Day 186

I read a tweet this morning about Crohnies and extreme heat and it got me to thinking...

It's been hot here in New York.  Really hot.  For months (okay, more like a week).  I "don't do well" in the heat.  I haven't since I was young.  I used to play softball in the summer and, while everyone else was doing just fine, my face would turn bright red and I would not be able to cool down.  I remember jumping in the community pool after the games and feeling my face burn against the cool water.  It would take me hours to return to normal.

Then there's now.  We went to a photography school/gallery/cool, temporary space made from freight containers last weekend (http://photovillenyc.org/).  The walk to the park wasn't so bad, but we ended up entering the wrong side of the park and walking in the sun for, I don't know, ten minutes?  Now, I just want to say here, I am a walker.  I live in New York.  We walk and we walk fast.  It's part of living here.  On a normal day, a half hour walk wouldn't even phase me.  But this day was hot.  It was already in the 90s by 11:00am, and the humidity and sun were oppressive.  By the time we got to the lecture I really thought for a few minutes that I was going to pass out.  I got to the I'm-so-hot-I'm-cold point and thought that was it.  I sat still and drank a bottle of water until I felt back to normal.

For the entirety of this heatwave, the news radio station I listen to has been constantly reminding listeners that the elderly and those who suffer from chronic illness should take extra care in this heat.  It didn't occur to me that I belong in that category until today, until I read that tweet.  I've been feeling so well for so long that I sometimes forget I have a chronic illness.  It hadn't occurred to me that the headache I couldn't get rid of this week was heat related.  Or that the heat is the reason I've been waking up in the morning feeling like I haven't slept a wink.  Or that the heat is causing the joint inflammation that is causing the feeling that my shoulder bones are grinding together as I type this.

I have been staying indoors in the air conditioning and drinking gallons of water, but maybe it's not possible to totally avoid the effects of extreme heat.  I walk around with a lot of pain a lot of the time, I think I'm just used to living with it.  But sometimes we must surrender.  The A/C is cranked up and I'm going to take a nap.     

I feel great! (Well, except for a couple of things.)

Today I had my first blood test in three months. It was just a regular old checkin-up-on-the-Humira test. My nurse told me I have a completely new face which, I think, was a compliment. The 6mp bloat is gone and I have some color. I know I look better. I feel better. My life is better. I just still don't feel great.

My stomach is almost 100% better. I rarely have any trouble digesting anything I eat - even the stuff I shouldn't be eating. I do, however, still have Crohn's belly after every meal. If I swallow anything, no matter how big or small, it results in a food baby. I still have some trouble if I'm in an uncomfortable situation or if I'm nervous - BUT - compared to last year at this time, I'm a new person. So, when I call for my results on Monday, do I complain about this stuff? Should I just shut up? I can eat now! I can leave my house after I eat! I can make it to work without getting off the train and running to find the nearest facilities! Do I have the right to complain about some minor (if embarrassing) discomfort?

Then there's the pain. I do still have some minor pain when I, uh, youknow. But I have other, more disruptive pain. There's a pain at the base of my neck, on my back, where my neck meets my shoulder. It's recurring. It's horrible. It's much worse when I'm stressed out.

And my legs. They still hurt. It's more of a stiffness in the morning. They feel strained when I go up and down stairs. By the end of the day it's a different kind of pain. It's an achy, crampy, swollen type of pain that makes me just want to sit with my feet up or lie down. I've also notice many, many visible blood vessels on my legs which weren't there just a few months ago.

Then there are the headaches. I still have them. Often. And they're sometimes drug-resistant and always incredibly disruptive. And they make me so tired. Do I tell my doctor?

I've told him a million times about the headaches but he seems to think it's from the Humira so it's either headaches or Crohn's.

The body aches? He will send me straight back to the Rheumatologist who will tell me it's either Arthritis or Fibromyalgia and I can go to physical therapy. But I don't want to go to physical therapy. I can't afford physical therapy nor do I have the spare time. I want to know what's wrong with me! I want to know what my options are!

How do I voice this to my doctor in a way that doesn't make me feel like a half-crazy, whiney baby?

Suggestions? Advice?

Complications

Things are getting so complicated.

I'm stressed. My routine has been disrupted. I'm not sleeping well. I was wrong about the timing.

For the last few days my stomach's been a little off. Friday I was in a lot of pain - not my stomach - my joints, my bones, my muscles - I'm not sure what it was. My arms hurt, my hips, my toes...

I was brave today. I took two Tylenol and walked at least 50, 60, 75 blocks. I had some business to take care of. I had a cloudy head to clear. I had to get out of here.

I'm swollen, I hurt and my stomach is so so upset.

Blah

I spoke with my doctor last week. My blood test was fine except for slightly elevated liver levels (sorry, I have nothing more specific). He thinks it's probably from the Tylenol I've been taking for headache but my numbers were not high enough to stop the Tylenol.

The doctor agrees that my joints shouldn't be more painful now that I'm (supposedly) in remission. He is sending me to a Rheumatologist who I will see next week. This particular doctor comes highly recommended by my Gastro, online reviews and someone I know who has seen him. As always, I am incredibly grateful to live in New York and have access to some of the best doctors in the world. I have an appointment next week.

Otherwise, I'm still having headaches several times a week although I haven't had a migraine in quite some time (knock knock). My guts are generally quiet during the week as long as I don't eat lunch - which I learned the hard way last week. The weekends are still a bit more tumultuous because I like food, OK?

And so we wait...

Weekend Madness

My weekend pattern continues. I did just fine this week but Saturday and Sunday were a different story. I did have an egg for breakfast each morning this weekend but I don't think I do that every weekend. Or do I? Hmmm... Anyway, as I sit here typing my stomach is churning away. I'm sure I will have to take a break in a minute. Those heavy butterflies are making their way through my abdomen.

I'm thinking it's time to see an allergist in case I'm eating something that's making me sick. I've said it a million times but I need to do it. I will put it on my to do list for Tuesday. I'm sure it will take a few days since I will have to deal with the insurance company first. The insurance company always adds about seven layers of annoyance to any search for medical care. I feel my blood pressure rising just thinking about the initial phone call. Yuck.

This weekend I am also having a lot of arthritis pain. I spent more time on my feet yesterday than I normally do. This morning I walked to the laundromat with a heavy bag on my back and I did a lot of walking this evening. It's pretty cold out there which probably doesn't help. So there are the reasons my joints are bothering me but I have no explanation. Why doesn't the Humira work for both? I have to call my Gastro for blood test results on Tuesday so I guess I will seek his advice then.

On a good note, I am feeling more confident lately and am trying to get out more now that I am feeling better. I've been busier this past week than I have in a while and it feels really good. I am hopeful.

Huh?

I may have mentioned this before but I am so confuuuuuused!

Don't get me wrong, I am grateful for the huge strides I've made since beginning Humira. My condition is 100 times better since I started the treatments in September. I'm just not 100% better and I have so many questions.

At this point I still don't feel comfortable eating lunch at work. I eat a small breakfast and a couple of safe snacks throughout the day. This, thus far, seems to make for a reasonably comfortable commute home in the evening. The problem is that I'm usually starving by the time I get home which causes me to eat more than I need to. This is probably also the reason I haven't lost weight - about which I am torn, but that is an entirely different post.

During the week I do ok. Better than ok. I do pretty well. The only complaint I have is my morning gut. My hour-long train ride is still a test to my sanity on a daily basis. Invariably I wake up nauseous and my stomach is uneasy at least until I am safely seated in my office. Some mornings I have heart burn that will not quit. Over the last three weeks, there were a handful of days where I was running for the bathroom by the time I got to work but I only got off the train once to use a bathroom. I am just never quite sure whether or not I have to get off.

The weekends seem to be worse. I have a milk-heavy cup of coffee in the morning (same as any weekday) and then an actual meal for (I guess you could call it) brunch. This is usually when the diarrhea starts and continues throughout the day. Maybe two meals is too much? I should try to have a very light breakfast as I do during the week and see if that helps but it's hard to resist a lazy, Saturday morning breakfast.

I'm not sure where to go from here. Today I filled out a survey for the Humira case study. I realized this process is probably as helpful for me as it is for those conducting the study - if not more so. Having to quantify the severity of the pain and other symptoms as well as how much those symptoms are affecting my life is helpful in gauging how far I've come and what I need to discuss with my doctor.

I'm having a pretty good week as far as my digestive function goes but I am realizing that my biggest problem is the arthritis in my feet, ankles and knees (also in my hands and elbows but less so). If my arthritis is connected to the inflammation in my intestines, why would I still have arthritis symptoms if I am in remission? Does this mean the arthritis and Crohn's are unrelated?

So many unanswered questions.

I also had one of my quarterly blood tests today so I should hear from the doctor soon. Hopefully he will have answers to my questions. In the meantime I am looking forward to a long weekend of rest (and some fun).