Next!

This time last year, I felt great.  It was wonderful to finally feel good again. 

Things fell apart when I tried to reduce my number of meds.  Discontinuing ssz was a huge mistake, so I added it back in.  Next I discontinued the hcq.  The difference wasn’t as dramatic as it had been with ssz, but it definitely made a difference.  Sometimes I wonder if we should have just added it back instead of switching to biologic #2.

After a year spent singing the praises of Enbrel, I’ve been fairly silent about my second biologic.  Reason being, it didn’t work.  It’s a med that works very well for many people, so I don’t want to denigrate it unfairly.  In my treatment plan, though, it’s history.

Given my druthers, my rheumatologist would have written prescriptions to return to what was working a year ago.  She, obviously, knows all sorts of things I don’t, and thought it better to try a different biologic (maybe because just a couple months ago she had to argue with my insurer that biologic #1 wasn’t working).

I’ve now received my first dose of Cimzia of the cool looking syringe.  I’ll post a picture if my insurance company ever gets around to processing my pre-auth.  They took their own sweet time with the last one, and it drives me crazy that think they know better than my doctor what treatment is appropriate. (/rant)

I feel better already – likely due to the 20mg prednisone that I’ll have the pleasure of tapering off in a couple months.  On the plus side, there’s no need to finance a steroid injection in my shoulder.  The pred has already helped dramatically.

I have no desire to work my way through every single biologic on the market.  Let’s hope this one works better than the last.

Cortisone

Given how wonderfully cortisone injections have helped my shoulders in the past, I was considering asking my rheumy about it.  BUT, both shoulders would be nice, not just one.  While we’re at it, how about elbows and wrists, ankles…  Maybe not such a good idea.  I didn’t bring it up.

We did, however, talk about how much my shoulders were hurting and she suggested a cortisone injection.  I asked if (1) she could do both shoulders, or (2) there was something systemic instead of limiting it to one joint.  Shot down twice!

  1. Only one joint injection at a time.  No reason given, but I already know that insurance will only pay for one so I’m guessing that’s the reason.
  2. The biologics are considered systemic and if we try prednisone right now, it wouldn’t be clear if any improvement is from the pred or from the Enbrel.  Only one change at a time.

The one-change-at-a-time part makes perfect sense to me.  I remember a couple years ago when I was given three prescriptions and asked a few weeks later which one had helped.  First time I ever showed annoyance with a medical professional.  How could I possibly know which med was responsible – or if my improvement was a complete coincidence and not related to any of the medications?

My rheumatologist uses depo-medrol (as did my former rheumy) for these injections, and my PCP uses kenalog.  My shoulder hurts worse now than it did before Wednesday’s cortisone shot.  Seriously.  Horrible, burning pain all the time instead of the aggravating rotator-cuff issues I’ve had off-and-on for the past few years.

I don’t know if the difference is the specific steroid or the skill of the person wielding the needle, but I will go on record here and now that if I ever get another steroid shot in the future, it will be from my PCP.

In completely unrelated news, my eldest child turned 16 and now has a driver’s license.