes, she’s had kittens!! I don’t know if they’ve survived or not, or where she had them or anything, but I’m just so glad she’s back. I’m thinking they MIGHT have survived because she’s not spending much time with us, so perhaps it’s because she’s feeding them. We’re assuming she’s eating for several anyway, so if we’re wrong, next time we see a pronounced rounding it’ll probably just be overfeeding!
Oh dear, Tiny Cat 2 has gone missing. I mean she wasn’t exactly ‘our’ cat anyway, but she’d pretty much made her home in our back garden and was there most of the time (when she wasn’t running away) but we had torrential rain on Wednesday and she didn’t appear all day. We thought perhaps she’d just found shelter somewhere and was keeping dry, but she’s not appeared since. I have a bad feeling …
Tags: absolutely nothing to do with RA, cats
We seem to have another tiny cat coming to fill Tiny Cat’s vacancy. Not that anyone could fill her paw prints of course, but … It was quite bizarre, about a week after Tiny Cat died we had a garden full of cats, and Middle-Sized and Enormous were surprisingly tolerant of all of them. Then it whittled down to two or three hanging around the following day and we joked that they’d been shortlisted by M-S and E to fill Tiny’s vacancy. Or at least we thought we joked … we now have a very tiny indeed cat who seems to be either a feral kitten or a young stray, who we’re feeding regularly. We haven’t got her (we assume it’s a her but may be wrong) to let us touch her yet, and she doesn’t come in the house (or not if she thinks we’re looking) but I think she’ll eventually come round to the idea of being part of the family. Unfortunately though, although Enormous is totally laid back, Middle-Sized Cat has taken agin her, and regularly chases her off or backs her into corners and beats her up! We’re hoping they’ll sort it out between them eventually!!