Friday, November 09, 2007

Note to Self: I am Not a Doctor

I have learned an important lesson this week: I am not a doctor. First I'd better explain...

I have JRA or juvenile rheumatoid arthritis. (Now that I am not a juvenile we mostly call it juvenile onset rheumatoid arthritis, but this is an important distinction from typical RA.) I was diagnosed at 10 so all you math whizzes know that I have been treated now for 21 years.

This, I guess is where things get fuzzy. You see, I presumed that 21 years as a patient meant I had enough know-how to change dosage on my medication and do it correctly. In my defense, I made almost half a dozen calls to two doctors trying to get a recommendation on what to do.

You see on Friday I had a very severe flare-up in my right hip. I was in excruciating pain and I was having a lot of trouble bending and walking. I take Prednisone and I knew that more would help. I just didn't know how much more.

So I called my Rheumatologist. There message said that they were out of the office until Tuesday. My hip couldn't wait until Tuesday. If I had the right dosage, my hip would be better before Tuesday. So I called my OB. I got a nurse that was really something of a *bubble-gummer. After my whole spiel she said, "Uh-huh, and we're treating you for your pregnancy?"

No, I just thought I'd call and give you a whole sob story for fun.

She said that she'd talk to a doctor and get back with me. To make a long story short she called at the end of the day and told me to sit in a warm bath and take Tylenol.

If there is anything that 21 years as a patient has taught me, it's that sitting in a warm bath and taking Tylenol won't help. Not only would I be a lot worse by Tuesday, but the flare-up could be so out of control as to leave me in excruciating pain for the rest of my pregnancy and perhaps several weeks or months beyond that. I personally feel that the end of a pregnancy is bad enough without adding ANY additional problems.

Now I'm not completely stupid, I did some checking on the Internet to make sure that the doses I was planning on taking weren't beyond the scope of the prescription. (As we all know the Internet is always right, right?) Then I began by doubling my meds on Friday. Increasing again on Saturday. Taking a triple dose on Sunday--and my wasn't my hip feeling a lot better! Back down to Saturday's dose on Monday. Only double dose on Tuesday, then regular dose on Wednesday. And this is when the problems start.

Wednesday night I have trouble sleeping. I get up Thursday after only 5 real hours of sleep to get the kids off to school. I run some errands. By the time I get home I feel awful. Weird. I'm nauseated, sleepy, I feel like my vision and thinking are fuzzy, and I'm strangely weak. I stick Annika in bed and climb into bed myself. 50 minutes later I wake up because Annika is crying. I try to eat a little, but I still feel awful. I pick up Nate from Kindergarten and I still feel weird. Through this cloudy state I begin to realize that all of these side effects could be the cause of messing with my Prednisone dosage.

Eventually, I got a hold of a nurse at the OB office and the basic thing is that I went off my meds too quickly. I'm kind of going through withdrawals. They recommend that I go back to double dose and taper off more slowly over time.

Thankfully, it worked and I'm feeling down right functional today. Plus I learned a valuable lesson.

*Person, usually a woman, whose main talent appears to be chewing gum; air-head; ditz; dumb.

1 comment:

Laurie said...

Wow! I'm so sorry to hear about your week. It's so frustrating to not get answers from doctors when we need them. It sounds like you weren't too far off. It's just extra hard when your miserabley pregnant, mothering 4 other children, and sick! I hope that you have family or friends close enough to help out some. I hope that your day goes better today!